1. Florida Refugee Health Program

2. Mission To provide culturally sensitive health services for refugees to enhance personal health status and to protect Florida’s public health.

3. Immigration Terms Refugee Asylee Immigrant (not eligible for refugee services) Cuban/Haitian Entrant Refugee Resettlement Agencies Quarantine Station Class A and B Conditions

4. RH Eligibility Requirements IMMIGRATION STATUS – Refugee – Asylee – Cuban/Haitian Asylum Applicant – Cuban/Haitian Entrant – Amerasian – Victims of Trafficking – Iraqi or Afghan Special Immigrant

5. Program Requirements TIME LIMITS 1.Health Assessments initiated within 90 days of eligibility date 2.Immunizations started within one year from eligibility date DOCUMENTATION 1.I-94 Card or Other Document must show arrival date and immigration status 2.Photo Identification

6. U.S. Refugee Processing UNHCR Referral DOS Referral Resettlement Support Center (RSC) USCIS Interview Approved Denied MedicalSponsor

7. Cuban Parole Programs Cuban/ Haitian Entrant Cuban Family- based Parole Cuban Family Reunification Parole USCIS

8. Cuban/Haitian Entrant Program U.S. Interests Section-Havana Applicant USCIS Interview Approved Denied Medical USCCB or CWS

9. “Irregular Maritime Arrivals”

10. “Border Crossers”

11. Health Assessments Protect public health Assist refugee in successful resettlement Early identification and treatment of disease is more cost effective and improves health outcomes for clients

12. Health Assessments Reimbursement is provided to LHDs for a: Physical assessment, which includes Communicable disease screening; and Chronic disease screening

13. Immunizations MMR Hepatitis B Hepatitis A Hep A & B (combo) Td Tdap Varicella Meningococcal Polio DTaP HIB Pneumococcal Rotavirus HPV Zoster

14. Linguistically Appropriate Services Telephonic Interpretation Services –DOH Contract-CODEA-R3 Interpreter Training –DOH Contract-CODEA-R3 Document Translation –DOH Contract-CODEA-R3 Language Line Services – Joe Mathews-1-800-316-5493

15. Arrivals by County- FFY 2014 Data Source: FL DOH Refugee Domestic Health Assessment System 1/12/2015

16. County Arrivals Contact Alonna Hudson at 850-245-4444, ext. 2324 for current county data.

17. National Statistics Number of Arrivals Eligible for Refugee Benefits by State FFY 2011-2012 Source: Office of Refugee Resettlement’s Proposed Two-Year Social Service Formula Allocation – FFY 2013

18. Arrivals by Country of Origin – FFY 2014 New Arrivals Eligible for Refugee Health Services By Country of Origin, FFY 14 Data Source: FL DOH Refugee Domestic Health Assessment System 1/21/2015

19. Arrivals CY 2007 - CY 2014 Data Source: FL DOH Refugee Domestic Health Assessment System 2/23/2015

20. Percent of Refugees Who Received a Health Assessment by Country of Origin, FFY 2014 Data Source: FL DOH Refugee Domestic Health Assessment System 1/09/2015

21. Arrival Notifications Overseas Medical Exam Refugee Health Program Local Health Departments Refugee EDN

22. Reimbursement Process LHD-Invoice Refugee Health Program DOH Revenue Management DCF Refugee Services DOH Revenue Mgmt LHD

23. Victims of Trafficking A form of modern-day slavery Involves the exploitation of persons for commercial sex or forced labor Often involves crossing an international border, but does not require moving a victim Traffickers use force, fraud, or coercion to control their victims

24. Adjustment of Status Refugees only need vaccination sign-off from Civil Surgeon Any health department “licensed physician with no less than four years of professional experience” can provide the vaccination sign-off All other immigration statuses need full medical exam by a designated Civil Surgeon Civil Surgeon Locator and information on becoming a Civil Surgeon –https://egov.uscis.gov/crisgwi/go?action=offices.type&OfficeLocator. office_type=CIVhttps://egov.uscis.gov/crisgwi/go?action=offices.type&OfficeLocator. office_type=CIV Technical Instructions for Civil Surgeons –http://www.cdc.gov/immigrantrefugeehealth/exams/ti/index.htmlhttp://www.cdc.gov/immigrantrefugeehealth/exams/ti/index.html

25. Resources See the Refugee Health Resources handout on the Refugee Health Program’s website, located under the Training Services and Information link http://www.floridahealth.gov/programs-and- services/community-health/refugee- health/training-services-and-information.html

26. Contacts REGISTERED NURSING CONSULTANT Brandi S. Andrews, R.N. 850-245-4444, ext. 2315 (clinical guidance, technical assistance, quality improvement) PROGRAM ADMINISTRATOR Kelly A. Browne, M.P.A., M.S.W. 850-245-4444, ext. 2306 (programmatic questions, funding) DATA MANAGER Alonna W. Hudson 850-245-4444, ext. 2324 (data, reimbursement) PROGRAM ANALYST Julie L. Framingham, M.A., M.S.W. 850-245-4444, ext. 2303 (budget, federal/state reporting, and programmatic questions)

27. 2008 Olympics From Lost Boy of Sudan to U.S. Flag-Bearer Lopez Lomong

28. Questions?