HHS OIG: Communication and Management Challenges Impeded HHS's Response to Zero-Tolerance Policy

March 5, 2020

WASHINGTON, DC—Interagency communication failures and poor internal management decisions impeded the ability of the U.S. Department of Health and Human Services (HHS) to provide prompt and appropriate care for separated children following the spring 2018 implementation of the zero-tolerance policy, according to a report released today by the HHS Office of Inspector General (OIG).

The report cites several factors that undercut HHS's efforts to care for separated children in its custody, including a lack of interagency coordination on immigration issues, despite a variety of channels that exist to facilitate high-level engagement. In addition, key senior HHS officials did not act on repeated, advance warnings from staff that family separations were occurring prior to the zero-tolerance policy and might increase. As a result, HHS was not prepared for family separation, according to the report, Communication and Management Challenges Impeded HHS's Response to the Zero-Tolerance Policy.

"Future immigration trends, practices, and policies will continue to affect the Unaccompanied Alien Children Program. In this quickly changing landscape, clear lines of communication across Federal agencies and within HHS are vital to its ability to adapt and respond effectively to new developments," said HHS OIG Principal Deputy Inspector General Christi A. Grimm. "The vulnerabilities we identified need to be addressed to ensure that HHS can effectively care for children in its custody. We commend HHS for taking several tangible steps and planning others to address our findings and recommendations."

Within HHS, the Unaccompanied Alien Children (UAC) Program serves minors who have no lawful immigration status in the United States and do not have a parent or legal guardian available in this country to provide care and physical custody. In 2017 and 2018, the Department of Justice (DOJ) and the Department of Homeland Security (DHS) took steps to increase enforcement of immigration laws, culminating in the spring 2018 implementation of a zero-tolerance policy for specified immigration offenses. Under this policy, families entering the United States without authorization were separated, with parents placed in Federal custody to await prosecution for illegal entry while their children, now unaccompanied, were transferred to the care of the HHS Office of Refugee Resettlement (ORR). In late June 2018, a Federal district court enjoined DHS from continuing to separate families, except in very limited circumstances largely related to criminal history and ordered the Government to reunite separated children still in the care of HHS with their parents.

Poor interagency communication and management decisions that failed to protect children's interests left HHS unprepared for the zero-tolerance policy.

Without a comprehensive plan for the possibility of large-scale family separations, ORR was unprepared for the surge in separated children after the zero-tolerance policy was implemented in 2018. This lack of preparation impeded HHS's ability to identify, care for, and reunify separated children.

ORR staff warned key senior HHS officials about family separation in 2017 and 2018, before the zero-tolerance policy was implemented, noting that the number of separated children had increased and might grow further. ORR staff raised concerns about the lack of "bed capacity to accommodate a large increase in separated children" and about the "trauma such a policy would inflict on children." However, key senior HHS officials did not elevate this information or direct any actions to prepare.

In the absence of a plan for the possibility of increased separations, the UAC Program was left to react to "changes as they occurred rather than taking proactive measures that might mitigate risk to children," the report noted. Furthermore, because no procedures or systems had been established to track separated families across HHS and DHS, HHS struggled to identify separated children after a Federal district court ordered the government to reunify separated families.

Care provider facilities faced significant operational challenges at every stage of the reunification process. These challenges were further complicated by poorly communicated guidance and directives from ORR.

Care provider facilities faced significant operational challenges at every stage of the reunification process. Facilities encountered difficulties locating and communicating with parents in DHS or DOJ custody, as well as determining whether parents and children could be safely reunified.

"Sometimes it's easier to find a parent in a rural village in Guatemala than to find them in detention," an ORR staff member told OIG.

Facilities also reported logistic and coordination problems, including extended delays at some DHS detention centers that served as reunification sites. In some cases, children and facility staff spent hours, late at night, waiting in vans in detention center parking lots.

Finally, facilities also reported that HHS poorly communicated its guidance and directives about separated children, with conflicting guidance coming from different sources within ORR. Inadequate communication contributed to confusion about the reunification process and increased children's stress.

"Not knowing what happened to their parents haunted the children. We couldn't tell them whether they would ultimately be reunited. It was challenging. We weren't notified initially about how to connect parents with their kids," said a facility lead mental health clinician. "The kids had lots of questions, but we had no answers for them."

HHS has taken steps to improve tracking of separated children, but the procedures include manual processes that are vulnerable to error.

In the wake of the zero-tolerance policy, HHS has taken steps to improve the tracking of separated children. However, even these improved procedures rely on multistep, manual processes that are inherently vulnerable to error. In addition, ORR continues to experience difficulties getting specific information from DHS about parents' criminal backgrounds, which impedes ORR's ability to provide appropriate care and placement.

OIG Recommendations to Better Serve Children in HHS Custody

HHS was not responsible for separating families, but HHS's inadequate communication, management, and planning made a difficult situation for separated children worse. HHS should address the communication and management concerns that we identified to ensure that it can provide appropriate care for children currently in its custody. Clear lines of communication-both across Federal agencies and within HHS-are also vital to HHS's ability to adapt and respond effectively to any new developments in immigration policy and practice that could impact children in the future.

OIG made four recommendations to address the challenges outlined in this report and to improve UAC Program operations. Specifically, HHS should:

take steps to ensure that children's interests are prioritized and represented in decisions affecting the UAC Program, both internally and when engaging with interagency partners;

modify or pursue formal agreements with DHS and DOJ to ensure that it is receiving information that supports its operation of, and ability to provide care for, children in the UAC Program;

improve communication to care provider facilities regarding interim guidance, operational directives, and other instructions that are not immediately available in published documents; and

further improve its ability to identify and track separated children by reducing reliance on manual processes.

In written comments on the reports, HHS concurred with the recommendations and outlined corrective actions it had taken or that are underway to address the findings identified in this report.

To read this full report and access other OIG completed work products related to the UAC Program, visit oig.hhs.gov/uac.