FY 13: Study of Domestic Capacity to Provide Medical Care for Vulnerable Refugees (U.S. Committee for Refugees and Immigrants)
The U.S. Committee for Refugees and Immigrants (USCRI) conducted a PRM-funded research project examining capability, impact, and service models used for medically vulnerable refugees at five major resettlement sites in the U.S. The study included analysis of qualitative data from surveys, interviews with refugee officials and resettlement affiliates, and quantitative data of the costs and impact of medical case management. The scope of the research was focused on PRM’s service period of 90 days after refugee arrival.
• Challenges of providing care: Refugees with complex or severe medical conditions require an additional 5.13-7.69 hours of case management and 27-64 miles driven by case staff during the 90-day post-arrival period; funds not covered by Reception and Placement are provided by private or affiliate resources funds.
• Impact of medical conditions: Mental illness, mobility issues, and emergency hospitalizations required the greatest affiliate support. However, resettlement affiliates lack consistent funding to address these health issues.
• Flow of refugee health information: Challenges to managing health conditions include incomplete or inaccurate pre-arrival health information and lack of appropriate and timely sharing of medical information between resettlement actors.
• ACA and Medicaid Expansion are still transitional and impacts on medically vulnerable refugees are yet to be seen. ACA-supported Healthcare Navigator services can be utilized to promote healthcare access and link refugees to insurance options.
• CDC should establish assessment tools for post-arrival mental health screening to provide guidance for mental health service provision to refugees.
• PRM should coordinate with other agencies to ensure that refugees are provided two months of essential medications prior to leaving their point of departure. Medication management should be reinforced at overseas Resettlement Support Centers.
• Resettlement affiliates should improve coordination of medical information, in particular pre-arrival planning for refugees with severe medical conditions. They should participate in Health Navigator and Health Advisor programs.