II 

118TH CONGRESS 

1ST SESSION S. 2864 

To require U.S. Customs and Border Protection to perform an initial health 

screening on all detainees, and for other purposes. 

IN THE SENATE OF THE UNITED STATES 

SEPTEMBER 20, 2023 

Mr. LUJA ́N introduced the following bill; which was read twice and referred 

to the Committee on the Judiciary 

A BILL 

To require U.S. Customs and Border Protection to perform 

an initial health screening on all detainees, and for other 

purposes. 

1 Be it enacted by the Senate and House of Representa2 tives of the United States of America in Congress assembled, 

3 SECTION 1. SHORT TITLE; TABLE OF CONTENTS. 

4 (a) SHORT TITLE.—This Act may be cited as the 

5 ‘‘Humanitarian Standards for Individuals in U.S. Cus6 toms and Border Protection Custody Act’’. 

7 (b) TABLE OF CONTENTS.—The table of contents for 

8 this Act is as follows: 

Sec. 1. Short title; table of contents. 

Sec. 2. Definitions. 

Sec. 3. Initial health screening protocol. 


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Sec. 4. Water, sanitation and hygiene. 

Sec. 5. Food and nutrition. 

Sec. 6. Shelter. 

Sec. 7. Coordination and surge capacity. 

Sec. 8. Training. 

Sec. 9. Interfacility transfer of care. 

Sec. 10. Planning and initial implementation. 

Sec. 11. Contractor compliance. 

Sec. 12. Inspections. 

Sec. 13. Government Accountability Office report. 

Sec. 14. Publication of data on complaints of sexual abuse at U.S. Customs and 

Border Protection facilities. 

Sec. 15. Rules of construction. 

1 SEC. 2. DEFINITIONS. 

2 In this Act: 

3 (1) CBP.—The term ‘‘CBP’’ means U.S. Cus4 toms and Border Protection. 

5 (2) CHILD.—The term ‘‘child’’ has the meaning 

6 given such term in section 101(b)(1) of the Immi7 gration and Nationality Act (8 U.S.C. 1101(b)(1)). 

8 (3) COMMISSIONER.—The term ‘‘Commis9 sioner’’ means the Commissioner of U.S. Customs 

10 and Border Protection. 

11 (4) DETAINEE.—The term ‘‘detainee’’ means 

12 any individual who is detained in CBP custody. 

13 (5) FORWARD OPERATING BASE.—The term 

14 ‘‘forward operating base’’ means a permanent facil15 ity that has been established by CBP in a forward 

16 or remote location and has been so designated by 

17 CBP. 

18 (6) INTERPRETATION SERVICES.—The term 

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1 ices that are performed in person or through a tele2 phone or video service. 

3 (7) U.S. CUSTOMS AND BORDER PROTECTION

4 FACILITY.—The term ‘‘U.S. Customs and Border 

5 Protection facility’’ includes— 

6 (A) U.S. Border Patrol stations; 

7 (B) ports of entry; 

8 (C) checkpoints; 

9 (D) forward operating bases; 

10 (E) secondary inspection areas; and 

11 (F) short-term custody facilities. 

12 SEC. 3. INITIAL HEALTH SCREENING PROTOCOL. 

13 (a) IN GENERAL.—The Commissioner, in consulta14 tion with the Secretary of Health and Human Services, 

15 the Administrator of the Health Resources and Services 

16 Administration, and nongovernmental experts in the deliv17 ery of health care in humanitarian crises and in the deliv18 ery of health care to children, shall develop guidelines and 

19 protocols for the provision of health screenings and appro20 priate medical care for detainees, as required under this 

21 section. 

22 (b) INITIAL SCREENING AND MEDICAL ASSESS23 MENT.—The Commissioner shall ensure that all detainees 

24 receive an initial in-person screening by a licensed medical 


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1 professional in accordance with the standards described in 

2 subsection (c)— 

3 (1) to assess and identify any illness, condition, 

4 or age-appropriate mental or physical symptoms that 

5 may have resulted from distressing or traumatic ex6 periences; 

7 (2) to identify acute conditions and high-risk 

8 vulnerabilities; and 

9 (3) to ensure that appropriate health care is 

10 provided to individuals as needed, including pedi11 atric, obstetric, and geriatric care. 

12 (c) STANDARDIZATION OF INITIAL SCREENING AND

13 MEDICAL ASSESSMENT.— 

14 (1) IN GENERAL.—The initial screening and 

15 medical assessment of detainees shall include— 

16 (A) an interview and the use of a stand17 ardized medical intake questionnaire or the 

18 equivalent; 

19 (B) screening of vital signs, including pulse 

20 rate, body temperature, blood pressure, oxygen 

21 saturation, and respiration rate; 

22 (C) screening for blood glucose for known 

23 or suspected diabetics; 

24 (D) weight assessment of detainees young25 er than 12 years of age; 


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1 (E) a physical examination; and 

2 (F) a risk assessment and the development 

3 of a plan for monitoring and care, as appro4 priate. 

5 (2) PRESCRIPTION MEDICATION.— 

6 (A) IN GENERAL.—The medical profes7 sional conducting the screening pursuant to 

8 subsection (b) shall— 

9 (i) review any prescribed medication 

10 that is in the detainee’s possession or that 

11 was confiscated by CBP upon arrival; and 

12 (ii) determine if such medication 

13 should be— 

14 (I) kept by the detainee for use 

15 during detention; 

16 (II) properly stored by CBP, with 

17 appropriate access for use during de18 tention; or 

19 (III) maintained with the de20 tained individual’s personal property. 

21 (B) RIGHT TO MEDICATION.—A detainee 

22 may not be denied the use of necessary and ap23 propriate medication for the management of the 

24 detainee’s illness. 


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1 (3) RULE OF CONSTRUCTION.—Nothing in this 

2 subsection may be construed as requiring detainees 

3 to disclose their medical status or history. 

4 (d) TIMING.— 

5 (1) IN GENERAL.—Except as provided in para6 graph (2), the initial screening and medical assess7 ment described in subsections (b) and (c) shall take 

8 place as soon as practicable, but not later than 12 

9 hours after a detainee’s arrival at a CBP facility. 

10 (2) HIGH PRIORITY INDIVIDUALS.—The initial 

11 screening and medical assessment referred to in 

12 paragraph (1) shall take place as soon as prac13 ticable, but not later than 6 hours after a detainee’s 

14 arrival at a CBP facility if the individual— 

15 (A) reasonably self-identifies as having a 

16 medical condition that requires prompt medical 

17 attention; or 

18 (B) is— 

19 (i) exhibiting signs of acute or poten20 tially severe physical or mental illness, or 

21 otherwise has an acute or chronic physical 

22 or mental disability or illness; 

23 (ii) pregnant; 

24 (iii) a child (with priority given, as ap25 propriate, to the youngest children); or 


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1 (iv) elderly. 

2 (e) FURTHER CARE.— 

3 (1) IN GENERAL.—If, as a result of the initial 

4 health screening and medical assessment described 

5 in subsections (b) and (c), the licensed medical pro6 fessional conducting such screening or assessment 

7 determines that 1 or more of the detainee’s vital 

8 sign measurements are significantly outside normal 

9 ranges, in accordance with the National Emergency 

10 Services Education Standards, or if the detainee is 

11 identified as high risk or in need of medical inter12 vention, the detainee shall be provided, as expedi13 tiously as possible, with an in-person or technology14 facilitated medical consultation with a licensed emer15 gency care professional. 

16 (2) REEVALUATION.— 

17 (A) IN GENERAL.—Each detainee de18 scribed in paragraph (1)— 

19 (i) shall be reevaluated not later than 

20 24 hours after the consultation required 

21 under such paragraph; and 

22 (ii)(I) shall be monitored thereafter as 

23 determined by an emergency care profes24 sional; or 


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1 (II) if the detainee is a child, shall be 

2 monitored thereafter as determined by a li3 censed emergency care professional with a 

4 background in pediatric care. 

5 (B) REEVALUATION BEFORE TRAVEL.—In 

6 addition to the reevaluations required under 

7 subparagraph (A), detainees described in para8 graph (1), before being transported to another 

9 location— 

10 (i) shall have all of their vital signs 

11 reevaluated; and 

12 (ii) shall be cleared by a medical pro13 fessional as being able to travel safely. 

14 (3) PSYCHOLOGICAL AND MENTAL CARE.—The 

15 Commissioner shall ensure that detainees who have 

16 experienced physical or sexual violence or who have 

17 experienced events that may cause severe trauma or 

18 toxic stress, are provided access to basic, humane, 

19 and supportive psychological assistance. 

20 (f) INTERPRETERS.—To ensure that health 

21 screenings and medical care required under this section 

22 are carried out in the best interests of the detainee, the 

23 Commissioner shall ensure that— 


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1 (1) language-appropriate interpretation serv2 ices, including interpretation of indigenous lan3 guages, are provided to each detainee; and 

4 (2) each detainee is informed of the availability 

5 of such interpretation services. 

6 (g) CHAPERONES.—To ensure that health screenings 

7 and medical care required under this section are carried 

8 out in the best interests of the detainee— 

9 (1) the Commissioner shall establish guidelines 

10 for, and ensure the presence of, chaperones for all 

11 detainees during medical screenings and examina12 tions in accordance with relevant guidelines in the 

13 American Medical Association Code of Medical Eth14 ics and recommendations of the American Academy 

15 of Pediatrics; and 

16 (2) to the extent practicable, the physical exam17 ination of a child shall always be performed in the 

18 presence of— 

19 (A) a parent or legal guardian; or 

20 (B) the detainee’s closest present adult rel21 ative, if a parent or legal guardian is unavail22 able. 

23 (h) DOCUMENTATION.—The Commissioner shall en24 sure that— 


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1 (1) the health screenings and medical care re2 quired under this section and any other medical 

3 evaluations and interventions for detainees are docu4 mented in accordance with commonly accepted 

5 standards in the United States for medical record 

6 documentation; and 

7 (2) such documentation is provided to any indi8 vidual who received a health screening and subse9 quent medical treatment upon release from CBP 

10 custody. 

11 (i) INFRASTRUCTURE AND EQUIPMENT.—The Com12 missioner or the Administrator of General Services shall 

13 ensure that each location to which detainees are first 

14 transported after an initial encounter with an agent or of15 ficer of CBP has— 

16 (1) a private space that— 

17 (A) provides a comfortable and considerate 

18 atmosphere for the patient; and 

19 (B) ensures the patient’s dignity and right 

20 to privacy during the health screening and med21 ical assessment and any necessary follow-up 

22 care; 

23 (2) all necessary and appropriate medical equip24 ment and facilities— 


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1 (A) to conduct the health screenings and 

2 follow-up care required under this section; 

3 (B) to treat trauma; 

4 (C) to provide emergency care, including 

5 resuscitation of individuals of all ages; and 

6 (D) to prevent the spread of communicable 

7 diseases; 

8 (3) basic over-the-counter medications appro9 priate for all age groups; and 

10 (4) appropriate transportation to medical facili11 ties in the case of a medical emergency, or an on12 call service with the ability to arrive at the CBP fa13 cility within 30 minutes. 

14 (j) PERSONNEL.—The Commissioner or the Adminis15 trator of General Services, as the case may be, shall en16 sure that each location to which detainees are first trans17 ported after an initial encounter has— 

18 (1) at least 1 licensed medical professional on 

19 site to conduct health screenings; and 

20 (2) other personnel that are or may be nec21 essary for carrying out the functions described in 

22 subsection (e), such as licensed emergency care pro23 fessionals, specialty physicians (including physicians 

24 specializing in pediatrics, family medicine, obstetrics 

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1 cine, and infectious diseases), nurse practitioners, 

2 other nurses, physician assistants, licensed social 

3 workers, mental health professionals, public health 

4 professionals, dieticians, interpreters, and chap5 erones, on site to the extent practicable, or, if not 

6 practicable, available on call. 

7 (k) ETHICAL GUIDELINES.—The Commissioner shall 

8 ensure that all medical assessments and procedures con9 ducted pursuant to this section are conducted in accord10 ance with ethical guidelines in the applicable medical field 

11 and respect human dignity. 

12 SEC. 4. WATER, SANITATION AND HYGIENE. 

13 The Commissioner shall ensure that all detainees 

14 have access to— 

15 (1) not less than 1 gallon of drinking water per 

16 person per day, in addition to any other age-appro17 priate fluids that may be needed; 

18 (2) a private, safe, clean, and reliable perma19 nent or portable toilet with proper waste disposal 

20 and a hand washing station, with not fewer than 1 

21 toilet available for every 12 male detainees, and not 

22 fewer than 1 toilet available for every 8 female de23 tainees; 


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1 (3) a clean diaper changing facility, which in2 cludes proper waste disposal, a hand washing sta3 tion, and unrestricted access to diapers; 

4 (4) the opportunity to bathe daily in a perma5 nent or portable shower that is private and secure; 

6 and 

7 (5) products for individuals of all age groups 

8 and for individuals with disabilities to maintain basic 

9 personal hygiene, including soap, a toothbrush, 

10 toothpaste, adult diapers, feminine hygiene products, 

11 and receptacles for the proper storage and disposal 

12 of such products. 

13 SEC. 5. FOOD AND NUTRITION. 

14 The Commissioner shall ensure that detainees have 

15 access to— 

16 (1) 3 meals per day, including— 

17 (A) for individuals 12 years of age or 

18 older, a diet that contains not fewer than 2,000 

19 calories per day; and 

20 (B) for children younger than 12 years of 

21 age, a diet that contains an appropriate number 

22 of calories per day based on the child’s age and 

23 weight; 

24 (2) accommodations for any dietary needs or 

25 restrictions; and 


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1 (3) access to food in a manner that follows ap2 plicable food safety standards. 

3 SEC. 6. SHELTER. 

4 The Commissioner shall ensure that in each facility 

5 at which a detainee is detained— 

6 (1) except as provided in paragraph (2), males 

7 and females are detained separately; 

8 (2) for any minor child arriving in the United 

9 States with an adult relative or legal guardian, such 

10 child— 

11 (A) is detained with such relative or legal 

12 guardian unless such an arrangement poses 

13 safety or security concerns; and 

14 (B) if such child is detained apart from an 

15 adult relative or legal guardian as a result of 

16 such safety or security concerns, is not detained 

17 with adults; 

18 (3) for any unaccompanied minor arriving in 

19 the United States without an adult relative or legal 

20 guardian, such child is detained in an age-appro21 priate facility and not detained with adults; 

22 (4) a detainee with a temporary or permanent 

23 disability is held in an accessible location and in a 

24 manner that provides for his or her safety, comfort, 


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1 and security, with accommodations provided to the 

2 extent needed; 

3 (5) no detainee is placed in a room for any pe4 riod if such placement would exceed the maximum 

5 occupancy level as determined by the appropriate 

6 building code, fire marshal, or other authority; 

7 (6) each detainee is provided with temperature 

8 appropriate clothing and bedding; 

9 (7) the facility is well lit and well ventilated, 

10 with the humidity and temperature kept at com11 fortable levels (between 68 and 74 degrees Fahr12 enheit); 

13 (8) detainees who are in custody for more than 

14 48 hours are given access to the outdoors for not 

15 less than 1 hour during the daylight hours during 

16 each 24-hour period; 

17 (9) detainees are allowed to practice their reli18 gion or to not practice a religion, at their discretion; 

19 (10) detainees are given access to lighting and 

20 noise levels that are safe and conducive for sleeping 

21 throughout the night between the hours of 10:00 

22 p.m. and 6:00 a.m; 

23 (11) CBP officers, employees, and contracted 

24 personnel— 


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1 (A) follow medical standards for the isola2 tion and prevention of communicable diseases; 

3 and 

4 (B) ensure the physical and mental safety 

5 of detainees who identify as lesbian, gay, bisex6 ual, transgender, or intersex; 

7 (12) the facility has video monitoring— 

8 (A) to provide for the safety of the detain9 ees; and 

10 (B) to prevent sexual abuse and physical 

11 harm of vulnerable detainees; 

12 (13) there is posted or otherwise made available 

13 in all areas where detainees are located a language 

14 appropriate ‘‘Detainee Bill of Rights’’ (including in15 digenous languages), which specifies all rights af16 forded to detainees under this Act; and 

17 (14) the facility certifies that— 

18 (A) the video monitoring required under 

19 paragraph (12) is properly working at all times; 

20 and 

21 (B) the videos resulting from video moni22 toring are preserved for at least 90 days. 

23 SEC. 7. COORDINATION AND SURGE CAPACITY. 

24 The Secretary of Homeland Security shall enter into 

25 memoranda of understanding with appropriate Federal 


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1 agencies, such as the Department of Health and Human 

2 Services, and applicable government emergency relief serv3 ices, and shall enter into contracts with health care, public 

4 health, social work, and transportation professionals, for 

5 purposes of addressing surge capacity and ensuring com6 pliance with this Act. 

7 SEC. 8. TRAINING. 

8 The Commissioner shall ensure that CBP personnel 

9 assigned to each short-term custodial facility are profes10 sionally trained, including by receiving such continuing 

11 education as the Commissioner determines appropriate, in 

12 all subjects necessary to ensure compliance with this Act, 

13 including— 

14 (1) humanitarian response protocols and stand15 ards; 

16 (2) indicators of physical and mental illness, 

17 and medical distress in children and adults; 

18 (3) indicators of child sexual exploitation and 

19 effective responses to missing migrant children; and 

20 (4) procedures to report incidents of suspected 

21 child sexual abuse and exploitation directly to the 

22 National Center for Missing and Exploited Children. 

23 SEC. 9. INTERFACILITY TRANSFER OF CARE. 

24 (a) TRANSFER.—When a detainee is discharged from 

25 a medical facility or emergency services department, the 


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1 Commissioner shall ensure that responsibility of care is 

2 transferred from the medical facility or emergency services 

3 department to an accepting licensed CBP health care pro4 vider. 

5 (b) RESPONSIBILITIES OF ACCEPTING PROVIDERS.— 

6 Each accepting licensed CBP health care provider shall 

7 review the medical facility or emergency department’s 

8 evaluation, diagnosis, treatment, management, and dis9 charge care instructions— 

10 (1) to assess the safety of the discharge and 

11 transfer; and 

12 (2) to provide necessary follow-up care. 

13 SEC. 10. PLANNING AND INITIAL IMPLEMENTATION. 

14 (a) PLANNING.—Not later than 60 days after the 

15 date of the enactment of this Act, the Secretary of Home16 land Security shall submit a detailed plan to Congress that 

17 describes the timeline, process, and challenges of imple18 menting the requirements under this Act. 

19 (b) IMPLEMENTATION.—The Secretary of Homeland 

20 Security shall ensure that the requirements under this Act 

21 are implemented not later than 6 months after the date 

22 of the enactment of this Act. 


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1 SEC. 11. CONTRACTOR COMPLIANCE. 

2 The Secretary of Homeland Security shall ensure 

3 that all personnel contracted to carry out this Act comply 

4 with the requirements under this Act. 

5 SEC. 12. INSPECTIONS. 

6 (a) IN GENERAL.—The Inspector General of the De7 partment of Homeland Security shall— 

8 (1) conduct unannounced inspections of ports of 

9 entry, border patrol stations, and detention facilities 

10 administered by CBP or contractors of CBP; and 

11 (2) submit to Congress— 

12 (A) reports on the results of the inspec13 tions conducted pursuant to paragraph (1); and 

14 (B) other reports related to custody oper15 ations. 

16 (b) PARTICULAR ATTENTION.—In carrying out sub17 section (a), the Inspector General shall pay particular at18 tention to— 

19 (1) the degree of compliance by CBP with the 

20 requirements under this Act; 

21 (2) remedial actions taken by CBP; 

22 (3) the health needs of detainees; and 

23 (4) the degree of compliance with part 115 of 

24 title 6, Code of Federal Regulations (commonly 

25 known as the ‘‘Standards to Prevent, Detect, and 


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1 Respond to Sexual Abuse and Assault in Confine2 ment Facilities’’). 

3 (c) ACCESS TO FACILITIES.—The Commissioner may 

4 not deny a Member of Congress entrance to any facility 

5 or building used, owned, or operated by CBP. 

6 SEC. 13. GOVERNMENT ACCOUNTABILITY OFFICE REPORT. 

7 (a) IN GENERAL.—The Comptroller General of the 

8 United States— 

9 (1) not later than 6 months after the date of 

10 the enactment of this Act, shall commence a study 

11 on implementation of, and compliance with, this Act; 

12 and 

13 (2) not later than 1 year after the date of the 

14 enactment of this Act, shall submit a report to Con15 gress containing the results of the study required 

16 under paragraph (1). 

17 (b) ISSUES TO BE STUDIED.—The study required 

18 under subsection (a)(1) shall examine— 

19 (1) the management and oversight by CBP of 

20 ports of entry, border patrol stations, and other de21 tention facilities, including the extent to which CBP 

22 and the Department of Homeland Security have ef23 fective processes in place to comply with the require24 ments under this Act; and 


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1 (2) the extent to which CBP personnel, in car2 rying out this Act, make abusive, derisive, profane, 

3 or harassing statements or gestures, or engage in 

4 any other conduct evidencing hatred or invidious 

5 prejudice to or about 1 person or group on account 

6 of race, color, religion, national origin, sex, sexual 

7 orientation, age, or disability, including on social 

8 media. 

9 SEC. 14. PUBLICATION OF DATA ON COMPLAINTS OF SEX10 UAL ABUSE AT U.S. CUSTOMS AND BORDER 

11 PROTECTION FACILITIES. 

12 Not later than 90 days after the date of the enact13 ment of this Act, the Secretary of Homeland Security, act14 ing in coordination with the Office of Inspector General 

15 and the Office for Civil Rights and Civil Liberties of the 

16 Department of Homeland Security, shall publicly release 

17 aggregate data on complaints of sexual abuse at CBP fa18 cilities on its website on a quarterly basis, excluding any 

19 personally identifiable information that may compromise 

20 the confidentiality of individuals who reported such abuse. 

21 SEC. 15. RULES OF CONSTRUCTION. 

22 Nothing in this Act may be construed as— 

23 (1) authorizing CBP to detain individuals for 

24 longer than 72 hours; 


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1 (2) contradicting the March 7, 2014, Depart2 ment of Homeland Security rule adopting Standards 

3 to Prevent, Detect, and Respond to Sexual Abuse 

4 and Assault in Confinement Facilities, which in5 cludes a zero tolerance policy prohibiting all forms 

6 of sexual abuse and assault of individuals in U.S. 

7 Customs and Border Protection custody, including 

8 in holding facilities, during transport, and during 

9 processing; 

10 (3) contradicting current protocols related to 

11 Department of Homeland Security background 

12 checks in the hiring process; 

13 (4) restricting the Department of Homeland Se14 curity from denying employment to, or terminating 

15 the employment of, any individual who— 

16 (A) would be or is involved with the han17 dling or processing at holding facilities, during 

18 transport, or during processing, or care of de19 tainees, including the care of children; and 

20 (B) has been convicted of a sex crime or 

21 other offense involving a child victim; or 

22 (5) affecting the obligation to fully comply with 

23 all applicable immigration laws, including being sub24 ject to any penalties, fines, or other sanctions. 

Æ 


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