Transcripts For CSPAN Hearing On Conditions At Immigration Detention Facilities 20240713

Put them. They are fully trained and are able to care and provide any type of antiviral flu and do flu testing. They are able to do that. They are able to do acute care and other things that arent referred to secondary care. Has written protocols that support that need . Yes or no. Im out of time. We do. If can you supply those. Well work to get that to you. Yes, maam. My time has expired. Thank you. Chair rice thank you. We now recognize the gentleman from mississippi, mr. Guest. Mr. Guest thank you, mr. Chairman. Chief hastings, want to speak to you on the overall Immigration Crisis that we have and are currently experiencing along our southwest border. I note on page 7 of our your written tum refer to fundamental flaws in the immigration system. You go on to say c. B. P. Has pleaded with congress to address the layers of existing law and judicial systems that adversely impact our ability to effectively manage our immigration system. There are three key gaps in our Legal Framework that congress has yet to address. And you list there the settlement, the tvpra and asylum assertion. Could you just take a few moments to expand on each of these factors that you have listed there in your report and how it impacts your departments ability to secure our border. Mr. Hastings we need the ability under flores, we need the ability to hold in a setting that is fair, provides fair and expeditious immigration proceedings. Flores is a major issue for us, completing that under the current 20day process thats required. When we released over 149,000 families, when we were interviewing these individuals, they literally told us that we were told, bring a child, and we will be released. Thats what is encouraging this large flow that we continue to see. We believe that they should be housing together with all the adequate things that have been provided, medical, dental, farmcy, education, all the many other things. The double standard for noncontiguous u. A. C. s being able to return a u. A. C. To guatemala, honduras, other countries like we are currently with mexico and canada, that would assist with the large number of u. A. C. s we are seeing cross our borders today. Again a vulnerable population. Lastly, tightening the asylum bar to the low asylum bar for credible fears. We see the backlog of over a million cases right now. Mr. Glonse would you agree if congress were to address these three issues that it would help stem the flow of illegal immigration that we have recently seen across our southwest border . Mr. Hastings we believe it would. Mr. Guest you were asked a question earlier about the moving, shifting of money designated for the department of defense to our southwest border for the purpose of border wall construction. Do you feel like that the construction of the border wall system has improved your agencys ability to protect our homeland . Mr. Hastings absolutely. Again, a border wall system is more than just a wall. Technology, roads, gives situational awareness, gives us impedence and denial and time to respond. I have seen it work personally in the many areas i have been in the field. I have seen what it does for us. I strongly support it. Mr. Guest thank you. Just lastly, is there any other recommendations that you would make to this committee as to how we can better help your department, again, to secure our homeland and then those individuals that are within our custody we can do our best to a make sure they are protected and receive the care they need . Mr. Hastings would request if we are not coming to an agreement on some of the recommendations we gave, we continue to fund h. H. S. And so we can move those u. A. C. s through the cycle and get them into the proper environment for care. Would also request assistance with i. C. E. Funding for single adult bed space. Thats another demographic that we ibaking up in our cibaking up in our facilities we see backing up in our facilities. Mr. Guest i yield back. Chair rice i recognize the gentlewoman from new york, ms. Clarke. Ms. Clarke thank you, madam chair and our witnesses for testifying here before us today. Chief hastings, last year you testified before the Judiciary Committee and my colleague, congressman lieu, asked you whether a 3yearold girl could pose a criminal or National Security threat and you responded i dont know. I think attitude goes a long way in addressing the multitude of issues that you have before you, but specifically preventing child deaths in custody. I believe that we shouldnt be surprised when children dont receive medical attention they need, particularly when we dont know what that 3yearold can pose a criminal or National Security threat. Having said that, last fall i introduced h. R. 3777, its the National Commission to investigate the treatment of migrant families and children act. Which would create an independent commission to study issues like family separation as well as the death of different in c. B. P. Custody. Short of passing my legislation, we have to rely on the Inspector General to get to the bottom of these matters. In a report recret cently released by d. H. S. , it states a Border Patrol supervisor had to pay out of their own pocket for overthecounter medication for an 8yearold because Border Patrols insurance did not cover it. In addition, the c. B. P. E. M. T. Was unable to take a Blood Pressure of a child age 7 because they lacked a pediatric cuff. What steps has c. B. P. Taken to ensure access to basic medical necessities and equipment across the northwest border . Mr. Hastings thank you for the question. We did see an issue, a problem with us being Border Patrol or c. B. P. Being able to fund nonprescriptions, overthecounter prescriptions. We have since fixed that. We have a contract through i. C. E. To be able to purchase any needed overthecounter remedy that is prescribed. So we have that. Additionally as i mentioned earlier, thank you for the supplemental funding we were able to provide much needed and equipment for our e. M. T. s out in the field. Those have been fixed. Ms. Clarke wonderful. I appreciate that. N the decade prior to 2018 there was not one single child death in custody. Im a big concerned that there seems to be a callousness taking place. Im glad we are focused on this. However if we are able to shift funding for our border wall, we should be able to shift funding to save human lives, particularly the lives of children. We need to understand what went wrong in 2018 and 2019. If a c. B. P. Official failed to take reasonable steps to prevent the death of a child, what kind of disciplinary measures do you think would be appropriate . Mr. Hastings maam, i havent seen any miss kwlark hip hiply. Mr. Hastings i would have to see all the everything that went into the report. I have to see the specifics. But if it was negligible, we certainly take immediate action. Ms. Clarke has any c. B. P. Official faced accountability for death of children in custody . Mr. Hastings no, maam. Theres been no negative findings. Ms. Clarke no problem. How does c. B. P. Determine what expenses qualify as consumeables or medical care . Mr. Hastings how do we determine sorry . Ms. Clarke how does c. B. P. Determine what expenses qualify as consumeables or medical care. Let me help chief hastings with that. We use the medparagraph system administered through i. C. E. The d. H. S. System that pace for the care. Ms. Clarke hold on a second. Provide us examples of the types of projects or activities which consumeables and medical care funds have been obligated or expended since. Dr. Eastman absolutely. Thank you for the supplemental funding. In response to that there are more than 40 locations that now have contract medical support. They have a standardized formulary of medications and equipment thats used to care for the migrants in custody. That is a clear example of how moneys been appropriated from the supplemental to help further the care of children in our custody. Ms. Clarke how is that reflenished . How do the subcontractors, are they dr. Eastman im not an expert in their supply chain management. But they have a system that replenishes those. The supplemental pays for that. Miss cloorning madam chair, i yield back the balance of my time. Chair rice i now recognize the gentleman from california, mr. Correa. Correa thank you, madam chair. Gentlemen, thanks for being here today. It member of both this committee as well as the house Judiciary Committee where we have had numerous oversight hearings concerning the dangerous detention facilities lack adequate standards of care for migrants, including young children. Like my colleagues here, im troubled by the multiple reports of overcrowded facilities. I have toured some of those facilities. And there is a general agreement that c. B. P. Your facilities were not meant to handle the influx of children and families that we have seen over the last two years. My question is what contingency plans does the department have in place to ensure the safety of those within your custody . Mr. Hastings sir, a couple things i would add. I mentioned in my opening we have soft sided facilities with complete wrap around, medical food services, shower, pretty much all amenities. Additionally, we have planned long term to put Central Processing Centers up in our busiest areas. The rio grande val lirks he paso sector. And the yuma sector. Those are modular buildings being completed now or will be completed and started in the spring for yuma. But they are being completed right now for el paso. Making in other words, having those facilities and those wrap around services is something that we are planning for now and we have a longterm solution. Mr. Correa mr. Hastings, i know you are chief of operations. Pull back a little bit, when general kelly was secretary of Homeland Security here in this committee, he testified, im going to paraphrase him, that Border Security goes beyond our order. Im thinking to myself, you dont wake up one morning say, oh, my gosh, look at all those folks at our doorstep. I have to imagine you coordinate with other agencies and federal government with other governments and begin to see that flow of refugees, flow of migrants moving. My thought is, how do you prepare or are you preparing for those ensuing waves of refugee that is are coming not only from south of the border, not only from central america, but other parts of the world. I dont see this as a one instant phenomenon but as the world areas of conflict continue to escalate, as you have folks in harms way, this is going to continue to be a challenge, migration, refugees from around the world. Are you doing anything to anticipate these kinds of situations near future and long term . Mr. Hastings yes. We are embedded with multiple different governments. Work closely with the northern triangle and agents on the ground down there working with them now. Also work very strongly with our mexican Law Enforcement partners as well on a daytoday basis. The chiefs in the field. Mr. Correa let me ask you something dr. Eastman may i just add something . A addition to what the Border Patrol does, the national bioinformation center, the cwmd entities with the chief medical officer, works to continuously, with our partners not just mexico but our partners south of the border and worldwide, to identify and begin to recognize and Counter Health based threats to the United States. Mr. Correa a little while ago my colleagues talked about the flu vaccinations and essentially your response, i believe, you can confirm this or not, operational challenges have prevented you from really vaccinating a lot of those individuals that need it. Dr. Eastman that is not my response. Just to be our approach is comprehensive. Therer there are migrants that come into u. S. Custody that have gotten vaccinations including and up to this entire c. Can d. C. Catchup protocol at h. H. S. We have administered 60,000 mr. Correa moving that direction. This discussion we have had of independent doctors volunteering to get you up to speed to get there, thats not a factor . You couldnt use them or doing fine on your own . Dr. Eastman medical volunteerism is a challenge to medical organizations not just ours. Because of the difficulties in utilizing volunteers and the difficulties with license sure and administration, we have actually encouraged them to volunteer in the local government shelters and c. B. P. Has both c. B. P. And our office has done to investigator those volunteers into place that is can utilize them more easily. Mr. Correa i would like to follow up on this issue of the challenges of the having licensed doctors integrated into your system of actually being able to vaccinate some of these children and deliver medical services that maybe c. B. P. Is not able to deliver because of limited capacity. Finally, madam chair, if coy get 30 seconds, dr. Eastman, you talked about you made a statement mexico is trying to improve on their side of the mexican border. Some health care. Are we coordinating at all the mexican authorities in terms of making sure that health care disease disease does not respect a border. Rather it addresses both sides. Are we addressing both side of the boarder . Dr. Eastman we made a visit, the chief medical officer made a visit to counterparts in mexico city last year. We continue the dialogue and continue to Work Together to make the situation. Mr. Correa i would like to have written testimony on that later on for view. Dr. Eastman well take the questions. Mr. Correa thank you very much. Thank you gentlemen for being here today. Chair rice thank you. I now recognize the gentleman from texas, mr. Green. Mr. Green thank you, madam chair. I greatly appreciate the opportunity. I thank the witnesses for appearing as well. To both of you, do you take the president seriously when he akes comments . Mr. Hastings sir what comments are you referring to . Mr. Green hes our president. You hear his comments. Mr. Hastings i dont know what youre referring to. Mr. Green about the wall. Mr. Hastings yeah. I think the wall works from my experience. From what i have seen it do in the field first hand. Mr. Green you take him seriously, then. On the wall. Mr. Hastings wall works. Mr. Green you think mexico should pay for the wall . Mr. Hastings sir. All i can tell you is the wall mr. Green you take the president seriously, dont you . Mr. Hastings i can just tell you mr. Green president said mexico should pay for the wall. Mr. Hastings im not involved in funding the wall. Im just telling you that the wall mr. Green lets go on. How many lives would the wall have saved . Mr. Hastings i dont know the nswer to that question, sir. Mr. Green thats fair. Let me ask you this. Are the saudis criminals . Mr. Hastings the what . Mr. Green the people who seek asylum criminals . Mr. Hastings people who cross mr. Green i didnt ask people across the border ill really. Do you know the definition asylee. . Mr. Hastings do i. Mr. Green my question is are asylees people who are seeking asylum, are they criminals . Mr. Hastings we are asking them to go to a port of entry to mr. Green that has little to do with my question, sir. My question is, are they criminals . Why are you evading . Why will you not state what you know to be the truth . Mr. Hastings they committed a crime. Mr. Green are asylees, people seeking asylum criminals. Mr. Hastings if they cross the border illegally mr. Green where do you find this in the law to support your people people seeking asylum are criminals . Are the babies crime canals in . This is why you treat them the way you treat them . You perceive them as criminals . Babies arent criminals. They have no mall list aforethought. Malice aforethought. At would you recommend we do to prevent future deaths . Mr. Hastings as i discussed, sir, we are taking a lot of those actions and have been taking those actions for quite some time. I think we are taking the right steps now to prevent further deaths. It will be difficult as we have explained to say we are going to prevent every death. The people that we encounter on the border, many of whom have traveled over 2,000 miles or more, some have never seen health care, some have never had treatments. Some may not have eaten or drank anything. But we are running into them, many times in their worst condition, and worst case scenario. We are doing everything we can to get them immediate treatment and aid when thats the case. Mr. Green again, what can we do, meaning congress . Mr. Hastings as i mentioned earlier i think taking some of the actions for the double standards for noncontiguous u. A. C. s, that is one. Withdrawing u. A. C. s up to our border because we are unable to return them unless its mexico or canada. And then i think as i mentioned earlier being able to hold everyone together, the entire family, in the proper setting while they go through their hearing. Mr. Green nor edification purposes, for edification purposes, u. A. C. I find to be a pejorative. Mr. Hastings its in the law mr. Green i understand. I still find it to be a pejorative. These are children. U. A. C. s. Madam chair, im going to yield back the balance of my time. Thank you. Chair rice thank you. I now recognize the gentlewoman from illinois, ms. Underwood. Ms. Underwood thank you, madam chair, for holding this hearing for continuing the committees oversilet work. During my three trips to the border last year i saw an heard firsthand about the need for resources to improve medical Record Keeping. As a nurse i know how important clear Record Keeping is when it comes to both Patient Outcomes and ensuring Health Care Providers can most effectively do their jobs. In response to what i saw at the border, im so proud that we passed Bipartisan Legislation last year to provide c. B. P. With an Electronic Health record. And just a few days ago, President Trump signed an appropriations package that includes 30 million in in cated dedicated funding for that Electronic Health record. Dr. Eastman, as a physician can you tell us more about why e. H. R. s are so important to your work at the border. Dr. Eastman yes, maam. Thank you very much. Again thank you for passing the funding we need. E. H. R. s serve a very specific function. They not only allow us to effectively document the care thats provided, but they also allow us easy access to the data to do things like quality assurance. It ensures that we are able to measure the care that we are providing, it ensures we are able to assess the quality of that care. And it ensures we are able to learn lessons from that. In addition, an e. H. R. System that we intend to develop will improve our ability to conduct disease and Health Disease surveillance using Artificial Intelligence eak phoenix that will trirg the presence of Infectious Disease before a human being could pick it up. Ms. Underwood how do they help providers better communicate about patient care . Dr. Eastman Electronic Health records, they are a complicated topic, but they allow us to describe the care that we have provided from the point of apprehension to the point of release from our custody. Not only internally, not only help us communicate internally across multiple settings, but they also allow us to communicate to external partners. One of the things i think is important in this hearing to mention is that the system thats provided not only protects migrants, a system thats been put together, it also protects the integrity of the Health Care System and local communities that were we not absorbing some of the blow, some of these local community Health Care Systems would be overrun by the amount of care thats required. Ms. Underwood i. C. E. And o. R. R. Has Electronic Health records. And d. H. S. Is in the prosselves building one for c. B. P. Congress directed d. H. S. To come up with an Implementation Plan for this d. H. R. Within 9 o days. Can you give us an update on where d. H. S. Is in this process . And what specific action vs. Been taken so far . Dr. Eastman yes, maam. We are in the right now we are in the process, first phase of this which is to identify some immediate solution that is can integrate the existing technology thats out there. Thats work is ongoing immediately. We are also working to plan for the longterm. And we have hired a chief medkea info matics officer who we think has the talent an expertise to help us build a system that will not only create an effective customized solution for us but will harness our ability to help our operators do their job more effectively. Everything we do has to take into account the effects that it has on the individual operator who is doing the job at the border at Processing Centers and ports of entry along the border. Ms. Underwood whats next . What are the next phases . Dr. Eastman the next phase is we work or fingers to the bone to try to get this plan together to come back to brief you in 90 days as to where we are headed. Ms. Underwood you mentioned you hired this info matics officer. What date were they hired . Dr. Eastman ill have to take that specific question. Been around five or six months. Ms. Underwood why is it important to ensure they are interoperable by those use bide d. H. S. Nd other d. H. S. Components . Dr. Eastman we want to make sure we are able to provide a seamless picture of all the care thats provided from the point of apprehension to discharge. Its important for a provider at i. C. E. To know what happened upstream of that when the for the care thats provided. That being said, we are working hand in hand with the Border Patrol to make sure that the solution that is we craft together, not only accomplish the goals of the e. H. R. , but also are user friendly and dont add to the load, processing load, time that the operators have fought forth to take care of the migrants in our custody. Ms. Underwood i appreciate those operational benefits. The other benefit is obviously saving lives. We are not missing information. We are not losing patients. We are not missing opportunities to identify Infectious Diseases or changes in current status. We are heading into another flu season thats protected to be severe. Dr. Eastman, you noted in your testimony you are working with c. D. C. And other Public Health agencies tome prove c. B. P. s response. What specific steps has d. H. S. Taken to strengthen its ability to respond to flu outbreaks at the border during this current flu season which we know has been particularly harmful and deadly for children throughout the United States. Dr. Eastman no question. This flu season according to the c. D. A. C. And others it may be rough. We have worked hand in hand to help craft flu control measures crafted with input from experts from the c. D. C. When they performed an acements along the border early on. In addition, we helped provide c. B. P. The ability to rapidly diagnose and treat the flu in our facilities at c. B. P. Again, these are that capability is present now in over 40 facilities along the southwest border. I would challenge folks to find another Law Enforcement agency that diagnoses and treats the flu on the Law Enforcement side not the custodial side. Ms. Underwood one last followup. What date, was it new for this flu season that that has been deployed . Its not our committees understanding that capability was there last year. Dr. Eastman thats been developing all along through the course of 2019. As the contract report has been developing, that flu capability capability has been put into place continuously over the years. Ms. Underwood thank you so much. I yield back. Chair rice i ask unanimous consent that representative jackson lee be permitted to sit and question the witnesses. Without objection. I now recognize the gentlelady from texas, ms. Jackson lee, for five minutes. Ms. Jackson lee madam chair and ranking member, thank you very much for this important hearing and let me thank the witnesses for being present today. I think it is very important. Mr. Hastings, let me be clear that you handle Law Enforcement operations covering both u. S. Border patrol and customs and Border Protection . Mr. Hastings no, maam. Just Border Patrol. Ms. Jackson lee all right. So a typo. It has you in both positions. You are not. Just wanted to clarify that. Mr. Hastings just Border Patrol, maam. Ms. Jackson lee let me just, for the record, take note of the fact that a number of children have died in 2018 that, in fact, no child had died in c. B. P. Custody for the entire decade before 2018. Nd we lost in particular jakelyn, felipe, and and a number of children that proceeded to get medical care who were detaped in places c. B. P. And ultimately for Migrant Children passed away while or shortly after being released from federal custody. Would both of you, whether you or around en or not, children or relatives acknowledge that the death of any child is a cries criecies and tragic, mr. Hastings. Mr. Hastings as i said earlier im a father and grandfather. It is a tragedy. Ms. Jackson lee dr. Eastman. Dr. Eastman maam, im a parent. And the death of any child is deaf tating. Devastating. I think its important to note not just devastating to the parents. But i was in our facility and i went and saw our personnel who triedle valiantly to safe jakelyn. Despite their best efforts they werent successful. That is brutal on the caregivers as well. Ms. Jackson lee you go right to my point. That dying in the custody of individuals who are basically Law Enforcement but seeing when they are basically committed to defend and protect alongside of the immigration responsibilities, their chief responsibilities, that that is both a crisis and tragic for them to have died in federal custody or having just been released. A that your opinion . Dr. Eastman maam, the death of any child, any person in Law Enforcement custody is tragic. And as you know, Law Enforcement officers across this country take very seriously their responsibility that when we place our handcuffs on someone we know we have an ethical, moral, and legal duty to care for them as well. Ms. Jackson lee i assume, mr. Hastings, you agree with that as well . Any death in federal custody of a child is tragic and brink of a crisis . Mr. Hastings yes. It is tragic. Ms. Jackson lee the idea of those line officers, and i have been and seen the efforts that they have made during some very difficult times, buying diapers, getting formula. I think that should be put on the record. I think the key point, and i appreciate some of the many great steps that congresswoman underwood has made. We traveled together to the border and several times thereafter. My question would be is it time now, as you present reports pursuant to the legislation path, to stand up a very effective parallel medical system based on the present policies of this administration . Meaning that asylum is being denied. They are not being able to access asylum in the way it should. There are migrants camps on just on the border in mexico where disease is rampant, or to be rampant. So that means when they come over they may be sick. Do we have an effective medical system that is parallel to your Law Enforcement system that can do additional things besides the records that are being done and some of the other aspects of reporting . An effective, almost semiquasi Health Center for these individuals that are coming in . Dr. Eastman maam, i think we have to be very cautious that we confab plate a had Health Care Facility with a Law Enforcement facility. We firmly believe at d. H. S. , its my personal belief as a physical yab, that health care is best provided in a health care setting. What we ought to continue to do is to facilitate the movement of people through our system to the best place to care for them. For children thats at h. H. S. Single adults thats in i. C. E. Custody. We have to continue to harden the system for the times that we face Unprecedented Demand for care and i believe thats what we are doing right now. Ms. Jackson lee can i have a quick followup. Mr. Hastings, your point on this Health System . Mr. Hastings i would agree completely. We want, the Border Patrol and c. B. P. Wants to see u. A. C. s, vulnerable populations, out of our custody as quickly as possible. Thats what we want to see. Through the proper places where they can receive the needed care. Ms. Jackson lee let me ask this quick question. It might have been misinterpreted. First of all the children were not out of your custody as soon as possible. We have challenges with a system i helped set up which is h. H. S. System. Well put that aside. My point is that there be some process that is more substantial than the Law Enforcement that can do Immediate Care besides putting someone in a police car and trying to rush them to the next or the nearest hospital. The question is, do we have an ffective Emergency Response on site that can deal with some of these crisis such as one of the young man, 16yearold, was found nonresponsive, and there was not much to deal with his nonresponsiveness. Quickly to mr. Hastings and dr. Eastman. Dr. Eastman to answer your question we are certainly going in the right direction. As i alluded to earlier, we went from three sectors covered by medical personnel contract support personnel to now nine. They are in our busiest location where is we need them. We are constantly monitoring to make sure we have them where we need them. Well continue to do so. On top of that we have 1,500 e. M. T. s that can provide support and do provide support. I believe we are taking all the right steps we need to. Dr. Eastman like wise, maam. Our strategy is to provide the right care to the right person at the right time. I believe we are taking the right steps currently to do that. We reserve, certainly i reserve the right to to reassess this system continuously as conditions change. Its our belief at d. H. S. And my belief personally that we are moving in the right direction. Ms. Jackson lee i look forward to that report coming in so i can understand how the system is working. I thank the chair for her indulgence. I yield back. Chair rice thank you. The chair now recognizes the gentlelady from texas, ms. Garcia. Ms. Garcia thank you, madam chair. Thank you for your vote on letting me in ontosit on this committee. Thank you to the witnesses. I have been following this issue for a great number of years, beginning with the first influx when i was the chair of the Senate Hispanic caucus in texas. Have visited probably about 10 facilities under the jurisdiction of c. B. P. Or o. R. R. I have seen the differences in a lot of the medical protocols, a lot of the medical care thats provided, and all the different facilities. I must say i never found them to be adequate. I never certainly found them to be a clinic or hospital. And to just borrow the words of my colleague to the right, congressman lee, no ones asking for a hospital. And dr. Eastman, i know you made reference to you cant make put a clinic in every single, used the word substation or Police Department facility. I dont think we are asking for that, either. But i think what we do want is what many of us have been talking about. Is the right protocols, the right screening to make sure we get on it as quickly as possible. I was completely stunned at the lack of any kind of screening that was done in the new mexico facility. I know my colleague, torres small, talked about the one in her district. Hats one i visited when jakelyn died. They literally took a microwave off a table to let her lay there because there was nowhere else to put her. And this was while they were waiting until they could get the transportation and bus to go on to the facility where perhaps she could get more treatment. Then of course she ended up going to the hospital. Are you telling me that under todays protocols that has now changed . I know you said you visited also. Dr. Eastman im telling you we do the absolute best we can under the circumstances we are provided. In my Opening Statement i told this committee and america that when we were faced with Unprecedented Demand for care ms. Garcia has that changed in that facility now . They wont have to remove microwave . Theyll have a screening method so they can detect it sooner . Dr. Eastman a lot of our areas have changed. The softsided facilities we put in place. Mr. Hastings in many of those areas, including el paso. El paso has a soft side. Soon to have a modular facility as well. That will give some increased capability, and some increased space. That we need. But still many of our stations and many of our different locations they havent changed. They were built for a completely different demographic. Ask they have not changed. We added as long as we have can in those locations in the way of food, health care products, those types of things. They were not built to house for long periods of time at all. Miss gar see yo i would like dr. Eastman the system thats in place today by virtue of the growth antihard work of a lot of people across the government and c. B. P. Bears little resemblance to what it looked like at christmastime 2018. Ms. Garcia i asked specifically because many people are using that since a lot of the port of entries that they were used to using, they are, frankly, not even allowed to get close enough to make entry. The question is, has that one now been improved . If someone presented themselves with high fever, chills, the typical flu symptoms would that person be put on the same microwave table . Dr. Eastman ill give two answers to answer your question. First of all the expand of contracted health care allows the Border Patrol to use their 1500 e. M. T. s in the role they were designed which was not to be screening personnel inside facilities but to be outside in the field carrying for our personnel and anyone else they encountered. Ms. Garcia thats a no. Dr. Eastman the second is there is contracted support in multiple locations for the border and will take for the record to get you back to details where that is today. Ms. Garcia along the entire border of texas there is screening protocols to ensure that this would never happen again . Dr. Eastman yes, maam. The tiered approach that i described earlier in this hearing is in place all along the southwest border. Ms. Garcia what about the medical assessment or screening. Any in place for the folks who are coming through and the migration protection protocols, remain in mexico program, are they screened at all . Im hearing that there is a lot of people on the other side of the border that have been turned away under this new program that are very, very sick. Dr. Eastman the care that occurs south of the United States southern border is outside my scope. Im not sure whats being done on the mexican side. Mr. Hastings i would add. They will go through medical clearance prior to us putting them into m. P. B. And returning them. They will go through the same process prior to being returned. Additionally, flaps up there hat outlines where they are where we are today slors the contract medical service. I realize we are looking at a bunch of dots on the map. The fact over 300 individuals on duty at any given time providing that additional medical support through our agents in the field. That map ms. Garcia owl all though they are being turned away to go back to mexico you do dreen screen them . Dr. Eastman the approach to medical to the Health Interview and medical assessment applies to everyone in our custody with the parameters ms. Garcia they are not in custody. You are turning them away. Dr. Eastman if they are in our custody they get the assets ements and care i described. Its outside my scope what happens to them south of the border. Ms. Garcia obviously the witness is not understanding the question. Im talking about the folks being turned away under the program. Chair rice you have an opportunity to ask that quen gwen. Do you have any additional questions . Mr. Higgins yes, madam chair. Before i ask my second round of questions, i ask unanimous consent to submit to Homeland Security Advisory Council final report by the c. B. P. , families and Children Care panel. Which was teashed in november of 2019. Ask unanimous consent to smet it for the record. Chair rice so received. Mr. Higgins mr. Hastings, would you like to clarify the all l screening that human beings that cross the border and come into our custody regard to program that are then subject would you clarify for my colleague, ms. Garcia, and for the rest of the committee . Mr. Hastings thank you for the opportunity. That is correct. Anyone that comes into our facility regardless of what program or initiative that they are going into, will go through all of that medical assessment, medical screening and interview. Mr. Higgins are you clarifying that minors including children, but all individuals that are returned to mexico under the program, prior to being returned, receive medical screening . Mr. Hastings prior to return we still have to process them. So during mr. Higgins what if they are sick . Mr. Hastings theyll go to the hospital or the appropriate medical care. Mr. Higgins if the screening determines that they are sick, to the extent they need professional medical attention, well get them that medical attention before we send them back to mexico . Mr. Hastings yes, as evident mr. Higgins as cross the border or one location . Mr. Hastings across the border. Mr. Higgins in your testimony you mentioned the close working relationship between c. B. P. And the office of d. H. S. Chief medical officer. Can you go into more key tail about the specialized nature of our teams assistance to custom and Border Patrol . And also based upon your observations how committed has c. B. P. Leadership been to expeditiously address in custody medical capabilities . Dr. Eastman sir, with regards to your first question, thank you, the relationship literally is hand in hand. Our office and Border Patrol and c. B. P. Communicate constantly. In fact, c. B. P. Senior medical advisors an employee of our office embeded in c. B. P. To help facilitate these issues. The relationship is hand in hand and we communicate literally at multiple levels, probably its safe to say daily. With regards to your second question, my direction has been clear and our direction has been clear from every leader in the department whether thats d. H. S. Or c. B. P. That the direction i was givenshall mr. Higgins what about the direction you received from the top . Dr. Eastman the direction i received has been clear and has been unanimous. Mr. Higgins that the executive branch and our president is committed by their leadership to expeditiously address in custody medical capabilities . Dr. Eastman i have not spoken to him directly. But my directions come from the secretaries and commissioners of the c. B. P. That i work with and its been clear, loud, and unanimous. Do the right thing. Break down barriers. And take good care of the people in our custody. Mr. Higgins that message has been pushed throughout the chain of command . Dr. Eastman unanimous and loud and clear we are going to leave this hearing on immigration, Detention Centers at this point to fulfill our long Time Commitment to bringing you live gavel to gavel coverage of the u. S. House. You can continue watching this hearing online at cspan. Org. This Morning House Speaker Nancy Pelosi announced through her caucus the house would appoint and vote on impeachment matters during tomorrows house session. Sending the articles of impeachment to the u. S. Snafment the today the house will take up the debate rules for two measures. The first bill provides discrimination protection for older workers. And then the second disapproves Education Department rule changes for student loans. Now to live coverage of the u. S. House here on cspan