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Financial Costs Are Mounting As HHS Tries To Reunite Families

AILSA CHANG, HOST:

When a public health emergency hits, whether it be a hurricane, Ebola or Zika, one of the agencies that jumps in with resources is the Department of Health and Human Services. HHS is also at the center of handling the White House policy that had separated children from their parents at the border. And as HHS continues trying to reunite families now, the financial costs are mounting. Politico reports that just within the past two months HHS has spent $40 million for housing, caring and reuniting the families.

Mark Greenberg worked at the Administration for Children and Families in HHS from 2009 until just last year. And he joins us now to talk about how the agency decides how money is spent. Welcome.

MARK GREENBERG: Thank you.

CHANG: So I imagine there isn't some pot with $40 million lying around HHS waiting to be deployed for whatever purpose. And I'm just curious. In your experience, when the agency is faced with a new challenge, how does it figure out where the money to address that challenge should come from?

GREENBERG: The agency gets an appropriation from Congress. It tries to make that money last through the year. And then if sudden, unexpected costs come up, it has to figure out what to do next.

CHANG: And in your experience, how do you figure out where the additional money should come from?

GREENBERG: It's not an easy process. Basically, the choices are - there is some ability to move around money within the Office of Refugee Resettlement. There is the possibility of getting money transferred from other parts of the HHS budget. And if neither of those will accomplish what's needed, then there's the possibility of asking Congress for a supplemental appropriation.

CHANG: And can you just describe what that conversation is like? Like, take me into the conference room. Let's say you're at the table trying to figure out what transfers of money to authorize inside the department. How would you make that decision?

GREENBERG: That decision is ultimately made by the secretary. And I do want to emphasize, though, that we did face issues like that, but we faced those kinds of issues because there was a large unexpected increase in arrivals of unaccompanied children.

CHANG: Right.

GREENBERG: The really big difference here is that the pressures are happening because the administration decided to do family separations and place the children in the shelters, which were really intended for a totally different purpose.

CHANG: I wanted to ask you about those shelters. The children are being housed in these so-called influx shelters. What is an influx shelter, and when are they usually used?

GREENBERG: There are two main categories of shelters - standard shelters and influx shelters. And the standard shelters are the ones that operate year-round. And then if there is a sudden unexpected increase, the agency will need to open up what are called influx shelters. And they are much more costly to operate.

CHANG: According to Politico, they're costing about $800 per night per child. Why would it be such a high cost?

GREENBERG: Because they have to be opened very quickly and need to have the capacity to close very quickly. So it involves doing extremely rapid hiring of staff for them. And often the influx shelters are in remote locations where there aren't people to hire in the community. And people need to come in to operate them and need to be living out of hotels during the time that they're doing so. And because this is all done so quickly, it winds up being much more costly than the standard shelters.

CHANG: Mark Greenberg is a senior fellow at the Migration Policy Institute. He worked at the Administration for Children and Families in HHS until last year. Thank you very much for coming in today.

GREENBERG: Thank you.

CHANG: We have asked HHS to confirm how much money it's had to divert to handle the White House's family separation policy, and we're waiting for a reply. Transcript provided by NPR, Copyright NPR.