CONGRESSIONAL HISPANIC CAUCUS Michelle Lujan Gris/mm I Chairwoman IISTH CONGRESS September 5, 2018 The Honorable Kirstjen Nielsen Secretary Department of Homeland Security 300 7th Street SW Washington, DC. 20024 Dear Secretary Nielsen: On July 19, 2018, Congressman Joaquin Castro sent a letter asking whether any child Who has been in your care has died or been seriously injured. At a July 25, 2018 meeting with you and members of the Congressional Hispanic Caucus, Congressman Castro asked you this question in person. At that time, you stated, to your knowledge, you were not aware of any child dying or being seriously injured. Then, on August 24, 2018, you responded to Congressman Castro?s July 19th letter, but failed to address his question. It is unclear whether you attempted to ?nd this answer. Unfortunately, we have recently learned through press reports of the death of Mariee, an 18- month-old child that was held 1n Department of Homeland Security (DHS) custody With her mother, Yazmin, from March 1St to March 25th. While 1n detention, Mariee ?rst became ill with a pulmonary illness and suffered a high fever of over 104 degrees. After a prolonged illness and infection, Mariee passed away on May 10th from pneumonitis. We believe this infection constitutes a serious injury and, therefore, should have been reported given the prior congressional 1nquiries. Further, her illness and rapid decline while in DHS custody is alarming, and raises serious concerns about the available medical care and conditions in detention facilities. News reports indicate that Mariee developed a cold six days after arriving at the South Texas Family Residential Center 1n Dilley, Texas with her mom.3 The next day, Mariee developed a high fever, a cough, diarrhea, and an accelerated heart rate. Medical staff diagnosed Mariee with bronchiolitis and an ear infection. Over the course of her time in detention, Mariee was prescribed pain relievers, an antibiotic, and even allergy medication. Shortly before Mariee?s release, medical staff heard wheezing in her lungs. Mariee and Yazmin were discharged on March 25th, 20 days after they arrived in detention. The next day, Mariee was admitted into a hospital. Two days later, she was transferred to the Intensive Care Unit upon being diagnosed with pneumonia. Her condition worsened so much that doctors put Mariee in a medically induced coma. Mariee passed away from viral pneumonitis six weeks after her release. Not Printed at Expense Her story has led two Texas state agencies to open an investigation.4 The Texas Department of Family and Protective Services and the Texas Health and Human Services Commission will determine if abuse or neglect played a factor in Mariee?s death. A number of physicians and mental health care workers have expressed grave concern with the manner in which children are held, the stress it causes, and the mental and physical rami?cations of these types of settings prolonging illness and recovery time.5 Harmful conditions in detention that many of us have seen ?rsthand, like crowded sleeping quarters, undue stress, and wait times to see medical practitioners, create settings rife for illness and infection. Given this Administration?s plans to drastically increase the number of children and families that are detained, these issues will likely get much worse. It is critical that conditions improve in these centers so that a case like Mariee?s never happens again. These families and young children have travelled thousands of miles to the United States to - escape violence, persecution, and possible death. It is indefensible that when these young children arrive in our country, they are forced in settings that increase disease transmission and that the stress and anxiety they have experienced in their journey will likely exacerbate any illness or mental health condition. We request that you direct the Of?ce of Inspector General to examine whether US. Immigration and Customs Enforcement (ICE) Health Service Corps provided the appropriate course of care for Mariee and whether, overall, ICE can improve the level of care provided to all detainees. Furthermore, we ask that DHS utilize alternatives to detention that have been shown to be effective, less costly, and provide healthier settings for children and families. Thank you for your attention to this matter. We remain very concerned about the treatment of migrants, especially children, in detention and hope that you will work swiftly to investigate gaps in medical care and employ alternatives to detention. Sincerely, . aquin Castro Michelle Luj an Gri sham CHC First Vice Chair CHC Chair 4 5 1 $06! 1 Ruben Gallego CHC Second Vice Chair Adriano Espaillat CHC Freshman Representative Member of Congress 221/1 Filemon Vela Member of Congress amt; race F. Napolitano Member of Congress MDug? Nanette Diaz Barr??m Member of Congress ma?a Huis Correa Member of Congress QM Pete Aguilar Member of Congress Member of Congress ?w?vao Ben Ray Lujiin Member 1" Congress Darren Soto Member of Congress al 0. rbaj a Member of Congress Ny 1a M. Velazquez Member of Congress