7 fAM 300
EMERGENCY FINANCIAL AND MEDICAL ASSISTANCE pROGRAMS FOR U.S. CITIZENS ABROAD
7 FAM 310
INTRODUCTION
(CT:CON-850; 09-18-2018)
(Office of Origin: CA/OCS)
7 FAM 311 SUMMARY
(CT:CON-120; 12-06-2005)
This chapter outlines the Department of State Bureau of
Consular Affairs (CA) policies, guidance and procedures in providing emergency
financial or medical assistance to U.S. citizens/U.S. non-citizen nationals
abroad. It provides information to assist consular officers in meeting your
responsibilities, developing internal procedures and controls, and reporting on
the status of destitute, ill or injured U.S. citizens or non-citizen nationals
and your efforts on their behalf.
7 FAM 311.1 Consular
Responsibilities
(CT:CON-780; 01-16-2018)
Your key responsibilities in financial and medical
emergencies are to:
(1) Locate and contact the next-of-kin (NOK) or assist
the individual in contacting his or her family as needed, consistent with the
Privacy Act. (See 7
FAM 060.);
(2) Assist the individual, the family, and host
country officials as appropriate in carrying out whatever financial, medical
and legal decisions they reach;
(3) Administer the consular financial assistance loan
programs as appropriate;
(4) Prepare triennial list of physicians, hospitals
and air ambulance services and make list available on post web page to which
CA/P can link;
(5) Provide the individual and his or her family with
post list of local physicians, hospitals and air ambulance services;
(6) Assist the individual or his or her family in
contacting emergency medical personnel if such services are available in the
host country;
(7) Conduct welfare and whereabouts check on the
individual, being particularly mindful of the needs of possibly vulnerable
citizens, including the mentally ill.
(8) Communicate with host country authorities,
attending physicians, air carriers and others consistent with the Privacy Act.
(See 7 FAM 060.);
(9) Coordinate with CA/OCS/ACS on public health
related issues (see 7 FAM 000 Appendix A); and
(10) Coordinate with CA/OCS/ACS on repatriation and
resettlement matters.
7 FAM 311.2 Objectives
(CT:CON-780; 01-16-2018)
a. Financial issues involving U.S. citizens or nationals range from the tourist who is temporarily inconvenienced by a
loss or theft to families who are totally destitute due to loss of employment,
abandonment, and individuals fleeing dangerous situations.
b. Medical issues include not only cases of individual
illness or injury and mass casualty events, but also broad threats to health,
such as outbreaks of disease, environmental health hazards and even chemical or
biological attacks.
c. The material in this chapter will help you to
handle a variety of issues:
(1) Informing families of alternative ways to get
emergency funds to their relatives abroad and processing OCS trusts (suspense
deposit accounts.) (See 7 FAM 320.);
(2) Using the Consular Information Program and
coordinating with the Centers for Disease Control and Prevention and other
health organizations as necessary to publicize health- related issues. (See 7
FAM 000 Appendix A and 7 FAM 330.);
(3) Assisting citizens or nationals suffering from
mental illness. (See 7 FAM 340.);
(4) Notifying families of the destitution, injury or
illness of a loved one. (See 7 FAM 340 and 7 FAM 350.);
(5) Preparing lists of doctors, dentists, hospitals,
air ambulance companies and other medical service providers. (See 7 FAM 350.);
(6) Checking on the well being of a hospitalized
citizen or national. (See 7 FAM 340, and 7 FAM 350.);
(7) Working with families to arrange repatriations,
including medical evacuations. (See 7 FAM 360.);
(8) Processing repatriation loans and emergency
medical and dietary assistance loans (EMDA). (See 7 FAM 370 and 7 FAM 380.); and
(9) Coordinating with CA/OCS/ACS in arranging for
reception and resettlement in the United States, as needed. (See 7 FAM 390.)
7 FAM 312 AUTHORITIES
(CT:CON-120; 12-06-2005)
The authority for protection of U.S. citizens abroad and
provision of emergency financial and medical assistance exists in a variety of
treaties, laws, regulations and Executive Orders. The principal authorities
are described below.
7 FAM 312.1 Treaties
7 FAM 312.1-1 The Vienna Convention on Consular Relations
(CT:CON-120; 12-06-2005)
The Vienna Convention on Consular Relations (VCCR)
provides the basic authority for consular protection of citizens and
nationals. If the VCCR is in force in the host country, you should be familiar
with the provisions of the treaty related to consular protection of nationals.
Articles 5 and 36 of the VCCR provide very specific consular authority and host
country responsibilities regarding protection of minors and persons lacking
full capacity. This reflects a general understanding among nations of the
world that some persons, by their innate vulnerability, require greater
protection.
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VCCR, Article 5 Consular functions include
(a) Protecting the interests of the sending State [the
United States] and its nationals, within the limits permitted by
international law
(e) Helping and assisting nationals
(h) Safeguarding within the limits imposed by the
laws and regulations of the receiving State [host country], the interests of
minors and other persons lacking full capacity who are nationals of the
sending State [the United States], particularly where any guardianship or
trusteeship is required with respect to such persons
Article 36 of the VCCR provides that
(a) Consular officers shall be free to communicate
with nationals and to have access to them. Nationals shall have the same
freedom with respect to communication with and access to consular officers.
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7 FAM 312.1-2 Bilateral Consular
Conventions
(CT:CON-120; 12-06-2005)
a. You should be familiar with any bilateral consular
treaty between the United States and the host country addressing the issue of
responsibility towards protection of minors and persons lacking full
capacity. (See Treaties in Force on the Department of State Internet home
page.)
b. You will find the texts of most bilateral consular
conventions on the treaties feature of the CA/OCS Intranet page.
7 FAM 312.2 Non-Binding United
Nations Declarations and Other Instruments
(CT:CON-120; 12-06-2005)
The United Nations General Assembly adopted the following
Principles and Declarations unanimously. You may find it useful to refer
to these instruments in any dialogue with the host country about medical
assistance matters. Please note that these are not international agreements,
and consequently are not legally binding, meaning that the nations of the world
are not obliged to follow them. CA/OCS has, however, successfully engaged
foreign States about mental health issues by initiating conversations or notes
verbale (see 7
FAM 030) with reference to these common points of reference;
(1) Principles for the Protection of Persons with
Mental Illness and the Improvement of Mental Health Care (1991);
(2) Declaration on the Rights of Disabled Persons
(1975); and
(3) Declaration of Rights of Mentally Retarded Persons
(1971).
7 FAM 312.3 U.S. Laws, Regulations
and Executive Orders
7 FAM 312.3-1 Emergency Medical
and Dietary Assistance Loans (EMDA)
(CT:CON-763; 12-13-2017)
a. Section 3(j) of the State Department Basic
Authorities Act 22 U.S.C. 2670(j) (Public Law 95-45 June 15, 1977) provides
The Secretary of State is authorized to provide emergency medical attention
and dietary supplements, and other emergency assistance, for United States
citizens incarcerated abroad or destitute United States citizens abroad who are
unable to obtain such services otherwise, such assistance to be provided on a
reimbursable basis to the extent feasible.
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22 U.S.C. 2670 Insurance on motor vehicles in foreign
countries; tie lines and teletype equipment; ice and drinking water; excise
taxes on negotiable instruments; remains of deceased persons; relief,
protection, and burial of seamen; acknowledgement of services of foreign
vessels and aircraft; rentals and leases
provides
The Secretary of State is authorized to
(j) provide emergency medical attention and dietary
supplements, and other emergency assistance, for United States citizens
incarcerated abroad or destitute United States citizens abroad who are unable
to obtain such services otherwise, such assistance to be provided on a
reimbursable basis to the extent feasible.
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b. The following regulations implemented the statute:
22 CFR 51.60(c)(1), 22 CFR 71.10, 22 CFR
71.11 and 22 CFR 71.12 as it pertains to prisoners.
7 FAM 312.3-2 Repatriation Loans
(CT:CON-763; 12-13-2017)
a. The State Department Basic Authorities Act, 22
U.S.C. 2671.
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22 U.S.C. 2671 Emergency Expenditures provides:
(a) Delegation of authority pertaining to certification
of expenditures
The Secretary of State is authorized to
(1) subject to subsection (b) of this section, make
expenditures, from such amounts as may be specifically appropriated
therefore, for unforeseen emergencies arising in the diplomatic and consular
service and, to the extent authorized in appropriation Acts, funds expended
for such purposes may be accounted for in accordance with section 3526 (e) of
title 31; and
(2) delegate to subordinate officials the authority
vested in him by section 3526 (e) of title 31 pertaining to certification of
expenditures.
(b) Activities subject to expenditures
(1) Expenditures described under subsection (a) of this
section shall be made only for such activities as
(B) loans made to destitute citizens of the United
States who are outside the United States and made to provide for the return
to the United States of its citizens.
(d) Repatriation loan program
With regard to the repatriation loan program, the
Secretary of State shall
(1) require the borrower to provide a verifiable address
and social security number at the time of application;
(2) require a written loan agreement which includes a
repayment schedule;
(3) bar passports from being issued or renewed for those
individuals who are in default;
(4) refer any loan more than one year past due to the Department
of Justice for litigation;
(5) obtain addresses from the Internal Revenue Service
for all delinquent accounts which have social security numbers;
(6) report defaults to commercial credit bureaus as
provided in section 3711 (e) of title 31;
(7) be permitted to use any funds necessary to contract
with commercial collection agencies, notwithstanding section 3718 (c) of
title 31;
(8) charge interest on all loans as of May 1, 1983, with
the rate of interest to be that set forth in section 3717 (a) of title 31;
(9) assess charges, in addition to the interest provided
for in paragraph (8), to cover the costs of processing and handling
delinquent claims, as of May 1, 1983;
(10) assess a penalty charge, in addition to the
interest provided for in paragraphs (8) and (9), of 6 per centum per year for
failure to pay any portion of a debt more than ninety days past due; and
(11) implement the interest and penalty provisions in
paragraphs (8), (9), and (10) for all current and future loans, regardless of
whether the debts were incurred before or after May 1, 1983.
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b. 31 U.S.C. 7701(b) includes a requirement that an
individual applying for a U.S. Government loan must provide his or her social
security number (SSN). Failure to provide ones SSN may render an applicant
ineligible for a loan.
c. 22 CFR 51.60 Denial,
Revocation, and Restriction of Passports includes provisions relevant to the
limitation and denial of passports to U.S. citizens who are recipients of
repatriation loans. (See also 7 FAM 1380,
Denial, Revocation, Limitation, Restriction, and Surrender of Passports.) The
pertinent regulations are:
(1) 22 CFR 51.60(a) provides that:
The Department may not issue a passport, except a
passport for direct return to the United States, in any case in which the
Department determines or is informed by competent authority that:
(1) The application is in default on a loan
received from the United States under 22 U.S.C. 2761(b)(2)(B) for the repatriation of the applicant and,
where applicable, the applicant's spouse, minor child(ren), and/or other
immediate family members, from a foreign country (see 22 U.S.C. 2671(d));
(2) 22 CFR 51.60(c) provides that:
The Department may refuse to issue a passport in
any case in which:
(2) The applicant has not repaid a loan
received from the United States under U.S.C. 2671(b)(2)(B) or 22 U.S.C.
2671(b)(2)(A) for the repatriation or
evacuation of the applicant and, if applicable, the applicant's child(ren),
spouse, and/or other immediately family members from a foreign country to the
United States.
d. 22 U.S.C. 2671(d)(4) 22 U.S.C. 2671(d)(11) directs
collection of repatriation loans, in accordance with Federal government-wide
debt collection laws codified at 31 U.S.C. 3711 and 31 U.S.C. 3717.
7 FAM 312.3-3 HHS/ISS Reception
and Resettlement Authority
(CT:CON-120; 12-06-2005)
a. 42 U.S.C. 1313 Assistance For United States Citizens
Returned From Foreign Countries provides that the U. S. Department of Health
and Human Services (HHS) may provide temporary assistance to U.S. citizens and
dependents identified by the Department of State who have returned or been
brought to the United States due to destitution, illness, war, threat of war,
invasion, or other crisis, and who are without readily accessible resources to
meet their needs. 45 CFR 212 contains the implementing regulations for this
statute.
b. 24 U.S.C. 321 - 329 (24 U.S.C. Chapter 9) (Public
Law 86-571, Section 1, July 1, 1960) Hospitalization Of Mentally Ill Nationals
Returned From Foreign Countries provides for reception, care, treatment,
transfer, and release of mentally ill U.S. citizens/noncitizens returned from
foreign countries. For an individual to be eligible for assistance, the
Secretary of Health and Human Services must receive:
(1) A certificate from the Secretary of State that the
individual is a national of the United States; and
(2) A certificate obtained or transmitted by the
Secretary of State that the individual has been legally judged insane in a
foreign country or a certificate of an appropriate authority or person
determined by the Secretary of Health and Human Services stating that at the
time of such certification the individual was in a named foreign country and
was in need of care and treatment in a mental hospital.
c. 45 CFR 211 contains the implementing regulations
for this statute. 45 CFR 211.3 describes the certificates required to
establish that an individual is eligible for assistance.
Note: The Department of State has not authorized consular
officers to issue such a certificate.
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45 CFR 211.3 Certificates
The following certificates are necessary to establish
that an individual is an eligible person:
(a) Certificates as to nationality. A certificate
issued by an authorized official of the Department of State, stating that the
individual is a national of the United States.
(b) Certificate as to mental condition. Either
(1) a certificate obtained or transmitted by an
authorized official of the Department of State that the individual has been
legally adjudged insane in a named foreign country; or
(2) a certificate of an appropriate authority or person
stating that at the time of such certification the individual was in a named
foreign country and was in need of care and treatment in a mental hospital. A
statement shall, if possible, be incorporated into or attached to the
certificate furnished under this paragraph setting forth all available
medical and other pertinent information concerning the individual.
(c) Appropriate authority or person. For the purpose
of paragraph (b)(2) of this section a medical officer of the Public Health
Service or of another agency of the United States, or a medical practitioner
legally authorized to provide care or treatment of mentally ill persons in
the foreign country, is an ``appropriate authority or person,'' and shall be
so identified in his execution of the certificate. If such a medical officer
or practitioner is unavailable, an authorized official of the Department of
State may serve as an appropriate authority or person,' and shall, in the
execution of the certificate, identify himself as serving as such person due
to the unavailability of a suitable medical officer or practitioner.
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d. The Office of Refugee Resettlement of the Department
of Health and Human Services (HHS/ACF/ORR) has entered into a sole-source
cooperative agreement with International Social Service, United States of
America Branch, Inc., (ISS-USA) Baltimore, Maryland, under which ISS provides
services to U.S. citizens returned from abroad through the U.S. Repatriate
Program. See Federal Register Notice, Vol. 66, No. 130, July 6, 2001, page
35651-35652.
e. State Programs: State laws and regulations
regarding these cases vary. (See, for example California Specialized Programs,
2002.)
7 FAM 312.3-4 OCS Trusts
(CT:CON-120; 12-06-2005)
The following laws are related to Overseas Citizens
Services (OCS) TRUST and OCS Obituary (OBIT) Procedures:
(1) 31 U.S.C. 1321(a)(63) Miscellaneous Trust Funds,
Department of State;
(2) 31 U.S.C. 1321(a)(73) Estates Of Decedents,
Department of State;
(3) 31 U.S.C. 1322 Payments of Unclaimed Trust Fund
Amounts and Refund of Amounts Erroneously Deposited;
(4) 22 U.S.C. 2668a Disposition of Trust Funds
Received From Foreign Governments For Citizens of the United
States;
(5) 22 CFR 22.1 Schedule of Fees Trust Funds; and
(6) Consular General Instruction No. 271, January 28,
1914 Accounts and Drafts for Special Funds
7 FAM 312.3-5 Fly America
Act
(CT:CON-763; 12-13-2017)
The "Fly America Act", 49 U.S.C. 40118, does not
require the use of United States air carriers in repatriation cases where the
individuals are loaned funds by the Department of State for their subsistence
and repatriation. Transportation procured by the individual with funds
borrowed from an executive department is not government-financed
transportation, so the "Fly America Act" does not apply. (See 60
Comp. Gen. 716, Matter Of Fly America Act - Repatriation Loans, B-202410,
Comptroller General of the United States, September 29, 1981.)
7 FAM 312.3-6 Transfer of
Mentally Ill Prisoners - Prisoner Transfer Treaties
(CT:CON-120; 12-06-2005)
18 U.S.C. 4102(9) authorizes the Attorney General, in
concert with the Secretary of Health and Human Services to make arrangements
with the appropriate authorities of a foreign country and issue regulations for
the transfer and treatment of individuals who are accused of an offense but who
have been determined to be mentally ill, the expenses of which are to be paid
by the country of which such person is a citizen or national. The Departments
of Justice and HHS have not promulgated such regulations, (see 7 FAM 480
Prisoner Transfer, and 7 FAM 340).
7 FAM 312.3-7 Volunteers
(CT:CON-120; 12-06-2005)
31 U.S.C. 1342 Limitation on Voluntary Services prohibits
an officer or employee of the United States Government from accepting voluntary
services other than voluntary services authorized by law except for emergencies
involving the safety of human life or the protection of property.
7 FAM 313 ENTITLEMENT TO SERVICES
(CT:CON-120; 12-06-2005)
Persons seeking emergency financial or medical assistance
from the U.S. Government must establish that they are U.S. citizens or
noncitizen nationals and are entitled to these services.
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NOTE: When a U.S. citizen or national is traveling or
residing abroad with immediate family members that include an alien immediate
family member (spouse, child), such an individual may be included in a
repatriation loanwe also say this is possible for EMDA loans. This practice
is being incorporated in the 22 CFR.
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7 fam 314 reporting
(CT:CON-201; 10-31-2007)
You need to keep the Department (CA/OCS/ACS) informed and up
to date in a manner consistent with the nature and urgency of each financial or
medical emergency case so that the Department can:
(1) Assist post in securing funds from family members
or other resources;
(2) Provide guidance, especially in difficult or
unusual circumstances, and
(3) Coordinate effectively with other U.S. Government
or private entities.
7 FAM 314.1 Reasons For Reporting
Financial/Medical Cases
(CT:CON-780; 01-16-2018)
a. Approve necessary loan(s) and assign financial data;
b. Coordination by Department (CA/OCS/ACS) with the
Department of Health and Human Services (HHS/ACF/ORR) and ISS (International
Social Service USA (ISS/USA) regarding reception in the United States;
c. Provide liaison with the Centers for Disease
Control and Prevention (CDC) as necessary, (see 7 FAM 000 Appendix A and 7 FAM 330);
d. Track and control the disbursement of funds
worldwide; and
e. Brief principals and coordinate on urgent or
critical cases and cases with potential public diplomacy or political impact.
7 FAM 314.2 Types of Reporting
(CT:CON-120; 12-06-2005)
a. Initial Informal Report. It is imperative that you
provide an immediate initial report via telephone or email when an incident
affecting the safety of U.S. citizen(s) occurs. Points of contact are:
(1) The appropriate country officer in CA/OCS/ACS
(202-647-5226); and
(2) The OCS Duty Officer. The CA/OCS/ACS office is
staffed from 8 a.m. to 8 p.m. Monday through Friday Washington, DC
time, and 9 a.m. to 3 p.m. Saturdays. After hours, you may contact the OCS
Duty Officer through the Operations Center (202-647-1512).
b. Routine Automated Reports: In any incident
involving a U.S. citizen for a situation addressed in this chapter, the case
should be entered in the ACS automated system.
c. Official Reporting Cable: Follow your telephonic
or other informal notification with a front channel cable as soon as possible,
preferably the same day. Once the initial crisis has peaked on high profile
cases, you should continue to provide regular front channel reporting cables
with CASC tags. This keeps all interested parties in the Department abreast of
developments in a case.
d. Note: Informal Reporting: E-mails, faxes and phone
calls are valuable tools for reporting daily activity; however, these informal
methods of communication do not take the place of official reporting cables,
which receive wide distribution in the Department. Significant information
provided by e-mails, faxes or phone calls should be followed up by immediate
cable.
7 FAM 315 through 319 UnassigneD