Office of the Assistant Secretary | 330 C Street, S.W.

, Suite 4034
Washington, D.C. 20201 | www.acf.hhs.gov

September 28, 2022

The Honorable Kathy Manning
U.S. House of Representatives
Washington, DC 20515

Dear Representative Manning:

Thank you for your letter dated July 18, 2022, regarding the Department of Health and Human
Services’ (HHS) Office of Refugee Resettlement’s (ORR) plans to open an Influx Care Facility
(ICF) in Greensboro, North Carolina.

By statute, HHS is required to provide care to all unaccompanied children referred to ORR by
the Department of Homeland Security (DHS). See 6 U.S.C. 279; 8 U.S.C. 1232(b). An
unaccompanied child is a child who has no lawful immigration status in the United States; has
not attained 18 years of age; and with respect to whom there is no parent or legal guardian in the
United States, or no parent or legal guardian is available to provide care and physical custody.

HHS is committed to ensuring the health and safety of all children in ORR care, and ORR
designs its continuum of care with this in mind. ORR’s primary mission is to provide
unaccompanied children with appropriate and safe care and shelter while working to safely and
timely release each child to a vetted sponsor, often a close family member, who can care for the
child’s physical and mental well-being while the child’s immigration claims are adjudicated.

ORR funds a network of approximately 220 care provider facilities throughout the country in 22
states, many in residential neighborhoods. These facilities are run by grantees and contractors
with expertise in childcare. For the safety of the children in our care and security of the
facilities, we do not provide specific locations. Sites are selected after a thorough review of
specifications and a location’s suitability for children. When ORR identifies a site, it considers
modifications that would be necessary, the availability of infrastructure, the location, the cost of
operating a shelter at the site, and other factors that can affect its appropriateness for children.

ORR also works in close coordination with local officials, including public safety officials.
Children do not attend local schools while in ORR care (unless they are in a long-term foster
care setting) but receive education on-site at the care provider facilities. Off-site outings under
the direct supervision of care provider staff may be used to meet minimum service requirements
found in Section 3.3 of the ORR Unaccompanied Children Program Policy Guide (e.g.,
recreation and leisure time services, medical services, religious services) or to supplement those
services.
 The Honorable Kathy Manning
Page 2

As with all ORR facilities, HHS and ORR take all necessary precautions to ensure the security
and safety of unaccompanied children as well as the surrounding communities. This includes
on-site security, continual staff training in trauma-informed best child welfare practices, and
relationships with local law enforcement. ORR provides internal security and perimeter security
services for ICFs, and per Section 7 of the ORR Unaccompanied Children Program Policy
Guide, ORR enters into agreements with federal, state, and/or local security providers or law
enforcement entities to protect life and property and investigate crimes, within the confines of
influx care facilities.

At ICFs, security assessments, access to emergency response services, and evacuation plans are
completed in tandem with local law enforcement. Although on-site security is provided by the
contractor, ORR coordinates closely with Federal Protective Services (FPS), the Federal Bureau
of Investigation, and local law enforcement to evaluate security needs. FPS provided a site risk
and security assessment for Greensboro-Piedmont ICF, which has informed the safety and
security plan for the site. There are security procedures and processes in place to vet and
approve visitors for tours and other approved on-site activities. If an ORR program has an
unauthorized unaccompanied child absence, ORR informs local law enforcement and other
necessary stakeholders per Section 5.8 of the ORR Unaccompanied Children Program Policy
Guide and, when necessary, may refer the child to a more restrictive setting upon return to ensure
the safety of that child. Furthermore, unaccompanied children are under consistent supervision
while in ORR care as outlined in Section 4.4 Staffing and Supervision of the ORR
Unaccompanied Children Program Policy Guide.

ORR has and will continue to convene regular stakeholder meetings with local law enforcement
and community leaders to provide information about the site, answer questions, and work in
collaboration to provide for the safety of children, staff, and the local community. ORR staff
met with local law enforcement from the Greensboro Police Department, the Guilford County
Sheriff’s Office, and the City of Greensboro Community Relations Department on August 16,
2022, to discuss the Greensboro Piedmont Academy ICF and answer questions the agencies had
on ORR operations, security and security policies for ICFs, emergency response protocols, and
incident reporting procedures. On August 30, 2022, ORR met with North Carolina lawmakers to
provide an initial briefing on who ORR is, what the Unaccompanied Children Program is, and
what to expect from the site in Greensboro. On August 31, 2022, ORR met with the Assistant
County Manager, Director of Public Health, and Director of Social Services to discuss
partnerships with local medical providers, health staffing, and emergency management services.

ORR also facilitates and funds health care for all unaccompanied children in its custody. ORR
has developed its medical services policies with the goals of ensuring the children’s physical and
mental well-being and the safety of care providers, medical personnel, and communities.
Through its care providers and other healthcare professionals, ORR provides routine medical and
dental care; family planning services; emergency health services; a complete medical
examination (including screening for infectious diseases) within 48 hours of admission unless the
youth was recently examined at another facility; immunizations; administration of prescribed
medications and special diets; and appropriate mental health interventions.
 The Honorable Kathy Manning
Page 3

Care providers must deliver services in a standardized manner that is sensitive to the age, culture,
native language, and needs of each unaccompanied child. Care providers also must meet state
and local licensing and public health requirements. Serious medical services, including
significant surgical or medical procedures and medical services that may threaten the life of an
unaccompanied child, require heightened ORR involvement by federal staff and limited
decision-making by ORR-funded care providers.

Each ORR shelter has access to medical providers and mental health counselors on a 24/7 basis.
Unaccompanied children receive medical and mental health screenings and any follow-up care
needed for injuries or illnesses. Children who have health conditions that cannot be treated on-
site are taken to local hospitals. Anytime that an unaccompanied child is off-site, which most
frequently is due to a medical appointment, they are chaperoned for the entire duration of the
excursion. It is important to note that children with complex medical cases are not placed in
ICFs.

All ORR facilities implement COVID-19 protocols including regular testing, provision of
COVID vaccinations, frequent hand washing and sanitization, mask wearing, cohorting, isolating
and quarantining positive and exposed cases – all in alignment with the most up-to-date Centers
for Disease Control and Prevention (CDC) guidelines. Additionally, ORR, in collaboration with
CDC, continually reviews COVID-19 trends among children in ORR care and the surrounding
communities to determine whether and when mitigation strategies should be enhanced, modified,
or discontinued.

The number of children at the Greensboro ICF facility will be determined by several factors
including capacity in the ORR standard network and number of referrals, but the capacity is
currently planned to be a maximum of 800 children. Children residing at the Greensboro ICF
will be both male and female between the ages of 13-17. The current average length of stay for
children at an ICF is 17 days. To support ORR’s mission at the Greensboro ICF, staffing
procedures are in place to hire at least 1,500 people to work across two or three shifts. This will
include the employment of youth case workers, case managers, clinicians, teachers, doctors and
nurses, and logistics and food staff across various shifts. ICF staffing is managed by a contractor
through a government contracting process. The contractor has shared information on job
openings with the local community through job postings, connections with local officials, and
job fairs. The job postings are included in the opportunities listed at
https://www.deployedservices.com/careers/.

Community partnership is vital to the success of ORR programs. ORR held two community
stakeholder meetings on July 19 in Greensboro. These meetings included local elected officials,
county and city administrators, local religious organizations, local advocacy groups, and the
neighborhood property board. These meetings served as an opportunity for ORR to share
information on the Unaccompanied Children Program, provide details on the new site, and
answer questions from community stakeholders. At your request, ORR has also provided a
community resource email for the site - GreensboroPiedmontAcademy@acf.hhs.gov – to answer
questions and address any concerns.
 The Honorable Kathy Manning
Page 4

Depending on the finalization of all contracts, the site might prepare to receive children by the
end of this calendar year. The decision to place children will also be informed by the current
census and capacity across ORR’s network. Children will not arrive at the facility before the site
is ready to safely receive children. ORR continues to prepare the facility based on ORR capacity
needs and will notify stakeholders within 15 days of activating the facility.
Thank you again for your time and dedication to this matter. If you have any additional
questions, please contact Scott Logan, Director for the Administration for Children and Families’
Division of Legislative and Regulatory Affairs within the Office of Legislative Affairs and
Budget, at (202) 401-4529.

Sincerely,

January Contreras
Assistant Secretary
Administration for Children and Families
U.S. Department of Health and Human Services