Health and Safety

ORR provides routine and emergency medical and mental health care for all unaccompanied children (UC) in its care.


Health Screenings

Children receive an initial medical screening and appropriate follow-up care.

An initial medical exam takes place within 48 business hours of admission to:  

  • Screen for infectious diseases
  • Identify acute and chronic conditions
  • Provide immunizations 

They also receive vaccinations at ORR shelter facilities. If children are found to have certain communicable diseases, they are separated from other children and treated as needed.

While children are in ORR custody, the federal government is responsible for their medical care.

Additional health care services include emergency care, follow-up immunizations, administration of prescribed medication and special diets, appropriate mental health counseling/interventions, and an initial dental exam done 70—90 days after placement into care provider programs

Additional information on UC medical services is provided in the UC Policy Guide.

Mental Health

ORR provides mental health care for all unaccompanied children in its care, including any appropriate follow-up care, and weekly individual and group counseling sessions.

Division of Health for Unaccompanied Children (DHUC)

Within ORR, the Division of Health for Unaccompanied Children (DHUC) is responsible for overseeing and monitoring the health care of UC and for providing guidance to care provider programs and healthcare professionals. In addition, DHUC ensures that reportable infectious diseases are identified, reported, and controlled.

DHUC is made up of physicians, epidemiologists, nurse consultants, and medical coordinators who are available to care provider programs 24 hours a day, 7 days a week.  


ORR is committed to protecting the unaccompanied children in its custody. Care providers are responsible for safety planning for the facility as a whole and for developing in care individual safety plans for those children who have special security concerns.

All care providers are required to report any incident affecting a child’s health, well-being, and safety, from verbal threats by one youth against another youth to physical altercations or allegations of sexual abuse.

ORR requires care providers to report and document in accordance with mandatory reporting laws, state licensing requirements, federal laws and regulations, and ORR policies and procedures. When appropriate, ORR works closely with outside entities, such as law enforcement, state licensing and child welfare authorities. Some incidents require notification to the U.S. Department of Justice or the U.S. Department of Homeland Security.


HHS has strong policies in place to ensure the confidentiality of unaccompanied children’s personal information. These children may have histories of abuse or may be seeking safety from threats of violence. They may have been trafficked or smuggled. HHS does not release information about individual children or their sponsors that could compromise the child’s location or identity.

Post-release Services

Once a child has been placed with a parent, relative, or other sponsor, the care and well-being of the child becomes the responsibility of that sponsor.  HHS provides ongoing services in limited cases, Services may be provided if a child has received a home study, or when the child has a mental health or other need and could benefit from ongoing assistance from a social welfare agency.

In 2015, ORR expanded its UC Help Line to accept calls from unaccompanied children or their sponsors looking for help with school enrollment, parenting resources, and safety-related concerns.

If a child is placed with a sponsor, within 180 days and the placement is disrupted or is at risk of disruption, a referral for post release services may be made. In the event that post-release service case workers or Help Line workers are concerned about a child’s safety, they are required under state and local laws to report those concerns to local child protective services and to local law enforcement, in some instances.

Care providers also conduct follow-up calls with unaccompanied children and their sponsors 30 days after the child’s release date.

Current as of: