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Refugee Health

Domestic Preventive Health Screening Program

Prior to their arrival, refugees receive a medical screening overseas by panel physicians selected by the U.S. Department of State Consular Officials. A copy of these medical records is provided to the U.S. Customs Office, the Centers for Disease Control and Prevention (CDC) Division of Global Migration and Quarantine, and the refugee. The CDC enters the information into a secure web-based Electronic Disease Notification System (EDN) which is made available to state and local public health departments.

A component of the local voluntary resettlement agencies cooperative agreement with the U.S. Department of State is that each refugee must undergo a medical screening within 90 days of arrival into the United States.

According to the HHS Office of Refugee Resettlement (ORR) State Letter # 95-37, Medical Screening Protocol for Newly Arrived Refugees, the purposes of screening are to:

  • Ensure follow-up of Class A and B conditions identified during overseas medical exam
  • Identify persons with communicable diseases of potential public health importance
  • Identify personal health conditions that adversely impact effective resettlement

The CDC publishes guidelines for both the overseas and domestic screenings.

In Arizona, there are two designated facilities that coordinate and provide domestic preventive health screenings:

Phoenix

The Maricopa County Department of Public Health (MCDPH) Refugee Services Clinic is contracted with the Arizona Refugee Resettlement Program and provides the medical screenings in the Phoenix area.

An initial visit to the clinic generally happens within the first two weeks after arrival to Arizona, where laboratory samples and chest X-rays are collected. Another appointment is scheduled with the refugee approximately one or two weeks later to document the patient’s medical history, review of laboratory results, receive a physical exam, a mental health screening and immunizations as needed.

Referrals are made by the MCDPH Refugee Services Clinic to the MCDPH Tuberculosis Clinic for those refugees who test positive for the disease and who may require further evaluation and treatment. Also, it is not uncommon for the refugee clinic to work with the client and their resettlement agency case manager to help the refugee establish a primary care provider or specialist depending upon the outcome of the exam.

Tucson

The University of Arizona Medical Center South Campus is the contracted provider and conducts the preventive health screenings for new refugee arrivals in Tucson. The exam is likewise comprised of two visits. The first is a walk-in visit to the hospital's laboratory. After the patient's results are received by the refugee clinic, an appointment is made and the refugee returns for a chest X-ray if needed, documentation of a comprehensive medical history, review of laboratory results, a physical exam, and immunizations as needed. The timeline in Tucson for completion of the health screening typically takes between 30 and 75 days due to the clinic only being open for 8 hours per week.

The clinic incorporates the tuberculosis blood test into the panel of laboratory screening components during the first visit. Any patients who test indeterminately or positive for tuberculosis or require any further follow-up care in this area, are referred to the Pima County Health Department Tuberculosis Clinic for further evaluation and treatment.