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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 
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 
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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 
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 
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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 
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, 
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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. 
(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. 
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(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— 
(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, 
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