medical exams for u.s. bound refugees minnesota department of health refugee health program
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Medical Exams for U.S. Bound
RefugeesMinnesota 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
Needed to obtain a Green Card 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.
““Excludable”Excludable” conditionsconditions:
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
Medical Screening for Entry into the United States
* 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 Communicable Diseases of Public Health SignificancePublic Health 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 Events that are reportable as a public health emergency of public health emergency of
international concern (PHEIC) to international concern (PHEIC) to WHOWHO
Polio Smallpox SARS Influenza Other public health emergencies of
international concern
10/20/08
Types of Medical Exams
Overseas Visa Medical ExaminationUnited States Public Health Service
Domestic Refugee Health AssessmentMinnesota Department of Health
Adjustment of Status Medical Examination US Citizenship and Immigration Services
Needed to obtain a Green Card 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 assessmenttreatmentreferral
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 ExaminationUnited States Public Health Service
Domestic Refugee Health AssessmentMinnesota Department of Health
Adjustment of Status Medical Examination US Citizenship and Immigration Services
Needed to obtain a Green Card 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.