Urgent Call for Action as Protections for Migrant Children Near Expiration Deadline

As the Biden administration's court-ordered protections for migrant children in custody approach their expiration date, concerns are mounting about the potential deterioration of health and safety standards for vulnerable minors. The settlement, established in 2022 after the tragic deaths of several children in custody, set forth specific requirements aimed at ensuring the well-being of minors detained at Customs and Border Protection (CBP) facilities along the southern border. With the agreement concluding just nine days after Donald Trump’s anticipated inauguration—a period marked by a pledge to ramp up deportations—advocates fear that the gains made over the past two years may quickly unravel. The legal settlement mandated critical improvements in conditions for children detained in the Rio Grande Valley and El Paso sectors, including access to emergency medical care, basic hygiene supplies, and prohibitions against prolonged separation from parents. A key element of the reforms was the appointment of an independent juvenile care monitor—a pediatrician tasked with regularly assessing the living conditions of minors and advising on best practices for care. Despite some progress, reports from the pediatrician monitor highlighted ongoing deficiencies. Marsha Griffin, a pediatrician active in the region, expressed alarm that the expiration of these protections could lead to a reversion to less humane practices. “This is a law enforcement agency with a law enforcement mentality, tasked with running a trauma-informed daycare center,” she stated, calling for continued oversight to ensure the well-being of these vulnerable children. CBP representatives have pointed to the extensive measures taken in recent years to enhance support for those in custody, including trauma-informed training for staff and improved integration of pediatricians into medical care frameworks. However, critics argue that the absence of independent monitoring could lead to a decline in standards. Mishan Wroe, a senior attorney at the National Center for Youth Law, voiced concerns about the implications of losing the monitor role, emphasizing that ongoing scrutiny has been crucial for safeguarding the rights and welfare of detained children. Historically, the U.S. border apprehension system was designed primarily for adult men seeking work, but the increasing number of family units and unaccompanied minors has revealed significant gaps in its capacity to adequately address the needs of children. The 1997 Flores settlement established the minimum standards of care for detained minors, but the details outlined in the 2022 settlement were essential for ensuring compliance and accountability. Dr. Paul Wise, who served as the juvenile care monitor, noted that while improvements have been made, maintaining these advancements is a significant challenge. He expressed concern over the system’s capacity to handle health crises, citing a tragic incident in which an 8-year-old girl died while in custody—a situation attributed to "catastrophically inadequate" medical protocols. Dr. Wise and other health professionals have consistently warned that these lapses are systemic and require urgent reform to prevent further harm to children. In light of the upcoming expiration of the agreement, pediatricians and legal advocates are calling for a more sustainable and child-centric approach to the care of migrant minors—a system that extends beyond the tenure of any administration and ensures consistent oversight and accountability. As the clock ticks down to the expiration of the settlement, the future of health protections for migrant children remains uncertain. With key monitoring roles potentially disappearing, experts fear that the strides made in recent years may soon be lost, leaving children in a precarious situation. “If the monitoring role goes away, all hell breaks loose,” cautioned Dr. Jeffrey L. Goldhagen, emphasizing that without vigilant oversight, the system risks reverting to its previous, less humane state. The urgency of the situation underscores a pressing need for systemic reform that prioritizes the well-being of the youngest and most vulnerable among us.