Refugee Assistance: Little Is Known about the Effectiveness of Different Approaches for Improving Refugees' Employment Outcomes
Published: 2011-03-31T00:00:00

Fast Facts:

Highlights:
section_title: Why GAO Did This Study
paragraphs: In fiscal year 2009, the United States resettled close to 70,000 refugees fleeing persecution in their homelands. To assist in their transition to the United States and help them attain employment, the Department of Health and Human Services Office of Refugee Resettlement (ORR) provides temporary cash, medical, and other assistance through four different assistance programs. The economic downturn and an increase in refugee arrivals posed challenges to ORR's efforts to assist refugees and estimate program costs, resulting in fluctuating unobligated balances. Congress required GAO to examine (1) differences in ORR's refugee assistance programs and factors program providers consider when placing refugees in a particular program; (2) refugee employment outcomes and the effectiveness of different approaches to providing assistance; and (3) how ORR estimates program costs and how its estimates have affected the agency's unobligated balances. GAO met with federal and state officials, voluntary agency staff, and refugees; reviewed selected case files; analyzed ORR performance data for fiscal years 2007 through 2009; and reviewed and analyzed relevant federal laws, regulations, and budget documents.
section_title: What GAO Found
paragraphs: ORR supports several approaches to providing cash, medical assistance, and social services to refugees through its Matching Grant, Publicly Administered, Wilson/Fish, and Public Private Partnership programs. The Matching Grant program, which is administered and partially funded by private voluntary organizations, features several design elements that set it apart from ORR's other programs. For example, voluntary organizations select refugees for the Matching Grant program and those who participate have 4 to 6 months to find employment before their cash assistance ends. Most states also offer one of ORR's other programs: these programs enroll any eligible refugee, and participants have up to 8 months to find a job before their assistance ends. Three of ORR's programs--the Wilson/Fish, Public Private Partnership, and Matching Grant--were designed to give providers flexibility in developing innovative approaches to help refugees find employment and become self-sufficient. GAO observed providers using a number of different approaches, including offering refugees cash incentives for early employment, and these approaches varied within and among programs. Voluntary agencies told GAO that they consider several factors, such as the refugee's English language and employability skills, in deciding whether to enroll a refugee in the Matching Grant program or another ORR assistance program. ORR's four assistance programs showed some success in helping refugees obtain employment in fiscal year 2009, but the percentage of program participants who obtained employment declined in recent years and little is known about which approaches are most effective in improving the economic status of refugees. In fiscal year 2007, between 59 percent and 65 percent of refugees receiving cash assistance from ORR programs entered employment within 4 to 8 months. By fiscal year 2009, these rates decreased to between 31 percent and 52 percent, depending on the program. Little is known about the effectiveness of the different approaches providers use to improve employment outcomes for refugees, such as intensive case management and employment incentives, in part because of differences in the way programs are structured and the populations they serve and in part because of differences in the way program performance is measured. ORR's estimates of program costs have generally tracked actual obligations but challenges in estimating specific variables such as the number of eligible refugees and the cost of serving them have contributed to fluctuations in unobligated balances between fiscal years 1999 and 2009. ORR has a 3-year period in which to obligate its annual appropriations. From fiscal years 1999 to 2005, ORR used unexpired and unobligated prior year funds to obligate more than it was appropriated for those years, in part because of higher-than-expected increases in refugee arrivals and medical costs. As a result, its unobligated balances were reduced in most of these years and were gone by fiscal year 2005. However, from fiscal years 2006 to 2009, ORR obligated less than it was appropriated, which allowed the agency to carry over funds from one year to the next. As a result, its unobligated balances grew from $17 million in fiscal year 2006 to over $83 million in fiscal year 2009.
section_title: What GAO Recommends
paragraphs: GAO recommends that the Secretary of Health and Human Services identify effective approaches that state and voluntary agencies can use to help refugees become employed and self-sufficient.

section_title: Letter
paragraphs: Millions of individuals worldwide have fled their countries for fear of  being persecuted for their race, religion, nationality, political opinions, or  belonging to a particular social group. The United States has a long- standing tradition of providing refuge to people fleeing persecution in their  homelands. Each year the United States resettles at least half of all  refugees referred worldwide by the United Nations High Commissioner for  Refugees for resettlement; the remaining refugees are resettled by other  countries. In fiscal year 2009, the United States admitted more than 70,000  refugees. According to the Department of Health and Human Services  (HHS), refugees often lack the basic foundation to rebuild their lives when  they first arrive in the United States, and many newly arrived refugees are  eligible for temporary cash, medical, and other assistance from one of four  programs funded in full or in part by Office of Refugee Resettlement  (ORR), located within the Administration for Children and Families (ACF)  at HHS. The primary goal of ORR’s refugee assistance programs is to help  refugees achieve self-sufficiency—that is, rely on their earnings, rather  than government-provided cash assistance, for their needs. In fiscal year  2009, Congress appropriated over $400 million to support ORR’s  resettlement programs.
According to ORR officials, fiscal year 2009 posed several challenges to  ORR and its budget. During 2009, more refugees entered the country than  in any year since the events of September 11, 2001, requiring ORR and  many state and voluntary agencies to provide assistance to more refugees  than expected. Furthermore, as a result of difficult economic conditions  and high unemployment rates in many communities, many refugees were  not able to find employment as quickly as they had prior to the recession.  Additionally, ORR officials stated that because the United States has  admitted an increased number of refugees who have spent many years  living in difficult conditions, such as refugee camps, a larger proportion of  recently arrived refugees have health and other issues that make it difficult  for them to work and achieve self-sufficiency. Because of these changes in  refugee populations, ORR faced difficulties in estimating the costs of  serving newly arrived refugees, which, in turn, has affected the agency’s  unobligated balances.
The House Report accompanying the Departments of Labor, Health and  Human Services, Education, and Related Agencies Appropriations Act for  fiscal year 2010 mandated that we conduct an evaluation of the Office of  Refugee Resettlement’s administration of the refugee assistance  programs. We examined: (1) differences in ORR’s refugee assistance  programs and factors program providers consider when placing refugees  in a particular program; (2) refugee employment outcomes and the  effectiveness of different approaches to providing assistance; and (3) how  ORR estimates program costs and how its estimates have affected the  agency’s unobligated balances.
subsections: section_title: Background
paragraphs: Data limitations stem from the fact that performance data are reported by multiple  agencies. the United States will admit for resettlement in a given year. The  presidential ceiling has decreased from about 90,000 in fiscal year 1999 to  80,000 in fiscal year 2009. However, the number of refugees actually  entering the United States has increased in recent years compared to the  relatively low numbers entering after the terrorist attacks of September 11,  2001. In the aftermath of those attacks, a review of refugee-related security  procedures was undertaken, refugee admissions were briefly suspended,  and enhanced security measures were implemented. As a result of these  and other factors, refugee admissions declined from 68,393 in fiscal year  2001 to 26,383 in fiscal year 2002 and 28,348 in fiscal year 2003. Admissions  have rebounded since, gradually increasing to 74,652 in fiscal year 2009.
subsections: section_title: Refugee Resettlement and Assistance Programs
paragraphs: The Refugee Act of 1980 provided a systematic and permanent procedure  for admitting refugees to the United States and established comprehensive  and uniform provisions to resettle refugees as quickly as possible and to  encourage them to become self-sufficient. The Departments of State and  Homeland Security handle the first part of the resettlement process by  approving and processing refugees overseas. The Department of State then  partners with 10 national voluntary agencies to determine where in the  United States refugees will live. The national voluntary agencies consider a  variety of factors when determining where refugees will live, including  placing refugees where they may already have relatives and where the  national agencies have offices to meet the needs of the refugees. Voluntary  agencies use their network of some 350 affiliates to provide refugees with  initial placement services, including meeting refugees at the airport when  they first arrive in the United States and providing housing, food, clothing,  and other necessities for the first 30 to 90 days.  Also, during this time,  staff from local voluntary agencies help refugees apply for federal  assistance.
After their initial month in the United States, many refugees are eligible for  temporary resettlement assistance from ORR. All states, except Wyoming,  administer an ORR-funded assistance program that provides up to 8  months of cash and medical assistance, as well as other social services,  and states have the flexibility to choose among three program delivery  models—the Publicly Administered, Wilson/Fish, or Public Private  Partnership programs. These three delivery models were established  over a 20-year period and give states options in how they provide refugee  assistance:    Publicly Administered: Refugee resettlement assistance is provided  primarily through the Publicly Administered program. States are not  required to administer this program, but those that do generally model the  program after their Temporary Assistance for Needy Families (TANF)  programs.
Wilson/Fish: In 1984, Congress authorized ORR to implement the  Wilson/Fish program, which gave states flexibility in how they provide  assistance to refugees, including whether to administer assistance  primarily through local voluntary agencies. One of the goals in developing  this program was to expand the number of states that offered a refugee  program so that an ORR-funded program could exist in every state that  resettles refugees.
Public Private Partnership: In 2000, ORR established the Public Private  Partnership program, which promotes states’ partnerships with voluntary  agencies to provide assistance, and gives states the flexibility to set  refugees’ cash grants at levels higher than those authorized for the  Publicly Administered program. (See fig. 1 for the geographical  distribution of refugee assistance programs.)
In addition, some refugees participate in the Matching Grant program,  which is only partially funded by ORR. According to ORR, this program is  administered by a network of national voluntary agencies, and is offered in  42 states and the District of Columbia. The Matching Grant program  provides refugees with cash and other assistance for 4 to 6 months with  the goal of helping them become self-sufficient without receiving cash  benefits from a public assistance program. Of the refugees who received  cash assistance from ORR in fiscal year 2009, just over 30 percent of them  participated in the privately administered Matching Grant program, while  most of the remaining percent participated in ORR’s other assistance  programs. (See fig. 2.)
All four programs fund cash and medical assistance as well as a broad  range of social services, including employment services, English language  instruction, case management, citizenship and naturalization preparation  services, and social adjustment services. Eligible refugees may also  receive other federal benefits, such as food assistance offered through the  United States Department of Agriculture’s Supplemental Nutrition  Assistance Program (SNAP, formerly the Food Stamp Program). Figure 3  shows the assistance offered to refugees who participate in one of ORR’s  resettlement programs.
Not all refugees receive assistance through ORR-funded programs.  Refugees who are eligible for or receiving cash assistance from programs  outside of ORR, such as TANF or Supplemental Security Income (SSI), are  generally not eligible to receive cash assistance from ORR’s Publicly  Administered, Wilson/Fish, or Public Private Partnership programs.  Refugees who are eligible for TANF but who are not receiving TANF  benefits may, however, receive cash assistance and other services offered  by the Matching Grant program. See figure 4 for the general path of  refugee resettlement in the United States.
section_title: Performance Management
paragraphs: In addition to helping newly arrived refugees adjust to their surroundings  and settle in the United States, the overall goal of ORR’s assistance  programs is to help refugees attain self-sufficiency. Self-sufficiency is  defined in ORR’s regulations as the refugee earning a total family income  at a level that enables a family unit to support itself without receiving a  cash assistance grant. ORR collects data on several employment-related  outcomes to assess program performance. As part of the Government  Performance and Results Act’s requirement for agencies to produce  performance measures used to assess their progress toward meeting  performance goals, the Publicly Administered, Public Private Partnership,  and Wilson/Fish programs have six shared outcome measures. The  Matching Grant program has its own measures—three of which are  directly related to the program’s goal of helping refugees become  economically self-sufficient. Table 1 lists the performance measures for  the different types of refugee assistance programs. (For a description of  these measures, see app. III.)
section_title: Program Funding
paragraphs: Congress appropriates a fixed amount of funding each year to fund  refugee assistance programs. ORR distributes this funding among seven  budget activities—each with a specific purpose. (See table 2.)
ORR’s largest budget activity, Transitional and Medical Services, primarily  supports refugees’ cash and medical assistance offered through the  Publicly Administered, Wilson/Fish, and Public Private Partnership  programs as well as the federal contribution to the Matching Grant  program. ORR is authorized to fully reimburse program providers for the  cash and medical assistance they provide to refugees enrolled in the  Publicly Administered, Wilson/Fish, and Public Private Partnership  programs,even if the costs of serving all eligible refugees exceed ORR’s  annual appropriation in a given fiscal year. The social services that state  and voluntary agencies provide to refugees enrolled in these programs,  such as employment services and case management, are primarily funded  through ORR’s Social Services budget activity. ORR receives a fixed  amount of Social Services funds each fiscal year and allocates these funds  to states based on estimates of arriving refugees. These Social Services  funds do not increase within a given year if the number of refugees served  is greater than anticipated. Together Transitional and Medical Services  and Social Services funding accounted for more than half of ORR’s total  appropriations in fiscal year 2009 (about $436 million, including  unobligated funds). Figure 5 shows the distribution of appropriations  across ORR’s budget activities in fiscal year 2009.
section_title: Design Elements Differentiate ORR’s Programs, and Program Placement Depends on Refugees’ Readiness to Work and Other Factors
subsections: section_title: Several Design Elements Differentiate ORR’s Four Assistance Programs
paragraphs: The Matching Grant program features several design elements that  distinguish it from assistance offered through the Publicly Administered,  Wilson/Fish, and Public Private Partnership programs. According to state  officials and voluntary agency staff, Matching Grant providers select the  refugees they want to participate in the program, and these refugees can  opt to participate in the Matching Grant program or may choose to apply  for and receive benefits from other programs if eligible. In contrast,  providers of the Publicly Administered, Wilson/Fish, or Public Private  Partnership programs enroll any eligible refugee. In interviews with  providers, we learned that refugees who find employment while  participating in the Matching Grant program may keep their earnings in  addition to their cash grant. However, refugees enrolled in ORR’s other  programs have their cash assistance reduced or terminated as a result of  their employment earnings. In addition, according to ORR and providers,  funding for the Matching Grant program is tied to refugees’ success in  finding employment while enrolled in the program—that is, providers of  the Matching Grant program who do not demonstrate that refugees have  achieved specific employment-related outcomes may have their funding  reduced the following program year. In contrast, funding for the Publicly  Administered, Wilson/Fish, or Public Private Partnership programs is not  affected by refugees’ employment outcomes, according to ORR officials.  (For more information on the Matching Grant program, see table 3.)
The extent to which each of the four ORR programs allow state and  voluntary agencies the flexibility to develop or use various service delivery  approaches differs. In the two states we visited that offered the Publicly  Administered program, refugee assistance was modeled after the states’  TANF programs. In these states, refugees generally received their cash and  medical benefits, employment assistance, and other social services from  multiple public and private agencies, such as county social service offices  and local community-based organizations, and typically met with several  caseworkers to receive these services. In comparison, the Wilson/Fish,  Public Private Partnership, and Matching Grant programs allow state and  voluntary agencies flexibility in developing approaches that are different  than those used in states’ TANF programs and at the same time focus on  helping the refugee become economically self-sufficient. These  approaches varied within and among programs and examples we observed  included providers integrating their refugee services, providing intensive  case management, and offering employment incentives:  Service integration: Some providers we visited used a single government  or voluntary agency to provide cash assistance, employment counseling  and case management to refugees, often in one location, while other  providers referred refugees to multiple agencies for different services. For  example, a Public Private Partnership program in Texas used a single  agency to provide refugees with most services while a Public Private  Partnership in Minnesota utilized multiple service providers. Refugees  enrolled in Minnesota’s Public Private Partnership program accessed their  cash assistance and case management from a local voluntary agency but  then often received other types of services, like employment counseling  and English language instruction, from a combination of other private,  nonprofit, and public agencies. Most of the Matching Grant and  Wilson/Fish programs we visited used a single agency to provide most  refugee services.
Intensive case management: In some of the states we visited, ORR  programs provided refugees with intensive case management using a  single case manager to oversee most aspects of a refugee’s case whereas  in other states, officials told us that providers spread responsibility for  managing a refugee’s case between multiple case workers, often in  different agencies. Guidelines state that refugees enrolled in the Matching  Grant program be assigned a caseworker who provides intensive case  management. Intensive case management can encompass a wide range of  activities, including referring refugees to needed services, such as  transportation, child care, English classes, employment-readiness training,  and food and housing assistance; helping the refugee adapt to the new  culture; and facilitating interactions between clients and employers or  other service providers. In Florida, one voluntary agency case manager  who provided intensive case management to his clients drove refugees  enrolled in the Matching Grant program to and from work on their first  day of employment and checked in with the employers to help resolve any  employment-related issues that may have arisen. However, the extent to  which refugees receive intensive case management can vary by program.  The Public Private Partnership program does not receive dedicated  funding from ORR to specifically support case management activities,  and two providers of the Public Private Partnership program told us they  could not always provide intensive case management services to refugees.
Incentives for early employment: In addition to the Matching Grant  program, the Wilson/Fish and Public Private Partnership programs allow  states or voluntary agencies to offer financial incentives to encourage  refugees to find employment quickly. While some providers may choose  not to offer incentives, all the Wilson/Fish and Public Private Partnership  providers we visited offered employment incentives to refugees. Providers  of the Wilson/Fish program in Massachusetts and San Diego County, for  example, offered refugees a cash bonus if they found full-time employment  within the first 4 months of arrival.
The four programs differ in others ways as well. Table 3 outlines some of  the different characteristics of these programs.
section_title: Providers Consider Several Factors when Placing Refugees in a Program, including the Refugee’s Readiness to Work
paragraphs: According to staff at voluntary agencies in four of the five states we  visited, enrollment in the Matching Grant program is based primarily,  though not necessarily exclusively, on the refugee’s readiness to work— including his or her level of motivation, English skills, education or  previous work experience, and physical and mental health. Agency  officials from one state we visited explained that because the program  duration is shorter than the other three assistance programs, the Matching  Grant program is best suited to those who are likely to obtain employment  quickly. In addition, as funding for Matching Grant programs is based on  the performance of voluntary agencies in helping refugees achieve  employment-related outcomes, voluntary agency staff have an incentive to  select refugees to participate in the program who they think are most  likely to be successful in finding a job. Some voluntary agency officials we  spoke with said that refugees with high motivation to work and high levels  of English proficiency are more likely than those who do not have these  qualities to find employment.
In some instances, the amount of cash assistance provided by refugee  assistance programs is another factor that can influence the placement of  refugees in particular programs. Because cash assistance levels under the  Publicly Administered, Public Private Partnership, and Wilson/Fish  programs are based on the benefits provided under a state’s TANF  program, the amount of cash assistance provided to families can vary by  state and can be either higher or lower than the amounts available under  the Matching Grant program. Some voluntary agency officials in the states  we visited told us they encourage refugees to participate in the assistance  program that offers the greatest monetary benefit to the refugee. In two  states we visited, Massachusetts and Texas, voluntary agencies told us  they preferred to enroll refugee families with children in the Matching  Grant program because, based on the number of eligible members, the  family could receive a higher cash benefit in the first few months after  their arrival compared to what the family would receive from other  assistance programs. In those states, refugees without children would  receive more cash assistance overall from the Public Private Partnership  or Wilson/Fish programs than from the Matching Grant program.
In addition, some voluntary agencies told us they select families who may  face relatively more obstacles than other refugees to participate in  programs that provide integrated services and intensive case management  because these families can benefit from these approaches. According to a  director at one voluntary agency, intensive case management and  integrated services tend to benefit refugees who might otherwise fall  through the cracks in a traditional assistance program that provides  assistance through multiple agencies and different case managers.  Voluntary agency staff in Minnesota told us that when possible, they  enrolled single-parent families who are ready to work into the Matching  Grant Program instead of the TANF program because they believe the  family will benefit from intensive case management and integrated  services. One voluntary agency manager explained that refugees enrolled  in the TANF program in Minnesota often have several case workers and  need to access multiple government and nonprofit agencies to receive the  type of services that are mostly offered through one voluntary agency  through the Matching Grant program.
State policies can also determine whether refugee families with children  are placed in ORR refugee assistance programs or the state’s TANF  program, which is generally available to eligible families with children.  While refugees who are eligible for or receiving cash assistance from  programs that are available to the general population—such as SSI and  TANF—are generally prohibited from receiving cash assistance from  Publicly Administered, Public Private Partnership, or Wilson/ Fish  programs, some states determine TANF eligibility in a way that allows  families with children—who in other states would likely be eligible for  TANF—to participate in an ORR-funded refugee assistance program. For  example, officials in Texas who administer the state’s Public Private  Partnership program explained to us that refugees with children who  apply for TANF soon after they arrive in Texas are often ineligible due to  the income they receive during the initial resettlement process.   According to Texas officials, families who are ineligible for TANF may  participate in the state’s Public Private Partnership, which offers higher  cash benefits than the state’s TANF program. In contrast, officials in  Minnesota who also administer the Public Private Partnership program  told us that refugees’ initial resettlement payments do not make families  ineligible for TANF in their state. As a result, many families with children  in Minnesota participate in TANF, not the state’s Public Private  Partnership program.
In addition, some states administering the Wilson/Fish program have the  flexibility to allow families who would otherwise be eligible for TANF to  participate in the Wilson/Fish program.  According to ORR, four out of 13  Wilson/Fish programs provided cash assistance to TANF-eligible refugees  in fiscal year 2010.
section_title: Refugees’ Employment Outcomes Have Declined Recently, and Little Is Known about the Effectiveness of Programs’ Approaches
subsections: section_title: Refugees’ Employment Declined in Recent Years
paragraphs: Overall, fewer refugees found jobs within their first months in the United  States in fiscal year 2009 than they did in fiscal year 2007. Before the  economic recession, in fiscal year 2007, ORR’s performance data show  that between 59 percent and 65 percent of all refugees receiving cash  assistance from ORR’s four assistance programs entered employment  within 4 to 8 months of coming to the United States. By fiscal year 2009,  however, these employment rates decreased, ranging from 31 percent to  52 percent, depending on the program. (See fig. 6.)
Several state officials and voluntary agency staff told us that refugees have  struggled to find and keep full-time jobs during the economic downturn.  Some explained that refugees today compared to 3 years ago have fewer  employment options because jobs that used to be relatively easy for  refugees to find, such as those in hospitality and construction sectors, are  now being filled by non-refugees who have more training or experience.
We also heard that of the refugees who do find work, an increasing  number have only part-time or temporary jobs. For example, in reviewing  the case file of a single Somali man who resettled in Minneapolis, we  learned that he had found a part-time job, only to have his schedule  reduced to 1 day per week. As a result, he continues to look for other  work. Our analysis of ORR’s performance data shows that fewer refugees  have been able to keep their jobs for at least 90 days in fiscal year 2009  than in fiscal year 2007. Specifically, in fiscal year 2007, the percentage of  refugees in the Publicly Administered, Wilson/Fish, and Public Private  Partnership programs who found work and kept their jobs for at least 90  days ranged from 77 percent to 84 percent, depending on the program. By  fiscal year 2009, these rates decreased somewhat to between 67 percent  and 80 percent. For more information, see appendix III.
section_title: ORR’s Programs Helped Some Refugees Achieve Positive Outcomes, but No Single Program Consistently Outperformed the Others
paragraphs: Performance data indicate that some refugees obtained employment while  enrolled in an ORR assistance program, but no single refugee assistance  program consistently outperformed the others across the various  performance measures in fiscal year 2009. In comparing the three ORR  programs that provide assistance for 8 months, we found, for example,  that the Public Private Partnership program performed relatively well at  helping refugees find jobs while the Wilson/Fish program had the most  positive outcomes related to job retention. Table 4 below shows the actual  measures for ORR’s 8-month programs in fiscal year 2009. For more  information on ORR’s performance measures, see appendix III.
The Matching Grant 4-to-6-month assistance program, with its own set of  employment measures, performed well on some but not all of its measures  in fiscal year 2009. (See table 5.)
section_title: Little Is Known about the Relative Effectiveness of Approaches Used by ORR Assistance Programs in Improving Refugees’ Economic Status
paragraphs: ORR performance data cannot be used to compare Matching Grant  program outcomes with the outcomes from the other three programs  because they do not share the same performance measures. While all four  refugee assistance programs have three measures in common, the  programs collect information for their common measures at different  points in time. For example, the Matching Grant program reports the  number of refugees who enter employment 4 months after the refugee  arrives in the United States, while providers of the other three programs  report entered employment rates for refugees receiving ORR-funded cash  assistance within 8 months of their arrival in the United States.
Because the approaches states and voluntary agencies use to provide  assistance vary both within and between programs, ORR’s performance  data provide little information on the relative effectiveness of specific  approaches. The Wilson/Fish, Public Private Partnership, and Matching  Grant programs were designed to allow providers to develop innovative  approaches that are different than those used in states’ TANF programs,  including integrated services, intensive case management, and  employment incentives. Several providers we spoke with believe that the  approaches they use to provide assistance play an important role in  helping refugees find employment. One study published in 1999 (based on  data from 1992 through 1994) compared a Wilson/Fish and a Publicly  Administered program in San Diego and concluded that the Wilson/Fish  program with integrated services, personal and flexible system of service  delivery, and intensive support services helped refugees find employment  more quickly than the Publicly Administered program that provided  services through multiple agencies and case workers, but we found no  other studies that were published recently and have reliably assessed the  effectiveness of the various approaches used by refugee assistance  programs. In addition, the way these approaches are implemented varies  significantly both within and across programs. For example, in Texas, the  voluntary agencies that administer both the Matching Grant and the Public  Private Partnership programs told us that the way employment related  services are provided under the two programs is virtually  indistinguishable, whereas in Minnesota, the Matching Grant and Public  Private Partnership programs use two very different service delivery  approaches, according to voluntary agency staff.
Because providers consider different factors when placing refugees in  assistance programs, it can be difficult to determine whether differences  in program performance are attributed to program approaches or to  differences in the populations served. For example, because refugee  families with children may face different challenges to employment than  refugees without children, a program that serves more families with  children could have different employment outcomes than one that serves  fewer. In one of our discussion groups, a single mother from Rwanda told  us that she was unable to find work when she first arrived in the United  States because she had to care for her children, the youngest being 6  weeks old at the time. Eventually, she found child care for her children  and found her first job after being in the United States for almost 4 years.  Additionally, several Matching Grant program administrators told us they  were more likely to enroll refugees who speak English fluently, as the  ability to speak English can greatly facilitate a refugee’s chances of finding  employment. One provider in Florida explained that in Miami, despite the  fact that most refugees can get by outside the workplace speaking only  Spanish, most employers require that job applicants also speak English. A  refugee from Belarus told us that in his home country he was an  economist and a construction manager, but since arriving in Los Angeles  over a year ago with his wife and child he has been unable to find work.  He told us that he did not speak English when he arrived and believes that  this has been a significant barrier to employment. According to the results  of ORR’s annual survey of refugees published in the agency’s 2007 report  to Congress (the most recent published report), English proficiency was  one of the most important factors influencing the economic status of  refugees, with close to 90 percent of those who lacked earnings and  received cash assistance living in a household where no one could speak  English.
section_title: Difficulties in Projecting Certain Program Costs Have Contributed to Fluctuations in ORR’s Unobligated Balances
paragraphs: ORR considers a broad range of factors when estimating its program costs,  and these estimates for fiscal years 1999 through 2009 have generally  tracked actual program obligations in most but not all years. When  estimating program costs, ORR officials told us they consider several  factors, such as the projected inflation rate; participation rates; costs for  cash and medical assistance; administrative costs; and monitoring, data  collection, and evaluation costs, as well as the projected number of  specific refugee groups such as unaccompanied refugee minors. According  to our analysis, ORR’s estimates of program costs have generally tracked  what the agency actually obligated. Between fiscal years 1999 and 2009,  ORR’s estimates were, on average, within 6 percent of the agency’s actual  obligations. (See fig. 7.)
Despite its efforts to consider various factors when estimating program  costs, ORR has faced difficulties in estimating specific variables, such as  the number of refugees that will enter the country in a given year and the  share of those refugees who will be eligible for ORR assistance programs,  according to officials. ORR officials told us they use the presidential  ceiling of refugees that may enter the United States in a given year when  estimating the number of refugees they must serve. In fiscal year 2009, the  number of refugees that arrived in the United States was more than 90  percent of the maximum number of refugees the United States set as the  ceiling that year. However, this ceiling has not always been a good proxy  of the actual number of incoming refugees. For fiscal years 2002 through  2007, the number of refugees that arrived was, on average, about 40  percent lower than the presidential ceiling. (See fig. 8.) In addition to using  the refugee ceiling, ORR projects the number of refugee arrivals by using  historical arrival patterns, and in its fiscal year 2004 budget estimate,  ORR requested less than it did in the previous year because of the  decreasing number of refugee arrivals since September 11, 2001.
Once ORR has refugee arrival estimates, the agency projects the number  of refugees who will likely participate in ORR-funded programs. The share  of refugees who are eligible for ORR-funded services varies from year to  year. For example, between fiscal years 2007 and 2009, the percentage of  all refugees who received cash assistance through ORR’s assistance  programs fluctuated between 26 percent and 38 percent. ORR must also  estimate the average cost of providing cash assistance to refugees  participating in its assistance programs, which can vary significantly  depending on the distribution of refugees across the country. A refugee  living in Texas participating in the Public Private Partnership program, for  example, receives a cash assistance grant of about $200 per month,  whereas a refugee living in Massachusetts participating in the Wilson/Fish  program receives a cash assistance grant of about $428 per month.  Consequently, the amount ORR reimburses state and voluntary agencies  for the costs of providing cash assistance may change as refugee arrival  patterns shift. For example, in fiscal year 2009, 3,082 more refugees were  settled in Texas—a low benefit state—than in fiscal year 2008, while  Minnesota and Connecticut—both high benefit states—saw decreases in  their numbers of arrivals. ORR officials also told us that because they do  not play a role in deciding where refugees are geographically placed, the  agency is limited in its ability to estimate costs associated with refugee  arrival patterns.
Uncertainty regarding the costs for medical expenses incurred by refugees  also affects ORR’s ability to accurately estimate funding for the amount of  services it must provide. Since an increasing proportion of arriving  refugees need intensive medical care, refugees’ medical costs on average  have increased over time, creating uncertainty for ORR in estimating these  expenses from year to year, according to officials. ORR officials indicated  that refugees admitted in recent years have more diverse medical  backgrounds than in the past, and that the number of refugees with  chronic mental and medical conditions has grown, due in part to increases  in refugee groups that have spent years living in refugee camps with  limited access to medical care and proper nutrition. Burmese refugees in  particular have lived for decades in refugee camps, according to ORR, and  have grown from 128 refugee arrivals in fiscal year 2002 to 18,275 arrivals  in fiscal year 2009, an increase from less than 1 percent to 24 percent of  the total population of arriving refugees. Partly because of this  demographic shift in the refugee arrival population, according to ORR  officials, the agency’s cost for medical assistance more than doubled from  fiscal year 1999 through fiscal year 2009. ORR officials and voluntary  agency staff explained that detailed information about refugees’ health  conditions are often not known prior to their arrival in the United States,  which contributes to uncertainty in medical costs. For example, one  voluntary agency director in Texas stated that medical information  provided on refugees prior to their arrival is minimal, and only describes  whether the client has a “Class A” condition, such as active tuberculosis,  or a “Class B” condition, such as hypertension, without specifying the  illness.
Estimating the number of children ORR will likely serve as a result of the  William Wilberforce Trafficking Victims Protection Reauthorization Act of  2008 also created uncertainty in ORR’s budget formulation in recent years,  according to ORR. Officials said they were uncertain about the impact this  Act would have on their budget due to a provision stipulating that victims  of trafficking and undocumented youths who are granted Special  Immigrant Juvenile status may receive care and placement services funded  by ORR instead of being returned to their home country. The Department  of Homeland Security provides ORR with estimates about asylees and  unaccompanied alien children who do not enter the United States through  the traditional resettlement channels. According to ORR officials, the  Department of Homeland Security estimated that the number of minors  receiving services from ORR in fiscal year 2009 would be approximately  12,000 to 14,000, but the overall number of Unaccompanied Alien Children  declined from 7,211 in fiscal year 2008 to 6,622 in fiscal year 2009.
Difficulties in accurately estimating program costs have contributed to  fluctuations in ORR’s unobligated balances at the end of each fiscal year.  For example, ORR officials said that they used the presidential ceiling of  70,000 to estimate the number of refugees they would likely serve during  fiscal years 2006 through 2007. However, refugee arrivals were  significantly lower those years, and consequently the agency’s costs to  support newly arrived refugees were less than the amount it received in  appropriations. Additionally, in anticipation of the potential influx of 4,000  to 6,200 additional unaccompanied alien children as a result of the William  Wilberforce Trafficking Victims Protection Reauthorization Act of 2008,  ORR requested supplemental funding, which was appropriated in fiscal  year 2009. According to ORR, the Act requires that youth entering the  United States from neighboring countries be screened to determine if they  are victims of trafficking. ORR anticipated that these youth would be cared  for under the Unaccompanied Alien Children program while being  screened. However, ORR’s Unaccompanied Alien Children program served  fewer children than anticipated, and at the end of fiscal year 2009, officials  said they carried over about $31 million of unobligated Unaccompanied  Alien Children funds and $52 million of unobligated supplementary funds.  In total, from fiscal years 2006 to 2009, ORR’s unobligated balances grew  from $17 million to over $83 million. (See fig. 9.)
Congress appropriates a certain amount of money to ORR each year to  fund its activities, and ORR has a 3-year period in which to obligate  funding for most of its budget activities—so funds that have not expired  and are not yet obligated for a specific activity at the end of a fiscal year  can be used during the following 2 fiscal years. From fiscal years 1999 to  2005, ORR used prior years’ unexpired and unobligated funds to allow it to  obligate more than it was appropriated in those years. For example, in  fiscal year 2005, ORR allocated $205 million of its appropriation to its  Transitional and Medical Services budget activity to reimburse states for  the costs of providing cash and medical assistance to refugees. When  states’ costs exceeded this amount, ORR was able to cover the difference  between its expenses and its allocation by using funds from its  unobligated balances from prior years. By the end of fiscal year 2005, ORR  did not have any remaining unobligated balances. From fiscal years 2006  to 2009, however, ORR obligated less than it was appropriated and thus  was able to accumulate balances again. ORR officials told us they  prioritize their unobligated balances to supplement the program costs of  refugees who participate in the agency’s Publicly Administered and Public  Private Partnership programs because they place an emphasis on these  programs in their funding decisions.
Officials explained they do not typically use the agency’s unobligated  balances to supplement funding for other activities, such as funds  dedicated to Social Services or the Wilson/Fish program. ORR’s  reimbursements to state and voluntary agencies for activities other than  cash and medical assistance generally do not increase as the number of  newly arrived refugees increase. Officials told us, for example, that the  amount appropriated for Social Services has remained at approximately  $154 million from fiscal years 2006 to 2009, even though the number of  refugee arrivals increased by 81 percent. As a result, program providers  have strategies to prioritize the use of limited funds in serving refugees. To  ensure that new arrivals continued to receive needed services, refugee  coordinators from Texas and Los Angeles told us they provided  employment services to refugees for only about 1 year rather than the 5  years allowed in regulation. Similarly, ORR does not generally increase  funding for Wilson/Fish services during a given year. In fiscal years 2008  and 2009, the San Diego Wilson/Fish program experienced an unexpected  increase in refugees from 3,309 to 5,178. In fiscal year 2010, ORR directed  providers to begin transferring refugee families with children, who were  otherwise eligible for TANF but had been allowed to enroll in the  Wilson/Fish program, off of their Wilson/Fish program and into the TANF  program thereby transferring the costs of resettling these refugee families  to other programs.
section_title: Conclusion
paragraphs: ORR spends millions of dollars every year on assistance that is critical to  addressing the basic needs of refugees who are new to the United States.  State and voluntary agencies that administer ORR’s programs vary in how  they provide assistance, and little is known about the effectiveness of the  approaches they use to help refugees become self-sufficient—an overall  goal of all of ORR’s programs. With refugees’ employment outcomes  declining because of the recession and significant pressures on the federal  budget, it is important that program providers use approaches that have  been shown to be effective in helping refugees find employment that  enables them to live without cash assistance. ORR tracks the success of its  programs using performance measures, but these measures alone provide  little information about the relative effectiveness of the various  approaches providers use. It is only by looking more closely at the  individual approaches and controlling for other factors that may influence  employment outcomes that ORR can begin to identify and promote the  most successful strategies while at the same time make more effective and  efficient use of its resources.
section_title: Recommendation for Executive Action
paragraphs: We recommend that the Secretary of Health and Human Services identify  effective approaches that state and voluntary agencies can use to help  refugees become employed and self-sufficient. To identify these  approaches, the Secretary may consider, for example, conducting a series  of rigorous evaluations of the programs and their approaches or  expanding information collected on the annual survey. Recommendations  from further study could be used by HHS or, if appropriate, by Congress,  to improve ORR’s refugee resettlement programs.
section_title: Agency Comments and Our Evaluation
paragraphs: We shared a draft of this report with HHS for review and comment. On  March 16, 2011, HHS provided written comments, which may be found in  appendix V, and technical comments, which we incorporated in the report  where appropriate.
In its written comments, HHS confirmed several of our findings and agreed  with our recommendation to identify effective approaches to help refugees  become employed and self-sufficient. HHS indicated that it seeks to  highlight promising practices related to effective employment approaches  and cited two recently published studies that it sponsored as examples of  its efforts. While the two studies cited described different services states  and voluntary agencies use to assist refugees and one study even  compared employment outcomes of refugees living in two cities, neither of  the studies evaluated the effectiveness of the programs or the approaches  providers use in helping refugees become self-sufficient. In fact, as HHS  indicated, one study suggested future research should include such an  evaluation. The agency also emphasized that refugee resettlement in the  United States is intended to be a rescue and restore program, which not  only provides refugees with temporary cash, medical, and employment  assistance, but also promotes cultural orientation, civic engagement, and  other activities. GAO acknowledges that HHS has a broad mission to  provide refugees with critical resources to assist them in becoming  integrated members of society. Nonetheless, we focused our report on the  temporary assistance and employment services refugees receive within the  first 4 to 8 months after arriving in the United States because it is within  this amount of time that refugees are expected to find employment and  become self-sufficient.
We are sending copies of this report to relevant congressional committees;  the Secretary of Health and Human Services, and other interested parties.  The report will also be available at no charge on the GAO Web site at  http://www.gao.gov.
If you or your staff have any questions about this report, please contact me  at (202) 512-7215 or brownke@gao.gov. Contact points for our Offices of  Congressional Relations and Public Affairs may be found on the last page  of this report. Key contributors to this report are listed in appendix VI.
section_title: Appendix I: Scope and Methodology
paragraphs: To describe how the Office of Refugee Resettlement (ORR) refugee  assistance programs differ and the factors used to place refugees in a  program, we interviewed ORR officials and National Voluntary Agency  officials from all nine National Voluntary Agencies who help administer  ORR programs. We also interviewed state, county, and local voluntary  agency officials in five states, including California, Florida, Massachusetts,  Minnesota, and Texas and conducted discussion groups with refugees in  all but Massachusetts. We selected four states with a high concentration of  ORR refugee caseloads and one state with a relatively low concentration  of refugee cases. We also selected states with a range of average 2009  unemployment rates. States we selected were geographically diverse and  all offered Matching Grant programs. We also collected and reviewed  refugee case files from the government and voluntary agencies we visited,  so that we would have case files representing refugees with different  experiences. From the states we visited except California, we collected  copies of two complete case files chosen by the voluntary agency—one  case file representing a refugee who participated in either the Publicly  Administered, Wilson/Fish, or Public Private Partnership; and one case file  representing a refugee who participated in a Matching Grant program.  The information we collected at these selected states does not allow us to  generalize to other states, refugees, or local voluntary agencies. We also  reviewed relevant federal laws and regulations.
To describe refugee employment outcomes and the effectiveness of  different approaches to providing assistance, we collected, aggregated,  and analyzed performance data across all states for fiscal years 2007, 2008,  and 2009 by program—Publicly Administered, Public Private Partnership,  and Wilson/Fish. To assess the reliability of the performance data, we  interviewed knowledgeable agency officials and reviewed official  documents. We compiled these data into a spreadsheet and only included  the performance outcomes of refugees who received cash assistance from  one of ORR’s programs. Because this study focused primarily on the  refugees who received cash assistance from ORR’s four assistance  programs, we did not include refugees who participated in the Temporary  Assistance for Needy Families (TANF) program. We also did not include  any data that represented refugees who were receiving ORR services but  not receiving refugee cash assistance. We also collected and analyzed  performance data for the Matching Grant program from the nine national  voluntary agencies for fiscal years 2007 through 2009. We analyzed these 3  years of performance data to gain insight on how refugee assistance  programs were performing most recently. While the performance data  have some limitations, we consider these data reliable and appropriate for  this engagement. We also conducted a literature review and found one  study that reliably addressed the effectiveness of approaches used by  providers to provide refugee assistance.
To describe how ORR estimates program costs and how estimates affect  its unobligated balances, we interviewed officials from the Department of  Health and Human Services (HHS), Administration for Children and  Families (ACF), and ORR to determine how ORR formulates its budget.  We also reviewed and analyzed budget documents from fiscal years 1999  through 2009, including ORR budget justifications and annual reports to  Congress. We interviewed knowledgeable agency officials and reviewed  official documents to assess the data that ORR uses to estimate program  costs, and found the data to be sufficiently reliable. Analyzing budget  information from fiscal years 1999 to 2009 allowed us to identify trends in  ORR’s obligations and unobligated balances. In addition, we spoke with  officials from the Departments of State and Homeland Security to obtain  information on how they develop budgets for their refugee programs and  what, if any, coordination occurs between these agencies and ORR to help  ORR formulate its budget. We conducted this performance audit from  December 2009 to March 2011 in accordance with generally accepted  government auditing standards. Those standards require that we plan and  perform the audit to obtain sufficient, appropriate evidence to provide a  reasonable basis for our findings and conclusions based on our audit  objectives. We believe that the evidence we obtained provides a  reasonable basis for our findings and conclusions.
section_title: Appendix II: Profiles of States Visited
paragraphs: Appendix II: Profiles of States Visited Benefit level per month   (1 adult/2 adults)
Public Private Partnership  $250/$437  Public Private Partnership  $200/$300 for months 1-4  $187.50/$252 for months 5-8  , 2010, News  Release, Report Number USDL-10-021. 7.50 per month for months 5-. For two adults,  $00 per month for months 1-4 and $252 per month for months 5-.
section_title: Appendix III: ORR Employment Outcomes
paragraphs: Appendix III: ORR Employment Outcomes The unduplicated number of refugees who entered employment.
The unduplicated number of refugees who entered full-time employment where health  benefits are offered within the first 6 months of employment.
The average wage at placement for all refugees who entered full-time employment.
The unduplicated number of refugees terminating cash assistance due to earnings from  employment.
Job Retention at 90th Day of Employment  The unduplicated number of refugees who entered employment between July of the  previous calendar year through June of the current calendar year. This rate is a measure  of refugee’s retention of employment—not retention of a specific job. As long as the  refugee is employed in a job a quarter after the date he or she entered employment, it is  considered retention.
The unduplicated number of refugees reducing cash assistance due to earnings from  employment.
The unduplicated number of refugees who entered employment.
The unduplicated number of refugees who entered full time employment where health  benefits are offered within the first 6 months of employment.
The sum of the hourly wages for the unduplicated number of full-time job placements  divided by the total unduplicated number of individuals placed in full-time employment.
This rate measures the self-sufficiency of refugees enrolled in the Matching Grant  program at the 120th day. Self-sufficiency means that the refugee or refugee family is  earning a total family income at a level that enables the family unit to support itself  without receipt of cash assistance. Refugees who receive non-cash assistance, such as  Supplemental Nutrition Assistance Program (SNAP) benefits or housing subsidies, are  considered to be self-sufficient by ORR if they have earnings and do not receive cash  assistance.
Economic Self-Sufficiency Retention (180)  This refers to the individuals who were reported to be self-sufficient at the 120th day and  continued to be self-sufficient 60 days later. Refugees who receive non-cash assistance,  such as SNAP benefits or housing subsidies, are considered to be self-sufficient by ORR  if they have earnings and do not receive cash assistance.
This rate measures the self-sufficiency of all refugees enrolled in the Matching Grant  program, including the status at 120 days and 180 days.
Economic Self-Sufficiency (120)
Economic Self-Sufficiency Retention (180)
Economic Self-Sufficiency (Overall)
Average Wage per Hour at Employment (full-time)
section_title: Appendix IV: Refugee Vignettes from Discussion Groups
paragraphs: The following examples are from our four discussion groups held in  various parts of the country. Voluntary agencies convened the discussion  groups, selected the participants, and provided translators when  necessary. These examples are illustrations of refugees’ experiences, and  are not indicative of any success or failure of ORR’s programs.
A single male from Iraq had job experiences as a shop owner, translator,  and sports trainer prior to arriving in the United States. His voluntary  agency provided him with assistance in finding an apartment and a job. He  currently works two jobs and makes enough money to make ends meet.  He hopes to begin a new career by taking training in massage therapy in  the near future.
A married couple from Burma with two teenagers lived an agrarian life in  their native land, farming rice and vegetables for their own subsistence  and selling the rest. Caseworkers from a voluntary agency enabled them to  obtain medical care and Social Security cards, and fill out job applications.  Neither husband nor wife was literate in their native Burmese dialect and  found learning English difficult. He has found work in a factory and his  wife has qualified for SSI. With these sources of income they are able to  pay their bills and save some money.
A man from Eritrea was a plant scientist in his native country and knew  some English. A voluntary agency helped him with enrolling in a nursing  assistant certification program and applying for a job. He aspires to  become a doctor.
Married with two children, an Iranian physician with 15 years of medical  experience in his native land arrived in the United States wanting to  practice medicine. However, because of his limited English, he said it was  difficult to study for the U.S. Medical Licensing exam. A voluntary agency  helped him find a job as a medical assistant, but he did not keep that job.  In the future, he hopes to enhance his English skills so he can enter and  complete a physician’s assistant program.
section_title: Appendix V: Comments from the Department of Health and Human Services
section_title: Appendix VI: GAO Contact and Staff Acknowledgments
subsections: section_title: Staff Acknowledgments
paragraphs: In addition to the contact named above, Kathryn Larin, Assistant Director;  Danielle Giese and Cheri Harrington, Analysts-in-Charge; Richard Burkard;  David Chrisinger; Erin Cohen; Rajiv D’Cruz; Mitchell Karpman; Carol  Henn; Brittni Milam; James Rebbe; Cynthia Saunders; Kathleen van  Gelder; Shana Wallace; and Daniel Webb made key contributions to this  report.
section_title: Related GAO Products
paragraphs: Displaced Iraqis: Integrated International Strategy Needed to  Reintegrate Iraq’s Internally Displaced and Returning Refugees.   GAO-11-124. Washington, D.C.: December 2, 2010.
Humanitarian Assistance: Status of North Korean Refugee Resettlement  and Asylum in the United States. GAO-10-691. Washington, D.C.: June 24,  2010.
Iraq: Iraqi Refugees and Special Immigrant Visa Holders Face  Challenges Resettling in the United States and Obtaining U.S.  Government Employment. GAO-10-274. Washington, D.C.: March 9, 2010.
Iraqi Refugee Assistance: Improvements Needed in Measuring Progress,  Assessing Needs, Tracking Funds, and Developing an International  Strategic Plan. GAO-09-120. Washington, D.C.: April 21, 2009.
Refugee Resettlement: Unused Federal Funds in 1991 and 1992.  GAO/HRD-94-44. Washington, D.C.: December 7, 1993.
Refugee Resettlement: Initial Reception and Placement Assistance.  GAO/NSIAD-93-193BR. Washington, D.C.: June 18, 1993.
Refugee Resettlement: Federal Support to the States Has Declined.  GAO/HRD-91-51. Washington, D.C.: December 21, 1990.
Soviet Refugees: Issues Affecting Domestic Resettlement.   GAO/HRD-90-106BR. Washington, D.C.: June 26, 1990.
Refugee Program: Financial Accountability for Refugee Resettlement  Can Be Improved. GAO/NSIAD-89-92. Washington, D.C.: March 17, 1989.
Refugee Programs: Status of Early Employment Demonstration Projects.  GAO/NSIAD-88-91. Washington, D.C.: February 3, 1988.
Refugee Program: Initial Reception and Placement of New Arrivals  Should Be Improved. GAO/NSIAD-86-69. Washington, D.C.: April 7, 1986.
Greater Emphasis on Early Employment and Better Monitoring Needed  in Indochinese Refugee Resettlement Program. GAO/HRD-83-15.  Washington, D.C.: March 1, 1983.