U.S. Repatriation Program for Citizens Returned from Abroad

U.S. Repatriation Program for Citizens Returned from Abroad

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Updated April 18, 2024
U.S. Repatriation Program for Citizens Returned from Abroad
Introduction
plans and make arrangements for the provision of
Section 1113 of the Social Security Act (42 U.S.C. §1313)
temporary assistance.
permanently authorizes the U.S. Department of Health and
Human Services (HHS) to provide temporary aid to certain
Repayment of Temporary Assistance
repatriated U.S. citizens and their dependents. To be
Section 1113 generally requires recipients of temporary
eligible, citizens must (1) be without available resources
assistance to repay the federal government. However, the
and (2) be identified by the Department of State (DOS) as
law also gives HHS the authority to waive repayment.
having returned or been brought back from a foreign
Federal regulations establish factors for such waivers. For
country because the citizen was destitute, because the
instance, repayment may be waived due to financial
citizen (or a dependent) was ill, or because of war, threat of
hardship or if recovering funds would be “against equity
war, invasion, or a similar crisis. Temporary aid is generally
and good conscience.” ACF reports that relatively few
provided as a loan. The Social Security Amendments of
waivers are granted each year (typically fewer than a
1961 (P.L. 87-64) established the program following the
dozen) and that loans are generally repaid in full. In the
repatriation of a “substantial number of American citizens
event costs are not recovered within 30 days of billing,
from Cuba” (S.Rept. 87-425). Jurisdiction for the program
loans begin accruing interest; further penalties may apply to
has traditionally been exercised by the House Ways and
debts delinquent by over 90 days. Costs recovered via loan
Means Committee and the Senate Finance Committee.
repayments do not directly offset program expenditures.
Federal Administration
Emergency Repatriations
Since August 2018, the program has been operated by the
In addition to routine repatriations (e.g., for individuals or
Office of Human Services Emergency Preparedness and
families due to destitution or illness), the program responds
Response within the HHS Administration for Children and
to emergency repatriation events, often resulting from war
Families (ACF). (Previously, the program was administered
or natural disasters. For example, the program supported
elsewhere within ACF.) ACF coordinates with DOS in
mass repatriations from Lebanon amidst the Hezbollah-
operating the program. Under its own statutory authorities,
Israel War in 2006. During a mass emergency repatriation,
DOS assists U.S. citizens abroad by providing for their
ACF or participating states or other entities typically set up
evacuation or return when their lives are endangered (22
a processing reception center at applicable ports of entry.
U.S.C. §4802) or when they are destitute (22 U.S.C.
This is done in coordination with DOS, as well as states
§2671). This is generally done via loans. Once individuals
selected to receive repatriates. At these centers, repatriates
arrive in the United States, ACF assumes responsibility for
who do not have immediate access to resources complete an
providing temporary aid under Section 1113 to eligible
intake form and loan repayment agreement. Repatriates are
repatriates referred by DOS. Some responsibilities for the
interviewed to determine what assistance they need (e.g.,
reception, temporary care, or transportation of eligible
travel costs, cash assistance). Later, states or other entities
repatriates may be carried out by states through repatriation
submit claims for the administrative costs incurred and for
agreements with ACF or by a non-governmental
temporary assistance provided directly to repatriates.
organization under a cooperative agreement with ACF.
Eligible Costs and Services
Funding Cap for Temporary Assistance
The program provides temporary assistance to eligible
The repatriation program receives mandatory funding in
repatriates and may also cover administrative costs incurred
annual HHS appropriations acts. Statute caps the amount of
by states or other entities. Temporary assistance is defined
funding that may be used for temporary assistance at $1
as money payments, temporary billeting, transportation,
million per fiscal year. Statute does not explicitly apply this
medical care, and other services (e.g., counseling) needed
cap to other program costs (e.g., HHS planning activities,
for the health or welfare of an individual. The resource test
administrative costs incurred by states). The current cap
for eligibility looks at whether resources are “immediately
was put in place in FY1990 (P.L. 101-382). It has been
accessible” to meet an individual’s needs. In general,
temporarily waived or raised multiple times since then,
temporary assistance may not be provided for more than 90
usually in response to emergency repatriation events (see
days. An exception may be made if an individual is
Table 1). In most cases, Section 1113 was amended to raise
“handicapped in attaining self-support or self-care for
or waive the cap in its entirety, not for limited purposes
reasons such as age, disability, or lack of vocational
(i.e., extra funds were not limited to a particular event or
preparation.” In such cases, aid may be extended by nine
activity, regardless of what prompted the cap adjustment).
months with prior approval. In addition to providing aid to
In two cases, however, the cap was effectively waived by
repatriates, HHS is also authorized to engage in a process,
provisions in supplemental appropriations acts that allowed
in consultation with DOS and other agencies, to develop
for additional spending notwithstanding the cap. In both
cases, spending in excess of the cap was restricted to
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link to page 2 U.S. Repatriation Program for Citizens Returned from Abroad
assistance in response to specified incidents (an earthquake
other medical and remedial care, food, lodging, money,
in Haiti in FY2010 and an Ebola outbreak in FY2015).
transportation, and other goods and services. In limited
Raising or waiving the cap does not mean additional funds
cases, continuing care and treatment in a hospital may also
will be used; it means the funds may be available if needed.
be provided. With few exceptions, the repatriates are
expected to repay the government for services received.
Table 1. Adjustments to Assistance Cap Since FY1990
Funding History and People Served
Affected
Treatment of the Funding Cap and
Table 2 displays the temporary assistance cap, total
Year(s)
Related Context
funding, and the number of people served since FY2014.
FY1990,
Cap effectively waived (P.L. 101-508)
Most people served are adults; children account for about a
FY1991
Context: conflict in Persian Gulf
quarter to a third of those served annually by the routine
program. Funds may be used for the main program and the
FY2003
Cap effectively waived (P.L. 108-11)
program for mentally ill repatriates. Statute authorizes HHS
Context: conflict in Iraq
to accept gifts to carry out the main program, but gifts may
only be used to the extent provided in appropriations acts.
FY2006
Cap raised to $6 mil ion (P.L. 109-250)
Context: conflict in Lebanon
Table 2. 10-Year History: Temporary Assistance Cap,
FY2010
Cap raised to $25 mil ion (P.L. 111-127)
Total Funding, and People Served ($ in thousands)
Cap later effectively waived for assistance provided
in response to the Haiti earthquake (P.L. 111-212)
Fiscal
Assistance
Total
People
Context: earthquake in Haiti
Year
Cap
Funding
Served
FY2015
Cap effectively waived for assistance provided in
2015
$1,000*
$927
615
the response to the Ebola outbreak (P.L. 113-235)
2016
$1,000
$932
617
Context: Ebola outbreak
2017
$25,000
$24,931
670 + 3,195
FY2017,
Cap raised to $25 mil ion (P.L. 115-57)
FY2018
Context: Hurricanes Irma, Jose (in Caribbean)
2018
$25,000
$2,937
789
FY2020
Cap raised to $10 mil ion (P.L. 116-148)
2019
$1,000
$938
751
Context: COVID-19 pandemic
2020
$10,000
$1,444
478 + 324
FY2021,
Cap raised to $10 mil ion (P.L. 117-39)
2021
$10,000
$8,660
442 + 626
FY2022
Context: U.S. withdrawal from Afghanistan
Source: Table prepared using bil text searches from 101
2022
$10,000
$10,600
606
st Congress
to present. Context is from various documents (e.g., conference
2023
$1,000
$12,238
925
reports). From P.L. 111-212 onward, these provisions have
designated funds as an emergency requirement.
2024
$1,000
$18,199
not available
Sources: Laws and HHS materials. *The FY2015 cap was waived for
Budget Proposals to Increase the Cap
limited purposes, but HHS did not use this authority. People are those
Several administrations have proposed permanent increases
served by the routine programs, plus mass repatriations. Total
to the temporary assistance funding cap. Most recently, the
funding is for temporary assistance and for activities not subject to
FY2025 Biden Administration budget proposed setting the
the cap. Funding reflects sequestration. FY2024 data are preliminary.
cap at $10 million and indexing it for inflation to “better
position the program to respond when a mass evacuation of
Recent Issues
U.S. citizens is necessary.” Trump Administration budget
According to ACF, the COVID-19 pandemic marked the
requests for FY2020-FY2021 had also proposed increasing
first time a mass emergency repatriation occurred due to an
the cap to $10 million using the same rationale. Previously,
infectious disease outbreak. In 2020, a whistleblower raised
the FY2006-FY2009 budget requests from the George W.
concerns that some deployed ACF staff were not properly
Bush Administration had proposed increasing the cap to $5
trained or outfitted before meeting quarantined repatriates.
million, stating that $1 million was “no longer sufficient.”
P.L. 116-148 later prohibited ACF staff from having direct
contact with repatriates, except for uniformed members of
Additional Repatriation Authorities
the Public Health Service Corps or the Ready Reserve
In addition to the main repatriation authorities discussed
Corps with appropriate training and equipment. This
above, HHS is also authorized to serve certain repatriates
prohibition expired with the COVID-19 public health
returned to U.S. soil as a result of mental illness (24 U.S.C.
emergency. A 2021 GAO report examining the COVID-19
§§321 et seq.). These authorities were established in 1960
repatriation response recommended that HHS (1) revise or
by P.L. 86-571 and are separate from authorities in Section
develop new emergency repatriation response plans, and (2)
1113 (e.g., funds are not subject to the Section 1113 cap).
conduct regular exercises with federal, state, and local
To be eligible, a repatriate must be (1) certified as a U.S.
partners to test and inform plans. A House Appropriations
national by DOS and (2) certified as having a mental health
Committee Report (H.Rept. 117-96) directed HHS to
condition (e.g., deemed legally insane, in need of treatment)
comply with these recommendations. Since FY2021, HHS
by an appropriate authority. Lack of resources is not a
data suggest more than 80% of annual funding has gone to
condition of eligibility. ACF may provide temporary care,
planning costs, including a new training and technical
treatment, and assistance in the form of hospitalization,
assistance center. HHS notes that such activities had not
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U.S. Repatriation Program for Citizens Returned from Abroad
historically been funded. Accounting for these costs, total
Karen E. Lynch, Specialist in Social Policy
funding in recent years has been higher than average.
IF11484

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