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. 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. 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.) 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. 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. 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. 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. 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.) 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. 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. 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. 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. 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. 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. 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-. 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) 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. 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. 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.

Summary: 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. 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. 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.