U.S. Border Patrol Medical Screening Standards Act

Floor Speech

Mr. Speaker, here we go again. Yesterday, the majority passed a partisan messaging bill to provide illegal immigrants with an additional complaint line at the Department of Homeland Security. It has no chance of becoming law. Today, they are back at it with another partisan messaging bill that will never become law. This time, it is a bill to provide illegal immigrants with electronic health records.

This bill before us today requires the Department of Homeland Security to set up an interoperable electronic health records system to track the medical history of millions of illegal immigrants. The bill requires the system to be up and running in 90 days.

Implementing an electronic health records system is a complicated, labor-intensive undertaking. They begin with a configuration process to tailor the commercial software to a client's needs and then proceed to a site-by-site installation process, followed by workforce training.

It typically takes a year or more to get new electronic health records up and running at a hospital with just one location. Making these systems interoperable across government agencies only creates more complexity, extending implementation by years.

If you need a real-world example of just how unachievable this is, look no further than the Coast Guard. The Coast Guard spent 7 years trying to get an interoperable health records system in place for its 50,000 employees. But, after all that time, the system didn't work. Coast Guard servicemembers are still forced to rely on paper medical records.

The Coast Guard is not alone. The Department of Defense and the Veterans Administration won't have fully interoperable health records systems in place for another 5 to 9 years, respectively.

H.R. 3525 also requires DHS to research innovative ways to conduct medical screenings on illegal immigrants. DHS already conducts thousands of medical screenings on migrants on a daily basis. Finding new ways to deliver health screenings more effectively could save time and money, but researching innovations in healthcare delivery is not the mission of DHS.

The research mandated by this bill is the responsibility of the Department of Health and Human Services. DHS research is properly focused on preventing drugs, criminals, and terrorists from entering our borders. We should not force DHS to lose its focus on these critical Homeland Security priorities.

Finally, the bill before us today fails to provide DHS with any funding to achieve the illegal immigrant medical screening research and interoperable health records mandates. We have no idea how much this bill will cost because the majority failed to file a cost estimate from CBO.

However, we do know from the experience of the VA, DOD, and Coast Guard that interoperable electronic health records systems are extremely expensive undertakings. The DOD and VA are on track to spend over $25 billion on their systems. The Coast Guard's failed system to track just 50,000 people cost $67 million.

Using the Coast Guard as a baseline, it would cost over $2.5 billion to track the medical history of just the illegal immigrants that have come into our country over the last 2 years. In other words, without any funding provided for the mandates in this bill, billions in critical DHS funding used to counter terrorist plots, equip first responders, and respond to natural disasters would be diverted to pay for a benefit for millions of illegal migrants.

Mr. Speaker, what is truly disappointing about this bill that we have considered over the last 2 days is that they did nothing to prevent another humanitarian crisis at our border. We should be working together on legislation that reforms our broken immigration system, protects vulnerable families and children from human smugglers, reduces the asylum backlog, and expands migrant processing and long-term housing.

When this partisan messaging bill fails to move in the Senate, I hope Democrats will finally choose policy over politics and agree to work with Republicans on solutions to our border security problems.

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Mr. ROGERS of Alabama. Mr. Speaker, I am curious about the announcement that the administration is in support of this and is working toward this, because they have already issued an announcement that they oppose this piece of legislation. So, if it did pass, it would be vetoed by the President.
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Mr. ROGERS of Alabama. Roe), the ranking member of the Veterans' Affairs Committee, and a physician.

Mr. DAVID P. ROE of Tennessee. Mr. Speaker, I rise today in opposition to H.R. 3525, the U.S. Border Patrol Medical Screening Standards Act.

Before coming to Congress, I was a practicing physician for over 31 years. I also served in the 2nd Infantry Division in Korea in the 2nd Medical Battalion where, at that time, we trained, we spent a lot of time in the field training for mass casualties and big events.

I went to the border; I spent four days down there on two separate occasions. The last time was in June of this year, with the Medical Director of the Department of Homeland Security, as chief medical adviser, and five other members of the Doctors Caucus at the McAllen, Texas, Rio Grande Valley sector to see for myself what was going on.

At that time, Mr. Speaker, there were 1,000 to 1,500 or more people a day who came across. As we stood there by the Rio Grande River, 15 people walked up and turned themselves in while we weren't there more than 15 or 20 minutes.

And we looked at the facilities they had; about how they tried to screen those folks; and then how they tried to sort them afterwards. And, Congress, it was a shame on us for not providing ICE more beds so you could move those folks off of the border more quickly.

With these folks, they have made--many of them have made long and terrible journeys to get to where they are.

There is some good news, and I want to share this with you now. We just had a meeting today that the ranking member on the committee was there with the Acting Director of Homeland Security; and daily arrivals are now down 64 percent. Attainee numbers are way down, from 20,000 in custody at the border, to an average of 3,500 to 4,500 per day. And the best news, I think, are unaccompanied children have been reduced from over 2,700 to fewer than 150.

So there have been great improvements, which will actually improve the health outcomes when you have time enough to go through and screen those folks.

Can you imagine in a facility that is set for 1,000 people, and you have 1,500 or 1,800 people, you have nowhere to send them, and a flu epidemic breaks out? It is a very difficult thing to deal with.

So the folks at Customs and Border Patrol I think were doing a yeoman's job based on the situation they were put in.

The problem we face isn't the lack of adequate care or screening. It is due to the previously lax enforcement of our immigration laws, and our Border Patrol agents just really being overrun with people illegally crossing the border.

Really, without adding new and impossible-to-meet guidelines for our Border Patrol agents, we should look for other ways to intervene with illegal crossings, and I have mentioned that.

These people are often, as I said, escaping unimaginable problems in their home country. But once they reach our border, the CBP is doing the absolute best they can to help them.

Now, the bill would accomplish very little but overburdening our already-taxed DHS staff with their limited resources. This bill would require the DHS to purchase and implement an electronic health record within 30 days in order to coordinate care for illegal border crossers.

Mr. Speaker, I think I may be one of the only people in the U.S. Congress that has actually implemented an electronic health record in my own practice. It took us a year to do it in our medical practice, to put 80,000 charts in.

Can you imagine putting over a million? And the U.S. military, the Department of Defense, right now is spending about $5-plus-billion for a million and a half soldiers.

The Veterans' Affairs Committee, which I am very aware of, and I will be going to Seattle, Washington, Madigan Army Medical Center on Sunday night and Monday of next week to evaluate their system. We are spending $16 billion to implement this.

Let me say this: The DOD and VA spent a billion dollars trying to implement a system where the electronic health record at DOD and VA could talk to each other, and they failed. So it is a very difficult, complex situation to put an electronic health record in.

I think it is a noble goal, and it should be looked at. But it is just something not doable in 30 days. I absolutely guarantee you it will fail. These are labor-intensive, and many of them fail.

I know, as I was saying a little bit ago, that the Department of Defense and VA are currently implementing this program which will--the total cost of that will be $25 billion.

And this legislation gives DHS a colossal, unfunded mandate and it has no expertise or capacity to handle this, and would consume all of the supplemental that we have sent them.

Further, implementing a new health record at a hospital takes a year or more, not 30 days. So it is absolute folly to think that DHS could do this, contract it, figure it out, train the people at all these ports of entry, and do that in 30 days. It can't be done.

The Coast Guard, a DHS component, had a disastrous experience trying to implement an EHR in about 40 clinics between 2010 and 2015, and they spent $67 million and gave up.

So if we can't deliver a modern healthcare record system to our men and women who put their lives on the line without spending billions of dollars and the better part of a decade, why would we rush to develop one that is doomed to failure for people who are knowingly breaking our laws?

Until the VA and DOD have secured a fully interoperable record for our servicemembers, we should not divert scarce resources and time creating one for illegal immigrants.

I do want to say that I am willing to work with the other side in any way, in all ways, to improve the health care of the people who come here. We are Americans. That is what we do, and we are the best in the world at it.

So if you want to sit down and work out an issue and a problem with me, I am more than happy to do that.

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Mr. ROGERS of Alabama. Mr. Speaker, I note several Members across the aisle have talked about the need to improve our health screenings. This bill does nothing to deal with that. It is about requiring the installation of electronic medical records.

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Mr. ROGERS of Alabama. Mr. Speaker, here we have another bill that demonstrates just how disingenuous Democrats are about securing our borders and fixing our broken immigration system. But in a new twist, today's bill shockingly prioritizes illegal immigrants over servicemembers and veterans. They are going to send another partisan messaging bill to the Senate, where it will promptly die.

When Democrats are ready to legislate real solutions to the problem that this country faces, Republicans stand ready to work with them. In the meantime, I urge all Members to oppose this bill.

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