August 20, 2019
The Honorable Joseph V. Cuffari, PhD
Department of Homeland Security
245 Murray Lane SW
Washington, DC 20528-0305
Dear Dr. Cuffari,
On behalf of the Academy of Nutrition and Dietetics, we are following up on previous communications to the Department of Homeland Security1,2,3 to restate our concerns about the nation’s immigration and border detainment policies and their long-term impacts on the mental and physical well-being of individuals being detained. Representing more than 107,000 registered dietitian nutritionists, nutrition and dietetic technicians, registered, and advanced- degree nutritionists, the Academy is the largest association of food and nutrition professionals in the United States and is committed to accelerating improvements in global health and well-being through food and nutrition.
The Academy is specifically concerned about 1) access to adequate, appropriate food and nutrition at U.S. Customs and Border Protection detention facilities; 2) inadequate nutrition and food safety standards for the food provided at these facilities; 3) CBP’s failure to comply with their own standards; and 4) the lack of transparency regarding these issues.
It is clear from the July 2, 2019, report Management Alert–DHS Needs to Address Dangerous Overcrowding and Prolonged Detention of Children and Adults in the Rio Grande Valley4 and a review of the CBP National Standards of Transport, Escort, Detention, and Search5 that CBP is failing to meet either its own standards or minimally adequate general nutrition policies with respect to food provided in CBP detention facilities. The findings in the published report—which align with multiple news reports6,7,8,9 and observations by members of Congress110—describe in part the food and nutrition practices at CBP detention facilities.
Your report spurred additional questions among our members for which we seek clarification and answers. We respectfully request additional information regarding the oversight and compliance of relevant food and nutrition TEDS standards at CBP detention facilities. We recognize some of these questions may require further investigation by your office but expect that other answers may be immediately available based on the inspections of border facilities already conducted.
1. Meal Service for Adults and Children
Institutional food service guidelines in the U.S. typically require compliance with national dietary guidelines such as the U.S. Dietary Guidelines or Dietary Reference Intake levels. As examples, Immigration and Customs Enforcement requires adherence to the Recommended Dietary Allowances in their detention facilities,11 and the National School Lunch Program and other USDA meal programs are based on the U.S. Dietary Guidelines.12 TEDS standards do not have similar requirements, but there should be transparency on how meals served at CBP facilities compare to national dietary guidance or to the standards in place at ICE facilities, prisons, or schools.
We ask for disclosure of any information collected or observations during the recent inspections on other aspects of meal preparation and service at CBP facilities. We request that your office confirm that:
- Established menus that outline meal content are in use and the macro and micronutrient content of meals including added sugars and the variety of foods being served
- There is continual access to clean drinking water and cups for both adults and children
- Food safety and handling guidelines are both posted and followed in facilities
- Detainees are provided access to handwashing stations for use before mealtimes and supervision is provided to ensure proper hygiene is being practiced by unaccompanied children
- Meals and snacks are served in locations other than holding or sleeping rooms that include tables and chairs
2. Infant and Toddler Feeding Practices
Infants and toddlers have unique nutritional needs. The TEDS standards require that food served be appropriate for at-risk detainees' age and capabilities. We were pleased to read in the report that all inspected facilities had infant formula in stock; however, the use of safe storage and preparation methods was unclear. There was also no mention in the report as to whether nursing mothers and their infants were being kept together as required by TEDS standards or whether infants otherwise had access to their mothers' breastmilk.
- Substantiation of compliance with the requirement for age and developmentally appropriate foods
- Clarification if infant formula is being stored, prepared and provided according to FDA food safety guidelines and the products' instructions13,14
- Confirmation that if formula is served in reusable bottles, that the bottles are being properly sterilized between uses
- Given current policies on family separations, whether CBP officials are complying with the non-separation policy and how this compliance is being documented
3. Special Health Care Needs
TEDS standards require that detainees be screened to determine if they may be considered an at- risk detainee due to age, disability status, circumstances such as pregnancy or lactation, or medical conditions that require life-sustaining treatment.
- Description of processes being used to screen for food allergies and how these needs are being accommodated
- Clarification regarding whether and how the health status of children with special health care needs is being monitored by appropriately trained professionals
- Confirmation that children with special needs and unaccompanied children are being monitored for adequate hydration, appetite and food intake, or weight loss
Oversight and Compliance
1. Compliance with TEDS Standards
As noted in the report, some CBP facilities are failing to comply with the existing TEDS standards. The report also questioned whether religious or other dietary restrictions were being followed.
- Clarification regarding which federal office is tasked with ensuring routine compliance with standards and oversight of the facilities and why such management had not occurred in the facilities inspected
- Insight regarding whether CBP officials were aware of their duty to "remain cognizant" of dietary restrictions and how they were interpreting that duty
2. Use of Private Contractors
The report noted that some facilities were in the process of obtaining contracts for hot meals. We are concerned about the oversight of meals served by contract companies given the limited and poorly followed food and nutrition TEDS standards.
- Clarification regarding whether food service contracts are the typical way that CBP detention facilities provide meals and snacks, or whether only the provision of hot meals is outsourced
- Disclosure of which CBP facilities have contracted food and beverage services, or have pending contracts and the identities of such companies
- Description of requirements provided to contractors regarding the quality, quantity, safety and nutrient contents of the meals they are providing, and whether these companies are required to have qualified nutrition professionals, such as Registered Dietitian Nutritionists, overseeing menus
- Identification of which CBP office is responsible for ensuring that food services contractors are complying with all relevant standards
3. Use of Officials' Personal Funds
We have heard unofficial reports of CBP officials using their private funds and non-approved credit cards to buy food for detainees.
- Whether your office has investigated similar reports
- The propriety of such actions
Thank you for the work that your office has already done and continues to do on this critical issue. We agree with the call to action to address the urgent problems identified in the management alert and would like to offer our professional partnership and collaboration to assist your office in further reporting on the food and nutrition practices at CBP detention facilities.
We request a meeting with OIG leadership to discuss your findings in this area, whether and when you plan to conduct a follow-up investigation into this issue, and how we could be of assistance for future investigations to ensure that all detainees are receiving adequate nutrition in accordance with federal standards.
Hannah Martin, MPH, RDN
Legislative and Government Affairs
Academy of Nutrition and Dietetics
Pepin Tuma, JD
Government and Regulatory Affairs
Academy of Nutrition and Dietetics
Jeanne Blankenship, MS, RDN
Policy Initiatives and Advocacy
Academy of Nutrition and Dietetics
1 Mary Russell. 2018, June 22. Academy Letter Urges DHS to Ensure Well-Being of Children and Families Affected by Immigration Policy. eatrightPRO. Accessed July 11, 2019.
2 Jeanne Blankenship, Pepin Tuma. 2018, November 6. Academy Comments to DHS and HHS re: Proposed Rule re: Apprehension, Processing, Care, and Custody of Alien Minors and Unaccompanied Alien Children. eatrightPRO. Accessed July 11, 2019.
3 Terri Raymond. 2019, July 30. Academy Urges Department of Homeland Security to Improve Nutrition at Border Facilities. eatrightPRO. Accessed July 30, 2019.
4 Office of Inspector General, Department of Homeland Security. 2019, July 2. Management Alert – DHS Needs to Address Dangerous Overcrowding and Prolonged Detention of Children and Adults in the Rio Grande Valley. DHS Office of Inspector General: OIG-19-51. Accessed July 11, 2019.
5 U.S. Customs and Border Protection. 2015, October. National Standards on Transport, Escort, Detention, and Search. U.S. Customs and Border Protection. Accessed July 22, 2019.
6 Scott Neuman. 2018, July 18. Migrants Allege They Were Subjected To Dirty Detention Facilities, Bad Food And Water. NPR. Accessed July 23, 2019.
7 Patricia Hurtado. 2018, July 24. Migrant children detail rough detention conditions as judge weighs monitoring. Virginia-Pilot. Accessed July 23, 2019.
8 Danyelle Khmara. 2018, July 19. 'Ice Box' Detention Facilities May Violate Flores Settlement. Tucson Weekly. Accessed July 23, 2019.
9 Obed Manuel. 2019, July 24. No shower for 23 days: U.S. citizen says conditions were so bad that he almost self-deported. Dallas News. Accessed July 25, 2019.
10 Betsy Klein, Caroline Kelly. 2019, July 13.'They have not washed in 40 days': House Democrats decry ‘inhumane’ conditions at Texas border facilities. CNN. Accessed July 25, 2019.
11 U.S. Immigration and Customs Enforcement. 2011. 2011 Operations Manual ICE Performance- Based National Detention Standards. Section 4.1 Food Service. U.S. Immigration and Customs Enforcement. Accessed July 15, 2019.
12 Healthy, Hunger-Free Kids Act of 2010, § Sec. 208. Nutrition Standards for all Foods Sold in School (2010).
13 Howard Seltzer. 2012, October 26. Keeping Infant formula Safe. Foodsafety.gov. Accessed August 14, 2019.
14 Food and Drug Administration. 2014, June 9. FDA Takes Final Step on Infant Formula Protections. FDA.gov. Accessed August 14, 2019.