Refugee Health Screening in MN Federal Refugee Act of 1980 Exam w/in the first 90 days of arrival Public health clinics and private providers Goal:...to control communicable disease among, and resulting from, the arrival of new refugees through: health assessment treatment referral
Refugee Health Partners County Services Volags Health Care Provider MDH Local Health Dept. 5/2010
Refugee Health Assessment Information Flow Quarantine Station/CDC HIV+ assurance all assurances Local Health Dept. Screens Forwards to primary provider Primary provider screens Screening form completed & returned Refugee Health Program, Minnesota Department of Health
Local Public Health LPH Private Medica l Clinic Private Medica l Clinic Public Health Screening Clinic Private Medica l Clinic MDH
Role of Local Public Health LPH is responsible for ensuring all health screening appointments are made and information is communicated to the refugee and VOLAG Locate new refugee arrivals to the county Within 5-10 days of notification from VOLAG or MDH Schedule health screening appointment(s) - assist with primary care need, varies by county Return Fax Cover Sheet to VOLAG case manager with scheduled health screening appointments VOLAG within 10 days or as soon as possible.
Role of Local Public Health, cont. If LPH works with private clinics: Contact clinic, make arrangements for appointment Send overseas medical papers received from MDH & Refugee Health Assessment Form ( pink form ) If the county has their own LPH clinic: - schedule 2-3 appointments Assure arrangements for health screening Transportation: contact VOLAG or family members for additional help with transportation as needed Confirm availability of professional interpreters
Role of Local Public Health, cont. Verify completion of health assessment - For any new refugee that moves to or from original county of arrival, assure transfer of information to new county and MDH Submit screening results to MDH & report outcomes to MDH Follow up for referrals is specific to each county For complex case needs, LPH is the starting point Each county will have specific resources to work with
Local Public Health What are the 2 most important things a case manager should know about your county s health screening program? What can the refugee expect from LPH before and after the health screening regarding primary care needs?
Ramsey County (1315*) SPRCPH is no longer providing refugee clinical screening services on site at 555 Cedar. All screening is done through community partner clinics. All refugee families with children birth to 21 years old on Medical Assistance or MinnesotaCare are contacted by Child and Teen Check Ups (C&TC) to provide information about the C&TC Program, identify a primary medical home, explain the benefits of preventive health care, the services available under the C&TC program and where and how to obtain those services. * Primary refugees to county through November 2010 2122 = State total primary refugees through November 2010
Ramsey Referrals for public health home visits are made for pregnant women and for parenting families with children up to age 6, where there are health, developmental or parenting concerns. Saint Paul - Ramsey County Public Health Refugee Coordinator will work with VOLAGS to provide community health resources for complex care and mental health issues during the first 90 days.
Hennepin County (401*) Public Health Clinic refers out to primary care Schedule refugees as a family for each of their appointments Complete the MDH recommended screening in 3 clinic visits Refugee Coordinator (Mai Yang) PHNs/LPNs/MA Provider Refugee Screening Exam * Primary refugee arrivals to county through November 2010 2122 = State total primary refugees through November 2010
Hennepin: Public Health Nurse Role Primary Care Assist in primary care establishment Make follow up to ensure smooth transition Electronic Health Record Complex cases PHN identifies families with complex medical issues and assists getting them medical services they need in communities where they live prior to refugee screening appointments Work with Multicultural Center, VOLAGs and other county departments for services, e.g insurance, transportation to appointments, housing issues. small clothing closet with children s cloths, able to give 1-2 items to those with highest need (sizing and season varies) Referral to specialty services e.g. Infectious disease, diabetes, WIC, Prenatal care, Family planning, social services-pca PHN can make home visit to families with multiple children (at least one 6 yrs old or younger) and high needs
Stearns County (118*) Works with private providers to complete Refugee Health Assessments St. Cloud area has shortage of primary care providers High volume of refugees in last quarter As result, difficulty meeting 90 day recommendation Recent meeting w/providers to address issues between public and private * Primary refugees to county through November 2010 2122 = State total primary refugees through November 2010
Stearns Interpreters provided by clinics Transportation is arranged thru VOLAG if refugees are free cases Transportation is ongoing challenge Recent discussions with Financial Services may provide some resources LPH provides TB follow up LPH assists in coordinating with other identified health concerns
Olmsted County (101*) Olmsted County LPH clinic provides the refugee health screening 3 clinic visits screens families together Work closely with Mayo Clinic for referrals as needed Support VOLAG case managers for requests for primary care before health screening County has Child and Teen Check-up Program * Primary refugees to county through November 2010 2122 = State total primary refugees through November 2010
Anoka County (73*) HAP TB Class B referred directly DP&C will follow case for completion of Refugee Health Exam and return screening form to MDH when complete Anoka County Community Health DP&C Refugee Health Nurse DP&C-Disease Prevention & Control Minnesota Department of Health MDH Private Clinic Refugee Health Assessment If indicated based on referral criteria, referral will be sent to Refugee Health PHN for follow-up for medical needs Public Health Nursing Via Intake Process * Primary refugees to county through November 2010 2122 = State total primary refugees through November 2010
Anoka Refugee Health concerns are identified from: Overseas medical information Completed refugee health assessment Other referral sources VOLAG, Income Maintenance, WIC Initial contact by phone with written follow up or a referral is made to the Family Health Refugee Health Nurse if: Pregnancy A child under 3 years lives in the home A child or adult has a significant health issue/infectious disease Positive findings on the refugee health assessment The Family Health Refugee Health nurse provides home visits to: Assess medical and social needs for individual refugee and/or family SSI, MH Assist in assuring immediate and long term health needs are met may include direct care such as DOT/LTBI, Family Home Visiting or referral & follow up Assist in identifying appropriate medical and community resources, including referral and follow up
Rice County (23*) Health Screening Process VOLAG involvement remains important in LPH notification of new refugee arrivals, guidance to refugees (completing MA forms, assistance, etc) and assisting in the overall process. LPH will contact client, ensure application for MA, assist in scheduling appt (medical info), follow up as necessary or assist in connecting client with resources, submit appropriate paperwork, etc. Clinics in our area generally request that MA be active prior to scheduling a refugee health assessment and they provide for interpreter as needed at appt. 100 mile radius service area for VOLAGs for cases with ties * Primary refugees to county through November 2010 2122 = State total primary refugees through November 2010
Rice Complex / critical medical issues can be managed through normal means (hospital/clinic) possibly with assistance from public health HealthFinders free Clinic available if needed LPH/Social Services will work to connect new refugees to appropriate services and make referrals as necessary