Cooperative Agreement
-What is the Cooperative Agreement?
-How are refugee resettlement agencies
monitored?
-Core Services and Timelines
-Scenarios/Success Stories
Cooperative Agreement

Agreement between the State Department in Washington, DC, with
nine domestic resettlement agencies (VOLAGS or Voluntary Agency)

Church World Service (CWS), World Relief, International Rescue
Committee (IRC), Episcopal Migration Ministries (EMM), Ethiopian
Community Development Council (ECDC), Hebrew Immigrant Aid
Society (HIAS), Lutheran Immigration & Refugee Service (LIRS), U.S.
Committee for Refugees and Immigrants (USCRI), U.S. Conference
of Catholic Bishops (USCCB)

In Minnesota there are 5 VOLAGS (International Institute, Catholic
Charities, Lutheran Social Service, Arrive Ministries, MN Council of
Churches)

Refugees are resettled in 49 states or about 190 communities
throughout the USA
Cooperative Agreement

Placement: Where will the refugee family live?

Family Reunification Cases vs. Free Cases

U.S. Tie (UST) / Anchor
 Relatives
or close friends who already live in the
United States

Examples: St. Cloud, Worthington, Willmar, Mankato,
Otsego, Barron, WI, and many more!
Cooperative Agreement

8.C.1.g. The Recipient shall describe its network of affiliates in its
annual proposal, including the proposed service area to be
covered by each affiliate. A Recipient may assure and place a
case assigned to it under the Agreement only within the approved
service area and caseload projections of its approved affiliates as
set forth in the proposal. The Bureau authorizes cases with U.S. ties to
be placed within a radius of one hundred (100) miles within the
same state of the affiliate and cases without U.S. ties to be placed
within a radius of fifty (50) miles within the same state of the affiliate.
Minneapolis/Saint Paul to Saint Cloud, MN, 66 miles
LSS Saint Cloud office to Willmar, MN, 62 miles.
Minneapolis/Saint Paul to Mankato 85 miles
Minneapolis/Saint Paul to Worthington, MN, 178 miles,
Placement Exception Form
Minneapolis/Saint Paul to Barron, WI, 90 miles.
Placement Exception Form and approval from Wisconsin
State Refugee Coordinator
R&P Core Services
Airport
Pickup
Housing
Furniture, Food,
Material Needs
Health
R&P GrantFinances/
Budgeting
30-90 Day
R&P Period
County
Assistance
Programs/
Documents- SS
cards, EAD
Volag
MNSure
ESL Enrollment
Transportation
Community
Orientation
Guardianship
SSI
School
Enrollment
Employment
Programs
WIC
PCA
‘Health’ Core Services

Assistance in accessing health screenings and appropriate
health services:
1. Ensure that every refugee has a health assessment within
thirty (30) days of arrival
2. Ensure that refugees with acute health care requirements
receive appropriate and timely medical attention. (pg. 14)

Ensure that its affiliates and local co-sponsors share relevant
information with health care providers and/or state and local
officials, as needed, in order to plan for the provision of
appropriate health services for refugees who have health care
requirements (pg. 15)
Coordination of Care:
Refugee Health Screening



Fax RHS Referral Form & Assurance Page to MDH & LPH
Inform clients about the RHS, its’ purpose and timeline
Metro:
 Receive
screening appointments from LPH with transportation
arranged by LPH
 Notify
the clients of the appointment dates/time; remind them not to
go to ESL/school, bring their IOM bag, & wait for taxi

Non-Metro:
 Notification
about appointments- Varies
 Ensure client is aware of the appointment & that their US Tie is able to
provide transportation if medical transportation cannot be arranged
Coordination of Care: Complex MedicalMetro & Non-Metro


Metro:

Send RHS Referral/Complex Med Referral to Ellen & Marge pre-arrival or when need identified
post-arrival

Expedite MA with DHS / Expedite RHS with LPH if needed

Coordinate with Marge for appointments needed

Ensure client has transportation to appointments (US Tie, Case Manager, taxi, etc)

Follow individualized care plan with ultimate goal of ensuring client is established with primary
care and can access independently
Non-metro:

Consultation with MDH regarding medical concerns/level of care needed although not
enrolled in the MDH complex medical care plan

Expedite MA with DHS

Combination of coordinating with LPH, US Tie or Clinics in the area to schedule appointments
and transportation as needed
Barriers to Care



General:

Medical issues not always identified pre-arrival

PMAPs- defaults into plans quicker in some areas than others, can cause problems
with screening clinic/taxi/primary care

Lack of interpreters for less common languages (i.e. Hakha Chin)

Clients missing appointments (…confusion, misunderstanding, non-cooperation)
Metro:

Periods of high arrivals– long delays in screenings

Differences among screening clinics (i.e. some refer to primary care, some don’t)
Non-Metro:

Transportation

Volag Differences (i.e. Stearns County: difference between a primary arrival to LSSSt. Cloud and primary arrival for CC- Twin Cities living in St. Cloud)
Case Scenario
-29 y male: “schizophrenia, under remission, on RX at present, no aggressive
behavior”; arrived with 10-day RX supply
-Volag completed RHS referral & complex med referral next day of arrival
-Volag submitted MNSure & requested expedited MA from DHS on day two
-Emails between MDH, HCPHC, Volag to expedite screening
-Screening at HCPHC: 11/6 10am with taxi however, would not be able to prescribe
the RX needed- need primary care appt for RX refill
Back-up: take client to Direct Access at HCMC
-Volag called Smiley’s & with advocacy from MDH, was able to get appt for client
with ‘MA pending’ status for 11/6 230pm however, pharmacy does not accept
‘MA pending’
Back-up: volag pays for RX from R&P grant
-MA approved on 11/5 (after a few ‘urgent’ emails from volag)
-Client attended RHS 11/6 am; Volag took him to Smiley’s 11/6 pm & got RX refilled
What Works Well
 Communication
Knowing
who to contact
 Coordination
 Patience
& Understanding
 Faxing/emailing
to Volags
 Back-up
plans!
RHS appointment schedules