The Office of Refugee Resettlement’s (ORR) commitment to helping refugees and other vulnerable populations, including asylees, Cuban/Haitian entrants, unaccompanied refugee minors, victims of torture, unaccompanied alien children (UAC), victims of human trafficking, and repatriated U.S. citizens, remains as strong as ever. ORR understands that refugees have inherent capabilities and it strives to provide the benefits and services necessary to help refugees and other vulnerable populations become self-sufficient and integrated members of American society. In Fiscal Year (FY) 2012, ORR served thousands of vulnerable populations through its various grants and services, administered at the state government level and via non-profit organizations, within an extensive public-private partnership network.
While FY 2012 started out like most other years at ORR, a slight change in the UAC program was noticeable from the outset. Whereas in prior years, higher referrals in the spring tended to drop in the summer and early fall, in FY 2012 referrals from the Department of Homeland Security (DHS) remained steady for the first few months, and then started to climb at a rate previously unseen.
In a five month period between March and July 2012, the UAC program received almost 7,200 referrals—surpassing FY 2011’s total annual referrals. Conducting round the clock operations with the help of the Department of Health and Human Services (HHS), DHS, the Department of Defense (DOD) and ORR’s providers on the ground, ORR increased its capacity in emergency and then permanent shelters to manage the increase. The program placed approximately 14,000 children for the year, more than double the number for FY 2011, and far exceeding projections for FY 2012.
The impact of this unanticipated increase in UAC referrals was primarily absorbed within the refugee program, by reprogramming existing refugee program funding. By incrementally funding FY 2012 and 2013 program expenditures across two funding years, ORR was able to cover the shortfall without loss of benefits for eligible refugees or disruption of services to any of the populations served by ORR. This was possible because overseas arrivals were far under the 76,000 ceiling authorized by the FY 2012 Presidential Determination, with final admission numbers totaling just over 58,000 refugees for the year.
Beyond the UAC program, FY 2012 also was a year in which ORR focused on refugee health. The official reorganization of the office was finalized in FY 2012, and included the addition of an Associate Deputy Director to oversee the Unaccompanied Children’s and Anti-Trafficking in Persons (ATIP) programs to support the larger program structure. The reorganization also created a new Division of Refugee Health to advance ORR's health initiatives, coordinating with federal partners, state refugee coordinators and the Association of Refugee Health Coordinators to prepare the refugee resettlement network for full implementation of the Affordable Care Act (ACA) in January 2014.
During the year, ORR issued two State Letters (#12-13 and #12-09) with revised cash and medical assistance (CMA) guidelines, outlining changes and clarifications related to the administration and coordination of refugee CMA. The second letter updated medical screening guidelines for the first time since 1995, including allowable medical screening services and further guidance related to reimbursement categories and limitations.
In addition to general health initiatives, ORR further worked to address mental health and wellness within the communities it serves. One important step was to partner with the Centers for Disease Control and Prevention (CDC), to try to understand what is triggering suicides in Bhutanese refugee communities. ORR continues to follow up on CDC recommendations and next steps, from an early FY 2012 CDC Epi-Aid study focusing on eleven communities in four states (Arizona, Georgia, New York and Texas). For example, several meetings with community leaders were held in FY 2012, including a workshop during the 2012 ORR National Consultation. ORR also has expanded its partnerships with Substance Abuse & Mental Health Services Administration (SAMHSA) and other agencies working on suicide prevention strategies and overall mental health post-resettlement.
In a similar vein, ORR expanded grants for the Survivors of Torture program to 29 grantees in FY 2012, also funding two national technical assistance providers. The Survivors of Torture program is open to all persons, including U.S. citizens, who have experienced torture in foreign countries. Services for Survivors of Torture programs focus on physical, psychological, social and legal services for torture survivors, as well as education and training of service providers.
Following ORR’s six “Guiding Principles,” the focus of the agency remained a client-centered one. In FY 2012, ORR continued to concentrate its efforts on programs designed to support the most vulnerable and often-marginalized persons: single mothers; lesbian, gay, bisexual and trans-gender (LGBT) refugees; survivors of torture and human trafficking, and unaccompanied minors.
Looking forward to FY 2013, ORR will continue to expand its focus on refugee health in preparation for the full implementation of the ACA in January 2014. Strategic resettlement placement is vital to ensuring that refugees have the access to employment, health care, and education to which they are entitled, and to ensure their successful resettlement and integration in the United States.
ORR is committed to putting refugees at the forefront of all of its programs and initiatives, to ensure that the U.S. Refugee Program upholds its humanitarian obligation to rescue and restore refugees’ safety and dignity as they become valuable members of the American public.