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Refugee Health Services

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Refugee Health Assessment

All refugees coming to the United States receive a pre-immigration medical screening whose primary focus is to ensure that people immigrating to the United States do not currently suffer from a health condition that would make them inadmissible according to U.S. law. These pre-immigration medical screenings are administered by panel physicians who follow the Centers for Disease Prevention and Control (CDC) Technical Instructions.

In addition to pre-immigration medical screening, all refugees are eligible to receive a domestic health assessment within 90 days of U.S. arrival. Domestic health assessments often serve as a refugee’s first experience with the U.S. health-care system. The domestic health assessment is intended to identify conditions for which refugees have particular risk, as well as provide referrals to address ongoing health needs. This helps ensure refugees have a healthy start in the U.S. so that they can successfully integrate into their new communities. Asylees, Cuban/Haitian parolees, and certified victims of human trafficking are also eligible for a domestic refugee health assessment within the first 90 days of status grant date.

The Indiana Refugee Health Program contracts with local health department, not-for-profit, and Federally Qualified Health Center clinics to provide domestic refugee health assessments in Indiana. These assessments also can be performed by private medical providers where needed after consultation with the Refugee Health Coordinator.

CDC has developed guidelines for the domestic refugee health assessment. Individual screening recommendations vary based on age, sex, and country of origin.

A domestic refugee health assessment generally includes:

  • A physical exam
  • Immunization assessment
  • Tuberculosis screening
  • Hepatitis screening
  • HIV screening
  • Sexually transmitted infections screening
  • Intestinal parasite screening
  • Lead testing for children younger than age 17
  • Metabolic conditions screening
  • Mental health screening
  • Referrals

Results from the domestic refugee health assessments are entered into the Refugee Health Program’s screening database, ITARA. Summaries pertaining to the health assessments are located under Refugee Health Data and Statistics .

Civil Surgeon Services

Civil surgeons are medical doctors designated by the United States Citizenship and Immigration Service (USCIS) to perform I-693 medical exams on people applying to become legal permanent residents.

Individuals wishing to adjust their immigration status to Legal Permanent Resident and receive their “Green Card” must file USCIS Form I-693 with their application. Requirements for the medical exam differ for refugees and other immigrants.

Refugees who arrive to the U.S. without a Class A health condition that requires more intensive follow-up only need an immunization review and update. In this case, a civil surgeon or their designee or the medical director of the local health department in participating counties can complete the exam and Form I-693. All other applicants require a full I-693 medical exam that must be completed by a civil surgeon.

A list of civil surgeons can be found here. The Marion County Public Health Department also provides civil surgeon services. For other counties, please contact the local health department to see what services are available.

Refugee Health Promotion

The Refugee Health Program provides oversight and reporting for the Refugee Health Promotion funds in Indiana. These funds are provided by the Office of Refugee Resettlement (ORR) and are designed to familiarize refugees with the U.S. health-care system and promote wellness through different programs. These funds are given to the three Indiana refugee resettlement agencies to provide health navigators to help refugees and other ORR eligible populations navigate the U.S. healthcare system, set up medical appointments, and sign up for insurance. Some grantees also offer health education classes, workshops, and mental wellness trainings.

Other Health Benefits

Refugees and other ORR populations are generally eligible for public assistance programs as they adjust to a new country, including income assistance, SNAP, and Medicaid. These benefits are administered by the Indiana Family and Social Services Administration.

Refugee Medical Assistance is federal funding to provide short-term medical assistance to ORR-eligible populations for up to eight months from the date of arrival in the U.S., date of final grant of asylum, or date of certification for trafficking victims. In Indiana these funds are administered by Indiana Medicaid, and eligibility is determined by the Family and Social Services Administration’s Division of Family Resources.