Office Of Refugee Resettlement: Data

Repatriation Annual Report

1-Overview | 2-Service Overview | 3-Training of U.S. Repatriation Program Partners | 4-Information Dissemination

U.S. REPATRIATION PROGRAM

#90RR0002

FINAL REPORT

OCTOBER 1, 2004 – September 30, 2005

Submitted by
International Social Service, United States of America Branch
207 E. Redwood Street, Suite 300
Baltimore , MD 21202
Tel: 443-451-1201
iss-usa@iss-usa.org

International Social Service-United States of America (ISS-USA) Branch was awarded a continuation of the cooperative agreement with Department of Health and Human Services, Office of Refugee Resettlement for the U.S. Repatriation Program for the project period of October 1, 2004 through September 30, 2005. The following report provides a summary of ISS-USA involvement in the U.S. Repatriation Program for that year.

I. Overview

ISS-USA has administered the U.S. Repatriation Program for eight years through a worldwide network of service agencies and partnerships in each of the 50 U.S. states. Since the first case managed by ISS in 1997, over 1,436 U.S. citizens have been repatriated and assisted in resolving psychiatric, medical, legal, abuse/abandonment, and/or financial crises. Without this service, the fate of the most vulnerable population of U.S. citizens (children, elderly, the mentally ill, and medically frail) would have been uncertain at best. Underscoring this fact, is the sad reality that a number of individuals referred for repatriation assistance have received it, but died before they were returned to the USA.

II. Service Overview

A. Repatriate Arrival Count

ISS-USA has provided expert social work service and consultation around the clock, extending care and protection to U.S. repatriates worldwide. In 2005, services have been provided in 198 repatriation cases. The chart below details comparison figures for the period 1997 through 2005.

Fiscal Year (October through September)	Number of Referrals for Service	Number of Individuals Repatriated
1997	165	167
1998	203	137
1999	187	152
2000	134	124
2001	180	140
2002	198	160
2003	223	182
2004	179	205
2005	198	169
Total	1667	1436

Working with the Office of Refugee Resettlement, Department of State and a network of local providers, ISS-USA has assisted individuals with a wide range of health, mental health, economic, social and legal crises. Case management and assessment services are available to all U.S. repatriates. Additional assistance has also been provided to program recipients geared to crisis remediation, stabilization and reintegration into the “home” community.

B. Types of Assistance Requested*

Types of assistance provided to repatriates for the period 1997 through 2005 are enumerated below. We anticipate that the assistance requested in the coming period will mirror the patterns below.

	1997	1998	1999	2000	2001	2002	2003	2004	2005
Financial	52	41	94	55	59	68	82	148	94
Food	29	29	54	20	37	20	22	62	26
Travel	83	63	58	58	98	86	31	26	27
Clothing	5	2	1	4	13	6	10	80	30
Ambulance	15	5	10	3	5	12	16	44	17
Police	1	4	0	0	2	1	3	1	1
Hospital	28	38	39	32	39	55	44	66	54
Escort	13	21	7	7	19	31	37	8	3
Shelter	34	44	64	45	66	95	85	134	108
Wheel Chair	12	4	1	2	5	16	8	2	12
Medical	21	15	37	30	27	46	58	64	62

*There may be more than one type of assistance per case.

C. Reasons for Repatriation*

Understanding the history of reasons repatriation assistance has been requested provides significant insight about the crises that Americans experience abroad. This understanding is critical for future planning. The following details by category and year the reasons for repatriation for the period 1997 through 2005:

	1997	1998	1999	2000	2001	2002	2003	2004	2005
Medical	17	18	17	21	27	30	34	32	21
Psychiatric	32	37	50	48	47	62	62	48	** 20
Financial	53	57	110	96	81	63	91	84	136
Family Crisis	5	12	11	11	12	25	14	5	21
Victim of Crime	10	3	11	8	9	7	7	3	5
Arrested	2	8	10	5	8	11	11	9	11
War, Civil Unrest, Nat. Dis.	4	3	2	0	0	0	0	6	1

*There may be more than one type of assistance per case
** Under count under review

Additional insight regarding trends in the program may be gleaned through analysis of the origin of the repatriation request. The following chart details the ‘requester’ of repatriation for all referrals received by ISS-USA during the period of this report.

Origin of Repatriation Request 2005
Repatriation Requested by Repatriate	155
Repatriate Deported by Host Country	26
Repatriation Ordered by Department of State	11
TOTAL	192

D. Countries of Debarkation

The following chart confirms how broadly repatriation services have reached, detailing the number of repatriation cases by country of debarkation.

COUNTRY	2005
Argentina	1
Australia	1
Azerbaijan	1
Barbados	2
Belgium	2
Belize	2
Bermuda	2
Brazil	3
Cameroon	1
Canada	1
China	7
Colombia	1
Costa Rica	3
Cuba	1
Dominican Republic	1
El Salvador	2
Ethiopia	2
France	3
Greece	2
Guatemala	4
Guyana	1
Haiti	1
Honduras	4
Hong Kong	1
India	6
Iraq	1
Israel	2
Jamaica	1
Jordan	1
Kenya	2
Korea	3
Kuwait	1
Laos	1
Latvia	1
Macedonia	1
Mexico	54
Morocco	2
Nepal	1
Netherlands	5
New Zealand	1
Nigeria	1
Panama	5
Philippines	8
Poland	1
Russia	2
Singapore	1
Spain	1
Sudan	1
Syria	1
Taiwan	1
Thailand	7
Tunisia	1
Turkey	1
Uganda	1
United Kingdom	10
Venezuela	1
Vietnam	1
Yemen (Sanaa)	1
Zimbabwe	1
TOTAL	178

E. Destination States

The ultimate success of the program relies on the quality of assistance that can be secured by ISS-USA in the state of destination. Thus, the ISS-USA works to preserve and sustain the extensive relationships with public and private human service agencies that it has established throughout the U.S. These relationships have enabled us to develop and implement comprehensive case plans. Maintaining regular contact with local providers, their parent agencies, their state cohorts and their national coordinating and professional bodies has been an ongoing priority, an activity that ISS-USA believes has yielded significant results. The following details by service year the number of individuals repatriated by state of final destination:

	Year
Final Destination	1997	1998	1999	2000	2001	2002	2003	2004	2005	Grand Total
Alabama	1	2	3				2	1	2	11
Alaska			2	1	1	2		2		8
Arizona		4	4	4	4	4	5	1	2	28
Arkansas	1		1	1			1	1	1	6
California	26	50	29	19	29	35	43	35	26	292
Colorado	3	3		1		4	2	2		15
Connecticut		1	1	1	2		3	1	1	10
Delaware						1				1
Dist. of Columbia	1	1	1	3	1	2	1	1	1	12
Florida	17	14	9	14	11	9	24	17	12	127
Georgia	2	2	2	3	4	5	1	2	5	26
Hawaii		1	3	1	1	4	2		1	13
Idaho	1	1	3		1	1				7
Illinois	2	3	4	6	8	5	4	6	3	41
Indiana		2	3	3	3	2	1	3	2	19
Iowa	1		5		1	1	1	1	4	14
Kansas	1		2	1		1	2	2		9
Kentucky	4	2				1		2	1	10
Louisiana		1	2	1	1		1	2	3	11
Maine	2						2	1		5
Maryland	4	4	1			3	2	3	4	21
Massachusetts	7	2	3	3	5	2	11	5	2	40
Michigan	4	7	5	2	8	8	5	2		41
Minnesota	1	1	2	2	3	2	2	4	2	19
Mississippi	1		2			1				4
Missouri	2		2	3	2	3	2	2	2	18
Montana	1	1	2	1	3		1			9
Nebraska		1			1	1		1	1	5
Nevada	1	4	3	2	1	2	1	2	1	17
New Hampshire	1		1		1	1				4
New Jersey	3	4	3	2	5	4	6	5	2	34
New Mexico	3	1	1		2	1	1			9
New York	20	27	29	12	20	27	23	29	21	208
North Carolina		2	2		3	8	1	1	1	18
North Dakota	1	1								2
Ohio	1		2	1	3	5	3	2		17
Oklahoma		2	2		1	2	3	1	1	12
Oregon	4	5	1	3	9	5	3	3		33
Pennsylvania	8	7	2	5	7	4	8	2	4	47
Rhode Island			1			2		2		5
South Carolina	1	1	1	1	5	1		1		11
South Dakota			2			1	1			4
Tennessee		2	3	1	5	1	3	1	1	17
Texas	8	11	15	22	20	20	22	24	18	160
Utah	1				1	5	3			10
Vermont
Virgin Islands								1		1
Virginia	4	3	7	4		5	2	2	3	30
Washington	5	10	7	7	5	6	18	9	5	72
Wisconsin	2	3	2	1	2	2	2	1	2	17
Wyoming				1						1
TOTALS	145	186	175	132	179	199	218	183	134	1551

F. Case Discussion

The day-to-day case management of the U.S. Repatriation Program repeatedly results in success stories for individuals and families in need of immediate social service, medical and/or financial assistance. The case files for this period are replete with accounts of individuals with psychiatric crisis, victims of accidents, organ who gain access to vital medical care in the U.S. Victims of domestic violence are afforded the opportunity to escape continued abuse. The destitute find a means to get resettled and on a path to economic recovery in their community of origin in many cases with the help and assistance of their biological family. In fact in some cases, the outcome of the extensive case planning is the successful reuniting of previously estranged family members. The following paragraphs highlight a few of the cases managed by ISS-USA during this period.

In several recent cases, American citizens were successfully repatriated and the quality of their lives were enhanced. A seven-year-old girl was sexually abused by her father while living with him in Mexico. The child’s mother was incarcerated in Arizona and no relatives were considered appropriate for placement. Social services in AZ placed the child in foster care and she is reportedly doing well. An Armenia-American family of five who were homeless in France were repatriated to their previous residence of New York. The children were not attending school and no one in the family was receiving medical care. All but the mother in the family were American citizens but the US Consulate was able to arrange for her to travel with the family so that they would not have to be separated. A five-year-old boy was repatriated to his mother in Florida following his abduction by his father to Brazil. The mother of the child filed under the Hague and a judge in Brazil ruled that the boy must be returned to the US because the parents could not reach an agreement. A sixty-one –year-old male who suffered a stroke as was found unconscious on a beach in France. He was returned to the US and was placed in an assisted living facility.

ISS-USA continued to see a wide variation in state approaches to repatriating unaccompanied minors. A three year old being repatriated from Mexico after being placed in the care of authorities due to abuse was returned and placed in foster care in a smooth and efficient fashion through the work of ISS-USA and a child protection team in NV. Another state, however, balked at accepting a pre-teen who had significant neurological problems and was suspected to be a victim of child sexual abuse. While medical reception and care was quickly arranged, the state child welfare agency had significant concerns about accepting a child who was likely to require expensive, long term foster care. ISS-USA was able to arrange state approval to send the child only after offering to arrange a teleconference among the state, ISS, and ORR staff.

Violent mentally ill repatriates pose unique challenges for transportation. In one case, a severely psychotic individual with violent behaviors was deemed to be inappropriate for travel without heavy sedation. Because transport on American air carriers requires a passenger to be alert on take off and landing, the DOS was able to arrange transport only on a foreign carrier. Due to the strong repatriation program in a port-of-entry for Latin American countries ( Miami), ISS-USA was able to arrange transport and reception of the citizen.

Interventions by ISS-USA helped identify needs for changes in DOS and Department of Homeland Security (DHS) procedures. In one situation, arrangements had been made for a mentally ill individual returning from Panama to be met at the airport. The state repatriation coordinator subsequently learned that the individual was apprehended upon immigration clearance due to an outstanding warrant. The need for DOS’s check for outstanding warrants in closer proximity to the flight to the U.S. was subsequently identified. In another case, the ISS-USA worker discussed the importance of running a criminal background check with the OH worker who was due to receive a newly released prisoner who was being deported from the UK. The worker did the background check and identified that the passenger was traveling on a fraudulent passport. This enabled the DHS to apprehend someone who otherwise may have been undetected.

A repatriation case that involved the return of three young girls to GA helped identify a suspected trafficking ring and led to vital training being provided to child welfare workers on the issue of trafficking. The girls were identified for repatriation from an orphanage in Mexico after the death of their grandmother guardian. ISS-USA recommended a home study of the mother’s home since the children had not lived with her for some time. The home study investigation found indicators of human trafficking and led to the involvement of the FBI and Task Force on Human Trafficking. The county subsequently initiated the training for the child welfare workers and altered protocols for reception of repatriates. The girls are now safely in foster care in GA.

G. Mass Repatriation

ISS-USA assists in the mass evacuations of individuals that are necessitated by natural disasters, war, threat of war or civil unrest in addition to the daily services provided to repatriates. During the 2005 fiscal year there has been no mass evacuation. However, during the early portion of the years there were many hours of debriefing following the mass evacuation from Grand Cayman on September 16 and 17, 2004, following a strike by Hurricane Ivan. Lessons learned and related recommendations for future mass evacuations were submitted for ORR consideration during the current period.

Even though a mass evacuation was not necessitated by the tsunami disaster of late December 2004, ISS-USA did serve as a conduit for several inquiries related to children identified without parental caretakers in Indonesian hospitals following the event. These efforts helped link agencies in the affected areas with the DOS task force formed in response to the emergency situation abroad. This served to help minimize the possibility of orphaned U.S. citizens remaining unidentified.

III. Training of U.S. Repatriation Program Partners

ISS-USA’ s training initiatives fall under the following categories:

Further update and expand the manual and maintain it as an electronic file whose contents can be accessed by new and on-going service providers.
Maintain an accurate and timely contact list and disseminate it four times a year.
Initiate regular trainings for all partners via teleconference calls, for both new staff and veterans, and involving state repatriation offices and DOS offices.
Launch and maintain a list serv.
Prepare and distribute fact sheets on handling of high risk cases (unaccompanied minors, mentally ill, incompetent adults, victims of domestic violence); and benefit programs for which repatriates may qualify.
Work with ORR/ACF/HHS to develop technical assistance on selected issues of import (legal authority to act on behalf of unaccompanied abandoned minors; federal statutes for dealing with mentally ill repatriates with criminal records).
Review in consultation with ORR, draft policy and procedures for DOS
Revise and provide model contracts between ISS-USA and state agencies or private agencies, with specific areas of service articulated (involvement of protective services, billing, requests for extensions, etc.).
Include OCS/CA/DOS in quarterly teleconferences and consider other venues for training DOS staff.
Utilize funding for on-site visits with state coordinators.

Specific actions in each of these areas are as follows:

A.Manual

ISS-USA maintains an electronic version of the training manual and sends out copies as requested by service providers. In the launching of a listserv in January 2005, electronic versions of the manual and supporting training materials were provided. In 2005, approximately three dozen additional requests have been made from agencies seeking copies of this manual. Further updates of the manual are in process. In addition, an updated, supplementary question and answer compendium, divided according to topics and issues most frequently raised by State Repatriation coordinators and their local staff in both work setting and trainings, is being finalized

B. Contact Information

A list of contact information on HHS/ACF/ORR staff, ISS-USA staff and all state repatriation coordinators is updated routinely; copies are distributed to all partners as updated via request and listserv.

C. Teleconference Trainings

A total of 11 training teleconferences took place in 2005, two in the first six months and 9 in the second six months specifically with State Repatriation coordinators and their staffs. These were the second (since 2004) in a series of 15 teleconference trainings and discussions directed toward the three sets of partners involved in the implementation and service provision of the U.S. Repatriation Program. ISS-USA has outlined a teleconference training segment for use with new OCS/ACS/CA officers and has discussed parts of its on a one-on-one basis with OCS/ACS/CA staff. Pending the formal reinstatement of an interagency meeting by ORR, ISS-USA expects to include consular staff in a series of teleconference trainings in 2006

1. April 5, 2005 Training. The target population for this training included State Repatriation Coordinators and new staff members in the offices of Repatriation Coordinators, and DOS/OCS division heads or new staff. Some 40 partners participated from 19 states. ISS-USA presented an overview of the program in terms of: governing directives and guidance for the program; nature of the program, eligibility and population now served; types of assistance provided; key players and their roles; and documentation. The ISS-USA Casework Supervisor described the range of current cases and gave examples of how they were resolved. Discussion with the participants touched on (a) the mandate for state agencies to take referred repatriates; (b) the success of an interagency team approach in establishing a service plan; and (c) experiences of coordinators in resolving issues of unaccompanied minors and state jurisdiction.

2. September-December 2005 Regional Meetings (9 total). The target population again included State Repatriation Coordinators, veteran staff who had specific experience with best practices around selected issues, and new staff ; as well as Regional ACF contact persons. The teleconferences were 1.5 to 2.0 hours each and took place on September 27, October 4, October 11, October 27, November 8, and November 15, November 29, December 8, and December 15. Each session included 6 to 12 participants, in keeping with the intention of providing each participant an opportunity to share his individual best practice experiences and concerns. ISS-USA’s overview of the program reviewed: governing directives and guidances; nature of the program, eligibility and population now served; types of assistance provided; key players and their roles; and documentation. In keeping with a special “theme,”(unaccompanied minors, domestic abuse, mentally ill clients), the ISS-USA Casework Supervisor described specific cases and examples of how they were resolved. Participants and agencies were then individually polled to present (1) their own experiences with the defined high-risk population and/or problematic cases; (2) limitations and strengths of the experience; (3) perceived needs for strengthening their work, in terms of needed support and collaboration among the three sets of partners involved with the program.; and (4) suggestions for future training, specifically for formats and agenda items to be include in a possible national training conference in 2006.

In addition, a one-on-one training for some 9-10 local social service providers by the ISS-USA Coordinator of Training and Technical Assistance, as requested or referred by case manager, was on-going in the past six months, to facilitate their understanding of program requirements and local responsibilities. ISS-USA case managers continue to work one-on-one with specific new service providers on a daily basis.

Plans and agenda are in place for a teleconference specifically involving OCS/CA/DOS division heads and staff, and with ORR participation, pending the approval of dates in 2006, as well as a series of follow-up teleconferences for those state repatriation coordinators, offices and new staff who missed the September-December 2005 trainings.

Further, ISS-USA conducted a review of the template agreement currently referred to as “State Plan” and drawn up in 1981 between the Social Security Administration and Offices of Health and Human Services in each state to handle repatriation of US nationals and US nationals with mental illness. Recommendations have been drafted and include the need for HHS/ORR to commit to (1) a revision of these contract to reflect the precise responsibilities of the state repatriation coordinators office and its local staff, as well as (2) an updating of the contacts and agents tasked to run the program in each state.

Finally, ISS-USA has put together a training module format, including materials which can be used for subsequent trainings.

D. Listserv

The listserv for Repatriation Program partners begun in January 2005 continued to provide a forum for monthly updates and to address issues and questions relevant to program implementation, etc. The most recent distributions included shared best practices for handling unaccompanied minors; and notes on the most recent teleconference. Contact information for repatriation program partners, electronic versions of the manual and of training power point slides, were also sent out as requested, and changes in listserv members were made to reflect new staffing. As of December 30, 2005, the listserv had a membership of approximately 94 individuals reflecting all 50 states, OCS/ACS/CA staff, and ACF regional contracts.

Production of Information Fact Sheets

Fact sheets on specific federal benefit programs (Veterans Administration, Social Security Insurance, Social Security Disability, Medicaid) have been produced and made available to State Repatriation offices and selected local care providers. Other prepared Fact sheets suggest protocols for: handling clients who are unaccompanied minors, mentally incompetent or mentally ill, and victims of domestic violence; .

Fact sheets on suggested protocols for working with local providers and filing for reimbursement of expenses have been prepared, along with a suggested checklist for consular offices at post of items to be included with referral cables, and a letter and revised question and answer sheet explaining the program for repatriates upon arrival on US soil. Summaries on best practices, based on surveys conducted with Repatriation partners and on-site trip reports to the four states with the most effective record of service and the highest volume—California, New York City, Massachusetts and Florida, have been distributed via listserv.

F. Technical Assistance in Conjunction with ORR/ACF/HHS

Technical assistance was secured or provided on the following topics, among others:

Determination of financial eligibility for minor whose citizenship status came under question
State reluctance to accept individuals through the Repatriation Program
Subcontracting of repatriation services by states
Protocol for accessing repatriate minors upon arrival at POE
Process and timetable for changes to governing legislation.
Criteria for, and best procedures for achieving, extensions or waivers in cases in which Repatriates need additional assistance
Procurement of a non-state agency professional assistant for the repatriation coordinator in Miami
Coordination efforts directed at transportation to
Rapid assessment of potential placement for cases of unaccompanied minors who are facing deportation or immigration detention ( Mexico) and for whom there is insufficient time to contract for a full home studies

G. Subcontracts with Nonprofit Providers

ISS-USA has updated is contracts with Lutheran Social Services in NYC, the Texas Multicultural Alliance (Houston), the Travelers Aid Family Services (Boston), Catholic Social Services (Laredo), Domestic Relief Services (RST-DRS)

( Dallas), and Travelers Aid/Heartland Alliance ( Chicago).

H. OCS/CA/DOS Involvement

An updated list of contacts for OCS/CA regional desks has been procured and these individuals have been added to the Listserv and all mailings pertinent to training. ISS-USA continues to recommend that quarterly meetings be held among the three parties to the Cooperative Agreement OCS/CA/DOS and ORR and ISS-USA for purpose of keeping all parties familiar with best practices and protocols for serving Repatriates and toward better collaboration on difficult and timely cases. In addition, ISS-USA completed an extensive review of the training materials on the Repatriation program currently utilized by OCS/ACS/CA/DOS

and submitted recommendations for changes and clarifications to the US. Department of State Foreign Affairs Manual Volume 7 (7 Fam 300 to .399.2-3

I. On-Site Visits

In response to the need to secure complete information on the best practices and resources and on specific training and technical support needs, the ISS Coordinator of Training and Technical assistance planned trips for April and May to Boston, MA (April 19); NYC, NY (April 21); Miami, FL (April 27); San Mateo and Los Angeles counties, CA ( May 24-26), and Buffalo, NY (August 30). In addition, Trip reports and summaries of best practices and suggested needs continue to be made available to all partners. In addition, ISS-USA has been instrumental in assisting partners in New York State and Colorado in drafting and finalizing Executive Directives for training country repatriation contacts on the program. On-site trips to the non-profit service providers in Texas, and to the Austin state government contact, will be recommended and implemented in the near future to facilitate more comprehensive training, articulation of responsibilities, and enhanced coordination between separate agents.

Outcomes from ISS-USA initiatives include:

Improvements in the understanding of all partners as to the scope of clients the program serves, the roles and responsibilities of each player within DOS, ORR, ISS and each state agency or private office, and the processes for best practices to service clients within the program
Better communication and coordination between collaborative parties in the repatriation program
Clear articulation of the areas in which current governing statutes and policies needs to be revised and articulated
Improved skills in planning and implementing case management and case follow up for repatriates.

IV. Information Dissemination

In addition to the training provided to U.S. Repatriation Program partners, ISS-USA has also been involved in several forums designed to help enhance awareness of the U.S. Repatriation Program and the services available. These forums include:

National College of District Attorney’s Fourteen Annual National Conference on Domestic Violence, October 31-November 4, 2004, Anaheim, CA. A seminar was provided by ISS-USA on “Assisting Domestic Violence Victims Overseas.” This seminar provided information on a range of services which attorneys could advise clients or U.S. based family members to seek when U.S. citizens became victims of domestic violence abroad. Chief among the options identified was the U.S. Repatriation Program.

Department of Defense Worldwide Planning Conference on Non-Combatant Evacuation and Repatriation Operations, December 13-14, 2004, Atlanta, GA. Two ISS-USA staff members attending this U.S. Army led conference that was designed “to bring together the principal planners and executors of evacuation and repatriation operations worldwide to discuss evacuation and repatriation planning in general, lessons learned from previous evacuations, new developments and agency roles in preparation for future operations.” ISS-USA staff helped provide a prospective of services offered in both day-to-day repatriation and mass evacuation operations.

Services provided through the U.S. Repatriation Program were included in the report ISS-USA completed on “Best Practices for Serving Unaccompanied Minors Faced with Return to their Country of Origin.” The report was commissioned by Lutheran Immigration and Refugee Service on behalf of ORR. Among the data collected were reports of the response to management of unaccompanied minors in 20 countries; through its role with the U.S. Repatriation Program, ISS-USA provided information on the processes and procedures for the return of U.S. citizen children identified as unaccompanied minors outside of the U.S.

National Association of Counsel for Children’s 28 th National Children’s Law Conference, Los Angeles, CA, August 25-28, 2005. ISS-USA in partnership with individuals from the American Bar Association Center on Children and the Law and Legal Services for Children, Inc. was invited to participate as faculty, for a presentation on “Representing Immigrant Children in the U.S. and U.S. Children Abroad.” One of the primary topics in this presentation was options available when U.S. citizen children are abused, neglected or abandoned abroad.