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entitled 'Refugee Assistance: Little Is Known about the Effectiveness 
of Different Approaches for Improving Refugees' Employment Outcomes' 
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United States Government Accountability Office: 
GAO: 

Report to Congressional Committees: 

March 2011: 

Refugee Assistance: 

Little Is Known about the Effectiveness of Different Approaches for 
Improving Refugees' Employment Outcomes: 

GAO-11-369: 

GAO Highlights: 

Highlights of GAO-11-369, a report to congressional committees. 

Why GAO Did This Study: 

In fiscal year 2009, the United States resettled close to 70,000 
refugees fleeing persecution in their homelands. To assist in their 
transition to the United States and help them attain employment, the 
Department of Health and Human Services Office of Refugee Resettlement 
(ORR) provides temporary cash, medical, and other assistance through 
four different assistance programs. The economic downturn and an 
increase in refugee arrivals posed challenges to ORR’s efforts to 
assist refugees and estimate program costs, resulting in fluctuating 
unobligated balances. Congress required GAO to examine (1) differences 
in ORR’s refugee assistance programs and factors program providers 
consider when placing refugees in a particular program; (2) refugee 
employment outcomes and the effectiveness of different approaches to 
providing assistance; and (3) how ORR estimates program costs and how 
its estimates have affected the agency’s unobligated balances. GAO met 
with federal and state officials, voluntary agency staff, and 
refugees; reviewed selected case files; analyzed ORR performance data 
for fiscal years 2007 through 2009; and reviewed and analyzed relevant 
federal laws, regulations, and budget documents. 

What GAO Found: 

ORR supports several approaches to providing cash, medical assistance, 
and social services to refugees through its Matching Grant, Publicly 
Administered, Wilson/Fish, and Public Private Partnership programs. 
The Matching Grant program, which is administered and partially funded 
by private voluntary organizations, features several design elements 
that set it apart from ORR’s other programs. For example, voluntary 
organizations select refugees for the Matching Grant program and those 
who participate have 4 to 6 months to find employment before their 
cash assistance ends. Most states also offer one of ORR’s other 
programs: these programs enroll any eligible refugee, and participants 
have up to 8 months to find a job before their assistance ends. Three 
of ORR’s programs—-the Wilson/Fish, Public Private Partnership, and 
Matching Grant-—were designed to give providers flexibility in 
developing innovative approaches to help refugees find employment and 
become self-sufficient. GAO observed providers using a number of 
different approaches, including offering refugees cash incentives for 
early employment, and these approaches varied within and among 
programs. Voluntary agencies told GAO that they consider several 
factors, such as the refugee’s English language and employability 
skills, in deciding whether to enroll a refugee in the Matching Grant 
program or another ORR assistance program. 

ORR’s four assistance programs showed some success in helping refugees 
obtain employment in fiscal year 2009, but the percentage of program 
participants who obtained employment declined in recent years and 
little is known about which approaches are most effective in improving 
the economic status of refugees. In fiscal year 2007, between 59 
percent and 65 percent of refugees receiving cash assistance from ORR 
programs entered employment within 4 to 8 months. By fiscal year 2009, 
these rates decreased to between 31 percent and 52 percent, depending 
on the program. Little is known about the effectiveness of the 
different approaches providers use to improve employment outcomes for 
refugees, such as intensive case management and employment incentives, 
in part because of differences in the way programs are structured and 
the populations they serve and in part because of differences in the 
way program performance is measured. 

ORR’s estimates of program costs have generally tracked actual 
obligations but challenges in estimating specific variables such as 
the number of eligible refugees and the cost of serving them have 
contributed to fluctuations in unobligated balances between fiscal 
years 1999 and 2009. ORR has a 3-year period in which to obligate its 
annual appropriations. From fiscal years 1999 to 2005, ORR used 
unexpired and unobligated prior year funds to obligate more than it 
was appropriated for those years, in part because of higher-than-
expected increases in refugee arrivals and medical costs. As a result, 
its unobligated balances were reduced in most of these years and were 
gone by fiscal year 2005. However, from fiscal years 2006 to 2009, ORR 
obligated less than it was appropriated, which allowed the agency to 
carry over funds from one year to the next. As a result, its 
unobligated balances grew from $17 million in fiscal year 2006 to over 
$83 million in fiscal year 2009. 

What GAO Recommends: 

GAO recommends that the Secretary of Health and Human Services 
identify effective approaches that state and voluntary agencies can 
use to help refugees become employed and self-sufficient. 

View [hyperlink, http://www.gao.gov/products/GAO-11-369] or key 
components. For more information, contact Kay E. Brown at (202) 512-
7215 or brownke@gao.gov. 

[End of section] 

Contents: 

Letter: 

Background: 

Design Elements Differentiate ORR's Programs, and Program Placement 
Depends on Refugees' Readiness to Work and Other Factors: 

Refugees' Employment Outcomes Have Declined Recently, and Little Is 
Known about the Effectiveness of Programs' Approaches: 

Difficulties in Projecting Certain Program Costs Have Contributed to 
Fluctuations in ORR's Unobligated Balances: 

Conclusion: 

Recommendation for Executive Action: 

Agency Comments and Our Evaluation: 

Appendix I: Scope and Methodology: 

Appendix II: Profiles of States Visited: 

Appendix III: ORR Employment Outcomes: 

Appendix IV: Refugee Vignettes from Discussion Groups: 

Appendix V: Comments from the Department of Health and Human Services: 

Appendix VI: GAO Contact and Staff Acknowledgments: 

Related GAO Products: 

Tables: 

Table 1: Performance Outcome Measures for Refugee Assistance Programs: 

Table 2: ORR's Budget Activities: 

Table 3: Characteristics of ORR's Refugee Assistance Programs: 

Table 4: Employment Outcomes of Refugees Receiving Cash Assistance 
through the Publicly Administered, Wilson/Fish, and Public Private 
Partnership Programs in Fiscal Year 2009: 

Table 5: Matching Grant Employment Outcome Measures in Fiscal Year 
2009: 

Table 6: State Profiles: 

Table 7: Employment Outcome Definitions of the Publicly Administered, 
Public Private Partnership, and Wilson/Fish Programs: 

Table 8: Employment Outcome Definitions of the Matching Grant Program: 

Table 9: Employment Outcomes for Refugees Receiving Cash Assistance 
from ORR's Publicly Administered, Public Private Partnership, or 
Wilson/Fish Program from Fiscal Years 2007 to 2009: 

Table 10: Matching Grant Performance Rates from Fiscal Years 2007 to 
2009: 

Figures: 

Figure 1: Geographical Distribution of Refugee Assistance Programs in 
2009: 

Figure 2: Distribution of Refugees Receiving Cash Assistance from ORR 
Programs in Fiscal Year 2009: 

Figure 3: Services Available to Refugees Participating in ORR-Funded 
Programs: 

Figure 4: General Path of Refugee Resettlement in the United States: 

Figure 5: Distribution of ORR's Appropriation by Budget Activity in 
Fiscal Year 2009: 

Figure 6: Percentage of Refugees Receiving Cash Assistance from ORR's 
Programs Who Entered Employment in Fiscal Years 2007, 2008, and 2009: 

Figure 7: ORR Projected Obligations Compared with Actual Obligations, 
Fiscal Years 1999-2009: 

Figure 8: Refugee Arrivals Compared to the Presidential Ceiling, 
Fiscal Years 1999-2009: 

Figure 9: ORR Appropriations, Obligations, and Unobligated Balances 
Fiscal Years 1999-2009: 

Abbreviations: 

ACF: Administration for Children and Families: 

DHS: Department of Homeland Security: 

HHS: Department of Health and Human Services: 

ORR: Office of Refugee Resettlement: 

SNAP: Supplemental Nutrition Assistance Program: 

SSI: Supplemental Security Income: 

State: Department of State: 

TANF: Temporary Assistance for Needy Families: 

volag: Voluntary Agency: 

[End of section] 

United States Government Accountability Office: 
Washington, DC 20548: 

March 31, 2011: 

The Honorable Tom Harkin: 
Chairman: 
The Honorable Richard Shelby: 
Ranking Member: 
Subcommittee on Labor, Health and Human Services, Education and 
Related Agencies: 
Committee on Appropriations: 
United States Senate: 

The Honorable Dennis Rehberg: 
Chairman: 
The Honorable Rosa DeLauro: 
Ranking Member: 
Subcommittee on Labor, Health and Human Services, Education and 
Related Agencies: 
Committee on Appropriations: 
House of Representatives: 

Millions of individuals worldwide have fled their countries for fear 
of being persecuted for their race, religion, nationality, political 
opinions, or belonging to a particular social group. The United States 
has a long-standing tradition of providing refuge to people fleeing 
persecution in their homelands. Each year the United States resettles 
at least half of all refugees referred worldwide by the United Nations 
High Commissioner for Refugees for resettlement; the remaining 
refugees are resettled by other countries. In fiscal year 2009, the 
United States admitted more than 70,000 refugees. According to the 
Department of Health and Human Services (HHS), refugees often lack the 
basic foundation to rebuild their lives when they first arrive in the 
United States, and many newly arrived refugees are eligible for 
temporary cash, medical, and other assistance from one of four 
programs funded in full or in part by Office of Refugee Resettlement 
(ORR), located within the Administration for Children and Families 
(ACF) at HHS. The primary goal of ORR’s refugee assistance programs is 
to help refugees achieve self-sufficiency-—that is, rely on their 
earnings, rather than government-provided cash assistance, for their 
needs.[Footnote 1] In fiscal year 2009, Congress appropriated over 
$400 million to support ORR’s resettlement programs. 

According to ORR officials, fiscal year 2009 posed several challenges 
to ORR and its budget. During 2009, more refugees entered the country 
than in any year since the events of September 11, 2001, requiring ORR 
and many state and voluntary agencies to provide assistance to more 
refugees than expected. Furthermore, as a result of difficult economic 
conditions and high unemployment rates in many communities, many 
refugees were not able to find employment as quickly as they had prior 
to the recession. Additionally, ORR officials stated that because the 
United States has admitted an increased number of refugees who have 
spent many years living in difficult conditions, such as refugee 
camps, a larger proportion of recently arrived refugees have health 
and other issues that make it difficult for them to work and achieve 
self-sufficiency. Because of these changes in refugee populations, ORR 
faced difficulties in estimating the costs of serving newly arrived 
refugees, which, in turn, has affected the agency's unobligated 
balances. 

The House Report accompanying the Departments of Labor, Health and 
Human Services, Education, and Related Agencies Appropriations Act for 
fiscal year 2010 mandated that we conduct an evaluation of the Office 
of Refugee Resettlement's administration of the refugee assistance 
programs.[Footnote 2] We examined: (1) differences in ORR's refugee 
assistance programs and factors program providers consider when 
placing refugees in a particular program; (2) refugee employment 
outcomes and the effectiveness of different approaches to providing 
assistance; and (3) how ORR estimates program costs and how its 
estimates have affected the agency's unobligated balances.[Footnote 3] 

To gather this information, we conducted site visits in five states 
(California, Florida, Massachusetts, Minnesota, and Texas); 
interviewed state, county, and refugee resettlement agencies; led four 
discussion groups with refugees selected by voluntary agency staff; 
[Footnote 4] and collected and reviewed eight refugee case files that 
were provided by local government officials and voluntary agency 
staff. We selected states with both large and small refugee caseloads, 
with both high and low unemployment rates relative to the national 
average, and representing different geographic regions. The 
information we collected from these states provided insights into 
providers' efforts to provide ORR-funded services, but this 
information cannot be generalized. In addition, we interviewed federal 
program officials and national voluntary agency staff; reviewed 
relevant federal laws, regulations, and agency reports; and examined 
ORR budget documentation. We also aggregated and analyzed ORR's 
performance data, which provide information on refugee employment 
outcomes for each of ORR's programs. While they have some limitations, 
[Footnote 5] we consider ORR's performance data reliable and 
appropriate for this engagement. We focused our study on ORR's refugee 
assistance offered through the Publicly Administered, Public Private 
Partnership, Wilson/Fish, and Matching Grant programs. We chose these 
four programs because they are the ones through which ORR provides 
most of its cash and medical assistance to refugees. For more 
information on our scope and methodology, see appendix I. For 
information on the states we visited, see appendix II. We conducted 
this performance audit from December 2009 to March 2011 in accordance 
with generally accepted government auditing standards. Those standards 
require that we plan and perform the audit to obtain sufficient, 
appropriate evidence to provide a reasonable basis for our findings 
and conclusions based on our audit objectives. We believe that the 
evidence we obtained provides a reasonable basis for our findings and 
conclusions. 

Background: 

A refugee is generally defined as a person who is outside his or her 
country and who is unable or unwilling to return because of 
persecution or a well-founded fear of persecution on account of race, 
religion, nationality, membership in a particular social group, or 
political opinion.[Footnote 6] Each year the President, after 
appropriate consultation with Congress and certain Cabinet members, 
determines the maximum number of refugees the United States will admit 
for resettlement in a given year.[Footnote 7] The presidential ceiling 
has decreased from about 90,000 in fiscal year 1999 to 80,000 in 
fiscal year 2009. However, the number of refugees actually entering 
the United States has increased in recent years compared to the 
relatively low numbers entering after the terrorist attacks of 
September 11, 2001. In the aftermath of those attacks, a review of 
refugee-related security procedures was undertaken, refugee admissions 
were briefly suspended, and enhanced security measures were 
implemented. As a result of these and other factors, refugee 
admissions declined from 68,393 in fiscal year 2001 to 26,383 in 
fiscal year 2002 and 28,348 in fiscal year 2003. Admissions have 
rebounded since, gradually increasing to 74,652 in fiscal year 2009. 

Refugee Resettlement and Assistance Programs: 

The Refugee Act of 1980[Footnote 8] provided a systematic and 
permanent procedure for admitting refugees to the United States and 
established comprehensive and uniform provisions to resettle refugees 
as quickly as possible and to encourage them to become self-
sufficient.[Footnote 9],[Footnote 10] The Departments of State and 
Homeland Security handle the first part of the resettlement process by 
approving and processing refugees overseas. The Department of State 
then partners with 10 national voluntary agencies to determine where 
in the United States refugees will live. The national voluntary 
agencies consider a variety of factors when determining where refugees 
will live, including placing refugees where they may already have 
relatives and where the national agencies have offices to meet the 
needs of the refugees. Voluntary agencies use their network of some 
350 affiliates to provide refugees with initial placement services, 
including meeting refugees at the airport when they first arrive in 
the United States and providing housing, food, clothing, and other 
necessities for the first 30 to 90 days. [Footnote 11],[Footnote 12] 
Also, during this time, staff from local voluntary agencies help 
refugees apply for federal assistance. 

After their initial month in the United States, many refugees are 
eligible for temporary resettlement assistance from ORR. All states, 
except Wyoming, administer an ORR-funded assistance program that 
provides up to 8 months of cash and medical assistance,[Footnote 13] 
as well as other social services, and states have the flexibility to 
choose among three program delivery models[Footnote 14]--the Publicly 
Administered, Wilson/Fish, or Public Private Partnership programs. 
[Footnote 15] These three delivery models were established over a 20-
year period and give states options in how they provide refugee 
assistance: 

* Publicly Administered: Refugee resettlement assistance is provided 
primarily through the Publicly Administered program. States are not 
required to administer this program, but those that do generally model 
the program after their Temporary Assistance for Needy Families (TANF) 
programs. 

* Wilson/Fish: In 1984, Congress authorized ORR to implement the 
Wilson/Fish program,[Footnote 15] which gave states flexibility in how 
they provide assistance to refugees, including whether to administer 
assistance primarily through local voluntary agencies. One of the 
goals in developing this program was to expand the number of states 
that offered a refugee program so that an ORR-funded program could 
exist in every state that resettles refugees. 

* Public Private Partnership: In 2000, ORR established the Public 
Private Partnership program, which promotes states' partnerships with 
voluntary agencies to provide assistance, and gives states the 
flexibility to set refugees' cash grants at levels higher than those 
authorized for the Publicly Administered program. (See figure 1 for 
the geographical distribution of refugee assistance programs.) 

Figure 1: Geographical Distribution of Refugee Assistance Programs in 
2009: 

[Refer to PDF for image: illustrated U.S. map] 

Not reported: 
Wyoming[A]: 

Publicly Administered: 
Arizona: 
Arkansas: 
California (except San Diego County): 
Connecticut: 
Delaware: 
District of Columbia: 
Florida: 
Georgia: 
Hawaii: 
Illinois: 
Indiana: 
Iowa: 
Kansas: 
Maine: 
Michigan: 
Mississippi: 
Missouri: 
Montana: 
Nebraska: 
New Hampshire: 
New Jersey: 
New Mexico: 
New York: 
North Carolina: 
Ohio: 
Pennsylvania: 
Rhode Island: 
South Carolina: 
Tennessee: 
Utah: 
Virginia: 
Washington: 
West Virginia: 
Wisconsin. 

Public Private Partnership: 
Maryland: 
Minnesota: 
Oklahoma: 
Oregon: 
Texas. 

Wilson/Fish: 
Alabama: 
Alaska: 
Colorado: 
Idaho: 
Kentucky: 
Louisiana: 
Massachusetts: 
Nevada: 
North Dakota: 
San Diego County, California: 
South Dakota: 
Vermont. 

Source: ORR. 

[A] At the time of this report, Wyoming did not provide a Publicly 
Administered, Wilson/Fish, or Public Private Partnership program. 

[End of figure] 

In addition, some refugees participate in the Matching Grant program, 
which is only partially funded by ORR. According to ORR, this program 
is administered by a network of national voluntary agencies, and is 
offered in 42 states and the District of Columbia.[Footnote 17] The 
Matching Grant program provides refugees with cash and other 
assistance for 4 to 6 months[Footnote 18] with the goal of helping 
them become self-sufficient without receiving cash benefits from a 
public assistance program.[Footnote 19] Of the refugees who received 
cash assistance from ORR in fiscal year 2009, just over 30 percent of 
them participated in the privately administered Matching Grant 
program, while most of the remaining percent participated in ORR's 
other assistance programs. (See figure 2.) 

Figure 2: Distribution of Refugees Receiving Cash Assistance from ORR 
Programs in Fiscal Year 2009: 

[Refer to PDF for image: pie-chart] 

Publicly Administered: 41%; 
Public Private Partnership: 10%; 
Wilson/Fish: 18%; 
Matching Grant: 31%. 

Source: GAO analysis of ORR's Annual Outcome Goal Plans and Matching 
Grant annual report data. 

Note: We combined the Annual Outcome Goal Plans and Matching Grant 
annual report data sources to calculate the percentages above. The 
numerators for the Publicly Administered, Public Private Partnership, 
and Wilson/Fish programs represent the number of refugees who received 
cash assistance and employment services in each of the three programs 
in fiscal year 2009. The numerator for the Matching Grant program is 
the number of employable adults who participated in the Matching Grant 
program in fiscal year 2009. The denominator represents the combined 
total of refugees who received cash assistance and employment services 
in the Publicly Administered, Public Private Partnership, and Wilson/ 
Fish programs as well as the employable adults participating in the 
Matching Grant program in fiscal year 2009. 

[End of figure] 

All four programs fund cash and medical assistance[Footnote 20] as 
well as a broad range of social services, including employment 
services, English language instruction, case management, citizenship 
and naturalization preparation services, and social adjustment 
services.[Footnote 21] Eligible refugees may also receive other 
federal benefits, such as food assistance offered through the United 
States Department of Agriculture's Supplemental Nutrition Assistance 
Program (SNAP, formerly the Food Stamp Program). Figure 3 shows the 
assistance offered to refugees who participate in one of ORR's 
resettlement programs. 

Figure 3: Services Available to Refugees Participating in ORR-Funded 
Programs: 

[Refer to PDF for image: illustrated table] 

Service: Cash assistance; 
Matching Grant: 4 to 6 months; 
Publicly Administered, Wilson/Fish, and Public Private Partnership: up 
to 8 months. 

Service: Medical assistance; 
Matching Grant: up to 8 months; 
Publicly Administered, Wilson/Fish, and Public Private Partnership: up 
to 8 months. 

Service: Employment services; 
Matching Grant: up to 180 days; 
Publicly Administered, Wilson/Fish, and Public Private Partnership: up 
to 5 years. 

Service: Citizenship preparation education/training other services; 
Matching Grant: up to 5 years; 
Publicly Administered, Wilson/Fish, and Public Private Partnership: up 
to 5 years. 

Service: Food assistance (through SNAP); 
Matching Grant: as long as eligible; 
Publicly Administered, Wilson/Fish, and Public Private Partnership: as 
long as eligible. 

Source: GAO. 

Note: Cash assistance amounts among ORR programs vary and are 
described in the following section of this report. 

[End of figure] 

Not all refugees receive assistance through ORR-funded programs. 
Refugees who are eligible for or receiving cash assistance from 
programs outside of ORR, such as TANF or Supplemental Security Income 
(SSI), are generally not eligible to receive cash assistance from 
ORR's Publicly Administered, Wilson/Fish, or Public Private 
Partnership programs.[Footnote 22] Refugees who are eligible for TANF 
but who are not receiving TANF benefits may, however, receive cash 
assistance and other services offered by the Matching Grant program. 
See figure 4 for the general path of refugee resettlement in the 
United States. 

Figure 4: General Path of Refugee Resettlement in the United States: 

[Refer to PDF for image: illustration] 

Refugee overseas: 
Overseas processing: 
Refugees are approved and processed by the Department of State (State) 
and the Department of Homeland Security (DHS). 

Refugee in United States: 

Voluntary Agency (volag) assignment: 
Refugees are matched to one of 10 national-level volags that have 
multiple local affiliates. 

Initial Reception and Placement: 
Representatives from volags greet refugees upon arrival. Volags 
provide housing and other basic needs for 30-90 days with funding from 
State. 

Program placement: 
Volags help refugees apply for the assistance they are likely eligible 
to receive: 
* ORR Assistance programs[A]: 
- Eight months of cash and medical assistance; 
- Administered by volags or by a government agency; 
- Totally funded by ORR; 
- Includes Publicly Administered, Public Private Partnership, and 
Wilson/Fish; 
* Privately administered Matching Grant program[A]: 
- Four to six months of cash assistance; 
- Administered by volags; 
- Funded in part by ORR; 
- Limited slots available; 
* Other public assistance: 
- Type and duration of assistance varies; 
- Administered by various government agencies; 
- Includes programs such as Temporary Assistance for Needy Families 
(TANF) and Supplemental Security Income (SSI). 

Source: GAO. 

[A] Fully or partially funded and administered by Department of Health 
and Human Services Office of Refugee Resettlement. 

[End of figure] 

Performance Management: 

In addition to helping newly arrived refugees adjust to their 
surroundings and settle in the United States, the overall goal of 
ORR's assistance programs is to help refugees attain self-sufficiency. 
Self-sufficiency is defined in ORR's regulations as the refugee 
earning a total family income at a level that enables a family unit to 
support itself without receiving a cash assistance grant.[Footnote 23] 
ORR collects data on several employment-related outcomes to assess 
program performance. As part of the Government Performance and Results 
Act's requirement for agencies to produce performance measures used to 
assess their progress toward meeting performance goals, the Publicly 
Administered, Public Private Partnership, and Wilson/Fish programs 
have six shared outcome measures. The Matching Grant program has its 
own measures--three of which are directly related to the program's 
goal of helping refugees become economically self-sufficient.[Footnote 
24] Table 1 lists the performance measures for the different types of 
refugee assistance programs. (For a description of these measures, see 
appendix III.) 

Table 1: Performance Outcome Measures for Refugee Assistance Programs: 

Publicly Administered, Public Private Partnership, and Wilson/Fish 
Programs: 1. Entered Employment; 
Matching Grant Program: 1. Entered Employment. 

Publicly Administered, Public Private Partnership, and Wilson/Fish 
Programs: 2. Average Wage at Employment; 
Matching Grant Program: 2. Average Wage at Employment. 

Publicly Administered, Public Private Partnership, and Wilson/Fish 
Programs: 3. Employment with Health Benefits; 
Matching Grant Program: 3. Employment with Health Benefits. 

Publicly Administered, Public Private Partnership, and Wilson/Fish 
Programs: 4. Job Retention for 90 days; 
Matching Grant Program: 4. Self-Sufficient at 120th day. 

Publicly Administered, Public Private Partnership, and Wilson/Fish 
Programs: 5. Cash Assistance Reductions due to Earnings; 
Matching Grant Program: 5. Economic Self-Sufficiency Retention at the 
180th day. 

Publicly Administered, Public Private Partnership, and Wilson/Fish 
Programs: 6. Cash Assistance Termination due to Earnings; 
Matching Grant Program: 6. Economic Self-Sufficiency Overall. 

Source: ORR Program Guidelines. 

[End of table] 

Program Funding: 

Congress appropriates a fixed amount of funding each year to fund 
refugee assistance programs. ORR distributes this funding among seven 
budget activities--each with a specific purpose. (See table 2.) 

Table 2: ORR's Budget Activities: 

Activities: Transitional and Medical Services; 
Purpose: Provides cash and medical assistance to refugees, asylees, 
entrants, and trafficking victims who participate in the Publicly 
Administered, Public Private Partnership, Wilson/Fish, and Matching 
Grant programs, and supports other activities, such as services 
provided by the Matching Grant program and the Unaccompanied Refugee 
Minor program; 
FY 2009 actual funding level[A]: ($282.3 million. 

Activities: Social Services; 
Purpose: Supports employment and other services such as social 
adjustment, translation, child care, and citizenship services as well 
as case management; 
FY 2009 actual funding level[A]: $154.0 million. 

Activities: Unaccompanied Alien Children; 
Purpose: Provides for the care and placement of unaccompanied alien 
minors who are apprehended in the United States and taken into care 
pending resolution of their claims for relief under U.S. immigration 
law or released to a family member or guardian; 
FY 2009 actual funding level[A]: $205.1 million. 

Activities: Targeted Assistance; 
Purpose: Primarily provides services designed to secure employment for 
refugees within 1 year or less in areas that are impacted by high 
arrival numbers and high concentrations of refugees; 
FY 2009 actual funding level[A]: $48.6 million. 

Activities: Victims of Torture; 
Purpose: Provides services and rehabilitation for victims of torture; 
FY 2009 actual funding level[A]: $10.8 million. 

Activities: Victims of Trafficking; 
Purpose: Certifies adults as trafficking victims and provides 
benefits, such as case management, housing assistance, and counseling; 
FY 2009 actual funding level[A]: $9.8 million. 

Activities: Preventive Health; 
Purpose: Promotes refugee access to health screening, assessment, 
treatment, and follow-up services; 
FY 2009 actual funding level[A]: $4.7 million. 

Source: ORR and ACF Budget Justification fiscal year 2011. 

[A] These fiscal year 2009 funding levels include unobligated balances 
from the previous year. 

[End of table] 

ORR's largest budget activity, Transitional and Medical Services, 
primarily supports refugees' cash and medical assistance offered 
through the Publicly Administered, Wilson/Fish, and Public Private 
Partnership programs as well as the federal contribution to the 
Matching Grant program. ORR is authorized to fully reimburse program 
providers[Footnote 25] for the cash and medical assistance[Footnote 
26] they provide to refugees enrolled in the Publicly Administered, 
Wilson/Fish, and Public Private Partnership programs,[Footnote 27] 
even if the costs of serving all eligible refugees exceed ORR's annual 
appropriation in a given fiscal year.[Footnote 28] The social services 
that state and voluntary agencies provide to refugees enrolled in 
these programs, such as employment services and case management, are 
primarily funded through ORR's Social Services budget activity. 
[Footnote 29] ORR receives a fixed amount of Social Services funds 
each fiscal year and allocates these funds to states based on 
estimates of arriving refugees. These Social Services funds do not 
increase within a given year if the number of refugees served is 
greater than anticipated. Together Transitional and Medical Services 
and Social Services funding accounted for more than half of ORR's 
total appropriations in fiscal year 2009 (about $436 million, 
including unobligated funds). Figure 5 shows the distribution of 
appropriations across ORR's budget activities in fiscal year 2009. 

Figure 5: Distribution of ORR's Appropriation by Budget Activity in 
Fiscal Year 2009: 

[Refer to PDF for image: pie-chart] 

Transitional and Medical Services: 39%; 
Unaccompanied Alien Children: 29%; 
Social Services: 22%; 
Targeted Assistance: 7%; 
Victims of Torture: 2%; 
Victims of Trafficking: 1%; 
Preventive Health: 1%. 

Source: ACF Fiscal Year 2011 Budget Justification. 

[End of figure] 

Design Elements Differentiate ORR's Programs, and Program Placement 
Depends on Refugees' Readiness to Work and Other Factors: 

Several Design Elements Differentiate ORR's Four Assistance Programs: 

The Matching Grant program features several design elements that 
distinguish it from assistance offered through the Publicly 
Administered, Wilson/Fish, and Public Private Partnership programs. 
According to state officials and voluntary agency staff, Matching 
Grant providers select the refugees they want to participate in the 
program, and these refugees can opt to participate in the Matching 
Grant program or may choose to apply for and receive benefits from 
other programs if eligible. In contrast, providers of the Publicly 
Administered, Wilson/Fish, or Public Private Partnership programs 
enroll any eligible refugee. In interviews with providers, we learned 
that refugees who find employment while participating in the Matching 
Grant program may keep their earnings in addition to their cash grant. 
However, refugees enrolled in ORR's other programs have their cash 
assistance reduced or terminated as a result of their employment 
earnings. In addition, according to ORR and providers, funding for the 
Matching Grant program is tied to refugees' success in finding 
employment while enrolled in the program--that is, providers of the 
Matching Grant program who do not demonstrate that refugees have 
achieved specific employment-related outcomes may have their funding 
reduced the following program year. In contrast, funding for the 
Publicly Administered, Wilson/Fish, or Public Private Partnership 
programs is not affected by refugees' employment outcomes,[Footnote 
30] according to ORR officials. (For more information on the Matching 
Grant program, see table 3.) 

The extent to which each of the four ORR programs allow state and 
voluntary agencies the flexibility to develop or use various service 
delivery approaches differs. In the two states we visited that offered 
the Publicly Administered program, refugee assistance was modeled 
after the states' TANF programs. In these states, refugees generally 
received their cash and medical benefits, employment assistance, and 
other social services from multiple public and private agencies, such 
as county social service offices and local community-based 
organizations, and typically met with several caseworkers to receive 
these services. In comparison, the Wilson/Fish, Public Private 
Partnership, and Matching Grant programs allow state and voluntary 
agencies flexibility in developing approaches that are different than 
those used in states' TANF programs and at the same time focus on 
helping the refugee become economically self-sufficient. These 
approaches varied within and among programs and examples we observed 
included providers integrating their refugee services, providing 
intensive case management, and offering employment incentives: 

Service integration: Some providers we visited used a single 
government or voluntary agency to provide cash assistance, employment 
counseling and case management to refugees, often in one location, 
while other providers referred refugees to multiple agencies for 
different services. For example, a Public Private Partnership program 
in Texas used a single agency to provide refugees with most services 
while a Public Private Partnership in Minnesota utilized multiple 
service providers. Refugees enrolled in Minnesota's Public Private 
Partnership program accessed their cash assistance and case management 
from a local voluntary agency but then often received other types of 
services, like employment counseling and English language instruction, 
from a combination of other private, nonprofit, and public agencies. 
Most of the Matching Grant and Wilson/Fish programs we visited used a 
single agency to provide most refugee services. 

Intensive case management: In some of the states we visited, ORR 
programs provided refugees with intensive case management using a 
single case manager to oversee most aspects of a refugee's case 
whereas in other states, officials told us that providers spread 
responsibility for managing a refugee's case between multiple case 
workers, often in different agencies. Guidelines state that refugees 
enrolled in the Matching Grant program be assigned a caseworker who 
provides intensive case management. Intensive case management can 
encompass a wide range of activities, including referring refugees to 
needed services, such as transportation, child care, English classes, 
employment-readiness training, and food and housing assistance; 
helping the refugee adapt to the new culture; and facilitating 
interactions between clients and employers or other service providers. 
In Florida, one voluntary agency case manager who provided intensive 
case management to his clients drove refugees enrolled in the Matching 
Grant program to and from work on their first day of employment and 
checked in with the employers to help resolve any employment-related 
issues that may have arisen. However, the extent to which refugees 
receive intensive case management can vary by program. The Public 
Private Partnership program does not receive dedicated funding from 
ORR to specifically support case management activities,[Footnote 31] 
and two providers of the Public Private Partnership program told us 
they could not always provide intensive case management services to 
refugees. 

Incentives for early employment: In addition to the Matching Grant 
program, the Wilson/Fish and Public Private Partnership programs allow 
states or voluntary agencies to offer financial incentives to 
encourage refugees to find employment quickly. While some providers 
may choose not to offer incentives, all the Wilson/Fish and Public 
Private Partnership providers we visited offered employment incentives 
to refugees. Providers of the Wilson/Fish program in Massachusetts and 
San Diego County, for example, offered refugees a cash bonus if they 
found full-time employment within the first 4 months of arrival. 
[Footnote 32] 

The four programs differ in others ways as well. Table 3 outlines some 
of the different characteristics of these programs. 

Table 3: Characteristics of ORR's Refugee Assistance Programs: 

Funding: 
Publicly Administered: ORR reimburses states for 100% of costs; 
Wilson/Fish: ORR reimburses states or voluntary agencies for 100% of 
costs; 
Public Private Partnership: ORR reimburses states for 100% of costs; 
Matching Grant: ORR provides national voluntary agencies $2 for every 
$1 they privately raise, up to $2,200 per person. 

Funding affected by refugees' employment outcomes: 
Publicly Administered: No; 
Wilson/Fish: No; 
Public Private Partnership: No; 
Matching Grant: Yes. 

Dedicated funding for case management services: 
Publicly Administered: No; 
Wilson/Fish: Yes; 
Public Private Partnership: No; 
Matching Grant: Yes. 

Duration of cash assistance: 
Publicly Administered: Up to 8 months; 
Wilson/Fish: Up to 8 months; 
Public Private Partnership: Up to 8 months; 
Matching Grant: 4-6 months. 

Cash assistance amount: 
Publicly Administered: Amount based on state's TANF formula; 
Wilson/Fish: Depending on the state, amounts may range from an amount 
based on the state's TANF formula to an amount set by ORR[A]; 
Public Private Partnership: Depending on the state, amounts may range 
from an amount based on the state's TANF formula to an amount set by 
ORR[A]; 
Matching Grant: A minimum of $200 a month per adult and $40 a month 
per minor in cash plus assistance with housing and transportation 
costs per adult refugee. 

Participation limits: 
Publicly Administered: All eligible refugees can enroll; 
Wilson/Fish: All eligible refugees can enroll; 
Public Private Partnership: All eligible refugees can enroll; 
Matching Grant: The number of refugees that can enroll is limited by 
available funding. Refugees selected by voluntary agencies may 
participate. 

Flexibility to states and voluntary agencies: 
Publicly Administered: In accordance with TANF regulations and 
policies; 
Wilson/Fish: States and voluntary agencies can partner with each other 
to provide cash assistance and services and develop early employment 
incentives; 
Public Private Partnership: States must partner with voluntary 
agencies to provide cash assistance and states have flexibility in how 
they provide other services and may offer early employment incentives; 
Matching Grant: Voluntary agencies have flexibility to design programs 
based on ORR guidelines. Agencies can offer early employment 
incentives. 

Source: ORR information compiled by GAO. 

[A] 45 C.F.R. § 400.60 provides a payment ceiling. 

[End of table] 

Providers Consider Several Factors when Placing Refugees in a Program, 
including the Refugee's Readiness to Work: 

According to staff at voluntary agencies in four of the five states we 
visited, enrollment in the Matching Grant program is based primarily, 
though not necessarily exclusively, on the refugee's readiness to 
work--including his or her level of motivation, English skills, 
education or previous work experience, and physical and mental health. 
Agency officials from one state we visited explained that because the 
program duration is shorter than the other three assistance programs, 
the Matching Grant program is best suited to those who are likely to 
obtain employment quickly. In addition, as funding for Matching Grant 
programs is based on the performance of voluntary agencies in helping 
refugees achieve employment-related outcomes, voluntary agency staff 
have an incentive to select refugees to participate in the program who 
they think are most likely to be successful in finding a job. Some 
voluntary agency officials we spoke with said that refugees with high 
motivation to work and high levels of English proficiency are more 
likely than those who do not have these qualities to find employment. 

In some instances, the amount of cash assistance provided by refugee 
assistance programs is another factor that can influence the placement 
of refugees in particular programs. Because cash assistance levels 
under the Publicly Administered, Public Private Partnership, and 
Wilson/Fish programs are based on the benefits provided under a 
state's TANF program,[Footnote 33] the amount of cash assistance 
provided to families can vary by state and can be either higher or 
lower than the amounts available under the Matching Grant program. 
Some voluntary agency officials in the states we visited told us they 
encourage refugees to participate in the assistance program that 
offers the greatest monetary benefit to the refugee. In two states we 
visited, Massachusetts and Texas, voluntary agencies told us they 
preferred to enroll refugee families with children in the Matching 
Grant program because, based on the number of eligible members, the 
family could receive a higher cash benefit in the first few months 
after their arrival compared to what the family would receive from 
other assistance programs.[Footnote 34] In those states, refugees 
without children would receive more cash assistance overall from the 
Public Private Partnership or Wilson/Fish programs than from the 
Matching Grant program.[Footnote 35] 

In addition, some voluntary agencies told us they select families who 
may face relatively more obstacles than other refugees to participate 
in programs that provide integrated services and intensive case 
management because these families can benefit from these approaches. 
According to a director at one voluntary agency, intensive case 
management and integrated services tend to benefit refugees who might 
otherwise fall through the cracks in a traditional assistance program 
[Footnote 36] that provides assistance through multiple agencies and 
different case managers. Voluntary agency staff in Minnesota told us 
that when possible, they enrolled single-parent families who are ready 
to work into the Matching Grant Program instead of the TANF program 
because they believe the family will benefit from intensive case 
management and integrated services.[Footnote 37] One voluntary agency 
manager explained that refugees enrolled in the TANF program in 
Minnesota often have several case workers and need to access multiple 
government and nonprofit agencies to receive the type of services that 
are mostly offered through one voluntary agency through the Matching 
Grant program. 

State policies can also determine whether refugee families with 
children are placed in ORR refugee assistance programs or the state's 
TANF program, which is generally available to eligible families with 
children. While refugees who are eligible for or receiving cash 
assistance from programs that are available to the general population--
such as SSI and TANF--are generally prohibited from receiving cash 
assistance from Publicly Administered, Public Private Partnership, or 
Wilson/Fish programs, some states determine TANF eligibility in a way 
that allows families with children--who in other states would likely 
be eligible for TANF--to participate in an ORR-funded refugee 
assistance program. For example, officials in Texas who administer the 
state's Public Private Partnership program explained to us that 
refugees with children who apply for TANF soon after they arrive in 
Texas are often ineligible due to the income they receive during the 
initial resettlement process. [Footnote 38] According to Texas 
officials, families who are ineligible for TANF may participate in the 
state's Public Private Partnership,[Footnote 39] which offers higher 
cash benefits than the state's TANF program.[Footnote 40] In contrast, 
officials in Minnesota who also administer the Public Private 
Partnership program told us that refugees' initial resettlement 
payments do not make families ineligible for TANF in their state. As a 
result, many families with children in Minnesota participate in TANF, 
not the state's Public Private Partnership program. 

In addition, some states administering the Wilson/Fish program have 
the flexibility to allow families who would otherwise be eligible for 
TANF to participate in the Wilson/Fish program. [Footnote 41] 
According to ORR, four out of 13 Wilson/Fish programs provided cash 
assistance to TANF-eligible refugees in fiscal year 2010. [Footnote 
42],[Footnote 43] 

Refugees' Employment Outcomes Have Declined Recently, and Little Is 
Known about the Effectiveness of Programs' Approaches: 

Refugees' Employment Declined in Recent Years: 

Overall, fewer refugees found jobs within their first months in the 
United States in fiscal year 2009 than they did in fiscal year 2007. 
Before the economic recession, in fiscal year 2007, ORR's performance 
data show that between 59 percent and 65 percent of all refugees 
receiving cash assistance from ORR's four assistance programs entered 
employment within 4 to 8 months of coming to the United States. By 
fiscal year 2009, however, these employment rates decreased, ranging 
from 31 percent to 52 percent, depending on the program. (See figure 
6.) 

Figure 6: Percentage of Refugees Receiving Cash Assistance from ORR's 
Programs Who Entered Employment in Fiscal Years 2007, 2008, and 2009: 

[Refer to PDF for image: vertical bar graph] 

Percentage who entered employment: 

Publicly Administered: 
Fiscal year 2007: 65%; 
Fiscal year 2008: 50%; 
Fiscal year 2009: 34%. 

Public Private Partnership: 
Fiscal year 2007: 64%; 
Fiscal year 2008: 75%; 
Fiscal year 2009: 52%. 

Wilson/Fish: 
Fiscal year 2007: 59%; 
Fiscal year 2008: 44%; 
Fiscal year 2009: 31%. 

Matching Grant: 
Fiscal year 2007: 64%; 
Fiscal year 2008: 57%; 
Fiscal year 2009: 47%. 

Source: ORR's Annual Outcome Goal Plans and Matching Grant annual 
report data compiled and analyzed by GAO. 

Notes: The differences in entered employment rates among programs do 
not necessarily reflect program effectiveness due to differences in 
populations served and other factors. 

These entered employment rates include only those refugees who 
received cash assistance from the Publicly Administered, Wilson/Fish, 
Public Private Partnership, or Matching Grant program. These rates do 
not include refugees who did not receive ORR-funded cash assistance 
but may have received other types of ORR-funded services, such as 
employment assistance. Refugees who do not receive ORR-funded cash 
assistance but receive other types of ORR assistance may include (1) 
those who are participating in the TANF program and receiving ORR-
funded employment services or (2) refugees who have exhausted their 
ORR-provided cash assistance but continue to receive ORR-funded 
employment services. ORR told us it typically includes all refugees 
who received some type of ORR-funded services when it reports 
employment outcomes for the Publicly Administered, Wilson/Fish, and 
Public Private Partnership programs. 

The Entered Employment rate for the Public Private Partnership in 
fiscal year 2008 is substantially higher than the rates for the other 
programs. We asked ORR if the performance data had any abnormalities 
that would cause rates to be particularly high or low for a given 
year. Officials said they believed the performance data to be accurate 
and were not aware of any abnormalities. 

[End of figure] 

Several state officials and voluntary agency staff told us that 
refugees have struggled to find and keep full-time jobs during the 
economic downturn. Some explained that refugees today compared to 3 
years ago have fewer employment options because jobs that used to be 
relatively easy for refugees to find, such as those in hospitality and 
construction sectors, are now being filled by non-refugees who have 
more training or experience. We also heard that of the refugees who do 
find work, an increasing number have only part-time or temporary jobs. 
For example, in reviewing the case file of a single Somali man who 
resettled in Minneapolis, we learned that he had found a part-time 
job, only to have his schedule reduced to 1 day per week. As a result, 
he continues to look for other work. Our analysis of ORR's performance 
data shows that fewer refugees have been able to keep their jobs for 
at least 90 days in fiscal year 2009 than in fiscal year 2007. 
[Footnote 44] Specifically, in fiscal year 2007, the percentage of 
refugees in the Publicly Administered, Wilson/Fish, and Public Private 
Partnership programs who found work and kept their jobs for at least 
90 days ranged from 77 percent to 84 percent, depending on the 
program. By fiscal year 2009, these rates decreased somewhat to 
between 67 percent and 80 percent. For more information, see appendix 
III. 

ORR's Programs Helped Some Refugees Achieve Positive Outcomes, but No 
Single Program Consistently Outperformed the Others: 

Performance data indicate that some refugees obtained employment while 
enrolled in an ORR assistance program, but no single refugee 
assistance program consistently outperformed the others across the 
various performance measures in fiscal year 2009. In comparing the 
three ORR programs that provide assistance for 8 months, we found, for 
example, that the Public Private Partnership program performed 
relatively well at helping refugees find jobs while the Wilson/Fish 
program had the most positive outcomes related to job retention. Table 
4 below shows the actual measures for ORR's 8-month programs in fiscal 
year 2009. For more information on ORR's performance measures, see 
appendix III. 

Table 4: Employment Outcomes of Refugees Receiving Cash Assistance 
through the Publicly Administered, Wilson/Fish, and Public Private 
Partnership Programs in Fiscal Year 2009: 

Employment outcome: Entered Employment within 8 Months after Refugee's 
Arrival; 
Fiscal year 2009[A]: Publicly Administered: 34%; 
Fiscal year 2009[A]: Wilson/Fish: 31%; 
Fiscal year 2009[A]: Public Private Partnership: 52%. 

Employment outcome: Employment with Health Benefits[B] Obtained within 
8 Months of Arrival; 
Fiscal year 2009[A]: Publicly Administered: 67%; 
Fiscal year 2009[A]: Wilson/Fish: 64%; 
Fiscal year 2009[A]: Public Private Partnership: 71%. 

Employment outcome: Cash Assistance Termination because of Employment; 
Fiscal year 2009[A]: Publicly Administered: 65%; 
Fiscal year 2009[A]: Wilson/Fish: 64%; 
Fiscal year 2009[A]: Public Private Partnership: 24%[C]. 

Employment outcome: Job Retention at 90th day of Employment; 
Fiscal year 2009[A]: Publicly Administered: 73%; 
Fiscal year 2009[A]: Wilson/Fish: 80%; 
Fiscal year 2009[A]: Public Private Partnership: 67%. 

Employment outcome: Cash Assistance Reductions due to Employment; 
Fiscal year 2009[A]: Publicly Administered: 4%; 
Fiscal year 2009[A]: Wilson/Fish: 16%; 
Fiscal year 2009[A]: Public Private Partnership: 1%. 

Employment outcome: Average Wage per Hour; 
Fiscal year 2009[A]: Publicly Administered: $8.87; 
Fiscal year 2009[A]: Wilson/Fish: $9.33; 
Fiscal year 2009[A]: Public Private Partnership: $8.90. 

Source: ORR's Annual Outcome Goal Plans data compiled by GAO. 

[A] These employment outcome rates include only those refugees who 
received cash assistance from the Publicly Administered, Wilson/Fish, 
or Public Private Partnership program. These rates do not include 
refugees who did not receive ORR-funded cash assistance but may have 
received other types of ORR-funded services, such as employment 
assistance. Refugees who do not receive ORR-funded cash assistance but 
receive other types of ORR assistance may include (1) those who are 
participating in the TANF program and receiving ORR-funded employment 
services or (2) refugees who have exhausted their ORR-provided cash 
assistance but continue to receive ORR-funded employment services. ORR 
told us it typically includes all refugees who received some type of 
ORR-funded services when it reports employment outcomes for the 
Publicly Administered, Wilson/Fish, and Public Private Partnership 
programs. 

[B] Employment with Health Benefits, Cash Assistance Termination 
because of Employment, and Cash Assistance Reductions due to 
Employment include the outcomes of those refugees who are captured 
under the Entered Employment measure. 

[C] According to ORR, the measure for Cash Assistance Termination 
because of Employment for the Public Private Partnership program is 
approximately 40 percentage points lower than the same measure for 
Publicly Administered and Wilson/Fish programs primarily because of 
the unique program design in Texas, one of the Public Private 
Partnership states. ORR officials explained that the Public Private 
Partnership programs in Texas collect data for this measure at the 
120th day, and these data represent the percent of refugees whose cash 
assistance was terminated because of incomes over 165 percent of the 
federal poverty income limit. In contrast, other Public Private 
Partnership states collect data for the same measure at 8 months, and 
in these states, the data represent the percentage of refugees whose 
cash assistance was terminated based on states' TANF provisions. 

[End of table] 

The Matching Grant 4-to-6-month assistance program, with its own set 
of employment measures, performed well on some but not all of its 
measures in fiscal year 2009. (See table 5.) 

Table 5: Matching Grant Employment Outcome Measures in Fiscal Year 
2009: 

Matching Grant employment outcome: Entered Employment by 120th Day of 
Refugee's Arrival; 
Fiscal year 2009: 47%. 

Matching Grant employment outcome: Employment with Health Benefits[A] 
within 120th Day of Arrival; 
Fiscal year 2009: 51%. 

Matching Grant employment outcome: Economic Self-Sufficiency at 120 
Days[B]; 
Fiscal year 2009: 52%. 

Matching Grant employment outcome: Economic Self-Sufficiency Retention 
at 180 Days[C]; 
Fiscal year 2009: 93%. 

Matching Grant employment outcome: Economic Self-Sufficiency 
Overall[D]; 
Fiscal year 2009: 67%. 

Matching Grant employment outcome: Average Wage per Hour at Employment 
(full-time) Obtained by 120th Day of Refugee's Arrival; 
Fiscal year 2009: $8.67. 

Source: ORR's Matching Grant annual report data compiled by GAO. 

[A] Employment with Health Benefits includes refugees who are captured 
under the Entered Employment measure. 

[B] Economic Self-Sufficiency at 120 days refers to those individuals 
who reached the 120th day after the date of eligibility who were self- 
sufficient--that is, earned a total family income at a level that 
enables a family unit to support itself without receipt of cash 
assistance per 45 C.F.R. 400.2. 

[C] Economic Self-Sufficiency Retention refers to the individuals who 
were reported to be self-sufficient at a 120th day and continued to be 
self-sufficient 60 days later. 

[D] Economic Self Sufficiency Overall is the percent of individuals 
who participated in the program for 180 days and reached self-
sufficiency, including those individuals who did not report being self-
sufficient at 120 days. 

[End of table] 

Little Is Known about the Relative Effectiveness of Approaches Used by 
ORR Assistance Programs in Improving Refugees' Economic Status: 

ORR performance data cannot be used to compare Matching Grant program 
outcomes with the outcomes from the other three programs because they 
do not share the same performance measures. While all four refugee 
assistance programs have three measures in common, the programs 
collect information for their common measures at different points in 
time. For example, the Matching Grant program reports the number of 
refugees who enter employment 4 months after the refugee arrives in 
the United States, while providers of the other three programs report 
entered employment rates for refugees receiving ORR-funded cash 
assistance within 8 months of their arrival in the United States. 
[Footnote 45] 

Because the approaches states and voluntary agencies use to provide 
assistance vary both within and between programs, ORR's performance 
data provide little information on the relative effectiveness of 
specific approaches. The Wilson/Fish, Public Private Partnership, and 
Matching Grant programs were designed to allow providers to develop 
innovative approaches that are different than those used in states' 
TANF programs, including integrated services, intensive case 
management, and employment incentives. Several providers we spoke with 
believe that the approaches they use to provide assistance play an 
important role in helping refugees find employment. One study 
published in 1999 (based on data from 1992 through 1994) compared a 
Wilson/Fish and a Publicly Administered program in San Diego and 
concluded that the Wilson/Fish program with integrated services, 
personal and flexible system of service delivery, and intensive 
support services helped refugees find employment more quickly than the 
Publicly Administered program that provided services through multiple 
agencies and case workers,[Footnote 46] but we found no other studies 
that were published recently and have reliably assessed the 
effectiveness of the various approaches used by refugee assistance 
programs. In addition, the way these approaches are implemented varies 
significantly both within and across programs. For example, in Texas, 
the voluntary agencies that administer both the Matching Grant and the 
Public Private Partnership programs told us that the way employment 
related services are provided under the two programs is virtually 
indistinguishable, whereas in Minnesota, the Matching Grant and Public 
Private Partnership programs use two very different service delivery 
approaches, according to voluntary agency staff. 

Because providers consider different factors when placing refugees in 
assistance programs, it can be difficult to determine whether 
differences in program performance are attributed to program 
approaches or to differences in the populations served. For example, 
because refugee families with children may face different challenges 
to employment than refugees without children, a program that serves 
more families with children could have different employment outcomes 
than one that serves fewer. In one of our discussion groups, a single 
mother from Rwanda told us that she was unable to find work when she 
first arrived in the United States because she had to care for her 
children, the youngest being 6 weeks old at the time. Eventually, she 
found child care for her children and found her first job after being 
in the United States for almost 4 years. Additionally, several 
Matching Grant program administrators told us they were more likely to 
enroll refugees who speak English fluently, as the ability to speak 
English can greatly facilitate a refugee's chances of finding 
employment. One provider in Florida explained that in Miami, despite 
the fact that most refugees can get by outside the workplace speaking 
only Spanish, most employers require that job applicants also speak 
English. A refugee from Belarus told us that in his home country he 
was an economist and a construction manager, but since arriving in Los 
Angeles over a year ago with his wife and child he has been unable to 
find work. He told us that he did not speak English when he arrived 
and believes that this has been a significant barrier to employment. 
According to the results of ORR's annual survey of refugees published 
in the agency's 2007 report to Congress[Footnote 47] (the most recent 
published report), English proficiency was one of the most important 
factors influencing the economic status of refugees, with close to 90 
percent of those who lacked earnings and received cash assistance 
living in a household where no one could speak English. 

Difficulties in Projecting Certain Program Costs Have Contributed to 
Fluctuations in ORR's Unobligated Balances: 

ORR considers a broad range of factors when estimating its program 
costs, and these estimates for fiscal years 1999 through 2009 have 
generally tracked actual program obligations in most but not all 
years. When estimating program costs, ORR officials told us they 
consider several factors, such as the projected inflation rate; 
participation rates; costs for cash and medical assistance; 
administrative costs; and monitoring, data collection, and evaluation 
costs, as well as the projected number of specific refugee groups such 
as unaccompanied refugee minors. According to our analysis, ORR's 
estimates of program costs have generally tracked what the agency 
actually obligated. Between fiscal years 1999 and 2009, ORR's 
estimates were, on average, within 6 percent of the agency's actual 
obligations. (See figure 7.) 

Figure 7: ORR Projected Obligations Compared with Actual Obligations, 
Fiscal Years 1999-2009: 

[Refer to PDF for image: multiple line graph] 

Year: 1999; 
Total obligations: $464 million; 
Total projected obligations: $415 million. 

Year: 2000; 
Total obligations: $450 million; 
Total projected obligations: $443 million. 

Year: 2001; 
Total obligations: $473 million; 
Total projected obligations: $433 million. 

Year: 2002; 
Total obligations: $511 million; 
Total projected obligations: $445 million. 

Year: 2003; 
Total obligations: $491 million; 
Total projected obligations: $465 million. 

Year: 2004; 
Total obligations: $474 million; 
Total projected obligations: $472 million. 

Year: 2005; 
Total obligations: $534 million; 
Total projected obligations: $488 million. 

Year: 2006; 
Total obligations: $553 million; 
Total projected obligations: $552 million. 

Year: 2007; 
Total obligations: $564 million; 
Total projected obligations: $615 million. 

Year: 2008; 
Total obligations: $623 million; 
Total projected obligations: $656 million. 

Year: 2009; 
Total obligations: $704 million; 
Total projected obligations: $667 million. 

Source: ORR and ACF Budget Justifications from fiscal years 2001 
through 2011. 

[End of figure] 

Despite its efforts to consider various factors when estimating 
program costs, ORR has faced difficulties in estimating specific 
variables, such as the number of refugees that will enter the country 
in a given year and the share of those refugees who will be eligible 
for ORR assistance programs, according to officials. ORR officials 
told us they use the presidential ceiling of refugees that may enter 
the United States in a given year when estimating the number of 
refugees they must serve. In fiscal year 2009, the number of refugees 
that arrived in the United States was more than 90 percent of the 
maximum number of refugees the United States set as the ceiling that 
year. However, this ceiling has not always been a good proxy of the 
actual number of incoming refugees. For fiscal years 2002 through 
2007, the number of refugees that arrived was, on average, about 40 
percent lower than the presidential ceiling. (See figure 8.) In 
addition to using the refugee ceiling, ORR projects the number of 
refugee arrivals by using historical arrival patterns,[Footnote 48] 
and in its fiscal year 2004 budget estimate, ORR requested less than 
it did in the previous year because of the decreasing number of 
refugee arrivals since September 11, 2001. 

Figure 8: Refugee Arrivals Compared to the Presidential Ceiling, 
Fiscal Years 1999-2009: 

[Refer to PDF for image: multiple line graph] 

Year: 1999; 
Arriving refugees: 85,019; 
Presidential ceiling: 91,000. 

Year: 2000 
Arriving refugees: 72,519; 
Presidential ceiling: 90,000. 

Year: 2001; 
Arriving refugees: 68,393; 
Presidential ceiling: 80,000. 

Year: 2002; 
Arriving refugees: 26,383; 
Presidential ceiling: 70,000. 

Year: 2003; 
Arriving refugees: 28,348; 
Presidential ceiling: 70,000. 

Year: 2004; 
Arriving refugees: 52,869; 
Presidential ceiling: 70,000. 

Year: 2005; 
Arriving refugees: 53,813; 
Presidential ceiling: 70,000. 

Year: 2006; 
Arriving refugees: 41,279; 
Presidential ceiling: 70,000. 

Year: 2007; 
Arriving refugees: 48,281; 
Presidential ceiling: 70,000. 

Year: 2008; 
Arriving refugees: 60,193; 
Presidential ceiling: 80,000. 

Year: 2009; 
Arriving refugees: 74,652; 
Presidential ceiling: 80,000. 

Source: ACF Budget Justifications fiscal years 2005 and 2011. 

[End of figure] 

Once ORR has refugee arrival estimates, the agency projects the number 
of refugees who will likely participate in ORR-funded programs. The 
share of refugees who are eligible for ORR-funded services varies from 
year to year. For example, between fiscal years 2007 and 2009, the 
percentage of all refugees who received cash assistance through ORR's 
assistance programs fluctuated between 26 percent and 38 percent. 
[Footnote 49] ORR must also estimate the average cost of providing 
cash assistance to refugees participating in its assistance programs, 
which can vary significantly depending on the distribution of refugees 
across the country. A refugee living in Texas participating in the 
Public Private Partnership program, for example, receives a cash 
assistance grant of about $200 per month, whereas a refugee living in 
Massachusetts participating in the Wilson/Fish program receives a cash 
assistance grant of about $428 per month. Consequently, the amount ORR 
reimburses state and voluntary agencies for the costs of providing 
cash assistance may change as refugee arrival patterns shift. For 
example, in fiscal year 2009, 3,082 more refugees were settled in 
Texas--a low benefit state--than in fiscal year 2008,[Footnote 50] 
while Minnesota and Connecticut--both high benefit states--saw 
decreases in their numbers of arrivals. ORR officials also told us 
that because they do not play a role in deciding where refugees are 
geographically placed, the agency is limited in its ability to 
estimate costs associated with refugee arrival patterns. 

Uncertainty regarding the costs for medical expenses incurred by 
refugees also affects ORR's ability to accurately estimate funding for 
the amount of services it must provide. Since an increasing proportion 
of arriving refugees need intensive medical care, refugees' medical 
costs on average have increased over time, creating uncertainty for 
ORR in estimating these expenses from year to year, according to 
officials. ORR officials indicated that refugees admitted in recent 
years have more diverse medical backgrounds than in the past, and that 
the number of refugees with chronic mental and medical conditions has 
grown, due in part to increases in refugee groups that have spent 
years living in refugee camps with limited access to medical care and 
proper nutrition. Burmese refugees in particular have lived for 
decades in refugee camps, according to ORR, and have grown from 128 
refugee arrivals in fiscal year 2002 to 18,275 arrivals in fiscal year 
2009, an increase from less than 1 percent to 24 percent of the total 
population of arriving refugees. Partly because of this demographic 
shift in the refugee arrival population, according to ORR officials, 
the agency's cost for medical assistance more than doubled from fiscal 
year 1999 through fiscal year 2009.[Footnote 51] ORR officials and 
voluntary agency staff explained that detailed information about 
refugees' health conditions are often not known prior to their arrival 
in the United States, which contributes to uncertainty in medical 
costs.[Footnote 52] For example, one voluntary agency director in 
Texas stated that medical information provided on refugees prior to 
their arrival is minimal, and only describes whether the client has a 
"Class A" condition, such as active tuberculosis, or a "Class B" 
condition, such as hypertension, without specifying the illness. 

Estimating the number of children ORR will likely serve as a result of 
the William Wilberforce Trafficking Victims Protection Reauthorization 
Act of 2008 also created uncertainty in ORR's budget formulation in 
recent years, according to ORR. Officials said they were uncertain 
about the impact this Act would have on their budget due to a 
provision stipulating that victims of trafficking and undocumented 
youths who are granted Special Immigrant Juvenile status may receive 
care and placement services funded by ORR instead of being returned to 
their home country.[Footnote 53] The Department of Homeland Security 
provides ORR with estimates about asylees and unaccompanied alien 
children who do not enter the United States through the traditional 
resettlement channels. According to ORR officials, the Department of 
Homeland Security estimated that the number of minors receiving 
services from ORR in fiscal year 2009 would be approximately 12,000 to 
14,000, but the overall number of Unaccompanied Alien Children 
declined from 7,211 in fiscal year 2008 to 6,622 in fiscal year 2009. 

Difficulties in accurately estimating program costs have contributed 
to fluctuations in ORR's unobligated balances at the end of each 
fiscal year. For example, ORR officials said that they used the 
presidential ceiling of 70,000 to estimate the number of refugees they 
would likely serve during fiscal years 2006 through 2007. However, 
refugee arrivals were significantly lower those years, and 
consequently the agency's costs to support newly arrived refugees were 
less than the amount it received in appropriations. Additionally, in 
anticipation of the potential influx of 4,000 to 6,200 additional 
unaccompanied alien children as a result of the William Wilberforce 
Trafficking Victims Protection Reauthorization Act of 2008, ORR 
requested supplemental funding, which was appropriated in fiscal year 
2009. According to ORR, the Act requires that youth entering the 
United States from neighboring countries be screened to determine if 
they are victims of trafficking. ORR anticipated that these youth 
would be cared for under the Unaccompanied Alien Children program 
while being screened. However, ORR's Unaccompanied Alien Children 
program served fewer children than anticipated, and at the end of 
fiscal year 2009, officials said they carried over about $31 million 
of unobligated Unaccompanied Alien Children funds and $52 million of 
unobligated supplementary funds. In total, from fiscal years 2006 to 
2009, ORR's unobligated balances grew from $17 million to over $83 
million. (See figure 9.) 

Figure 9: ORR Appropriations, Obligations, and Unobligated Balances 
Fiscal Years 1999-2009: 

[Refer to PDF for image: horizontal bar graph] 

Year: 1999; 
Total obligations: $465 million; 
End of year unobligated balances: $2 million; 
Appropriations: $435 million. 

Year: 2000; 
Total obligations: $450 million; 
End of year unobligated balances: $50 million; 
Appropriations: $426 million. 

Year: 2001; 
Total obligations: $473 million; 
End of year unobligated balances: $22 million; 
Appropriations: $433 million. 

Year: 2002; 
Total obligations: $511 million; 
End of year unobligated balances: $24 million; 
Appropriations: $460 million. 

Year: 2003; 
Total obligations: $491 million; 
End of year unobligated balances: $15 million; 
Appropriations: $478 million. 

Year: 2004; 
Total obligations: $474 million; 
End of year unobligated balances: $7 million; 
Appropriations: $445 million. 

Year: 2005; 
Total obligations: $534 million; 
End of year unobligated balances: $0 million; 
Appropriations: $481 million. 

Year: 2006; 
Total obligations: $553 million; 
End of year unobligated balances: $17 million; 
Appropriations: $569 million. 

Year: 2007; 
Total obligations: $564 million; 
End of year unobligated balances: $41 million; 
Appropriations: $588 million. 

Year: 2008; 
Total obligations: $623 million; 
End of year unobligated balances: $73 million; 
Appropriations: $656 million. 

Year: 2009; 
Total obligations: $704 million; 
End of year unobligated balances: $83 million; 
Appropriations: $715 million. 

Source: ORR’s Budget Justifications fiscal years 2001-2011 compiled 
and analyzed by GAO. 

Note: These unobligated balances are at the end of fiscal years 1999 
to 2009. Since ORR's funds are available for 3 fiscal years, ORR's 
total obligations and unobligated balances in a particular fiscal year 
may not equal the appropriation amount enacted for that fiscal year, 
an amount which also remains available for obligation during the 2 
subsequent fiscal years. 

[End of figure] 

Congress appropriates a certain amount of money to ORR each year to 
fund its activities, and ORR has a 3-year period in which to obligate 
funding for most of its budget activities[Footnote 54]--so funds that 
have not expired and are not yet obligated for a specific activity at 
the end of a fiscal year can be used during the following 2 fiscal 
years. From fiscal years 1999 to 2005, ORR used prior years' unexpired 
and unobligated funds to allow it to obligate more than it was 
appropriated in those years.[Footnote 55] For example, in fiscal year 
2005, ORR allocated $205 million of its appropriation to its 
Transitional and Medical Services budget activity to reimburse states 
for the costs of providing cash and medical assistance to refugees. 
When states' costs exceeded this amount, ORR was able to cover the 
difference between its expenses and its allocation by using funds from 
its unobligated balances from prior years. By the end of fiscal year 
2005, ORR did not have any remaining unobligated balances. From fiscal 
years 2006 to 2009, however, ORR obligated less than it was 
appropriated and thus was able to accumulate balances again. ORR 
officials told us they prioritize their unobligated balances to 
supplement the program costs of refugees who participate in the 
agency's Publicly Administered and Public Private Partnership programs 
because they place an emphasis on these programs in their funding 
decisions. 

Officials explained they do not typically use the agency's unobligated 
balances to supplement funding for other activities, such as funds 
dedicated to Social Services or the Wilson/Fish program. ORR's 
reimbursements to state and voluntary agencies for activities other 
than cash and medical assistance generally do not increase as the 
number of newly arrived refugees increase. Officials told us, for 
example, that the amount appropriated for Social Services has remained 
at approximately $154 million from fiscal years 2006 to 2009, even 
though the number of refugee arrivals increased by 81 percent. As a 
result, program providers have strategies to prioritize the use of 
limited funds in serving refugees. To ensure that new arrivals 
continued to receive needed services, refugee coordinators from Texas 
and Los Angeles told us they provided employment services to refugees 
for only about 1 year rather than the 5 years allowed in regulation. 
Similarly, ORR does not generally increase funding for Wilson/Fish 
services during a given year. In fiscal years 2008 and 2009, the San 
Diego Wilson/Fish program experienced an unexpected increase in 
refugees from 3,309 to 5,178. In fiscal year 2010, ORR directed 
providers to begin transferring refugee families with children, who 
were otherwise eligible for TANF but had been allowed to enroll in the 
Wilson/Fish program, off of their Wilson/Fish program and into the 
TANF program thereby transferring the costs of resettling these 
refugee families to other programs.[Footnote 56] 

Conclusion: 

ORR spends millions of dollars every year on assistance that is 
critical to addressing the basic needs of refugees who are new to the 
United States. State and voluntary agencies that administer ORR's 
programs vary in how they provide assistance, and little is known 
about the effectiveness of the approaches they use to help refugees 
become self-sufficient--an overall goal of all of ORR's programs. With 
refugees' employment outcomes declining because of the recession and 
significant pressures on the federal budget, it is important that 
program providers use approaches that have been shown to be effective 
in helping refugees find employment that enables them to live without 
cash assistance. ORR tracks the success of its programs using 
performance measures, but these measures alone provide little 
information about the relative effectiveness of the various approaches 
providers use. It is only by looking more closely at the individual 
approaches and controlling for other factors that may influence 
employment outcomes that ORR can begin to identify and promote the 
most successful strategies while at the same time make more effective 
and efficient use of its resources. 

Recommendation for Executive Action: 

We recommend that the Secretary of Health and Human Services identify 
effective approaches that state and voluntary agencies can use to help 
refugees become employed and self-sufficient. To identify these 
approaches, the Secretary may consider, for example, conducting a 
series of rigorous evaluations of the programs and their approaches or 
expanding information collected on the annual survey. Recommendations 
from further study could be used by HHS or, if appropriate, by 
Congress, to improve ORR's refugee resettlement programs. 

Agency Comments and Our Evaluation: 

We shared a draft of this report with HHS for review and comment. On 
March 16, 2011, HHS provided written comments, which may be found in 
appendix V, and technical comments, which we incorporated in the 
report where appropriate. 

In its written comments, HHS confirmed several of our findings and 
agreed with our recommendation to identify effective approaches to 
help refugees become employed and self-sufficient. HHS indicated that 
it seeks to highlight promising practices related to effective 
employment approaches and cited two recently published studies that it 
sponsored as examples of its efforts. While the two studies cited 
described different services states and voluntary agencies use to 
assist refugees and one study even compared employment outcomes of 
refugees living in two cities, neither of the studies evaluated the 
effectiveness of the programs or the approaches providers use in 
helping refugees become self-sufficient. In fact, as HHS indicated, 
one study suggested future research should include such an evaluation. 
The agency also emphasized that refugee resettlement in the United 
States is intended to be a rescue and restore program, which not only 
provides refugees with temporary cash, medical, and employment 
assistance, but also promotes cultural orientation, civic engagement, 
and other activities. GAO acknowledges that HHS has a broad mission to 
provide refugees with critical resources to assist them in becoming 
integrated members of society. Nonetheless, we focused our report on 
the temporary assistance and employment services refugees receive 
within the first 4 to 8 months after arriving in the United States 
because it is within this amount of time that refugees are expected to 
find employment and become self-sufficient. 

We are sending copies of this report to relevant congressional 
committees; the Secretary of Health and Human Services, and other 
interested parties. The report will also be available at no charge on 
the GAO Web site at [hyperlink, http://www.gao.gov]. 

If you or your staff have any questions about this report, please 
contact me at (202) 512-7215 or brownke@gao.gov. Contact points for 
our Offices of Congressional Relations and Public Affairs may be found 
on the last page of this report. Key contributors to this report are 
listed in appendix VI. 

Sincerely Yours, 

Signed by: 

Kay E. Brown: 
Director, Education, Workforce, and Income Security Issues: 

[End of section] 

Appendix I: Scope and Methodology: 

To describe how the Office of Refugee Resettlement (ORR) refugee 
assistance programs differ and the factors used to place refugees in a 
program, we interviewed ORR officials and National Voluntary Agency 
officials from all nine National Voluntary Agencies who help 
administer ORR programs.[Footnote 57] We also interviewed state, 
county, and local voluntary agency officials in five states, including 
California, Florida, Massachusetts, Minnesota, and Texas and conducted 
discussion groups with refugees in all but Massachusetts. We selected 
four states with a high concentration of ORR refugee caseloads and one 
state with a relatively low concentration of refugee cases. We also 
selected states with a range of average 2009 unemployment rates. 
States we selected were geographically diverse and all offered 
Matching Grant programs. We also collected and reviewed refugee case 
files from the government and voluntary agencies we visited, so that 
we would have case files representing refugees with different 
experiences. From the states we visited except California, we 
collected copies of two complete case files chosen by the voluntary 
agency--one case file representing a refugee who participated in 
either the Publicly Administered, Wilson/Fish, or Public Private 
Partnership; and one case file representing a refugee who participated 
in a Matching Grant program.[Footnote 58] The information we collected 
at these selected states does not allow us to generalize to other 
states, refugees, or local voluntary agencies. We also reviewed 
relevant federal laws and regulations. 

To describe refugee employment outcomes and the effectiveness of 
different approaches to providing assistance, we collected, 
aggregated, and analyzed performance data across all states for fiscal 
years 2007, 2008, and 2009 by program--Publicly Administered, Public 
Private Partnership, and Wilson/Fish. To assess the reliability of the 
performance data, we interviewed knowledgeable agency officials and 
reviewed official documents. We compiled these data into a spreadsheet 
and only included the performance outcomes of refugees who received 
cash assistance from one of ORR's programs. Because this study focused 
primarily on the refugees who received cash assistance from ORR's four 
assistance programs, we did not include refugees who participated in 
the Temporary Assistance for Needy Families (TANF) program. We also 
did not include any data that represented refugees who were receiving 
ORR services but not receiving refugee cash assistance. We also 
collected and analyzed performance data for the Matching Grant program 
from the nine national voluntary agencies for fiscal years 2007 
through 2009. We analyzed these 3 years of performance data to gain 
insight on how refugee assistance programs were performing most 
recently. While the performance data have some limitations, we 
consider these data reliable and appropriate for this engagement. We 
also conducted a literature review and found one study that reliably 
addressed the effectiveness of approaches used by providers to provide 
refugee assistance. 

To describe how ORR estimates program costs and how estimates affect 
its unobligated balances, we interviewed officials from the Department 
of Health and Human Services (HHS), Administration for Children and 
Families (ACF), and ORR to determine how ORR formulates its budget. We 
also reviewed and analyzed budget documents from fiscal years 1999 
through 2009, including ORR budget justifications and annual reports 
to Congress. We interviewed knowledgeable agency officials and 
reviewed official documents to assess the data that ORR uses to 
estimate program costs, and found the data to be sufficiently 
reliable. Analyzing budget information from fiscal years 1999 to 2009 
allowed us to identify trends in ORR's obligations and unobligated 
balances. In addition, we spoke with officials from the Departments of 
State and Homeland Security to obtain information on how they develop 
budgets for their refugee programs and what, if any, coordination 
occurs between these agencies and ORR to help ORR formulate its 
budget. We conducted this performance audit from December 2009 to 
March 2011 in accordance with generally accepted government auditing 
standards. Those standards require that we plan and perform the audit 
to obtain sufficient, appropriate evidence to provide a reasonable 
basis for our findings and conclusions based on our audit objectives. 
We believe that the evidence we obtained provides a reasonable basis 
for our findings and conclusions. 

[End of section] 

Appendix II: Profiles of States Visited: 

Table 6: State Profiles: 

State: California; 
Program: Wilson/Fish in San Diego County; 
Benefit level per month (1 adult/2 adults): $359/$584; 
Caseloads[A]: 2007: 801; 
Caseloads[A]: 2008: 2,182; 
Caseloads[A]: 2009: 4,046; 
[Empty]; 
2009 average state unemployment rates[B]: 11.4%. 

State: California; 
Program:Publicly Administered in all other counties; 
Benefit level per month (1 adult/2 adults): $382/$627 and $363/ 
$598[C]; 
Caseloads[A]: 2007: 2,208; 
Caseloads[A]: 2008: 757; 
Caseloads[A]: 2009: 2,721; 
2009 average state unemployment rates[B]: 11.4%. 

State: Florida; 
Program: Publicly Administered; 
Benefit level per month (1 adult/2 adults): Ranges from $95/$158 to 
$180/$241[D]; 
Caseloads[A]: 2007: 5,448; 
Caseloads[A]: 2008: 7,779; 
Caseloads[A]: 2009: 10,048; 
2009 average state unemployment rates[B]: 10.5%. 

State: Massachusetts; 
Program: Wilson/Fish; 
Benefit level per month (1 adult/2 adults): $428/$531; 
Caseloads[A]: 2007: 431; 
Caseloads[A]: 2008: 464; 
Caseloads[A]: 2009: 696; 
2009 average state unemployment rates[B]: 8.4%. 

State: Minnesota; 
Program: Public Private Partnership; 
Benefit level per month (1 adult/2 adults): $250/$437; 
Caseloads[A]: 2007: 1369; 
Caseloads[A]: 2008: 803; 
Caseloads[A]: 2009: 438; 
2009 average state unemployment rates[B]: 8.0%. 

State: Texas; 
Program: Public Private Partnership; 
Benefit level per month (1 adult/2 adults): $200/$300[E] for months 
1-4 $187.50/$252 for months 5-8; 
Caseloads[A]: 2007: 1,021; 
Caseloads[A]: 2008: 2,122; 
Caseloads[A]: 2009: 3,340; 
2009 average state unemployment rates[B]: 7.6%. 

Source: Information compiled by GAO. 

[A] Caseloads represent refugees who received cash assistance and 
employment services from the Publicly Administered, Wilson/Fish, or 
Public Private Partnership program. 

[B] As reported by the Bureau of Labor Statistics, U.S. Department of 
Labor in a March 3, 2010, News Release, Report Number USDL-10-0231. 

[C] Based on the state's TANF payment standards, California's Publicly 
Administered program has two benefit levels: one for high-cost 
counties and one for all other counties, according to state officials. 

[D] The range in Florida depends on the amount of rent the refugee 
pays. For a single adult who does not pay rent, the lowest benefit 
payment applies. For a single adult who pays more than $50 in rent, 
the highest benefit payment applies. 

[E] For one adult, $200 per month for months 1-4 and $187.50 per month 
for months 5-8. For two adults, $300 per month for months 1-4 and $252 
per month for months 5-8. 

[End of table] 

[End of section] 

Appendix III: ORR Employment Outcomes: 

Table 7: Employment Outcome Definitions of the Publicly Administered, 
Public Private Partnership, and Wilson/Fish Programs: 

Outcome measure: Entered Employment; 
Definition: The unduplicated number of refugees who entered employment. 

Outcome measure: Employment with Health Benefits; 
Definition: The unduplicated number of refugees who entered full-time 
employment where health benefits are offered within the first 6 months 
of employment. 

Outcome measure: Average Wage per hour; 
Definition: The average wage at placement for all refugees who entered 
full-time employment. 

Outcome measure: Cash Assistance Terminations because of Employment; 
Definition: The unduplicated number of refugees terminating cash 
assistance due to earnings from employment. 

Outcome measure: Job Retention at 90th Day of Employment; 
Definition: The unduplicated number of refugees who entered employment 
between July of the previous calendar year through June of the current 
calendar year. This rate is a measure of refugee's retention of 
employment--not retention of a specific job. As long as the refugee is 
employed in a job a quarter after the date he or she entered 
employment, it is considered retention. 

Outcome measure: Cash Assistance Reductions Due to Employment; 
Definition: The unduplicated number of refugees reducing cash 
assistance due to earnings from employment. 

Source: ORR. 

[End of table] 

Table 8: Employment Outcome Definitions of the Matching Grant Program: 

Outcome measure: Entered Employment; 
Definition: The unduplicated number of refugees who entered employment. 

Outcome measure: Employment with Health Benefits; 
Definition: The unduplicated number of refugees who entered full time 
employment where health benefits are offered within the first 6 months 
of employment. 

Outcome measure: Average Hourly Wage; 
Definition: The sum of the hourly wages for the unduplicated number of 
full-time job placements divided by the total unduplicated number of 
individuals placed in full-time employment. 

Outcome measure: Economic Self-Sufficiency (120); 
Definition: This rate measures the self-sufficiency of refugees 
enrolled in the Matching Grant program at the 120th day. Self-
sufficiency means that the refugee or refugee family is earning a 
total family income at a level that enables the family unit to support 
itself without receipt of cash assistance. Refugees who receive non-
cash assistance, such as Supplemental Nutrition Assistance Program 
(SNAP) benefits or housing subsidies, are considered to be self-
sufficient by ORR if they have earnings and do not receive cash 
assistance. 

Outcome measure: Economic Self-Sufficiency Retention (180); 
Definition: This refers to the individuals who were reported to be 
self-sufficient at the 120th day and continued to be self-sufficient 
60 days later. Refugees who receive non-cash assistance, such as SNAP 
benefits or housing subsidies, are considered to be self-sufficient by 
ORR if they have earnings and do not receive cash assistance. 

Outcome measure: Economic Self-Sufficiency Overall; 
Definition: This rate measures the self-sufficiency of all refugees 
enrolled in the Matching Grant program, including the status at 120 
days and 180 days. 

Source: ORR. 

[End of table] 

Table 9: Employment Outcomes for Refugees Receiving Cash Assistance 
from ORR's Publicly Administered, Public Private Partnership, or 
Wilson/Fish Program from Fiscal Years 2007 to 2009: 

Employment outcomes: Entered Employment; 2007; 
Publicly Administered: 65%; 
Public Private Partnership: 64%; 
Wilson/Fish: 59%. 

Employment outcomes: Entered Employment; 2008; 
Publicly Administered: Employment outcomes 50%; 
Public Private Partnership: Employment outcomes 75%; 
Wilson/Fish: Employment outcomes 44%. 

Employment outcomes: Entered Employment; 2009; 
Publicly Administered: 34%; 
Public Private Partnership: 52%; 
Wilson/Fish: 31%. 

Employment outcomes: Employment with Health Benefits; 2007; 
Publicly Administered: 54%; 
Public Private Partnership: 67%; 
Wilson/Fish: 81%. 

Employment outcomes: Employment with Health Benefits; 2008; 
Publicly Administered: 76%; 
Public Private Partnership: 62%; 
Wilson/Fish: 77%. 

Employment outcomes: Employment with Health Benefits; 2009; 
Publicly Administered: 67%; 
Public Private Partnership: 71%; 
Wilson/Fish: Employment outcomes 64%. 

Employment outcomes: Cash Assistance Termination because of 
Employment; 2007; 
Publicly Administered: 69%; 
Public Private Partnership: 37%; 
Wilson/Fish: 80%. 

Employment outcomes: Cash Assistance Termination because of 
Employment; 2008; 
Publicly Administered: 51%; 
Public Private Partnership: 26%; 
Wilson/Fish: 68%. 

Employment outcomes: Cash Assistance Termination because of 
Employment; 2009; 
Publicly Administered: 65%; 
Public Private Partnership: 24%; 
Wilson/Fish: 64%. 

Employment outcomes: Job Retention at 90th day of Employment; 2007; 
Publicly Administered: 77%; 
Public Private Partnership: 81%; 
Wilson/Fish: 84%. 

Employment outcomes: Job Retention at 90th day of Employment; 2008; 
Publicly Administered: 58%; 
Public Private Partnership: 80%; 
Wilson/Fish: 85%. 

Employment outcomes: Job Retention at 90th day of Employment; 2009; 
Publicly Administered: 73%; 
Public Private Partnership: 67%; 
Wilson/Fish: 80%. 

Employment outcomes: Cash Assistance Reductions due to Employment; 
2007; 
Publicly Administered: 1%; 
Public Private Partnership: 6%; 
Wilson/Fish: 5%. 

Employment outcomes: Cash Assistance Reductions due to Employment; 
2008; 
Publicly Administered: 3%; 
Public Private Partnership: 3%; 
Wilson/Fish: 9%. 

Employment outcomes: Cash Assistance Reductions due to Employment; 
2009; 
Publicly Administered: 4%; 
Public Private Partnership: 1%; 
Wilson/Fish: 16%. 

Employment outcomes: Average Wage per Hour; 2007; 
Publicly Administered: $8.72; 
Public Private Partnership: $8.96; 
Wilson/Fish: $8.98. 

Employment outcomes: Average Wage per Hour; 2008; 
Publicly Administered: $8.86; 
Public Private Partnership: $9.09; 
Wilson/Fish: $9.31. 

Employment outcomes: Average Wage per Hour; 2009; 
Publicly Administered: $8.87; 
Public Private Partnership: $8.90; 
Wilson/Fish: $9.33. 

Source: ORR's Annual Outcome Goal Plans compiled by GAO. 

Notes: The Entered Employment rate for the Public Private Partnership 
in fiscal year 2008 is substantially higher than the rates for the 
other programs. We asked ORR if the performance data had any 
abnormalities that would cause rates to be particularly high or low 
for a given year. Officials said they believed the performance data to 
be accurate and were not aware of any abnormalities. 

These rates include only those refugees who received cash assistance 
from the Publicly Administered, Wilson/Fish, or Public Private 
Partnership program. These rates do not include refugees who did not 
receive ORR-funded cash assistance but may have received other types 
of ORR-funded services, such as employment assistance. Refugees who do 
not receive ORR-funded cash assistance but receive other types of ORR 
assistance may include (1) those who are participating in the 
Temporary Assistance for Needy Families (TANF) program and receiving 
ORR-funded employment services or (2) refugees who have exhausted 
their ORR-provided cash assistance but continue to receive ORR-funded 
employment services. ORR told us it typically includes all refugees 
who received some type of ORR-funded services when it reports 
employment outcomes for the Publicly Administered, Wilson/Fish, and 
Public Private Partnership programs. 

[End of table] 

Table 10: Matching Grant Performance Rates from Fiscal Years 2007 to 
2009: 

Employment outcomes: Entered Employment; 
Matching Grant: 2007: 64%; 
Matching Grant: 2008: 57%; 
Matching Grant: 2009: 47%. 

Employment outcomes: Employment with Health Benefits; 
Matching Grant: 2007: 58%; 
Matching Grant: 2008: 55%; 
Matching Grant: 2009: 51%. 

Employment outcomes: Economic Self-Sufficiency (120); 
Matching Grant: 2007: 69%; 
Matching Grant: 2008: 62%; 
Matching Grant: 2009: 52%. 

Employment outcomes: Economic Self-Sufficiency Retention (180); 
Matching Grant: 2007: 95%; 
Matching Grant: 2008: 95%; 
Matching Grant: 2009: 93%. 

Employment outcomes: Economic Self-Sufficiency (Overall); 
Matching Grant: 2007: 80%; 
Matching Grant: 2008: 78%; 
Matching Grant: 2009: 67%. 

Employment outcomes: Average Wage per Hour at Employment (full-time); 
Matching Grant: 2007: $8.58; 
Matching Grant: 2008: $8.68; 
Matching Grant: 2009: $8.67. 

Source: ORR's Matching Grant annual report data compiled by GAO. 

[End of table] 

[End of section] 

Appendix IV: Refugee Vignettes from Discussion Groups: 

The following examples are from our four discussion groups held in 
various parts of the country. Voluntary agencies convened the 
discussion groups, selected the participants, and provided translators 
when necessary. These examples are illustrations of refugees' 
experiences, and are not indicative of any success or failure of ORR's 
programs. 

* A single male from Iraq had job experiences as a shop owner, 
translator, and sports trainer prior to arriving in the United States. 
His voluntary agency provided him with assistance in finding an 
apartment and a job. He currently works two jobs and makes enough 
money to make ends meet. He hopes to begin a new career by taking 
training in massage therapy in the near future. 

* A married couple from Burma with two teenagers lived an agrarian 
life in their native land, farming rice and vegetables for their own 
subsistence and selling the rest. Caseworkers from a voluntary agency 
enabled them to obtain medical care and Social Security cards, and 
fill out job applications. Neither husband nor wife was literate in 
their native Burmese dialect and found learning English difficult. He 
has found work in a factory and his wife has qualified for SSI. With 
these sources of income they are able to pay their bills and save some 
money. 

* A man from Eritrea was a plant scientist in his native country and 
knew some English. A voluntary agency helped him with enrolling in a 
nursing assistant certification program and applying for a job. He 
aspires to become a doctor. 

* Married with two children, an Iranian physician with 15 years of 
medical experience in his native land arrived in the United States 
wanting to practice medicine. However, because of his limited English, 
he said it was difficult to study for the U.S. Medical Licensing exam. 
A voluntary agency helped him find a job as a medical assistant, but 
he did not keep that job. In the future, he hopes to enhance his 
English skills so he can enter and complete a physician's assistant 
program. 

[End of section] 

Appendix V: Comments from the Department of Health and Human Services: 

Department Of Health & Human Services:	
Office Of The Secretary: 
Assistant Secretary for Legislation: 
Washington, DC 20201: 

March 16 2011: 

Kay E. Brown, Director: 
Education, Workforce, and Income Security Issues: 
U.S. Government Accountability Office: 
441 G Street N.W. 
Washington, DC 20548: 

Dear Ms. Brown: 

Attached are comments on the U.S. Government Accountability Office's 
(GAO) draft report entitled, "Refugee Assistance: Little is Known 
about the Effectiveness of Different Approaches for Improving 
Refugees' Employment Outcomes" (GAO 11-369). 

The Department appreciates the opportunity to review this report prior 
to publication. 

Sincerely, 

Signed by: 

Jim R. Esquea: 
Assistant Secretary for Legislation: 

Attachment: 

[End of letter] 

General Comments Of The Department Of Health And Human Services (HHS) 
On The Government Accountability Office's (GAO) Draft Report Entitled, 
"Refugee Assistance: Little Is Known About The Effectiveness Of 
Different Approaches For Improving Refugees' Employment Outcomes" (GA0-
11-369): 

The Department appreciates the opportunity to comment on this draft 
report. 

GAO Recommendations: 

We recommend that the Secretary of Health and Human Services identify 
effective approaches that state and voluntary agencies can use to help 
refugees become employed and self-sufficient. To identify these 
approaches, the Secretary may consider, for example, conducting a 
series of rigorous evaluations of the programs and their approaches or 
expanding information collected on the annual survey. Recommendations 
from further study could be used by HHS or, if appropriate, by 
Congress to improve ORR's refugee resettlement programs. 

HHS Response: 

The Department agrees with GAO's recommendation concerning the 
importance of identifying effective approaches that state and 
voluntary agencies can use to help refugees become employed and self-
sufficient. HUB' Office of Refugee Resettlement is engaged in ongoing 
efforts to do so, including activities to share information about 
effective approaches with grantees and providers. We also agree that 
important insights could be gained through rigorous evaluations of 
alternative approaches, and that it may be possible to expand 
information collected in the annual survey of refugees to learn more 
about their employment experiences through the direct input of 
refugees. 

HHS wishes to emphasize that the goals of refugee assistance include 
but are not limited to employment; that the U.S. refugee resettlement 
program is a Federal/state partnership in which states are given 
certain discretion to utilize program approaches that best address the 
self-sufficiency needs of refugees being resettled in their 
communities; that the flexibility in program design presents 
challenges for comparing program outcomes; that current activities 
seek to highlight promising practices about effective employment 
approaches within a very flexible framework; and that while program 
budgeting projections have been within 6 percent of actual 
obligations, we continue to seek to improve those projections. 

The draft report examines differences in three assistance programs and 
the Voluntary Matching Grant program. The different program models 
were developed over time in response to local conditions and state 
preferences in implementation. 

While each of these programs provides services to promote employment, 
it is important to appreciate that the goals of refugee assistance 
include but are not limited to employment. The U.S. refugee 
resettlement program is rooted in humanitarian concern, foreign 
affairs and national security considerations. Refugees are admitted to 
the United States for resettlement based on each individual's 
persecution or well-founded fear of persecution on account of race, 
religion, nationality, membership in a particular social group or 
political opinion. An individual's employability is not a determining 
factor for admission to the United States	Similarly, resettlement 
services go beyond the temporary assistance and employment services 
discussed in this draft report to include health and mental health 
care, civic engagement, English language instruction, cultural 
orientation, case management and other social services. Taken 
together, the refugee resettlement program is intended to be a rescue 
and restore program, of which employment services is one component. 

States have discretion in determining whether or not to participate in 
refugee resettlement, and in how to structure their participation. 
Thirty-two states and the District of Columbia operate publicly 
administered resettlement assistance and services. Oregon, Texas, 
Oklahoma, Minnesota and Maryland operate a variation of the publicly 
administered program with an emphasis on public and private 
partnerships. Twelve states and San Diego County, California, provide 
resettlement services through an alternative known as the Wilson-Fish 
program. Wyoming does not provide resettlement services. These 
programs and the Matching Grant program were not created as competing 
options, but as solutions to particular needs and conditions. As such, 
refugees can receive refugee cash assistance or Temporary Assistance 
for Needy Families and participate in the Wilson-Fish and Matching 
Grant programs. 

The type of assistance program a refugee participates in is determined 
by the program that exists in the state of the refugee's initial 
resettlement. The Department of State's (State) Bureau of Population, 
Refugees and Migration determines the initial placement of refugees. 
[Footnote 1] HHS is working closely with states to enhance placement 
decisions by linking newly arriving refugees and the receiving 
communities with refugee resettlement resources. 

This level of flexibility and variation across programs makes it 
difficult to directly compare program outcomes. As the report notes, 
the Matching Grant program uses different performance outcomes for 
employment from those used by the three assistance programs. One 
reason for this difference is that the Matching Grant program design 
focuses on early employment; consequently employment outcomes are 
measured at 120 days and 180 days instead of eight months or 0 to 60 
months as in the assistance programs. In addition, because the 
Matching Grant program is not an assistance program, it does not 
measure termination or reduction of Federal cash assistance. 

Even if the same outcome measures were used, there would still be 
limitations in the ability to compare effectiveness of alternative 
approaches through outcome measures alone, because there are 
significant differences in program designs across states, in the 
characteristics of refugee populations across states, and because the 
characteristics of individuals served through voluntary matching 
grants may differ from the characteristics of those served in other 
programs. 

Nevertheless, HHS believes that having and reporting annual outcome 
measures provides important information to states and policymakers 
about the employment-related goals of the program and allows 
measurement of progress over time within and across states. At the 
same time, we appreciate that outcome measures are not measures of 
program impact, and that additional research could benefit the program. 

In the interest of identifying effective approaches across states, the 
Department sponsored two studies in 2008 and 2009.[Footnote 2] These 
studies identified promising approaches (e.g., English language 
instruction where refugees live and work; professional recertification 
and career laddering for refugees who were professionals in their 
native countries; leveraging mainstream social service resources; and 
partnering with ethnic community based organizations for culturally 
competent service-delivery). The 2009 report also suggested a follow-
up study to evaluate whether employment and self-sufficiency programs 
are more effective when administered by a Voluntary Agency (i.e., 
generally Wilson-Fish or Matching Grant programs) or by state or 
county agencies. It also recommended examining whether refugees fare 
better when they quickly enter the workforce or when they focus on 
English language instruction before entering the workforce. HHS will 
consider incorporating these recommendations in future studies as 
funding for program evaluation becomes available. 

In addition to these studies, HHS administers a training and technical 
assistance grant dedicated to refugee employment. The training and 
technical assistance provider assists refugees, the nationwide refugee 
resettlement network, employers and policymakers with employment and 
self-sufficiency efforts by promoting promising practices and 
providing trainings. 

The Department provides cash and medical assistance to refugees 
through the Transitional and Medical Services (TAMS) budget. This 
budget also supports state administration costs, monitoring, data 
collection, and evaluation costs, as well as the Matching Grant 
program, the Wilson-Fish program, the Anti-Trafficking In Persons 
program and the Unaccompanied Refugee Minors program (URM). The 
program develops budget projections after considering many factors, 
some of which are unpredictable (e.g., arrival numbers, participation 
rates). On average, projections for the TAMS budget have tracked 
within 6 percent of the program's actual obligations for fiscal years 
1999 through 2009. We are reviewing our process for projecting the 
TAMS budget in an effort to track even more closely with actual 
obligations for each fiscal year. An emerging consideration is the 
increasingly large impact that the URM program has on the TAMS budget. 
The URM program and associated costs are growing due to recent 
legislation, the Trafficking Victims Protection Act and subsequent 
reauthorizations, which authorizes certain unaccompanied alien 
children and victims of trafficking to be eligible for services. 

Appendix V Footnotes: 

[1] The Immigration and Nationality Act (INA) states, "[Ole 
Director... shall consult regularly (not less than quarterly) with 
State and local governments and private nonprofit voluntary agencies 
concerning the sponsorship process and the intended distribution of 
refugees among the States and localities before their placement in 
those State and localities." See INA §412(a)(2)(A), 8 U.S.C. 
§1522(a)(2)(A). In addition. "[t]he director shall develop and 
implement, in consultation with representatives of voluntary agencies 
and State and local governments, policies and strategies for the 
placement and resettlement of refugees within the United States." See 
INA §412(a)(2)(B), 8 U.S.C. § 1522(a)(2)(B). "Such policies and 
strategies... shall — (i) insure that a refugee is not initially 
placed or resettled in an area highly impacted (as determined under 
regulations prescribed by the Director after consultation with such 
agencies and governments) by the presence of refugees... (ii) provide 
for a mechanism whereby representatives of governments to plan and 
coordinate in advance of their arrival the appropriate placement of 
refugees among the various States and localities, and (iii) take into 
account — (I) the proportion of refugees and comparable entrants in 
the population in the area. (ii) the availability of employment 
opportunities, affordable housing, and public and private resources 
(including education, health care, and mental health services) for 
refugees in the area, UM the likelihood of refugees placed in the area 
becoming self-sufficient and free from long-term dependence on public 
assistance, and (IV) the secondary migration of refugees to and from 
the area that is likely to occur. 

The Office of Refugee Resettlement (ORR) Director is responsible for 
the care of unaccompanied refugee children. Under section 412(d) of 
the INA, the ORR Director "shall attempt to arrange for the placement 
under the laws of the States of such unaccompanied refugee 
children..." See INA §412(d)(2)(B)(ii), It U.S.C. § 1522(d)(2)(B)(ii). 

[2] The HHS-sponsored studies, Building an Integrated Refugee Program 
and The Evaluation of the Refugee Social Services (RSS) and Targeted 
Assistance Formula Grant (TAG) Programs were published in 2008 and 
2009 respectively. The 2008 study focused on four sites (i.e., 
Northern Virginia; Fort Wayne, Indiana; Seattle, Washington: 
Metropolitan Detroit, Michigan) and the 2009 study focused on three 
sites (i.e., Houston, Texas; Miami, Florida; and Sacramento, 
California). 

[End of section] 

Appendix VI: GAO Contact and Staff Acknowledgments: 

GAO Contact: 

Kay E. Brown (202) 512-7215 or brownke@gao.gov: 

Staff Acknowledgments: 

In addition to the contact named above, Kathryn Larin, Assistant 
Director; Danielle Giese and Cheri Harrington, Analysts-in-Charge; 
Richard Burkard; David Chrisinger; Erin Cohen; Rajiv D'Cruz; Mitchell 
Karpman; Carol Henn; Brittni Milam; James Rebbe; Cynthia Saunders; 
Kathleen van Gelder; Shana Wallace; and Daniel Webb made key 
contributions to this report. 

[End of section] 

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[hyperlink, http://www.gao.gov/products/GAO/HRD-91-51]. Washington, 
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[hyperlink, http://www.gao.gov/products/GAO/NSIAD-88-91]. Washington, 
D.C.: February 3, 1988. 

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http://www.gao.gov/products/GAO/NSIAD-86-69]. Washington, D.C.: April 
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Greater Emphasis on Early Employment and Better Monitoring Needed in 
Indochinese Refugee Resettlement Program. [hyperlink, 
http://www.gao.gov/products/GAO/HRD-83-15]. Washington, D.C.: March 1, 
1983. 

[End of section] 

Footnotes: 

[1] ORR considers refugees to be self-sufficient if they have earnings 
and do not receive cash assistance, even if they receive other types 
of public assistance, such as Supplemental Nutrition Assistance 
Program (SNAP) benefits or Medicaid. 

[2] H.R. Rept. No. 111-220 at 162 (2009). 

[3] An unobligated balance represents the portion of the unexpended 
balance of an appropriation unencumbered by recorded obligations. 

[4] The discussion groups focused primarily on the refugees' 
experiences before coming to the United States and the assistance they 
received from the voluntary agencies. 

[5] Data limitations stem from the fact that performance data are 
reported by multiple agencies. 

[6] 8 U.S.C. § 1101(a)(42)(A). In special circumstances, a refugee 
also may be a person who is within his or her country and who is 
persecuted or has a well-founded fear of persecution on account of 
race, religion, nationality, membership in a particular social group, 
or political opinion. Excluded from the definition of a refugee is any 
person who participated in the persecution of another. 

[7] The Department of State submits a report to Congress with its 
recommendations on how many refugees should be admitted, which 
according to Department of State officials, takes into account 
government agencies' refugee processing capabilities. 

[8] Pub. L. No. 96-212, 94 Stat. 102. 

[9] The intent of the legislation was, among other things, to end an 
ad hoc approach to refugee admissions and resettlement that had 
characterized U.S. refugee policy since World War II. 

[10] In addition to refugees, other groups are eligible for the same 
benefits and services for which refugees are eligible, including 
asylees (persons physically present in the United States who, in order 
to be granted asylum, must establish that they are refugees), Cuban/ 
Haitian Entrants, Amerasians, victims of severe forms of trafficking, 
and Iraqi and Afghan Special Immigrants. This study generally uses the 
term "refugees" to refer to all groups that qualify for ORR services. 

[11] Before the Refugee Act of 1980, voluntary agencies assumed the 
primary responsibility for resettling refugees in the United States, 
usually by using their own resources. 

[12] The Department of State helps fund the services provided to 
refugees within their first 30 to 90 days in the United States. 

[13] According to ORR, over the years, the eligibility period for a 
refugee to receive cash assistance through ORR programs has been 
shortened. In April 1981, assistance was limited to the first 36 
months after a refugee entered the country. The duration of cash and 
medical assistance available to refugees was reduced to 18 months in 
1982, to 12 months in 1988, and to 8 months in 1991, which is the 
eligibility period that exists today. 

[14] A state will typically adopt either the Publicly Administered, 
Wilson/Fish, or Public Private Partnership program on a state-wide 
basis; however, California has two programs: the Wilson/Fish Program 
is offered in the County of San Diego, and the Publicly Administered 
program is offered throughout the rest of the state. 

[15] While ORR does not consider the Publicly Administered, Public 
Private Partnership, and Wilson/Fish as three separate programs, we 
refer to each as a separate program in this report. 

[16] According to HHS, the Wilson/Fish program was named after Senator 
Pete Wilson (from California) and Representative Hamilton Fish (from 
New York), both of whom collaborated to enact the legislation that 
established the program (8 U.S.C. § 1522(e)(7)). 

[17] The Matching Grant program is not provided in the following 
states: Alaska, Arkansas, Delaware, Mississippi, Montana, Oregon, West 
Virginia, and Wyoming. 

[18] A refugee does, however, continue to receive medical assistance 
until he or she reaches the end of his or her time-eligibility period 
for refugee medical assistance, which may not correspond to the 
refugee's eligibility period for cash assistance. 45 C.F.R § 400.104(c) 

[19] According to ORR, refugees who receive assistance from the 
Matching Grant program may not receive assistance or funding from any 
of ORR's other three assistance programs at the same time. If a 
refugee does not find employment after participating in the Matching 
Grant program for 4 to 6 months, he or she may receive services, 
including cash and medical assistance, from one of ORR's other 
assistance programs. 

[20] Refugee medical assistance is provided through state and local 
health departments or their proxies, according to ORR. 

[21] Refugees eligible for ORR-funded social services may include 
those who are receiving ORR-funded cash assistance and those who are 
not receiving ORR-funded cash assistance, including refugees 
participating in the TANF program. 

[22] Under 45 C.F.R. § 400.53(a)(2), refugees who are eligible for 
TANF and SSI cannot receive ORR cash assistance under the Publicly 
Administered or Public Private Partnership program. Refugees receiving 
cash assistance under the Wilson/Fish program are prohibited from 
receiving TANF payments pursuant to 8 U.S.C. § 1522(e)(7)(B). 

[23] 45 C.F.R. § 400.2. The regulations use the term "economic self- 
sufficiency." 

[24] According to ORR, it is not authorized to collect similar 
information related to self-sufficiency for the other three programs-- 
Publicly Administered, Wilson/Fish, and Public Private Partnership-- 
without permission from the Office of Management and Budget. The 
Paperwork Reduction Act requires agencies to get the Office of 
Management and Budget's approval for information collected from 10 or 
more nonfederal entities. 44 U.S.C. § § 3502(3) and 3507. ORR 
officials also said the agency is allowed to collect information 
related to economic self-sufficiency without the Office of Management 
and Budget's approval for the Matching Grant program because it is 
collecting it from less than 10 entities. Nine national voluntary 
agencies administer the Matching Grant program in 42 states with the 
help of their affiliates. 

[25] In this report, we refer to providers as the government and local 
voluntary agencies who offer ORR-funded services to refugees. 

[26] The term medical assistance used in this report refers to the 
assistance provided through ORR-funded programs. 

[27] ORR does not reimburse providers of the Matching Grant program 
for all eligible refugees. Voluntary agencies are given a set amount 
of funds each fiscal year, and must determine the number of refugees 
they can serve with the set amount. 

[28] When states' cash and medical assistance expenses exceed the 
agency's appropriation in a given year, ORR may use its unexpired and 
unobligated balances to cover costs. 

[29] The Social Services budget activity does not fund social services 
for the Matching Grant program. Funding for services for the Matching 
Grant program comes from the Transitional and Medical Services budget 
activity. 

[30] In this report, we use the terms refugees' employment outcomes 
and programs' performance measures interchangeably. 

[31] The Publicly Administered program also does not receive dedicated 
funding from ORR to provide case management activities. Providers of 
the Publicly Administered, Wilson/Fish, and Public Private Partnership 
programs may use Refugee Social Service funding to support case 
management activities as well as other services, such as employment 
services, immigration assistance, and social adjustment services for 
up to 5 years, based on available funding. 

[32] In Massachusetts a state official told us they offer refugees a 
cash bonus of $600 for finding employment within 4 months and 
retaining employment for 90 days. In San Diego, a refugee who has 90 
days or more of employment within 120 days of his or her arrival to 
the United States, will receive a cash bonus that is equal to the 
amount of cash assistance he or she would have received during the 
second and third months (31 to 90 days) of continuous employment. 

[33] For the Wilson/Fish and Public Private Partnership programs, cash 
assistance amounts may range from an amount based on the state's TANF 
formula to an amount set by ORR within a payment ceiling set by 45 
C.F.R. § 400.60. 

[34] A refugee family consisting of two adults and three children may 
receive an average monthly amount of $1,220 in cash, rental, and 
utility assistance from a Matching Grant program in Texas. The same 
family living in Texas would receive an average of $712 per month in 
cash, rental, and utility assistance from another assistance program. 
Compared to the Public Private Partnership program, the Matching Grant 
program may initially offer higher cash, rental, and utility benefits; 
however, assistance from the Matching Grant program is provided for up 
to four months, unless the family needs additional months of rental 
assistance, according to voluntary agency staff we spoke with. In 
contrast, a refugee family participating in another assistance program 
may receive rental and utility assistance for 4 months and cash 
assistance for up to 8 months. 

[35] An adult refugee without children would receive an average 
monthly amount of $367 in cash, rental, and utility assistance over a 
four-month period from a Matching Grant program in Texas. The same 
refugee would receive an average monthly amount of $316 in cash, 
rental, and utility assistance for up to 8 months from the Texas 
Public Private Partnership program. Overall, a single refugee without 
children participating in the Public Private Partnership for 8 months 
could receive about $2,500 whereas a refugee participating in a 
Matching Grant program for 4 months would receive approximately $1,450. 

[36] In addition to the Matching Grant program, both the Wilson/Fish 
and Public Private Partnership programs allow states the flexibility 
to design their programs in ways that offer intensive case management 
and integrated services to refugees. 

[37] According to ORR, refugee families who are enrolled in the 
Matching Grant program and do not find employment within 4 to 6 months 
may apply and receive benefits from their states' TANF programs. 

[38] Refugees receive an initial resettlement grant from the 
Department of State's Reception and Placement program (through one of 
the voluntary agencies participating in the program) for their first 
30 to 90 days in the United States. 

[39] Officials in Texas told us that while refugee families with 
children may be eligible for their Public Private Partnership program, 
their data show that most families with children are in the Matching 
Grant program. 

[40] Families who do not find employment within the 8-month benefit 
period of Texas's Public Private Partnership program may reapply for 
the state's TANF program. 

[41] ORR allows some states to enroll refugees who would otherwise be 
eligible for TANF under the stipulation that states provide the full 
amount of TANF funding to the eligible refugee and ORR provides the 
differential between the TANF payment rate and the Wilson/Fish payment 
rate. 

[42] Wilson/Fish programs that accepted TANF-eligible refugees were 
located in Idaho, North Dakota, South Dakota, and Vermont. 

[43] Until October of 2009, ORR allowed providers in San Diego County 
and Colorado to allow TANF-eligible refugees to participate in the 
Wilson/Fish program. One of the states we visited, Massachusetts, does 
not allow TANF-eligible refugees to participate in the Wilson/Fish 
program. 

[44] The Matching Grant program does not have a job retention 
performance measure, but it does measure self-sufficiency retention. 

[45] ORR officials told us that states also collect and report 
employment outcome information on refugees who have been in the United 
States for up to 60 months and do not receive ORR-funded cash 
assistance but receive other types of ORR-funded services. Refugees 
who do not receive ORR-funded cash assistance but receive other types 
of ORR assistance may include (1) those who are participating in the 
TANF program and receiving ORR-funded employment services or (2) 
refugees who have exhausted their ORR-provided cash assistance but 
continue to receive ORR-funded employment services. 

[46] This 1999 study, A Quantitative Comparison of the Effectiveness 
of Public and Private Refugee Resettlement Programs: An Evaluation of 
the San Diego Wilson/Fish Demonstration Project (Hohm et al), compared 
the effectiveness of a privately administered Wilson/Fish program with 
a Publicly Administered program managed by a county social service 
agency. The study described the Wilson/Fish program as one agency 
providing concurrent refugee services in a way that was flexible, 
outcome oriented, performance based, and budget neutral. In contrast, 
the Publicly Administered program consisted of multiple agencies that 
provided consecutive and sequential services in a way that was, for 
example, bureaucratic and process oriented. The study's results 
indicated that the average number of cash assistance dollars received, 
the average number of days the refugee received cash assistance, and 
the average number of days it took a refugee to find employment were 
less in the Wilson/Fish program compared to the Publicly Administered 
program. In addition, the proportion of refugees who participated in 
the Wilson/Fish program who found employment was higher than the 
proportion of refugees who participated in the Publicly Administered 
program. The researchers concluded that the following qualities of the 
Wilson/Fish program contributed to the differences in performance: 
integrated services in a single agency, personal and flexible system 
of service delivery, and intensive support services, such as 
transportation and assistance with job searches. Two samples of 800 
refugees from each of these programs were drawn at random for the 
period of January 1992 to August 1994. However, subjects were not 
randomly assigned to these programs. Both samples consisted only of 
adults without children who were predominately Vietnamese, male, and 
less than 30 years of age. 

[47] This report publishes the survey results of refugees who arrived 
in the United States from 2002 to 2007. For the 2007 survey, a total 
of 1,205 households were contacted and interviewed. The overall 
response rate for this survey was 36.6 percent. 

[48] ORR also uses historical arrival patterns to estimate the numbers 
of other eligible populations who do not enter the United States 
through the traditional resettlement process, such as asylees and 
Cuban Haitian entrants, according to officials. 

[49] The portion of refugees who did not receive ORR-funded cash 
assistance may have received benefits from TANF, SSI, or other ORR- 
funded assistance, such as employment services or language instruction. 

[50] In fiscal year 2008, 5,130 refugees were resettled in Texas. The 
8,212 refugees that were resettled in fiscal year 2009 represent a 60 
percent increase. 

[51] The estimated average cost of providing medical assistance to an 
estimated number of refugees participating in ORR programs increased 
significantly over the years from $1,717 per recipient of medical 
services in fiscal year 1999 to $3,324 in fiscal year 2004 to $4,338 
in fiscal year 2009. It is important to note that these average 
medical costs per refugee are only estimates. We were unable to 
calculate actual costs in part because ORR does not have an 
unduplicated count of refugees who have received medical assistance 
during this time period. In addition, not all states reported their 
refugee medical expenses in two of the years we examined--fiscal years 
1999 and 2004. 

[52] According to officials at the Department of State Bureau of 
Population, Refugees, and Migration, the Department of State typically 
does not provide a refugee's detailed medical information prior to a 
voluntary agency agreeing to accept a refugee case. Officials believe 
that providing the refugee's detailed medical information may result 
in the voluntary agency selecting one refugee case over another. 
Department of State officials told us they believe that the initial 
medical information they provide is enough for the national voluntary 
agency staff to know if the affiliate offices can resettle the refugee. 

[53] See Pub. L. No. 110-457, § 212, 122 Stat. 5044, 5063. Funds 
dedicated to the Unaccompanied Alien Children budget activity provide 
for the care and placement of immigrant children who arrive in the 
United States without a parent or guardian--a relatively new 
responsibility for ORR. In March 2003, functions under U.S. 
immigration law with respect to the care of unaccompanied alien 
children the presidential ceiling and the accompanying appropriations 
connected to those functions were transferred to ORR from the 
Immigration and Naturalization Service in accordance with the Homeland 
Security Act of 2002. Pub. L. No. 107-296, § 462, 116 Stat. 2135. 

[54] Funding for the Victims of Torture budget activity cannot be 
obligated beyond the year in which they are appropriated. 

[55] In fiscal year 2000, in addition to its unobligated balances, ORR 
also had approximately $72 million in other unexpended balances, the 
majority of which were deobligated from states. 

[56] While refugees participating in the TANF program may not receive 
cash assistance from ORR's assistance programs, these refugees may 
receive some resettlement services, such as employment services, from 
ORR's programs. 

[57] Ten voluntary agencies administer the Department of State's 
Reception and Placement Program. Of these, nine administer ORR's 
Matching Grant Program. 

[58] In California we did not collect any case files because the 
agencies were not comfortable with GAO taking the case files off of 
the premises. 

[End of section] 

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(202) 512-4400: 
U.S. Government Accountability Office: 
441 G Street NW, Room 7125: 
Washington, D.C. 20548: 

Public Affairs: 

Chuck Young, Managing Director, youngc1@gao.gov: 
(202) 512-4800: 
U.S. Government Accountability Office: 
441 G Street NW, Room 7149: 
Washington, D.C. 20548: