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Health assessment for refugees and other humanitarian entrants into Australia

Question and Answers

Printable version of Health assessment for refugees and other humanitarian entrants into Australia -Questions and Answers

What is the purpose of this health assessment?

The purpose of the assessment is to develop a detailed history and undertake a physical examination of the patient to identify immediate and long term health care needs and to initiate treatment. Patients can also be introduced to preventative health care in Australia, in particular immunisation, maternal and child health care and breast and cervical screening.

How can a patient be identified as eligible for a refugee and other humanitarian entrants health assessment?

This health assessment is a voluntary service and applies to refugees and other humanitarian entrants who are resident in Australia with access to Medicare services.

If the patient comes from a country which has a history of conflict and human rights violations, eg Sudan, Burma, Iraq, Afghanistan, Sri Lanka, they are likely to be from a refugee background. A country of asylum or transit, eg, Kenya, Egypt or Thailand can also suggest a refugee background. Patients from refugee backgrounds can also be identified by their visa number which indicates the category of Australia’s Humanitarian program under which they arrived – see fact sheet for visa details.

This information may also be provided by the settlement service if they refer the patient to the GP.

What proof is there that a patient is a humanitarian entrant and eligible for a health assessment?

A humanitarian entrant should be able to provide proof of their visa status and date of arrival or residence (date of visa grant). Doctors can check that a patient holds an eligible visa in one of the following documents:

• A travel card known as a Document for Travel to Australia (DFTTA);
• A travel document including a Passport, a Titre de Voyage or a Certificate of Identity; or
• A Visa Evidence Card identified by the numbers PLO56 or M56 at the bottom of the card.

The date of entry to Australia is stamped in the patient’s travel document or card. The date of visa grant for Onshore Protection Programme visas is printed on the visa label. Doctors may telephone Medicare Australia on 132 011, with the patient present (with their Medicare card), to check whether the patient is eligible for this health assessment.

What medical records do refugees and other humanitarian entrants have on them when they arrive in Australia?

Not all refugees arrive in Australia with medical records. Some refugees may receive some form of medical records prior to their flight to Australia if their pre-departure health check found any health problems, or they had received treatment, or they had signed a Health Undertaking document at the time of the visa grant. The Health Manifest which includes personal and health information and the Pre Departure Results form are provided to refugee and humanitarian entrants and the IHSS settlement service provider. Doctors should ask refugee or humanitarian patients if they have brought medical documents with them at the consultation.

What health checks are undertaken offshore?

Visa medical examination: All refugee and humanitarian entrants undergo a basic medical examination during the visa application process to determine if they have any diseases or conditions which would represent a threat to public health, place too great an economic burden on the health system or prejudice the access of Australian citizens to health care services. For more information see Department of Immigration and Citizenship (DIAC) Fact Sheet 22, The Health Requirement.

Pre-departure Medical Screening (PDMS): The primary purpose of the PDMS is to determine fitness to fly and is undertaken within 72 hours of departure. Not all entrants undergo this screening. It is currently conducted in East and West Africa, Egypt, Sudan and Thailand. This consists of a symptom review, a rapid diagnostic test for malaria and empirical treatment of parasites. Chest x-rays may be repeated if done more than 6 months prior. See DIAC Fact Sheet 67a.

What is a Health Undertaking?

A patient with a Health Undertaking has been assessed to have specific health issues such as hepatitis or inactive tuberculosis that need follow-up and monitoring in Australia. By signing the Undertaking, the refugee agrees to report to the Health Undertaking Service for follow-up with their respective State or Territory health authority. Doctors should ask patients if they have a Health Undertaking. See DIAC Form 815.

What is a Red or General Alert?

Red or general alerts ensure entrants granted a visa but identified with significant medical conditions are provided with suitable medical attention during travel and upon arrival in Australia. See DIAC Fact Sheet.

What interpreting services are available to doctors and patients?

Fee-free interpreting services are available to doctors or specialists in private practice who provide services, claimable under Medicare, to patients who do not speak English and are permanent residents. The Department of Immigration and Citizenship through the Translating and Interpreting Service (TIS) provides the following fee-free interpreting services:

• a Doctor’s Priority Line which is a telephone interpreting service 24 hours, 7 days a week on 1300 131 450.
• limited on-site interpreting service which must be booked in advance (4 weeks is advised) by faxing request forms to 1300 654 151 or email Transplanting and Interpreting Service.
• a document translating service for select documents such as the patient’s medical certificate/report and vaccination certificate.

To become eligible for fee-free interpreter services the doctor’s provider number is forwarded to TIS by the doctor. Information about interpreter services can be obtained by phoning 1300 131 450 or from the DIAC website.

Does the health assessment need to be completed in a single consultation?

No. The assessment may be conducted over more than one consultation to ensure all elements of the assessment, including investigations, results and management plan can be undertaken. The GP claims only after the final session. In this situation, doctors should add the time taken in each consultation to determine which time-based MBS health assessment item applies.

Are patients eligible for other types of health assessment?

Only one refugee and other humanitarian entrant health assessment can be undertaken per patient within 12 months of arrival or grant of visa. If clinically indicated and with patient consent, other health assessments may be undertaken eg, a type 2 diabetes risk evaluation.

What tests are eligible for a Medicare rebate?

Medicare pays for clinically relevant services. This means services that are generally accepted by the medical profession as being necessary for the appropriate treatment of the patient and which are listed in the MBS.

Can the GP order pathology tests if there is no consultation item claimed for that day?

Yes.

Does Medicare have rules in regard to follow-up testing?

The principle of ‘clinical relevance’ applies to repeat pathology services.

What settlement support is available for new arrival refugees?

The Department of Immigration and Citizenship provide intensive settlement services through the Integrated Humanitarian Settlement Strategy (IHSS) to new arrivals arriving on visa class 200, 201, 203, 204 and 866. Services are generally provided for 6 months but may be extended for vulnerable clients. They include:

• on-arrival reception and initial orientation
• information about and referral to other service providers and mainstream agencies
• assistance with accommodation and basic household goods
• short term torture and trauma counselling (12 months)

Further information available on DIAC Fact Sheet 66 Integrated Humanitarian settlement Strategy.

Who is a proposer?

A proposer is a friend, relative or community organisation who has agreed to assist the person to settle in Australia. Proposers only apply to visa class 202, Global Special Humanitarian. Any proposer who accompanies a patient may be able to provide useful information about the patient on matters such as physical, psychological and social function but should not be used as an interpreter.

Further Information

For more information visit the Department of Health and Ageing’s website or phone the Medicare Australia enquiry line on 132 150.