Chairman thompson the committee is meeting today to receive testimony on children in cbp custody, examining death, medical care procedures and improper spending. Without objection, the chair is authorized to declare the committee in recess at any point. The committee is convening today to examine three critical, related, and deeply troubling issues. The terrible deaths of Young Children in the custody of customs and Border Protection, cbps failure to consistently implement the revised medical screening procedures it adopted after children died in its custody, and cbps improper expenditure of emergency funding appropriated by congress for the care of migrants. In december 2018, two children died in cbp custody. A sevenyearold girl named jakelin and an 8yearold boy named felipe. Last year, another three children died in cbp custody or shortly after being released. On january 4, 2019, i sent a letter to the department of Homeland Security requesting documents related to the deaths in 2018. After the department failed to produce all documents responsive to the committees request, in november 2019, the committee issued a narrowly tailored subpoena by voice vote for many of the documents originally requested in my letter ten months prior. In december 2019, the dhs Inspector Generals Office publicly issued two onepage summaries of its investigations into the deaths that had occurred a year earlier. Unfortunately, the Inspector Generals investigations left us with more questions than answers. Earlier this year, i sent a letter to Inspector General cuffari detailing the concerns we identified with the reports. My entire letter is available on the committees website. Among the concerns i raised were the following the Inspector Generals reports and public summaries proclaim that there was no malfeasance or misconduct by dhs personnel. It is unclear why that standard was used because there do not appear to have been any allegations of malfeasance or misconduct on the part of agents. In fact, all Available Evidence indicates that Border Patrol agents showed great compassion for both children. However, the Inspector Generals reports appear to presume that since its investigations found no malfeasance or misconduct, thats the end of the story. The reports fail to examine the many troubling questions that these deaths raise regarding cbps ability to care for children in custody, including questions about the adequacy of the agencys policies, procedures, and training. Further, while the Inspector Generals Office certainly conducted many interviews, it appears that key documents and evidence were not collected and reviewed. My letter also identified omissions in the public summary of one of the Inspector Generals reports that were so severe as to render the summary inaccurate and potentially misleading. The Inspector General revised the public summary after receiving my letter. Over the past 6 months, dhs has produced some documents in response to the committees subpoena, but these productions are clearly incomplete. For example, the Inspector Generals reports reference documents that have never been provided to the committee. Dhs has also made extensive and improper redactions in the documents it has produced. Through its refusal to comply fully with the committees subpoena and through its many redactions, the department is intentionally impeding the committees investigation. Despite these hurdles, the committee has worked to advance our investigation. To help with that effort, we asked a pediatrician and a medical examiner to conduct independent examinations of the two deaths that occurred in december 2018. We will receive their testimony today. Today, the Government Accountability office is also releasing a report we requested. It examines both cbps use of emergency funding appropriated to care for migrants as well as its implementation of the new medical screening procedures it announced after the deaths in 2018. Gaos report finds that after cbp claimed it urgently needed emergency funding to provide care for migrants taken into custody, the agency misspent money it received. The Border Patrol agents who cared for felipe while he was in custody had to pay for medicine for him out of their own pockets. But cbp used some of the emergency funding that congress appropriated for the specific purpose of paying for medical care to instead buy jet skis and dirt bikes and even dog food. There is something seriously wrong with this picture, just as there is something seriously wrong with this administrations approach to caring for migrants, including children. I note that gaos report also finds that although cbp adopted new policies governing medical assessments for children following the tragic deaths of the two children in late 2018, cbp did not consistently implement these policies. We welcome dr. Fiona danaher and dr. Roger mitchell before the committee, as well as rebecca gambler from gao. And i am glad that after initially refusing to do so, the Inspector General has agreed to testify before the committee, so that we can explore the many questions we have regarding the work of the Inspector Generals Office. We also invited cbps acting director, mark morgan, to testify. In a letter to the committee, he stated that because of the white houses baseless rules prohibiting administration witnesses from attending virtual hearings, he could not appear. As i close, let me say i fully recognize the sensitivities of the issues we are discussing. I encourage all members to be very careful and thoughtful in how we approach this subject. That said, it is clear that this administration will do everything it can to avoid oversight. Therefore, we must continue to do everything we can to hold this administration accountable. Given the 18 months of obstruction we have endured as we have sought documents and information about the deaths of children in custody, as well as issues like the administrations child separation policy, i see no other way to advance our investigation and to identify changes needed in cbps policies and procedures than to convene todays hearing. Before i recognize the Ranking Member, i will read statements from the fathers of the two children who died in cbp custody in 2018. Mr. Cruz, the father of jakelin, provided the following statement. Id like to say what i have always believed. It is better to check on all children when they are sick and even when they are not sick. Speak up and Say Something even when you are afraid. The most important thing is to check on the children so the thing that happened to my daughter does not happen to anyone ever again. I offer my thanks to the committee for taking the time to look into my daughters case and i am very grateful to you all. The father of felipe stated, i want justice. I want to know why my son did not receive medical care in time. I do not want other children to go through the same thing. This is painful for me today and it will be painful for the rest of my life. Every night i ask myself why my son did not receive medical attention in time. Felipes treatment was inhumane. I ask unanimous consent to submit their letter to the record. The chair recognizes the Ranking Member of the full committee, the gentleman from alabama for an opening statement. Mr. Rogers thank you mr. Chairman, can you hear me . Chairman thompson yes. Mr. Rogers i appreciate you holding this hearing and granting our request. I am saddened by the loss of felipe and jakelin. They died in the custody of cbp or shortly after entering custody which is unacceptable. The department has taken steps to improve migrant care but it is up to congress to address the root cause of the problem. That can only happen in a bipartisan manner. We must fix immigration loopholes and we must provide adequate resources to both cdp and ice. We must not encourage illegal immigration. We must disrupt the cartels and human smuggling partners and i hope we never have to hear of another tragedy at the borders like what happened with these three minors. Mr. Chairman, i am disappointed at the events leading up to this hearing. The acting commissioner should be here so the committee can directly hear from him. It is important we understand what happened and what cbp has done since the deaths. The majority did invite the acting commissioner. Omb has provided guidance to officials forbidding them to participate in remote hearings. They are permitted to appear in person. The acting commissioner did before the senate committee. I asked unanimous consent to insert into that record commissioner morgans response to the invitation. In that letter, morgan request to appear before the committee with omb guidance. If we want productive hearings, i would suggest to the majority that we find time to hear from him in the next two weeks when we are in d. C getting to the bottom of those two deaths is something that this committee has worked together on. We voted unanimously to subpeona the department on information related to the deaths of felipe and jakelin. It appears the majority received information from the university of Mexico Office of medical investigations. It appears the majority did not share this information with witnesses here today and who knows who else but were informing the minority of its existence. One witness claims to have received the information on june 30. The minority got it on july 12. It is disappointing to partner with you on things like this less than a week before the hearing. I am alarmed by the autopsy information the majority requested. I do not see any reason why this committee or any committee of congress would need human tissue samples from a deceased eightyearold boy. Im concerned the majority has been requesting and sharing with witnesses these autopsy specimens to place blame on the men and women of Border Patrol. If that is true, it is deplorable. The ig found no misconduct or nonfeasance in any of the actions of dhs or its employees surrounding these deaths. I understand that answer does not provide political satisfaction, but those are the facts. If the majority requested and shared human tissue samples of a deceased child to advance a political narrative, it would mark an appalling new low for this committee, i hope this is not the case. We have to remember that for Months Congress refused to address the border crisis that precipitated these deaths. Record numbers of families and children crossed our borders last year. Groups of hundreds to thousands of migrants came across at once. Migrants traveled over 2000 miles at the whims of the cartels and human smugglers to get to our border. Many told of abuse, assault and worse of the journey to our border. Food, nutrition, access to medicine was not adequate if at all provided. As a result many arrived in , extremely poor health. At the height of the crisis, Border Patrol spent over half their time transporting migrants to hospitals. For months last year the majority refused to acknowledge the problem, going as far as to call it a manufactured crisis. Even after the children died, the majority insisted there was no crisis. At one point the majority response to the border crisis was to send 316 tweets, 11 press releases, and hearings. None of which solved anything. After denying it, majority admitted there was a crisis, a supplemental approach bill was brought forward to the house. That bill had so many poison pills attached the senate had to strip them out before it could head to the border. That bill was at best a stopgap measure. The committee concluded that until Congress Takes action to address the root cause of the crisis, it is only a matter of time before another occurs. I hope we can get off of the political messaging game and work to fix this immigration loophole that encourages parents to send their children on a dangerous and deadly trek to our border. Thank you, mr. Chairman. I yield back. Chairman thompson thank you very much. Other members of the committee are reminded that Opening Statements may be submitted for the record. Members are reminded that the committee will operate according to the guidelines laid out by myself and the Ranking Member in our july 8 colloquy. I now welcome our witnesses. Our first witness is dr. Fiona danaher, a pediatrician at massachusetts general hospital, Chelsea Healthcare Center and a member of the Child Protection team. She is also an instructor in pediatrics at harvard medical school. She is a graduate of Mount Sinai School of medicine. Our second witness is dr. Roger mitchell junior, a chief medical examiner for washington d. C. Dr. Mitchell junior is boardcertified in forensic pathology by the american board of pathology and a fellow in the National Association of medical examiners. He began the study of Forensic Science as a forensic biologist at the federal bureau of investigation in 1997. Dr. Mitchell is a graduate of the new Jersey Medical school. Our third witness is the honorable joseph cuffari. He was confirmed as the Inspector General of the department of Homeland Security in 2019. He previously served as the policy advisor for military and veteran affairs for the governors of arizona. He also served more than 40 years in the u. S. Air force. He earned a phd in management in 2002. Our final witness is ms. Rebecca gambler, a director in the Government Accountability office Homeland Security injustice team. She joined in 2002 and currently leads the agencys work on border security, immigration and election issues. Without objection, the full statement will be inserted in the record. I asked each witness to summarize his or her statement for five minutes beginning with dr. Danaher. Dr. Danaher good morning. Chairman thompson and members of the committee, thank you for the opportunity to testify today. I am dr. Fiona danaher, a pediatrician at massachusetts general hospital. Much of my work focuses on children. It is a privilege to participate in this committees efforts. As you know in 2018 [indiscernible] jakelin at age seven died from septic shock because it went untreated over many hours cascaded into multiple organ failure. Felipe, age eight, died from untreated influenza complicate it by preliminary hemorrhage in the context of bacterial pneumonia and sepsis. Their deaths as well as those of four other children in government custody between september 2018 and may 2019 underscore the deficiencies in an immigration system poorly designed to protect vulnerable children. The available records make clear that they both suffered terrifying and painful deaths that could have been prevented by access to pediatric medical care. In both cases medical examiners determined the children died of Natural Causes and it was concluded that there was no misconduct by dhs personnel. Death by Natural Causes does not mean death was inevitable. Lack of misconduct or even the efforts went to in assisting the children does not absolve cbp as an agency of perpetuating the systems that place children at risk of medical neglect. Cbp responded to the deaths by issuing an enhanced medical directive in 2019 to ensure that all children under 18 would be interviewed while in custody. The final enhanced support effort issued by cbp in december 2019 removed the safeguards instituted under the guidance, weakening it so much that it is unlikely its provisions would have prevented their death. Children are not adults. Their physiological resilience can mask severe disease from those untrained to recognize it. Any period of detention is inherently unhealthy for longterm physical and emotional development. Substandard conditions put childrens lives at risk. If children are to be detained, it is incumbent upon the agency that it strengthen medical infrastructure. Their deaths illustrate the need for cbp to eliminate bureaucratic hurdles that unnecessarily prolong detention and delay access to medical care. They highlight the urgency of addressing dentention conditions that promote distress. Children in detention need timely access to comprehensive medical treatment in their native language conducted by clinicians and pediatric experts followed by referral. Those diagnosed with illness or underlying medical conditions [indiscernible] which are fundamentally unequipped to provide obligations or cooperation. All Foreign Operating bases should be stocked with basic medical equipment and their staff trained in its use. They must implement the recommendations for the prevention of influenza and covid19 in the facilities. Independent oversight of the quality medical care needs to occur regularly. The oig indicated in its report that it does not possess the medical expertise. Given the current epidemic, time is of the essence. Action must be taken so that other children do not meet the painful and preventable fate while in custody of the United States government. Thank you and i look forward to taking your questions. Chairman thompson thank you for your testimony. I recognize dr. Mitchell to summarize his statement for five minutes. Dr. Mitchell good afternoon, chairman thompson and Ranking Member rogers and members of the committee of Homeland Security. I am dr. Roger mitchell junior and i currently serve as the chief medical examiner of washington, d. C. It brings me no pleasure to testify today on these deaths, but