Aos Medical Exam by EndlessHallway

VIEWS: 59 PAGES: 16

									     Medical Exams




                             

for U.S. Bound Refugees

  Minnesota Department of Health




                                   

     Refugee Health Program

    Types of Medical Exams

™   Overseas Visa Medical Examination

    ™ United States Public Health Service




™   Domestic Refugee Health Assessment

    ™ Minnesota Department of Health



™   Adjustment of Status Medical Examination

    ™ US Citizenship and Immigration Services

       ƒ   Needed to obtain a Green Card

       ƒ   Adjusts status from temporary to permanent

           resident
                   

       Overseas Visa Medical




                                         

           Examination

™ Mandatory    for refugees and immigrants


™ Completed by Panel Physicians trained

  and overseen by CDC

™ Is   exclusionary in nature

™ Results   recorded on form DS-2053, etc.

     Medical Screening for Entry into

           the United States


  “Excludable” conditions:

  ™     Communicable diseases of public health significance
  ™     Physical and mental disorders with associated
        harmful behaviors
  ™     Psychoactive substance abuse and dependence
  ™     Other physical or mental abnormalities, disorders or
        disabilities
* Note: every immigrant regardless of their arrival category must have this screening completed
  in order to come to the USA

Refugee Health Program, Minnesota Department of Health
      Communicable Diseases of




                                           

      Public Health Significance

                    Significance

™   Infectious tuberculosis
™   Hepatitis B
™   Human Immunodeficiency Viral infection (HIV)
™   Syphilis
™   Other Sexually Transmitted Diseases (STD)
    e.g. chancroid, gonorrhea, granuloma

    inguinale, lymphogranuloma venereum

™   Hansen’s disease (leprosy)
                                               10/20/08

      Quarantinable Diseases Designated




                                          

       by Presidential Executive Order


™   Cholera
™   diphtheria
™   infectious tuberculosis
™   plague
™   smallpox
™   yellow fever
™   viral hemorrhagic fevers
™   SARS
™   pandemic flu

                                          10/20/08

    Events that are reportable as a public




                                             

      health emergency of international




                                         

           concern (PHEIC) to WHO

                              WHO

™   Polio
™   Smallpox
™   SARS
™   Influenza
™   Other public health emergencies of
    international concern

                                             10/20/08

    Types of Medical Exams

™   Overseas Visa Medical Examination

    ™ United States Public Health Service


™   Domestic Refugee Health Assessment

    ™ Minnesota Department of Health


™   Adjustment of Status Medical Examination

    ™ US Citizenship and Immigration Services

       ƒ   Needed to obtain a Green Card

       ƒ   Adjusts status from temporary to permanent

           resident
                   

     Domestic Refugee Health




                                             

     Screening: Best Practices

• Exam w/in the first 90 days of arrival
• Public health clinics &/or private providers

• Goal:
...to control communicable disease among, and
   resulting from, the arrival of new refugees
   through:
     ™health assessment
     ™treatment

     ™referral
               

   National Guidance on Domestic




                                                      

     Refugee Health Screening


• Developed in collaboration with
   – Centers for Disease Control, Division of Global
     Migration and Quarantine (DGMQ/CDC)
   – Office of Refugee Resettlement (ORR)
   – NIH Substance Abuse Mental Health Services
     Administration (SAMHSA)

• http://www.cdc.gov/ncidod/dq/refugee/rh_guide/index.htm

    Types of Medical Exams

™   Overseas Visa Medical Examination

    ™ United States Public Health Service


™   Domestic Refugee Health Assessment

    ™ Minnesota Department of Health


™   Adjustment of Status Medical Examination

    ™ US Citizenship and Immigration Services

       ƒ   Needed to obtain a Green Card

       ƒ   Adjusts status from temporary to permanent

           resident
                   

   What is a “Green Card”?



• Refugees: adjusts immigration status from
  Lawful Temporary Resident (LTR) to
  Lawful Permanent Resident (LPR);
  provides permanent work authorization.
• Immigrants: permission to reside and work
  in the United States
 Adjustment of Status Exam




                                          

     (Green Card Exam)


• Civil Surgeon MUST perform the full
   physical exam needed for immigrants,
   asylees
• ONLY immunizations are needed for
   refugees
• Local public health may act as civil
   surgeon for refugees
•	 www.uscis.gov for needed information and
   forms
       Requirements to be a




                                     

          Civil Surgeon

• Licensed physician
• Four years professional experience




                                     

  beyond internship and residency

• Good standing with local and state
  medical boards
• Must apply to local USCIS office (not
  applicable for LPH MD acting as civil
  surgeon)
         Refugees and




                                 

      Adjustment of Status


• No medical exam unless arrived with
  Class A condition, then exam is required
• Vaccination requirements only
• I-693 can be signed by state or local
  health department officials who meet
  definition of civil surgeon
• Place original signed I-693 in envelope,
  seal and give to refugee
• Give copy of completed I-693 to refugee

    Immunizations for




                             

Adjustment of Status Exam


• NEW POLICY 2008

 All vaccinations recommended by the
 ACIP are required for everyone
 applying to adjust their status.

								
To top