SECTION II – ASSISTANCE AND SERVICES
A. CASH AND MEDICAL ASSISTANCE
Cash and Medical Assistance
DPW’s Office of Income Maintenance administers RCA and RMA through its CAOs. DPW administers these programs pursuant to 55 Pa. Code Section 293.1 (www.pacode.com) which incorporates regulations found at 45 CFR Chapter 400, Subparts E and G.
Pennsylvania will operate the refugee cash assistance program consistent with the provisions of its TANF program as per 45 CFR Section 400.66.
Eligibility for RCA is limited to those refugees who:
1. Are new arrivals, who have resided in the United States less than the RCA eligibility period determined by the ORR Director in accordance with 45 CFR Section 400.211;
2. Are ineligible for Temporary Assistance for Needy Families (TANF), Supplemental Security Income (SSI), Old Age Assistance (OAA), Aid to the Blind (AB), Aid to the Permanently and Totally Disabled (APTD), or Aid to the Aged, Blind, and Disabled (AABD) programs;
3. Meet immigration status and identification requirements in Subpart D of Part 400 or are the dependent children of, and part of the same family unit as, individuals who meet the requirements in Subpart D, subject to the limitations in 45 CFR Section 400.208 with respect to non-refugee children;
4. Are not full-time students in institutions of higher education, as defined by the ORR Director; and
5. Are determined financially eligible.
Eligibility for RCA is determined using TANF income and resource requirements and need standards found at 55 Pa. Code Sections 175.21, 183.11 and 183.101.
The procedure used to determine eligibility for RCA is:
1. The CAO determines the refugee eligibility for TANF before determining eligibility for RCA. Eligibility is determined as it would be for any other TANF client. If ineligible for RCA, eligibility for General Assistance is determined.
2. Eligibility for SSI, OAA, AB, APTD or AABD must be determined for refugees who are 65 years of age or older, or who are blind or disabled. If the refugee is eligible for RCA, the CAO must furnish such assistance until eligibility for SSI, OAA, AB, APTD, or AABD is determined.
3. The CAO will consider only those resources available at the time assistance is needed. Any resources remaining in the applicant’s country of origin are excluded in determining income eligibility.
4. A sponsor’s income and resources may not be considered when determining a refugee’s income eligibility.
5. Any cash grant received by a refugee under the Reception and Placement Programs may not be considered in determining income eligibility.
6. The date of application is used as the date of RCA authorization, if eligible, regardless of the date that eligibility was determined.
7. Each RCA applicant and recipient is informed about eligibility regulations and the rights and responsibilities of applicants and recipients of RCA. These rights and responsibilities are available in Spanish, Russian and Vietnamese, and are translated into other languages as needed.
8. Notices that clearly explain the reasons for TANF ineligibility are provided to refugees who apply for cash assistance and are found ineligible for TANF, but are found eligible for RCA. Notices of eligibility for RCA are also provided.
Note: An asylee’s date of entry will be the date the individual is granted asylum in the U.S. The eight months of eligibility for RCA will begin on the date asylum is granted.
The State will notify the refugee’s local resettlement agency which provided for the refugee’s initial resettlement whenever the refugee applies for RCA as per 45 CFR Section 400.68.
The following steps are taken to determine RMA eligibility for refugees:
1. Eligibility must first be determined for Medicaid and Children’s Health Insurance Program (CHIP) prior to determining RMA eligibility.
2. Individuals who do not meet the categorical requirements for any TANF-related Medicaid, SSI-related Medicaid or CHIP, qualify for RMA if:
· The refugee meets immigration status and identification requirements applicable to RMA; and
· Meets the income and resource requirements for RMA based on the applicant’s income and resources on the date of application.
3. Resource eligibility is determined for RMA using Medically Needy Only (MNO) resource limits based on the number of persons in the budget group. Resources are excluded for all applicants/recipients with a natural or adoptive child under 21 years of age (including unborn children) living in the household.
4. Income eligibility for RMA is determined by applying the TANF-related MNO income disregards and comparing total countable income of the budget group to 185 percent of the Federal Poverty Income Guidelines (FPIGs).
5. In-kind services and shelter provided to an applicant by a sponsor or VOLAG is excluded in determining eligibility for and receipt of RMA.
6. Cash assistance payments made under the RCA program, the Reception and Placement Programs and Match Grant Programs are excluded and not counted when determining eligibility for RMA.
7. If a refugee, who is receiving RCA, TANF or Medicaid and has been residing in the U.S. less than the time-eligible period for RMA, becomes ineligible for RCA, TANF or Medicaid because of earnings from employment, the refugee is automatically transferred to RMA without an eligibility redetermination.
8. Earnings are disregarded and RMA benefits are continued for refugees who are receiving RMA and receive earnings from employment until the recipient reaches the end of the time-eligibility period (eight months).
9. Applicants for RMA who do not meet the financial eligibility standards (185 percent of the FPIGs) are permitted to spend-down to such a standard using deductions incurred for medical expenses.
Note: An asylee’s date of entry will be the date the individual is granted asylum in the U.S. The eight months of eligibility for RMA for the asylee will begin on the date they are granted asylum.
The Commonwealth of Pennsylvania extends to entrants under the Cuban/Haitian Entrant Program (CHEP) those same benefits and services available to refugees under Title IV of the Immigration and Nationality Act. For the purposes of determining the eligibility of Cuban/Haitian Entrants for cash and medical assistance, the same standards and criteria shall be applied to entrants as are applied to refugees under 45 CFR §400.62. The same social services available to the refugees provided directly or purchased by the Commonwealth of Pennsylvania and funded with federal funds will also be made available to entrants.
SECTION II - - ASSISTANCE AND SERVICES
B. SERVICES
Employment Services
The Road to Economic Self-Sufficiency through Employment and Training (RESET) Program is Pennsylvania's welfare reform program for helping welfare clients move into the workforce and become self-sufficient. To this end, refugee service providers are engaged to supplement the CAOs efforts in assisting clients to find, retain and advance in employment so that they can become economically independent and self-sufficient.
All employable refugees receiving RCA or TANF are required to participate in an employment program administered by a refugee social services contractor and are referred to the appropriate contracted employment services program at the time of application by the CAO. If the refugee has been in the U.S. for less than five years, he/she is referred to a refugee specific employment services program. If the refugee has been in the U.S. for over five years, he/she is referred to a mainstream employment provider. Employment participation requirements are the same for and applied uniformly to refugee and non-refugee TANF recipients. These requirements are found in 55 Pa. Code Chapter 165 (www.pacode.com) (see Appendix B). However, as per Title 45 CFR Section 400.67, TANF work requirements may not apply to RCA recipients. Sanctions are applied to refugees who do not cooperate with Refugee Employment Service Providers.
A refugee who is not exempt from employment requirements must cooperate with the employment service provider designated to provide services to the refugee. To be exempt from employment requirements, a refugee must be:
Before referring the refugee to the employment services provider, CAOs are required to complete an Agreement of Mutual Responsibility (AMR) for each refugee and include the number of employment activity hours required to be completed by the client. For clients who have good cause to participate for fewer than the required hours per week, the CAO will include on the AMR, the number of hours required to be completed by the client. A copy of the AMR is given to the Service Provider, who must ensure that this information is provided to the client’s employment specialist prior to the completion of the refugee’s Employment Service Plan (ESP).
Refugee service providers assisting clients in the development of employment activities must ensure that both the federal and state requirements are met.
In an effort to assist refugees to adjust to cultural differences in the U.S. and if needed, to attend English Language Training classes, required hours of participation in employment activities will be applied on a gradual basis. DPW has adopted the following gradual engagement policy for refugees:
A refugee receiving RCA must accept, at any time, from any source, an offer of employment. The State will contact the recipient’s sponsor or the local resettlement agency concerning offers of employment as per 45 CFR Section 400.68.
Pennsylvania requires periodic redetermination of eligibility for all public assistance programs. Refugees are redetermined for cash and medical assistance on the same schedule as non-refugee clients. These requirements are found in 55 Pa. Code Chapter 133 (www.pacode.com).
Pennsylvania will follow the procedures outlined in 45 CFR §400.54 and will provide the same notices listed in 55 Pa. Code Chapters 125 and 133 to the refugee as it provides to any other applicant/client (www.pacode.com). The notices will be available in English and in the appropriate language(s) of the respective recipient population.
In accordance with 45 CFR Section 400.83 (a), Pennsylvania will follow the TANF compliance review procedures found at 55 Pa. Code 165.51. The compliance review takes the place of Mediation/Conciliation.
The refugee has the right to request a fair hearing when any benefit is denied, terminated, reduced or suspended. All hearing requests will be referred to the Department of Public Welfare, Bureau of Hearings and Appeals and will be processed according to established regulations, policy and procedures found at 55 Pa. Code Chapter 275, Appeal and Fair Hearing and as per 45 CFR Sections 400.54 and 400.83 (b).
If the refugee is appealing because he believes the CAO is using an incorrect date of entry, the CAO will resolve the issue by inspecting the refugee’s INS documents and notifying INS that there is no need for a fair hearing.
Non-TANF Refugees
Refugees who have not obtained employment through Reception and Placement or Match Grant Programs are automatically referred to refugee employment service providers by those programs after they are terminated from those programs. In addition, outreach is conducted by all employment service providers to encourage refugees who are not receiving cash assistance to register for employment services, if desired.
English Language Training (ELT)
The lack of English proficiency can be a major barrier to securing and maintaining employment and, therefore, can impede a refugee’s attainment of self-sufficiency. Participation in ELT is required for all employable refugees, if needed. As part of the Family Self-Sufficiency Plan, ELT is made available to all eligible refugees in each region through contracted ELT providers. In addition to contract services, refugees may participate in mainstream ELT programs.
The duration of the ELT will depend upon the proficiency level of the individual. Refugees are encouraged to continue their ELT after obtaining employment by attending classes available through employers (Vocational ELT) and at times that do not interfere with their work schedules. ELT is made available concurrently with employment or employment related activities outside normal business hours and to accommodate those individuals working different shifts.
Priority of Service Provision
Except in certain extreme circumstances, the state provides RSS in the following order of priority:
The Commonwealth provides services through Targeted Assistance funding in the following order of priority:
Time Eligibility
With the exception of translation/interpretation, referral and citizenship services, the refugee population’s time-eligibility period for services is 60 months from their date of arrival.
Bilingual/Bicultural Requirements
To the maximum extent possible, all refugee service providers provide services in a manner that is culturally and linguistically appropriate and includes the use of bilingual/bicultural women on agency staff.
To further ensure that services are provided in a culturally and linguistically appropriate manner, the Commonwealth of Pennsylvania enters into contracts with Mutual Assistance Associations (MAAs), which provide services to specific ethnic groups. In addition, many refugee service providers have collaborations with MAAs throughout the Commonwealth.
Family Self-Sufficiency Plan
Employment service is the key to the self-sufficiency of refugee families. All refugee employment service providers must complete a Family Self-Sufficiency Plan (FSSP) for each refugee participating in employment services. This plan must include a series of well-planned activities that enhance vocational, educational and personal strengths while addressing linguistic and cultural barriers to self-sufficiency. Achieving independence for refugee families through long-term employment in a non-subsidized job is the goal of the FSSP.
The FSSP includes an employment assessment and an ESP for each employable refugee. The ESP includes all support services that need to be provided, by whom, and how these services will lead to employment and self-sufficiency. The ESP must include specific time frames for the provision and completion of all necessary support services. The ESP is the essential planning document around which all services, including case management, vocational training, and ELT, as well as employment services, are provided. The ESP is completed in coordination with other service providers and, if the individual is receiving cash assistance, the CAO; and a copy is given to those agencies when completed. The ESP is updated every time an individual’s goals change and a copy of the revised ESP is given to the CAO if the individual is receiving cash assistance.
If an individual is receiving cash assistance, the copy of the ESP forms a basis for continued eligibility for refugee cash and medical assistance. As part of the cash and medical assistance recipient’s re-determination review, the refugee employment service provider is required to submit an updated ESP with a case management plan in order to ensure integration of the overall planning process for the refugee. The updated ESP and case management plan is then made part of the refugee’s public assistance case file and incorporated into the AMR.
SECTION II – ASSISTANCE AND SERVICES
C. UNACCOMPANIED REFUGEE MINOR CHILDREN
As of July 2005, the Commonwealth of Pennsylvania’s URMP is administered by DPW/OIM through a contract with Lutheran Children and Family Service (LCFS) of Southeastern Pennsylvania. Typically, services provided for these children are custodial foster care placement, case management services, supervised independent living, medical assistance and cash assistance. Reporting and record keeping for this program is in accordance with 45 CFR §400.120 and §400.28.
The URMP in Pennsylvania is part of a national effort to resettle unaccompanied refugee minors in the U.S. Minors are selected through a complex process administered by the United States Citizenship and Immigration Service (USCIS) and the United States Department of State. Often, children are identified for resettlement because of humanitarian concern. A joint committee of VOLAGS assigns minors to their respective state affiliates. Currently, most states have a single VOLAG designated to resettle minors. In Pennsylvania, LCFS is designated as that agency. Funding for URMP is completely reimbursed through the Federal ORR.
Once it has been determined that the minor will be resettled by LCFS, the agency processes the required paperwork and notifies the RRP of its intention to place the minor in care. LCFS then petitions the Montgomery County Court system for custody of the child and works on foster care home placement. Some unaccompanied refugee minors may be placed in semi-independent living situations or in residential centers. LCFS works cooperatively with other resettlement agencies and with the Office of Children and Youth Services to ensure that refugee minors receive appropriate care.
Legal responsibility for the unaccompanied refugee minor is vested in LCFS. Within 30 days of resettlement, LCFS prepares a written service plan which identifies the daily care and treatment to be provided. LCFS then submits the ORR 3 Placement Report to ORR and the RRP.
Unaccompanied minors are eligible for the same range of social services that other needy Pennsylvania children receive. Social services are provided until the minor reaches the age of 21 years or until self-emancipation or family reunification occurs. Services include foster care, supervised independent living, child protective services, community residential care, counseling, day care, emergency shelter service, homemaker service, information and referral service, life skills, education and service planning.
ORR 4 Progress Reports for unaccompanied minors are submitted annually in June to the ORR URM Program Director.
SECTION II – ASSISTANCE AND SERVICES
D. MEDICAL SCREENINGS
In accordance with 45 CFR §400.107, Pennsylvania utilizes Medicaid funds for refugee families and RMA funds to provide medical benefits for single adult refugees. The health screening procedure is also funded through these benefits. Health screenings and follow-up care procedures are issued medical codes so that the appropriate Federal program is billed. Through the CAO, a Medical Assistance Access Card is issued to the refugee and a health screening is scheduled by staff at the VOLAG. If refugees are arriving with specific health concerns, VOLAGS are made aware of these conditions by their national affiliate and health screenings are scheduled as soon as possible to provide for continuity of care.
Additionally, the Office of Medical Assistance in Pennsylvania provides transportation to medical appointments should refugees need this service. Often, VOLAG caseworkers accompany refugees to health screenings and follow-up appointments if the refugees feel more comfortable with that arrangement.
The RRP defers to the VOLAGS who receive information pertaining to medical needs as these organizations are the first point of contact for arriving refugees. Medical examinations performed overseas are forwarded to resettlement agencies for reference, as well as the Department of Health’s Office of Communicable Diseases if the case pertains to tuberculosis and other infectious diseases. Also, copies of the exams are forwarded to the RRP as a courtesy. Biographical data from these are stored electronically and in paper form should VOLAG, RRP or Department of Health staff need to revisit a particular case.
Staff from the RRP participates in monthly and quarterly conference calls held by the Association of Refugee Health Coordinators and ORR to keep apprised of refugee health issues. New and follow-up data provided in those calls are disseminated to refugee service providers. This enables agencies to better prepare themselves for any health problems associated with their newly arrived or soon-to-be arriving refugees.
Refugee program staff also receives daily email notifications from the Centers for Disease Control (CDC) via the Epi-X confidential information-sharing system. These notices serve the purpose of alerting the RRP to arriving refugee groups with specific health issues that may require special attention. If action is required by the CDC, the RRP works closely with the resettling VOLAGS to ensure that proper and timely care is given to the affected refugees.
In addition to reporting to their national affiliates, VOLAGS periodically update RRP staff with unusual numbers of refugees arriving with the same health concerns, as well as any findings by the medical provider that seem out of the ordinary.
State Refugee Coordinator: Normanne Rothermel
Designated State Agency: Department of Public Welfare
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Normanne Rothermel Date