Christopher Coen
Melissa Sogard
nancylee1
A sudden increase in refugee resettlement in Wilmington, North Carolina is taxing local medical providers. The Wilmington affiliate of Episcopal Migration Ministries, Interfaith Refugee Ministry, based in New Bern, just began resettling refugees to Wilmington earlier this year.
A program to relocate political refugees in Wilmington has expanded faster than initially expected since it started earlier this year, leaving some medical providers pushed to fulfill the required health screenings.
As of mid-July, 43 refugees had moved to Wilmington since the beginning of the year. Resettlement officials expect that number to grow in the coming years.
The New Hanover County Health Department is in charge of the refugees’ initial health screenings soon after they arrive.
Betty Jo Bennett, a personal health nurse supervisor at the health department, described the services as an unfunded mandate, though she added the health department was fine with doing the tests.
“It’s growing faster than we anticipated,” she said during a presentation on refugee health to the county health board this month.
The health department so far has shifted job responsibilities to handle the screenings. But if the number of refugees double as expected next year, the health department will have to hire another full-time position, officials said.
Because the health department is responsible for public health, they are required to handle the communicable disease screenings and prevention.
Two licensed practical nurses and an administrative support staffer handle the screenings. The refugees undergo lab work and testing for tuberculosis or other communicable diseases and receive immunizations if necessary.
“Some come without an immunization record,” Bennett said. “We’re just doing infectious disease control like we always do.”
Many of the individuals who have come to Wilmington this year are ethnic Karen who fled from Myanmar, said Jamie Mills, director of the Interfaith Refugee Ministry Wilmington group that opened offices in January at St. James Episcopal Church on Third Street. here
Although New Hanover County Health Department is screening the refugees for communicable diseases, as required of all health departments, they decided that they could not do physical exams for refugees. As a result, Interfaith Refugee Ministry must find medical providers to do the exams – medical providers who also accept Medicaid.
As part of the refugee resettlement program, those coming into the country are eligible for Medicaid for up to eight months.
The refugees also are required to undergo physical exams as part of their entrance process. The health department has the option to conduct those physicals, as is done at New Bern’s health department, but New Hanover health officials decided they could not take on the extra work since they do not handle primary care.
Mills said that when he got to Wilmington, he received a page of area primary care doctors’ offices that stated they accepted Medicaid.
When he started making appointments for the refugees’ physical exams, he ran into the same problem other Medicaid recipients face.
“Only three accepted new patients,” Mills said. “At this point, we’re managing.”
My question about this, therefore, is why the State Department, EMM, and Interfaith Refugee Ministry are resettling refugees faster than initially expected? Regulations mandate that the state refugee coordinator hold quarterly meetings with state and local officials, resettlement agencies and other service providers. Were these meetings ever held? Was any plan set up for how refugees would receive both health screenings (for communicable diseases) as well as physical exams? It seems a bit late in the process to suddenly find out that the public health office won’t do the physical exams, and that there are only three medical providers who both accept Medicaid and are able to accept new patients.
