Eliminating Barriers to Refugees Accessing Developmental Disabilities Services in Rhode Island (RI UCEDD)

June 26, 2017


A refugee is defined by the United Nations as person who flees their country due to fear of persecution based on race, religion, nationality, membership of a particular social group or political opinion. They are unable to return to their countries. Most people become refugees due to wars and conflicts in their countries. They mostly end up in camps around the world. For humanitarian reasons, some countries send officials to these camps to process and admit a few of these refugees to their respective for assistance.

The US is the largest refugee re-settler. A chain of federal departments are involved in this process. The US Department of Homeland Security does the admission overseas, the US Department of State takes over to bring the refugees into the country for resettlement. Afterwards, the federal Office of Refugee Resettlement (ORR) under the US Department of Health and Human Services handles internal refugee resettlement. Refugees can adjust their status to permanent residence (green card) after a year of arrival, and to citizenship after five years.

In Rhode Island, at least 350 refugees were resettled in the fiscal year 2015-2016. In the past 10 years, an estimated 10,000 refugees have resettled in Rhode Island through the ORR or by relocating from other states within the country. They are from different countries of origin mainly from Africa and the Middle East.

Benefits & Services for Refugees in the U.S.

Upon arrival, refugees are qualified for almost every benefit and service as American citizens. Below are some of those benefits and services:


  • I-94 Card that identifies their refugee status and gives them access to benefits and services
  • Cash Assistance (RCA) for up to eight months of admission to the U.S.
  • Medicaid and/or Refugee Medical Assistance (RMA)  
  • Employment Authorization
  • Social Security Number
  • Food stamps
  • Disability assistance
  • Case management
  • English language education
  • Public Housing


Problems in Accessing Disability Services in RI

Accessing Services from the RI Department of Behavioral Healthcare, Developmental Disabilities & Hospitals (BHDDH) is currently impossible for refugees, especially adult refugees. The policies that enable a person to access such benefits and services place refugees with developmental disabilities at a disadvantage. This project therefore seeks to create awareness and make a case for policy change so that refugees can apply for/and receive services.

Under the current RI Division of Developmental Disabilities (DDD) policy refugees can meet all the criteria except two. The DDD eligibility criteria states that one must prove that there is the presence of developmental disability, meaning severe, chronic disability of a person which:

  • Is attributed to a mental of physical impairment or combination of mental and physical impairment
  • Is manifested before the person attains age 22
  • Is likely to continue indefinitely
  • Results in substantial functional limitations in three or more of the following areas of major life activities: personal care, communication, mobility, self-direction, capacity for independent living, economic self-sufficiency
  • And a person must provide a copy of a birth certificate

Two items in the eligibility criteria make these services inaccessible for refugees. Adult refugees must proof that their developmental disability has manifested before they turned 22. The problem with this policy is that most refugees do not have documentation of their medical records. The only most likely records refugees enter the US with are their basic pre-travel medical screenings which does not entail the person's medical history. The lack of records of medical history for refugees is caused either by their original countries' lack of robust health system, or because they fled their countries and left everything behind. Furthermore, refugees are faced with another obstacle which is the requirement to provide a copy of a birth certificates. Refugees only begin receiving formal documents with the I-94. Therefore, it is hard or impossible for refugees to produce their birth certificates. Thus, even though refugee children under the age of 22 can have their developmental disabilities documented in the U.S., they will still not be qualified under the current RI policy requiring their birth certificates.

Next Steps

With the support and guidance of my team lead at the Sherlock Center, I have been able to meet with five different coordinators at the Sherlock Center. The intention was to enable me identify the best area to focus on during my fellowship. As a result, I am currently working closely with the Adult Supports Coordinator at the Center who is helping me explore options to address this issue. I have two pending items to work on:

I.  I will gather material regarding policies and practices in other states for comparison with Rhode Island.

II. I will have meetings with the director of DDD scheduled for June 2017. The Adult Supports Coordinator at the Sherlock Center will join me in these meetings.


BHDDH. (2017)Apply for Services: Introduction to the Application for Services. Retrieved May

20, 2017 from http://www.bhddh.ri.gov/developmentaldisabilities/pdf/Application%20Eligibility%20UPDATE%202017-05-10.pdf

Office of Refugee Resettlement. (2017). Benefits and services. Retrieved May 20, 2017 from


United Nations High Commissioner for Refugees. (2015). Flowing Across Borders. Retrieved

March 2, 2016 from http://www.unhcr.org/pages/49c3646c125.html. Wikipedia The Free Encyclopedia. (2016). Immigration. Retrieved March 10, 2016, from https://en.wikipedia.org/w/index.php?title=Immigration&oldid=709198528