Border officials didn’t follow guidelines on migrant children’s health care, federal investigators find

Minors are seen as they exercise in a common area at the Homestead shelter for unaccompanied migrant children on April 08, 2019 in Homestead, Florida. Credit: Joe Raedle/Getty Images

U.S. Customs and Border Protection has not consistently followed new guidelines for medical care of migrant children and spent some of the agency’s money designated for “medical care” on unrelated items like printers, speakers and its canine program, according to a new federal investigation.

The U.S. Government Accountability Office, an independent “congressional watchdog,” found gaps in care across border facilities. Border officials also chose to go against a recommendation from the U.S. Centers for Disease Control and Prevention to give the flu vaccine to children who crossed the border into the United States.  

The GAO released the findings Wednesday, as members of the House Homeland Security Committee held a hearing as part of an ongoing investigation of Customs and Border Protection (CBP) policies.

“The simple reality is that children shouldn’t be locked up by our government. I have supported, and the House has passed, legislation to protect the health of children in custody, but they shouldn’t be there in the first place,” Florida Congresswoman Val Demings said in an email to the Phoenix

U.S. Rep. Val Demings (D-FL). Photo by Shawn Thew – Pool/Getty Images.

“This administration’s anti-immigrant hysteria has led to deeply inhumane treatment of asylum seekers and others who are seeking legal status here in the United States.”

Demings, a Democrat, is a member of the committee but did not question witnesses at the hearing. The former chief of the Orlando Police Department, Demings is on the short list to be the vice presidential candidate for presumptive Democratic nominee Joe Biden.  

Lawmakers began to investigate health conditions at the border, after two children died in custody in December 2018. Those deaths happened in the midst of a surge at the border last year. 

CBP apprehended more than twice the number of undocumented migrants from September 2018 to October 2019 than they had in the previous four fiscal years, according to the Homeland Security Department’s Inspector General.

As a result, cramped and overcrowded detention centers risked becoming breeding grounds for illnesses like the flu. Some people were kept in custody for days or weeks. CBP’s policy is that migrants should not remain in their custody for more than three days.

“The Trump administration is making a conscious decision to put the health of children and families at risk by not following the law,” Demings said. “Regardless of the policies from the top, CBP needs to make certain their policy is to treat people with dignity and respect.”

In response to the crisis last summer, the government drafted new policies for medical care of children held in custody. But the GAO found “inconsistent implementation” of the medical care policies and procedures.

For example, GAO found three of 10 border stations it visited in South Texas last November did not have medical staff present to perform assessments. Over one week in February, 143 of 373 children taken into custody did not receive basic health checks. 

The Centers for Disease Control recommended border patrol offer the flu vaccine to all incoming migrant children. But CBP declined to do so, saying it would be too challenging to have enough cold storage for the vaccine or providers to administer it. 

“Throughout our work we found CBP did not identify or fully document reasons for their decision not to offer the flu vaccine for those in custody … they did not document how they weighed those costs with benefits for the flu vaccine,” Rebecca Gambler, a director in Homeland Security and Justice at the GAO, told lawmakers this week. 

The investigation also found CBP has inconsistently reported deaths in its custody. GAO’s review found that 31 individuals died in border patrol custody from 2014 to 2019. CBP only documented 20 of them in congressional reports. CBP told the congressional watchdog agency it would overhaul its record-keeping and send information more consistently.

‘There is something seriously wrong’

The U.S. Capitol. Credit: Samuel Corum/Getty Images

Congress approved a $4.5 billion emergency humanitarian-aid package last summer in response to the situation at the border. The package included a $112 million line item specifically for “consumables and medical care.”

But border agents misspent almost 20 percent of the money, using it to buy printers, speakers, and dog food and other equipment for its canine program, according to the GAO. 

“We concluded that CBP violated the statute under appropriations and should make adjustments,” GAO’s Gambler told lawmakers. 

CBP has obligated nearly $87 million of the approximately $112 million. After the congressional watchdog’s investigation, CBP said they would adjust accounts for $17 million that was used for spending not related to medical care. Agents used the rest of the money for relevant investments in gloves, masks, clothes, medical equipment and other items. 

“There is something seriously wrong with this picture, just as there is something seriously wrong with this administration’s approach to caring for migrants and children,” said Homeland Security Committee Chairman Bennie Thompson (D-Miss.).

The congressional watchdog found CBP made progress in some areas: The agency hired more medical personnel and received guidance and training from health professionals. 

In response to outcry over conditions for children, one large and controversial detention center in Florida was effectively shut down over the past year.

Last August, officials relocated the last of the more than 3,000 children who had been held at Homestead detention center in Florida. The government did not renew its contract with the private prison company that ran the center — a move that immigrants rights groups saw as a major win.

The situation this summer is starkly different. Federal officials erected new holding facilities to process children at the border but many remain empty.

President Donald Trump. Pennsylvania Capital-Star file photo.

The Trump administration issued new emergency rules during the COVID-19 pandemic that instruct border agents to turn children and almost all other migrants back to Mexico immediately. They are not  given a chance to ask for humanitarian protection.

The Trump administration has expelled 2,175 unaccompanied minors since March in response to the coronavirus pandemic, according to a USA Today analysis of figures from the CBP. 

Immigrants who crossed before the order have been in a long holding pattern and legal battle, awaiting decisions on their asylum claims. A federal judge ordered immigrant children released from three family detention centers on July 17, but immigration officials may not allow their parents to leave with them.

Medical neglect?

The congressional investigation first came in response to the deaths of two children at the border in December 2018. The children, 8-year-old Felipe Alonzo-Gomez and 7-year-old Jakelin Caal, were both Guatemalan and died in different CBP holding facilities in Texas and New Mexico.

The IG found there was no misconduct or malfeasance from border patrol agents. 

But Dr. Fiona Danaher, a pediatrician who Democrats asked to review the investigation, said the agency needs more policies in place to protect children.

“Death by natural causes does not mean death was inevitable,” said Danaher, an instructor of pediatrics at Harvard Medical School. “The effort several agents went through in assisting the children does not absolve CBP as an agency of perpetuating systems that place children at risk for medical neglect.”