In East Asia, the Bureau funds English-as-a-Second-Language and Cultural Orientation (ESL/CO) programs in Thailand and the Philippines. At these sites adult Indochinese refugees ticipate in a 20-week program consisting of ESL, CO, and Work Orientation. A special program for 11% to 16 year olds, Preparation for American Secondary Schools (PASS), includes instruction in English, American Studies, basic math, and school orientation. In the Philippines, a program for 6 to 11%2 year olds, Preparing Refugees for Elementary Programs (PREP), also provides instruction in English, basic math, and school skills. In FY 1990 over 40,000 Indochinese refugees, including Amerasians departing Vietnam under the Orderly Departure Program, are expected to complete this training. In In Europe, the Bureau has funded short Cultural Orientation programs since 1983 for Eastern European refugees who have been accepted for U.S. resettlement. Because the Eastern European caseload is expected to drop sharply in FY 1991 and beyond, the Bureau will phase out these programs by the end of FY 1990. Aizica, the Bureau conducts a small Cultural Orientation program in Botswana for U.S.-bound refugees who come primarily from Angola, Namibia, and the Republic of South Africa. By the e of FY 1990, an orientation program will also be in place in Kenya to provide services primarily to Ethiopian refugees en route to the United States. The Office of Refugee Health (ORH), in the Office of the Assistant Secretary for Health, Department of Health and Human Services (HHS), is the focal point for all activities of the U.S. Public Health Service in refugee health. The ORH develops health and mental health policy and identifies problem areas and solutions. Public Health Service agencies active in refugee matters include the Alcohol, Drug Abuse, and Mental Health Administration, the Centers for Disease Control, and the Health Resources and Services Administration. Close and regular consultative relations are maintained with the Department of State (DOS), Department of Justice, HHS's Office of Refugee Resettlement, State and local health departments, and with international organizations such as the United Nations High Commissioner for Refugees (UNHCR) and the International Organization for Migration (IOM). Routine U.S. Public Health Service refugee operations include: Monitoring of the quality of medical examinations provided to refugees in Southeast Asia and worldwide through training conferences; Inspection of each refugee at the U.S. port of entry; Notification of local health department of each refugee Administration of a preventive health program which provides for refugee health assessments locally following resettlement. Special initiatives undertaken or completed recently have included: Consultation with DOS and IOM to develop an effective and reliable medical screening process in Moscow for Soviet refugees departing to the United States directly from MOSCOW; Consultation with ORR to provide mental health training Implementation by IOM of a routine hepatitis B vaccination program for all Southeast Asian refugee children age 6 and below in the Refugee Processing Centers (RPCs); and Consultation with GAO on Asian Americans: a Status Report developed for the House of Representatives (GAO/HRD-90-36FS), which documents the medical and mental health needs of Southeast Asian refugees. Initial Reception and Placement and the Refugee Data Center In 1982 the Administration along with the voluntary agencies established a set of principles intended to improve initial refugee placement in this country and to discourage refugees from secondary migration. Since then, initial placement of "free case" refugees (those without anchor relatives) in heavily impacted areas (where numbers of refugees have strained local public services) has not been a permitted resettlement practice. Under Reception and Placement (R&P) program cooperative ancements administered by the Bureau for Refugee Programs, twelve private voluntary agencies are responsible for providing initial resettlement services to refugees during their first 90 days in the United States. Voluntary agencies receive per capita funding ($560 in FY 1990), which is to be used along with cash and in-kind contributions from private and other sources. Refugee reception and placement services include: In FY 1990 the Bureau's on-site monitoring of the Reception and Flacement program included in-depth reviews of refugee resettlement in seven states. As a result of the monitoring, strengths and weaknesses of voluntary agency programs have been identified, and where needed, corrective action has been recommended. In FY 1990 the domestic resettlement program will have witnessed the first large-scale arrival of reeducation ex-detainees exiting Vietnam through the Orderly Departure Program. Based on interviews conducted between October 1989 and July 1990, 15,526 reeducation ex-detainees and accompanying family members will be coming to the United States. At least 60 percent of the cases will be joining family in the United States. Amerasians continue to be resettled in the United States, with 15,000 Amerasians and accompanying family members estimated to arrive during FY 1990. 5. Transportation The Department of State funds the transportation of refugees resettled in the United States through a program administered by the Intergovernmental Organization for Migration (IOM) which includes funding for international and domestic airfares, IOM processing, medical screening, communications, documentation, and transit accommodations where required. The cost of the airfares (over 80 percent of this total) is provided for refugees in the form of a loan; loan beneficiaries are responsible for repaying a designated sum over time after resettlement. Funds provided for transportation loans and related services cover most refugees resettled in the United States. Amerasian immigrants receive services provided to refugees. Other immigrants enter the United States on prepaid tickets. 6. Ongoing Domestic Resettlement Programs Federal resettlement assistance to refugees is provided by the HHS Office of Refugee Resettlement (ORR) primarily through a State-administered refugee resettlement program. - 35 ORR funds States for the provision of cash assistance, medical assistance, and social services for refugees. Under regulations that took effect on July 1, 1989, ORR requires that States give top priority to English language training and employment services in their programs for refugees. During FY 1990, approximately 85 percent of all ORR social service funds allocated to States ($63 million) is expected to be used for these priority activities. The Department of Education has funded some special educational services for children resettled in the United States through its Transition Program for Refugee Children. This program has included English language training for refugee children in elementary and secondary schools where a demonstrated need has been shown. In FY 1989, approximately $15.8 million was awarded to 47 States for the provision of these educational services on behalf of 74,084 refugee children. Since FY 1980, over $156 million has been appropriated and awarded to help refugee children. In FY 1990, funds were not appropriated for the Transition Program. ORR also provides matching funds on a dollar-for-dollar basis to voluntary resettlement agencies for the provision of comprehensive services in resettling refugees. This Matching Grant Program, which originated as an alternative initial resettlement approach for Soviet and Eastern European refugees during a period of high arrival rates in 1979 and 1980, is now available to resettlement agencies on behalf of any refugee group but is still principally used for Soviet and Eastern European refugees. Matching grants fund a wide range of activities including case management, employment services, maintenance assistance, and support services (English language training and health services). In FY 1990, ORR is providing $54.936 million to the voluntary resettlement agencies in matching funds for assistance and services. The Fish/Wilson Amendment to the Immigration and Nationality Act, contained in the FY 1985 Continuing Resolution on Appropriations, enables ORR to develop alternative projects which promote early employment of refugees. It provides to States, voluntary resettlement agencies, and others the spportunity to develop innovative approaches for the provision of cash and medical assistance, social services, and case management. In the summer of 1985, ORR awarded grants to the States of California and Oregon for demonstration projects designed to decrease refugee reliance on welfare and to promote earlier economic self-sufficiency. Both of these projects got fully - 36 under way in FY 1986 and continued to operate through FY 1989. An application submitted by the United States Catholic Conference for a project in San Diego -- to be operated by USCC's affiliate, Catholic Community Services was approved, with funding dependent upon submission of a new budget and resolution of several State and county issues. - The California Refugee Demonstration Project (RDP) On July 1, 1985, the State of California began implementing a 3-year refugee demonstration project (RDP). The RDP is designed to test whether the removal of refugee employment disincentives in the AFDC program, such as the 100-hour rule, will result in more refugees becoming employed and to test the effects of increased employment experience upon2refugee self-sufficiency. The project intends to: (1) increase the participation of refugees in employment services and training programs specifically designed for refugees; (2) increase refugees' potential for economic independence by allowing them a transition into entry-level full-time employment without immediately forfeiting the entire cash grant and other benefits; and (3) reduce long-term program costs through grant reductions as a result of employment. Generally, RDP participants are eligible for the same level of cash assistance that they would receive under AFDC but are subject to the requirements of the RDP, which are similar to those for the refugee cash assistance (RCA) program. In FY 1989, California applied for and received an extension of the RDP until September 1990 to maintain services to refugees until the California Greater Avenues for Independence (GAIN) program is fully implemented for AFDC clients in all countries. However, with the reduction of the period of Federal reimbursement for the State's share of AFDC costs to 4 months after a refugee's arrival, effective January 1, 1990, California stopped enrolling new arrivals and began phase-out of current clients. Touche Ross, under contract to the State of California Department of Social Services, evaluated the results of the first three years of the demonstration. In its Final Report, dated August 18, 1989, it reported mixed results: RDP participants entered employment at a higher rate - with the 100-hour rule waived in the RDP, the percentage of refugees who worked more than 100 hours while on assistance increased substantially from 12 percent for |