Mission
To provide culturally sensitive health services for refugees to enhance personal health status and to protect Florida’s public health.
Immigration Terms
• Refugee• Asylee• Immigrant (not eligible for refugee
services)• Cuban/Haitian Entrant• Refugee Resettlement Agencies• Quarantine Station• Class A and B Conditions
RH Eligibility Requirements
• IMMIGRATION STATUS– Refugee– Asylee– Cuban/Haitian Asylum Applicant– Cuban/Haitian Entrant– Amerasian– Victims of Trafficking– Iraqi or Afghan Special Immigrant
Program Requirements
TIME LIMITS
1. Health Assessments initiated within 90 days of eligibility date
2. Immunizationsstarted within one year from eligibility date
DOCUMENTATION
3. I-94 Card or Other Document
must show arrival date and immigration status
2. Photo Identification
U.S. Refugee Processing
UNHCRReferral
DOS Referral
Resettlement Support Center (RSC)
USCIS InterviewApproved Denied
MedicalSponsor
Cuban Parole Programs
Cuban/Haitian Entrant
Cuban Family-based Parole
Cuban Family Reunification
Parole
USCIS
Cuban/Haitian Entrant Program
U.S. Interests Section-Havana
Applicant
USCIS InterviewApproved Denied
Medical
USCCB or CWS
Health Assessments
• Protect public health
• Assist refugee in successful resettlement
• Early identification and treatment of disease is more cost effective and improves health outcomes for clients
Health Assessments
Reimbursement is provided to LHDs for a:
Physical assessment, which includes• Communicable disease screening; and• Chronic disease screening
Immunizations
• MMR
• Hepatitis B
• Hepatitis A
• Hep A & B (combo)
• Td
• Tdap
• Varicella
• Meningococcal
• Polio• DTaP• HIB• Pneumococcal• Rotavirus• HPV• Zoster
Linguistically Appropriate Services
• Telephonic Interpretation Services– DOH Contract-CODEA-R3
• Interpreter Training – DOH Contract-CODEA-R3
• Document Translation
– DOH Contract-CODEA-R3
• Language Line Services– Joe Mathews-1-800-316-5493
Arrivals by County- FFY 2014
HOLMES
PIN
ELL
AS
ORANGE
MADISON
TAYLOR
HAMILTON
SUWANNEE
LAFAYETTE
DIXIE
CO
LUM
BIA
GIL
CH
RIS
T
LEVY
UNION
BRADFORD
ALACHUAPUTNAM
MARION
LAKECITRUS SU
MTE
R
BAKER
NASSAU
DUVAL
CLAY ST. JOH
NS
FLAGLER
VOLUSIA
SEMINOLE
BREVARD
OSCEOLAHILLSBOROUGH
POLK
MANATEEHARDEE
INDIAN RIVER
OKEECHOBEEST. LUCIE
MARTIN
PALM BEACH
BROWARD
MIAMI-DADE
COLLIER
HENDRYLEE
CHARLOTTE GLADES
DESOTOSARASOTA
JEFFERSON
ES
CA
MB
IA
SANTA ROSA OKALOOSA
WALTON
JACKSON
WASHINGTON
CALHOUN
BAY
GULF
GADSDEN
FRANKLIN
LEON
WAKULLALIBERTY
PASCO
HIGHLANDS
HERNANDO
MONROE
No Arrivals
20,000+
1,000 – 2,000
700 - 999
400 - 699
100 - 399
1 - 99
Data Source: FL DOH Refugee Domestic Health Assessment System 1/12/2015
National StatisticsNumber of Arrivals Eligible for Refugee Benefits by State
FFY 2011-2012
-
5,000
10,000
15,000
20,000
25,000
30,000
35,000
40,000
45,000
Florida California Texas New York Michigan
Source: Office of Refugee Resettlement’s Proposed Two-Year Social Service Formula Allocation – FFY 2013
Arrivals by Country of Origin – FFY 2014
Cuba31,052 (93%)
Burma397 (1%)
Haiti517 (1%)
Iraq569 (2)%
Other999 (3%)
New Arrivals Eligible for Refugee Health ServicesBy Country of Origin, FFY 14
Data Source: FL DOH Refugee Domestic Health Assessment System 1/21/2015
Arrivals CY 2007 - CY 2014
Data Source: FL DOH Refugee Domestic Health Assessment System 2/23/2015
2007 2008 2009 2010 2011 2012 2013 20140
5,000
10,000
15,000
20,000
25,000
30,000
35,000
Percent of Refugees Who Received a Health Assessment
by Country of Origin, FFY 2014
Data Source: FL DOH Refugee Domestic Health Assessment System 1/09/2015
Burma Columbia Cuba Egypt Haiti Iraq Venezuela Other75%
80%
85%
90%
95%
100%
Arrival Notifications
Overseas Medical Exam
Refugee Health Program
Local Health Departments
Refugee
EDN
Reimbursement Process
LHD-Invoice
Refugee Health Program
DOH Revenue Management
DCF Refugee Services
DOH Revenue Mgmt
LHD
Victims of Trafficking
• A form of modern-day slavery
• Involves the exploitation of persons for commercial sex or forced labor
• Often involves crossing an international border, but does not require moving a victim
• Traffickers use force, fraud, or coercion to control their victims
Adjustment of Status
• Refugees only need vaccination sign-off from Civil Surgeon
Any health department “licensed physician with no less than four years of professional experience” can provide the vaccination sign-off
• All other immigration statuses need full medical exam by a designated Civil Surgeon
• Civil Surgeon Locator and information on becoming a Civil Surgeon
–https://egov.uscis.gov/crisgwi/go?action=offices.type&OfficeLocator.office_type=CIV
• Technical Instructions for Civil Surgeons– http://www.cdc.gov/immigrantrefugeehealth/exams/ti/index.html
Resources
See the Refugee Health Resources handout on the Refugee Health Program’s website,
located under the Training Services and Information link
http://www.floridahealth.gov/programs-and-services/community-health/refugee-health/training-services-and-information.html
Contacts
REGISTERED NURSING CONSULTANT
Brandi S. Andrews, R.N.850-245-4444, ext. 2315
(clinical guidance, technical assistance, quality improvement)
PROGRAM ADMINISTRATOR
Kelly A. Browne, M.P.A., M.S.W. 850-245-4444, ext. 2306
(programmatic questions, funding)
DATA MANAGER
Alonna W. Hudson850-245-4444, ext. 2324(data, reimbursement)
PROGRAM ANALYST
Julie L. Framingham, M.A., M.S.W.850-245-4444, ext. 2303
(budget, federal/state reporting, and programmatic questions)