It wasn't exactly a war zone. But when the Obama administration needed to rapidly set up a full-fledged medical operation at a Homestead center for unaccompanied migrant children, it turned to a private contractor whose prior experience included providing critical medical services at one of the largest US military bases in Iraq.
Today, the Homestead shelter is housing children who have been separated from their families. Kenneth Wolfe, a spokesman for Health and Human Services (HHS), told El Nuevo Herald that 391 girls and 801 boys were housed there, for a total of 1,192 children.
The federal government has signed contracts for more than $2 billion to shelter unaccompanied immigrant children since fiscal 2015. While many of the children's shelters around the country are being run by nonprofit agencies, a handful of for-profit companies have also earned contracts. Cape Canaveral-based Comprehensive Health Services Inc. is one of them.
"During the last part of the Obama administration, they thought to make use of contractors' capacity in a time of need to rapidly expand capacity," said Mark Greenberg, former head of the Administration of Children and Families at the Department of Health and Human Services. He currently serves as a senior fellow at the Migration Policy Institute.
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"When there had been sudden increases in the number of arriving unaccompanied children, and we had been dependent on existing grantees, there was a strong interest in trying to expand potential service providers for program," he said.
In 2015, Comprehensive Health received a contract worth up to $388 million to provide staffing, medical support and medical equipment at "temporary shelters housing children who had entered the U.S. unaccompanied by a parent or legal guardian." The contract made Comprehensive Health the largest private contractor providing emergency and other relief services, according to independent site GovTribe, which tracks federal government contracts.
The following year, an 800-bed temporary shelter was set up for unaccompanied minor immigrants near the Homestead Air Force Base.
Earlier this year, the Trump administration quietly reopened the Homestead facility after it was closed in 2017. The government turned to Comprehensive Health to resume operations, awarding it a new contract worth up to $50.7 million. In May, the administration bumped its initial order of 500 beds to 1,000; on June 26, it exercised a $9 million option to keep the facility running.
A spokesperson for Comprehensive Health declined to comment. On June 25, Comprehensive Health confirmed in a Tweet that it is providing "high quality medical services and humanitarian care to support the immigrant children who enter the shelters."
In May, California-based for-profit Brookstone Emergency Services, also known as American Canyon Solutions, received a contract worth up to 13.2 million to help run the Homestead facility. Brookstone has received contracts of at least $210 million since fiscal 2015 to provide "emergency and other relief services," the most common type of category the government is using when awarding unaccompanied immigrants services contracts.
Other for-profit providers include General Dynamics, best known as a defense contractor. Since fiscal 2015 it has received contracts worth up to almost $40 million to provide "infrastructure" and "case coordination."
Details about these contracts — including the exact nature of the services provided — were not immediately available. The Office of Refugee Resettlement says its contracts and grants are awarded competitively.
The government also awards grants to nonprofits as part of a specific "unaccompanied alien children program," created during the Bush Administration.
So far, the grants have been much more valuable than the contracts.
Among nonprofits, Southwest Key Programs in Texas has been awarded more than $1 billion for its unaccompanied children's shelters since 2015. San Antonio-based BCFS has been awarded more than $800 million.
Among both private and nonprofit organizations, no Florida group has received more money to service unaccompanied migrant children than Comprehensive Health. Founded in 1975, it specializes in jobsite medical testing, but also handles medical responses during extreme events like hurricanes, wars or terrorist attacks, according to its website. The company was active in the wake of Sept. 11 and hurricanes Katrina and Rita, it says online.
The majority of its federal contracts — more than 235 — have been for medical employment screenings, such as drug tests, for public and private organizations, according to GovTribe records, which date the company's federal awards back to 1983. Since 2011, it has received multiple contracts worth more than $400 million to provide medical care at U.S. military bases in Iraq via a subsidiary, according to USASpending.gov, a federal government website.
In 2016, Comprehensive Health moved its headquarters to Florida from Virginia after receiving $600,000 in state incentives from Tallahassee. The move was slated to create 150 new jobs and boost the Cape Canaveral region by $4.5 million. The company currently has more than 2,000 employees worldwide.
Comprehensive Health has not been politically active, with no political action committees in its name, according to OpenSecrets, a nonprofit site that tracks money in politics. Federal Election Commission records show only small donations of less than $5,000 from company officers and employees.
According to Comprehensive Health's website, the firm generates more than $100 million in revenues. Its current president, Gary G. Palmer, has been with the company for 14 years. Previously, he worked with Lockheed Martin in a business development unit across a range of sectors that included military products. In November, the company formed a Department of Defense subcommittee with the goal of winning more contracts from military contracts.
The company has not gone without legal troubles.
In 2012, the Miami Herald reported, an Arkansas man and woman sued a subsidiary of Comprehensive Health, claiming they'd been fired by the company after complaining of "substandard care" at Iraq's Sather Air Force Base, now known as Baghdad Diplomatic Support Hospital. In their lawsuit, the two claimed a man died after a "critical care practitioner" botched the insertion of a breathing tube. The lawsuit was later settled.
In February 2017, the company paid a settlement of more than $3 million for knowingly double-billing the government after a whistle-blower flagged the incident, according to then-U.S. Attorney Rod Rosenstein. The company has said the double-billing was accidental.
The Miami Herald reported in June that an individual then facing drug charges was working at the Homestead facility caring for children. Comprehensive Health has declined to say whether he is or was an employee. And last fall, a former Homestead facility worker was charged with soliciting a minor. When asked whether that individual was employed by Comprehensive Health, a representative for the Department of Health and Human Service's Office of the Inspector General declined to comment.
LARGEST PRIVATE COMPANIES
Largest prime award contracts to private companies by the Department of Health and Human Services for emergency and other relief services, the category associated with servicing unaccompanied immigrant minors, since fiscal 2015
1) Comprehensive Health Services, Cape Canaveral, FL: $266 million
2) Brookstone Emergency Services (American Canyon Solutions), Murrieta, CA: $211 million
3) General Dynamics, West Falls Church, VA: $14 million
4) Dynamic Service Solutions, Oxon Hill, MD: $1.6 million
5) Dynamic Educational Systems, Phoenix, AZ: $939,000
Largest prime award grants to nonprofit companies for services associated with the Unaccompanied Alien Children Program, since fiscal 2015
1) Southwest Key Programs, Inc.:, Austin, TX $1.5 billion
2) BCFS Health and Human Services, San Antonio, TX: $884 million
3) International Educational Services, Los Fresnos, TX: $288 million
4) Heartland Human Care Services, Chicago, IL: $153 million
5) Cayuga Centers (Cayuga Home for Children), Auburn, NY: $115 million