TIM KAINE \wasuneTow oF: im) mane save Senvcts Wnited States Senate CcoMmirTee ON WASHINGTON, DC 20510-4807 FOREIGN RELATIONS Ccommirree ON ‘THE BUDGET Ccommirree oN HEALTH, EDUCATION, LABOR, [AND PENSIONS. ‘August 29, 2019 ‘The Honorable Kevin K, McAleenan Acting Secretary U.S. Department of Homeland Security Washington, DC 20528 Dear Acting Secretary Mcaleenan: I write in regard to press reports this week that the U.S. Citizenship and Immigration Services (USCIS) has sent letters to immigrants with serious medical conditions indicating that the agency will no longer consider most deferrals of deportation and that such decisions will now be made by the U.S. Immigration and Customs Enforcement (ICE).! This shift in policy for “medical deferred action,” if true, is alarming and cruel, as it could result in de facto death sentences for immigrants with extreme medical need who require treatments that are unavailable or inadequate in their country of origin. Many cases of extreme medical need reportedly include patients or guardians of patients with ailments such as cancer, eystic fibrosis, HIV, cerebral palsy, muscular dystrophy, and epilepsy. With these concerns in mind, please provide answers to the following questions: 1. Under what authority is the Department of Homeland Security (DHS) transferring the decision-making power for medical deferred action from the USCIS to ICE? Has DHS issued a formal announcement of this transfer of power? Is ICE now the sole arbiter of requests for medical deferred action requests? How many medical deferred action requests has DHS received? How many have been accepted? How many have been denied? ‘What medical standards or evaluation criteria are being used by USCIS or ICE to make medical deferred action decisions? 6. Do concems about medical treatment options or capabilities in an immigrant’s country of origin affect decisions on medical deferred action? 7. What guidance, if any, is provided to USCIS and ICE officials in making determinations concerning medical deferred actions? 8. Who, if anyone, monitors USCIS and ICE compliance with protocols to identify serious ‘medical conditions and whether an immigrant’s country of origin is capable of providing similarly effective treatment? SER ‘hetps:/ www. wbur org/news/2019/08/26/medical-deferment-immigration-program-endedMercy, compassion, and humanitarianism are core American values, and they are entirely consistent with proper enforcement of our nation’s immigration laws. ‘Thank you for your prompt attention to these matters. Sincerely, —) United States Senator