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. 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. 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. 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. 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. 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. 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. 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. 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. 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. 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. 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. 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. 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. 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. 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. 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.

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 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. 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. 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.