Tuesday, March 20, 2012

Introduction to Refugee Medical Access

Here is a brief introduction to refugee medical care. Most of this information is true for all refugees but it is specific to Multnomah County. If your family is in the Washington county area and you still have questions, please feel free to contact Jeanne Toal, our volunteer coordinator, or the family’s case manager.
When refugees first arrive they have what is called an “open medical card”—they have not been assigned to a clinic, they do not have a primary care provider, but they are covered in case they have to go to the emergency room. After the refugee’s intake, their case manager will refer them to the Department of Human Services (DHS) which signs them up for refugee medical insurance through the Oregon Health Plan (OHP)—aka Medicaid. At their DHS appointment, every refugee will be given an OHP insurance card. 
[Side note: OHP provides insurance through several different systems—some refugees might have cards that say CareOregon, some might have Providence insurance, and others might even have insurance through Kaiser. This will affect which clinic they are assigned to but it does not mean that they get different benefits.]  
After being signed up for insurance, every refugee must be taken to a medical screening at the Mid County Health Center within a few weeks of arrival. EVERY refugee has to go to this medical screening. Afterwards, they will be assigned to a primary care clinic that should be closer to them (though due to some clinics getting overwhelmed with patients, this is not always the case). During the initial medical screening immunizations are sometimes given for free to the entire family—other times, only the children are immunized. In some other cases, the clinic may ask the refugee family to go to their primary care provider at their assigned clinic for immunizations.
Refugee medical insurance is the equivalent of OHP plus—in short, they get medical, dental, and mental health benefits but their benefits do not extend to vision care. All care is coordinated through the primary care provider at the refugee’s assigned clinic. If a refugee has forgotten where his or her clinic is, they can call the number on the back of their insurance card and tell them their member ID number (listed on the front of the card).
OHP plus benefits only last for the first eight months after a refugee’s arrival. After that they must apply to extend their benefits. Case managers can and do help families with this transition but the families must get an application to extend benefits from DHS themselves. If benefits can be extended (depending on eligibility under DHS guidelines) individuals may or may not receive OHP plus again—more likely OHP which does not include dental—except for very young children who are still eligible for OHP plus.
Since OHP plus extends to the first eight months of a refugee’s time in Oregon, it is important for families to take care of any necessary medical or dental work as soon as possible. Immunizations are particularly important, as they are required for status adjustment application for green card after 1 year (aka permanent residency), and for school attendance. Refugees can get immunizations from their primary care providers—they just need to ask for them. Many clinics now charge small fees for immunizations, which may discourage some families, but it is significantly cheaper for them to pay these fees during the first eight months than to make up all of the missing immunizations during the green card application process. If there are a lot of children in the family it may be cheaper to register the kids for a School-Based Health Clinic  where they can get immunizations--though make sure to remind families to bring their yellow immunization records with them to every visit! 
As always, if you have any questions about any of this information, please don’t hesitate to email Jeanne, our volunteer coordinator.

Monday, March 5, 2012

Refugee Vision Clinic

Dr. Carkner in action
Carkner Family Vision Care donated more than a dozen eye exams and glasses to refugees settled by Catholic Charities during a vision clinic held in February. We have been delivering the glasses this week and the recipients are thrilled with the results. 

     These clinics are a great opportunity for our refugee families since typically their insurance does not provide for basic vision care when they get to the United States. We had been working for some time to address this gap when Dr. Carkner, OD, generously volunteered his team's time and resources. 

     We will continue to hold these vision clinics monthly with Carkner Family Vision Care. If members of the refugee families with whom you volunteer are in need of glasses then please call us and let us know.We will happily add them to our waiting list (the vision clinic can handle about a dozen patients each month). Thanks again to Dr. Carkner, OD, and his team!

This Bhutanese couple received two pairs of bifocals