II 

117TH CONGRESS 

2D SESSION S. 4096 

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 

APRIL 27, 2022 

Mr. LUJA ́N (for himself, Mr. HEINRICH, and Mrs. FEINSTEIN) 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. 


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Sec. 3. Initial health screening protocol. 

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 the custody of 

13 CBP. 

14 (5) FORWARD OPERATING BASE.—The term 

15 ‘‘forward operating base’’ means a permanent facil16 ity established by CBP in forward or remote loca17 tions, and designated by CBP. 

18 (6) INTERPRETATION SERVICES.—The term 

19 ‘‘interpretation services’’ includes translation servVerDate Sep 11 2014 15:53 Apr 28, 2022 Jkt 029200 PO 00000 Frm 00002 Fmt 6652 Sfmt 6201 E:\BILLS\S4096.IS S4096

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1 ices that are performed either in person or through 

2 a telephone 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 healthcare 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 travel— 

9 (i) shall have all of their vital signs 

10 reevaluated; and 

11 (ii) shall be cleared by a medical pro12 fessional as being able to travel safely. 

13 (3) PYSCHOLOGICAL AND MENTAL CARE.—The 

14 Commissioner shall ensure that detainees who have 

15 experienced physical or sexual violence or who have 

16 experienced events that may cause severe trauma or 

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

18 and supportive psychological assistance. 

19 (f) INTERPRETERS.—To ensure that health 

20 screenings and medical care required under this section 

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

22 Commissioner shall ensure that— 

23 (1) language-appropriate interpretation serv24 ices, including interpretation of indigenous lan25 guages, are provided to each detainee; and 


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1 (2) each detainee is informed of the availability 

2 of such interpretation services. 

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

4 and medical care required under this section are carried 

5 out in the best interests of the detainee— 

6 (1) the Commissioner shall establish guidelines 

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

8 detainees during medical screenings and examina9 tions in accordance with relevant guidelines in the 

10 American Medical Association Code of Medical Eth11 ics and recommendations of the American Academy 

12 of Pediatrics; and 

13 (2) to the extent practicable, the physical exam14 ination of a child shall always be performed in the 

15 presence of— 

16 (A) a parent or legal guardian; or 

17 (B) the detainee’s closest present adult rel18 ative, if a parent or legal guardian is unavail19 able. 

20 (h) DOCUMENTATION.—The Commissioner shall en21 sure that— 

22 (1) the health screenings and medical care re23 quired under this section and any other medical 

24 evaluations and interventions for detainees are docu25 mented in accordance with commonly accepted 


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1 standards in the United States for medical record 

2 documentation; and 

3 (2) such documentation is provided to any indi4 vidual who received a health screening and subse5 quent medical treatment upon release from CBP 

6 custody. 

7 (i) INFRASTRUCTURE AND EQUIPMENT.—The Com8 missioner or the Administrator of General Services shall 

9 ensure that each location to which detainees are first 

10 transported after an initial encounter with an agent or of11 ficer of CBP has— 

12 (1) a private space that— 

13 (A) provides a comfortable and considerate 

14 atmosphere for the patient; and 

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

16 to privacy during the health screening and med17 ical assessment and any necessary follow-up 

18 care; 

19 (2) all necessary and appropriate medical equip20 ment and facilities— 

21 (A) to conduct the health screenings and 

22 follow-up care required under this section; 

23 (B) to treat trauma; 

24 (C) to provide emergency care, including 

25 resuscitation of individuals of all ages; and 


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1 (D) to prevent the spread of communicable 

2 diseases; 

3 (3) basic over-the-counter medications appro4 priate for all age groups; and 

5 (4) appropriate transportation to medical facili6 ties in the case of a medical emergency, or an on7 call service with the ability to arrive at the CBP fa8 cility within 30 minutes. 

9 (j) PERSONNEL.—The Commissioner or the Adminis10 trator of General Services, as the case may be, shall en11 sure that each location to which detainees are first trans12 ported after an initial encounter has— 

13 (1) at least 1 licensed medical professional on 

14 site to conduct health screenings; and 

15 (2) other personnel that are or may be nec16 essary for carrying out the functions described in 

17 subsection (e), such as licensed emergency care pro18 fessionals, specialty physicians (including physicians 

19 specializing in pediatrics, family medicine, obstetrics 

20 and gynecology, geriatric medicine, internal medi21 cine, and infectious diseases), nurse practitioners, 

22 other nurses, physician assistants, licensed social 

23 workers, mental health professionals, public health 

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1 erones, on site to the extent practicable, or, if not 

2 practicable, available on call. 

3 (k) ETHICAL GUIDELINES.—The Commissioner shall 

4 ensure that all medical assessments and procedures con5 ducted pursuant to this section are conducted in accord6 ance with ethical guidelines in the applicable medical field 

7 and respect human dignity. 

8 SEC. 4. WATER, SANITATION AND HYGIENE. 

9 The Commissioner shall ensure that detainees have 

10 access to— 

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

12 person per day, in addition any other age-appro13 priate fluids that may be needed; 

14 (2) a private, safe, clean, and reliable perma15 nent or portable toilet with proper waste disposal 

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

17 toilet available for every 12 male detainees, and not 

18 fewer than 1 toilet available for every 8 female de19 tainees; 

20 (3) a clean diaper changing facility, which in21 cludes proper waste disposal, a hand washing sta22 tion, and unrestricted access to diapers; 

23 (4) the opportunity to bathe daily in a perma24 nent or portable shower that is private and secure; 

25 and 


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1 (5) products for individuals of all age groups 

2 and for individuals with disabilities to maintain basic 

3 personal hygiene, including soap, a toothbrush, 

4 toothpaste, adult diapers, feminine hygiene products, 

5 and receptacles for the proper storage and disposal 

6 of such products. 

7 SEC. 5. FOOD AND NUTRITION. 

8 The Commissioner shall ensure that detainees have 

9 access to— 

10 (1) 3 meals per day, including— 

11 (A) for individuals 12 years of age or 

12 older, a diet that contains not less than 2,000 

13 calories per day; and 

14 (B) for children younger than 12 years of 

15 age, a diet that contains an appropriate number 

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

17 weight; 

18 (2) accommodations for any dietary needs or 

19 restrictions; and 

20 (3) access to food in a manner that follows ap21 plicable food safety standards. 

22 SEC. 6. SHELTER. 

23 The Commissioner shall ensure that in each facility 

24 at which a detainee is detained— 


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

2 and females are detained separately; 

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

4 States with an adult relative or legal guardian, such 

5 child— 

6 (A) is detained with such relative or legal 

7 guardian unless such an arrangement poses 

8 safety or security concerns; and 

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

10 adult relative or legal guardian as a result of 

11 such safety or security concerns, is not detained 

12 with adults; 

13 (3) for any unaccompanied minor arriving in 

14 the United States without an adult relative or legal 

15 guardian, such child is detained in an age-appro16 priate facility and not detained with adults; 

17 (4) a detainee with a temporary or permanent 

18 disability is held in an accessible location and in a 

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

20 and security, with accommodations provided to the 

21 extent needed; 

22 (5) no detainee is placed in a room for any pe23 riod if such placement would exceed the maximum 

24 occupancy level as determined by the appropriate 

25 building code, fire marshal, or other authority; 


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1 (6) each detainee is provided with temperature 

2 appropriate clothing and bedding; 

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

4 with the humidity and temperature kept at com5 fortable levels (between 68 and 74 degrees Fahr6 enheit); 

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

8 48 hours are given access to the outdoors for not 

9 less than 1 hour during the daylight hours during 

10 each 24-hour period; 

11 (9) detainees are allowed to practice their reli12 gion or to not practice a religion, as they may de13 cide; 

14 (10) detainees are given access to lighting and 

15 noise levels that are safe and conducive for sleeping 

16 throughout the night between the hours of 10:00 

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

18 (11) CBP officers, employees, and contracted 

19 personnel— 

20 (A) follow medical standards for the isola21 tion and prevention of communicable diseases; 

22 and 

23 (B) ensure the physical and mental safety 

24 of detainees who identify as lesbian, gay, bisex25 ual, transgender, or intersex; 


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1 (12) the facility has video monitoring— 

2 (A) to provide for the safety of the detain3 ees; and 

4 (B) to prevent sexual abuse and physical 

5 harm of vulnerable detainees; 

6 (13) there is posted or otherwise made available 

7 in all areas where detainees are located a language 

8 appropriate ‘‘Detainee Bill of Rights’’ (including in9 digenous languages), which specifies all rights af10 forded to detainees under this Act; and 

11 (14) the facility certifies that— 

12 (A) the video monitoring required under 

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

14 and 

15 (B) the videos resulting from video moni16 toring are preserved for at least 90 days. 

17 SEC. 7. COORDINATION AND SURGE CAPACITY. 

18 The Secretary of Homeland Security shall enter into 

19 memoranda of understanding with appropriate Federal 

20 agencies, such as the Department of Health and Human 

21 Services, and applicable government emergency relief serv22 ices, and shall enter into contracts with health care, public 

23 health, social work, and transportation professionals, for 

24 purposes of addressing surge capacity and ensuring com25 pliance with this Act. 


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1 SEC. 8. TRAINING. 

2 The Commissioner shall ensure that CBP personnel 

3 assigned to each short-term custodial facility are profes4 sionally trained, including by receiving such continuing 

5 education as the Commissioner determines appropriate, in 

6 all subjects necessary to ensure compliance with this Act, 

7 including— 

8 (1) humanitarian response protocols and stand9 ards; 

10 (2) indicators of physical and mental illness, 

11 and medical distress in children and adults; 

12 (3) indicators of child sexual exploitation and 

13 effective responses to missing migrant children; and 

14 (4) procedures to report incidents of suspected 

15 child sexual abuse and exploitation directly to the 

16 National Center for Missing and Exploited Children. 

17 SEC. 9. INTERFACILITY TRANSFER OF CARE. 

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

19 a medical facility or emergency services department, the 

20 Commissioner shall ensure that responsibility of care is 

21 transferred from the medical facility or emergency services 

22 department to an accepting licensed CBP health care pro23 vider. 

24 (b) RESPONSIBILITIES OF ACCEPTING PROVIDERS.— 

25 Each accepting licensed CBP health care provider shall 

26 review the medical facility or emergency department’s 


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1 evaluation, diagnosis, treatment, management, and dis2 charge care instructions— 

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

4 transfer; and 

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

6 SEC. 10. PLANNING AND INITIAL IMPLEMENTATION. 

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

8 date of the enactment of this Act, the Secretary of Home9 land Security shall submit a detailed plan to Congress that 

10 describes the timeline, process, and challenges of imple11 menting the requirements under this Act. 

12 (b) IMPLEMENTATION.—The Secretary of Homeland 

13 Security shall ensure that the requirements under this Act 

14 are implemented not later than 6 months after the date 

15 of the enactment of this Act. 

16 SEC. 11. CONTRACTOR COMPLIANCE. 

17 The Secretary of Homeland Security shall ensure 

18 that all personnel contracted to carry out this Act comply 

19 with the requirements under this Act. 

20 SEC. 12. INSPECTIONS. 

21 (a) IN GENERAL.—The Inspector General of the De22 partment of Homeland Security shall— 

23 (1) conduct unannounced inspections of ports of 

24 entry, border patrol stations, and detention facilities 

25 administered by CBP or contractors of CBP; and 


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1 (2) submit to Congress— 

2 (A) reports on the results of the inspec3 tions conducted pursuant to paragraph (1); and 

4 (B) other reports related to custody oper5 ations. 

6 (b) PARTICULAR ATTENTION.—In carrying out sub7 section (a), the Inspector General shall pay particular at8 tention to— 

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

10 requirements under this Act; 

11 (2) remedial actions taken by CBP; 

12 (3) the health needs of detainees; and 

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

14 title 6, Code of Federal Regulations (commonly 

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

16 Respond to Sexual Abuse and Assault in Confine17 ment Facilities’’). 

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

19 not deny a Member of Congress entrance to any facility 

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

21 SEC. 13. GOVERNMENT ACCOUNTABILITY OFFICE REPORT. 

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

23 United States— 

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

25 the enactment of this Act, shall commence a study 


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

2 and 

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

4 enactment of this Act, shall submit a report to Con5 gress containing the results of the study required 

6 under paragraph (1). 

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

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

9 (1) the management and oversight by CBP of 

10 ports of entry, border patrol stations, and other de11 tention facilities, including the extent to which CBP 

12 and the Department of Homeland Security have ef13 fective processes in place to comply with the require14 ments under this Act; and 

15 (2) the extent to which CBP personnel, in car16 rying out this Act, make abusive, derisive, profane, 

17 or harassing statements or gestures, or engage in 

18 any other conduct evidencing hatred or invidious 

19 prejudice to or about 1 person or group on account 

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

21 orientation, age, or disability, including on social 

22 media. 


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1 SEC. 14. PUBLICATION OF DATA ON COMPLAINTS OF SEX2 UAL ABUSE AT U.S. CUSTOMS AND BORDER 

3 PROTECTION FACILITIES. 

4 Not later than 90 days after the date of the enact5 ment of this Act, the Secretary of Homeland Security, act6 ing in coordination with the Office of Inspector General 

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

8 Department of Homeland Security, shall publicly release 

9 aggregate data on complaints of sexual abuse at CBP fa10 cilities on its website on a quarterly basis, excluding any 

11 personally identifiable information that may compromise 

12 the confidentiality of individuals who reported such abuse. 

13 SEC. 15. RULES OF CONSTRUCTION. 

14 Nothing in this Act may be construed as— 

15 (1) authorizing CBP to detain individuals for 

16 longer than 72 hours; 

17 (2) contradicting the March 7, 2014, Depart18 ment of Homeland Security rule adopting Standards 

19 to Prevent, Detect, and Respond to Sexual Abuse 

20 and Assault in Confinement Facilities, which in21 cludes a zero tolerance policy prohibiting all forms 

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

23 Customs and Border Protection custody, including 

24 in holding facilities, during transport, and during 

25 processing; 


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1 (3) contradicting current protocols related to 

2 Department of Homeland Security background 

3 checks in the hiring process; 

4 (4) restricting the Department of Homeland Se5 curity from denying employment to, or terminating 

6 the employment of, any individual who— 

7 (A) would be or is involved with the han8 dling or processing at holding facilities, during 

9 transport, or during processing, or care of de10 tainees, including the care of children; and 

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

12 other offense involving a child victim; or 

13 (5) affecting the obligation to fully comply with 

14 all applicable immigration laws, including being sub15 ject to any penalties, fines, or other sanctions. 

Æ 


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