Unaccompanied Children: HHS Can Take Further Actions to Monitor Their Care
Released: 2016-02-22T00:00:00


Highlights: section_title: Why GAO Did This Study
paragraphs: ORR is responsible for coordinating and implementing the care and placement of unaccompanied children. The number of children placed in ORR's care rose from nearly 6,600 in fiscal year 2011 to nearly 57,500 in fiscal year 2014. GAO was asked to review how ORR managed their care.

This report examines (1) ORR's response to the increase in unaccompanied children, (2) how ORR cares for children in its custody and monitors their care, (3) how ORR identifies and screens sponsors for children, and (4) what is known about services children receive after they leave ORR custody. GAO reviewed relevant federal laws and regulations, ORR policies, and ORR and Executive Office for Immigration Review data. GAO also visited nine ORR grantee facilities in three states selected to vary in the type of care provided, shelter size, and location, and conducted a random, non-generalizable case file review of 27 case files of children released from these facilities. GAO interviewed agency officials and community stakeholders in six counties that received unaccompanied children, representing diversity in geographic location, size, and demographics.

section_title: What GAO Found
paragraphs: In fiscal year 2014, nearly 57,500 children traveling without their parents or guardians (referred to as unaccompanied children) were apprehended by federal immigration officers and transferred to the care of the Department of Health and Human Services' Office of Refugee Resettlement (ORR). Most of these children were from Central America. GAO found that ORR was initially unprepared to care for that many children; however, the agency increased its bed capacity to accommodate up to 10,000 children at a time. Given the unprecedented demand for capacity in 2014, ORR developed a plan to help prepare it to meet fiscal year 2015 needs. The number of children needing ORR's care declined significantly through most of fiscal year 2015, but began increasing again toward the end of the summer. Given the inherent uncertainties associated with planning for capacity needs, ORR's lack of a process for annually updating and documenting its plan inhibits its ability to balance preparations for anticipated needs while minimizing excess capacity.

ORR relies on grantees to provide care for unaccompanied children, including housing and educational, medical, and therapeutic services. GAO's review of a sample of children's case files found that they often did not contain required documents, making it difficult to verify that all required services were provided. ORR revised its on-site monitoring program in 2014 to ensure better coverage of grantees. However, ORR was not able to complete all the visits it planned for fiscal years 2014 and 2015, citing lack of resources. By not monitoring its grantees consistently, ORR may not be able to identify areas where children's care is not provided in accordance with ORR policies and the agreements with grantees.

ORR grantees conduct various background checks on potential sponsors prior to releasing children to them. These potential sponsors are identified and screened by the grantees as part of their responsibilities for the unaccompanied children in their care. The extent of the checks conducted depends on the relationship of the sponsor to the child. Between January 2014 and April 2015, ORR released about 50,000 children from Central America to sponsors to await their immigration hearings. In nearly 90 percent of these cases, the sponsors were a parent or other close relative already residing in the United States. Sponsors do not need to have legal U.S. residency status.

There is limited information available on post-release services provided to children after they leave ORR care. In part, this is because ORR is only required to provide services to a small percentage of children, such as those who were victims of trafficking. In May 2015, ORR established a National Call Center to assist children who may be facing placement disruptions, making post-release services available to some of them. Also, in August 2015, ORR began requiring well-being follow-up calls to all children 30 days after their release. ORR is collecting information through these new initiatives, but does not currently have a process to ensure that the data are reliable, systematically collected, or compiled in summary form. Service providers GAO spoke with also noted that some of these children may have difficultly accessing services due to the lack of bilingual services in the community, lack of health insurance, or other barriers.

section_title: What GAO Recommends
paragraphs: GAO recommends that HHS (1) develop a process to regularly update its capacity plan, (2) improve its monitoring of grantees, and (3) develop processes to ensure its post-release activities provide reliable and useful summary data. HHS agreed with GAO's recommendations.

section_title: Letter
paragraphs: The number of unaccompanied children apprehended by Department of  Homeland Security (DHS) officials and subsequently placed in the care of  the Department of Health and Human Services’ (HHS) Office of Refugee  Resettlement (ORR) increased from nearly 6,600 in fiscal year 2011 to  nearly 57,500 in fiscal year 2014, the highest number of children on  record. In particular, the number of unaccompanied children from three  Central American countries—El Salvador, Guatemala, and Honduras— has increased dramatically. Many traveled hundreds or thousands of  miles under dangerous conditions, such as atop trains or on foot through  deserts, to reach the U.S. border. Once transferred into ORR custody,  they are placed in shelters or foster care homes, operated by ORR  grantees until they can be matched with sponsors, for example, parents  or other family members who reside in the United States, to await  immigration hearings, referred to herein as removal proceedings.

The rapid increase in children entering ORR care from 2011 through 2014  has at times strained ORR’s capacity to find shelter beds and raised  questions about ORR’s management of its program for unaccompanied  children. There are reports that the increase has also created challenges  for the communities in which these children are eventually placed. You  asked us to review ORR’s response to the increasing number of  unaccompanied children. This report addresses the following questions:  (1) how ORR has responded to the increased number of unaccompanied  children, (2) how these children are cared for while in ORR custody and  how ORR monitors their care, (3) how ORR identifies and screens  sponsors before children are transferred to their care, and (4) what is  known about services, challenges, and the status of removal proceedings  for children after they leave ORR custody?

To address these questions, we reviewed relevant federal laws and  regulations, annual reports to Congress, budget justifications, and other  ORR policy documents. In addition, we interviewed ORR and HHS  officials. To address how ORR responded to the increased number of  unaccompanied children, we reviewed ORR’s funding opportunity  announcements and relevant planning documents. We also reviewed a  plan that was developed by an interagency group, called the Unified  Coordination Group, led by DHS’s Federal Emergency Management  Agency and established to coordinate the federal response to the  increase of unaccompanied children apprehended at the southwest  border. To gather information about how children were cared for while in  ORR custody, we analyzed information from ORR’s web-based portal, a  database that contains intake, placement, and sponsor information, as  well as individual service plans for these children. We analyzed  information for children admitted to and discharged from ORR’s care  between January 7, 2014, when ORR began using the portal, and April  17, 2015. To assess the reliability of these data, we reviewed the data for  erroneous dates, reviewed ORR business rules to ensure data reliability,  and interviewed ORR officials and contractors knowledgeable about the  data. We determined that the data were sufficiently reliable for the  purposes of this report. We also visited nine ORR facilities in three  states—New York, Texas, and Virginia—to observe areas where children  are housed and receive educational, medical, and recreational services,  and while at these sites we interviewed ORR grantee staff. These states  were selected for variation in the types of care provided by ORR  grantees, shelter size, and location. Additionally, we reviewed a  nongeneralizable random sample of 27 case files of children released in  fiscal year 2014 or 2015 from the nine shelters we visited.

To assess ORR’s monitoring of its grantees, we reviewed ORR and  grantee documents, including monitoring schedules and reports. We also  discussed monitoring with grantees’ staff during site visits. Lastly, to learn  what is known about these children once they leave ORR’s custody, we  conducted phone interviews with individuals representing local entities  such as school districts and human services agencies and organizations  in six counties where 50 or more children have been released to sponsors  in fiscal year 2014. The counties include Fairfax County, Virginia; Harris  County, Texas; Nobles County, Minnesota; Pulaski County, Arkansas;  San Mateo County, California; and Scott County, Mississippi. These  counties were selected to represent a diversity of size, geographic  location, and demographics. Additionally, we analyzed Department of  Justice’s (DOJ) Executive Office for Immigration Review (EOIR) data and  interviewed relevant officials from that office as well. To assess the  reliability of EOIR data we reviewed related documentation and  interviewed officials knowledgeable about the data. We also spoke with  DHS officials. DHS’s U.S. Immigration and Customs Enforcement (ICE)  and U.S. Citizenship and Immigration Services (USCIS) responded to  written questions regarding the reliability of their data. We found these  data to be sufficiently reliable for our purposes. See appendix I for  additional information on our scope and methodology.

We conducted this performance audit from October 2014 to February  2016 in accordance with generally accepted government auditing  standards. Those standards require that we plan and perform the audit to  obtain sufficient, appropriate evidence to provide a reasonable basis for  our findings and conclusions based on our audit objectives. We believe  that the evidence obtained provides a reasonable basis for our findings  and conclusions based on our audit objectives.
subsections: section_title: Background
subsections: section_title: Increased Apprehensions
paragraphs: In recent years there has been a significant increase in apprehensions of  unaccompanied children from El Salvador, Guatemala, and Honduras  (see table 1). We previously reported that children from El Salvador,  Guatemala, and Honduras often leave their home country due to crime,  violence, and lack of economic opportunity, among other reasons. In  particular, the decision to migrate to the United States is also influenced  by a desire for family reunification, educational opportunities, perception  of U.S. immigration policy, and the role of smuggling networks that  encourage migration. Historically, most unaccompanied children have  been adolescents 14 to 17 years of age, with males representing a higher  percentage of the children; however, the population is diverse and  includes children of all ages, as well as pregnant and parenting teens.

section_title: ORR’s Responsibility for Children
paragraphs: Under the William Wilberforce Trafficking Victims Protection  Reauthorization Act of 2008 (Trafficking Victims Protection  Reauthorization Act), except in the case of exceptional circumstances,  unaccompanied children in the custody of any federal department or  agency, including DHS, must be transferred to ORR within 72 hours after  determining that they are unaccompanied children. The Homeland  Security Act of 2002 gives ORR responsibility for coordinating and  implementing the care and placement of unaccompanied children— individuals younger than 18 years old with no lawful immigration status  and no parent or legal guardian in the United States available to provide  care and physical custody. While these children may have parents or  guardians already in the United States, if the parent or guardian is unable  to provide immediate care, the children are considered unaccompanied.  The children remain in the custody of the federal government throughout  their stay in ORR care, but are in the physical custody of ORR residential  care providers (see fig. 1). ORR solicits residential care providers,  referred to as grantees in this report, through funding opportunity  announcements, and funds these grantees through 3-year cooperative  agreements. When making funding decisions, ORR evaluates  applications against a set of established criteria. The grantees are  private nonprofit and for-profit organizations and must be licensed by a  state licensing agency to provide residential, group, or foster care  services for dependent children, for example, in a shelter setting.

The aim of shelter care is to provide the least restrictive environment  commensurate with the safety, emotional, and physical needs of the child.  In keeping with the 1997 Flores v. Reno Settlement Agreement (Flores  Agreement), which articulates a number of broad principles and policies  applicable to the detention of unaccompanied children, grantees are  required to provide proper physical care and shelter for children that ORR  has interpreted to include suitable living accommodations (e.g., bed,  chair, desk, storage for clothing and other personal items), culturally  appropriate meals and snacks, several sets of new clothing, and personal  grooming items. The facilities where children are housed are required  by ORR to have designated common areas, including space for  education, recreation, and case management as well as space to hold  confidential services, such as health services and counseling. The  primary settings in which children receive care include:

Shelters. These residential facilities are operated by state-licensed  ORR grantees aiming to provide the least restrictive shelter  environment based on the safety, emotional, and physical needs of  the child. The majority of children going through ORR are placed in  shelter care.

Foster care. Transitional foster care is short term care that is designed  for children under the age of 13, sibling groups with one sibling under  the age of 13, pregnant and parenting teens, and children with special  needs. Long-term foster care is designed for children who ORR  expects to be eligible for immigration relief and who are expected to  have an extended stay within the ORR system, for example trafficking  victims or orphaned children. Therapeutic foster care is for  unaccompanied children whose exceptional needs cannot be met in  regular family foster care homes and consists of intensive supportive and  clinical services in the homes of specially trained foster parents. Foster  family homes must be licensed according to their state’s licensing  regulations. Foster care placements are the least restrictive  placement option in the ORR continuum.

Staff-secure shelters. These facilities maintain a heightened level of  security measures within a licensed shelter care context. The  population is primarily made up of children with an offender history,  but does not typically include children with serious offenses, a violent  or assaulting history, or serious sex offenders. Service provision is  to be tailored to address the individual needs and underlying behavior  and reasons for such a placement.

Secure shelters. These are ORR’s most restrictive residential settings.

These facilities are designed for a child who requires very close  supervision and may need the additional internal controls and physical  structure of a secure facility. This secure population is primarily made  up of children with a serious offender history; children who are serious  escape risks; children who have attempted to escape or escaped from  a staff-secure care provider; or children who have been severely  disruptive in a staff-secure setting. A secure facility may be a licensed  juvenile detention center or a highly structured therapeutic facility.

Residential treatment centers. These facilities are considered  therapeutic placements for children diagnosed with a mental health  disorder by a psychiatrist or psychologist. These centers provide  services in a highly structured clinical program and have the ability to  provide services to children with various diagnoses, such as bipolar,  depressive, and conduct disorders.

Group home. A group home specializes in caring for specific populations  (e.g., teen mothers). A group home is run by 24-hour staff or house  parent and typically houses 4 to 12 unaccompanied children. Extended  care group homes are for children who may be in ORR custody for an  extended period.

In addition to caring for the children, ORR’s grantees assess the  suitability of potential sponsors—generally parents or other relatives in  the country who can care for the child after they leave ORR custody. This  assessment includes background checks, and in some cases, conducting  home studies when there are questions about the ability of the sponsors  to meet the needs of a child and provide a safe environment. In cases  in which a child is considered to have mental health or other needs that  could benefit from ongoing assistance from a social welfare agency, ORR  may arrange for post-release services. Additionally, in cases in which a  favorable home study was conducted, post-release services are  automatically provided. Post-release service providers refer sponsors and  children to community resources, such as legal, psycho-social, or  educational services. Children released to sponsors may attend public  schools and use other services they are eligible for, such as health care  provided by state or local agencies or nonprofit organizations in the  communities in which they reside. Release to a sponsor does not grant  legal immigration status to these children.

Children are scheduled for removal proceedings in EOIR immigration  courts to determine whether they will be ordered to be removed from the  United States or granted immigration relief. ORR requires sponsors to  ensure that children attend their removal proceedings. Immigration  judges, who are located in courts around the country, hear children’s  cases and make determinations regarding whether they should be  ordered removed from the United States or granted legal immigration  status. Children who wish to apply for asylum or Special Immigrant  Juvenile (SIJ) status do so through DHS’s USCIS. USCIS has initial  jurisdiction over all asylum applications filed by unaccompanied children,  including those in removal proceedings. If USCIS does not grant asylum,  an immigration judge considers the asylum claim anew. When applicable,  ICE is responsible for the removal and repatriation of children.

section_title: ORR Responded to the Increase in Unaccompanied Children by Expanding Its Capacity, but Has Not Yet Updated Its Plans to Meet Future Needs
subsections: section_title: ORR Expanded Capacity to Care for the Highest Number of Children on Record in 2014 and Updated Policies to Help Expedite Release of Children to Sponsors
paragraphs: In response to an increased number of referrals of unaccompanied  children from DHS in recent years, particularly in fiscal year 2014, ORR  increased its shelter capacity (the number of beds it has available) and  updated its policies and procedures to reduce the number of days  children spend in ORR custody. From fiscal years 2003 through 2011,  ORR cared for less than 10,000 unaccompanied children per year (see  fig. 2). Beginning in fiscal year 2012, the number of unaccompanied  children apprehended at the southwest border by DHS and transferred to  ORR custody rose to unprecedented levels, and peaked in fiscal year  2014 at nearly 57,500.

The vast majority (95 percent) of the children in ORR’s care from January  2014 through April 2015 were from Guatemala, Honduras, and El  Salvador according to our analysis of ORR data (see table 2). As noted  earlier, some children from contiguous countries such as Mexico who  meet certain conditions are also referred to ORR. Over half of the children  were 16 or 17 years old; the remainder were 15 and younger.

Examples of Experiences of  Unaccompanied Children  Reasons for Migration: Children in ORR care  reported a variety of reasons for traveling to  the United States. Several children reported a  desire to reunite with a parent or relative in  the United States and pursue better education  opportunities. One child reported being  threatened by a gang member who wanted to  date her, while others were being pressured  to join local gangs. Another child described  leaving his biological parents and siblings to  find work in the United States in order to send  money home to provide for his family.  The Journey: Children described diverse  experiences during their journeys to the  United States. A number of children or their  relatives paid professional smugglers or  “coyotes” to facilitate their journey to the  United States. One child described a journey  that took a month traveling by buses, a plane,  several stays in a house with other migrants  and finally a boat crossing into the United  States. Another child reported that it took  nearly 45 days to make it to the border by  bus.  Some children traveled with other relatives.  One child described traveling for 10 days with  a cousin, taking a combination of cars, buses,  taxis, walking, and swimming across the Rio  Grande together.  In some cases children faced troubling  circumstances during their journey. One girl  describes being physically assaulted by  Mexican border officials who took money and  belongings from migrants traveling from  countries outside of Mexico.

Sponsors  Shortened time frame for identifying and approving sponsors, and simplified sponsor application.

Established priority categories for approving sponsors based on relationship to child.

Streamlined procedures and simplified documentation requirements for sponsors, including elimination of fingerprinting requirement  for parents/legal guardians with no criminal or child abuse history.  Release  Reduced the maximum number of days between approval of a child’s release and actual discharge, and paid for travel of child to  sponsor, if needed, during the height of the surge.  Clarified policy to staff that optional medical services should not delay a child’s release.

Collaborated with Executive Office for Immigration Review on a pilot to expedite requests for voluntary departure; streamlining  voluntary departure process.   Internal Policies  Reduced various paperwork requirements and standardized case management forms.

Standardized mechanisms for tracking providers’ performance on release processing, for example, created tools to track timeframes  from ORR approval of release to the physical discharge of the child, by the care provider.

Revised care provider policies including child assessments, safety planning, and services mandated by Flores Settlement  Agreement.   Staffing  Expanded duties for field staff.

Provided training on sponsor identification and approval procedures to all care providers.

Additionally, ORR implemented several policy changes to address  fluctuations in the number of children in its custody. In November 2014,  ORR implemented a new policy in order to address fluctuations in its  standard capacity needs by defining a “high” season (April through July)  and a “low” season (August through March), and providing 25 percent  less funding during the low season to shelters with more than 50 beds.  Generally, this means ORR is paying less money per bed, while still  maintaining capacity in case those beds at the larger shelters are needed.  However, the fluctuations in seasons can create challenges for grantees,  according to shelter staff. For example, grantees employ and train  professional staff (such as licensed counselors) which makes it difficult for  them to downsize shelter operations during the low season while  remaining sufficiently staffed for the high season or an influx of children.

Another policy change that occurred in June 2014 decreased the number  of children staff served. The number of children per case manager  decreased from 20:1 to 8:1 and per clinician from 25:1 to 12:1.  According to ORR officials, these changes helped ensure that children  received needed services and facilitated the timely release of children.  Agency officials said that while these policy changes could improve  service provision for children and sponsors, the changes also increased  shelter staffing costs, making it more difficult for grantees to decrease  their budgets to account for the low season. Although grantees told us the  low season is used to train staff while fewer children are in care, it is  possible staff may not be fully utilized from August through March.

section_title: ORR Continues to Assess Capacity Needs
paragraphs: ORR has taken additional steps to prepare to meet ongoing and future  capacity needs by developing a framework to guide its efforts and is  continuing to participate in an interagency group created in response to  the influx of unaccompanied children.

Bed Capacity Framework—ORR developed a bed capacity framework for  fiscal year 2015 that outlines its plans to continually monitor data on the  referrals of unaccompanied children and other indicators, such as  apprehensions and releases, to help it assess its capacity needs. The  framework also includes key information ORR should have and  mechanisms that should be in place to meet its needs, such as an  inventory of available beds, timelines and decision points for determining  if and when bed capacity should be increased, and ways to operationalize  these decisions. ORR officials said that prior to 2014, ORR’s shelter  capacity was based on the number of children referred to its care in  previous years. The new capacity framework provides bed capacity  based on two possible scenarios: (1) a baseline scenario similar to fiscal  year 2014 in which about 58,000 children would be served during fiscal  year 2015, and (2) a surge scenario that can serve 104,000 children over  the fiscal year. The framework also includes three types of beds: “standard” beds, which are available year-round through the annual  grant process; “temporary” beds, which are part of the annual grant process but  provide additional capacity for a portion of the year as needed; and “surge” beds, which can be made available during surges and outside  of the annual grant process.

The Unified Coordination Group—The President established this  interagency effort, led by the DHS’s Federal Emergency Management  Agency, to enhance coordination among HHS, DHS, and other agencies  in response to the significant increase in the number of unaccompanied  children. The Unified Coordination Group issued a strategic plan in March  2015 that outlines indicators (for example, when a certain percent of ORR  beds are occupied) for determining when partnering agencies need to  meet and for deciding appropriate levels of response.

Even with these efforts in place and as we have previously reported, ORR  officials said predicting the number of unaccompanied children that will be  apprehended each year is difficult because there are many factors that  affect a child’s decision to leave his or her home country and come to the  United States. ORR officials added that determining appropriate  capacity levels for ORR shelters is challenging because the agency must  be prepared for a large increase of children without overspending on  unused beds if fewer children arrive.

In ORR’s bed capacity framework for fiscal year 2015, its baseline  scenario was informed by the 2014 influx (58,000 children annually with  the peak need of 10,600 beds). The actual number of children placed in  ORR’s care in fiscal year 2015 was over 33,700 with almost 6,000  children in ORR’s custody in September 2015 (see fig. 4). Generally,  children needing care in fiscal year 2015 numbered well below the fiscal  year 2014 baseline and below the actual number of beds available,  particularly during the “low” season months at the beginning of fiscal year  2015. As discussed earlier, ORR has reduced funding levels for some  facilities during this low time period to help manage costs and two of the  grantees we spoke with said this time was used to train employees. The  children served in fiscal year 2015 were less than one-third of ORR’s  alternative scenario of 104,000 children needing care.

The number of children in ORR’s care increased during the “high” season  in 2015 and reached more than 50 percent of ORR’s bed capacity in  June. This percentage of capacity in use—one of the indicators  developed by the Unified Coordination Group—triggered a meeting of the  group. Because fewer children were arriving than expected, officials  decided that a higher level response was not needed and ORR did not  increase shelter capacity at that time.  However, as shown in figure 4, the number of children in ORR’s care  increased in August, departing from historical trends in which August  marked the start of the “low” season. In our testimony on October 21,  2015, we provided analyses of DHS data that indicated that unlike the  prior year, apprehensions at the border in the month of August 2015  increased compared to previous months in 2015, and exceeded by nearly  50 percent August 2014 apprehensions. In mid-August 2015, ORR had  5,500 children in its care and approximately 7,800 available beds. ORR  officials told us that information it received from DHS and the Department  of State through its work with the Unified Coordination Group suggest that  the rate of referrals will remain steady or increase in fiscal year 2016. As  a result, ORR plans to increase its bed capacity to between 8,500 and  8,700 as of November 15, 2015, adding beds through its existing network  of shelter providers.

As noted above, ORR is taking several actions, including working with  related agencies, to minimize the risks of not meeting its charge of  providing care and services to unaccompanied children by ensuring it has  capacity to meet demand. At this point, given the uncertainty of the  number and timing of children’s journeys from Central America, ORR has  supported some levels of unused capacity in order to be prepared. The  bed capacity framework it developed for fiscal year 2015 included plans  and steps to manage its capacity and ORR officials said they continue to  use it as a roadmap. However, they have not updated this framework for  fiscal year 2016 and have not established a systematic approach to  update their framework on an annual basis to account for new information  so that it remains current and relevant to changing conditions. For  example, adjustments may be warranted for baseline and alternative  scenarios that influence plans for bed capacity. According to federal  standards for internal control, an agency’s processes for decision making  should be relevant to changing conditions and completely and accurately  documented.  Not having a documented and continually updated  process for capacity planning may hinder ORR’s ability to be prepared for  an increase in unaccompanied children while at the same time minimizing  excess capacity to conserve federal resources.

section_title: Grantees Provided Education, Medical, and Therapeutic Services to Unaccompanied Children in ORR Custody, but ORR’s Monitoring of Grantees Is Inconsistent
subsections: section_title: Grantees Provided Services to Children
paragraphs: ORR policy requires certain care and services be provided to  unaccompanied children while in ORR facilities (see table 4).

During our site visits to nine facilities, staff described providing services to  children that ranged from intake, orientation, and medical screening  processes, to recreational activities and supervised field trips to  museums. Staff also provided information to us about the Know Your  Rights presentations, which provide basic legal information to children,  and other legal screening services, through arrangements with various  nonprofit organizations. Staff also shared with us information about  ORR’s program to provide children with independent advocates. In  addition, we saw children’s rooms, and we observed staff distributing  clothing and personal hygiene items to children. We also visited dining  and recreational areas, health clinics where children are vaccinated and  receive medical care, and classrooms. Classrooms and course instruction  varied across the facilities that we visited. Some facilities had classrooms  dedicated to single subjects, while others taught all subjects in the same  space. In some instances, teachers from local school districts provided  on-site instruction. In other instances, grantees employed teachers. One  facility we visited bused children to a school off-site. Children placed in  transitional foster care attended school at the facility.

section_title: Grantees Did Not Always Document the Services They Provided
paragraphs: ORR requires grantees to document in case files many of the services  they provide to children and review of case files figures prominently in  ORR’s monitoring of grantees. However, we found that required  documents were often missing from the 27 randomly selected case files  that we reviewed. Facility staff must maintain numerous documents in  children’s case files to ensure that care is provided and that facilities are  in compliance with ORR policy and applicable laws, according to ORR  policy. For example, ORR’s case file checklist includes admission, legal,  and medical documents; education services, case management, clinical  services and discharge records; acknowledgement of program forms; and  significant incident reports. The checklist also includes the reunification  packet, which contains sponsor information, such as proof of  identification, including a birth certificate; proof of relationship to the child,  including the child’s birth certificate; and a completed reunification  application.

While our site visits suggest that the ORR facilities were generally  providing care to children as required by ORR policy; none of the 27 case  files we reviewed contained all of the required documents to verify the  services provided. Specifically, 14 case files were missing the Know Your  Rights legal presentation acknowledgement form, 10 were missing a  record of group counseling sessions, and 5 were missing clinical progress  notes. In addition, we identified several cases in which forms that were  present in the files were not signed or dated. Although ORR uses its web- based data system, the UAC portal, to track some information about the  services children receive, and grantees report on the services they  provide in their annual reports, the documents contained in case files are  the primary source of information about the services provided to individual  children.

ORR staff told us that some of the documents were probably not included  in the case files we reviewed for the following reasons:

Facility staff sometimes forget to place copies of acknowledgements  in case files.

Some group activities are documented through sign-in forms that may  not get placed in individual case files.

Staff may not place documents in files until cases are closed.

However, because all of the cases we reviewed were closed cases, this  explanation does not apply to the files we reviewed. ORR officials added  that missing documentation is often a routine reason for corrective action.

Without all of the documents included in the case files, it is difficult for  ORR to verify that required services were actually provided in accordance  with ORR policy and grant agreements during its monitoring visits.

section_title: ORR’s On-Site Monitoring of Facilities Is Inconsistent
paragraphs: ORR’s most comprehensive monitoring of its grantees occurs during on- site monitoring visits, however we found that on-site visits of facilities has  been inconsistent. According to ORR documents, during on-site  monitoring visits, ORR project officers spend a week at facilities touring,  reviewing children’s case files and personnel files, and interviewing  children and staff. Additionally, prior to visiting the facilities, ORR  guidance directs project officers to review quarterly reports, recent audit  reports, organization charts, grant applications and agreements, facility  leases, safety and sanitation certificates, and other items. They are also  to consult with other ORR staff who work with grantees. Also, according  to ORR, on-site monitoring typically includes a review of a random  sample of case files for children cared for at a facility. ORR officials noted  that, in addition to on-site monitoring, they monitor grantees in other  ways, such as desk monitoring where project officers, review, among  other things, significant incident, quarterly reports, and obtain feedback  from facility staff. Additionally, according to ORR officials, ORR field  staff—contract field specialists and federal field specialists—provide  oversight and work directly with facility staff. For example, field staff  provide technical assistance, attend facility staffing meetings, and advise  ORR headquarters officials on decisions involving the placement,  transfer, discharge, and special needs of unaccompanied children.

Prior to fiscal year 2014, project officers were supposed to conduct on- site monitoring of facilities at least once a year. However, our review of  data provided by the agency found that many facilities went several years  without receiving a monitoring visit. For example, ORR did not visit 15  facilities for as many as 7 years. ORR officials acknowledged that some  facilities went many years without on-site monitoring and attributed it to  lack of staff resources. The officials noted that in 2009, four project  officers were responsible for 45 facilities, as well as other tasks. By 2013,  although the number of facilities had increased, there were two project  officers responsible for on-site monitoring.

In 2014, ORR implemented a biennial on-site monitoring program, hiring  new project officers whose sole responsibility is to provide on-site  monitoring of all of its facilities. Nevertheless, ORR did not meet its goal  to visit all of its facilities by the end of fiscal year 2015. ORR officials said  they rescheduled some monitoring visits because of limited resources  and administrative challenges, such as limited travel funds. In fiscal year  2014, project officers visited 12 of 133 facilities, and by August of fiscal  year 2015, they completed 22 of 29 scheduled visits to 140 facilities. ORR  rescheduled 11 other monitoring visits from fiscal 2015 to 2016, bringing  the total number of visits scheduled for 2016 to 70. Given ORR’s recent  history, its ability to visit 70 facilities in a single year is uncertain.  According to standards for internal control, management should establish  and operate monitoring activities to monitor the internal control system  and evaluate the results. Monitoring generally should be designed to  assure that it is ongoing and occurs in the course of normal operations, is  performed continually, and is ingrained in the agency’s operations.

In addition to ORR’s scheduled onsite monitoring, officials said that  project officers occasionally visited facilities out of cycle. However, they  did not use specific criteria to determine when out-of-cycle visits were  warranted. Instead, they assessed facility risks on a case-by-case basis.  According to ORR officials, as part of ORR’s desk monitoring of facilities,  project officers looked for patterns that indicated a possible lack of  oversight by facility staff, such as an increase in significant incident  reports, and the need for a monitoring visit. Officials said that staff were  more likely to provide technical assistance or schedule a 1-day site visit,  rather than a week-long on-site monitoring visit. During fiscal year 2015,  ORR officials said that they scheduled one out-of-cycle visit after an  unaccompanied child ran away from a facility under unclear  circumstances.

Monitoring visits are intended to provide an opportunity to identify  program deficiencies or areas where programs are failing to comply with  ORR policies. For example, according to ORR site visit monitoring reports  that we reviewed, during two separate visits to one facility project officers  found that facility staff had failed to medicate children properly, including,  in one instance, accidental overdoses of medicine. At another facility,  children informed ORR staff that they were not meeting regularly with  their case managers. All of the monitoring reports that we reviewed  included findings that were gleaned from case file reviews about grantees  failing to document services. Project officers prepare monitoring reports,  citing remedial steps or corrective actions that programs must take to  comply with ORR policies. According to ORR officials, in 2014, grantees  typically implemented corrective actions within 30 days of receiving notice  of a program deficiency. Without consistently monitoring its grantees,  ORR cannot know whether they are complying with their agreements and  that children are receiving needed services.

section_title: ORR Grantees Have Identified and Screened Sponsors before Placing Children with Them
paragraphs: ORR has delegated the responsibility for identifying and screening  sponsors to its grantees. In addition to the day-to-day care that grantees  provided to children, facilities’ staff are responsible for identifying and  screening potential sponsors. During the initial intake process, case  managers ask children about potential sponsors with whom they hope to  reunite. Within 24 hours of identifying potential sponsors, case managers  are required to send them a Family Reunification Application to complete.  The application includes questions about the sponsor and other people  living in the sponsor’s home, including whether anyone in the household  has a contagious disease or criminal history. Additionally, the application  asks for information about who will care for the child if the sponsor is  required to leave the United States or becomes unable to provide care.  Sponsors also are asked to provide documents to establish their identity  and relationship to a child. The manner in which grantees screen the  sponsor varies based on the sponsor’s relationship to the child (see table  5). The Trafficking Victims Protection Reauthorization Act requires home  studies in cases in which it is determined that the child is a victim of a  trafficking; the child has a disability as defined by the Americans with  Disabilities Act; the child has been a victim of physical or sexual abuse  significantly affecting their health or welfare; or the child’s sponsor clearly  presents a risk of abuse, maltreatment, exploitation or trafficking to the  child. In addition, ORR policy requires home studies in cases where the  sponsor is a non-relative and a child is 12 years old or younger, the  individual is seeking to sponsor multiple children to whom he or she is not  related, or as required by the Trafficking Victims Protection  Reauthorization Act. ORR officials reported that 2.2 percent of released  cases received a home study in fiscal year 2014.

Table 5 identifies the types of background checks that are conducted as  part of the reunification process to help ensure the safety of the child  once released to a sponsor.

In these rare instances, children remain in ORR facilities or are placed in ORR’s long-term foster care.

Legend: ●  A full-circle indicates that the background check is required in all cases. ◑ A half-circle indicates that the background check is only required in cases in which there is a documented risk to  the safety of the unaccompanied child, the child is especially vulnerable, and/or the case is being referred for a mandatory home study.

Prior to children’s release to sponsors, sponsors sign a Sponsor Care  Agreement, which stipulates, among other things, that they will: provide for the physical and mental well-being of the child; ensure that the child appears for all removal proceedings in ensure that the child reports to ICE in the event that they are  ordered removed from the United States by an immigration judge; notify DHS of address changes; and if not the parent or legal guardian of the child, attempt to establish  legal guardianship through the local court system.

Between January 7, 2014, and April 17, 2015, ORR released 51,984  children from El Salvador, Guatemala, or Honduras to sponsors. Of these  children, nearly 60 percent were released to a parent. Fewer than 9  percent of these children were released to a non-familial sponsor, such as  a family friend, and less than 1 percent of these children were released to  a sponsor to whom their family had no previous connection (see table 6).

In fiscal year 2014, ORR released a total of 53,518 children to sponsors,  and these children were released in every state except one. The largest  number of children were placed in Texas, New York, California, Florida,  and the Washington, D.C. area, respectively, with Harris County, TX  receiving 4,028 children in fiscal year 2014, more children than any other  single county (see fig. 5). Often children were placed in counties with  large Latino populations.

section_title: Limited Information Is Available on Services Provided and Status of Children Once Released from ORR Care
subsections: section_title: ORR Continues to Serve a Small Percentage of Children After They Have Been Released, but Has Limited Contact with Most
paragraphs: The Trafficking Victims Protection Reauthorization Act requires ORR to  provide post-release services in cases in which a home study was  conducted prior to a child’s release to a sponsor, and authorizes ORR to  provide post-release services to other children, such as those with mental  health needs, who may benefit from them. These services include direct  assistance to the child and sponsor by ORR grantees in the form of  guidance to the sponsor to ensure the safest environment possible for the  child, as well as assistance accessing legal, medical, mental health, and  educational services, and initiating steps to establish guardianship if  necessary. These services can also include providing information about  resources available in the community and referrals to such resources.

According to ORR officials, a relatively small percentage of  unaccompanied children received post-release services, and ORR’s  responsibility for the other children typically ended once it transferred  custody of the children to their sponsors. According to information  provided by ORR, the number of children receiving post-release services  increased from fiscal year 2012 through fiscal year 2014, but, due to the  overall increase in the number of unaccompanied children served by  ORR, the percentage receiving these services decreased from 24 percent  to 9.5 percent over this timeframe. However, ORR officials also stated  that they had not confirmed that these data provided by grantees are  accurate. Post-release services are limited in nature and typically last  for 6 months; however, in cases in which a home study was conducted,  ORR is required to provide post-release services until the child’s  immigration case is resolved. According to ORR, in these cases, post- release services last, on average, a year to a year and a half.

Although ORR provides post-release services to a small percentage of  children after they leave its care, the office has recently taken several  steps to expand access to services to children. For example, according to  ORR officials, the agency recently expanded the eligibility criteria for post- release services to include all children released to a non-relative or  distant relative. In addition, on May 15, 2015, ORR began operating a  National Call Center help-line. Children who contact ORR’s National  Call Center within 180 days of release who have experienced or are at  risk of experiencing a placement disruption are also now eligible for post- release services according to ORR officials. In its first month of operation,  ORR officials stated that the call center received 25 calls from children  and sponsors related to placements that had been disrupted or were in  danger of becoming disrupted. Lastly, in August 2015, ORR instituted a  new policy requiring facility staff to place follow-up calls to all children and  their sponsors after the children are released. The purpose of these calls  is to determine whether the children are still living with their sponsors,  enrolled in or attending school, aware of upcoming removal proceedings,  and safe. ORR guidance requires the “Safety and Well Being” calls to  occur 30 days after the children are released from ORR care to sponsors.  Staff are required to make a “reasonable effort” to contact the children  and document the results of the call in the children’s case files. Facilities  are also required to submit a tracking report to ORR monthly to document  these follow-up calls. In cases in which additional services are needed,  the case manager will refer the child and sponsor to ORR’s National Call  Center. In cases in which the child is believed to be unsafe, ORR’s policy  requires that the case manager comply with mandatory reporting laws,  state licensing requirements, and federal laws and regulations regarding  reporting to child protective agencies and law enforcement.

ORR officials told us these policy changes were made as a result of an  overall review of ORR policies, including those related to post-release  services. These changes expand post-release services to children and  families who may need additional support, but were not assigned such  services when the child was initially placed with the sponsor.

ORR already has some information from its post-release grantees on  services provided to children after they leave ORR custody, and its newly  instituted well-being calls and National Call Center allow it to collect  additional information about these children. However, ORR does not have  processes to ensure that all of these data are reliable, systematically  collected, and compiled in summary form to provide useful information  about this population for its use and for other government agencies.  Regarding post-release services, as noted previously, ORR officials had  not confirmed that data provided on the number of children served by  their grantees were reliable and had not compiled or summarized  information on post-release services. In addition, ORR officials told us  that reports on post-release services are not currently entered in ORR’s  web-based database; although they said they had plans to incorporate  this information into the database in the future. Because post-release  information is currently stored in grantees’ individual quarterly program  performance reports, it is difficult to compile and summarize. Regarding  the National Call Center, ORR officials said they did not have a process in  place for systematically summarizing information collected from these  calls. According to ORR officials, for the National Call Center that began  operation in May 2015, ORR receives weekly and monthly reports from  the contractor operating the call center with information on calls related to  child abuse and neglect; placement disruptions; domestic violence; and  children who have run away from their sponsors. ORR officials told us  that they plan to analyze the call center data for trends, but as of October  2015, they had not yet begun to do so. Federal internal control standards  require that an agency must have relevant, reliable, and timely  information to enable it to carry out its responsibilities.

According to ORR officials, the agency is generally not required by law to  track or monitor the well-being of these children once they are released to  sponsors. However, because of its expansion of post-release services,  the new call center, and the new well-being calls, ORR will have access  to information on children’s well-being. Compiling and sharing this  information presents an opportunity that could help ORR and other  federal and state agencies better understand and respond to changing  circumstances, such as the potential involvement of unaccompanied  children with state child welfare services and emergency medical  services. Without processes to ensure that the data from its activities are  reliable, systematically collected, and compiled in summary form, ORR  may be missing an opportunity to provide useful information about this  population for the use of other government agencies.

section_title: Children Placed with Sponsors by ORR Generally Have Access to Similar Services as Other Children without Lawful Immigration Status
paragraphs: Once children are released from ORR custody to their sponsors, ORR  policy states the sponsors are responsible for providing for their physical  and mental well-being. Services available to unaccompanied children  through local service providers are typically the same as those available  to other children without lawful immigration status. For example, children  without lawful immigration status are generally not eligible for federal  benefits, such as the Supplemental Nutrition Assistance Program,  Medicaid, and Temporary Assistance for Needy Families; however they  are eligible for other federal benefits such as emergency medical  assistance. Local service providers we spoke with in six counties told us  that the children’s status would have no effect on eligibility for many of the  services they provide. For example, school districts are required to  educate students regardless of their immigration status. Similarly  unaccompanied children were not precluded from receiving services at  health clinics we spoke with.

Overall, the level of awareness about, and services available to,  unaccompanied children varied across the jurisdictions we spoke with.  For example, in two of the counties in which we conducted phone  interviews, representatives from mayors’ offices told us that they were  unaware that unaccompanied children were living in their city or had  limited knowledge about the issue. However, in another jurisdiction we  visited, the mayor’s office had established a working group related to  unaccompanied children that included representatives from several city  departments and nonprofits. In this city, representatives from the health  and education departments regularly attended immigration court to  screen and enroll children in the state’s Children’s Health Insurance  Program and to help with school enrollment.

In some locations, non-profit organizations work specifically with  unaccompanied children, providing legal, medical, or other services. In  one community, we spoke with a staff member at a nonprofit organization  that provides services to unaccompanied children from Central America,  such as case management, individual and family counseling, support  group services, and educational services. This organization also has  other programs that serve unaccompanied children, along with other at- risk children, that focus on gang prevention and intervention services.  Program staff told us they receive the bulk of their referrals from gang  prevention coordinators and school social workers, but also receive  referrals from courts, mental health counselors, and parents. Program  staff told us the program is “overwhelmed” by the number of recently  immigrated youth referred to it. Unaccompanied children may also receive  some services through local or national nonprofit organizations that other  children without lawful immigration status do not. For example, services  provided through post-release service grants with ORR or by legal service  organizations under DOJ’s Executive Office for Immigration Review’s  (EOIR) Legal Orientation Program for Custodians of Unaccompanied  Alien Children.

Local service providers we spoke with expressed concerns that  unaccompanied children might have unmet needs or face barriers to  receiving some necessary services. For example, representatives we  spoke with in four of the six school districts, as well as representatives  from a County Office of Education, discussed the mental and behavioral  health needs of these children and several noted barriers to meeting  these children’s needs. We were also told by seven local service  providers who worked with these children that they had previous  exposure to violence and trauma. Four local service providers noted that  in some cases children have experienced challenges related to  reunification with parents they had not seen for many years. Six service  providers said that these factors could contribute to behavioral and  mental health needs or make them more susceptible to gang recruitment  and trafficking.

A staff member in a local health clinic and a school district official told us  that some children disclosed harrowing stories of their journeys to the  United States, including incidents such as being tied to a tree for several  days, experiencing a sexual assault, and watching a fellow train rider’s  execution by beheading. One health care provider estimated that about  50 percent of unaccompanied children he served required mental health  services. Some counties reported challenges attracting bilingual  professionals, such as mental health providers, making it difficult for these  children to obtain needed services. Officials we spoke with in five of the  six school districts also noted that newly arrived children from Central  America—many of whom may have been unaccompanied—often have  limited or disrupted educational histories and face language barriers.  Officials from four of these school districts said that these issues can  make academic achievement or graduation challenging. According to  officials we spoke with, state and local requirements may also create  barriers for unaccompanied children. Officials we spoke with in one  county told us that non-parental sponsors lack the rights of a parent or  legal custodian under state law. In this county, such sponsors must apply  for legal custodianship in court. However, until they have obtained  custodianship, it can be difficult to enroll children in school or access  health services for them, according to court and social service agency  officials in this county.

Unaccompanied children also face barriers similar to those faced by other  children without lawful immigration status. Staff we spoke with at all three  of the clinics, as well as other local agency officials told us that lack of  health insurance, lack of knowledge about where to seek services, and/or  fear of disclosing their immigration status made it challenging to access  certain health care services and other services. Staff at the three clinics  and local agency officials in one county told us that lack of health  insurance made obtaining some health care services especially difficult,  such as dental care and care for more specialized health needs, which  tend to be more expensive and not available through local clinics.  Officials in two school districts told us that finding teachers who are  bilingual or teach English as a second language was a challenge for them  and ensuring that they had appropriate personnel to serve these children  was therefore difficult. However, officials in some school districts we  spoke with appeared to have more resources available to serve these  students. Specifically, one official we spoke with said the school district  was establishing a “newcomers division” within its Multilingual Education  Department, which would serve newly arrived immigrant students— including formerly unaccompanied children. Another school district we  contacted had a contract with a nonprofit organization to provide services  to these students, including socio-emotional supports.

section_title: Immigration Proceedings May Result in Several Possible Outcomes for Unaccompanied Children, and the Outcomes for Many Have Not Yet Been Determined
paragraphs: Under the Trafficking Victims Protection Reauthorization Act,  unaccompanied children are generally required to be transferred to ORR  and await immigration removal proceedings while in the custody of either  ORR or a qualified sponsor. Upon apprehension by DHS,  unaccompanied children are given a Notice to Appear before EOIR for  removal proceedings. During these proceedings, EOIR’s immigration  judges, who are located in courts around the country, decide whether the  child is removable from the United States and, if so, whether he or she is  eligible for relief or protection from removal. In 2007, EOIR issued  guidance for immigration judges concerning cases involving  unaccompanied children, which sets out basic principles that immigration  judges should use in court proceedings. These include employing child- sensitive procedures and how the best interest of the child should be  taken into account in the context of the judge’s discretion. In addition,  ORR requires sponsors to ensure that children attend their removal  proceedings.

An unaccompanied child who is in removal proceedings could apply for  various types of lawful immigration status with DHS’s U.S. Citizenship  and Immigration Services (USCIS), including asylum and Special  Immigration Juvenile (SIJ) status. USCIS’s asylum officers have initial  jurisdiction of any asylum application filed by an unaccompanied child,  even where such child is in removal proceedings. If, for example, an  unaccompanied child intends to apply for asylum with USCIS, an  immigration judge may administratively close (i.e., temporarily remove the  case from the immigration judge’s calendar) or continue the removal  proceeding pending the adjudication of the asylum application with  USCIS. According to EOIR officials, administrative closure does not grant  the child lawful immigration status, but the child is not at risk of removal  while the proceeding is closed. In general, an individual is eligible for  asylum if he or she (1) applies from within the United States; (2) suffered  past persecution, or has a well-founded fear of future persecution, based  on race, religion, nationality, membership in a particular social group, or  political opinion; and (3) is not statutorily barred from applying for or being  granted asylum. If USCIS determines that the unaccompanied child is  ineligible for asylum and does not otherwise have lawful immigration  status in the United States, USCIS asylum officers refer the asylum  application for review by an immigration judge, who will reopen the case  and reinitiate the child’s removal proceedings. In addition to asylum,  unaccompanied children may seek to apply for SIJ status through USCIS,  which is designed to help immigrant children who have been abused,  abandoned, or neglected. According to USCIS, certain children who are  unable to be reunited with a parent can obtain lawful permanent resident  (or green card) status as a SIJ, and children who obtain a green card  through the SIJ program can live and work permanently in the United  States. To be eligible for SIJ status, among other things, a child must be  declared dependent on a state court or such court must decide to legally  place the child with a state agency, or an individual or entity appointed by  a state or juvenile court; it must be determined not in the best interests of  the child to be returned to his or her home country; and it must be that  reunification of the child with a parent is not viable due to abuse, neglect,  abandonment, or a similar basis found under state law. Once an  unaccompanied child has met all the eligibility requirements for SIJ  status, he or she must then file for adjustment of status to receive an SIJ- based green card.

In July 2015, the Associate Director of the Refugee, Asylum and  International Operations Directorate at USCIS testified that USCIS has  received increasing numbers of asylum applications from unaccompanied  children in recent years and, in particular, from fiscal years 2012 through  2014. Specifically, the Associate Director testified that USCIS received  534 asylum applications from unaccompanied children who were  apprehended in fiscal year 2011 as compared to 6,990 asylum  applications from such children who were apprehended in fiscal year  2014. In addition, according to USCIS, when compared to the number of  unaccompanied children apprehended annually over the 2011 through  2014 time period, the percent of children applying for asylum with USCIS  has also increased (from 3 percent in fiscal year 2011 to 10 percent in  fiscal year 2014). Further, the Associate Director testified that since fiscal  year 2009, USCIS granted asylum to unaccompanied children at a rate of  42.6 percent (according to USCIS, the overall rate at which all new  asylum applicants with USCIS were granted asylum was 41 percent).  From fiscal year 2009 through May 31, 2015, USCIS’s testimony  statement indicated that 92 percent of the unaccompanied children who  applied for asylum with USCIS were from El Salvador, Guatemala, or  Honduras.

If unaccompanied children have not yet sought, or are not granted,  certain immigration benefits within the jurisdiction of USCIS, there are  several other possible outcomes, and various forms of relief that may be  available to them during immigration proceedings. For example:

Removal order: An immigration judge rules that the child is  removable, not otherwise eligible for relief or protection from removal,  and therefore is to be removed from the United States. ICE is  responsible for carrying out such orders.

Administrative closure: When a case is temporarily removed from an  immigration judge’s calendar or from the Board of Immigration  Appeals’ docket. According to EOIR, a judge may administratively  close a case, for example, if a child applies for asylum during their  removal hearing. EOIR officials said that such an action does not  grant the child legal immigration status, but the child is not at risk of  removal while the case is closed. Cases that are administratively  closed can be reopened at a later date.

Termination: A decision by an immigration judge that dismisses the  case related to a particular charging document. In such cases, the  child is not subject to removal relating to the dismissed charging  document, but this decision does not grant the child legal immigration  status.

Voluntary departure: An order from the immigration judge that allows  a child who is removable to voluntarily leave the country in a  designated time frame in lieu of formal removal.

Relief: An immigration judge may grant relief or protection from  removal to a child who is otherwise removable, provided the  applicable eligibility requirements are satisfied.

In July of 2014, DHS began noting on Notices to Appear whether the  juvenile who was apprehended was accompanied or unaccompanied.  With this information, EOIR began using a specific code in its automated  case management system to identify unaccompanied children.  According to EOIR data, from July 18, 2014, through July 14, 2015, DHS  initiated more than 35,000 removal proceedings for unaccompanied  children. Of these 35,000 removal proceedings, EOIR data indicate that  as of July 14, 2015, an immigration judge issued an initial decision in  nearly 13,000 proceedings (or 36 percent). Of those 13,000 decisions,  about 7,000 (or 55 percent) resulted in a removal order for the  unaccompanied child. According to EOIR data, about 6,100 (or 88  percent) of those initial decisions that resulted in removal orders were  issued in absentia, which is when a child fails to appear in court for their  removal proceedings and the immigration judge conducts the proceeding  in the child’s absence. However, a judge’s initial decision does not  necessarily indicate the end of the removal proceedings. For example,  cases that are administratively closed can be reopened, and new charges  may be filed in cases that are terminated. In addition, children who  receive a removal order in absentia, and with respect to whom a motion  to reopen their case has been properly filed, are granted a stay of  removal pending a decision on the motion by the immigration judge.  Moreover, a child may seek to appeal a removal order; thus, it is unclear  from the data pertaining to orders of removal whether such orders were  deemed administratively final as a result of all avenues for appeal with  EOIR to remain in the United States being exhausted or waived.  Overall, according to ICE data, from fiscal year 2010 through August 15,  2015, based on final orders of removal, ICE removed 10,766  unaccompanied children, 6,751 of whom were from El Salvador,  Guatemala, or Honduras. According to EOIR data, as of July 14, 2015,  there were over 23,000 pending cases for unaccompanied children.  Therefore, the ultimate legal outcome for many unaccompanied children  has not yet been determined.

section_title: Conclusions
paragraphs: To accommodate the increase in the number of unaccompanied children,  ORR has increased its number of grantees and bed capacity in recent  years and developed a framework to help it prepare for future demand,  starting with fiscal year 2015. The number of children referred to ORR  through most of fiscal year 2015, while high by historical standards, was  less than expected, and ORR grantees had many unoccupied beds.  However, the number of referrals began increasing towards the end of the  summer and has remained high through the beginning of what is typically  ORR’s “low” season. Although ORR may not be able to predict the exact  number of facilities and beds needed in any given year, developing a  process for updating its bed capacity framework on an annual basis may  help ensure an adequate response while minimizing the use of federal  funds and provide documentation of its analysis and decisions in support  of its capacity levels.

In addition, ORR brought new grantees online quickly and increased the  number of its staff responsible for monitoring these grantees. Now, ORR  has to determine how best to leverage its resources and use its staff to  monitor these grantees. Grantees provide care and services to  unaccompanied children, many of whom have been exposed to trauma  and violence and travelled great lengths to get to the United States. It is  important that grantees comply with ORR’s policies to ensure these  children receive, among other things, medical, clinical and educational  services, and that children are quickly reunified with sponsors. However,  ORR does not regularly monitor its grantees, and cannot ensure that they  are providing these needed services and properly documenting them.  Lastly, in addition to many questions about the children’s well-being and  whether they have access to needed services, there are questions about  their potential involvement with state child welfare services, and whether  these children will return to their country of origin or legally remain in the  United States. Although ORR has recently taken steps to gather more  information on the children once they are released, it does not have a  process to ensure that the data are reliable, systematically collected, and  summarized. While ORR is not required to gather this information, an  opportunity would be lost to help ORR and other government agencies  better understand and respond to issues related to unaccompanied  children if this information is not collected in a reliable and consistent  manner.

section_title: Recommendations for Executive Action
paragraphs: We recommend that the Secretary of the Department of Health and  Human Services direct the Office of Refugee Resettlement to take the  following three actions:

Develop a process to update its bed capacity framework on an annual  basis to include the most recent data related to numbers of  unaccompanied children who may be referred to its care and adjust its  planning scenarios that guide its bed capacity as appropriate.

Review its monitoring program to ensure that onsite visits are  conducted in a timely manner, case files are systematically reviewed  as part of or separate from onsite visits, and that grantees properly  document the services they provide to children.

Develop a process to ensure all information collected through its  existing post-release efforts are reliable and systematically collected  so that they can be compiled in summary form and provide useful  information to other entities internally and externally.

section_title: Agency Comments and Our Evaluation
paragraphs: We provided a draft of this report to the Departments of Health and  Human Services (HHS), Homeland Security, and Justice for review and  comment. Each of the departments provided technical comments that we  incorporated in the report as appropriate. HHS also provided written  comments that are reproduced in appendix III.

HHS concurred with all of our recommendations and stated that it is  committed to continuously working to improve its operations. HHS agreed  to update its bed capacity framework annually. Additionally, HHS agreed  to improve its monitoring of grantees. HHS described several of its  monitoring efforts, for example day long site visits, desk monitoring, and  monthly reporting, which we discuss in the report, and stated that it has  created a new monitoring initiative workgroup to examine opportunities for  further improvement. These are all important efforts, but it is also  important for HHS to take steps to strengthen its most comprehensive  monitoring of grantees, its weeklong on-site monitoring, through timely  visits, systematic reviews of case files, and properly documenting  services provided to children. HHS also agreed to improve its data  collection process to provide more systematic and standardized  information on post-release services.

As agreed with your office, unless you publicly announce its contents  earlier, we plan no further distribution of this report until 30 days from its  issue date. At that time, we will send copies of this report to relevant  congressional committees, the Secretaries of Health and Human Services  and Homeland Security, and the U.S. Attorney General. In addition, this  report will be available at no charge on GAO’s website at  http://www.gao.gov.

If you or your staff have any questions about this report, please contact  me at (202) 512–7215 or brownke@gao.gov. Contact points for our  Offices of Congressional Relations and Public Affairs may be found on  the last page of this report. GAO staff who made key contributions to this  report are listed in appendix VI.

section_title: Appendix I: Scope and Methodology
paragraphs: We used several approaches to address our objectives, including  reviewing relevant laws and regulations, court settlement agreements,  and agency policies. In addition, we interviewed relevant ORR and HHS  officials and officials from the Departments of Homeland Security and  Justice.

To address how ORR responded to the increased number of  unaccompanied children, we analyzed changes in the number of ORR’s  grantees and ORR’s average monthly bed capacity from fiscal year 2010  through 2015. We reviewed ORR documents, such as ORR’s Bed  Capacity Framework for fiscal years 2015, funding opportunity  announcements, and other relevant planning documents. We also  reviewed a plan developed by the Unified Coordination Group and  interviewed ORR and ACF officials about the Unified Coordination  Group’s activities. In addition, we reviewed ORR’s policy guide for its  unaccompanied children program, updates to this guidance, and ORR’s  schedule for additional policy updates.

To gather information about how children were cared for while in ORR  custody, we analyzed information from ORR’s web-based UAC portal for  children admitted to and discharged from ORR care between January 7,  2014, when ORR began using the portal, and April 17, 2015. This  database contains information such as children’s date and country of  birth, intake, placement, and sponsor information, among other data. To  assess the reliability of these data, we conducted electronic testing of the  data, reviewed ORR business rules to ensure data reliability, and  interviewed ORR officials and contractors knowledgeable about the data.  We determined the data were sufficiently reliable for our purposes. We  also visited nine ORR facilities in three states—New York, Texas, and  Virginia—to interview ORR grantee staff. Locations were selected to  ensure variation in the types of care provided by ORR grantees, shelter  size, and location. We visited shelters, staff-secure shelters, secure  shelters, and transitional foster care providers. We also reviewed a  nongeneralizable random sample of 27 case files of children who were  released from the nine shelters we visited. This sample was generated  using alien identification numbers from data from ORR’s UAC portal for all  children with a status of discharged and a valid discharge date. Each  case file was reviewed by two GAO analysts to assess the extent to  which documents required by the Flores Agreement and specific ORR  policies were present and complete. After both analysts reviewed the  files, they reconciled any differences between their reviews.

To assess ORR’s monitoring of its grantees, we reviewed ORR and  grantee documents, including monitoring schedules, reports, and  corrective actions. We also analyzed data provided by ORR on the  frequency of past monitoring and levels of staffing devoted to monitoring  activities. In addition, we discussed monitoring with grantees’ staff during  site visits and with ORR officials.

Lastly, to learn what is known about these children once they leave  ORR’s custody, we conducted phone interviews with school districts and  other local government officials and nonprofit groups in 6 counties where  50 or more children were released to sponsors in fiscal year 2014. We  interviewed individuals representing 19 local entities including—six school  districts, one county office of education, five human services agencies or  organizations, one county health system, one county executive’s office,  one county juvenile court system, one mayor’s office, and three local  health clinics. We also corresponded via email with a representative from  a second mayor’s office. The counties include Fairfax County, VA; Harris  County, TX; Nobles County, MN; Pulaski County, AR; San Mateo County,  CA; and Scott County, MS. These counties were selected to represent a  diversity of size, geographic location, and demographics, including  variation in the size of the Latino population. We used publically available  ORR data on the number of children released to sponsors by county and  county demographic data from the United States Census Bureau to select  counties. We then obtained additional data on the cities within selected  counties children were being released to from ORR to select localities  within counties to contact. Separately, we conducted interviews with city  officials and nonprofit service providers in one of the cities in which we  conducted a site visit.

We also analyzed Department of Justice’s Executive Office for  Immigration Review (EOIR) data and interviewed relevant officials from  EOIR. To assess the reliability of EOIR data we reviewed related  documentation and interviewed officials knowledgeable about the data.  We also spoke with DHS officials. DHS’s Immigration and Customs  Enforcement (ICE) and U.S. Citizenship and Immigration Services  (USCIS) responded to written questions regarding the reliability of their  data. We found these data to be sufficiently reliable for our purposes.

We conducted this performance audit from October 2014 to February  2016 in accordance with generally accepted government auditing  standards. Those standards require that we plan and perform the audit to  obtain sufficient, appropriate evidence to provide a reasonable basis for  our findings and conclusions based on our audit objectives. We believe  that the evidence obtained provides a reasonable basis for our findings  and conclusions based on our audit objectives.

section_title: Appendix II: Unaccompanied Children’s Age at Office of Refugee Resettlement Admission for Children from El Salvador, Guatemala, and Honduras, January 2014 through April 2015

section_title: Appendix III: Comments from the Department of Health and Human Services

section_title: Appendix IV: GAO Contact and Staff Acknowledgments
subsections: section_title: GAO Contact

section_title: Staff Acknowledgments
paragraphs: In addition to the contact named above, Gale Harris (Assistant Director),  Kathryn Larin (Assistant Director), Ramona L. Burton (Analyst-in-Charge),  David Barish, Erika Huber, and Jesse Lamarre-Vincent made key  contributions to this report. In addition, key support was provided by  Lucas M. Alvarez, Sandra L. Baxter, James Bennett, Kathryn Bernet,  Justin Fisher, Alison Grantham, Jean L. McSween, Jon Najmi, James  Rebbe, Almeta J. Spencer, and Kathleen van Gelder.

section_title: Related GAO Products
paragraphs: Unaccompanied Alien Children: Improved Evaluation Efforts Could  Enhance Agency Programs to Reduce Migration from Central America.  GAO-16-163T. Washington, D.C.: October 21, 2015.

Central America: Improved Evaluation Efforts Could Enhance Agency  Programs to Reduce Unaccompanied Child Migration. GAO-15-707.  Washington, D.C.: July 29, 2015.

Unaccompanied Alien Children: Actions Needed to Ensure Children  Receive Required Care in DHS Custody. GAO-15-521. Washington, D.C.:  July 14, 2015.

Central America: Information on Migration of Unaccompanied Children  from El Salvador, Guatemala, and Honduras. GAO-15-362. Washington,  D.C.: February 27, 2015.


Question-summary annotations: questions: question: What issue did ORR initially have when given the care of tens of thousands of children?
answer: GAO found that ORR was initially unprepared to care for that many children; however, the agency increased its bed capacity to accommodate up to 10,000 children at a time.
child_questions: question: What did ORR do to fix the issue for the future?
answer: Given the unprecedented demand for capacity in 2014, ORR developed a plan to help prepare it to meet fiscal year 2015 needs.

question: How did the number of children in ORR's care change through 2015?
answer: The number of children needing ORR's care declined significantly through most of fiscal year 2015, but began increasing again toward the end of the summer.

question: How could ORR improve its ability to balance preparations for anticipated needs while minimizing excess capacity?
answer: Given the inherent uncertainties associated with planning for capacity needs, ORR's lack of a process for annually updating and documenting its plan inhibits its ability to balance preparations for anticipated needs while minimizing excess capacity.

question: What happened to the children apprehended by federal immiagration officers?
answer: In fiscal year 2014, nearly 57,500 children traveling without their parents or guardians (referred to as unaccompanied children) were apprehended by federal immigration officers and transferred to the care of the Department of Health and Human Services' Office of Refugee Resettlement (ORR).
child_questions: question: What part of the world were most of these children from?
answer: Most of these children were from Central America.

questions: question: How is ORR able to provide care for unaccompanied children?
answer: ORR relies on grantees to provide care for unaccompanied children, including housing and educational, medical, and therapeutic services.
child_questions: question: How did GAO attempt to verify that all required services were being provided?
answer: GAO's review of a sample of children's case files found that they often did not contain required documents, making it difficult to verify that all required services were provided.

question: What efforts did ORR make to ensure better coverage of grantees?
answer: ORR revised its on-site monitoring program in 2014 to ensure better coverage of grantees.

question: Why might ORR not be able to identify areas where children's care is not provided in accordance with policies and agreements?
answer: However, ORR was not able to complete all the visits it planned for fiscal years 2014 and 2015, citing lack of resources. By not monitoring its grantees consistently, ORR may not be able to identify areas where children's care is not provided in accordance with ORR policies and the agreements with grantees.

questions: question: What do ORR grantees do to potential sponsors before releasing children to them?
answer: ORR grantees conduct various background checks on potential sponsors prior to releasing children to them. These potential sponsors are identified and screened by the grantees as part of their responsibilities for the unaccompanied children in their care.
child_questions: question: How does the extent of what the grantee does vary?
answer: The extent of the checks conducted depends on the relationship of the sponsor to the child.

question: What kinds of people might be sponsors?
answer: In nearly 90 percent of these cases, the sponsors were a parent or other close relative already residing in the United States. Sponsors do not need to have legal U.S. residency status.

question: What are these children often waiting for when with their sponsors?
answer: Between January 2014 and April 2015, ORR released about 50,000 children from Central America to sponsors to await their immigration hearings.

questions: question: Why is there limited info available on post-release services provided to children?
answer: There is limited information available on post-release services provided to children after they leave ORR care. In part, this is because ORR is only required to provide services to a small percentage of children, such as those who were victims of trafficking.

question: What was the purpose behind the National Call Center established by ORR?
answer: In May 2015, ORR established a National Call Center to assist children who may be facing placement disruptions, making post-release services available to some of them.
child_questions: question: What other initiatives has ORR undertaken in order to track children’s progress?
answer: Also, in August 2015, ORR began requiring well-being follow-up calls to all children 30 days after their release.

question: Why might this data not be reliable?
answer: ORR is collecting information through these new initiatives, but does not currently have a process to ensure that the data are reliable, systematically collected, or compiled in summary form.

question: What other difficulties may these services run into?
answer: Service providers GAO spoke with also noted that some of these children may have difficultly accessing services due to the lack of bilingual services in the community, lack of health insurance, or other barriers.

questions: question: What does this report examine about ORR?
answer: This report examines (1) ORR's response to the increase in unaccompanied children, (2) how ORR cares for children in its custody and monitors their care, (3) how ORR identifies and screens sponsors for children, and (4) what is known about services children receive after they leave ORR custody.
child_questions: question: What data did GAO review in order to create this report?
answer: GAO reviewed relevant federal laws and regulations, ORR policies, and ORR and Executive Office for Immigration Review data.

question: How were interviews part of the report process?
answer: GAO interviewed agency officials and community stakeholders in six counties that received unaccompanied children, representing diversity in geographic location, size, and demographics.

question: How did GAO choose a sample ORR grantee facilities to visit?
answer: GAO also visited nine ORR grantee facilities in three states selected to vary in the type of care provided, shelter size, and location, and conducted a random, non-generalizable case file review of 27 case files of children released from these facilities.