Florida Refugee Health Program

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

“Irregular Maritime Arrivals”

“Border Crossers”

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

County Arrivals

Contact Alonna Hudson at 850-245-4444, ext. 2324 for current county data. 

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)

2008 Olympics

From Lost Boy of Sudan to U.S. Flag-Bearer

Lopez Lomong

Questions?