By Elizabeth Cohen
January 1, 2020 / CNN
More than a year after migrants in the custody of US Customs and Border Protection began to die, the agency released a plan on Tuesday to improve medical screening.
Doctors said they were disappointed it took that long to come up with the plan, which is lacking in many details and provides health screenings only for children, not adults.
"To me, this is beyond disappointing. It's incredibly frustrating," said Dr. Joshua Sharfstein, a professor at the Johns Hopkins Bloomberg School of Public Health.
"This agency is responsible for people's lives and should act like it is," he added.
Four children died in CBP custody from December 2018 through May 2019. Three died of the flu and one died of sepsis. Adults in CBP custody have also died in the past year.
The CBP plan calls for the screenings to be rolled out in three phases. In the first phase, upon initial encounter with the migrant, border patrol agents will "observe and identify potential medical issues" and tell migrants to alert them if they have medical problems.
In the second phase, migrants under age 18 will receive "health interviews," and migrants age 12 and under, as well as anyone identified as having medical concerns, will receive "medical assessments."
The document does not explain what "interviews" and "assessments" entail, or why all adults won't receive these screenings.
Dr. Paul Spiegel, director of the Center for Humanitarian Health at Johns Hopkins University, said vulnerable adults -- pregnant women, for example, or those who need lifesaving medications, such as insulin -- could be missed and not receive the care they need.
"It took CBP this long to come up with something like this, and it's so bare bones," Spiegel said.
The agency did not say when this new screening plan would be rolled out, or if parts were already in place.
In August, Spiegel, Sharfstein and other physicians wrote a letter to Rep. Rosa DeLauro, D-CT, expressing concerns about CBP's medical care for migrants. DeLauro forwarded the letter to CBP and requested a response. Nearly five months later, she still has not received one.
CBP officials did not respond to emails from CNN with questions about their screening plan.
Dr. Katherine McKenzie, director of the Yale Center for Asylum Health, said the screenings were "common sense" and questioned why it took the deaths of four children before the agency came up with the plan.
"If they had done these screenings earlier, perhaps the children wouldn't have died," she said. "If you're taking people into your custody, you're responsible for their health."
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