Initial health screening protocol

(a) In general The Director of U.S. Immigration and Customs Enforcement and the Commissioner of U.S. Customs and Border Protection (referred to in this Act as the Director and Commissioner), in consultation with the Secretary of Health and Human Services, the Administrator of the Health Resources and Services Administration, and nongovernmental experts in the delivery of health care in humanitarian crises and in the delivery of health care to children, shall develop guidelines and protocols for the provision of health screenings and appropriate medical care for individuals in the custody of U.S. Immigration and Customs Enforcement (referred to in this Act as ICE) or U.S. Customs and Border Protection (referred to in this Act as CBP), as the case may be, as required under this section. (b) Initial screening and medical assessment The Director and Commissioner shall ensure that any individual who is detained in the custody of ICE or CBP, as the case may be, (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)— (1) to assess and identify any illness, condition, or age-appropriate mental or physical symptoms that may have resulted from distressing or traumatic experiences; (2) to identify acute conditions and high-risk vulnerabilities; and (3) to ensure that appropriate healthcare is provided to individuals as needed, including pediatric, obstetric, and geriatric care. (c) Standardization of initial screening and medical assessment (1) In general The initial screening and medical assessment shall include the following: (A) An interview and the use of a standardized 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. (F) A risk-assessment and the development of a plan for monitoring and care, when appropriate. (2) Prescription medication The medical professional shall review any prescribed medication that is in the detainee’s possession or that was confiscated by ICE or CBP, as the case may be, upon arrival and determine if the medication may be kept by the detainee for use during detention, properly stored by ICE or CBP, as the case may be, with appropriate 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 may be construed as requiring detainees to disclose their medical status or history. (d) Timing (1) In general Except as provided in paragraph (2), the initial screening and medical assessment 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 an ICE or CBP facility, as the case may be. (2) High priority individuals The initial screening and medical assessment described in subsections (b) and (c) shall take place as soon as practicable, but not later than 6 hours after a detainee’s arrival at an ICE or CBP facility, as the case may be, if the individual reasonably self-identifies as having a medical condition that requires 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 disability or illness; (B) pregnant; (C) a child (with priority given, as appropriate, 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 licensed 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 National Emergency Services Education Standards, or if the detainee is identified as high-risk or in need of medical intervention, the detainee shall be provided, 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 transportation 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 Director and 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 Director and Commissioner shall ensure that language-appropriate interpretation services, including indigenous languages, are provided to each detainee and that each detainee is informed 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 Director and Commissioner shall establish guidelines for and ensure the presence of chaperones for all detainees 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 Pediatrics; and (2) to the extent practicable, the physical examination 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 relative if a parent or legal guardian is unavailable. (h) Documentation The Director and Commissioner shall ensure that the health screenings and medical care required under this section, along with any other medical evaluations 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 received a health screening and subsequent medical treatment upon release from ICE or CBP custody, as the case may be. (i) Infrastructure and equipment The Director and Commissioner 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 officer of ICE or CBP, as the case may be, 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 appropriate for all age groups. (4) Appropriate transportation to medical facilities in the case of a medical emergency, or an on-call service with the ability to arrive at the ICE or CBP facility, as the case may be, within 30 minutes. (j) Personnel The Director and Commissioner or the Administrator of General Services shall ensure that each location to which detainees are first transported after an initial encounter has onsite at least one licensed medical professional 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 physicians 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, interpreters, and chaperones, shall be located on site to the extent practicable, or if not practicable, shall be available on call. (k) Ethical guidelines The Director and Commissioner shall ensure that all medical assessments and procedures conducted pursuant to this section are conducted in accordance with ethical guidelines in the applicable medical field, and respect human dignity.