U.S. Government Makes Significant Strides in Recei..

The federal government has made notable progress since March in getting unaccompanied children arriving at the U.S.-Mexico border out of Border Patrol facilities and into Office of Refugee Resettlement (ORR) custody, and releasing them to parents or other sponsors. The number of children at Border Patrol facilities has been sharply reduced. But at this writing, more than 18,000 children remained in ORR custody and there are serious concerns about standards of care and conditions in some ORR facilities set up this spring.

The program for unaccompanied children has changed in a fundamental way with the addition of emergency intake sites. Most children in custody are now in these sites, which are not state licensed, have reduced staffing requirements and reduced services, and in some cases have serious deficiencies in their operations. Despite efforts to expand regular ORR licensed capacity, the number of children in state-licensed beds is no higher than now than in January. There is an urgent need for ORR to improve conditions in emergency intake sites, shift to licensed care with the full set of services as rapidly as is practicable, ensure that releases of children to parents and other sponsors are expedited and with appropriate safeguards, and strengthen post-release supports for children.

What Changed?

Unaccompanied children apprehended by U.S. Customs and Border Protection (CBP) are required to be turned over to ORR within 72 hours absent exceptional circumstances. They are sent to ORR-funded shelters and other facilities that must be state licensed and meet additional ORR requirements. The agency seeks to release children to parents or other adults after a vetting process intended to minimize risks of releases to traffickers or into other abusive settings.

In March, the number of unaccompanied child arrivals was the highest ever; April was the second highest. ORR did not have sufficient licensed beds, both because of high arrivals and because when the Trump administration left office, the agency had only about half of the bedspace previously identified as needed for preparedness. As a result, there were serious backups at CBP and an urgent need to rapidly expand ORR capacity.

It is typically impossible to rapidly expand licensed capacity, and ORR previously has turned to influx facilities—exempt from state licensing, though generally offering the same or similar services as standard shelters—when bedspace was needed on short notice. Influx facilities have been criticized for being large and not subject to state regulation, and there were multiple additional concerns about the influx facility in Homestead, Florida in 2018 and 2019.

This spring, after opening one influx facility in Carrizo Springs, Texas, the Biden administration apparently determined that it needed a different model. The Federal Emergency Management Agency (FEMA) and Department of Health and Human Services (HHS) together developed a new category of shelter called emergency intake sites. Fourteen emergency intake sites were opened in March and April, of which 12 are still operating.

Opening these sites made it possible to sharply reduce the number of children in CBP custody while greatly expanding ORR capacity. On March 28, there were 5,767 children at CBP facilities and 11,886 at ORR facilities, according to daily HHS/Department of Homeland Security (DHS) reports shared with reporters. As of May 23, the figures fell to 614 in CBP custody and 18,187 at ORR, with the ORR figure down from nearly 23,000 in late April. Migration Policy Institute (MPI) analysis of recent data suggests that about 58 percent of children in ORR custody are in emergency intake sites. The numbers would have been higher but for the fact that ORR greatly increased the numbers of children released to parents and other sponsors. The average number of children released grew from 245 per day in the last week of March to 559 daily in the first week of May.

Concerns over Emergency Intake Sites

While observers generally agree that it is better for children to be in emergency intake sites than in overcrowded CBP facilities, these sites pose multiple concerns.

Standard HHS shelters are typically set up in dorm-like settings, with providers that often have substantial experience with services to unaccompanied children. Providers are chosen through a competitive grant process. The emergency intake sites were established at auditoriums and coliseums and other large structures, including at least one warehouse and one tented facility. Contracts were awarded without competitive bidding, often to companies with previous FEMA experience but no prior expertise in serving unaccompanied children.

Standard shelters are subject to state licensing and monitoring and additional federal standards mandating aspects of care for unaccompanied children. Standard shelters are required to provide a comprehensive medical exam within 48 business hours of arrival, ongoing access to medical and mental health services, six hours of education five days a week, daily outdoor activity and recreation time, legal services, case management and counseling, and privacy policies. Influx facilities must meet similar requirements, though the length of daily education services is not specified and some requirements can be waived.

On April 30, HHS issued a guidance document explaining that emergency intake sites are “designed for mass care with basic standards to meet immediate sheltering needs of unaccompanied children.” The guidance says medically fragile children and ones needing close supervision will not be placed in these sites. Otherwise, entry criteria that apply to influx facilities—such as that children should be 13 or older, speak English or Spanish, and be expected to be released within 30 days—will only apply “to the extent feasible.” Direct care staff in standard facilities must undergo FBI criminal records checks and child abuse and neglect checks before hiring; in contrast, direct care staff at emergency facilities only need public criminal records checks. The guidance addresses a set of health and safety requirements, and indicates that case management, educational services, recreation, legal services, and access to privacy should be provided “as soon as possible and to the extent practicable.” Emergency health care must be provided and may include a limited initial medical exam and staff who can render first aid “to the extent feasible.” Case management may be conducted by volunteers.

There is only limited public information about the conditions in emergency intake sites. In contrast with policies that apply to standard shelters, media visits have not been allowed and at least some locations staff and volunteers have been required to sign nondisclosure agreements; it is unclear if this is due to agency policy or decisions by individual providers.

Media accounts describe significant concerns about some facilities. Reports include accounts of a facility closed amidst serious allegations about conditions; reports of runaways and children who may have been released to a trafficker; urgent unmet needs for mental health services, with some children reporting suicidal thoughts; concerns about lack of fresh air, depression, fighting, and children complaining about hunger. In one facility set to expand capacity to 10,00 children, reporting describes limited access to showers and clean clothes, and children sitting on cots for much of the day without access to activities. One article described conditions in which children are unable to see the sun or know what time it is. Another described children kept on buses for days in a parking lot waiting to travel to reunite with relatives. There are reports of children being in custody for weeks or longer without parents knowing where they are. Sponsors describe being terrified and frustrated due to the lack of communication.

Costs for the emergency intake sites are high but not clear. HHS has used a figure of about $775 per child per night, which is the same estimate it has used to describe influx facility costs since at least 2018. Actual costs could be higher or lower. These costs appears to be a principal reason why HHS transferred more than $2 billion from other HHS programs to cover unaccompanied children costs.

Expediting the Discharge Process

The other major initiative to reduce the number of children in federal custody has involved efforts to expedite the release process. The great majority of arriving children have a parent or close relative in the United States, but before they can be released to a prospective sponsor, the applicant undergoes a vetting process to minimize the risk of an unsafe placement.

This spring, HHS adopted policies to expedite releases to parents, legal guardians, and close relatives, who presently comprise about 90 percent of sponsors. Several of these steps seem clearly advisable, including dropping questions for parents that provide little useful information and taking applications over the phone for parents and relatives. Of greater concern, ORR no long requires criminal records and sex abuse registry checks for persons in the home other than the sponsor. Importantly, HHS has not modified procedures for releases to distant relatives and nonrelatives, the group historically of greatest concern.

Initially, even with expedited procedures, release numbers from emergency intake sites were low because case management was not in place. Releases have grown significantly in recent weeks, though it is unclear who is doing the case management leading to release decisions or the quality of those decisions.

The Challenges Ahead

HHS reportedly plans to close some emergency intake sites by the end of May, given declining child apprehensions and higher discharge numbers. It appears to be planning to consolidate numbers of children into an emergency intake site at Fort Bliss with a potential capacity of 10,000 children.

The clearest immediate challenge is to strengthen services and improve conditions at the emergency intake shelters. Staffing should be expanded, with a commitment to having skilled and trained case managers, and staff screening should be increased to the levels that apply to other ORR facilities. Activities and curriculum for children can be strengthened, and children should have improved access to mental health counseling and legal services. And, there should be transparency about who is operating the sites, what standards they are subject to, how conditions are monitored, and what steps are taken to address deficiencies.

While conditions can be improved, it is doubtful that these sites can ever be good places for children to stay for any extended period. That highlights the need to continue speeding releases while minimizing increased risks. It also underscores the need for HHS to build licensed capacity. Recently released data suggest there has been little to no progress in expanding licensed capacity since January. It seems clear that for the foreseeable future, HHS will need to maintain a high number of beds available on short notice. Increasing the supply of licensed beds, while not easy, is essential to minimize future use of emergency intake sites. It is also needed to expand appropriate care options for children who cannot be quickly released to sponsors.

HHS also should expand post-release services available to children. Reliance on the emergency intake sites has meant that children have not gotten full, and in some cases, any, needed legal screenings or know your rights presentations. They have not received the mental health counseling and supports they would have otherwise gotten. They are not receiving educational or needed acculturation services or comprehensive medical exams. Post-release services are no substitute for a careful sponsor vetting process, but they become increasingly essential in light of the limitations at the emergency intake sites.

Finally, DHS needs to improve Border Patrol holding facilities. Throughout the spring, it has been taken as a given that CBP facilities are not places where children should be held for any length of time, even though they may be there for up to 72 hours under normal circumstances. It has been clear since at least 2014 that at times large numbers of unaccompanied children will need to be housed in CBP facilities. This latest increase in child arrivals again underscores the need for a comprehensive review of how to improve CBP capacity to receive children and the conditions in which they are held in Border Patrol facilities.

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