Health IG Launches Inquiry After Senators Demand Investigation of Health Department’s Treatment of Children Separated from Parents Under Trump Policy

WASHINGTON, D.C. – The Office of Inspector General of the Department of Health and Human Services (HHS) announced it would conduct a comprehensive review of the Office of Refugee Resettlement’s (ORR) Unaccompanied Alien Children (UAC) program after U.S. Senators Tom Udall and Martin Heinrich sent a letter to the Office of Inspector General requesting they look into the issue. The request for an investigation follows weeks of uncertainty about the Health Department’s ability to appropriately care for children placed in its custody as a result of President Trump’s family separation policy, as well as the Department’s lack of clarity around plans to reunite children and parents. 

“We write to request a comprehensive review of the operations of the Department of Health and Human Services (HHS) Office of Refugee Resettlement’s (ORR) Unaccompanied Alien Children (UAC) program, particularly focused on how the Office has approached and responded to President Trump’s family separation policy. We are alarmed by the uncertainty and pain inflicted on thousands of families arriving at the U.S. border, particularly the mental and physical harm inflicted on immigrant children and their parents by this policy, and we are deeply troubled by recent reports of maltreatment of children while under ORR custody. While we are encouraged by the announcement of recent efforts to prioritize family reunification, we also have significant questions about how the Department is working to accomplish this goal. It is equally important that we understand what measures, if any, HHS undertook to prioritize the health, safety, and wellbeing of children in its custody as it implemented the family separation policy, both before and after President Trump’s June 20 Executive Order to reverse the policy,” wrote the senators. 

The letter led by Senator Patty Murray (D-WA) was signed by U.S. Senators Dick Durbin (D-IL), Dianne Feinstein (D-CA), Ron Wyden (D-OR), Tom Udall (D-NM), Elizabeth Warren (D-MA), Edward Markey (D-MA), Patrick Leahy (D-VT), Catherine Cortez Masto (D-NV), Martin Heinrich (D-NM), Tina Smith (D-MN), Cory Booker (D-NJ), Tammy Duckworth (D-IL), Angus King (I-ME), Jeanne Shaheen (D-NH), Sheldon Whitehouse (D-RI), Richard Blumenthal (D-CT), Maria Cantwell (D-WA), Bernie Sanders (I-VT), Tammy Baldwin (D-WI), Chris Coons (D-DE), Amy Klobuchar (D-MN), Tim Kaine (D-VA), Brian Schatz (D-HI), Chris Van Hollen (D-MD), Maggie Hassan (D-NH), Michael Bennet (D-CO), Bill Nelson (D-FL), Kamala Harris (D-CA), Chris Murphy (D-CT), Mazie Hirono (D-HI), Jack Reed (D-RI), Kirsten Gillibrand (D-NY), Bob Casey (D-PA), Robert Menendez (D-NJ), Jeff Merkley (D-OR), Gary Peters (D-MI), Debbie Stabenow (D-MI), Sherrod Brown (D-OH), Mark Warner (D-VA), and Tom Carper (D-DE). 

A copy of the letter is available here and below. 

The Honorable Daniel R. Levinson
Office of Inspector General 
Department of Health and Human Services
330 Independence Avenue, SW 
Washington, DC 20201 

Dear Inspector General Levinson:

We write to request a comprehensive review of the operations of the Department of Health and Human Services (HHS) Office of Refugee Resettlement’s (ORR) Unaccompanied Alien Children (UAC) program, particularly focused on how the Office has approached and responded to President Trump’s family separation policy. We are alarmed by the uncertainty and pain inflicted on thousands of families arriving at the U.S. border, particularly the mental and physical harm inflicted on immigrant children and their parents by this policy, and we are deeply troubled by recent reports of maltreatment of children while under ORR custody. While we are encouraged by the announcement of recent efforts to prioritize family reunification, we also have significant questions about how the Department is working to accomplish this goal. It is equally important that we understand what measures, if any, HHS undertook to prioritize the health, safety, and wellbeing of children in its custody as it implemented the family separation policy, both before and after President Trump’s June 20 Executive Order to reverse the policy.

Under President Trump’s family separation policy, thousands of children who arrived in this country with their parents were placed in ORR custody while their parents were detained separately awaiting immigration proceedings. On June 20, 2018, President Trump signed an Executive Order purportedly to reverse the policy, but the path forward to execute the Order remains unclear. The Executive Order instructs the Secretary of Defense to provide “facilities available for the housing and care of alien families.” Later on June 20, the Department of Defense (DoD) issued a memo announcing that HHS had asked whether DoD has the ability to house up to 20,000 children at military installations between July and December 2018, in order to accommodate HHS’s need to rapidly increase its capacity. As HHS addresses an increased number of children in its custody at HHS-contracted UAC program facilities, it is unclear what steps are being taken to ensure that HHS contractors and facilities are meeting established standards for ensuring the safety and wellbeing of children in their care—including meeting requirements related to background checks, inspections, qualifications, training, and licensure. 

Recent press reports have also detailed concerning allegations of abuse of children in HHS-contracted UAC program facilities, raising concerns about the Department’s oversight of the UAC program, especially as it seeks to ramp up capacity. One report from a Virginia facility described aggressive and routine use of physical force to restrain children. Another story from a Texas site recounted coerced use of numerous psychotropic drugs on children, including through forced injections and medications disguised as vitamins. These allegations are deeply worrisome and merit intense scrutiny of the quality of care in HHS-contracted UAC program facilities, particularly as the Administration is separating and detaining more and more children. 

The forced separation of immigrant children from their parents is a serious, traumatizing event that should never have occurred. Forced separation can over-activate the body’s stress-response system, creating a constant “fight-or-flight” mode that can disrupt a child’s brain chemistry and create potentially long-term or lifelong health consequences as documented in the Centers for Disease Control and Prevention’s (CDC) Adverse Childhood Experiences (ACEs) study. As the Department responsible for children’s health and wellbeing, HHS should be dedicating resources to ensuring children are receiving the medical and mental health care they need. HHS has the tools to measure capacity in its facilities and to assess the potential needs of children in their custody. Yet, we remain concerned about whether the Department is ensuring children receive the care they need and whether the services and treatments they receive are trauma-informed and evidence-based. 

To better understand HHS’s efforts to implement the family separation policy and the June 20 Executive Order, we ask that you conduct an investigation of the UAC Program and address the following questions:

1. What processes does HHS employ to assess the needs of children in the UAC program, including the capacity needed at HHS-contracted UAC program facilities and their ability to provide needed services for children of all ages and medical needs?