Oct 24, 2019 — serious risk to the best interests of the child. The Department of Homeland Security should conduct greater oversight and inspection of.

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U.S. COMMISSION ON CIVIL RIGHTS The U.S. Commission on Civil Rights is an independent, bipartisan agency established by Congress in 1957. It is directed to:Ł Investigate complaints alleging that citizens are being deprived of their right to vote by reason of their race, color, religion, sex, age, disability, or national origin, or by reason of fraudulent practices.Ł Study and collect information relating to discrimination or a denial of equal protection of the laws under the Constitution because of race, color, religion, sex, age, disability, or national origin, or in the administration of justice.Ł Appraise federal laws and policies with respect to discrimination or denial of equal protection of the laws because of race, color, religion, sex, age, disability, or national origin, or in the administration of justice.Ł Serve as a national clearinghouse for information in respect to discrimination or denial of equal protection of the laws because of race, color, religion, sex, age, disability, or national origin. Ł Submit reports, ˜ndings, and recommendations to the President and Congress.Ł Issue public service announcements to discourage discrimination or denial of equal protection of the laws. 142 U.S.C. §1975a.MEMBERS OF THE COMMISSION Catherine E. Lhamon, Chairperson*Patricia Timmons-Goodson, Vice Chairperson Debo P. Adegbile Gail L. HeriotPeter N. Kirsanow David KladneyKaren Narasaki Michael Yaki Mauro Morales, Staff Director U.S. Commission on Civil Rights 1331 Pennsylvania Avenue, NW Washington, DC 20425 (202) 376-8128 voice TTY Relay: 711www.usccr.gov *recused

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Letter of Transmittal October 24, 2019 President Donald J. Trump Vice President Mike Pence Speaker of the House Nancy Pelosi On behalf of the United States Commission on Civil Rights (fithe Commissionfl), I am pleased to transmit our report, Trauma at the Border: The Human Cost of Inhumane Immi gration Policies . The report is also available in full on the Commission™s website at www.usccr.gov . For this report, the Commission reopened our 2015 report on the condition of immigration detention centers, amid renewed concerns about worsening conditions. Based on media reports, government investigations, eyewitness accounts, and public testimony recei ved by the Commission, the report details how the current Administration™s changes to asylum, the detention of children, and certain other immigration policies, practices, and procedures have created an unnecessary human and civil rights crisis at the southern border. The report does not rely on information provided directly by the relevant federal agencies as, regretfully, they did not respond to our discovery requests. The institution of the Zero Tolerance policy and decision to forcibly and deliberately separate children, including infants and toddlers, from parents or adult family members on a mass scale, which proceeded with no plans or coordination to reunite families, is a gross human and civil rights violation. The impact of separating immigrant families and indefinite detention is widespread, long- term, and perhaps irreversible physical, mental and emotional childhood trauma. Disturbingly, there remain credible allegations that family separations continue, despite an Executive Order halting them. Immigrant children, as well as adults, experienced trauma as a result of the Administration™s policies. The Commission heard directly from immigrant detainees who confirmed traumatic experiences as a result of not only being separated from their familie s, but also the trauma they suffered as a result of enduring inhumane conditions at detention facilities and sometimes on account of the cruel treatment by Department of Homeland Security personnel. In addition, the new testimony and data indicate that federal agencies have not heeded the Commission™s recommendations from its 2015 report. Agencies continue not to provide appropriate and critical legal and medical services to detainees, or transparency about the government™s policies in detaining individua ls. Further, agencies continue inequitable treatment of Lesbian, Gay, B isexual, and Transgender (LGBT) individuals, individuals with disabilities, and non-English speakers. The Commission found that detention conditions have significantly deteriorated und er the current Administration™s policies. Some child detention facilities lack basic hygiene and sleeping arrangements; they sometimes lack soap, blankets, dental hygiene, potable UNITED STATES COMMISSION ON CIVIL RIGHTS 1331 Pennsylvania Ave., NW Suite 1150 Washington, DC 20425 www.usccr.gov

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water, clean clothing, and nutritious food. The Commission received evidence and testimony that child detention facilities lack appropriately trained medical personnel and medicine, medical staff are not routinely present at detention facilities, and wait times to see a doctor can be weeks long, regardless of how dire the situatio n. Language barriers pose an immense hurdle to staff™s ability to offer adequate and appropriate medical and mental health treatment to children while detained. The Commission majority voted for key recommendations, including the following: the Administration must immediately reunify any remaining children with their parents, including parents who were deported before, during, and after Zero Tolerance, unless ther e is a proven serious risk to the best interests of the child. The Administration should immediately remedy conditions in detention centers regarding overcrowding, food, and sanitation so as not to further traumatize children forced to flee their homes. The Department of Homeland Security should conduct greater oversight and inspection of detention centers, specifically those relating to child detention centers, and should enforce detention center standards up to and including the closure of a detention facility for violating detention center standards and other applicable laws. Congress should expand the authority of Department of Homeland Security Office for Civil Rights and Civil Liberties to respond directly to complainants and enforce civil rights p rotections. New immigration policies should be precleared by Office for Civil Rights and Civil Liberties or another independent body to ensure they do not violate civil rights, prior to causing harm. Due to the inconsistent and inhumane treatment of child ren, Congress should pass legislation that sets minimum safe, sanitary and humane detention conditions, and provide sufficient funding to address the crisis in detention facilities for both children and adults. Because the purpose of immigration detention is not punitive, the standard of care should be based on providing reasonable care and safety, and not on incarceration standards. Congress should require that no funds should be used for the detention of any asylum seeker who has been found to establish a credible fear of persecution, apart from narrow exceptions. Congress must provide sufficient funding to address the need for hiring, full training, and retention of experienced and qualified administrative law judges and related staff to process asylum a nd other immigration claims, to ensure asylum seekers and other immigrants are accorded full due process. Congress should pass legislation allowing members of Congress and members of this Commission to conduct independent inspections of detention facilitie s with minimal notice (no more than 24 hours) and be given full access to detainees to interview them. We at the Commission are pleased to share our views, informed by careful research and investigation as well as civil rights expertise, to help ensure th at all Americans enjoy civil rights protections to which we are entitled. For the Commission, Patricia Timmons Goodson Vice Chair

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Lack of Pediatric Care Testimony . 64 Mental Health and Children .. 65 Lack of Mental Health Screening Testimony .. 67 Trauma in Children Testimony 67 Use of Physical Restraints and Juveniles Testimony 67 Use of Solitary Confinement, Juveniles and Mental Health Testimony . 68 Sexual and Physical Violence Against Detained Children . 68 Testimony .. 69 Length of Stay in Detention Facilities .. 70 Indefinite Detention for Children Testimony .. 73 Migrant Children Sent to Foster Care 74 Legal Representation of Unaccompanied Minors 75 Detention of Adults: Oversight and Transparency of Conditions 76 Transparency and Oversight Testimony . 78 Legal Standard for Medical Care . 79 Medical Resources and Improper Care . 81 Lack of Medical Care Testimony .. 82 Withholding Medication Testimony . 83 Competency of Staff in Providing Medical Care Testimony 84 Mental Health and Adults .. 85 Pregnancy 87 Lack of Transparency in Providing Medical Care .. 87 Deaths while Detained Testimony . 88 Basic Needs: Nutrition, Hygiene and Clothing .. 90 Food in Detention Testimony .. 91 Hygiene and Clothing Testimony .. 92 Prison -like Conditions in Facilities . 93 Working Conditions Testimony .. 94 Solitary Confinement as Punishment .. 95 Solitary Confinement Testimony 96 Sexual Violence and Application of Prison Rape Elimination Act to Detention Facilities . 97 Allegations of Sexual Abuse .. 99 Sexual Violence Testimony 100 Abuse of Authority 100

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iii TABLE OF CONTENTS Misuse of Auth ority Testimony 101 Treatment of LGBT Individuals . 102 Treatment of Transgender Detainees Testimony . 104 Physical and Sexual Assaults of LGBT Testimony 105 Due Process 106 Due Process Testimony . 107 Length of Stay in Detention Facilities & Withholding Release 107 Indefinite Detention of Adults Testimony .. 108 Legal Representation in Immigration Proceedings .. 109 Limited English Proficiency and Legal Representation Testimony .. 111 Access to Legal Representation Testimony 112 Detention Centers in Remote Locations Testimony .. 113 Understanding the Legal Process .. 113 Navigating Immigration Proceedings Without Repre sentation Testimony 114 Lack of Independence for Immigration Courts .. 114 Location of Detention Facilities .. 115 Opening Detention Centers on Potentially Hazardous Sites Testimony . 116 Allocation of Federal Monetary Resources Testimony 117 CHAPTER 4: FINDINGS AND RECOMMENDATIONS . 119 Findings 119 I. Creating a Humanitari an Crisis . 119 II. Discriminatory Immigration Policies . 120 III. Trauma as a Result of Family Separations . 121 IV. Inhumane Detention Conditions for Children and Adults .. 122 V. Barriers to Access to Justice .. 124 VI. Lack of Transparency and Accountability .. 125 Recommendations .. 125 I. Addressing Fa mily Separations 125 II. Addressing Detention Conditions for Children and Adults 126 III. Ensuring Due Process 127 IV. Increasing Accountability 128 COMMISSIONERS™ STATEMENTS AND DISSENTS . 130 Statement of Commission Michael Yaki .. 131 Dissenting Statement of Commissioner Gail Heriot 137

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Dissenting Statement of Commissioner Peter N. Kirsanow 143 Appendices . 157 Appendix A: Federal Agency Roles in Immigration .. 158 Department of Homeland Security .. 158 Customs and Border Protection 158 Immigration and Customs Enforcement .. 158 Citizenship and Immigration Services .. 159 Department of Justice ŠExecutive Office for Immigration Review . 160 Department of Health and Human Services 160 Appendix B: Copy of Department of Homeland Security Discov ery Request . 162 Appendix C: Copy of Department of Health and Human Services Discovery Request 179

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v TABLE OF CONTENTS ACKNOWLEDGEMENTS This report was produced under the direction of Commissioners and Commissioner Special Assistants . Special Assistant Jason T. Lagria coordinated the drafting of this report, as well as the review of public comments with the help of Special Assistants Amy Royce and Carissa Mulder and law clerks Erin Drolet (J.D Candidate 2021, George Washington University ), Kori Pruett (J.D. Candidate 2021, Georgetown University ), and Mark Saunders (J.D. Candidate 2021, Duke University ). Special Assistants Alec Deull, Alison Somin, Amy Royce, Irena Vidulovic, Jason T. Lagria, and Rukku Singla and Law Clerks Erin Drolet, Kori Pruett , and Patrick Williamson (J.D. Candidate 2021, Georgetown University) also reviewed, edited , and offered editorial comments for the report , or findings and recommendations, or both . Katherine Culliton -González, Esq., the Commission™s Office of Civil Rights Evaluation (OCRE) Director, conducted substantial principal research and drafting on the background of this report and also reviewed, edited, and offered editorial comments for the report . With the assistance of Attorney -Advisor Pilar Velasquez McLaughli n, and Law Clerks Christine Kumar (J.D. Candidate 2020, George Washington University), Lilian Ofili (J.D. Candidate 2021, George Washington University), Benjamin Falstein (J.D. Candidate 2021, George Washington University), and Brooke Schwartz (J.D. Candid ate 2021, George Washington University), the Commission™s General Counsel Maureen E. Rudolph reviewed and approved the report for legal sufficiency. Attorney -Advisor Pilar Velasquez McLaughlin, Law Clerks Christine Kumar, Lilian Ofili, Benjamin Falstein, a nd Brooke Schwartz, and the Commission™s General Counsel Maureen E. Rudolph also provided valuable legal research assistance and writing for the report.

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