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42–742 PDF 2008

S. HRG. 110–419 

FORCED TO FLEE: CARING FOR THE 

ELDERLY DISPLACED BY WAR, POVERTY AND 

PERSECUTION ABROAD 

HEARING 

BEFORE THE

SPECIAL COMMITTEE ON AGING 

UNITED STATES SENATE 

ONE HUNDRED TENTH CONGRESS 

FIRST SESSION 

WASHINGTON, DC 

DECEMBER 5, 2007 

Serial No. 110–18 

Printed for the use of the Special Committee on Aging 

( 

Available via the World Wide Web: http://www.gpoaccess.gov/congress/index.html 

SPECIAL COMMITTEE ON AGING 

HERB KOHL, Wisconsin, Chairman 

RON WYDEN, Oregon 

BLANCHE L. LINCOLN, Arkansas 

EVAN BAYH, Indiana 

THOMAS R. CARPER, Delaware 

BILL NELSON, Florida 

HILLARY RODHAM CLINTON, New York 

KEN SALAZAR, Colorado 

ROBERT P. CASEY, Jr., Pennsylvania 

CLAIRE McCASKILL, Missouri 

SHELDON WHITEHOUSE, Rhode Island 

GORDON H. SMITH, Oregon 

RICHARD SHELBY, Alabama 

SUSAN COLLINS, Maine 

MEL MARTINEZ, Florida 

LARRY E. CRAIG, Idaho 

ELIZABETH DOLE, North Carolina 

NORM COLEMAN, Minnesota 

DAVID VITTER, Louisiana 

BOB CORKER, Tennessee 

ARLEN SPECTER, Pennsylvania 

DEBRA WHITMAN, Staff Director 

CATHERINE FINLEY, Ranking Member Staff Director 

(II) 

C O N T E N T S 

Page 

Opening Statement of Senator Gordon H. Smith ................................................. 1 

PANEL I 

Kelly Ryan, deputy assistant secretary, Bureau of Population, Refugees and 

Migration (PRM), Department of State, Washington, DC ................................ 3 

Brent Orell, acting director, Office of Refugee Resettlement (ORR), Administration for Children and Families, Department of Health and Human Services, Washington, DC ........................................................................................... 32 

Michael Gabaudan, regional representative for the U.S. and Caribbean, Office 

of the United Nations High Commission on Human Rights, Washington, 

DC .......................................................................................................................... 42

PANEL II 

Richard Parkins, chair, Refugee Council USA, Washington, DC ........................ 50 

Maria Teverovsky, MSSA, associate director, Refugee Family Enrichment 

Program, Hebrew Immigrant Aid Society, New York, NY ............................... 57 

Salah Ansary, regional director, Lutheran Community Services, Northwest, 

Portland, OR ......................................................................................................... 70 

Khammany Mathavongsy, director, California Office of Southeast Asia Resource Action Center, Washington, DC .............................................................. 82 

APPENDIX 

Remarks of Senator Herb Kohl .............................................................................. 93 

Ms. Teverovsky Responses to Senator Kohl’s Questions ...................................... 94 

Responses to Senator Kohl’s Questions from Mr. Mathavongsy ......................... 94 

Material submitted by Immigrant Refugee Community Organization ............... 97 

(III) 

(1) 

FORCED TO FLEE: CARING FOR THE 

ELDERLY DISPLACED BY WAR, POVERTY 

AND PERSECUTION ABROAD 

WEDNESDAY, DECEMBER 5, 2007 

U.S. SENATE, 

SPECIAL COMMITTEE ON AGING, 

Washington, DC. 

The Committee met, pursuant to notice, at 10:30 a.m., in room 

SD–106, Dirksen Senate Office Building, Hon. Gordon H. Smith, 

presiding. 

Present: Senator Smith. 

OPENING STATEMENT OF SENATOR GORDON H. SMITH, 

RANKING MEMBER 

Senator SMITH. Good morning, ladies and gentlemen. You are the 

brave few that traversed the treacherous Washington traffic on a 

snowy morning. We welcome you all here. 

I had expected Senator Kohl, but I know he has been detained 

in the Judiciary Committee. With his blessing and encouragement, 

we are going to proceed without him, and he will join us if and 

when he can. 

I know some of you have come a short distance, but many of you 

have come a long way, including some from my home State of Oregon. However, I can safely say that probably none of us has come 

so far as the populations that we are here to discuss—the elderly 

refugees and asylees who are now in the United States. 

The goal of today’s hearing is to learn more about the refugee 

populations that we have here in America and the needs of those 

who tend to be more frail and require supportive services—those 

who are elderly and disabled. 

The elderly refugees who come to our Nation have many of the 

same needs that nonelderly refugees have: a place to live, a job and 

a safe environment, and a means to connect to their new country. 

However, due to age and frailty, these needs become more difficult 

for many elderly refugees to obtain. 

In their times of need, there are resources to support them. 

Through the work of the State Department, the Department of 

Health and Human Services, other non federal organizations like 

the United Nations and refugee resettlement agencies, there is a 

network of support that aid in their transition to life in America. 

Today we are here to learn about these programs and to hear from 

the experts on how we can make improvements for elderly refugees. 

2 

I think every child in America learned, and I certainly did as 

well, that our Nation is an immigrant Nation. It is where many 

have come as refugees. Many of our own families left native countries to find religious freedom, to escape war and poverty and persecution. As our Nation has grown and advanced, we have held 

close to our obligations to those in the world who are less fortunate 

and who seek a better life; one safe from harm. 

Many of the individuals we will discuss here today are elderly 

refugees who fled persecution or torture in their home countries. 

They include Jews fleeing religious persecution in the former Soviet Union. Iraqi Kurds fleeing the former Saddam Hussein regime. 

Cubans and Hmong people from the highlands of Laos who served 

on the side of the United States military during the Vietnam war. 

Many of these refugees are elderly, and some are disabled and 

unable to work. Some have come with their families, some have 

come alone. Many are working to learn, at an advanced age, a new 

language and a new culture. 

In my home State of Oregon, we have welcomed more than 

55,000 refugees from around the world since 1975. Nearly twothirds of Oregon’s refugee population are from the former Soviet 

Union or Vietnam. Many of these refugees found themselves fighting for and otherwise helping the United States in war. 

The remaining one-third of Oregon’s refugees come from many 

Nations who have found themselves in troubled times. Somalia, 

Cuba, Bosnia and Afghanistan are just a few. Of these refugees, 

many are elderly and some will require additional services and 

support as they age. 

To help refugees who are elderly and disabled, I introduced a bill 

with Senator Kohl that would allow them to retain their SSI, or 

another acronym in all our alphabet soup here, meaning supplemental security income (SSI). They get this until they gain their 

American citizenship, or at least ideally so. 

The bill that we have entitled ‘‘SSI Extension for Elderly and 

Disabled Refugees Act’’ is one important step we could take to 

make a significant impact in helping our most vulnerable. 

As many of you know, Congress modified this supplemental security income program to include a seven-year time limit on the receipt of benefits for refugees and asylees. Unfortunately, the naturalization process takes longer than seven years. Applicants are required to live in the United States for a minimum of five years 

prior to applying for citizenship. In addition to that time period, 

their application process often can take three or more years before 

resolution. 

Because of this time delay, many individuals are trapped in the 

system and faced with the loss of their SSI benefits. In fact, we 

know that, to date, more than 7,000 elderly and disabled refugees 

have lost their SSI benefits, and that another 16,000 are threatened to lose their benefits as well in coming years. 

The Bush Administration in its fiscal year 2008 budget acknowledged the necessity to correct this problem by dedicating funding 

to extend this population beyond the seven-year limit. The legislation I introduced with Senator Kohl builds upon those efforts by 

the Administration by allowing an additional two years of benefits 

3 

for these people, and other qualified humanitarian immigrants, including those whose benefits have expired in recent past. 

A similar bill that has passed the House, similar to the bill I am 

working to pass here in the Senate, would allow benefits to be extended for a third year for those same refugees who are awaiting 

a decision on a pending naturalization application. These policies 

are limited to 2010, and are completely offset in cost by a provision 

that will work to recapture Federal Government funds due to unemployment insurance fraud. 

I hope the Senate will soon pass this package, as it would send 

a message that we have not and will not turn our backs on the 

most vulnerable refugees. To penalize them as we currently do because of delays encountered through bureaucratic process seems 

unjust and certainly inappropriate. 

So I look forward to the testimony we will hear today from our 

panelists. We have a wide array of experts and dedicated witnesses 

ranging from the United Nations to the U.S. State Department, the 

U.S. Department of Health and Human Services, and representatives of many of the organizations that are the backbone of the 

services refugees can access in our Nation. They are truly dedicated people and we thank them for their service. 

Our first panel consists of Ms. Kelly Ryan. She is the deputy assistant at the Bureau of Population, Refugees and Migration at the 

State Department. 

So, Kelly, we appreciate your being here. 

Then Mr. Brent Orrell, the acting director of the Office of Refugee Resettlement at the Department of Health and Human Services. 

So thank you both for being here. 

Kelly, why don’t we start with you. 

STATEMENT OF KELLY RYAN, DEPUTY ASSISTANT SECRETARY, BUREAU OF POPULATION, REFUGEES AND MIGRATION, DEPARTMENT OF STATE 

Ms. RYAN. Thank you very much, Senator Smith. 

It is a pleasure to appear before you today to discuss U.S. assistance to refugees, including U.S. efforts to protect elderly refugees 

here and abroad. With your permission, I would like to submit my 

formal statement for the record and use this opportunity to highlight the responsibilities of my bureau, Population, Refugees, and 

Migration. 

Senator SMITH. Without objection. 

Ms. RYAN. Thank you. I am going to talk about our humanitarian 

assistance programs and the admission of refugees to the United 

States. 

PRM plays a major role in U.S. foreign assistance, administering 

nearly $1.1 billion in fiscal year 2007. These Congressionally appropriated monies were furnished to international organizations 

and NGO’s to protect refugees, internally displaced persons, and 

other vulnerable persons including victims of conflict and trafficking. 

PRM-funded programs provide life-sustaining protection and relief to some of the world’s most vulnerable populations, including 

women, children and the elderly. 

4 

The United States and our international and NGO partners recognize that some elderly refugees can become, or are, extremely 

vulnerable. Some have medical challenges, some have become disabled, and some have been separated from family members 

through a variety of means. 

We fund and urge our international and NGO partners to ensure 

that services are designed with the most vulnerable in mind, including the elderly. 

The United Nations High Commissioner for Refugees, UNHCR’s, 

age, gender, and diversity mainstreaming project is specifically focused on tailoring services to meeting the needs of vulnerable populations, including the elderly, whether by designing appropriate 

food distribution systems, providing mental health support as part 

of comprehensive healthcare, or emergency shelter assistance, particularly for those without other family members in camp or urban 

refugee settings. 

Assistance funds in particular support programs to provide basic 

assistance needs at internationally accepted standards, such as 

food, shelter, healthcare, water and sanitation. 

In fiscal year 2007, of the nearly $1.1 billion PRM programmed, some $847 million was expended on overseas assistance programs, 

and $171 million was used to administer the U.S. refugee admissions program. 

Senator Smith, it is a tragic reality that violence, insecurity and 

persecution continue, causing people to flee and resulting in a need 

for humanitarian protection and assistance. Our humanitarian aid 

is a hallmark of U.S. foreign policy engagement. We support durable solutions for refugees through a combination of diplomacy, program expertise and financial support for voluntary returns, local 

integration and resettlement to the United States. 

Refugee resettlement is a critical solution for a small number of 

the world’s refugees. The number of refugees resettled annually in 

the U.S. is more than the total of refugees resettled by all resettlement countries combined. 

In fiscal year 2007, the U.S. resettled 48,281 refugees. In recent 

years, the United States has admitted refugees of over 60 nationalities and conducted processing in over 40 remote locations worldwide. The program is more geographically diverse and operationally complicated than ever before, but we continue to find ways to 

make it more responsive. 

While the program is subject to many logistical and political 

challenges, it offers unparalleled opportunities for saving lives, reuniting families and ending protracted refugee situations. 

The Refugee Act of 1980 created the modern day refugee program, but we have welcomed refugees since the founding of our republic. The act directs the President to submit an annual report to 

Congress containing the Administration’s proposal for the number 

of refugees to be admitted in the coming fiscal year. This proposal 

is prepared after extensive consultations within the Administration 

and with officials of UNHCR, other international organizations, as 

well as human rights and advocacy groups, and interested citizens. 

Following House and Senate Judiciary Committee consultations, 

the President issues a determination establishing the size and 

scope of the refugee program for the next fiscal year. For fiscal year 

5 

2008, the President authorized the admission of 80,000 refugees, 

allocated amongst geographic regions. 

PRM is responsible for coordinating and managing the admissions program. A key part of our work is determining who will be 

given access, thereby allowing them to apply for refugee admission 

to the U.S. 

Unlike some other resettlement countries, age, educational level, 

employability, English language ability or health conditions are not 

factors evaluated in determining which refugees should be considered for refugee status and for resettlement to the U.S. USCIS determines both eligibility and admissibility in accordance with U.S. 

law and policy. 

The refugee program assesses and considers vulnerabilities 

throughout refugee processing. Age-related vulnerabilities of both 

the very young and the elderly are factors in case composition, and 

can also be the basis for requests to UNHCR and USCIS for special 

process consideration. Elderly refugees who would be left in countries of first asylum without care or support should their family depart without them can and are included on refugee cases with 

USCIS agreement. 

PRM engages an overseas processing entity to assist in the processing of refugee applicants. These OPEs prescreen applicants and 

prepare the cases for CIS interviews. OPE staff guide the refugees 

through the post-adjudication steps, including the medical exams in 

close coordination with HHS, and attending cultural orientation 

programs. The OPE obtains sponsorship assurances and, once all 

required steps are completed, refers the case to the international 

organization for travel to the United States. 

Medical clearances are required for refugees prior to their resettlement to the U.S., and is particularly important for elderly refugees. In addition to having a higher prevalence of chronic medical 

conditions such as high blood pressure or diabetes, these refugees 

are more prone to developing certain infectious disease such as tuberculosis and other severe complications of certain vaccine-preventable diseases such as influenza. 

For these refugees, in addition to performing medical screening 

mandated by U.S. regulations, IOM also looks for signs of medical 

conditions that would require follow up after resettlement to the 

U.S. 

Our program strives to ensure that those who are accepted for 

admission are prepared for the significant life changes they will experience by providing cultural orientation programs prior to their 

departure. 

The State Department funds their travel through a program administrated by IOM. Refugees are responsible for repaying the 

travel costs over time, beginning 6 months after their arrival. The 

special travel arrangements are made by IOM as required, and elderly refugees get appropriate travel assistance. 

Prior to refugees’ arrival in the U.S. domestic resettlement agencies receive biographic data on each arriving refugee. This includes 

age and any physical disabilities or chronic illnesses. This information is used by the receiving agencies to prepare appropriately for 

the arriving refugee. 

6 

Consideration of age and physical limitations is used in the selection of housing, and also provides the opportunity for advance contact with local medical service providers to address medical needs 

immediately upon arrival. 

The Reception and Placement program is a unique public-private 

partnership under which resettlement agencies contribute significant cash or in-kind resources to supplement U.S. per capita 

grants. PRM currently funds cooperative agreements with 10 entities—nine private voluntary agencies and one State, the State of 

Iowa—to provide initial resettlement services. 

Under this agreement, PRM provides voluntary agencies with $850 per refugee, of which the local affiliate must spend $425 directly on each refugee to meet their immediate needs post-arrival 

in the U.S. The R&P agencies agree to provide initial resettlement 

and core services to refugees, and these services are provided according to jointly agreed upon standards of care. 

The 10 organizations maintain a National network of 360 affiliates. This program operates in close coordination with our colleagues from HHS and its HHS-funded grantees to begin to assist 

refugees through their programs after the PRM-funded initial resettlement activities are complete. 

Refugees may be lawfully employed upon arrival to the U.S. 

Some of our refugees who are over 65 are gainfully employed or are 

informally employed as caregivers for family member. 

After one year, a refugee is required to apply for adjustment of 

status to lawful permanent resident; 5 years after admission, refugees who have been lawfully admitted for permanent residency and 

who meet other statutory requirements, are eligible to apply for 

naturalization. We believe naturalization is critical for successful 

refugee integration and for those who may require further Federal 

assistance. Our resettlement partners assist elderly refugees in obtaining U.S. citizenship. 

Senator Smith, PRM’s humanitarian assistance to refugees and 

its coordination of the U.S. resettlement program reinforce U.S. 

commitments to the principles of democracy and freedom. They 

support an overarching goal of President Bush’s National security 

strategy to champion human dignity. This work is critical to U.S. 

foreign policy leadership. 

This concludes my oral statement and I would be happy to respond to any questions you may now have or following my colleague’s presentation. Thank you. 

[The prepared statement of Ms. Ryan follows:] 

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Senator SMITH. Kelly, are you getting all the medical and cultural information you need from other organizations, the U.N. and 

others, on those who are coming here, to help them in terms of resettlement? 

Ms. RYAN. We try to obtain information from the refugee themselves, as well as our colleagues at UNHCR and IOM. IOM has 

doctors—in particular on the medical side—that conduct the 

prescreening for us on the medical issues. I think a key communication element is what I have discussed with the biographic data. 

That information is critical to making sure that, upon resettlement, 

the—our affiliate has the information in order to make the right 

judgment about how to help the refugee. 

Can we do better? Probably. 

Senator SMITH. Do you have enough information? 

Ms. RYAN. I think we have a lot of information. I think we can 

always do better. But we are trying to really make sure that there 

are no surprises for the resettlement agency or for the refugees 

upon his or her arrival. 

Senator SMITH. Do you have data on the number of refugees, elderly refugees that arrive every year? 

Ms. RYAN. Yes, sir. We—last year—I have the figures for you. I 

am counting elderly as over 65, although I know there is some debate about the age break-off. But out of the 48,281 who arrived in 

last fiscal year, 1,386 were over the age of 65. So that is a 2.8 percent ratio. 

Senator SMITH. Now, I understand there is a cap of 70,000 that 

you could take in. I don’t know why we only take in 48,000. Is that 

all that apply? 

Ms. RYAN. We have had some difficulty based on some changes 

to the law in the Real ID Act and the Patriot Act that have stopped 

some of the arrivals based on an expanded provision that we are 

working with Congress to address. But this year we are funded 

right now to admit 70,000, but we are authorized to admit up to 

80,000. We hope to use as many of those places as possible, sir. 

Senator SMITH. Well, what is the reason why the 20,000 plus 

that could be here aren’t? 

Ms. RYAN. The chief reason in the past several years has been 

the change in the law on material support. So some of our Burmese 

refugees, for example, have not been able to obtain exemptions 

under the law. So we are looking at trying to have a legislative fix 

on that. 

We have also had some difficulties with medical screening that 

has pushed us a little bit back. 

Senator SMITH. But otherwise, there would be 70,000? 

Ms. RYAN. Yes. We are trying to move up, up, up. We are trying 

to use the places that the President has authorized. 

Senator SMITH. So it is not an issue of demand for admission. 

Ms. RYAN. No, sir. 

Senator SMITH. OK. Well, thank you, Kelly. 

Ms. RYAN. You are welcome. 

Senator SMITH. Brent, take it away. 

32 

STATEMENT OF BRENT ORRELL, ACTING DIRECTOR, OFFICE 

OF REFUGEE RESETTLEMENT, ADMINISTRATION FOR CHILDREN AND FAMILIES, DEPARTMENT OF HEALTH AND 

HUMAN SERVICES 

Mr. ORRELL. Senator Smith, I would like to thank you for the opportunity to testify on assistance provided by the Office of Refugee 

Resettlement to elderly refugees. 

Just as a personal point, it is a special honor to be before you. 

You are the senator from my home State of Oregon. 

Senator SMITH. What town are you from, Brent? 

Mr. ORRELL. Sherwood. 

Senator SMITH. Sherwood. 

Mr. ORRELL. Yes. 

Senator SMITH. Nice town, Brent. 

Mr. ORRELL. Yes. Yes. Thanks. So it is great my first showing 

here before the Congressional Committee is also in front of a senator from my home State. 

Senator SMITH. I hope it is not too big a disappointment . . . 

Mr. ORRELL. Yes. Yes. 

Senator SMITH. . . . on my part. 

Mr. ORRELL. It is perfect, actually, so . . . 

My testimony today will provide general background information 

on elderly refugee populations and the type of services that are 

made available for this unique population. With the Committee’s 

approval I will also be submitting a full statement for the record. 

Senator SMITH. We will receive that. 

Mr. ORRELL. Great. 

In 2005, the principle groups of arriving refugees included 

Hmong and Burmese from Thailand, Bantu from East Africa, Liberians from West Africa, Vietnamese from the Philippines, and 

Meskhetian Turks from Russia. Each of these nationalities faces 

unique resettlement challenges reflecting the difficult circumstances they faced prior to their arrival. 

Approximately 46,000 refugees 65 years or older were admitted 

to the United States between 2001 and 2007. For older refugees, 

there are issues which make them particularly vulnerable to poverty, abuse, neglect or exploitation. These include chronic health 

and emotional problems stemming from the conditions of refugee 

flight; family loss and separation; an inability to advocate for themselves because of cultural, language, or educational barriers; limited access to health and social services agencies; and limited incomes due to work histories. 

Elderly refugees are eligible for all the benefits and services that 

are available to all age groups of new arrivals. Those provisions include up to 8 months of cash and medical assistance; health screening and assessment; and a broad range of supportive services such 

as employment services, English language instruction, case management and citizenship and naturalization preparation. 

Additionally, ORR has taken a leadership role in targeting specific programs for elderly refugees. For the past 10 years we have 

funded grants to help link older refugees with mainstream aging 

programs in their local communities to enable them to remain independent as long as possible. 

33 

Currently, ORR funds 21 such grants, totaling $3.5 million, to 

State refugee agencies to provide supportive and social services to 

12,100 older refugees. These projects initiate, expand and encourage collaborative partnerships between domestic resettlement services providers and the aging networks at the State and local community levels. 

Through ORR’s Elderly Refugee Discretionary Program, we also 

link older refugees with the services of the Senior Community 

Service Employment Program that is administered by the U.S. Department of Labor. This 40-year-old program provides part-time 

employment and training opportunities for low income adults age 

55 and over. 

The program serves the community by providing useful community services, and fostering individual economic self-sufficiency for 

older adults who may experience barriers to gainful employment. 

For those older refugees who are unable to work, the Elderly Refugee Discretionary Grant Program also supports services and programs aimed at helping the refugees become naturalized U.S. citizens. 

Examples of State programs under the Elderly Refugee Program 

include a project in Wisconsin that provides 500 older refugees 

with case management, social integration services, citizenship assistance, social and medical translation, transportation, health and 

nutrition assistance. We also have a project in the Portland metropolitan area to create a complete network of services to benefit refugee seniors. 

Within the Department of Health and Human Services, ORR 

works closely with other agencies like the Administration on Aging. 

An interagency agreement with AOA is in place to ensure that 

there is a coordinated response to link older refugees to Older 

American Act programs and services. 

ORR encourages its network of domestic resettlement agencies to 

work closely with 56 State units on aging and 655 area agencies 

on aging to help ensure that older people remain as independent 

as possible in their communities. 

Finally, while not under the jurisdiction of ORR, I think it is important to mention the assistance that refugees who are aged, blind 

or disabled receive through the SSI program. This is the most common form of cash assistance that elderly refugees receive. In 2005 

about 14 percent of all refugee households received SSI payments. 

The Office of Refugee Resettlement understands that older refugees face unique challenges in integrating into the American culture. They are beginning a new life in a new place far from home, 

often without benefit of understanding English and facing a unique 

and unknown cultural situation. 

These challenges, combined with age-related medical concerns, 

make improving the availability of health services and community 

resources critical for this population. In response, ORR continues 

to work with our State and Federal partners to safeguard the interests of these refugees. We appreciate the support that Congress 

gives us in addressing these issues. 

I will be glad to take . . . 

Senator SMITH. Brent, to that point . . . 

Mr. ORRELL. . . . Any questions you have. 

34 

[The prepared statement of Mr. Orrell follows:] 


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Senator SMITH. I understand that there is an account called the 

Older Refugees Program that has allocated $3.5 million for discretionary grants to states. 

Mr. ORRELL. That is right. 

Senator SMITH. Now, am I wrong that it has been scaled back or 

cut? Does it serve the people you are talking about? 

Mr. ORRELL. It does. I don’t believe it has been scaled back. 

Senator SMITH. OK. 

Mr. ORRELL. We have—it is a total of 21 grants to 21 states providing these services. We only had. 

Senator SMITH. Is that because they are the states getting most 

of the refugees? 

Mr. ORRELL. Those—actually, the large states that receive the 

largest number of refugees are receiving these grants. A number of 

other states that are receiving refugees also get these grants. 

We had a total of 27 applications and we funded 21 of those applications last year to provide these kinds of coordination services 

for elderly refugees. 

Senator SMITH. I see. Do you think it is a good program? 

Mr. ORRELL. I believe it is. I have been the acting director for 

about 6 weeks, so I am still feeling my way through these programs. But the feedback we get from most of our programs is quite 

good. 

Senator SMITH. I am curious. Is Oregon one of the 21 States? 

Mr. ORRELL. It is. 

Senator SMITH. OK. 

Mr. ORRELL. Yes. 

Senator SMITH. The services that the ORR provides include 

grants to states and state alternative programs for public, private, 

nonprofits to ensure that refugees age 60 and above are linked to 

mainstream aging services in their community. Is this happening? 

Mr. ORRELL. That is, the core purpose of those 21 grants . . . 

Senator SMITH. OK. 

Mr. ORRELL. Is really to try to build partnerships between the 

refugee programs and those programs that are serving elderly, 

whether they are refugees or not. 

I think one of the chief barriers that every refugee faces in coming to the United States is social isolation and a need to do as 

much work as we can to link refugees to services, and also make— 

just bring them into the mainstream of American society. 

Senator SMITH. Am I correct that once they have completed naturalization process this program is no longer available to them? 

Mr. ORRELL. That is correct, yes. 

Senator SMITH. You know, the problem with legislating is you 

have to draw a line somewhere. 

Mr. ORRELL. Right. 

Senator SMITH. Wherever you draw a line there are some people 

on one side and some on the other. I am sure there are examples 

where maybe it wasn’t the most humane thing to cut them off right 

at that point. But I assume that they fully know that these services 

go away once they become naturalized. 

Mr. ORRELL. I would think that, after having been in the country 

that long and having been in case management systems and talking with experts that run the programs at the local level, they are 

42 

fairly well aware of the limitations on the services that are available. 

Senator SMITH. Is there any need for any flexibility in that? I am 

not advocating, I am just wondering. Do we create some hardships 

that a little bit of flexibility could help? 

Mr. ORRELL. I hesitate to offer an opinion on it. 

Senator SMITH. Yes. 

Mr. ORRELL. But I will say that in other programs we do think 

about those kinds of transitions, that there would be some opportunity—it wouldn’t necessarily be a bad idea for there to be some 

transitional period. 

Senator SMITH. OK. 

Well, Brent, thank you. 

Kelly. 

To both of you, our appreciation for what you do. I suppose we 

can always do better, as Kelly said. But for what you do, we thank 

you and we hope in 2008 we will all do better. 

So we will call up our next panel then. 

Now, as you are taking your seats I will read your short biographies of you here. Panel two is just Mr. Michel Gabaudan. 

I am sorry if I mispronounced that at all, sir. 

He is the regional representative for the United States and the 

Caribbean at the Office of the United Nations High Commissioner 

for Refugees (UNHCR). He will provide an overview of the protection issues elderly refugees face, as well as the U.N.’s effort to address those challenges, both internationally and in the United 

States. 

Michel, thank you. 

STATEMENT OF MICHEL GABAUDAN, REGIONAL REPRESENTATIVE, U.S. AND CARIBBEAN, OFFICE OF THE UNITED 

NATIONS HIGH COMMISSION ON HUMAN RIGHTS 

Mr. GABAUDAN. Thank you very much, Senator. 

I would like to express my appreciation on behalf of UNHCR for 

the opportunity to testify before you today on the unique protection 

challenges facing elderly refugees. We welcome this focus in part 

because addressing the needs of older refugees is truly emerging as 

an issue in the refugee field. 

Ten years ago, then High Commissioner Sadako Ogata, made a 

statement that ‘‘The elderly are among the most invisible group of 

refugees and displaced persons, and I hope to change that.’’ So 

have we 10 years after. 

We carried out the survey after Mrs. Ogata’s decision on the elderly in 1977. I believe that since then we have made some strides 

in monitoring, assessing and addressing those needs in our field operations. But I must say up front that we recognize that much 

more still needs to be done. My hope is to provide you with some 

international context on the situation of refugees today. 

The elderly are a subgroup of the refugee community who are 

among the most at risk during armed conflict, during their subsequent flight, and while in exile. They are also a community whose 

needs are too often overlooked, as they frequently remain hidden 

within their own communities, as well as to the agencies which are 

there to help the displaced. 

43 

Older refugees comprise approximately 10 percent of our overall 

population of concern, but the number ranges between 1 and 2 percent of refugee population in some countries and up to 30 percent 

in some others. 

For example, in Eastern Europe, refugee communities tend to 

have a high percentage of older refugees, perhaps due to a generally longer life expectancy in that region, to the fact that we deal 

there with very protracted situations, and perhaps with the conditions of flight which in many cases involves motorized means of 

exile. 

The elderly share distinct protection challenges that often differ 

from the rest of the refugee community. In situations of persecution, violence, conflict, and displacement older refugees are vulnerable to losing close family and caregivers. They are often physically 

incapable of fleeing with their families, or may become stranded 

during flight. 

In other cases families make the difficult decision during flight 

that results in the abandonment of their elders because of their 

lack of mobility or because of their state of health. Separation from 

their families means nothing less for these people than the collapse 

of the traditional support structures which in many communities 

assist the elderly. 

In certain countries public services that may normally be available to support the elderly in their country of origin often collapse 

during periods of political turmoil. For example, after the dissolution of the former Soviet Union, elders witnessed the disintegration 

of their health and pension plans, thus adding to their vulnerability and perhaps, as a result, increasing the chances they would 

be forced to flee. 

For those elders who are able to make their way to a country of 

asylum, protection challenges do not end once they have arrived in 

the host country. In both urban and camp settings, older persons 

often face marginalization within their families and communities. 

They may be unable to access the services that establish their 

status as refugees, including transportation, the provision of background information, and registration that can provide documentation and support. They also may have difficulty recalling or recounting with accuracy relevant details for these status interviews. 

Humanitarian aid workers, including our own staff, may lack the 

skills to identify the specific rights and needs of elderly refugees. 

This can lead to insufficient analysis of the protection risks, status, 

as well as a disregard of their capacities. 

Assistance efforts may neglect the specific needs of older refugees. Shelter, latrines and washing facilities must accommodate 

their restricted mobility, food distribution sites must be readily accessible, and food itself appropriate to their dietary needs. 

Healthcare programs mast have the ability to address chronic illnesses that are prevalent among older people, for example hypertension, diabetes, arthritis, and eye problems. These are medical 

conditions which are usually not at the forefront of the public 

health issues that we prioritize in planning our programs in refugee settings. 

The elderly generally have difficulties accessing programs that 

are geared toward self-sufficiency. These include vocational trainVerDate Aug 31 2005 14:29 Jun 24, 2008 Jkt 000000 PO 00000 Frm 00047 Fmt 6633 Sfmt 6633 H:\DOCS\42742.TXT SAGING1 PsN: JOYCE
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ing, literacy classes, and income generation projects. Cash assistance, which can generate dependency, is often necessary to support 

the elderly who are unaccompanied and otherwise cannot support 

themselves, or whose families cannot care for them in an adequate 

way. 

Older refugees often are overlooked in the identification of durable solutions to refugee situations. Local integration in the host 

country may be hindered by language barriers, lack of employment 

opportunities, or lack of access to pension, health and education 

programs. 

Return programs tend to focus on younger families who may 

have an easier time rebuilding their lives and communities in the 

home country. This results in residual case loads left behind in 

host countries that are proportionately even more heavily comprised of elders. 

Resettlement programs which should benefit the most vulnerable 

ironically also at times discriminates against the elderly due to the 

preference of many resettlement countries for able-bodied refugees 

who can more easily integrate into the receiving societies. 

But here I must make a proviso that your country is the resettlement country that is the most generous in not putting conditions 

on the person who submits and not having criteria that are based 

on the potential for integration which, unfortunately, many other 

resettlement countries impose upon us. 

Senator SMITH. All right. Because that was one of the questions 

I was going to ask you. How does the U.S. stack up compared to 

other countries on this? 

Mr. GABAUDAN. Well, in respect to elders, much better. I mean, 

you are not only the largest resettlement country, but the criteria 

for resettlement in the U.S. are based on needs and not on the potential for integration, so you have the most broad criteria. If you 

are convinced of the needs you will accept. 

We do tend when we present families to include a broad definition of the family unity, which will include the elderly which some 

other countries refuse. 

Senator SMITH. They refuse them because they say, well, you 

can’t be productive so we don’t want you. 

Mr. GABAUDAN. Exactly. They will be a drag on social system. 

Senator SMITH. I see. 

Mr. GABAUDAN. So the U.S. in that respect fares much better 

than other countries. 

Senator SMITH. Oh, that is nice to hear. 

Mr. GABAUDAN. Responds well to our requests. 

Senator, in response to the needs of the most vulnerable, 3 years 

ago UNHCR has developed what Kelly was mentioning, an approach to enhance refugee protection for all members of the community which we call the Age, Gender and Diversity 

Mainstreaming—AGDM—process. 

This process obliges UNHCR representatives to program our activities through a participatory planning mechanism where we 

have to sit with refugees divided into subsets of the refugee community, therefore providing a structure to ensure that the rights 

and needs of those who might otherwise be marginalized can be addressed. 

45 

This, Age, Gender, and Diversity Mainstreaming (AGDM) process 

has begun to service many of the needs of the elderly that have historically been overlooked, many of which I have previously outlined. In response, we are now attempting to enhance our protection response to elderly refugees and to raise awareness among our 

staff of these specific needs. 

This effort has resulted in concrete improvements including: 

The early identification of, and care for, older persons with special needs in emergency settings. 

Prevention measures to ensure that the elderly are not abandoned by their families. 

The regularization of the status of the elderly so that they can 

receive benefits for which they are eligible. 

The consistent collection of data and incorporation of age sensitive protection and assistance criteria to help assess, monitor, and 

address the needs of the elderly and to ensure their inclusion in 

durable solution efforts. 

More effective outreach to refugees through community services 

programs such as the creation of community centers and mobile 

registration and health clinics. 

Not least, enhanced training of staff and the development of effective partnerships with government agencies and NGO’s to address more effectively the needs of the elderly. 

In closing, Senator, I would also like to note that this AGDM 

process has reminded us that the elderly must not only be supported due to the protection problems they may face, but also because they can serve as significant assets in their communities. 

For example, because conflict may result in the absence or death 

of parents, the elderly often step in to become the primary caregivers to children. The elderly also often serve as the informal or 

formal leaders of their communities. 

This role means that elderly refugees can contribute to the implementation of protection and assistance programs during displacement. They can also contribute to peace and reconciliation efforts. To halt the cycle of displacement, elderly refugees can serve 

as the transmitters of culture, skills and crafts that will sustain 

the tradition of displaced communities. 

In conclusion, I would like to say that the proper focus on the 

elderly is therefore not only an issue of addressing vulnerability, 

but this is an opportunity to strengthen communities and to improve our overall capacity to respond to the needs of the whole displaced communities. 

I would like to thank you very much, Senator, to have included 

refugees in the purview of your Committee. Thank you very much. 

Senator SMITH. Well, thank you, Michel. I really want to commend you for what the UN is doing on this issue. You are out there 

where the rubber meets the road and you see how many different 

countries do it. 

You mention the AGDM survey you took—or the initiative, rather. I am wondering if what the U.N. has learned from this initiative that could apply to U.S. programs? Can you identify anything 

where you think we can do a better job? 

Mr. GABAUDAN. Well, I think you do already quite a good job, 

Senator, to be honest. I think we can always all improve on what 

46 

we do. What this process has told us is that, when you look for 

issues you find them. You find that the solutions are not all that 

difficult. 

Senator SMITH. Yes. 

Mr. GABAUDAN. We don’t have an overall response to elderly. But 

through this participatory planning we identify specific responses 

to particular refugee circumstances that depend very much on the 

culture of a given population. 

So this is—we think a system—as I said, representatives now are 

obliged to go through that. It is a process we roll out and it is becoming part of the normal functioning of the organization. 

It is still a little bit in pampers, but I think we are learning from 

it and certainly seeing that what we identify does not necessarily 

require very increased resources. It requires a better use of the resources we have. 

Senator SMITH. Yes. 

Well, I a you, Michel. You know, don’t be shy. If you see things 

that we can do better let us know and we will do our best. I don’t 

suppose anybody does it perfectly, but I am proud of this country 

and the efforts that we make in this regard. But that doesn’t relieve us of the responsibility to always try to do better. 

Thank you for your time. 

Mr. GABAUDAN. It is good to be here. 

[The prepared statement of Mr. Gabaudan follows:] 

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Senator SMITH. Thank you very much. 

We will call up now our third panel. That consists of Richard 

Parkins who is the chair of the Refugee Council USA. He will discuss how the council serves as an umbrella group for national resettlement organizations. 

Ms. Maria Teverovsky, who is the associate director for the Refugee Family Enrichment Program, Hebrew Immigrant Aid Society. 

She came to the U.S. as a refugee herself and will discuss issues 

surrounding resettlement of the elderly refugee population with a 

focus on Jewish refugees. 

Mr. Salah Ansary is the regional director of the Lutheran Community Services, Northwest. I am particularly pleased that you are 

here, Salah, because you are from Oregon. I always love it when 

a constituent can experience the same thing I do on a nearly weekly basis, which is a very long plane ride. 

He will discuss the obstacles, struggles, and successes of refugees, in particular the elderly refugees in Oregon and the greater 

Northwest. 

Mr. Khammany Mathavongsy. I apologize. I am not so good at 

names, but very good to have you here. Thank you. Please give me 

the correct pronunciation. 

Mr. MATHAVONGSY. It is Mathavongsy. 

Senator SMITH. Mathavongsy. Very good. 

Well, why don’t we start with you, Richard. 

STATEMENT OF RICHARD PARKINS, CHAIRMAN, REFUGEE 

COUNCIL USA 

Mr. PARKINS. Good morning, Senator. 

As chair of the Refugee Council USA, we are a coalition of 23 organizations dedicated to the welfare and the protection of refugees. 

I am pleased this morning to be one of the several witnesses who 

will speak to you today. 

I also happen to be the director of Episcopal Migration Ministries, which is the refugee and immigration assistance arm of the 

Episcopal Church in the United States. 

We of course are deeply interested in the protection and welfare 

of elderly refugees. As has been mentioned several times this morning, they are not only the most vulnerable of those whom we resettle, but are also the custodians of the culture and the social mores 

that get transferred to the new environment in which refugees find 

themselves. 

As you know, the resettlement of refugees in the United States 

is the responsibility of the 10 agencies that was mentioned this 

morning by my colleague from the State Department. Through 

these affiliate operations we are providing direct services to refugees, and most particularly to the vulnerable among the refugees 

population. Indeed, the elderly are a significant part of that group. 

But let me first commend the Committee for expressing a concern for elderly refugees. Your interest indicates that you understand clearly that services which communities and governments 

provide to the elderly need to include outreach to elderly refugees. 

Unless those agencies and groups and institutions who serve the 

elderly recognize that elderly refugees are also stakeholders in 

51 

their programs, an important segment of the elderly population 

will be overlooked. 

Most of the services today for refugees are focused on the initial 

transition period of resettlement and are understandable and quite 

legitimately biased toward employment and training since self-sufficiency has historically been the primary goal of the U.S. refugee 

assistance program. 

We are pleased, of course, that there has been increased awareness—some would suggest belated awareness, to the plight and to 

the needs of the elderly refugees. While some funds are provided 

to assist elderly refugees—and my agency, a private agency, has 

committed several thousand dollars to the care of elderly refugees 

through several of our affiliate offices—this group nevertheless 

does not get the attention that they deserve and need. 

Therefore, we would strongly urge that any publicly supported 

service for the elderly make it a matter of obligation that those 

communities hosting significant numbers of refugees accept a special responsibility to reach out to older refugees. Such outreach 

may well be the only assistance beyond family support that these 

vulnerable persons receive. 

Now, you have become aware this morning by work done by 

members of the council, primarily through the leadership of some 

of our member agencies such as the Hebrew Immigrant Aid Society 

or the Southeast Asian Resource Action Center, both of whom have 

been advocating for the message that you conveyed earlier this 

morning, and that is the need to extend SSI benefits to elderly refugees, particularly those who have not been able to meet the requirements of citizenship because of the impediments of language, 

age and culture. 

I must emphasize, as you well know, sir, that the SSI safety net 

needs to be extended to any at risk older refugee so that the protection and safety that they sought when they were admitted as refugees to the United States be available to them as they advance in 

years. To do less is to fail to complete the task of allowing them 

to recover from the trauma of being forcibly displaced. 

Furthermore, I would like to offer an observation on the gifts 

given to us by elderly refugees. Others will underscore this point. 

Our colleague from the United Nations High Commissioner for Refugees also made this observation. But as noted, they are often the 

cultural anchor for refugee communities as they attempt to respect 

their traditions while embracing the requirements of their adopted 

homeland. 

Most refugee cultures venerate age and are especially respectful 

of the contributions that parents and grandparents have made to 

their survival as a family and as a community. Even as refugees 

take on the requirements of a new society, their concern for their 

elderly kin continues. 

Their accommodation to life in the United States does not allow 

them to be indifferent to their older members. In fact, having their 

older family members adequately provided for is generally a priority which, if honored, allows the family to identify with the society which is welcoming them. 

Family ties are especially vital to the wellbeing of refugee families. If services and support can be extended to those elderly refuVerDate Aug 31 2005 14:29 Jun 24, 2008 Jkt 000000 PO 00000 Frm 00055 Fmt 6633 Sfmt 6633 H:\DOCS\42742.TXT SAGING1 PsN: JOYCE
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gees who remain at risk, the wellbeing of the refugee family is enhanced. 

So therefore, the issue of extending SSI benefits to these vulnerable persons relates quite directly to the purposes and the goals 

and objectives of the U.S. resettlement program. 

A major challenge which refugees—and this is an observation 

made by our affiliate offices around the country—and those who 

serve them, is having mainstream service providers take seriously 

the needs of refugees who are legitimate contenders for their services. While refugees may be eligible for services, the way in which 

services are designed and delivered can often inhibit access by 

these persons. 

Cultural norms and practices, as well as language barriers, can 

limit the value of mainstream services to the refugee community. 

Thus, the work that was noted this morning by the representative 

of the Office of Refugee Resettlement in helping local providers to 

do outreach to the elderly refugee is extremely important and 

needs to be supported and enhanced. 

Therefore, the refugee council would urge the Committee to consider in its deliberations the importance of providing services which 

are culturally and linguistically appropriate, and being very clear 

that the civil rights of refugees are only served when services are 

not only theoretically available, but are genuinely accessible because measures are taken to make these services relevant to their 

clients. 

A major premise of the U.S. refugee program is that special 

funds are designated largely to assist refugees as they are beginning their journey to a new life in the United States, and that 

mainstream providers recognize refugees as clients as they integrate themselves into their communities. 

Refugees come to the United States as an act of rescue. They 

come to the United States at our invitation. Because their experience of persecution and displacement—forcible displacement—confers upon them their designation as refugees, we also recognize 

that our hospitality to these newcomers must include the provision 

of special services and a safety net as is reflected in the SSI benefits. 

Since self-sufficiency is not always an appropriate goal for elderly 

refugees, their need for services and the safety net will exist long 

after the transitional period experienced by other refugees has 

passed. If there is any segment of the U.S. refugee population requiring access to services for extended periods of time, it is the elderly cohort. 

Now, I will defer to my colleagues from HIAS and SEARAC to 

elaborate more fully on the special needs of elderly refugees and 

our advocacy on their behalf. 

But in closing, sir, I want to thank the Committee for taking on 

the issue of elderly refugees, and for recognizing that their voice 

needs to be heard and their needs recognized as our Nation seeks 

a compassionate response to the needs of all our elderly members. 

In particularly, sir, I want to once again underscore the fact that 

elderly refugees are a significant part of the refugee community 

that we bring to the United States. It is our intention to continue 

53 

to advocate for their needs and that adequate resources be provided 

to support those needs. 

Thank you, sir, for this opportunity to testify. 

[The prepared statement of Mr. Parkins follows:] 


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Senator SMITH. Thank you, Richard. That was excellent testimony. You know, I couldn’t agree with you more that we need to 

fix the SSI feature. I do want to represent, I think accurately, that 

there is very broad support for doing that and from the President 

for that. 

I even offered that on the floor recently, but it was objected to 

for reasons unrelated to the merits of the issue. So what we are 

looking for is the right legislative vehicles to leave the station, 

which we can hook this on, because it will make it all the way. 

Mr. PARKINS. Thank you, sir. Your leadership is very much appreciated on this. 

Senator SMITH. Well, you are welcome. I think you made the 

point in your testimony that if an elderly refugee has a family in 

which to come into it is just a whole lot better for them. 

But I wonder, can you give me a ballpark sense in your own experience how many elderly refugees come with no family to receive 

them? 

Mr. PARKINS. I wouldn’t be able to give you the statistic on that, 

but often what does happen is that the family will arrive and then 

they will petition to bring in the elderly member of the family. 

Senator SMITH. I see. 

Mr. PARKINS. So that is often the way the process works. 

Senator SMITH. But you have probably seen cases where there is 

just some desperate refugee, elderly, and comes into our country 

with no family to receive them. 

Mr. PARKINS. Yes. That is absolutely the case. In fact, I am sure 

some of my colleagues, both from HIAS and from the Southeast 

Asian Resource Action Center can speak more authoritatively to 

that, because they are at the front line serving these people. 

But we do have a program that we work through in Chicago 

where we have an affiliate office. There are significant numbers of 

both refugees and asylees and immigrants—and we are speaking 

primarily to refugees this morning, but there is this broader community of need that we also try to respond to. 

We do find that, in those situations, there are often elderly refugees who have almost no family connection except the informal connections that they have with the refugee community itself. So these 

services are extremely important for them. 

Senator SMITH. You represent the great Episcopal cause, and I 

am wondering if the Episcopal faith has an outreach on this as 

well, that gives them another community in which to come into. 

Mr. PARKINS. Yes, we do. In fact, we are through several of our 

affiliate offices supporting services for seniors. However, as you 

know, all of the resettlement agencies in this country serve members of all traditions and faiths. So there is only a fraction of our 

refugee case load that are a part of our faith tradition. But we are 

serving all refugees. 

Senator SMITH. You 

Mr. PARKINS. Whatever services we provide are available to all 

of the refugees. 

Senator SMITH. Use the other faith traditions. 

Mr. PARKINS. Absolutely. 

Senator SMITH. Replicating what you do? 

Mr. PARKINS. Absolutely. 

57 

Senator SMITH. I do, too. 

Mr. PARKINS. Yes. I would say that all of the resettlement agencies through their affiliate structures are very sensitive to the need 

to provide services to senior refugees, yes. It is not uniquely our 

purpose. It is a purpose broadly shared by the resettlement community. 

Senator SMITH. That is wonderful. 

Maria, thank you. 

STATEMENT OF MARIA TEVEROVSKY, ASSOCIATE DIRECTOR, 

REFUGEE FAMILY ENRICHMENT PROGRAMS, HEBREW IMMIGRANT AID SOCIETY 

Ms. TEVEROVSKY. Good morning, sir—Senator Smith. On behalf 

of the Hebrew Immigrant Aid Society it is my pleasure to be here 

today to discuss the psychological, social and cultural needs of elderly refugees and asylees. 

For more than 125 years HIAS, the migration arm of the American Jewish Community, has assisted in rescue, reunion, and resettlement of over 4.5 million migrants around the world and in the 

United States as an expression of Jewish tradition and values. 

Through my experience as director of HIAS’ Refugee Family Enrichment Program and my previous experience as a social worker, 

I have become acutely familiar with the urgent psychological, social 

and cultural needs of elderly refugees. 

On a personal level, I came to the U.S. as a refugee from the 

former Soviet Union 10 years ago with my parents, who struggled 

through many of the issues that I will be speaking about today. 

HIAS has developed expertise on the issues faced by elderly refugees through its partnerships with affiliate Jewish social service 

agencies across the Nation, many of which provide targeted services to elderly refugees. 

HIAS’ Refugee Family Enrichment Program, established in 2002 

with funds from ORR to provide marriage and relationship education and communication skills training to refugees, has also proven effective in assisting elderly refugees in their adjustment to the 

life in the U.S. 

Many elderly refugees suffer from depression and post-traumatic 

stress disorder. Furthermore, many refugee cultures believe that 

mental health ailments are disgraceful, not only for the particular 

person, but to the whole community. As a result, many mental disorders suffered by the elderly go untreated. 

Many elderly refugees encounter difficulties with their family relationships upon arriving to the United States. I am sorry. Many 

arrive as widows and widowers and others have been separated 

from their loved ones for a long time during the conflicts. 

Even when families are able to stay together during or after migration, traditional family ties often transform which can lead to 

increased feelings of isolation and depression. Owing to the strains 

of migration, many couples that have lived together for many, 

many years find themselves on the verge of divorce or in high conflict relationships. 

Because refugees are often dealing with mental and physical 

health problems, they have an even harder time learning English. 

Many refugee elders may not have had access to education in their 

58 

home countries and thus come to the United States illiterate in 

their own language. 

The inability to learn English has very serious implications for 

elderly refugees and asylees, from impeding their ability to access 

healthcare, protect themselves against fraud or crime, or even just 

banking and shopping, to serious health and social implications. 

Many elderly refugees also exhibit an extreme fear of authority 

due to previous traumatic experiences of persecution and war. This 

fear affects their ability to call 911 for emergency assistance or 

seek mental health assistance and puts them at a greater risk of 

being criminally victimized. 

Refugees do not become eligible for many public assistance programs available to seniors until the age of 65. Older refugees who 

haven’t yet reached this age are less employable as a result of a 

variety of factors, including age, limited English proficiency, mental 

health problems and medical issues. 

Elderly refugees who do find employment typically have not 

worked long enough in this country to buildup savings or earn the 

Social Security benefits necessary for a secure retirement. 

As it was mentioned before, refugees often face communication 

barriers when trying to access healthcare, primarily due to a lack 

of qualified translators. Although State and Federal laws require 

the availability of linguistically and culturally appropriate 

healthcare, these services remain largely inaccessible for refugees 

due to inadequate funding, a lack of qualified translators, and the 

lack of public awareness of the issue. 

While naturalization is a challenging process for many immigrants, it can be particularly devastating for elderly and disabled 

refugees and asylees. In particular, refugees experience greater difficulties passing the citizenship examination and fulfilling the various requirements because of physical and mental disabilities, low 

educational levels, inability to speak English, and lack of access to 

naturalization outreach and educational programs. 

Elderly and disabled refugees who manage to complete the citizenship exam are faced with immigration processing delays that 

can make it impossible to achieve citizenship within 7 years. As a 

result, many of these refugees lose their SSI benefits since Congress limited refugees’ eligibility for SSI to 7 years. 

There is a great need for a stop-gap measure to provide immediate relief to the thousands of elderly refugees who have lost or 

are about to lose their SSI benefits. HIAS has long advocated that 

Congress repeal the 7-year time limit entirely, thereby delinking 

naturalization from SSI eligibility for humanitarian immigrants. 

Basing eligibility for life-sustaining assistance on citizenship not 

only debases citizenship, but puts many elderly and disabled refugees in financial dire straits, leaving them with no safety net. 

In addition to repealing the time limit on SSI eligibility for elderly and disabled refugees, HIAS makes the following recommendations to better serve the particular needs of elderly refugees and 

asylees: 

Increase support for psychological programs targeted directly at 

elderly refugees. 

Elderly refugees should continue to be eligible for some refugee 

services and programs, even after they become naturalized citizens. 

59 

Provide ESL programs that specifically accommodate the different needs and learning abilities of elderly refugees by designing 

special programs for them. 

Ease citizenship task requirements for the elderly by exempting 

them from the English test and allowing them to take the civics 

test in their native language. 

The enforcement of Federal and State regulations regarding 

translation services in medical facilities should be enhanced, and 

additional funding should be provided to better recruit, train and 

certify medical interpreters and translators. 

In closing I would like to thank you for recognizing the importance of caring for elderly refugees and asylees who have been displaced by war and persecution in their home countries. 

Thank you very much. 

[The prepared statement of Ms. Teverovsky follows:] 

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Senator SMITH. Thank you, Maria. 

I am just curious on a personal level. Where was your home in 

Russia? 

Ms. TEVEROVSKY. Moscow. 

Senator SMITH. Moscow. When did you come to the United 

States? 

Ms. TEVEROVSKY. Exactly this date 10 years ago. 

Senator SMITH. Welcome. Your English is great. 

Ms. TEVEROVSKY. Thank you. 

Senator SMITH. You didn’t have any trouble learning it. Did you 

know it before? 

Ms. TEVEROVSKY. I actually, yes. 

Senator SMITH. You did. 

Ms. TEVEROVSKY. Started learning it. 

Senator SMITH. In school? 

Ms. TEVEROVSKY. Yes. 

Senator SMITH. I am struck by your comments about the extra 

difficulties in mental health. This is a personal passion and concern 

of mine. I assume you are speaking of mental health disorders unrelated to those that exist with normal aging? 

Ms. TEVEROVSKY. Absolutely. 

Senator SMITH. I can’t remember names as well as I used to. 

I assume it comes from trauma of persecution and intolerance. 

Then that is compounded by what, the cultural shock of assimilating in this country? 

Ms. TEVEROVSKY. Yes. It is—you put it absolutely the way it is. 

Also—I mentioned this fear of authorities that is absolutely overwhelming in older people. I can speak for Jewish people of former 

Soviet Union who lived through holocaust, stalin purges and antiSemitism. My own mother was fired because she was Jewish. 

This makes them think of any authority as something you never 

deal with. It includes not only police and law enforcement, but social workers and doctors. 

Senator SMITH. Is it your judgment that in this country we do 

not have sufficient mental health availability, accessibility for 

them? 

Ms. TEVEROVSKY. You know, I believe that in this country we are 

blessed to have access to the best healthcare ever. My concern is 

cultural sensibility and linguistic—linguistic part of it because accessibility and quality of translation is really serious issue that is 

not being addressed enough. Translation is a profession and it has 

to be looked at as a profession. 

Senator SMITH. Very well said. Thank you very much. 

Ms. TEVEROVSKY. You are welcome. Thank you for having me. 

Senator SMITH. Salah, take it away. 

70 

STATEMENT OF SALAH ANSARY, REGIONAL DIRECTOR, LUTHERAN COMMUNITY SERVICES, NORTHWEST, FORMER 

REFUGEE 

Mr. ANSARY. The Honorable Senator Smith, thank you for the opportunity to come before you. I am deeply honored. 

I have a few letters also that some of our students, elderly students that have given to me to deliver to you. So I have those here 

in front of me. 

Senator SMITH. We will include. 

Mr. ANSARY. I would like to make it part of the record. 

Senator SMITH. We will include them as part of the record. 

Mr. ANSARY. Thank you. 

I am also here to convey the greetings of many of our elder and 

disabled refugees from the State of Oregon who personally could 

not be here, but wanted you to know that they have you in their 

thoughts and prayers as you deliberate on this very important bill 

that could provide much needed relief—much more relief in their 

lives. 

Many of these elders and disabled refugees attend citizenship 

classes at Lutheran Community Services Northwest. They also 

hope to meet our Oregon delegation in the near future in person 

in Oregon. They want to express their concern and struggles. They 

also would like to express proudly how proud they are to say that 

many of their children and grandchildren are proud U.S. citizen 

now and involved in many civic engagements. 

My very own daughter, who is sitting behind me here, is an example of that. She pays her own way to be here to witness this proceeding. A few years ago during college she spent one summer as 

an intern with Congressman Blumenauer. 

She is also here because of her grandmother, who is my mother, 

now a U.S. citizen, fled Afghanistan when the soviet invaded Afghanistan in 1980. She is on SSI. She is 78 years old, living independently. 

My mother has been a tremendous source of connection for my 

two daughters about their roots and cultural heritage. For the past 

27 years of my work with refugees, elder refugees like my mother, 

who are instilling invaluable and rich cultural heritage to their 

grandchildren. As I understand, our very own senior senator from 

Oregon, Senator Ron Wyden’s parents also emigrated from Germany. 

Unfortunately, the unintended consequences of Section 402 of 

Welfare Reform Act of 1996 has caused tremendous hardship for 

many of our elder and disabled refugees. Refugees have suffered 

enormous tragedies in their lives. 

Sometimes I compare elder refugees to the majestic old growth 

trees in the Pacific Northwest that have been yanked from the 

roots that laments from the pain of separation. They are uprooted 

and forced out because of persecution in their homeland. 

The grim statistics from Social Security Administration points 

out that of the 48,000 elderly and disabled immigrants who have 

or are likely to reach their 7-year SSI limit between 2004 and 2010, 

at least 74 percent are refugees. 

Fifty-seven of 48,000 or 20,100 are refugees and humanitarian 

immigrants from former Soviet Union, which Oregon has a number 

71 

of those, a large number of refugees now. Seventeen percent or 

8,200 from Asia. I think Wisconsin is one, which my colleague will 

talk about that, the Hmong refugees from Highland Laos. Sixteen 

percent, 7,600 from the Caribbean, mostly Cuban and Haitians. 

Eight percent, 3,900 from Africa. 

As we have welcomed the elder and disabled refugees, as some 

of my colleagues have pointed out here, we must also not abandon 

them until they stand on their feet. 

Refugees are proud, resilient and dignified people. As local community provider, we will do whatever we can to help. But we also 

feel that this is a joint responsibility. The injustice of 1996 welfare 

reform pertaining to this population we ask must be corrected. 

We applaud and are grateful for you, Senator Smith, in a bipartisan support or effort with Senator Kohl in introducing S. 821. We 

feel this is a step in the right direction. We ask you, all of the other 

members, to lend their support for this bill. 

I also would like to invite you and your staffers and some of your 

colleagues to visit with elder and disabled refugees to hear and 

learn about their heart-wrenching stories, challenges, dreams, aspirations, their gratitude and appreciation. I have no doubt in my 

mind upon hearing these stories you will be compelled to hasten 

the passage of this bill. 

In Oregon there are four faith-based agencies that resettle refugees: Lutheran Community Services Northwest, Catholic Charities, 

Ecumenical Ministries of Oregon and Jewish Family and Child 

Services. Other refugee service providers include the Immigrant 

and Refugee Community Organization called IRCO, the State and 

local government branches. 

Since 1975, Lutheran Community Services alone has resettled 

close to 30,000 refugees in the Northwest. Behind these numbers 

are individuals. Each has a unique story of suffering and survival, 

hopes for happiness and security, and individual strengths and talents to offer. 

The State of Oregon ranks ninth in this Nation for refugee resettlement. As you pointed out, 55,000 refugees have been resettled 

since 1975 in Oregon. The majority from Southeast Asia and, most 

recent, 18,000 from former Soviet Union and the rest from other 

countries of the world. Of course, these figures do not take into account birth and secondary migration into the State. 

The people of Oregon responded magnificently in welcoming 

many asylees and refugees with their love and support. In particular, the church congregations across our network have joined 

hands in welcoming the strangers. Oregon is known for its well-established and close coordination of services to refugees. 

The passage of Immigration and Nationality Act of 1980 provided 

alternative approaches in seeking to reduce refugee dependency on 

welfare programs. Oregon was one of the first States to design and 

implement an innovative project that successfully demonstrated 

refugee could enter the job market and achieve their early self-sufficiency goals with adequate resources during their initial month of 

resettlement. 

Today, this public and private partnership continues in the 

State. We do make referrals of elder seniors to Aging Services, a 

county program. Lutheran Community Services and other faithVerDate Aug 31 2005 14:29 Jun 24, 2008 Jkt 000000 PO 00000 Frm 00075 Fmt 6633 Sfmt 6633 H:\DOCS\42742.TXT SAGING1 PsN: JOYCE
72 

based agencies administer cash eligibility determination and provide intensive case management services for all newly arrived refugees, asylees, during their first 8 months in the country, while 

IRCO, our partner agency, works to place them into jobs before 

their benefit expires. 

This function had previously been handled by the State welfare 

program. As I recall, former Senator Hatfield was a strong advocate and true champion for refugees who helped Oregon with such 

program innovation. 

Of course, Lutheran Community Services has a long history of 

providing services; 75 years or more. In 2001 joined the Lutheran 

Social Service of State of Washington to form Lutheran Community 

Services Northwest. It is a nonprofit agency and its mission to 

partner to partner with individuals, families, communities for 

health, justice and hope. 

For refugee resettlement work, Lutheran Community Service is 

affiliated with Immigration and Refugee Service—LIRS—a national 

voluntary agency, whose tireless advocacy on behalf of the uprooted 

spans 68 years. 

Lutheran Community Services, through their partnership with 

the State Department contracts with 26 affiliate Lutheran social 

service agencies across the country similar to what my colleague, 

Dick Parkins, mentioned about the EMM affiliate offices across the 

country. 

Lutheran Community Services provide an array of social services 

tailored toward the specific needs of refugees, such as the ESL, literacy program, youth mentorship program, mental health services 

for African and Slavic refugees, drug and alcohol treatment, immigration counseling services, citizenship services for elderly population, and African Women’s Empowerment program. 

There are a total of 36 languages spoken by the staff in our Lutheran Community Services Multicultural Community Services, 

and offices in Portland, Vancouver and Seattle. 

I think in terms of the challenges that was pointed out—I don’t 

know if I have time to mention some of those barriers that the 

elder refugees face. May I point out those? Do I have any time? 

Senator SMITH. Well, yes. We are supposed to be done at 12, but 

we can also put them in the record, Salah. 

Mr. ANSARY. OK. Why don’t I just leave it for the record. Thank 

you. 

[The prepared statement of Mr. Ansary follows:] 

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Senator SMITH. Well, Salah, I don’t want to cut you short, but 

your testimony is very powerful and very heart-felt. You have been 

there, and I commend you for the work that you do and the Lutheran Community Services. You are working on the side of the angels, as the others are, and I can’t thank you enough. 

Also want to thank your daughter for coming back here and at 

her expense to accompany you. It is just wonderful to have you 

here. 

Mr. ANSARY. Thank you. Thank you. 

Senator SMITH. Hopefully the storms pass in Oregon so when you 

go home you won’t have too bumpy a ride. 

Mr. ANSARY. Thank you. I think the storm has died down. 

Senator SMITH. Yes. Thank you, Salah. 

Mr. ANSARY. Thanks. 

Senator SMITH. Khammany, take it away. 

STATEMENT OF KHAMMANY MATHAVONGSY, DIRECTOR, CALIFORNIA OFFICE OF SOUTHEAST ASIA RESOURCE ACTION 

CENTER 

Mr. MATHAVONGSY. Good morning. Thank you, Senator Smith. 

My name is Khammany Mathavongsy. I am with Southeast Asia 

Resource Action Center, better known as SEARAC and I am the director of the California office. 

SEARAC is a national organization established in 1979 to facilitate resettlement of Southeast Asian refugees from the countries of 

Laos, Cambodia and Vietnam. In the past 28 years we work to advance the interests of this community through leadership development, capacity building and public policy advocacy. 

Our work in California specifically focuses on empowering Southeast Asian elderly refugees and also bringing greatly needed attention to this underserved population. As a refugee myself, this hearing today is particularly importance for me. 

People from Laos, Cambodia and Vietnam constitute the largest 

group of refugees to ever build new lives in America. Many have 

made homes in the State that a member of this Committee represent, most notably Wisconsin, Minnesota, Florida, Pennsylvania 

and Oregon. 

These populations share a unique histories with this country because of their support of the United States during the war in Vietnam. Many resettled refugees—including our elders—fought alongside American troops, risking their lives in support of freedom and 

democracy. 

Contrary to the popular ‘‘model minority myth’’, which purports 

that all Asian-American are excelling and facing no obstacles, all 

too frequently, the very real needs and challenges that a large 

number of our southeast Asian population face are often overlooked. 

Many of the challenges facing these communities remain 

unaddressed. For example, according to the 2000 census, 29 percent of the Cambodian-American population live below Federal poverty line. The same can be said. 

Senator SMITH. Twenty-four percent? 

Mr. MATHAVONGSY. Twenty-nine percent. 

Senator SMITH. Twenty-nine percent. 

83 

Mr. MATHAVONGSY. The same can be said for 38 percent of 

Hmong, 19 percent of the Lao, and 16 percent of Vietnamese-Americans. 

In our written testimony that we submitted for the record, we 

discussed in detail about the SSI 7-year limit for refugees. But because of the panel—our colleague here—has spoken in depth and 

explained the impact, I will hold my comments on SSI at this time. 

So I would like to highlight the Medicare Part D that has impact 

on our community. 

The intent of the Medicare Part D was to ensure that most vulnerable population receive the maximum level of protection. Since 

its inception in 2005, however, the Part D program has incurred 

numerous difficulties for our low-income Southeast Asian American 

elders. 

One of their ongoing challenges is the inability of our seniors to 

receive linguistically appropriate information from drug plan. Unable to read and write English, they require intensive one-on-one 

consumer counseling. 

Part D plans are also required to make important information 

accessible to these beneficiaries whose English proficiency is limited. Yet, according to a survey conducted by National Senior Citizens Law Center—this is from California—drug plans failed their 

obligation to provide services in languages other than English. 

In fact, more than 60 percent of the calls placed to the call centers never reached an individual speaking the primary language of 

the caller. Lack of language access under Medicare Part D makes 

it nearly impossible for this population to navigate the already 

complex world around Part D program. 

Second, the minimal copayment required by Part D is also unduly burdensome and inequitable compared to other Medicaid recipient. Under Medicaid, they were unable to afford copayment. 

They were not denying necessarily medication. 

This financial requirement creates additional barriers for this 

vulnerable population. So I urge the Special Committee on Aging 

to ensure that the needs of our elders, especially disabled refugees, 

are made a priority. 

We would like to make the following recommendation pertaining 

to SSI and also Part D: 

Congress should enact legislation to delink the SSI eligibility 

from U.S. citizenship for refugees and humanitarian immigrants. 

At the very least, Congress should provide a stop-gap measure of 

extending 7-year limit on SSI. 

In April 2007, member of this Committee introduced Medicare 

Part D Outreach and Enrollment Enhancement Act of 2007. Among 

other things, this piece of legislation seek additional funding for 

outreach and assistance for those who qualify for Medicare, but 

needed additional assistance navigating the program. 

So we applaud this effort and recommend that any Congressional 

effort to provide additional assistance on this topic take into consideration the importance of improving language access, and also provide culturally appropriate materials. Materials on Part D needed 

to also be made available in many languages and at appropriate literacy level. 

84 

Congress should also ensure that the poorest and most vulnerable population are not financially devastated by Part D cost-sharing requirements by providing copayment assistance for dual eligible beneficiaries who receive both Medicare Part D and also Medicaid. Also, this would help eliminate the financial burden of low 

income seniors. 

The U.S. has been a leader in providing refuge for people around 

the world, many of whom have faced persecution, dislocation because of a conflict and war. Many who find refuge in the U.S. have 

been longtime allies and supporters of this country and as such, 

have risked their lives and those of their loved ones to be here. 

It is unimaginable that we would allow our disabled and elderly 

refugee population to endure further hardship and destitution because of unfair policies which do not take into consideration the 

unique circumstances of this vulnerable population. 

In conclusion, I like to thank the Committee, for the opportunity 

to highlight these issues affecting our Southeast Asian refugees 

and welcome any questions that you have. 

Thank you. 

[The prepared statement of Mr. Mathavongsy follows:] 

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Senator SMITH. Khammany, thank you very much. 

I am curious. For my own knowledge, how large is the Hmong 

population in the Highlands? 

Mr. MATHAVONGSY. In Laos? 

Senator SMITH. Yes. How large of a community is it? How many 

millions of people? 

Mr. MATHAVONGSY. I don’t have the number for that, but we do 

have a large number of Hmong population in Wisconsin and in 

your State, as well as California. 

Senator SMITH. As a percentage of Hmong globally, how many 

were displaced by the Vietnam war? 

Mr. MATHAVONGSY. That I have to get back to you, sir. I don’t 

have . . . 

Senator SMITH. I am just curious. 

Mr. MATHAVONGSY. The number. 

Senator SMITH. I just know the contribution you made in that 

very distressful war. We were grateful to the Hmong people, and 

we are glad many are American citizens and living among us and 

contributing to our society. 

I do believe that this Congress will get the seven-year extension 

done. I think it is imperative we do it for all the reasons that each 

of you have mentioned, and I support it fully. 

Whether we do the additional you speak of, it is certainly something Congress needs to take up and consider, and that much I can 

promise you. But I also know that passing a law around here is, 

well, let me put it this way. Our founders designed the Congress 

to be inefficient and we are pretty good at it. [Laughter.] 

But, when I get discouraged by that I am reminded that it is a 

good thing that it is hard to make laws because we only want the 

best laws. Good ideas persisted in long enough by good people become good laws. Our system’s produced a pretty great Nation. 

We are grateful you are all here, and we salute you for your service. We thank you for your taking the time to be a part of this 

hearing. I wish more of my colleagues were here, but I don’t want 

you to take that as an indication of lack of interest or support. 

You have contributed measurably to the record of the U.S. Senate. We have received many good ideas from you this morning of 

which we will take into our deliberations, committees, on the Senate floor, and in House-Senate conferences. We will get as many of 

them as we can to the President of the United States for his signature. 

So thank you all for being here and Salah for coming so far. 

Khammany, you came from Wisconsin. Is that where you live? 

Mr. MATHAVONGSY. California. 

Senator SMITH. California. Well, you have come a long way, too. 

Try the Oregon Trail next time. [Laughter.] 

With that, our heart-felt thanks and we are adjourned. 

[Whereupon, at 12 p.m., the Committee was adjourned.] 

(93) 

A P P E N D I X 

REMARKS OF SENATOR HERB KOHL

I would like to thank Senator Smith for holding today’s hearing; I would also like 

to thank the witnesses for their testimony and for being here today. The challenges 

facing elderly refugees are too often overlooked or ignored. I hope the testimony 

given here can shed some light on how we can better serve these individuals. 

In July of 2004, as Wisconsin was preparing for an influx of thousands of Hmong 

refugees, the Milwaukee Journal Sentinel ran a three part series on the challenges 

those refugees faced. The series painted a picture of a shared history—of fighting 

against Communist forces with the CIA during the ‘‘secret war’’ in Laos; living in 

refugee camps; fleeing to the U.S.; and starting anew in America. In relating the 

stories of individuals such as Chua Tong Vue, a 75 year old man living at the time 

in a refugee camp in Thailand, readers came away with a greater understanding 

for the obstacles refugees must overcome—both abroad and once they reach the U.S. 

A greater understanding of those challenges and finding ways to lessen them is 

the goal of today’s hearing. The federal government certainly has a role to play in 

the resettlement of refugees. That role begins with the determination of who is considered a refugee and continues through helping them to adapt to life in America. 

We must ensure that we serve them as effectively as possible. I believe there is a 

lot of room for improvement, and I look forward to hearing the ideas and recommendations of today’s witnesses. 

With more than 69,000 current and former refugees living in Wisconsin, I have 

a particular interest in this issue. Wisconsin is a leader in easing the transition for 

refugees with a strong record of combining federal, state and local resources. In addition, the hard work and coordination of volunteer agencies in the state—Catholic 

Charities, Jewish Families Services, United Refugee Services of Wisconsin, and Lutheran Social Services—is critical to the resettlement of refugees. Both the volunteer 

agencies and the State have proven their dedication to ensuring that refugees are 

granted access to all the tools they need to adapt. For example, in 2004, Governor 

Doyle appointed the Hmong Resettlement Task Force to study the needs of the 

Hmong refugee population. Comprised of a large coalition of interests and organizations, the Task Force made recommendations on how to improve access to a wide 

range of services—a testament to the State’s dedication to serving this constituency. 

The federal government can and should be doing more to ease the burden of resettlement—especially for the elderly. For the past several years, I have worked with 

Senator Smith on one of the biggest challenges facing refugees in the US—the loss 

of SSI benefits due to a 7 year time limit. As many of you know, Supplemental Security Income, or SSI, provides minimal cash assistance to elderly and disabled individuals with little or no income. Due to short-sighted policy passed in the 1990’s, 

elderly and disabled humanitarian immigrants have seven years to become citizens 

in order to remain eligible for these benefits. This is an inadequate amount of time, 

given the bureaucratic delays and hurdles these individuals face. Thus, thousands 

have already lost their benefits, and tens of thousands more will lose this important 

benefit if Congress does not enact our legislation. 

The Smith-Kohl bill, the SSI Extension for Elderly and Disabled Refugees Act, 

would extend SSI eligibility for two years for refugees and asylees, including those 

whose benefits recently expired. This legislation protects the estimated 40,000 individuals who will lose these benefits if Congress doesn’t act, and restores benefits to 

the thousands who have already seen them cut. I am very pleased that the House 

has passed by voice vote an offset version of our legislation. While I remain hopeful 

that the Senate can enact the bill before the end of this year, time is running out. 

I hope that today’s hearing will help raise the profile of this and other challenges 

faced by elderly refugees in our country. Our policy toward refugees and asylees embodies the best of our country—compassion, opportunity, and freedom. I am proud 

of the example our policies set with respect to the treatment of those seeking refuge. 

94 

But our commitment to these individuals cannot end with the decision to grant refugee status. The policies of compassion and opportunity should continue throughout 

the resettlement process. I want to again thank Senator Smith for having this hearing and thank the witnesses for attending today. I look forward to today’s proceedings. 

MS. TEVEROVSKY RESPONSES TO SENATOR KOHL’S QUESTIONS

Question. Ms. Teverovsky, can you speak to the level of coordination between the 

Office of Refugee Resettlement and the Administration on Aging? Does the current 

level of coordination best serve the needs of older refuges? 

Answer. I cannot speak to the level of coordination between ORR and the Administration on Aging. 

Question. Ms. Teverovsky, we have all heard about those individuals who have 

lost their SSI benefits and the thousands more who stand to lose them if Congress 

doesn’t act. How has your organization helped those who have lost their benefits? 

Answer. The American Jewish community has demonstrated a steadfast commitment to ensuring that Jewish arrivals to the United States receive support if and 

when they need it. Jewish community action in response to the loss of SSI has 

ranged from English and citizenship training and naturalization application assistance; to garnering community resources to try to keep those who have lost their 

benefits from becoming hungry or homeless; to advocacy for restoring benefits at the 

local, state, and national levels. Although charitable efforts can be helpful, sufficient 

resources are unavailable to help all those losing SSI benefits under the seven year 

policy. 

Predicting the serious problems that would come to pass after welfare reform was 

adopted in 1996, HIAS developed a series of initiatives aimed at helping people— 

particularly in the Russian-speaking community—to naturalize. Despite HIAS’ extensive efforts since the 1990s to preempt the looming problem, in 2003 considerable 

numbers of refugees around the country, who had been unable to naturalize and 

had fallen through the cracks because of language barriers, ill health or bureaucratic delays, began losing their SSI benefits. In the years 2003 and 2004, according 

to the Social Security Administration, close to 3,000 non-citizen refugees and asylees 

were terminated from SSI. 

In 2005, HIAS launched the National SSI Initiative, with staff dedicated exclusively to assessing the nationwide scope of the SSI program, providing data to HIAS’ 

Washington, DC office to support ongoing efforts to achieve legislative change, providing naturalization assistance to individuals, producing citizenship and training 

materials, and developing a national network of professionals to provide pro bono 

assistance in preparing naturalization applications for needy refugees. 

Question. Ms. Teverovsky, Are you aware of any state efforts to protect those 

whose benefits have expired? 

Answer. There are six states—California, Illinois, Hawaii, Maine, New Hampshire, Nebraska—that have state-funded programs that provide cash-assistance to 

immigrants who are not eligible for coverage under the federal SSI program. However, these programs vary by state. Please see Attachment A for additional information about the programs available in these six states. 

RESPONSES TO SENATOR KOHL’S QUESTIONS FROM MR. MATHAVONGSY

Question. Mr. Mathavongsy, what has been the effect of losing SSI benefits on the 

refugees your organization serves? 

Answer. For many Southeast Asian elderly and disabled refugees, Supplemental 

Security Income (SSI) is their lifeline. Without SSI benefits, many disabled elders 

may have no cash income and may not be able to meet their most basic needs, including paying for rent and essential medications. In most states, SSI recipients 

automatically qualify for Medicaid, especially for people with disabilities, this health 

coverage is critical. When and individual loses SSI benefits, he or she also loses 

automatic eligibility for Medicaid. When become destitue, the burden falls on family 

members who are also struggling to put food on the table. But most importantly, 

the human toll is profound; after the enactment of the 1996 restrictions, newspapers 

reported that some refugees who were facing loss of their SSI benefits committed 

suicide and the recent SSI losses have once again raised the prospect of suicides. 

The following story illustrates the impacts of the seven year SSI time limit: 

Mr. K’Keng is a 75 years old Montagnard refugee from the central highlands of 

Vietnam. Mr. Keng, along with thousands of other Montagnards, were recruited and 

trained by the U.S. Special Forces to fight alongside American soldiers during the 

95 

Vietnam War. In 1970, while serving in the Province Reconnaissance Unit (PRU), 

he was hit by pieces of B40 artillery from the North Vietnamese Communists which 

injured his right eye and broke my left wrist and hand. His right eye was completely blind as a result of the injury. He also spent 6 years in the Vietnamese communist prison camp. In 1996 his family was resettled in the United States through 

the Humanitarian Operation (HO) refugee resettlement program created for political prisoners. 

Both he and his wife found jobs shortly after they arrived in the U.S. working 

in a bakery. Three months later he was laid off because of his disabilities. He applied for SSI benefits. His wife continued to work until 2001 and when she was laid 

off she also applied for SSI benefits because of her age. Their SSI benefits were cut 

in February of 2003 because of the 7-year time limit. Since the loss of their SSI benefits, the only source of assistance for him and his wife is food stamps of $280 a 

month. They have no income. For this reason, his 20 year old son has had to leave 

his full-time enrollment in school to work full-time to help them financially. At the 

young age of 20, his son has to delay his own educational goals to help provide food, 

shelter and other necessities for his family because they no longer receive SSI. 

Question. Mr. Mathavongsy, can you elaborate on what the initial experience is 

for a refugee coming into this country? 

Answer. As newly arrived refugees, it was not easy to make adjustment to new 

life in America due to the language difficulties, the sudden experience of ‘‘culture 

shocks,’’ and lack social support once the resettlement organizations/sponsored families ended their initial three months of support. For refugees who speak English, 

it was a bit easier making the transition. However, for those families without the 

inability to speak English, it was a daily struggle to even learn to utilize public 

transit system and navigate the social services, searching for employment, enrolling 

children into local schools. For elderly refugees, the social isolation due to language 

barriers compounded with pre-existing conditions of Post Traumatic Stress Disorder 

(PSTS) put them at extremely vulnerable situation. Some of them went into longterm depression because they felt the sense of hopelessness and always depended 

on their adults family members for their basic needs. Nevertheless, the refugee service organizations such as ethnic community-based organizations or mutual assistance association (MAAs) have been one of the pillars to assist with initial adjustment and basic support services. MAA was the first organization that newly arrived 

refugees turn to for culturally appropriate services and integration programs. With 

bilingual staff who can interpret during the doctor’s visits and filing out school enrollment forms, etc., newly arrived refugees received navigational support. Both 

Southeast Asian American MAAs, federal, and state agencies would mutually benefit from partnerships and collaborations, particularly to address the needs of approximately 15,000 Hmong refugees who just arrived from Wat Thamkrabok, a Buddhist temple in central Thailand. Southeast Asian American MAAs had to ensure 

that these new refugees were able to access services to address their many needs, 

but the sheer number of refugees has overwhelmed many of their resources. The 

federal agencies such as Office of Refugee Resettlement must financially support 

these MAAs who are best able to provide a combination of service delivery, advocacy, research, and cultural programs or who can direct their communities to other 

services. 

Question. How well do you think the Department of State and Health and Human 

Services prepare elderly refugees for starting life in the US? 

Answer. The Departments of State and Health and Human Services have done 

sufficient jobs to prepare working adults and children with new lives in the US 

through vocational ESL course, job training, and cultural orientation, but sometimes 

the elderly refugees were usually the forgotten populations because majority arrived 

as part of the large and extended families. Elderly refugees must also be the priority 

population in order to increase their knowledge about American cultural and familiarize themselves with the network of aging services such as Social Security, Medicare and Medicare Services and Area Agencies on Aging. 

Question. Your testimony mentions the lack of linguistically appropriate information for refugees. What should the federal government be doing in order to encourage the availability of translated materials and of translation services? 

Answer. Enforce Title VI of the Civil Rights Act of 1964 to ensure equal access 

to services, including health related benefits, for persons with limited English proficiency. 

Step up Congressional Oversight over Center for Medicare and Medicaid Services 

(CMS) to hold sponsored drug plans accountable for non-compliance of the Civil 

Rights Act. 

Funding national language access pilot that would promote access for Medicare 

beneficiaries. 

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Better coordination of services within the Department of Health and Human Services (e.g. Center for Medicare and Medicaid Services, Social Security Administration, 

Office of Refugee Resettlement, Administration of Aging, etc...) 

Support of Ethnic Specific Service Agencies: Southeast Asian Mutual Assistance 

Associations (MAAs) and other ethnic-specific organizations provide vital support for 

elderly refugees of their communities; however, services are often not funded by 

public and private funding. In order for MAAs to fully serve the older refugee community, we encourage federal agencies to support MAAs with resources. 

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