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Chairwoman DeLauro Opening Remarks for House Appropriations Subcommittee on Labor, Health and Human Services, and Education “Oversight Hearing: Mental Health Needs of Children in HHS Custody”

September 18, 2019
Press Release

(As prepared for delivery)

A video of the hearing can be found here.

Good morning. Welcome to the Labor, HHS, and Education Appropriations Subcommittee. We are here today for another oversight hearing, this time with administration officials and members of the Department’s Office of Inspector General to discuss the recently released report on the mental health needs of children in the care of the Department of Health and Human Services’ Unaccompanied Children Program.

Let me thank our witnesses for being here today. I will introduce them more before their remarks. They are:

  • Ann Maxwell, Assistant Inspector General, Office of Inspector General of Department of Health and Human Services;
  • Jonathan Hayes, Director, Office of Refugee Resettlement, Department of Health and Human Services;
  • Let me also recognize Jonathan White, Commander, Public Health Service Commissioned Corps, Department of Health and Human Services

This hearing is part of our oversight responsibility, which we take very seriously. We must. Considerable taxpayer resources are at stake. And, something even more precious is at stake: the mental and physical wellbeing of children.

That is why the Office of Inspector General’s new report was so alarming. It confirms our worst fears: that intentional policy choices by this administration created what I would call a mental health crisis with children, which the OIG said that HHS and ORR—the Office of Refugee Resettlement—failed to address.

It is a crisis of deliberate, government-sanctioned child abuse.

We must stop the trauma inflicted on these children. So, I believe the administration must quickly implement the OIG’s proposed recommendations, which are included in the report. The Administration for Children and Families (ACF) has concurred with each of the recommendations, but words alone are not enough. The gaps created a mental health crisis as children are still dealing with the effects.

As Ms. Maxwell summarized in her testimony, quote, “Policy changes in 2018 exacerbated existing challenges, as they resulted in (1) a rapid increase in the number of children separated from their parents after entering the United States, many of whom were younger, and (2) longer stays in ORR custody for children.”

Those policy changes in 2018 were the administration’s zero-tolerance family separation policy—which ripped children from their parents—and the administration’s grossly intentional changes to fingerprinting and screening requirements that ground discharge to a halt. As a result, a child’s average length of stay in government custody nearly tripled: from 35 days to 93 days.

The numbers have improved since the administration began implementing its four operational in December to reverse their changes to the screening process. I will note that those changes followed a consistent drumbeat for accountability from this Subcommittee.

Now, we need to see the agency’s plan to improve the discharge process, so we are able to get children in and out of ORR’s care as safely and quickly as possible, so they do not experience toxic stress and mental trauma. We do not only need a plan for bed capacity.

And as I understand, the onus with respect to discharge is on the grantees. ORR must then have policies in place that get children in and out of the facility as quickly as possible. Because when Homestead—which is an influx facility—is charging $750 a night per child, the motivation to move these kids may not be as strong as it needs to be.

There must be change, because as the OIG concluded, children have been suffering because of these intentional policy choices.

Ms. Maxwell wrote in her testimony that, quote, “children who experienced longer facility stays exhibited higher levels of defiance, hopelessness, and frustration, along with more instances of self-harm and suicidal ideation.”

She also noted in her testimony, quote, “separated children exhibited more fear, feelings of abandonment, and post-traumatic stress than did children who were not separated.”

And, the OIG’s report also described how, quote, “…some separated children expressed acute grief that caused them to cry inconsolably.”

In another story, the OIG’s report shared that, quote “A 7- or 8-year-old boy was separated from his father, without any explanation as to why the separation occurred. The child was under the delusion that his father had been killed and believed that he would also be killed. This child ultimately required emergency psychiatric care to address his mental health distress.”

It is terrible. And, then the administration failed to fully or adequately treat it.

As the OIG report spotlighted, quote, “Facilities struggled to address the mental health needs of children who had experienced intense trauma and had difficulty accessing specialized treatment for children who needed it.” Overwhelmed by the deluge, clinicians reported caseloads more than double what they should have been. And, unprepared for the younger children, those mental health providers who were available were primarily prepared to serve teenagers, not the mental and social needs of preschoolers, who cannot communicate their backgrounds, their needs, or even their pain.

So, as I read the OIG’s report and testimony, the administration’s intentional policies traumatized youngsters, who then did not receive proper care. It is twisted and shameful.

And, let me add, that we do not know the mental state of the children who were separated in 2017, a matter that is still in the courts. We can assume their trauma mirrors that of the children the OIG identified in this report.

It should add to the urgency we feel to stop the trauma. ORR is a child welfare agency and we must be ensuring it is upholding its mission, which brings me to the OIG’s recommendations.

One recommendation from the OIG is that ORR should take all reasonable steps to reduce the time that children remain in ORR’s care. I wholeheartedly agree. In fact, I will reiterate what I have been pushing this administration to do for months: rescind the MOA, the memorandum of agreement between DHS and HHS.

With respect to the MOA, this Subcommittee has heard from outside witnesses and ORR grantees, who said it continues to scare away potential sponsors, who otherwise want to take care of a child, but are too afraid to come forward. In fact, at our July hearing, Assistant Secretary Johnson agreed with this Subcommittee that the MOA should be rescinded. Since there has not yet been action, then, it would appear the responsibility to rescind the MOA is in the hands of the White House.

Because if the administration wholeheartedly agrees with the OIG’s recommendation here, then the administration must rescind the memorandum of agreement immediately.

Another recommendation from the OIG is that ORR should identify and disseminate evidence-based approaches to addressing trauma. Again, I wholeheartedly agree.

This Subcommittee has repeatedly provided resources for the care of children: in the Appropriations the House passed the last two years and in the Emergency Supplemental.

With respect to 2019’s appropriations, I thank Ranking Member Tom Cole, then Chairman Cole, for accepting by voice vote my amendment to provide funding for SAMSHA, the Substance Abuse and Mental Health Services Administration, through the National Child Traumatic Stress Network in what was a total of increase $10 million for the Network, $4 million of which was for these children.

We are committed to ensuring ORR and HHS are upholding their mission to care for children, not act as a tool of immigration enforcement. That is why we need to see the administration quickly implement the necessary changes, including the OIG’s recommendations.

Children did not just arrive at our border; they suffered by our hands and they still are suffering due to the long-term mental health trauma. That is not something we can ignore or sweep under the rug. We must race to stop the pain and suffering. Caring for the most vulnerable is the most sensitive of our duties as members of this body, as people of this great nation. There can be no greater sin than allowing ourselves to live by any lesser standard.

So, to close, let me thank the OIG for this report and for their work. I look forward today to hearing more about it and hearing from the administration. I hope to learn from HHS how they intend to take to prevent the traumatization of youngsters, as a result of the administration’s cruel and heartless immigration policies moving forward.

But first, let me introduce my Republican colleague, the Ranking Member of the Subcommittee, Mr. Tom Cole of Oklahoma, for any remarks he would like to make.