From fiscal years 2003 through 2011, ORR cared for fewer than 10,000 unaccompanied children per year. 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 (see fig. 1). While the number of children served by ORR in fiscal year 2015 was less than the number served in fiscal year 2014, it was still higher than in previous years. Further, DHS data show that the number of unaccompanied children apprehended at the southwest border in fiscal 2016 through January is more than double the number apprehended during the same time period in fiscal year 2015. In response to the increased number of unaccompanied children in recent years, particularly in fiscal year 2014, ORR increased its shelter capacity (the number of beds it has available). We found that ORR was initially unprepared to care for the rapid increase in children needing services; however, ORR solicited new grantees to provide shelter services in both 2013 and 2014 and awarded additional cooperative agreements. From fiscal year 2011 through June of fiscal year 2015, the number of ORR grantees increased from 27 that operated 59 facilities to 57 that operated 140 facilities, and the number of beds available to serve unaccompanied children increased from almost 1,900 to nearly 7,800. The number of beds ORR needs depends on the number of unaccompanied children in its custody and how long these children stay in grantee facilities before they can be placed with sponsors. To further manage its capacity to care for the increased number of children, ORR updated policies and procedures to reduce the number of days children spend in its custody and expedite their release to sponsors. Specifically, ORR simplified documentation requirements for sponsors by eliminating notarization requirements and allowing photocopies (rather than original copies) of supporting documentation, such as birth certificates. ORR also removed the fingerprinting component of background checks for parents and legal guardians with no criminal or child abuse history, reduced the maximum number of days between approval of a child's release and actual discharge, and in some cases paid for a child's travel to the sponsor. According to shelter staff, these changes were feasible, in part, because most children come with contact information for a relative who can serve as a sponsor. Agency officials also noted that they can now more quickly release children to their parents or other relatives. We also found that ORR is taking other actions to ensure it has the capacity to meet demand caused by increases in the number of unaccompanied children and to minimize the risks of not being able to provide care and services to these children. Specifically, ORR developed a framework for fiscal year 2015 that included plans and steps to manage its capacity, based in part on the record levels of children needing care in 2014. This framework 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. It 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's bed capacity framework for fiscal year 2015 was based on the number of children served in fiscal year 2014. 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 toward the end of the summer and has remained relatively high through the beginning of fiscal year 2016. While developing the framework was a positive step and ORR officials said they continue to use the capacity framework as a "roadmap," we found that they have not updated this framework for fiscal year 2016 and have not established a systematic approach to update the framework on an annual basis to account for new information so that it remains current and relevant to changing conditions. 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. We concluded that 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. We recommended in our February 2016 report that the Secretary of HHS direct ORR to develop a process to update this bed capacity framework on an annual basis. HHS concurred with our recommendation. ORR relies on grantees to provide care for unaccompanied children, such as housing and educational, medical, and therapeutic services, and to document in children's case files the services they provide. However, in our February 2016 report we found that documents were often missing from the 27 randomly selected case files we reviewed. Specifically, 14 case files were missing a legal presentation acknowledgement form, 10 were missing a record of group counseling sessions, and 5 were missing clinical progress notes. Grantees are required to provide these services and document that they did so. 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 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. 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 cooperative agreements. ORR's most comprehensive monitoring of grantees occurs during on-site monitoring visits. However, we found that onsite visits to 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. 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 agency data 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. In 2014, ORR revised its on- site monitoring program to ensure better coverage of grantees and implemented a biennial on-site monitoring schedule. Nevertheless, ORR did not meet its goal to visit all of its facilities by the end of fiscal year 2015, citing lack of resources. Monitoring visits are intended to provide an opportunity to identify program deficiencies or areas where programs are failing to comply with ORR policies. 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. We concluded that without consistently monitoring its grantees, ORR cannot know whether they are complying with their agreements and that children are receiving needed services. We recommended in our February 2016 report that the Secretary of HHS direct ORR to 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. HHS concurred, and in its response to the report described several of its other monitoring efforts, and stated that it has created a new monitoring initiative workgroup to examine opportunities for further improvement. ORR grantees that provide day-to-day care of unaccompanied children are responsible for identifying and screening sponsors prior to releasing children to them. During children's initial intake process, case managers ask them 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 are also asked to provide documents to establish their identity and relationship to the child. Grantees conduct background checks on potential sponsors. The types of background checks conducted depend on the sponsor's relationship to the child (see table 1). In certain circumstances prescribed by the Trafficking Victims Protection Reauthorization Act or ORR policy, a home study must also be conducted before the child is released to the sponsor. Additionally, in certain situations, such as where 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, other household members are also subjected to background checks. In our February 2016 report, we found that between January 7, 2014, and April 17, 2015, nearly 52,000 children from El Salvador, Guatemala, or Honduras were released to sponsors by ORR. 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 2). In the fall of 2014, ORR officials told us that they had not seen evidence that adults are fraudulently sponsoring unaccompanied children. Nonetheless, ORR officials told us that ORR has been monitoring the number of children it releases to sponsors, through its web-based portal, to help ensure that individuals are not sponsoring too many children unrelated to them. In August 2015, two individuals pleaded guilty to charges related to luring Guatemalan children into the United States on false pretenses in 2014. According to the indictment, one of the individuals submitted fraudulent information to ORR officials to obtain custody of six children, among other things. There is limited information available about the services provided to unaccompanied children after they leave ORR custody. According to ORR officials, a relatively small percentage of unaccompanied children received post-release services, and they said ORR's responsibility for the other children typically ended once it transferred custody of the children to their sponsors. The Trafficking Victims Protection Reauthorization Act requires ORR to provide post-release services to children if a home study was conducted, and authorizes ORR to provide these services to some additional children. According to ORR data, in fiscal year 2014, slightly less than 10 percent of unaccompanied children received post-release services, including those for whom a home study was conducted. Post- release services are limited in nature and typically last a relatively short time. 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. Recently, ORR has taken steps to expand eligibility criteria for post- release services to additional children. According to ORR officials, all children released to a non-relative or distant relative are now eligible for such services. In addition, in May 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. And in August 2015, ORR instituted a new policy requiring grantee facility staff to place follow-up calls, referred to as Safety and Well Being follow up calls, to all children and their sponsors 30 days after the children are placed to determine whether they are still living with their sponsors, enrolled in or attending school, aware of upcoming removal proceedings, and safe. ORR policy requires grantees to attempt to contact the sponsor and child at least three times. Although there is limited post-release information for unaccompanied children, ORR is in a position to compile and share the data it collects internally and with other federal and state agencies to help them better understand the circumstances these children face when they are released to their sponsors. This is because 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, such as state child welfare services. Federal internal control standards require that an agency have relevant, reliable, and timely information to enable it to carry out its responsibilities. As a result, in our February 2016 report, we recommended that the Secretary of HHS direct ORR to develop a process to ensure all information collected through its existing post-release efforts are reliable and systematically collected so that the information can be compiled in summary form and provide useful information to other entities internally and externally. HHS concurred and stated that ORR will implement an approved data collection process that will provide more systematic and standardized information on post-release services and that it would make this information available to other entities internally and externally. We found that 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, some public health assistance, and school meals. 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. Some local service providers 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. Similarly, local services providers told us these children had previous exposure to violence and trauma and in some cases 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 the children more susceptible to gang recruitment and trafficking. Some school district and other service providers reported challenges such as attracting bilingual professionals, such as mental health providers, making it difficult for these children to obtain needed services. In addition, unaccompanied children also face barriers similar to those faced by other children without lawful immigration status such as lack of health insurance, lack of knowledge about where to seek services, fear of disclosing their immigration status, and language barriers. We also found that the level of awareness about, and services available to, unaccompanied children varied across the jurisdictions in which we spoke with stakeholders, with some jurisdictions appearing to have more resources than others. For example, in one 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. Conversely, representatives from two other mayors' offices told us that they were unaware that unaccompanied children were living in their city or had limited knowledge about the issue. With respect to unaccompanied children's immigration proceedings, we found that there are several possible outcomes and that the outcomes for many children have not yet been determined. An unaccompanied child who is in removal proceedings can apply for various types of lawful immigration status with DHS's U.S. Citizenship and Immigration Services (USCIS), including asylum and Special Immigration Juvenile status. USCIS's asylum officers have initial jurisdiction of any asylum application filed by an unaccompanied child, even if a child is in removal proceedings. 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. USCIS received 534 such applications in fiscal year 2011 and 6,990 in fiscal year 2014. The Associate Director testified that since fiscal year 2009, USCIS has granted asylum to unaccompanied children at a rate of 42.6 percent, similar to the overall rate at which all new asylum applications were approved. 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, an immigration judge may order them removed from the United States, administratively close their case, terminate their case, allow them to voluntary depart the United States, or grant them relief or protection from removal. From July 18, 2014, when DOJ's Executive Office for Immigration Review began to consistently use a code to identify cases involving unaccompanied children, to 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, new charges may be filed in cases that are terminated, and children may appeal a removal order. In addition, a child who receives a removal order in absentia, and with respect to whom a motion to reopen their case has been properly filed, is granted a stay of removal pending a decision on the motion by the immigration judge. Overall, according to DHS's Immigration and Customs Enforcement (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. Chairman Grassley, Ranking Member Leahy, and Members of the Committee, this concludes my prepared remarks. I would be happy to answer any questions that you may have. For further information regarding this testimony, please contact Kay E. Brown 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 statement. Individuals who made key contributions to this testimony include Gale Harris (Assistant Director), David Barish (Analyst-in-Charge), James Bennett, Ramona Burton, Jamila Jones Kennedy, Jean McSween, James Rebbe, Almeta Spencer, and Kate van Gelder. This is a work of the U.S. government and is not subject to copyright protection in the United States. The published product may be reproduced and distributed in its entirety without further permission from GAO. However, because this work may contain copyrighted images or other material, permission from the copyright holder may be necessary if you wish to reproduce this material separately.

Summary:
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 testimony is based on GAO's February 2016 report and addresses (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, challenges, and the status of removal proceedings for children after they leave ORR custody. For its February 2016 report, 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. In fiscal year 2014, nearly 57,500 children traveling without their parents or guardians (referred to as unaccompanied children) were apprehended 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. 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 nearly 52,000 children from El Salvador, Guatemala, or Honduras to sponsors. 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. In its February 2016 report, GAO recommended 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.