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


In spring 2018, the Department of Justice and Department of Homeland Security (DHS) adopted a zero-tolerance policy under which large numbers of families entering the United States without authorization were separated by DHS. Typically, adults were held in Federal detention while their children were placed in Department of Health and Human Services (HHS) custody and provided care through the Unaccompanied Alien Children (UAC) Program. A Federal district court subsequently ordered the Federal Government to reunify separated families who met certain criteria. Given the impact of the zero-tolerance policy on vulnerable children and families, OIG conducted this review to examine challenges that HHS faced in responding to the zero-tolerance policy and carrying out the reunification effort.


This report synthesizes information from interviews with, and written responses from, senior HHS officials and HHS staff; interviews with staff at 45 HHS-funded care provider facilities under the UAC Program; case reviews for a purposive sample of separated children; and more than 5,000 documents obtained through requests to the Department, from facility staff, and from interview respondents. We analyzed interview and documentary data to identify significant challenges that HHS and facilities faced in responding to the zero-tolerance policy and reunifying separated children, as well as factors that contributed to those challenges.


Interagency channels for coordinating immigration policy across Federal departments were not used to notify HHS of the zero-tolerance policy in advance. Meanwhile, key senior HHS officials did not act on staff's repeated warnings that family separations were occurring and might increase. HHS's lack of planning for the possibility of larger-scale family separation left the Department unable to provide prompt and appropriate care for separated children when the zero-tolerance policy was implemented. Further, because no procedures or systems had been established to track separated families across HHS and DHS for later reunification, HHS struggled to identify separated children. Additionally, care provider facilities faced significant operational challenges at every stage of the reunification process, complicated by poorly-communicated guidance from HHS. Finally, HHS has taken steps to improve tracking of separated children, but the procedures include manual processes that are vulnerable to error.


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. HHS should also 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. Additionally, HHS should improve communication to care provider facilities regarding interim guidance, operational directives, and other instructions that are not immediately available in published policy documents. Finally, HHS should further improve its ability to identify and track separated children by reducing reliance on manual processes.