Refugee Office Updates Health Forms for Unaccompanied Children
Published Date: 10/26/2026
Notice
Summary
The Office of Refugee Resettlement is updating health forms for unaccompanied children in their care to make them clearer and easier to use. These changes will improve how health info is shared, including with Homeland Security when needed, and help kids get the care they deserve. Public comments are open until November 25, 2026, with no extra costs expected.
Analyzed Economic Effects
4 provisions identified: 3 benefits, 0 costs, 1 mixed.
Health data shared with DHS for repatriation
If a child in ORR care who requires daily health management is identified for DHS-led repatriation, ORR will share limited health information with the Department of Homeland Security (DHS) Field Office Juvenile Coordinator when travel arrangements have been made. Shared items include the child's name, alien number, date of birth, active diagnoses or concerns that require management during travel, allergies, current medications and dosages, isolation/quarantine requirements, health-related accommodations (including durable medical equipment), and health-related travel restrictions. ORR states this sharing is for continuity of care and is not for immigration enforcement purposes.
Surgery approvals and emergency waiver
ORR requires that all non-emergent procedures performed under anesthesia or IV sedation have ORR approval, and the Serious Medical Procedure (SMR) form must be completed by the treating healthcare provider and submitted to ORR before ORR can decide. ORR will waive the SMR form requirement if completing it is not in the child's best interest (for example, during a hospitalization or emergency department visit related to a medical emergency).
Large reduction in provider paperwork burden
ORR revised the Medical Assessment Form, Dental Assessment Form, and SMR to remove redundant fields and add skip patterns. ORR reports the overall annual burden of response decreased by 93.2 percent and recordkeeping time decreased by 90.4 percent, with estimated total annual response burden of 4,166.6 hours and estimated total annual recordkeeping burden of 9,613.92 hours across respondents.
Better health fields for accommodations and records
ORR will strengthen disabilities and accommodations fields, add a field for all ordered or completed labs and imaging on the Medical Assessment Form, replace fixed diagnosis choices with free-text fields, add clearer instructions by visit type, and include a healthcare provider acknowledgement and signature section authorizing record sharing with ORR. These changes are intended to improve data quality, care tracking, and alignment with ORR requirements.
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Key Dates
Department and Agencies
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