Refugee and Entrant Assistance State/Replacement Designee Administered Programs

Cash and Medical Assistance (CMA) program provides funding for short-term cash and medical assistance to refugees and other eligible individuals of the refugee resettlement program. CMA also provides funding for foster care and youth services for una

The Refugee Cash and Medical Assistance (CMA) Program reimburses States and Replacement Designees for the cost of cash and medical assistance provided to refugees, certain Amerasians from Vietnam, Cuban and Haitian entrants, asylees, victims of a severe form of trafficking, Iraqi and Afghan Special Immigrants, certain Afghan Humanitarian Parolees, and certain Ukrainian Humanitarian Parolees during the first 4 months after their date of arrival or date of eligibility. Specifically, CMA covers the Refugee Cash Assistance (RCA), Refugee Medical Assistance (RMA), and Medical Screening activities, and recipient administrative costs. CMA also includes Unaccompanied Refugee Minors (URM), and reimbursement is provided for care of enrolled URMs and recipient administrative costs. Refugee Support Services (RSS) provides formula funding for employment and other social services for the same population for 5 years after their date of arrival or date of eligibility. In FY 2022, in response to new priorities, Congress appropriated specific funding to support certain arrivals from Afghanistan and Ukraine. See ORR Policy Letters 22-01, 22-02, 22-10, and 22-13 for additional information on Afghan and Ukrainian arrivals eligible for these services.

State agencies and Replacement Designees (RDs) are eligible to receive these funds. ORR issued PL 25-04 on March 14, 2025, Changes to ORR Support Services Recipients Beginning in FY 2026. It requires that the Refugee Support Services (RSS) grant be directly issued only to states. As a result, ORR will no longer issue RSS to RDs; however, some services may continue to be provided by RDs through the end of the grant period during the transition.

Refugees, certain Amerasians from Vietnam, Cuban and Haitian entrants, asylees, victims of a severe form of human trafficking, Iraqi and Afghan Special Immigrants, certain Afghan humanitarian parolees, certain Ukrainian humanitarian parolees are eligible for benefits and services. Detailed information on eligibility of ORR-funded projects is available at 45 CFR §400.43 and ORR Policy Letters 16-01, 22-01, 22-02, 22-10, and 22-13, which can be found on the ORR website at: https://www.acf. gov /orr/policy-guidance/policy-letters. Cash and medical assistance is transitional for up to four months; Refugee Support Services may be provided for up to five years.

See ORR Policy Letters for allowable costs and activities.

Costs of case management services, as defined in 45 CFR 400.2, may not be charged to the Cash and Medical Assistance award.

Funds are awarded on a quarterly basis. Funds for Refugee Cash and Medical Assistance (CMA) and administrative costs must be obligated during the Federal fiscal year (FFY) in which the grants are awarded, and liquidated by the end of the next FFY, unless otherwise specified. With respect to CMA funds used for services for unaccompanied minors, the State may obligate its CMA funds during the FFY in which the grants are awarded and the following FFY; funds must be liquidated by the end of the second FFY, unless otherwise specified. Funds for Refugee Support Services must be obligated no later than one year after the end of the FFY in which the grants are awarded and liquidated by the end of the third FFY, unless otherwise specified. Method of awarding/releasing assistance: Quarterly for Cash and Medical Assistance and Refugee Support Services base funds; annually for Refugee Support Services set-aside funds supporting designated purposes. Method of awarding/releasing assistance: Quarterly for Cash and Medical Assistance and Refugee Support Services base funds; annually for Refugee Support Services set-aside funds supporting designated purposes.

State Plan-URL https://acf.gov/orr/form/report-forms. States and RDs apply for CMA and RSS by submitting an annual State Plan (CMA and RSS), ORR-6 Annual Service Plan (RSS), and ORR-1 CMA Program Estimates.

Cash and Medical Assistance awards are made to State agencies and Replacement Designees following submittal of approved State Plans and annual Cash and Medical Assistance Program Estimates (ORR-1). For Refugee Support Services awards, State agencies and Replacement Designees must submit an Annual Service Plan (ASP).

Annual submission of Refugee Cash and Medical Assistance Program Estimates (ORR-1) and a State Plan are required in order to receive Refugee Cash and Medical Assistance funding.

Other. For existing recipients, appeals in regard to disputes may take place in accordance with 45 CFR Part 16, subject to the limitations of the Appendix A. Also: States may request a hearing on the decisions made by the Director or designee on any plan or plan amendment in accordance with 45 CFR §400.9.