I 
116TH CONGRESS 
1ST SESSION H. R. 1336 
To require the Federal Government to provide mental health services to 
each child who has been separated from one or more parent as a 
result of implementation of the Trump Administration’s zero tolerance 
policy at the United States border, and for other purposes. 
IN THE HOUSE OF REPRESENTATIVES 
FEBRUARY 25, 2019 
Ms. BARRAGA´N introduced the following bill; which was referred to the Com-
mittee on Energy and Commerce, and in addition to the Committee on 
the Judiciary, for a period to be subsequently determined by the Speaker, 
in each case for consideration of such provisions as fall within the juris-
diction of the committee concerned 
A BILL 
To require the Federal Government to provide mental health 
services to each child who has been separated from one 
or more parent as a result of implementation of the 
Trump Administration’s zero tolerance policy at the 
United States border, and for other purposes. 
Be it enacted by the Senate and House of Representa-
tives of the United States of America in Congress assembled, 
SECTION 1. SHORT TITLE. 
This Act may be cited as the ‘‘Mental Health Care 
for Children Inhumanely Separated from Parents by the 
Federal Government Act of 2019’’. 
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SEC. 2. FINDINGS; SENSE OF CONGRESS. 
(a) FINDINGS.—Congress finds the following: 
(1) On April 6, 2018, Attorney General Jeff 
Sessions announced that the Trump Administration 
would begin implementing a new zero tolerance pol-
icy for immigrants crossing the border into the 
United States illegally. 
(2) Between April 19 and May 31, 2018, 1,995 
children were separated by the Department of 
Homeland Security from their migrant parents at 
the border. 
(3) On May 8, 2018, the president of the Amer-
ican Academy of Pediatrics issued a statement op-
posing separation of children and parents at the bor-
der, explaining that ‘‘highly stressful experiences, 
like family separation, can cause irreparable harm, 
disrupting a child’s brain architecture and affecting 
his or her short- and long-term health. This type of 
prolonged exposure to serious stress—known as 
toxic stress—can carry lifelong consequences for 
children.’’. 
(4) On May 29, 2018, the president of the 
American Psychological Association issued a state-
ment regarding the ‘‘traumatic effects of separating 
immigrant families’’, explaining that ‘‘[t]he longer 
that children and parents are separated, the greater 
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the reported symptoms of anxiety and depression for 
the children. Negative outcomes for children include 
psychological distress, academic difficulties and dis-
ruptions in their development.’’. 
(b) SENSE OF CONGRESS.—It is the sense of Con-
gress that the separation of children from migrating par-
ents, as is resulting from the Trump Administration’s im-
plementation of the zero tolerance immigration policy, is 
cruel, inhumane, and harmful to the mental health of sep-
arated children. 
SEC. 3. MENTAL HEALTH SERVICES FOR CHILDREN SEPA-
RATED BY THE DEPARTMENT OF HOMELAND 
SECURITY AT THE BORDER. 
(a) IN GENERAL.—The Federal Government shall, 
including through contracts with qualified mental health 
professionals, ensure that— 
(1) beginning not later than 24 hours after a 
child is separated from one or more parent by the 
Department of Homeland Security at the United 
States border, such child receives a mental health 
assessment by such a professional who is not em-
ployed by the Federal Government; 
(2) not later than 24 hours after the date of the 
enactment of this Act, any child who was separated 
from one or more parent at the United States border 
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at any time on or after April 6, 2018, shall receive 
a mental health assessment from such a professional 
who is not employed by the Federal Government; 
(3) on an ongoing basis and as described in 
subsection (c), a child described in paragraph (1) or 
(2) is, subject to subsection (b), provided with men-
tal health services by such a professional regardless 
of whether such child remains in a detention center 
or is released to a family member or guardian (pro-
vided such child remains in the United States) and 
an adequate network of such professionals is avail-
able nationwide to enable access to such services; 
and 
(4) 100 percent of the costs of such assessment 
and services provided to a child pursuant to this 
subsection are covered by the Federal Government, 
without any cost-sharing or other related obligation 
with respect to such assessment or services provided 
to such child. 
(b) OPT-OUT.—After release from a detention center, 
the parent or legal guardian of a child described in sub-
section (a) may choose for such child to not receive serv-
ices otherwise made available pursuant to paragraph (3) 
of such subsection and to not be provided an independent 
assessment described in subsection (c). 
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(c) TERMINATION.—On an annual basis, a child re-
ceiving mental health services provided pursuant to sub-
section (a)(3) shall be subject to an independent assess-
ment by a qualified mental health professional who is not 
directly involved in the provision of mental health services 
to such child and who is not employed by the Federal Gov-
ernment to determine whether such child continues to 
need such services or if such services should be termi-
nated. In the case a determination is made pursuant to 
the previous sentence that such services should be termi-
nated, the requirements under subsection (a) with respect 
to such child shall terminate. Prior to the termination of 
services, the qualified mental health professional involved 
in the provision of mental health services to such child 
shall consult the parent or guardian of such child in plan-
ning for reducing and then terminating such services. 
(d) QUALIFIED MENTAL HEALTH PROFESSIONAL 
DEFINED.—In this section, the term ‘‘qualified mental 
health professional’’ means a provider of mental health 
services who is eligible to participate as such a provider 
under a State plan under the Medicaid program under 
title XIX of the Social Security Act or under a State child 
health plan under the Children’s Health Insurance Pro-
gram under title XXI of such Act and who— 
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(1) has training in the treatment of mental ill-
ness in children and adolescents; and 
(2) agrees to maintain patient records for chil-
dren and adolescents receiving mental health serv-
ices under this Act in accordance with State and 
Federal health information privacy and security laws 
in the same manner and to the same extent as such 
provider would be required under such laws to main-
tain such records for such children and adolescents 
if such children and adolescents were nationals of 
the United States (as such term is defined in para-
graph (22) of section 101 of the Immigration and 
Nationality Act (8 U.S.C. 1101)). 
Æ 
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