Border officials did not follow guidelines on migrant children’s health care, government investigators find

U.S. Customs and Border Protection has not consistently followed new guidelines for medical care of migrant children and spent some of the agency’s money designated for “medical care” on unrelated items like printers, speakers and its canine program, according to a new federal investigation.

The U.S. Government Accountability Office, an independent “congressional watchdog,” found gaps in care across border facilities. Border officials also chose to go against a recommendation from the U.S. Centers for Disease Control and Prevention to give the flu vaccine to children who crossed the border into the United States.

The GAO released the findings Wednesday, as members of the U.S. House Homeland Security Committee held a hearing as part of an ongoing investigation of Customs and Border Protection (CBP) policies in light of the deaths of two children at the border in December 2018.

The children, 8-year-old Felipe Alonzo-Gomez and 7-year-old Jakelin Caal, were both Guatemalan and died in different CBP holding facilities in New Mexico and Texas.

“The simple reality is that children shouldn’t be locked up by our government,” U.S. Rep. Val Demings of Florida said in an email. “This administration’s anti-immigrant hysteria has led to deeply inhumane treatment of asylum seekers and others who are seeking legal status here in the United States.”

Demings, who is under consideration to be the vice presidential candidate for presumptive Democratic nominee Joe Biden, is a member of the committee but did not question witnesses at the hearing.

U.S. Rep. Debbie Lesko, an Arizona Republican who sits on the committee, called the children’s deaths tragic but said the federal government isn’t necessarily at fault. “We should start blaming the cartels, don’t you think, and they should be at least partially accountable for children’s death,” she said at the hearing.

Pennsylvania Sen. Bob Casey, a Democrat, asked the GAO to look into the matter in the wake of reports showing what he called an “appalling disregard for the lives of migrant children” at the border. He tweeted Wednesday that the funding for the U.S. Homeland Security Department — which oversees CBP — must carry “clear directives and restrictions to ensure transparency and accountability.”

The Inspector General of the Homeland Security Department released its own findings Wednesday that both children died of natural causes related to the flu and bacterial infections. The Inspector General found there was no misconduct or malfeasance from border patrol agents.

But Dr. Fiona Danaher, a pediatrician who Democrats asked to review the records, said the agency needs more policies in place to protect children.

“Death by natural causes does not mean death was inevitable,” said Danaher, an instructor of pediatrics at Harvard Medical School.

Democratic lawmakers grilled witnesses from the GAO and Inspector General’s office on whether CBP equips its agents to identify when a child might need further medical help.

“CBP did not provide officers and agents with training to identify medical distress in children, is that correct?” Rep. Cedric Richmond, a Democrat from New Orleans and a member of the committee, asked.

The Homeland Security Department’s Inspector General, Joseph Cuffari, said agents are trained in basic first aid, CPR and trauma care. They had no pediatric training.

Tennessee Republican Rep. Mark Green, a physician, said putting more medical staff at the border may be an unreasonable ask in a country already facing a shortage of doctors in rural areas.

“Where in the world are we going to get the doctors to put somebody at every single crossing?” Green asked.

Richmond opened his remarks with criticism of that perspective.

“It is a proverbial Trumpism, pitting communities against each other. I guess that is where we are going in terms of access to doctors. I just won’t entertain it,” Richmond said. “We are the greatest country in the world.”

Gaps in care

The deaths happened in the midst of a surge at the border that backed up the immigration system last year. Read more

Fauci warns reopening too soon could cause ‘suffering and death’

Dr. Anthony Fauci testified remotely Tuesday. Photo credit: U.S. Senate Committee on Health, Education, Labor & Pensions

WASHINGTON — A top Trump administration health official warned U.S. senators Tuesday that reopening the economy too quickly could cause suffering, death and an even longer economic setback.

Dr. Anthony Fauci, the head of the National Institute of Allergy and Infectious Diseases at the National Institutes of Health, told lawmakers there could be a surge of COVID-19 cases if states, cities and regions disregard the government’s “checkpoints” on when and how to pull back from mitigation measures.

“If that occurs, there is a real risk that you will trigger an outbreak that you might not be able to control, which, in fact, paradoxically, will set you back, not only leading to some suffering and death that could be avoided, but could even set you back on the road to trying to get economic recovery,” said Fauci.

“We would almost turn the clock back, rather than going forward.”

His statements came at a highly anticipated hearing before the Senate Health, Education, Labor and Pensions Committee. He last testified before the panel March 3, before President Donald Trump declared a national emergency over the novel coronavirus.

The unprecedented hearing included remote testimony from Fauci and the other witnesses, including representatives from the U.S. Department of Health and Human Services, the Centers for Disease Control and Prevention, and the Food and Drug Administration.

About half of the senators were in the hearing room — spaced 6 feet apart at an extended dais that took the whole room, where spectators would usually sit. Some senators wore masks but removed them for questioning. Other senators dialed in from their homes.

Senator Richard Burr listens to Tuesday’s testimony, waiting his turn to ask questions.

Overall, Fauci said that some parts of the country are seeing spikes in infection, while the curve looks flat or is trending downward in other areas.

“I think we are going in the right direction, but the right direction does not mean we have, by any means total control of this outbreak,” Fauci said.

His remarks were markedly more guarded than the more optimistic portrait Trump outlined in remarks at a White House briefing Monday.

Trump said the number of coronavirus cases were going down “almost everywhere,” even though many states show a steady number of new cases. An internal report obtained by NBC shows cases spiking in some communities.

“We have met the moment and we have prevailed,” Trump told reporters at a White House briefing Monday, with tables displaying testing and treatment materials on either side of his podium. “Americans do whatever it takes to find solutions, pioneer breakthroughs, and harness the energies we need to achieve total victory.”

‘Cautiously optimistic’ on vaccine

Fauci gave a guarded but optimistic update on the development of a vaccine for COVID-19. The process is moving faster than on any other vaccine in history, and there are at least eight vaccines in various stages of development. Researchers may know if they are successful as early as late fall or early winter. Read more

NC’s Josh Stein among nation’s AGs to tell Trump: Put the brakes on new regulations

NC Attorney General Josh Stein

WASHINGTON — North Carolina Attorney General Josh Stein and 20 other attorneys general from across the country are pressing the Trump administration to freeze pending regulations so officials can focus on the response to the COVID-19 pandemic.

The attorneys general sent a letter Tuesday to the White House Office of Management and Budget requesting that the administration cease other regulations and focus only on those related to the pandemic.

“The need to prioritize regulations responsive to the COVID-19 pandemic should be self-evident,” the letter states.

The move for a regulatory freeze comes as President Donald Trump pushes to overhaul some significant federal regulations. For instance, the Trump administration finalized new rules Tuesday that will markedly weaken fuel-efficiency standards over the next six years, a rollback of a major Obama-era climate policy.

The new auto emissions standards are just one of the regulatory rollbacks in the works that analysts expected to see this spring.

Other pending regulatory proposals include a rule that would relax standards on mercury emissions, a plan that would limit the scientific studies used to underpin U.S. EPA rules, restrictions on food stamps under the Supplemental Nutrition Assistance Program and a controversial change to how sexual assault charges are handled at schools.

In the past three weeks, the EPA has finalized at least three other regulatory rollbacks, according to tracking from the Brookings Institution. EPA streamlined pre-construction air quality approvals in tribal areas. The agency also revised Clean Air Act requirements for refrigerants. And the EPA instituted a temporary policy suspending enforcement of some environmental rules in response to COVID-19.

‘Daily life … has been upended’

Proposals for new federal regulations undergo a formalized public input process with certain deadlines.

But the attorneys general said responding to these proposals and implementing final rules is increasingly difficult as society focuses on the pandemic.

“While the federal government is mobilizing, state and local governments across the country have been wholly dedicated to responding to the emergency and combating the spread of this deadly virus, and daily life in our communities has been upended by the need to maintain social distancing,” the letter states.

For regulations that are unrelated to the virus, the AGs asked the government to extend comment periods and reopen those that had already closed.

They join a growing chorus of officials and advocates asking the government to pause some regulations.  The Independent Community Banking Association sent a letter to federal agencies Monday asking them to delay all non-COVID-19 related financial rules by at least 180 days.

The group, which represents small community banks across the country, said the virus and its mitigation efforts are taking a toll on its members. They specifically asked federal regulators to freeze six different financial rules, half of which have public comment deadlines in the next two weeks.

Earlier in March, Sen. Sherrod Brown (D-Ohio), the top Democrat on the Senate Banking Committee, said comment periods closing after March 1 should be suspended or extended.

And a  group of 170 public interest, labor and environmental organizations also asked the White House to slow down the regulatory process. The groups — including Public Citizen, Center for American Progress, Center for Progressive Reform, Southern Poverty Law Center, and Amnesty International USA — sent a letter to the White House OMB in March asking to hold the public comment period open for non-emergency rules.

‘One area they are not shutting down’

The federal government has altered some operations in response to the unprecedented challenge of the COVID-19 virus.

Federal workers have been instructed to work from home, if possible. Agencies have lengthened some deadlines. EPA has waived some of its environmental reviews. But much of the agency’s work on new regulations goes on.

“I think it is becoming more and more conspicuous that this administration is basically shutting a lot of agency actions and work down, but the one area they are not shutting down at all is where there is a deregulatory impact,” said Amit Narang, regulatory policy advocate for Public Citizen.

The new auto emissions standards that the Trump administration finalized this week roll back what had been a major climate policy for the Obama administration. The Obama rules sought to make noticeable cuts to emissions from the transportation sector, the largest source of climate-warming greenhouse gases in the United States.

The Trump rule will increase stringency of carbon dioxide emissions standards for automakers by 1.5 percent per year through vehicle model year 2026. That’s weaker than Obama’s standards, which required a 5 percent annual increase over that time. The Trump team said those rules would be too expensive for automakers and consumers.

“We are delivering on President Trump’s promise to correct the current fuel economy and greenhouse gas emission standards,” EPA administrator Andrew Wheeler said in announcing the rules.

Wheeler said the new rules would “strike the right regulatory balance that protects our environment, and sets reasonable targets for the auto industry.”

Consumer watchdog organizations and environmental groups say the standards will lead to more polluted air and cost consumers more in the long run at the gas pump.

‘Attacking the public safeguards’ 

“It is wildly inappropriate to do this stuff now; there is a sense of attacking the public safeguards while people are distracted,” said James Goodwin, who tracks regulations for the Center for Progressive Reform.

Goodwin said the EPA rules are particularly problematic because of the missed opportunity to reduce air pollution, which would be a societal benefit as the nation grapples with widespread respiratory illness.

“One of the most important things we can be doing right now is reducing our air pollution. It is up there with building ventilators,” Goodwin said. “But what you see the administration doing right now is quite the opposite. These rollbacks make pollution worse.”

To put these rulemakings out “is functionally equivalent to rounding up spare ventilators and dumping them in the ocean,” he added.

Trump took office with a promise to undo much of what President Barack Obama had put in place. The administration is pushing to get many of these regulations in place by mid-May, to make it harder to reverse the rules if Democrats gain more control after the 2020 election.

A 1996 law called the Congressional Review Act allows Congress to overturn recently completed regulations from the executive branch. Under the act, lawmakers can review rules that have taken effect in the last 60 working days of the congressional calendar.

With a majority vote, they can pass a “joint resolution of disapproval” to nullify a rule and prohibit the federal government from issuing a “substantially similar” one in the future.

Republicans broadly used the Congressional Review Act in 2017, wiping out 16 Obama-era rules on issues from labor and finance to surface-mining, according to an analysis from the Center for Progressive Reform. Before then, Congress had only used it to eliminate one rule: a regulation on ergonomics from President Bill Clinton that was thrown out after President George W. Bush took office.

Federal government sends conflicting messages on safety of national parks during health crisis

The lighthouse at Cape Lookout National Seashore – Image: National Park Service

WASHINGTON — The Trump administration is urging Americans to head to national parks as the COVID-19 pandemic continues to spread. 

Many people are heading outdoors to seek a reprieve from being cooped up at home. But in many locations, some fear that the sudden influx of visitors to national parks could put those parks and the public’s health at risk.

And the situation could soon be changing. The New York Times reported late yesterday that three of the nation’s busiest national parks — Yellowstone, Grand Teton and the Great Smoky Mountains (which straddles the North Carolina-Tennessee border) — have closed. Other national parks in North Carolina have closed visitor centers and, in some instances, campgrounds, but have kept other areas, like hiking trails, open.

Despite the precautions parks are taking, there’s been increased concern about park visitors’ health after Interior Secretary David Bernhardt last week announced that the government would temporarily suspend collection of entrance fees at its 419 parks and heritage sites. 

“I’ve directed the National Park Service to waive entrance fees at parks that remain open,” Bernhardt said in a statement. “This small step makes it a little easier for the American public to enjoy the outdoors in our incredible National Parks.”

Some are warning that the announcement was irresponsible, both for the parks and public health.

“Our national parks are spaces that often provide an escape from everyday life. They can be places of peace and sanctuary. And under normal circumstances, we would certainly support sending more Americans to visit our national parks,” said Phil Francis, chairman of the Coalition to Protect America’s National Parks, which represents over 1,700 current, former and retired park employees.

“But these are not normal circumstances. We should not be encouraging more visitation to our national parks. It is irresponsible to urge people to visit national park sites when gathering at other public spaces is no longer considered safe.” Read more

State health experts ask Congress for help combating opioid crisis

WASHINGTON — North Carolina and other states need sustained, flexible federal funding to support programs working to reduce deaths and addiction from opioids and other drugs, state health officials told Congress today.

Public health officials asked lawmakers for continued commitment to Medicaid and programs that help states address drug addiction problems. A panel of the U.S. House Energy and Commerce Committee held a hearing on the issue.

“Moving an entire system of care is a monumental task. We’re working diligently and we’ve made staggering progress, but please don’t give up,” Jennifer Smith, secretary for the Pennsylvania Department of Drug and Alcohol Programs, told lawmakers. “It depends on sustained funding and support.”

States, particularly North Carolina, have been trying to respond to a growing problem of addiction and overdose to opioids and other drugs. From 1999 to 2017, nearly 400,000 people across the United States died from opioid overdoses, according to the Centers for Disease Control and Prevention.

Federal lawmakers passed a collection of bipartisan bills in 2018 aimed at fighting the crisis. The legislation provided states billions of dollars in federal funding to assist with response, treatment and recovery.  

State public health officials from Pennsylvania, Massachusetts, Rhode Island and West Virginia also credited Medicaid expansion in their states for giving them the ability to pay to treat many of those who face addiction.

Rep. Diane DeGette (D-Colo.), who chaired the hearing, said states are now facing a “fourth wave” of the opioid crisis: a large increase in methamphetamine use.  

“In 2018, there were more than twice as many deaths involving meth as 2015, and meth is increasingly turning up in overdose deaths and drug busts across the country,” DeGette said. 

“Given the complexity of the epidemic and its ability to evolve, states, federal government agencies and Congress must remain vigilant.”

“This is not a crisis that we can resolve overnight, and it requires ongoing federal and state attention,” said Energy and Commerce Committee Chairman Frank Pallone (D-N.J.). “States are on the front lines of this national emergency, providing much of the support for those in need.  They are our eyes and ears on what is occurring on the ground, and that’s why this hearing is so important.”

Over the past two decades, North Carolina has had 12,000 deaths due to opioid overdose, according to the North Carolina Department of Health and Human Services (DHHS).  In 2016, North Carolina was in the top eight states for fentanyl overdose deaths alone.

“North Carolina was hard hit by the opioid crisis. The consequences have been large, and far reaching,” said Kody Kinsley, a DHHS deputy secretary.

In 2016, 1,407 people died in North Carolina due to unintended overdoses. For each death, there were six more hospitalizations, Kinsley said. But in 2018, North Carolina saw its first decline in deaths in five years. 

“The most significant thing you can do would be to give us more time. Sustaining funding over longer windows of time or permanently would allow states to be ready for the next wave of the epidemic,” Kinsley said. 

Kinsley asked for lawmakers to increase the substance abuse and treatment block grants, which have stayed constant for North Carolina even though the population is growing. 

Kinsley said an even bigger boost would be for North Carolina lawmakers to expand Medicaid. More than half of the people who come to North Carolina hospitals with an overdose are uninsured, so much of the extra federal funding for opioids in North Carolina goes directly to their treatment. North Carolina provided treatment to 12,000 uninsured persons with the federal programs.

But that also means that money is not available to start new programs like other states that rely on Medicaid to treat their patients, like Pennsylvania and Rhode Island.

“At present, more than two-thirds of our federal opioid response grants are just going for treatment and expanding care for those that are uninsured,” Kinsley said. “So we do not have those dollars available to expand workforce and treatment.”

Read more