A New Office Seeks to Improve the Health and Wellness of DHS Employees and Detainees

The Homeland Security Department announced on Tuesday that it is creating a new office to supervise and coordinate health care for both its own workforce and those in its care, saying the streamlined approach would lead to better outcomes for both groups. 

DHS has at times struggled to provide care across the far-reaching corners under its purview, but the department said its new Office of Health Security would create a new organizational structure that will better serve all of its constituents. The office will focus on improving work-life balance and wellness in its 230,000-person workforce, as well as medical care for immigrants and others that come into its custody. It will also help the department fulfill its mission in preparing for terrorist attacks and natural disasters, officials said. 

“Over the past several years, Americans have faced a series of unprecedented challenges impacting their health security, from the pandemic to natural disasters and more,” said DHS Secretary Alejandro Mayorkas. “Our department must be prepared to adapt to an ever-expanding, dynamic, and complex public health threat landscape. The Office of Health Security will lead our efforts to meet that charge.”

DHS Chief Medical Officer Pritesh Ghandi will lead the office, bringing the department's medical, workforce health and safety and public health functions all under one roof. The office will aim to increase standardization and accountability, while boosting emergency preparedness and response. Gandhi said the reorganization would ensure health care voices in the department are elevated within its structure.

“We will focus on promoting a healthier and safer workforce, supporting appropriate and timely medical care for those in our care and custody, ensuring a robust health security posture, and being a strong partner and advocate with and for our interagency and community partners.”

Prior to their release or transfer into the custody of Immigrations and Customs Enforcement or another agency, immigrants detained at the border typically spend 48-72 hours in facilities maintained by Customs and Border Protection. CBP is responsible for providing medical care and other services during this time. The agency has come under fire in recent years after several children died while in its custody. In its most recent update on immigrant processing data, CBP said it continues to encounter unusually high numbers of migrants at the border and warned that its workload was particularly elevated as traffickers disregard the health and safety of those they transport.

“We continue to rescue and provide medical assistance to those who are in distress,” CBP said.

Just earlier this month, DHS said its Border Patrol Agents, facing allegations of improper treatment toward immigrants crossing from Mexico into Texas, worked with partners to provide “food, hygiene supplies, COVID-19 testing, and medical care to address the humanitarian needs” of 30,000 migrants in a several-day period. The DHS inspector general has identified several detention facilities with dilapidated facilities that have failed to provide adequate health care to detainees. In one infamous case, a surprise inspection revealed an ICE detention center maintained by the GEO Group had many cells containing nooses fashioned from sheets in a facility with a history of suicides and limited access to medical care. 

Earlier this year, DHS announced it was surging employees to the border to handle the higher number of immigrants and in anticipation of the administration ending a pandemic-era policy that limited opportunities for migrants to seek asylum. Among those employees, it said, were medical professionals to care for both those in its custody and its own workforce. The resources, applied with assistance throughout the department as well as partners at the departments of Defense and and Health and Human Services, were expected to be sufficient to provide urgent and specialty care for an unprecedented level of immigration. 

DHS’ medical mission has taken on additional responsibilities as CBP and ICE have engaged in testing of those entering the country, as well as offering them vaccines. The department also launched a program to vaccinate its own workforce, partnering with the Veterans Affairs Department to inoculate 58,000 workers. The IG identified several lessons for DHS, including pre-establishing a staffing plan for emergencies and providing more consistent guidance to its components and workforce.

DHS said it drew from those lessons, and others learned throughout the pandemic and the recent significant increases in unaccompanied children and other migrants arriving at the border, in conceptualizing its new health office. It added that it worked closely with Congress in standing up the office and will work with key lawmakers to pass legislation to permanently authorize it. DHS did not respond to an inquiry into how the office would be funded or if the office would receive a boost of resources.