Sec. 1. Short title; table of contents. 
Sec. 2. Initial health screening protocol. 
Sec. 3. Water, sanitation, and hygiene. 
Sec. 4. Food and nutrition. 
Sec. 5. Shelter. 
Sec. 6. Coordination and surge capacity. 
Sec. 7. Training. 
Sec. 8. Interfacility transfer of care. 
Sec. 9. Planning and initial implementation. 
Sec. 10. Contractor compliance. 
Sec. 11. Inspections. 
Sec. 12. GAO report. 
Sec. 13. Rules of construction. 
Sec. 14. Definitions. 
SEC. 2. INITIAL HEALTH SCREENING PROTOCOL. 
(a) IN GENERAL.—The Commissioner of U.S. Cus-
toms and Border Protection (referred to in this Act as 
the ‘‘Commissioner’’), in consultation with the Secretary 
of Health and Human Services, the Administrator of the 
Health Resources and Services Administration, and non-
governmental experts in the delivery of health care in hu-
manitarian crises and in the delivery of health care to chil-
dren, shall develop guidelines and protocols for the provi-
sion of health screenings and appropriate medical care for 
individuals in the custody of U.S. Customs and Border 
Protection (referred to in this Act as ‘‘CBP’’), as required 
under this section. 
(b) INITIAL SCREENING
AND MEDICAL ASSESS-
MENT.—The Commissioner shall ensure that any indi-
vidual who is detained in the custody of CBP (referred 
to in this Act as a ‘‘detainee’’) receives an initial in-person 
screening by a licensed medical professional in accordance 
with the standards described in subsection (c)— 
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(1) to assess and identify any illness, condition, 
or age-appropriate mental or physical symptoms that 
may have resulted from distressing or traumatic ex-
periences; 
(2) to identify acute conditions and high-risk 
vulnerabilities; and 
(3) to ensure that appropriate healthcare is 
provided to individuals as needed, including pedi-
atric, obstetric, and geriatric care. 
(c) STANDARDIZATION OF INITIAL SCREENING AND 
MEDICAL ASSESSMENT.— 
(1) IN
GENERAL.—The initial screening and 
medical assessment shall include— 
(A) an interview and the use of a stand-
ardized medical intake questionnaire or the 
equivalent; 
(B) screening of vital signs, including pulse 
rate, body temperature, blood pressure, oxygen 
saturation, and respiration rate; 
(C) screening for blood glucose for known 
or suspected diabetics; 
(D) weight assessment of detainees under 
12 years of age; 
(E) a physical examination; and 
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(F) a risk-assessment and the development 
of a plan for monitoring and care, when appro-
priate. 
(2) PRESCRIPTION MEDICATION.—The medical 
professional shall review any prescribed medication 
that is in the detainee’s possession or that was con-
fiscated by CBP upon arrival and determine if the 
medication may be kept by the detainee for use dur-
ing detention, properly stored by CBP with appro-
priate access for use during detention, or maintained 
with the detained individual’s personal property. A 
detainee may not be denied the use of necessary and 
appropriate medication for the management of the 
detainee’s illness. 
(3) RULE OF CONSTRUCTION.—Nothing in this 
subsection shall be construed as requiring detainees 
to disclose their medical status or history. 
(d) TIMING.— 
(1) IN GENERAL.—Except as provided in para-
graph (2), the initial screening and medical assess-
ment described in subsections (b) and (c) shall take 
place as soon as practicable, but not later than 12 
hours after a detainee’s arrival at a CBP facility. 
(2) HIGH PRIORITY INDIVIDUALS.—The initial 
screening and medical assessment described in sub-
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sections (b) and (c) shall take place as soon as prac-
ticable, but not later than 6 hours after a detainee’s 
arrival at a CBP facility if the individual reasonably 
self-identifies as having a medical condition that re-
quires prompt medical attention or is— 
(A) exhibiting signs of acute or potentially 
severe physical or mental illness, or otherwise 
has an acute or chronic physical or mental dis-
ability or illness; 
(B) pregnant; 
(C) a child (with priority given, as appro-
priate, to the youngest children); or 
(D) elderly. 
(e) FURTHER CARE.— 
(1) IN GENERAL.—If, as a result of the initial 
health screening and medical assessment, the li-
censed medical professional conducting the screening 
or assessment determines that one or more of the 
detainee’s vital sign measurements are significantly 
outside normal ranges in accordance with the Na-
tional Emergency Services Education Standards, or 
if the detainee is identified as high-risk or in need 
of medical intervention, the detainee shall be pro-
vided, as expeditiously as possible, with an in-person 
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or technology-facilitated medical consultation with a 
licensed emergency care professional. 
(2) RE-EVALUATION.— 
(A) IN GENERAL.—Detainees described in 
paragraph (1) shall be re-evaluated within 24 
hours and monitored thereafter as determined 
by an emergency care professional (and in the 
care of a consultation provided to a child, with 
a licensed emergency care professional with a 
background in pediatric care). 
(B) REEVALUATION PRIOR TO TRANSPOR-
TATION.—In addition to the re-evaluations 
under subparagraph (A), detainees shall have 
all vital signs re-evaluated and be cleared as 
safe to travel by a medical professional prior to 
transportation. 
(3) PYSCHOLOGICAL AND MENTAL CARE.—The 
Commissioner shall ensure that detainees who have 
experienced physical or sexual violence or who have 
experienced events that may cause severe trauma or 
toxic stress, are provided access to basic, humane, 
and supportive psychological assistance. 
(f) 
INTERPRETERS.—To 
ensure 
that 
health 
screenings and medical care required under this section 
are carried out in the best interests of the detainee, the 
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Commissioner shall ensure that language-appropriate in-
terpretation services, including indigenous languages, are 
provided to each detainee and that each detainee is in-
formed of the availability of interpretation services. 
(g) CHAPERONES.—To ensure that health screenings 
and medical care required under this section are carried 
out in the best interests of the detainee— 
(1) the Commissioner shall establish guidelines 
for and ensure the presence of chaperones for all de-
tainees during medical screenings and examinations 
consistent with relevant guidelines in the American 
Medical Association Code of Medical Ethics, and 
recommendations of the American Academy of Pedi-
atrics; and 
(2) to the extent practicable, the physical exam-
ination of a child shall always be performed in the 
presence of a parent or legal guardian or in the 
presence of the detainee’s closest present adult rel-
ative if a parent or legal guardian is unavailable. 
(h) DOCUMENTATION.—The Commissioner shall en-
sure that the health screenings and medical care required 
under this section, along with any other medical evalua-
tions and interventions for detainees, are documented in 
accordance with commonly accepted standards in the 
United States for medical record documentation. Such 
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documentation shall be provided to any individual who re-
ceived a health screening and subsequent medical treat-
ment upon release from CBP custody. 
(i) INFRASTRUCTURE AND EQUIPMENT.—The Com-
missioner or the Administrator of General Services shall 
ensure that each location to which detainees are first 
transported after an initial encounter with an agent or of-
ficer of CBP has the following: 
(1) A private space that provides a comfortable 
and considerate atmosphere for the patient and that 
ensures the patient’s dignity and right to privacy 
during the health screening and medical assessment 
and any necessary follow-up care. 
(2) All necessary and appropriate medical 
equipment and facilities to conduct the health 
screenings and follow-up care required under this 
section, to treat trauma, to provide emergency care, 
including resuscitation of individuals of all ages, and 
to prevent the spread of communicable diseases. 
(3) Basic over-the-counter medications appro-
priate for all age groups. 
(4) Appropriate transportation to medical facili-
ties in the case of a medical emergency, or an on- 
call service with the ability to arrive at the CBP fa-
cility within 30 minutes. 
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(j) PERSONNEL.—The Commissioner or the Adminis-
trator of General Services shall ensure that each location 
to which detainees are first transported after an initial en-
counter has onsite at least one licensed medical profes-
sional to conduct health screenings. Other personnel that 
are or may be necessary for carrying out the functions 
described in subsection (e), such as licensed emergency 
care professionals, specialty physicians (including physi-
cians specializing in pediatrics, family medicine, obstetrics 
and gynecology, geriatric medicine, internal medicine, and 
infectious diseases), nurse practitioners, other nurses, 
physician assistants. licensed social workers, mental health 
professionals, public health professionals, dieticians, inter-
preters, and chaperones, shall be located on site to the 
extent practicable, or if not practicable, shall be available 
on call. 
(k) ETHICAL GUIDELINES.—The Commissioner shall 
ensure that all medical assessments and procedures con-
ducted pursuant to this section are conducted in accord-
ance with ethical guidelines in the applicable medical field, 
and respect human dignity. 
SEC. 3. WATER, SANITATION, AND HYGIENE. 
The Commissioner shall ensure that detainees have 
access to— 
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(1) not less than 1 gallon of drinking water per 
person per day, and age-appropriate fluids as need-
ed; 
(2) a private, safe, clean, and reliable perma-
nent or portable toilet with proper waste disposal 
and a hand washing station, with not less than 1 
toilet available for every 12 male detainees, and 1 
toilet for every 8 female detainees; 
(3) a clean diaper changing facility, which in-
cludes proper waste disposal, a hand washing sta-
tion, and unrestricted access to diapers; 
(4) the opportunity to bathe daily in a perma-
nent or portable shower that is private and secure; 
and 
(5) products for individuals of all age groups 
and with disabilities to maintain basic personal hy-
giene, including soap, a toothbrush, toothpaste, 
adult diapers, and feminine hygiene products, as well 
as receptacles for the proper storage and disposal of 
such products. 
SEC. 4. FOOD AND NUTRITION. 
The Commissioner shall ensure that detainees have 
access to— 
(1) three meals per day including— 
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(A) in the case of an individual age 12 or 
older, a diet that contains not less than 2,000 
calories per day; and 
(B) in the case of a child who is under the 
age of 12, a diet that contains an appropriate 
number of calories per day based on the child’s 
age and weight; 
(2) accommodations for any dietary needs or 
restrictions; and 
(3) access to food in a manner that follows ap-
plicable food safety standards. 
SEC. 5. SHELTER. 
The Commissioner shall ensure that each facility at 
which a detainee is detained meets the following require-
ments: 
(1) Except as provided in paragraph (2), males 
and females shall be detained separately. 
(2) In the case of a minor child arriving in the 
United States with an adult relative or legal guard-
ian, such child shall be detained with such relative 
or legal guardian unless such an arrangement poses 
safety or security concerns. In no case shall a minor 
who is detained apart from an adult relative or legal 
guardian as a result of such safety or security con-
cerns be detained with other adults. 
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(3) In the case of an unaccompanied minor ar-
riving in the United States without an adult relative 
or legal guardian, such child shall be detained in an 
age-appropriate facility and shall not be detained 
with adults. 
(4) A detainee with a temporary or permanent 
disability shall be held in an accessible location and 
in a manner that provides for his or her safety, com-
fort, and security, with accommodations provided as 
needed. 
(5) No detainee shall be placed in a room for 
any period of time if the detainee’s placement would 
exceed the maximum occupancy level as determined 
by the appropriate building code, fire marshal, or 
other authority. 
(6) Each detainee shall be provided with tem-
perature appropriate clothing and bedding. 
(7) The facility shall be well lit and well venti-
lated, with the humidity and temperature kept at 
comfortable levels (between 68 and 74 degrees Fahr-
enheit). 
(8) Detainees who are in custody for more than 
48 hours shall have access to the outdoors for not 
less than 1 hour during the daylight hours during 
each 24-hour period. 
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