The Acting DHS Secretary and CBP leadership are committed to ensuring that individuals in CBP custody receive appropriate medical support. To that end, CBP continues to take steps to significantly enhance its medical support efforts, consistent with CBP’s law enforcement mission.
In December 2019, CBP issued the Enhanced Medical Directive setting foundational levels of medical support.
- The Directive provided clear direction for USBP and OFO regarding contract mechanisms that support enhanced medical support efforts along the SWB.
- The Directive also outlined the responsibilities and procedures for how CBP will deploy enhanced medical support efforts to mitigate health risks to those in CBP custody.
On March 30, 2020, CBP finalized USBP and OFO specific implementation plans for the Directive codifying, in significant additional detail, a systematic expansion and enhancement, in both scope and scale, of CBP medical support efforts.
These implementation plans were informed by the last year and a half of expansion of enhanced medical support along the southwest border, and developed in consultation with numerous expert internal and external stakeholders, including the Department of Homeland Security’s Countering Weapons of Mass Destruction Office (CWMD) and the DHS Chief Medical Officer.
The plans for OFO and USBP are separate to account for differences in their command and control structures, as well as their nomenclatures; however, the implementing language is the same in both
The Implementation Plans include a high-level Concept of Operations (CONOPS) with accompanying detailed annex, comprised of Standard Operating Procedures (SOP).
These documents are a snapshot of current guidance and medical support efforts; CBP will continue to refine and enhance its practices and procedures to ensure alignment with Department-wide decisions or address new and emerging threats.
Some areas that have been addressed in detail include:
- Medical Support for Juveniles
- Identification and Notification of Medical Issues
- Enhanced Medical Monitoring
- Medication Review
- Medical Quality Management (MQM)
- Public Health (PH)/Infectious Disease (ID) Management
- Surge and Crisis Level Medical Support
CBP’s Enhanced Medical Directive and the CONOPS portion of the Implementation Plans are publically available documents. The SOP portion of the Implementation Plans are For Official Use Only (FOUO) documents, as they contain details that are not appropriate for public release.
For additional public awareness, CBP notes that the SOP portion addresses metrics, reporting and public health considerations, including coordination with DHS, CWMD, and other USG stakeholders regarding public health crisis determinations. In addition, the SOP portion addresses public health response considerations in coordination with DHS, CWMD, and other USG stakeholders, including USG considerations and plans regarding public health crisis vaccinations and coordinated USG efforts to prevent inappropriate backlogs of persons in CBP custody. Furthermore, the SOP addresses peer review of deaths in custody by the CBP Chief Medical Officer, the DHS Chief Medical Officer, and additional, external reviewers as appropriate.