Serving Other ORR-Eligible Populations

Definition

There are two kinds of asylees. 

• U.S.-granted asylees meet the definition of refugee, seek asylum while already present in the U.S., and receive asylum while residing in the U.S.
• Follow-to-join asylees join a family member who has been granted asylum in the U.S. These are also called derivative asylees.

Overseas medical exams

• U.S.-granted asylees do not receive overseas medical exams.
• Follow-to-join asylees do receive overseas medical exams. MRHP receives those records from CDC/EDN and uploads them to eSHARE for local public health access.

How do asylees get connected with services?

• U.S.-granted asylees often have difficulty connecting to services and benefits, especially since MRHP does not receive official notifications of their arrival or their contact information from federal partners. They often self-refer once their asylum is granted.  
• MRHP receives contact information for follow-to-join asylees in their overseas medical records. MRHP sends them a letter and an email describing the Refugee Health Assessment and how to apply for health insurance and other benefits. If asylees do not contact local public health or MRHP in response, local public health or MRHP will complete a Refugee/Immigrant Health Assessment Outcome Report (PDF) and close the eSHARE record.

Health insurance status

• Follow-to-join asylees may be joining established family members who are working. Therefore, they may not qualify for Medical Assistance (MA). MRHP recommends waiting to schedule follow-to-join asylees after MA is active.

Case managers

• U.S.-granted and follow-to-join asylees do not receive services through Reception and Placement (R&P) and will not have R&P case managers. However, asylee may have a case manager through the preferred communities/intensive case management program.

Definition

There are four ways in which a Cuban or Haitian national may be classified as an Entrant

• Humanitarian parole under INA 212(d)(5)
• Conditional parole under INA 236 (as long as they have not acquired any other status) and no final order of removal
• In removal proceedings (under INA 212 or expedited removal under INA 235) and no final order of removal
• Pending asylum application with DHS and no final order of removal

Overseas medical exams

• Cuban and Haitian Entrants do not receive overseas medical exams.

How do Cuban and Haitian Entrants get connected with services?

• Cuban and Haitian Entrants often have difficulty connecting to services and benefits, especially since MRHP does not receive official notifications of their arrival or their contact information from federal partners. They often self-refer or are referred by their U.S.-based sponsors.

Case managers

• Cuban and Haitian Entrants do not receive services through Reception and Placement (R&P) and will not have R&P case managers. However, Cuban and Haitian Entrants may have a case manager through the preferred communities/intensive case management program.

Definition

• Humanitarian parolees are provided temporary legal entry into the U.S. during urgent humanitarian circumstances. Some individuals apply for parole under special programs such as Uniting for Ukraine and Operation Allies Welcome (Afghanistan). Some parolees have private sponsors who have agreed to be financially responsible for them during the duration of their time in the U.S. Only some humanitarian parolees are eligible for ORR benefits.

Overseas medical exams

• Humanitarian parolees do not receive overseas medical exams.

How do humanitarian parolees get connected with services?

• Humanitarian parolees often have difficulty connecting to services and benefits, especially since MRHP does not receive official notifications of their arrival or their contact information from federal partners. They often self-refer or are referred by their U.S.-based sponsors or community-based organizations.

Case managers

• Humanitarian parolees do not receive services through Reception and Placement (R&P) and will not have R&P case managers. However, humanitarian parolees may have a case manager through the preferred communities/intensive case management program.

Definition

• Special Immigrant Visas may be granted to individuals who worked with the U.S. Armed Forces or under Chief of Mission authority as a translator or interpreter in Iraq or Afghanistan.

Overseas medical exams

• Special Immigrant Visa holders (SIVs) receive overseas medical exams. However, MRHP only receives overseas medical records for some SIVs, including those who work with resettlement agencies or have a Class B condition.

How do Special Immigrant Visa holders get connected with services?

• SIVs access services through various channels, including with the assistance of case managers, family and friends, and community organizations.

Case managers

• SIVs are eligible for resettlement agency case management services and choose whether or not they utilize these services.

Definition

• Human trafficking involves the use of force, fraud, or coercion to obtain some type of labor or commercial sex act.
• The federal Office on Trafficking in Persons (OTIP) issues certification letters (adults) and eligibility letters (minors) to permit individuals who have experienced trafficking to access ORR benefits. 

Overseas medical exams

• Victims of trafficking (VOTs) do not receive overseas medical exams.

How do VOTs get connected with services?

• MRHP receives notification of VOTs from OTIP. Notifications include a point of contact which is often a lawyer or a case worker at a legal, social service, or non-profit agency. MRHP connects with points of contact to offer the Refugee Health Assessment and advise about applying for health insurance and other benefits.

Health insurance status

• VOTs may have been in the U.S. for years, in contrast to other groups MRHP serves. Therefore, they may have already established healthcare or health insurance. MRHP recommends waiting to schedule VOTs after Medical Assistance (MA) is active.

Case managers

• VOTs often have case managers at a legal, social service, or non-profit agency.

Confidentiality

• Maintaining confidentiality is especially important for this population. MRHP advises local public health to discuss clients’ communication preferences prior to sending mail, leaving voicemails, requesting parent/guardian signatures, etc. At the beginning of the relationship, local public health should also inform clients about exceptions to confidentiality such as mandated reporting so that clients can decide what to share.

Definition 

• Secondary newcomers initially settle in a state other than Minnesota but migrate to live in Minnesota. This move can occur within days, weeks, months, or longer after arrival to the U.S. 

Overseas medical exams

• Secondary refugees and follow-to-join asylees will have completed overseas medical exams. MRHP will request the overseas medical records, if available, from the initial state of arrival.

How do secondary newcomers get connected with services?

• Secondary newcomers often move to Minnesota to be closer to family and friends. Their family and friends often assist in connecting them with services.

Refugee Health Assessments for secondary newcomers

• The Refugee Health Assessment is appropriate for ORR-eligible populations who are within one year of their U.S. arrival or eligibility date and who have not yet received an assessment. Refer to Who is eligible for a Refugee Health Assessment.

Health insurance status

• It is important to verify the health insurance status of secondary newcomers before starting the Refugee Health Assessment. If a secondary newcomer does not qualify for public or private health insurance, they will be responsible for cost of the health assessment. It is not necessary to complete an assessment under these circumstances.
• Currently, secondary newcomers do not qualify for the federal Flat Fee reimbursement. Refer to Health Insurance and Provider Reimbursement.

Case managers

• Secondary newcomers, unless their case is officially transferred from their primary state, will not have Reception and Placement (R&P) case managers in Minnesota.

Process for secondary newcomers

If primary state notifies MRHP of a secondary newcomer’s move to Minnesota:

• MRHP will create an eSHARE file containing overseas medical records. These records will indicate assessment eligibility on the cover page.
• If a secondary newcomer completed or started the Refugee Health Assessment in the primary state, MRHP will provide local public health the contact information of the facility that conducted the screening. Local public health will be responsible for obtaining the results by contacting the facility, which usually requires that the patient sign a medical release form.

If secondary newcomers contact local public health requesting assistance with Refugee Health Assessment:

• Local public health will complete the New Arrival Notification and Screening Referral form.
• MRHP will request the assessment status and overseas medical records, if available, from the initial state of arrival. MRHP will create an eSHARE file.
• If a secondary newcomer completed or started the screening in the primary state, MRHP will obtain the facility’s name and contact information. Local public health will be responsible for obtaining the screening results by contacting the facility, which usually requires that the patient sign a medical release form.