Health Professionals Serving Refugees - Frequently Asked Questions (FAQs)
- What is the scope of the domestic refugee preventive health screenings?
- How is the Tuberculosis testing conducted?
- How can I obtain medical records for my patient from their domestic health screening exam?
- What if I have a patient who has not received a domestic preventive health screening yet?
- What is Refugee Medical Assistance (RMA)?
- What else do I need to know about the refugee resettlement system?
- Why do I need an interpreter?
- How can I learn more about language access?
- How do I incorporate interpretation and translation into my work?
- What do I need to know about the translation of documents?
- Where can I learn more about cultural competency standards?
- Where can I learn more about various cultures?
- Where can I get more information regarding the medical requirements for a refugee to adjust their status?
Both contracted clinics in Arizona apply the current CDC guidelines to their screenings. The intent of this exam is to determine if the refugee has any communicable diseases.
The domestic preventive health screening consists of:
- Patient Medical History
- Physical Exam
- Brief Mental Health Assessment
- Tuberculosis Blood Test and Chest X-ray
- Laboratory Testing for:
- Hepatitis B/Hepatic Function
- Lead (16 years and younger)
- Sexually Transmitted Infections (12 years and older) Gonorrhea, Chlamydia and Syphilis
- Hansen's Disease
The MCDPH and University of Arizona Medical Center incorporate tuberculosis blood tests into their screening protocols. The MCDPH is currently using the T-SPOT test and the U of A Medical Center has currently chosen the QuantiFERON®-TB Gold test (QFT-G). Please consult the CDC Morbidity and Mortality Weekly Report (MMWR) document Updated Guidelines for Using Interferon Gamma Release Assays to Detect Mycobacterium Tuberculosis Infection - United States 2010 for more information about the use and application of these tests.
Both of these tests require only one visit; unlike the traditional skin test (TST) which requires two. This measure has reduced the number of trips the clients need to make to the clinic and streamlined the response process for those clients with indeterminate or positive results. Both clinics are continuing to conduct chest X-rays and sputum tests as needed with clients to rule out active tuberculosis.
Maricopa County Department of Public Health
602-506-1970 - Fax
Pima County Health Department
520-243-8465 - Fax
Medical records from the patient's domestic screening are available only with a signed Release of Information from the patient at the following:
Maricopa County Department of Public Health
Medical Records Office
1645 E. Roosevelt
Phoenix, AZ 85006
602-506-5079 - FAX
University of Arizona Medical Center South Campus
2800 E. Ajo Way
Tucson, Arizona 85713
The intent of the refugee domestic preventive health screening is to rule out any communicable diseases and the role of the clinics is not to serve as the refugee's primary care provider. Therefore, if other health conditions are known to be present, or arise shortly after arrival, your practice or facility may see the patient prior to their screening. Each refugee carries their own overseas medical records during transit. If the appointment is made in advance, ask the patient to bring their "IOM" bag and any immunization records.
It is very common for a newly arrived refugee to not remember the name or address of the first health professional that they see after their arrival. A simple way to enhance communication between your practice or facility and the screening clinic, is to give the refugee a business card during or after the first visit and encourage them to carry it with them. When they arrive to the clinic for their preventive health screening, the clinic can ask for the card and will know who their PCP or health provider is and can work with your office for any follow-up care or exam findings.
Prior to obtaining eligibility for public, private or an employer's insurance plan, the issuance of a temporary public benefit called Refugee Medical Assistance (RMA) may be in place. The eligible patient will present a picture ID for this insurance.
For information regarding patient eligibility, policies for providers and all other inquiries regarding RMA please contact:
Refugee Medical Assistance Program
Arizona Department of Economic Security
Refugee Resettlement Program
PO Box 6123 - Site Code 086Z
Phoenix, AZ 85005
602-542-6400 - FAX
1-866-228-1662 - statewide
Refugees may also be eligible for and need assistance in navigating the Arizona Health Care Cost Containment System (AHCCCS) system.
During the visit, be sure to ask the patient if they currently have a caseworker and a resettlement agency that they are working with. The local voluntary agencies assign a case manager to each refugee arrival. Caseloads for the case managers are significant, but they can be the best source of information if a refugee has moved or has gained employment, especially within the first 30-60 days of arrival.
When contacting the case worker it is especially helpful if you provide the patient's name, date of birth and RMAP ID number (which is the same as their alien number) so that you can obtain any forwarding information on the patient.
According to Title VI of the 1964 Civil Rights Act,
"No person in the United States shall, on ground of race, color or national origin, be excluded from participation in, be denied benefits of, or be subjected to discrimination under any program or activity receiving Federal financial assistance."
U.S. HHS OCR FAQs (includes the applicability of Title VI of the Civil Rights Act (1964) for Medicaid, CHIP, & Medicare Providers
U.S. HHS OCR Civil Rights Obligations as a Covered Entity Information for Providers of Healthcare and Social Services
National Center for Cultural Competence Working with Linguistically Diverse Populations - Language Access FAQs
National Health Law Program - Language Access Publications
A wide range of briefs, archived webinars and publications on a wide variety of related topics can be found here. Examples include:
Language Services Resource Guide to Healthcare
Language Services Resource Guide for Pharmacists
Translation: Getting it Right: A Guide to Buying Translations
American Translators Association
U.S. Department of Health and Human Services - Agency for Healthcare Research and Quality - Creating Easy-To-Read Informed Consent Documents
Robert Wood Johnson Foundation - Practical Solutions for Effective Translated Health Information
Culturally and Linguistically Appropriate Services (CLAS) Standards - Office of Minority Health
Office of Minority Health Think Cultural Health
Health Resources and Services Administration Cultural Competency Resources for Healthcare Providers
The Center for Applied Linguistics has published several "Refugee Backgrounders" and Cultural Profiles. It is important not to generalize about the characteristics, preferences or attitudes of various cultures. However, learning more about a culture's history and background can help develop an appreciation and understanding of diverse refugee populations.
After residing in the United States for one year, refugees are eligible to apply for an adjustment of status to that of a legal permanent resident. Part of this application process to the U.S. Citizenship and Immigration Services is the completion of an I-693 medical form.
If the refugee has already had a medical exam upon admission as a refugee under section 207 of the Immigration and Nationality Act, they generally do not need to repeat the entire medical exam. For those that have a Class A or B condition identified during their initial exam, the form must be completed by a civil surgeon.
For all other refugee applicants applying for an adjustment of status under Section 209 of the Immigration and Nationality Act the "vaccination sign-off" portion can be completed by an attending physician of a local health department that is voluntarily participating in the Headquarters Office of Adjudications blanket civil surgeon designation.
For more information, please see:
U.S. Citizenship and Immigration Services Report of Medical Examination and Vaccination Record