Transcript A presentation - St. Michael`s Hospital

Interim Federal Health
Program: information for
health providers
Prepared September, 2013 by the Centre for Research on Inner City Health at St. Michael’s Hospital.
Please note: the information in this presentation is taken from resources developed in 2012 and early
2013. For more information, please contact: [email protected]
Interim Federal Health Program: information for health providers
About this presentation
This presentation contains a broad overview of changes to the Interim Federal Health
Program (IFH), in particular as they apply in Ontario. For more detail, and updates to the
policy, please consult the Citizenship and Immigration Canada website
(www.cic.gc.ca/english/refugees/outside/summary-ifhp.asp).
Most of the information included here comes from ‘Refugee Health Cuts Flowchart for
Frontline Workers in Ontario,’ created in February 2013 by a group of physicians/clinicians
and a lawyer. The most recent version is available at: www.crich.ca/refugeehealthcare
The information in this presentation is based on the best of our knowledge at the time of
writing. As IFH policy and its application are difficult to discern and change frequently, and
as different provincial governments have made varying commitments to refugee health
care, the information here cannot be considered definitive or applicable in all jurisdictions.
Please also note that some organizations offer people who are refugees health services not
covered under IFH. Providers should seek up-to-date information on policies, practices and
referral possibilities from other providers, health institutions and government sources.
Interim Federal Health Program: information for health providers
Additional resources
For more information on the changes to IFH, please see:
- Doctors for Refugee Health Care
(www.doctorsforrefugeecare.ca)
- Health for All (www.health4all.ca)
- Canadian Council for Refugees
(http://ccrweb.ca)
Interim Federal Health Program: information for health providers
Background: the Interim Federal Health program
Before the changes, all refugees in Canada
received access upon arrival to:
- Health care roughly comparable to what OHIP
provides.
- Basic medications, basic vision care, emergency
dental care, prosthetic limbs, psychotherapy, home
care, long term care and assistive devices.
Interim Federal Health Program: information for health providers
Background: the Interim Federal Health program
Now, there are several classes of federal health
coverage for refugees:
1. Expanded health care coverage
2. Health care coverage
3. Public health and safety coverage
Interim Federal Health Program: information for health providers
Expanded health care coverage
- Applies to Government Assisted Refugees (GARs),
Privately Sponsored Refugees in receipt of Resettlement
Assistance, some people classified as victims of human
trafficking and potentially others at the discretion of the
Minister of Citizenship and Immigration.
- Is the same as the old IFH program: covers medical
services, basic medications, basic vision care, emergency
dental care, prosthetic limbs, psychotherapy, home care,
long term care and assistive devices. (For a full list please
consult CIC.)
Interim Federal Health Program: information for health providers
Health care coverage
- Applies to refugee claimants who do not qualify for expanded health care coverage and
who are not:
- From a Designated Country of Origin
- Rejected refugee claimants
- Includes all medical services (clinic, ER, hospital, specialists) and diagnostic tests. Does
not include coverage for medications unless condition is considered a matter of public
health and safety. (Please see: www.cic.gc.ca/english/refugees/outside/arrivinghealthcare.asp#public for CIC’s definition of ‘public health and safety.’)
- Refugees who are eligible for Ontario Works or OSDP can access medications through
these programs. (Please note, Privately Sponsored Refugees receive OHIP but are not
eligible for OW or ODSP.)
- It does not cover long-term care, rehabilitative care or elective surgery. Chemotherapy
does not seem to be covered. It is unclear whether in-hospital medicines are covered.
Interim Federal Health Program: information for health providers
Public health and safety coverage
- Applies to refugees from Designated Countries of Origin (DCOs) and
rejected refugee claimants.
- Rejected refugees claimants are only covered until date of deportation.
- Provides no medical coverage in most situations.
- Provides medical coverage for conditions deemed a matter of ‘public
health and safety.’
-These include some diseases on Public Health Agency of Canada
website or a public safety concern as identified by an MD. More at:
www.cic.gc.ca/english/refugees/outside/arriving-healthcare.asp#public
Interim Federal Health Program: information for health providers
What is a Designated Country of Origin?
- A Designated Country of Origin (DCO) is a country placed by the Minister of Citizenship
and Immigration on a list of ‘safe’ countries. The list was declared on December 15th and
additional countries have been added since.
- New countries can be added to the list at any time at the discretion of the Minister.
- Please note: people from DCO countries who claimed refugee status before
December 15th 2012 still qualify for health care coverage. (Those from DCO countries
who claimed refugee status after December 15th receive only public health and safety
coverage.)
-There are currently 37 countries on the DCO list.
- The Minister of Citizenship and Immigration can add countries to the list at any time at his
discretion. The updated list can be found at: www.cic.gc.ca/english/refugees/reformsafe.asp
Interim Federal Health Program: information for health providers
What constitutes a ‘rejected refugee claimant’?
- For details on this, please consult with a legal professional.
- As far as we understand, health coverage does not end
until appeal mechanisms are exhausted.
Interim Federal Health Program: information for health providers
What else?
While the CIC website is clear that people with health coverage – which would include most
people with IFH – are covered for diagnostic tests, specialists, etc., this might not always
be happening in practice.
In addition, there have been occasions when clients were misclassified by Blue Cross. If
this is the case, the client can go to CIC themselves to find out their citizenship status and
attempt to have this corrected. *
If someone who should be covered is rejected by a lab or external provider, providers can
follow-up with the lab or external provider directly. They can also request a portal log-in with
Blue Cross and check what kind of coverage is listed for the client.
* Whatever follow-up action you take – or advise clients to take – with providers, CIC
or any external party, please consider the potential impact on clients who have
precarious immigration status.