Improving post-release care to migrant children and sponsors: Standardizing the Safety and Wellbeing Follow Up Calls

About ACF

The Office of Refugee Resettlement (ORR), within the Administration for Children and Families (ACF), helps new populations maximize their potential in the United States by linking them to critical resources that assist them in becoming integrated members of American society. In addition to resettlement services, ORR runs the Unaccompanied Children (UC) program. ORR has provided care for and found suitable sponsors for over 410,000 unaccompanied children.

Unaccompanied children apprehended by Department of Homeland Security immigration officials are transferred to the care and custody of ORR. ORR promptly places unaccompanied children in the least restrictive setting that is in the best interests of each child, who is provided age-appropriate care and wraparound services in one of the approximately 200 state-licensed facilities and programs funded by ORR in 22 states. As soon as children enter ORR care, they are put in contact with their parents, guardians, or relatives, if known, and the process of finding a suitable sponsor begins. ORR evaluates potential sponsors’ ability to provide for the child’s physical and mental well-being, as required by law. Once ORR approves an unaccompanied child for release, the care provider collaborates with the sponsor to ensure physical discharge happens as quickly as possible.

ACF Tech, a division within ACF, seeks to deliver reliable, purposeful, and secure technology, data, and innovation to advance the ACF mission. ACF Tech’s U.S. Digital Corps Fellows are working to improve the technology within the UC program by modernizing its core technology platform and building supplemental applications.

The challenge

ORR’s care providers must conduct a Safety and Well Being (SWB) Follow-Up Call with an unaccompanied child and their sponsor 30 days after the child’s release. The purpose of the follow-up call is to determine whether the child is still residing with the sponsor, is enrolled in or attending school, is aware of upcoming court dates, and is safe.

Currently, there is no standardized form or series of questions for the hundreds of care providers to use. As a result, each program uses their own scripts, questions, and formats.

Furthermore, care providers must document the outcome of the follow-up call in the child’s case file. Currently, providers do this by uploading the call notes as a document or PDF in ORR’s case management system since there is no digitized version of questions within the system itself. The UC program manually compiles an Excel sheet with call outcomes in a time-intensive process.

The goal was to standardize the questions asked to unaccompanied children and their sponsors after the child leaves ORR care to ensure all children receive consistent levels of support. To address this problem, two USDC Fellows conducted a five-week research and design sprint that concluded in April 2023.

The approach

USDC product management and design fellows at ACF Tech partnered with ORR project officers to introduce design thinking to the policymaking process, following a process of iterative research and synthesis to define the problem statement and turn unstructured interview findings into more clear and actionable insights.

In the first research phase, the Fellows conducted a discovery effort to better understand the challenges and scope down the problem. They first met with the project officer team to understand their goals around expanding post-release services and broader program considerations using a card-sorting exercise. They also engaged the policy team about Paperwork Reduction Act compliance and the data team about recommendations from child welfare organizations. From these conversations, the Fellows learned of several open questions that needed to be addressed:

• How might we design calls that are open-ended enough for care providers to meet the unique needs of children and sponsors, but specific enough to provide consistent program-level data?
• How can we reach as many children and sponsors as possible?
• How might we design questionnaires that ask timely and relevant questions at different touchpoints post-release?
• What are the impacts and potential synergies of shifting the follow-up call responsibilities from shelters to post-release services programs?

In the next phase, the Fellows interviewed two groups of users affected by the Safety and Well Being Follow Up Call: leaders of home study and post-release services programs, who would implement the new process, and case aides, who currently conduct calls. After five hours of calls, the team was better able to empathize and understand the perspectives of the callers, sponsors, and children. They learned that one of the biggest challenges, for everyone involved, was limited availability of sponsors and children during business hours, when many are working or in school.

Finally, the Fellows conducted a process map and content audit of the existing universe of procedures, reports, proposals, and a motley of program questionnaires to learn best practices that shelters were already using in their SWB calls. They prepared a proposal of over 30 new plain language questions that incorporated three virtual check-ins at seven business days, 14 business days, and 30 business days after a child’s release to a sponsor. An expanded medical and mental health section would eliminate the need for redundant post-release COVID-19 check-ins. The proposal also included relevant pre-call information, standardized the post-call assessment and escalation process, and coordinated with partners such as the Department of Justice’s Executive Office of Immigration Review.

The solution

USDC Fellows passed the final draft of SWB questions, informed by five hours of user interviews and a content audit, to the UC Policy Team to submit the questions for a substantive clearance process with the Office of Management and Budget, as required by the Paperwork Reduction Act. Since this standardized set of questions will be asked to care providers, children, and sponsors - who are members of the American public - the questions must go through a clearance process that includes extensive internal and external review, including public comment. The standard timeline for PRA clearance is six to nine months.

Once that clearance process is complete, care providers will receive and be trained on the standardized set of questions. Additionally, the questions will be digitized into the UC program’s case management system to reduce the need for burdensome paper-based methods. This will allow ORR to automatically flag any child who needs additional support, monitor completion rates, and identify trends across programs - ensuring that ORR provides as high-quality care as possible to children and sponsors after their release.