Health and Safety

Health Screenings

ORR provides routine and emergency medical and mental health care for all unaccompanied alien children in its care, including an initial medical examination, appropriate follow-up care, and weekly individual and group counseling sessions with care provider clinicians.

Children receive an initial screening for visible and obvious health issues when they first arrive at U.S. Customs and Border Patrol (CBP) facilities. Children must be considered “fit to travel” before they are moved from the border patrol station to an ORR shelter.

Children receive additional medical screening and 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.

Read more about medical services ORR provides to unaccompanied alien children.

Mental Health

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


ORR is committed to protecting the unaccompanied alien children in its custody, and therefore, requires all care providers to report incidents affecting a child’s health, well-being and safety. 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. Care providers must report on a wide range of incidents from, for example, 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 also require notification to the U.S. Department of Justice (DOJ) or the U.S. Department of Homeland Security (DHS).

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. For the great majority of children who are released to sponsors, HHS does not provide ongoing post-release services; rather, those services are limited to children for whom there had been a home study, and to a limited number of other children who have been determined to have mental health or other needs and who could benefit from ongoing assistance from a social welfare agency. In 2015, ORR expanded its hotline to accept calls from unaccompanied alien children or their sponsors seeking assistance with safety-related concerns.

HHS offers post-release services to the child and sponsor if the child was placed within 180 days and the placement has disrupted or is at risk of disruption.  In the event that post-release service case workers or the 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 safety and well-being follow-up calls with unaccompanied children and their sponsors 30 days after the child’s release date.


HHS has strong policies in place to ensure the confidentiality of unaccompanied alien 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.

Zika Fact Sheets (English PDF 652KB) (Spanish PDF 723KB)

Last Reviewed: February 11, 2019