Transcripts For CSPAN3 Hearing On Mental Health Needs Of Mig

The subcommittee will come to order. Good morning to all and welcome to the labor hhs and education appropriations subcommittee. Were here today for another oversight hearing. This time, with Administration Officials and members of the Departments 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. I want to thank our witnesses for being here today. And maxwell, office of the Inspector General, department of health and Human Services. Jonathan hayes, who is the director of the office of Refugee Resettlement. The department of health and Human Services. And jonathan white, department of health and Human Services. This hearing is really part of our oversight responsibility which we take very, very seriously. We must. Considerable taxpayer resources are at stake. And something even more presscis is at stake, the mental and physical well being of children. That is why the office of the Inspector Generals new report was so alarming. It confirms our worst fears that intentional policy choices by this administration created a mental crisis. Which the office of Inspector General said thats health and Human Services and the office of Refugee Resettlement failed to address. Its 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 oigs proposed recommendations which are included in the report. The administration for children and families has concurred with each of the recommendations, but words alone are not enough. The gaps created a Mental Health crisises as children are deali with the effects. As maxwell summarized on page 8 on her testimony, policy changes in 2018 exacerbated existing challenges as they resulted in one, a rapid increase in the number of children separated from their parents and entering the United States. Many of whom were younger. Two, longer stays in orr custody for children, end quote. Those policy changes in 2018 were the administrations zero tolerance family separation policy. It ripped children from their parents and the administrations grossly intentional changes for fingerprinting and screening requirements that ground discharge to a halt. As a result, the childs 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 operational directives in december to reverse their changes to the screening process. I will note those changes followed a consistent drumbeat for accountability from the subcommittee. Now we need to see the agencys plan to improve the discharge process. So were able to get children in and out of orrs care as safely and as 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 it, the onus with respect to discharge is on the contractor, who is responsible for the discharge consistent with policies, o. R. R. Policies and regulations. But the contractor is responsible. So o. R. R. 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 per night per child, the motivation to move these kids may not be as strong as it needs to be. It must be changed because as the oig concluded people have been suffering because of these intentional policy choices. Ms. Maxwell wrote in her testimony, children who experience longer facility stays exhibited higher levels of defiance, hopelessness and frustration along with more instances of selfharm. Also in her testimony on page 8. Separated children exhibited more fear, feelings of abandonment and post Traumatic Stress than did children who were not separated. And the oigs report on page 10 also described how some separated children expressed acute grief that caused them to cry inconsolably. Another story, the oigs report shared a 7 or 8yearold boy who 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 imagine Psychiatric Care to address his Mental Health distress. Its terrible. The administration failed today fully or adequately treat it. As the oig report spotlighted in its executive summary, they failed 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, case loads were reported more than double what they should have been. Unprepared for the younger children, those Mental Health providers who were available were primarily prepared to serve teenagers, not the mental and the social needs of preschoolers who cannot communicate their backgrounds, their needs, or even their pain. So as i read the oigs report and testimony, the administrations intentional policies traumatized youngsters who then did not receive the proper care they needed. Ill say it honestly, i believe its twisted and shameful. Let me add that we do not know the mental state of the children who were separated in 2017. Thats a matter that is still in the courts. Understand we only know about the 2017 children because of the office of the Inspector General and the aclu. And its really very interesting to me as to at the time of july in 2018, who made the decision to certify a list that was inaccurate . It was 2018, not what happened in 2017. What was the role . I dont know, mr. Hayes, about your role. What factors went into making that decision. We can also assume that their trauma of these children mirrors that of the children that the oig identified in this report. It should add to the urgency we feel to stop the trauma. O. R. R. Is a Child Welfare agency. And we must be insuring it is upholding its mission which brings me to the oigs recommendation. One recommendation from oig is that o. R. R. Should take all the reasonable steps to reduce the time that children remain in o. R. R. s care. I wholeheartedly agree. Ill reiterate what ive been saying to this administration for months. Rescind the memorandum of agreement between the department of Homeland Security and the department of health and Human Services. With respect to the agreement the subcommittee has heard from outside witnesses and o. R. R. 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, in our july hearing, assistant secretary johnson agreed with the subcommittee that the memorandum of agreement should be rescinded. Since there have not yet been any action it would appear that the responsibility to rescind the moa is in the hands of the white house. Because if the administration wholehearted wholeheartedly agrees, then the Administration Must rescind the memorandum of agreement immediately. Another recommendation from the oig is that o. R. R. 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 and the Appropriations Bills that the house passed the last two years. And in the emergency supplemental bill. With respect to the 2019 appropriatati appropriatation i want to say thank you to chairman cole for accepting my voice, vote, my amendment to provide funding for the Substance Abuse and Mental Health Services Administration through the National Child Traumatic Stress network in what was a total increase of 10 million for the network. 4 million of which was for these children. We need more funding to the network to deal with this issue. We are committed today insuring o. R. R. And hhs are upholding their mission to care for children, not to act as a tool of immigration enforcement. Which is why we need to see the administration quickly implement the necessary changes including the oigs recommendation. Children did not just arrive at our border. They suffered by our hands and they are suffering still due to the longterm Mental Health trauma. Thats not something that we can ignore or that we can sweep under the rug. We need to stop the pain and the suffering. Caring for the most vulnerable, the most sensitive of our duties as members of this body and as a people of this great nation. There can be no greater sin than allowing ourselves to live by a lesser standard. So to close, i want to say a thank you to the oig to this report, for your work, i look forward today to hearing more about it. Hearing from the administration. I hope to learn from hhs how you intend to take to prevent the traumatization of youngsters as a result of the way i characterize it, the administrations cruel heartless immigration policies moving forward. First, let me introduce my republican colleague, the Ranking Member of the subcommittee, congressman tom cole from oklahoma. Thank you very much, madam chairman. Im going to depart from my prepared remarks for a second. I want to begin with four thanks. The first one is to you. Your focus on this issue has been unrelenting and i think appropriate. While we may disagree over this or that interpretation, the fact is youve kept this committee focused where it needed to be, on the welfare of these people. You deserve all of our thanks. Its the right way to do oversight. We be done weve done it. I want to thank the ig. My mom used to have a wonderful saying, your friends will tell you what you need to know, not what you wanted today hear. I think thats your job and you di did it very well. I want to thank director hayes. I had the opportunity to travel to the border region with him over the august break. I see a lot of effort to implement some of the changes and to be responsive to criticism and to correct the situation that we all agree. Finally, to a much and maligned congress, i want to give a thanks to the congress. It took us a little too long, but we finally gave the Administration Resources it needed in the emergency supplemental. It hasnt solved every problem, but things are better than they were 120 days ago because congress acted. It took us six weeks. Did the same thing for president obama in three. But in the end it was a bipartisan action by congress that provided the resources that began to let us address some of the problems that ms. Maxwell has appropriately and wisely pointed out. Still have a long way to go. This was a promising start. So with that, madam chair, i want to welcome our witnesses for the subcommittees third hearing on unaccompanied alien Children Program. Were here to focus on the Mental Health needs of the children in the care of the department of health and Human Services. I want to focus on the history of this program over the past few years. In 2012, this program received an appropriatation of 169 million. This past year, the fiscal year, 2019 appropriatation, this committee provided more than 1. 3 billion. In seven years, the appropriation for this program has grown by more than 670 . Theres been a focus on it here. In 2012, the department of health and Human Services office of Refugee Resettlement had over 13,000 children referred to them by the department of Homeland Security. In the current year, hhs has had over 60,000 children referred to them for care. By the end of the fiscal year, hhs will likely have cared for over 70,000 children. More children than at any prior year. Again, in just seven years, an increase of 370 . Pretty staggering. Both the democratic and a republican president have requested supplemental appropriations in the billions to support unanticipated arrivals of teenagers. Hhs routinely cares for tens of thousands of children who travelled thousands of miles. Objectively this is a crisis and one that needs a comprehensive bipartisan solution. Federal law requires the department of Homeland Security to transfer to hhs any unauthorized minor not accompanied by a parent or legal guardian. This means when Customs Enforcement apprehend a minor with an uncle, an aunt, grandmother, grandfather, older brother, sister, the law defines that minor as unaccompanied and requires transfer of that child to hhs. I understand there are many who believe these children should remain with the adult relative their traveling with. Thats not the law of the United States and thats probably something we should look at. I also want to address the topic of zero tolerance policy implemented by the department of justice in 2018. The administration has made several attempts to stem the flow of migration happening to our southern border. The zero tolerance policy was clearly a mistake. And im glad that the president quickly ended it and the implementation of it. But the consequences continue. And while we may all disagree on the merits of such a policy, we can all agree hhs does not play a role in the establishment of immigration policy. Hhs does not separate children from their parents. Hhss responsibility is to care for children referred to them by dhs and to find suitable sponsors. In that area weve made considerable progress. As i said, many children are coming to our borders through mexico from Central America. No surprise that such an arduous, dangerous journey is traumatic. Many children left Family Members, poverty and dangerous conditions to come here. Once apprehended by dhs, the children are turned over to hhs to begin the process of finding a sponsor. For a short time the children are in hhss care, theyre provided with education and legal information. Referral to Mental Health services can be part of that process. The office of Inspector General highlighted the challenges with meeting the Mental Health needs of the children in care. A significant portion of america, frankly also faces the challenge of assessing Mental Health service accessing Mental Health services. According to the administration, 34 of the American Population live in a Mental Health provider shortage area. The challenges facing adequate access to Mental Health services is something many areas are having to deal with. Ill add when i was fortunate to be chairman of this committee, there was a lot of Mental Health provisions in that. And a former member, congressman murphy, came to me and i said youve got multiple things here. I cant fund them all. Im not an authorizer, i got to live within a budget. He hesitated for a second. Number one thing is we need more Mental Health care professionals. Otherwise were just competing back and forth for a very small pool of professionals. We need to invest more in creating literally the healthcare professional service core that we need. I appreciate the desire for hhs role in the care of these children to be expanded. However, given the unprecedented surge in the number of children crossing our southern border, hhs primary focus should be the establishment of small facilities. I want to commend you, mr. Hayes, youve done a lot of that in the last 60 to 90 days. I know my friends at hhs are doing their best that they can with a challenging situation. I want to commend them and note that theyre facing in many of the same challenges faced by the prior administration. Its my hope this committee will work with them in a bipartisan fashion to provide the resources needed to confront this urgent challenge. That, madam chair, i yield back my time. Thank you, very much congressman cole. Id like to yield to the Ranking Member of the full appropriations committee. Shes the chairman. You can call me anything. I said the chair you said the Ranking Member. Make no mistake. She is a chair. I thank you, madam chair. My friend for a very long time. I want to thank the chair and Ranking Member for holding this hearing. I thank you specter general maxwell and mr. Hayes for joining us today. The fact were here again today is a clear example of how damaging and cruel the Trump Administrations actions have been on the Mental Health of vulnerable children. This could have been largely avoided. Children belong with their parents. Now, many of us have read this