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HHS Official: We Were Never Asked About Immigrant Child Detentions

WASHINGTON -- Members of a House subcommittee pressed Health and Human Services officials and others regarding what the department knew about the Trump administration's "zero tolerance" policy on illegal immigration, and whether the department had tried to stop it.

On April 6, 2018, Attorney General Jeff Sessions announced "an escalated effort to prosecute those who choose to illegally cross our border." The policy led to thousands of children being separated from adult family members at the U.S.-Mexico border, until President Trump signed an executive order reversing the decision in June 2018. Later that same month, a federal judge ordered the children be reunited with their families.

A January 2019 report from the HHS Office of the Inspector General suggested that thousands more children may have been separated at the border in 2017, before the official policy was announced.

Government officials along with physicians, psychologists, and other witnesses described the impact of such separations on parents and children, during a hearing of the House Energy and Commerce Committee's Oversight and Investigations subcommittee on Thursday.

"There's no evidence that HHS leaders ever tried to stop this abhorrent policy. ... We need to know why," said subcommittee chair Diana DeGette (D-Colo.).

The committee is also still trying to learn how many children were separated from their parents, and what's being done to reunify them, she added.

HHS Role in Separation, Reunification

Cmdr. Jonathan White, a career Public Health Service officer who previously served as the Office of Refugee Resettlement's (ORR) deputy director, stressed that no one in the department was responsible for the actual separations. ORR manages the "temporary custody" of such children, typically unaccompanied children, referred there by the Department of Homeland Security.

Of the more than 2,500 children separated from their families -- the government has yet to issue a confirmed final figure, though estimates vary from about 2,600 to 2,800 -- only six have yet to be reunited, according to White.

When questioned by ranking member Brett Guthrie (R-Ky.), White said he only became aware of the formal policy of family separations when the Attorney General announced it on television last April.

"Would you have advised the DOJ or DHS to implement the [family separation] policy ... if they had asked?" Guthrie asked.

"Neither I, nor the current personnel at ORR, would ever have supported such a policy," White said emphatically.

Regarding the scope and duration of the problem, White said that he had observed an increase in the number of children being brought into ORR's custody in 2017 and expressed concerns to leadership, including Scott Lloyd, ORR director. White said he was told that a "family separation [policy] wasn't going to happen."

White said he had no reason to doubt the statement.

He said Congress could limit the administration's authority to separate children from their families.

"There is no specification in law ... about the permissible grounds for separating a child from a parent," he said. "If you want to see that, that's on y'all."

Impacts of Separation

Also at the hearing, physicians and psychologists described the short and long-term impacts of separation and ways to prevent such issues in the future.

"Prolonged exposure to highly stressful situations, known as toxic stress, can disrupt a child's brain architecture and adversely impact short and long-term health," said Julie Linton, MD, who spoke on behalf of the American Academy of Pediatrics as co-chair of its Immigrant Health Special Interest Group.

A parent or primary caregiver serves as a "buffer" for such stress, and "separation robs children of that buffer."

The immediate response to such separations for children can include abdominal pain, headaches, changes in "eating, sleeping, and toileting," and behavioral problems including "anger, irritability, and aggression," as well as challenges with learning and memory, she said.

Separated children may also endure "feelings of mistrust ... guilt or shame," she said. They are also more susceptible to chronic conditions such as depression, post-traumatic stress disorder, diabetes, or heart disease, Linton added. She also noted that if a pregnant woman is separated from her children, there is risk of adverse outcomes for the unborn child due to the mother's stress.

Cristina Muñiz de la Peña, PhD, a clinical psychologist and co-founder of Terra Firma at Montefiore Medical Center in New York City, testified on behalf of the American Psychological Association. She told a story of one immigrant mother separated from her young son for 2 months. The mother brought her then 3-year-old son to Muñiz de la Peña because of his extreme anxiety and hypervigilance.

"During the sessions, the boy clung to his mother [with] a fearful demeanor, and had great difficulty relaxing and letting go to initiate the normal exploring behavior of a child his age," Muñiz de la Peña said.

Research has shown that the longer a child is separated from a parent or caregiver the greater the symptoms of depression and anxiety, she noted. Sustained separations can also lead to difficulty trusting adults and institutions, and hinder "educational attainment," she added.

"In lay terms, attachment, love, and protection from a parent is to a child's mental health what water, oxygen, and food are for physical health."

Next Steps

Linton stressed the importance of distinguishing separations for cause from those ordered under the "no tolerance" policy.

"Government sanctioned systematic separation without any type of consideration of what's in the best interest of a child is never in the best interest of a child," she said. "No child should ever be separated from his or her parent without a very clear concern that the child's safety is at risk at the hand of a parent," and that decision should be made in a family court.

Jennifer Podkul, JD, senior director of policy and advocacy for Kids in Need of Defense, also underscored that child welfare specialists should be involved in any separation decisions.

Linton pressed committee members not to allow children to be placed in unlicensed facilities, either by the HHS or the Department of Homeland Security. The AAP has recommended "formal supervision" of all facilities where children are being cared for by child welfare professionals, such as independent pediatricians.

Source: https://www.medpagetoday.com/primarycare/generalprimarycare/77933

HHS Official: We Were Never Asked About Immigrant Child Detentions

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And I have no reason to doubt the veracity of their statements. When White learned of the possibility of the policy being implemented in early 2017, he produced memos, wrote emails and raised his concern in meetings, he said. As of this week, there are 12,800 immigrant children being cared for by the Health and Human Services Department. And that counts only children who have already left, experts point out, making it impossible to know how long some kids have been waiting. About drugs simply

"The ultimate security is not releasing any child to a sponsor, because then nothing would happen to them. The immediate response to such separations for children can include abdominal pain, headaches, changes in "eating, sleeping, and toileting and behavioral problems including "anger, irritability, and aggression as well as challenges with instagram vows to remove all graphic self-harm images from site learning and memory, she said. "I'm girl, 13, dies one day after getting cancer diagnosis not aware of that, but that doesn't mean it didn't occur White said. Muddying the two could undermine the best interests of the children, she said. "I would argue that sharing information on the immigration status of sponsors with ICE, I don't see how that would have any impact on child safety (vs.) the chilling effect it would have.".



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