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Refugee Assistance Manual
Chapter I: REFUGEE ASSISTANCE BACKGROUND
I. REFUGEE ASSISTANCE OVERVIEW
Refugees are individuals fleeing from persecution in their homelands who have been designated for resettlement elsewhere in the world. In order to make determination of refugee status, representatives of the United States Citizenship and Immigration Services (CIS) conduct interviews overseas of individuals who have fled persecution. Once refugee status is established, a joint effort, conducted by the Department of State, the International Organization for Migration (IOM) and CIS, brings approved individuals to the United States for resettlement.
A. Background
The United States’ humanitarian response to the unique needs of refugees was formally addressed with the enactment of The Refugee Act of 1980 (Public Law 96-212) that became effective on April 1 of that year. The Refugee Act amended the Immigration and Nationality Act (INA) to create a domestic refugee resettlement program designed to provide assistance and services to refugees resettling in the United States.
The Refugee Act established the Office of Refugee Resettlement (ORR) within the U.S. Department of Health and Human Services (DHHS) to coordinate the program at the national level. In addition, the legislation created a State Coordinator of Refugee Resettlement position in those states administering a refugee program. Federal regulations provide 100% federal financial participation for administrative and assistance costs associated with aiding refugees.
The Federal refugee program, administered by the states, consists of three distinct programs. Refugee Cash Assistance (RCA) and Refugee Medical Assistance (RMA) are two short-term public benefits programs available to refugees for the first eight months after their date of entry in the United States. Refugee Social Services are longer-term, refugee-specific programs for which refugees are eligible. Social Services primarily include employment services such as job development, job readiness and placement, job follow-up, vocational skills training, and English Language Training (ELT). Supportive services, including case management, transportation, interpretation/translation, and various social adjustment services, such as home and health management and community orientation, are also funded.
B. Eligible Recipients
Throughout this manual the term “refugee” will refer to all groups mentioned below that are eligible for Refugee Cash or Medical Assistance. Qualified individuals are as follows:
1. Refugees - The CIS definition of 'refugee' is:
“Any person who is outside his/her country of such person’s nationality; or, in the case of a person having no nationality, is outside any country in which such person last habitually resided, and who is unable or unwilling to return to, and is unable or unwilling to avail himself or herself of the protection of that country because of persecution or a well-founded fear of persecution on account of race, religion, nationality, membership in a particular social group, or political opinion. “
Using this definition, representatives of the U.S. Citizenship and Immigration Services (CIS) conduct interviews overseas of individuals who have fled persecution and desire to be designated as refugees. CIS then makes a determination of the individual’s refugee status. Once an individual is determined to be a refugee, a joint effort, conducted by the Department of State, the International Organization for Migration (IOM), the CIS, and National Volunteer Agencies (VOLAGS), brings certain individuals to the United States for resettlement.
2. Asylees
Asylees also meet the definition of 'refugee' for eligibility purposes. However, asylees are individuals who, on their own, travel to the United States, apply for and receive a grant of asylum. These individuals do not enter the United States as refugees. They may enter as students, tourists, business people, or without papers. Once they are in the United States, or at a land border or port of entry, they apply to the CIS for asylum, a status that will acknowledge that they meet the definition of a refugee and allows them to remain in the United States. Asylees are eligible for state assistance and services once CIS has granted asylum.
NOTE: Applicants for asylum are not eligible, except for some Cuban and Haitian entrants. (See information below regarding Cuban and Haitian entrants.)
3. Certain Cuban and Haitian Entrants, as described below:
Any individual granted parole status as a Cuban or Haitian Entrant (Status Pending), or granted any other special status subsequently established under the immigration laws for nationals of Cuba or Haiti, regardless of the current status of the individual at the time of application for Refugee Medical Assistance; and
Any other national of Cuba or Haiti
a. Who: (i) was paroled into the United States and has not acquired any other status under the INA; (ii) is the subject of exclusion or deportation proceedings under the INA; or (iii) has an application for asylum pending with the CIS; and
b. With respect to whom a final, nonappealable, and legally enforceable order of deportation or exclusion has not been entered.
4. Certain Amerasians (from Vietnam)
This status refers to aliens born in Vietnam after January 1, 1962, and before January 1, 1976, if the alien was fathered by a U.S. citizen. Immigrant visas are issued to Amerasians under Public Law 100-202 (Act of 12/22/87), as well as to their spouses, children, parents or guardians if they accompany the Amerasian to the United States.
[Specifically referred to herein are certain Amerasians from Vietnam who are admitted to the U.S. as immigrants pursuant to section 584 of the Foreign Operations, Export Financing, and Related Programs Appropriations Act, l988.]
5. Trafficking Victims Any individual who has been subjected to “severe forms of trafficking in persons”, which includes;
a. involvement in activity in which a commercial sex act is induced by force, fraud, or coercion, or in which the person induced to perform such act is under 18 years of age; or,
b. the recruitment, harboring, transportation, provision, or obtaining of a person for labor or services through the use of force, fraud, or coercion for the purpose of subjection to involuntary servitude, peonage, debt bondage, or slavery.
6. Lawful Permanent Residents (i.e. green card holders) who held one of the above statuses prior to adjusting to Lawful Permanent Resident.
II. CIS DOCUMENTATION MOST OFTEN PRESENTED BY ALIENS
ELIGIBLE FOR RCA and RMA
For a comprehensive list of CIS documentation, and instructions on how to determine eligibility status, refer to Appendix C, CIS Documentation for Aliens Eligible for RCA. A child(ren) who arrives with a parent(s) carries the same alien status as the parent(s).
If a applicant has a document which is a(n): Then the status is:
I-94 (Arrival/Departure Record): Coded with a reference to the following section:
Section 207 Refugee, Eligible
[See Chart #2]
I-94 (Arrival/Departure Record): Coded with a reference to the following section:
Section 208 Granted Asylum, Eligible
[See Chart #3 and Appendix I]
I-94 (Arrival/Departure Record): Coded AM-1,
AM-2, or AM-3 Amerasian, LPR, Eligible
[See Chart #5]
I-94 (Arrival/Departure Record indicating at least 12 months): Coded with Section 212 (d)(5) Parolee; Cuban or Haitian National, Eligible
[See Chart #’s 4a, 4b, 4c and 4d]
U. S. Passport or CIS document bearing the Endorsement "Processed for I-551, Temporary Evidence of Lawful Permanent Residence" Permanent Resident, Lawfully Admitted
for Permanent Residence (LPR), Eligible
I-551 (Resident Alien Card):
Coded AM-1, AM-2, AM-3, Amerasian, LPR, Eligible
[See Chart #5]
I-551 (Resident Alien Card):
Coded CH-6 Cuban/Haitian, Eligible
I-551 (Resident Alien Card):
Coded RE6, RE7, and RE8 Other Refugees, Eligible
III. DEFINITION OF REFUGEE ASSISTANCE TERMS
AABD – Aid to the Aged, Blind, and Disabled
AB – Aid to the Blind
Adjustment to Lawful Permanent Resident (Immigrant) Status -- Procedure requiring certain aliens, such as refugees already in the United States, to apply for a change in alien status. Aliens admitted to the United States in a refugee or parolee category are issued an I-94 Arrival/Departure Record. After residing in the USA for one year, the alien must apply to have the status changed to that of lawful permanent resident.
Adult – For determining Refugee Cash Assistance eligibility, an adult is defined as any individual age 18 or older.
Alien - Any person not a citizen or national of the United States.
Amerasian (Vietnam) -- Aliens born in Vietnam after January 1, 1962, and before January 1, 1976, if the alien was fathered by a U.S. citizen. Immigrant visas are issued to Amerasians under Public Law 100-202 (Act of 12/22/87), as well as to their spouses, children, parents or guardians if they accompany the Amerasian to the United States.
AAPD – Aid to the Permanently and Totally Disabled
Asylee -- An alien in the United States or at a port of entry who is found to be unable or unwilling to return to his or her country of nationality, or to seek the protection of that country because of persecution or a well-founded fear of persecution. Persecution or the fear thereof must be based on the alien’s race, religion, nationality, membership in a particular social group, or political opinion. For persons with no nationality, the country of nationality is considered to be the country in which the alien last habitually resided. Asylees are eligible to apply to adjust to lawful permanent resident status after residing one year in the USA.
Benefit Diversion – A cash assistance alternative to traditional Work First Family Assistance (WFFA). This program offers eligible families the opportunity to choose a one-time payment. This payment is equal to a maximum of three months of WFFA benefits. Other assistance includes Medicaid and Food Stamps while in the program; referrals to child support, child-care assistance; and other community and agency resources. At this time, the Benefit Diversion option is not available for Refugee Cash Assistance applicants.
Budget Unit -- Persons whose income and resources are considered in the determination of eligibility for an individual or family group. For WFFA, the Budget Unit includes everyone who is in the family unit plus financially responsible individuals. Parents or stepparents who are recipients of SSI are not included in the budget unit.
Case Management Services -- The determination of which service(s) to refer a refugee to, referral to such service(s), and tracking of the refugee's participation in such service(s).
CHIP (Children’s Health Insurance Program) –A federal program funded under Title XXI of the Social Security Act. In North Carolina, this program is known as the NC Health Choice for Children, or NCHC.
Cuban/Haitian Entrant -- Any individual granted parole status as a Cuban or Haitian Entrant (Status Pending), or granted any other special status subsequently established under the immigration laws for nationals of Cuba or Haiti, regardless of the current status of the individual at the time of application for Refugee Cash Assistance. This also applies to any other national of Cuba or Haiti who:
o was paroled into the United States and has not acquired any other status under the INA;
o is the subject of exclusion or deportation proceedings under the INA;
o has an application for asylum pending with the CIS; or,
o with respect to whom a final, nonappealable, and legally enforceable order of deportation or exclusion has not been entered.
Date of Entry – date an alien arrived in the US, usually notated on the CIS document. For Refugee Program eligibility for asylees, substitute the date asylum was granted for the actual date of entry.
Deductible (sometimes called a "spenddown") -- An amount for medical expenses which must be paid or incurred by the applicant/recipient or a current budget unit member before Medicaid can be authorized. A deductible results when the countable income of the budget unit members exceeds the established income or maintenance level for the number of persons in the budget unit.
Economic Self Sufficiency -- Earning a total family income at a level that enables a family unit to support itself without receipt of a cash assistance grant.
Eligibility Information System (EIS) – An automated system which provides support for Work First (WFFA), Special Assistance (SA), Medical Assistance (MA), Medicaid for Foster Care and Adoption Children, and Refugee Assistance Programs. It allows entry and retrieval of case and individual data required to produce assistance checks, Medicaid ID cards, and federal, state and county level management reports.
Employability Plan for RCA Recipients – A written, individualized plan for a refugee who is not exempt from work registration that sets forth a program of employment services intended to result in the earliest possible employment of the refugee.
Employability Services for RCA Recipients – Services designed to enable an individual to obtain employment and/or improve the employability or work skills of the individual. These services include, but are not limited to, world-of-work and job orientation, job clubs, job workshops, job development, referral to job opportunities, job search, job placement and follow-up, on-the-job training, vocational training, skills re-certification, and work-related transportation.
Exemptions, RCA-Related – Criteria for exemption from registration for employment services, participation in employability service programs, and acceptance of appropriate offers of employment that apply to Refugee Cash Assistance applicants. Exemptions include a refugee who is:
o under age 18, or is age 65 or older;
o a parent or other relative who is caring for a child under age 2;
o ill or incapacitated, or is required in the home to care for another member of the household who is ill or incapacitated.
A refugee's inability to communicate in English is not a reason for exemption.
Family Unit – For determining eligibility for RCA a family unit is:
o an individual adult, age 18 or older; or
o a married couple without minor children.
Family Self-Sufficiency Plan for RCA Recipients – A required written plan for RCA recipients that addresses the employment service needs of non-exempt members for the purpose of enabling the family to become self-supporting through the employment of one or more family members.
Family Violence Option – To help raise the awareness of families who participate in Work First about the impact that violence can have on individuals and families, and to assure that all individuals seeking assistance are given the opportunity and services necessary to address the violence.
First Stop Employment Assistance – A program administered by the Employment Security Commission (ESC) established to assist applicants and participants of both Work First and Refugee Cash Assistance in becoming employed. Certain local resettlement agencies are also designated First Stop sites where refugees can register for work (see Appendix A).
Food Stamp Program – This program provides benefits to help low-income families purchase food.
Immigration Act of 1990 -- Public Law 101-649 (Act of November 29, 1990), which increased the limits on legal immigration to the United States, revised all grounds for exclusion and deportation, authorized temporary protected status to aliens of designated countries, revised and established new nonimmigrant admission categories, revised and extended the Visa Waiver Pilot Program, and revised naturalization authority and requirements.
Immigration and Nationality Act (INA) -- The Act which, along with other immigration laws, treaties, and conventions of the USA, relates to the immigration, temporary admission, naturalization, and deportation of aliens.
Immigration and Naturalization Service (INS) – See definition for U.S. Citizenship and Immigration Services (CIS).
Job Bonus – A 100% exclusion of earned income for the first three months after a Work First recipient begins employment or after a Work First applicant begins employment or begins working 20 or more hours weekly. At this time, the Job Bonus option is not available to Refugee Cash Assistance recipients or Refugee Medical Assistance recipients.
Local Resettlement Agency/Local affiliate – An agency that contracts with the Department of State and a National Voluntary Resettlement Agency (VOLAG) to provide Reception and Placement services to refugees who reside in the state in which they operate. Services include housing, essential furnishings, food, clothing, and other basic necessities as well as case management and cultural orientation. (See Appendix A for a list of North Carolina Local Resettlement Agencies.)
Match Grant – A federal program designed to help refugees attain economic self-sufficiency within four months (120 days) after date of entry in the United States, without accessing public cash assistance. Participating local resettlement agencies agree to match the Office of Refugee Resettlement (ORR) grant with cash and in-kind contributions for refugees who qualify. Beginning upon enrollment and continuing at least until the first paycheck is received, agencies must provide a minimum of $200 cash allowance per month or $50 per week, or the maximum amount that will not affect Medicaid eligibility, to all adult refugees, and $10 per week to each minor in the case.
Medicaid – A federally-funded entitlement program that provides medical assistance and benefits to individuals who meet eligibility criteria as outlined in the Family and Children’s Medicaid Manual, or in the Aged, Blind, and Disabled (Adult) Medicaid Manual.
Mutual Responsibility Agreement – Core Requirements – An agreement that outlines and describes the Work First family’s specific responsibilities and ways in which the worker will assist the family to achieve them. It includes Core Requirements and Plan of Action Requirements, and is prepared jointly and signed by both the worker and applicant. Reference Economic Independence form DSS-6963A and 6963B (Rev 5/99).
MRF – EIS code for entering Refugee Medical Assistance (RMA) activity. In this document, RMA references will often be displayed as “RMA/MRF” for cross-referencing purposes.
North Carolina Health Choice for Children (NCHC) -- North Carolina’s response to SCHIP, the State Children’s Health Insurance Program, created by Title XXI of the Social Security Act. This program provides health coverage for uninsured low-income children from birth through age 18 who meet eligibility criteria, as determined in the Family and Children’s Medicaid Manual, Section MA-3255.
Numerical Limit, Exempt from --- Those aliens accorded lawful permanent residence who are exempt from the provisions of the flexible numerical limit of 675,000 set by the Immigration Act of 1990. Exempt categories include immediate relatives of U.S. citizens, refugees, asylees (limited to 10,000 per year by section 209(b) of the Immigration and Nationality Act), Amerasians, aliens adjusted under the legalization provisions of the Immigration Reform and Control Act of 1986, and certain parolees from the former Soviet Union and Indochina.
OAA – Old Age Assistance
OASDI – Old Age, Survivors, and Disability Insurance
Office of Refugee Resettlement (ORR) -- The federal agency under the Department of Health and Human Services (DHHS) that coordinates refugee resettlement services at the national level and awards participating states funds to administer the Refugee Resettlement Program which includes Refugee Cash Assistance (RCA/RRF), Refugee Medical Assistance (RMA/MRF), and Refugee Social Services (RAP-SS).
Parolee -- An alien, appearing to be inadmissible to the inspecting officer, allowed into the United States for urgent humanitarian reasons, such as a medical emergency, or when that alien’s entry is determined to be for significant public benefit, such as, aliens who enter to take part in legal proceedings, as well as for some Cuban and Haitian Entrants. Parole does not constitute a formal admission to the United States and confers temporary status only, requiring parolees to leave when the conditions supporting their parole cease to exist. Individuals who are paroled into the USA as refugees or asylees under INA § 212(d)(5) are also eligible for refugee assistance and services.
Permanent Resident Alien - An alien admitted to the United States as a lawful permanent resident (LPR). Permanent residents are also commonly referred to as immigrants. Lawful permanent residents are legally accorded the privilege of residing permanently in the USA. They may be issued immigrant visas overseas by the Department of State or adjusted to permanent resident status by the CIS in the United States. See “Adjustment to Lawful Permanent Resident Status”.
Qualified Alien – This term was created under the Personal Responsibility and Work Opportunity Reconciliation Act of 1996 (PRWORA) to define those non-citizens who are eligible to receive certain Federal public benefits such as Medicaid. Qualified aliens are potentially eligible for all Medicaid programs just like U.S. Citizens. Generally, there are two main categories of qualified aliens: (1) Lawful Permanent Resident (LPR) admitted for permanent residence under the INA, and (2) Aliens Admitted Under a Specific Political Status. Eligibility is based on the date admitted and CIS documentation of alien status. A child(ren) who arrives with a parent(s) carries the same alien status as the parent(s).
Refugee - Any person who is outside his or her country of nationality who is unable or unwilling to return to that country because of persecution or a well-founded fear of persecution. Persecution or the fear thereof must be based on the alien’s race, religion, nationality, membership in a particular social group, or political opinion. People with no nationality must generally be outside their country of last habitual residence to qualify as a refugee. Refugees are subject to ceilings by geographic area set annually by the President in consultation with Congress and must apply to adjust to lawful permanent resident status after residing one year in the USA.
Refugee Act of 1980 (Public Law 96-212) – The Act that created a domestic refugee resettlement program designed to provide assistance and services to refugees resettling in the USA.
Refugee Assistance Program (RAP) – North Carolina’s implementation of the Refugee Resettlement Program, funded under Title IV of the Immigration and Nationality Act, a federal program of assistance and services to refugees resettling in the USA. The North Carolina Refugee Assistance Program provides Refugee Cash Assistance and/or Refugee Medical Assistance for up to 8 months after a refugee’s date of entry in the USA. Federal funding also provides for social services, targeted assistance, child welfare services, including services to unaccompanied minors, and state administrative costs.
Refugee Cash Assistance (RCA/RRF) -- Cash assistance provided to refugees who are ineligible for TANF funds via the Work First Program or other cash assistance programs. Refugee Cash Assistance is limited to eight months beginning with the first month of date of entry in the USA.
Refugee Medical Assistance (RMA/MRF) -- Medical assistance provided to refugees who are ineligible for any of the mainstream Medicaid programs {Family and Children’s Medicaid, Aged, Blind, and Disabled (Adult) Medicaid (MAABD) and NC Health Choice for Children (NCHC)}. Refugee Medical Assistance is limited to eight months beginning with the first month of date of entry in the USA.
Refugee Resettlement in the USA-- Permanent relocation of refugees to the USA, allowing them to establish residence and become productive members of society. Refugee resettlement is accomplished with the direct assistance of private voluntary agencies working with the Department of State under the Reception and Placement Program (R&P) for the first 90 days of resettlement. Refugee Social Services are available through service providers under contract with the State Refugee Office via the US Department of Health and Human Services - Office of Refugee Resettlement.
Registrant – An individual who has registered for employment services as a condition for receiving Refugee Cash Assistance.
Resettlement Agency -- See Local Resettlement Agency.
Resident – Applicant is living in the state of North Carolina voluntarily, and with the intent to remain in the state.
Responsible Person – For these purposes, a responsible person includes, but is not limited to, a representative from a local resettlement agency or National Voluntary Agency (VOLAG), a sponsor, relative, friend, agency staff member, or other personnel acting on behalf of the refugee.
RRF -- EIS code for entering Refugee Cash Assistance (RCA) activity. In this document, RCA references will often be displayed as “RCA/RRF” for cross-referencing purposes.
S.A.V.E. Verification (Systematic Alien Verification for Entitlements) – A Bureau of Citizenship and Immigration Services (CIS) system designed to aid eligibility workers in public agencies in determining an applicant’s immigration status in order to establish the person’s entitlement to receive certain federal public benefits.
Do not verify a refugee’s status via the SAVE system for RMA or RCA benefits unless the documentation appears questionable.
Spend down -- See Deductible.
Sponsor -- An individual, church, civic organization, or other group or organizations that has agreed to help in the reception and initial placement of refugees in the USA. Refugees do not have legally binding sponsors, as no Affidavit of Support is required for the admission of refugees.
Supplemental Security Income (SSI) – A federal assistance program administered by the Social Security Administration for aged, blind, and disabled persons. SSI recipients automatically receive Medicaid.
State Refugee Coordinator – An individual who is designated and authorized by the Governor or the appropriate legislative authority of the State to be responsible for coordination of public and private resources in refugee resettlement and administration of the Refugee Assistance program in that state.
State Refugee Office – The office that oversees the implementation of North Carolina’s Refugee Assistance Program. In North Carolina, it is headquartered within the Department of Health and Human Services, Division of Social Services, Economic Services Section.
Substance Abuse/Mental Health Initiative – To assist families confronted with the barriers of substance abuse and mental health issues, the Program offers screenings and follow-up for both. Screening for substance abuse is required of all participants in the WFFA, and mental health screenings are voluntary.
TANF (Temporary Assistance for Needy Families) -- A revamping of the federal program formerly known as AFDC (Aid to Families with Dependent Children) under Title IV-A of the Social Security Act. It is known as Work First Family Assistance (WFFA) or simply “Work First” in NC.
Targeted Assistance Grant (TAG) – A special grant from the ORR used to supplement current available resources in providing services in localities with large refugee populations, high refugee concentrations, and high use of public assistance. TAGs are primarily used to assist in refugee employment and achievement of self-sufficiency.
Trafficking – Involvement in activity in which a commercial sex act is induced by force, fraud, or coercion, or in which the person induced to perform such act is under 18 years of age; or the recruitment, harboring, transportation, provision, or obtaining of a person for labor or services through the use of force, fraud, or coercion for the purpose of subjection to involuntary servitude, peonage, debt bondage, or slavery.
U.S. Citizenship and Immigration Services (CIS) – Created in 2003, a new bureau under the US Department of Homeland Security (DHS). It is responsible for the administration of immigration and citizenship services. The Immigration and Naturalization Service (INS) formerly provided these services.
Voluntary Resettlement Agency (VOLAG) – A nationally recognized agency that has entered into a grant, contract, or cooperative agreement with the US Department of State to provide for the Reception and Initial Placement of refugees. National VOLAG’s contract with local affiliates in various locations across the country for reception and placement services. The local agency, which operates under the auspices of the national VOLAG, is called a “local affiliate” or “local resettlement agency.” (See Appendix A for a list of local affiliates.]
Work First Family Assistance (WFFA) – The component of NC's TANF program that provides cash and medical assistance and is designed to promote self-sufficiency built upon strategies that include promoting work, requiring personal responsibility, helping families get and keep jobs, locating absent parents, and reducing out-of-wedlock births. Implemented in 1995, the program requires active caretakers to participate 30 hours/week in work or work-related activities.
Any refugee seeking financial assistance must be evaluated for Work First eligibility before being considered for Refugee Cash Assistance (RCA/RRF).
IV. REFUGEE Agencies
A. Resettlement Agencies
A Local Resettlement Agency, or “local affiliate”, operates under the auspices of a national VOLAG (Voluntary Agency) and under contract with the U.S. Department of State to provide Reception and Placement services at the local level. The State Refugee Office and local departments of social services work in partnership with these agencies to provide the necessary continuum of services for refugees. The local resettlement agency may refer refugees to apply for public assistance benefits - most commonly, food stamps, medical, and cash assistance. When sending a refugee to apply for assistance, the local affiliate will send a Notification of Refugee Arrival and Intent to Apply for Benefits (Appendix D). See Appendix A for a list of North Carolina Local Resettlement Agencies.
1. Resettlement and Placement (R&P) Services: For the first 30 days in the country, R&P services are usually provided by local resettlement agencies to refugees who arrive under Section 207. These services include help with housing, essential furnishings, food, clothing, and other basic necessities.
2. Match Grant Program: Some local resettlement agencies participate in the federal Match Grant Program. This program gives financial assistance to employable refugees who enroll for up to 4 months (120 days) from date of date of entry. Agency participation is optional and contingent upon the availability of funds; therefore, not all of North Carolina's local resettlement agencies participate and not all clients of a participating agency receive Match Grant. If a Match Grant Agency sends a refugee to apply for public benefits, they will also send a Notification of Refugee Arrival and Intent to Apply for Benefits (Appendix D) noting whether or not the refugee receives Match Grant. Refugees receiving a Matching Grant are automatically ineligible for cash assistance through Work First or Refugee Cash Assistance for the duration of the Match Grant.
NOTE: Not all refugees are associated with a local resettlement agency. This does not affect eligibility for refugee benefits.
B. Service Agencies
NC refugee service providers contract directly with the State Refugee Office to provide a wide variety of ongoing refugee-specific services such as delivery of or coordination of English Language Training (ELT), translation and interpretation, case management, employment services, outreach, and Emergency Services. These services can last for 5 years or more.
1. Local Affiliates – Some local affiliates also contract to provide ongoing services to refugees after the initial R&P.
2. Non-Affiliates – Agencies who are not involved in the initial R&P, but who contract to provide ongoing services to refugees.
A listing of all agencies, local affiliates as well as non-affiliates that provide refugee-specific services in North Carolina, can be found in Appendix B, NC Refugee Service Providers. This list contains location and contact information, and includes the primary services provided and counties served by each agency. A refugee may receive services from more than one service provider.
All refugee service providers funded under contract with the State Refugee Office are available to offer assistance, within their realm of expertise, to other agencies that offer assistance to refugees in North Carolina.
CHAPTER II – REFUGEE MEDICAL ASSISTANCE PROGRAM
I. INTRODUCTION
Refugees who resettle in the USA have often been living in poor conditions, many in refugee camps, with inadequate or no health care. Since restoration of good health is a key factor in becoming self-sufficient, refugees may apply for medical assistance at the local Departments of Social Services (DSS).
Refugee Medical Assistance (RMA/MRF) is the program of last resort. Therefore, the agency must first assess each individual refugee applicant for Family and Children’s Medicaid, Aged, Blind, and Disabled (Adult) Medicaid and NC Health Choice for Children (NCHC). Refer to the Family and Children’s Medicaid Manual and the Aged, Blind, and Disabled (Adult) Medicaid Manual.
NOTE: At age 18, a refugee is potentially eligible for Refugee Cash Assistance. Explore this option before considering Family and Children’s Medicaid (M-AF) only.
NOTE: Refugees 65 years of age or older, or who are blind or disabled, would meet criteria for the Supplemental Security Income (SSI). However, since the SSI approval process is typically a lengthy one, the state authorizes receipt of RMA until the refugee applicant is approved for SSI, or until the 8-month RMA eligibility period expires--whichever comes first.
The North Carolina Refugee Medical Assistance Program (RMA) was established to provide health care to needy refugees who do not meet qualifications for any other health care program. RMA is a short-term transitional program available for the first eight months a refugee resides in the USA. In determining eligibility for RMA, the county DSS (herein referred to as the agency) must comply with the policies and procedures described in this chapter of the NC Refugee Assistance Manual. In providing RMA to refugees, the agency must provide at least the same services in the same manner and to the same extent as provided under the North Carolina Medicaid program.
NOTE: Throughout this Chapter, the term “refugee” will refer to all groups below, who are Qualified Aliens, and potentially eligible for RMA. See Chapter I., III. for definitions.
• Refugees
• Asylees
• Certain Cuban and Haitian Entrants
• Certain Amerasians (from Vietnam)
• Trafficking victims
• Lawful Permanent Residents (LPR) who held one of the above statuses prior to adjusting to LPR status
II. ELIGIBILITY GUIDELINES
A. Determine eligibility for RMA
After you have determined that a refugee individual is not eligible for Family and Children’ Medicaid, Aged, Blind, and Disabled (Adult) Medicaid, or NCHC, you are ready to determine eligibility for RMA.
1. Process the application immediately and automatically for RMA/MRF eligibility.
2. Do not require additional contact with the applicant.
3. Do not change the application date.
B. To be eligible for RMA, a refugee must:
1. Be unable to meet the eligibility requirements for Family and Children’s Medicaid, Aged, Blind, and Disabled (Adult) Medicaid, or NCHC, and,
2. Be in the USA 8 months or less, or have eligible status, such as asylee, for 8 months or less; and
3. Have the proper immigration status and documentation or be the dependent child of, and part of the same family unit as, an individual who meet the proper immigration status; and
4. Not be a full-time student in an institution of higher education; and
5. Live in North Carolina with the intent to remain.
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