Medical care for the 13,000 migrant children in U.S. custody

Pro Publica reports that the care of immigrant children in U.S. custody has faced intense scrutiny over the past year as thousands of sexual abuse allegations and reports of personal enrichment by some nonprofit operators have raised questions about the federal government’s ability to monitor its network of about 100 shelters.

The federal Office of Refugee Resettlement (ORR), in the Department of Health and Human Services, oversees the shelters. Lapses in medical care documented by a New Jersey-based pediatrician, Elana Levites-Agababa raise critical questions about the patchwork of state regulations that ORR relies on to monitor the shelters, which range from tiny group homes to 2,000-bed facilities and are often tucked in small towns and remote locations. The other day, a 16-year-old boy died shortly after arriving at an ORR shelter in Texas.

There were 13,500 children in shelters as of the end of February, more than five times as many as there were two years ago. On May 1, Trump requested congressional funding to nearly double the number of beds.

Under a federal court settlement, the shelters are required to provide routine medical care and emergency services, including a medical exam, immunizations and screening for infectious diseases within 48 hours of admission.

ORR’s guidelines further require shelter workers to observe children for signs of illness and to respond to nonemergency requests for medical attention within 24 to 48 hours. The shelters must notify ORR within four hours of an emergency room visit, review hospital discharge plans and follow doctors’ treatment recommendations.

But while ORR has the power to remove kids from shelters and cut off funding, it’s also desperate for beds, and any major reduction in capacity could create a crisis. Those conflicting priorities are why child advocates say state oversight is important.

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