The DHS Office of Inspector General issued a management alert to advise the Department of Homeland Security and U.S. Customs and Border Protection (CBP) of the urgency and short timeframe to award a new medical services contract to support operations on the Southwest border.
During OIG’s review of CBP’s Use of FY 2019 Humanitarian Funds and ongoing audit of CBP’s Policies and Procedures for Detained Migrants Experiencing Serious Medical Conditions, OIG learned that CBP’s current contract for medical services will expire on September 29, 2020. As of September 3, 2020, CBP had not issued a solicitation for a new contract.
This leaves fewer than 30 days for the necessary funding and contracting reviews and approvals before CBP can make the award. A lapse in this contract could jeopardize the health and safety of migrants in CBP custody, as well as that of U.S. Border Patrol agents, CBP officers, and staff, especially during the current pandemic, OIG said.
In 2015, CBP awarded Loyal Source Government Services (LSGS) a blanket purchase agreement to provide onsite medical services, initially for migrants in CBP custody in the Rio Grande Valley Sector. The agreement included the base year with four options to extend performance to 2020. LSGS provides health interviews, medical evaluations, screening, triage, limited treatment for low complexity medical complaints by migrants, and the ability to refer individuals to the local health system.
In 2018, CBP expanded the blanket purchase agreement to have LSGS provide medical personnel to additional locations along the Southwest border during the migrant surge. As of July 2020, LSGS reported it provided CBP an average of 440 medical professionals in a 24-hour period at 67 stations and ports of entry along the Southwest border. LSGS maintained an average of 800 professionals in a month to meet its contractual requirements to expand. Locations without contracted support rely on CBP officers, Border Patrol agents, or local healthcare providers to conduct medical health interviews.
During two ongoing reviews, OIG learned that CBP was in its last option period for the 2015 LSGS blanket purchase agreement. CBP had the option to extend its agreement by 6 months, notifying LSGS of its intent to do so by August 30, 2020, or award a new contract, prior to expiration of the current agreement on September 29, 2020.
According to GAO, officer and agent medical training is generally limited to American Red Cross training on how to perform cardiopulmonary resuscitation (CPR) and First Aid Kit training related to agent and officer self-care and combat medicine. In July 2020, Border Patrol staff expressed concerns to OIG about the status and consequences of not having a medical contract, noting that CBP could not risk deaths in custody again. A CBP contracting officer shared similar concerns with us. Additionally, in November 2019, OIG completed two investigations into the deaths of two migrant children in CBP custody, which prompted OIG’s congressionally requested audit. Migrant deaths in custody have also prompted congressional investigations, as well as two congressional hearings.
A lapse in onsite medical services at CBP facilities could jeopardize the health and safety of migrants in CBP custody, who may already be at higher risk of more severe illness from COVID-19. Further, a gap in medical services during the COVID-19 pandemic and at the start of the 2020-2021 flu season presents a heightened public health risk for migrants in CBP custody, as well as CBP officers, agents, and staff.
OIG has significant concerns about the compressed timeframe CBP has to award a new bridge contract, without all the benefits of full and open competition, for medical services. Accordingly, DHS and CBP should dedicate all available resources to ensure continuity of CBP’s onsite medical services, as well as comprehensive, timely, and fully communicated planning and implementation of future medical services contracts, said OIG.