Support and Resources for Ukrainian Newcomers to the U.S.
TB & Ukrainian Newcomers
TB Nurse Network July 20, 2022
Helen McGuirk
State Refugee Health Coordinator
Uniting for Ukraine (U4U)
•
On April 21, 2022, President Biden announced
, a new process
to provide Ukrainian citizens and others fleeing Russia’s aggression opportunities
to come to the U.S.Uniting for Ukraine
•
Stay temporarily in the U.S. with a two-year parole
•
Ukrainians participating in U4U must have a supporter in the U.S. who agrees to
provide them with
for the duration of their U.S. stay.financial support
U4U Health Requirements
•
Prior to U.S. arrival
health attestation:
―
Attest received at least one dose of
MMR, IPV, and COVID-19
•
Within 90 days of U.S. arrival
health attestation:
―
IPV
and
COVID-19 vaccines
(if not available prior to entry)
―
2 years and older: TB screening starting with an
IGRA
blood test. TST is not
accepted. The attestation includes agreeing to take appropriate measures,
including additional screening and treatment measures should the screen be
positive.
•
Failure to comply can lead to termination of their parole, detention, and removal
from U.S.
•
Example of the health attestation page
Ukrainian Newcomer Health Considerations
•
Vaccination coverage
in Ukraine is among the lowest in the WHO European Region.
Vaccine
hesitancy
is a major concern.
•
Increased risk of
diarrheal disease
in children (rotavirus vaccine not included in Ukraine’s national
routine vaccination schedule
).
•
Measles
is endemic in Ukraine
•
In October 2021, an outbreak of vaccine-derived
polio
was confirmed in Ukraine. The national
polio immunization campaign was suspended following the Russian invasion.
•
Ukraine is considered a high TB priority country and has a high burden of
multidrug-resistant
(MDR) TB
.
•
Mental health
– trauma/PTSD, depression, anxiety, family separation
•
Many left without medications, eyeglasses, health aids, medical/vaccine records.
CDC Interim Clinical Considerations for Providers Caring for Newcomers from Ukraine
•
As of May 21, 2022, the
AUSAA
gives specific Ukraine populations and other non-
Ukrainian individuals eligibility for benefits
―
Mainstream benefits: Temporary Assistance for Needy Families, Medicaid,
Supplemental Nutrition Assistance Program, Supplemental Security Income
―
Refugee benefits/services: ORR federally-funded programs like cash assistance,
medical assistance, and
domestic medical exam
.
Additional Ukrainian Supplemental Appropriations Act,
2022 (AUSAA)
Pathways to the U.S. for Ukrainian Newcomers
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Courtesy of Washington Department of Health
Ukrainian Newcomers – Process & Eligibility
Courtesy of Washington Department of Health
1
Includes TB screening (per CDC Technical Instructions) and recommended immunizations, if eligible
2
Plans to fund resettlement agencies for outreach, intake and assessment, referral, and follow-up services for this population.
U4U Supporter Applications*
•
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)
―
1 U4U application = 1 potential Ukrainian beneficiary
•
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)
―
Ukrainian beneficiaries have 90 days to arrange travel and enter the U.S.
•
Michigan is the 10
th
highest state for U4U supporter applications, receiving 2% of nation’s total.
*data as of 7/15
[Note – about 20,000 Ukrainians arrived in the U.S. prior to the U4U program]
U4U Supporter
Applications* –
Michigan Counties
O
a
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l
a
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d
,
M
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8
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o
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*data as of 7/15
N
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E
:
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U
4
U
a
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v
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l
s
.
Office of Global Michigan
•
Coordinating with Ukrainian coalitions in SEMI to communicate benefit eligibility,
resources available for this pop., and create new programing
•
Federal funding arriving soon to support school and mental health programs
•
Communicating health requirements and considerations with LHDs, refugee
clinics, FQHCs, and other health partners
•
Creating partnerships in regions where refugees are typically not resettled
MI Refugee Health Clinics
How to Help
•
In Wayne/Oakland/Macomb Counties refer to Samaritas (refugee resettlement agency) and ACC
(refugee health clinic)
•
Refer to refugee health clinics for medical exam, IGRAs, and vaccinations
•
Share the
Michigan factsheet
(English, Ukrainian, Russian)
•
Questions:
LEO-RefugeeServices@michigan.gov
Resources
G
e
n
e
r
a
l
•
Ukrainian Humanitarian Parolees in Michigan
•
Benefits for Ukrainian Humanitarian Parolees
•
USCIS
and
DHS
Uniting for Ukraine sites
•
Cultural Quick Reference Guide: Ukraine (SNTC)
H
e
a
l
t
h
C
o
n
s
i
d
e
r
a
t
i
o
n
s
•
CDC Interim Clinical Considerations for Providers Caring for Newcomers from Ukraine
•
Clinicians Caring for Ukrainian Arrivals
•
Refugee Health Exam
•
U4U health attestation example
•
Documenting Vaccination
•
Pink Book: VPDs in Multiple Languages
T
u
b
e
r
c
u
l
o
s
i
s
•
Q&A About TB - Booklet (CDC) (PDF)
Ukrainian (PDF)
•
General TB Information Fact Sheet (CDC) (PDF)
|
Ukrainian (PDF)
•
12-Dose Regimen for Latent TB Infection Medication- Tracker And Symptom Checklist (CDC) (PDF)
|
Ukrainian
•
12-Dose Regimen for Latent TB Infection- Patient Education Brochure (CDC) (PDF)
|
Ukrainian
•
You Can Prevent Tuberculosis: A Patient Educational Handout (SNTC)
|
Ukrainian
•
You can have TB and Feel Healthy (Massachusetts Dept. of Health)
|
Ukrainian
|
Russian
•
You have TB Infection (Massachusetts Dept. of Health)
|
Ukrainian
|
Russian
•
How to take your TB medicine (Massachusetts Dept. of Health)
|
Ukrainian
|
Russian
•
Keep taking your TB medicine (Massachusetts Dept. of Health)
|
Ukrainian
|
Russian
Helen McGuirk
State Refugee Health Coordinator
mcguirkh@michigan.gov
517-256-4250
The content provides essential information on health considerations, vaccination requirements, and available benefits for Ukrainian newcomers arriving in the U.S. It covers topics like TB screening, vaccine coverage in Ukraine, mental health trauma concerns, and supplemental appropriations available under the AUSAA. The materials aim to assist healthcare providers and support systems in ensuring the well-being of Ukrainian immigrants during their transition.
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Presentation Transcript
TB & Ukrainian Newcomers TB Nurse Network July 20, 2022 Helen McGuirk State Refugee Health Coordinator mcguirkh@michigan.gov
Uniting for Ukraine (U4U) On April 21, 2022, President Biden announced Uniting for Ukraine, a new process to provide Ukrainian citizens and others fleeing Russia s aggression opportunities to come to the U.S. Stay temporarily in the U.S. with a two-year parole Ukrainians participating in U4U must have a supporter in the U.S. who agrees to provide them with financial support for the duration of their U.S. stay.
U4U Health Requirements Prior to U.S. arrival health attestation: Attest received at least one dose of MMR, IPV, and COVID-19 Within 90 days of U.S. arrival health attestation: IPV and COVID-19 vaccines (if not available prior to entry) 2 years and older: TB screening starting with an IGRA blood test. TST is not accepted. The attestation includes agreeing to take appropriate measures, including additional screening and treatment measures should the screen be positive. Failure to comply can lead to termination of their parole, detention, and removal from U.S. Example of the health attestation page
Ukrainian Newcomer Health Considerations Vaccination coverage in Ukraine is among the lowest in the WHO European Region. Vaccine hesitancy is a major concern. Increased risk of diarrheal disease in children (rotavirus vaccine not included in Ukraine s national routine vaccination schedule). Measles is endemic in Ukraine In October 2021, an outbreak of vaccine-derived polio was confirmed in Ukraine. The national polio immunization campaign was suspended following the Russian invasion. Ukraine is considered a high TB priority country and has a high burden of multidrug-resistant (MDR) TB. Mental health trauma/PTSD, depression, anxiety, family separation Many left without medications, eyeglasses, health aids, medical/vaccine records. CDC Interim Clinical Considerations for Providers Caring for Newcomers from Ukraine
Additional Ukrainian Supplemental Appropriations Act, 2022 (AUSAA) As of May 21, 2022, the AUSAA gives specific Ukraine populations and other non- Ukrainian individuals eligibility for benefits Mainstream benefits: Temporary Assistance for Needy Families, Medicaid, Supplemental Nutrition Assistance Program, Supplemental Security Income Refugee benefits/services: ORR federally-funded programs like cash assistance, medical assistance, and domestic medical exam.
Pathways to the U.S. for Ukrainian Newcomers Overseas medical exam Overseas medical exam Application for Refugee Visa Security Checks Security approved Refugee visa Resettlement/ Refugee Refugee Travel to U.S Overseas medical exam Domestic medical exam Domestic medical exam Ukrainian beneficiary completes attestation: 1. Supporter relationship 2. Vaccines TB and immunization attestation USCIS/DHS reviews: 1. Background check 2. Financial support Complete TB and Humanitarian Parole Humanitarian Parole through through U4U U.S. supporter files I-134 I-134 approved TB and immunization attestation immunization attestation within 90 days Travel to U.S I-134 U4U Humanitarian Parole Humanitarian Parole independent travel Complete health requirements (if required for parole) Travel from overseas to U.S. border Enter U.S. via humanitarian parole Travel from overseas to U.S. border Temporary Protected Temporary Protected Status Status (TPS) Apply for nonimmigrant visa Nonimmigrant visa approved Enter U.S. with nonimmigrant visa Apply for TPS TPS approved (TPS) Courtesy of Washington Department of Health
Ukrainian Newcomers Process & Eligibility Overseas Medical Overseas Medical Exam Exam1 1 Domestic Medical Domestic Medical Exam Exam1 1 U.S. Entry Pathway U.S. Entry Pathway Health Attestation Health Attestation Resettlement Support Resettlement Support Medical Records Medical Records Refugee resettlement agencies EDN (English) Eligible, Recommended Refugee Required None Before and after arrival Eligible, Recommended Humanitarian Parolee Uniting for Ukraine (U4U) Only with client (Potentially in Ukrainian) Sponsor support2 None Eligible, Recommended Humanitarian Parolee independent travel Only with client (Potentially in Ukrainian) None2 None None Temporary Protected Status (TPS) Only with client (Potentially in Ukrainian) None None None Not eligible 1 Includes TB screening (per CDC Technical Instructions) and recommended immunizations, if eligible 2 Plans to fund resettlement agencies for outreach, intake and assessment, referral, and follow-up services for this population. Courtesy of Washington Department of Health
U4U Supporter Applications* 79,970 79,970 U4U supporter applications filed in the U.S. (8% increase from previous week) 1 U4U application = 1 potential Ukrainian beneficiary 52,236 52,236 U4U beneficiaries approved for travel to the U.S. (10% increase from previous week) Ukrainian beneficiaries have 90 days to arrange travel and enter the U.S. Michigan is the 10thhighest state for U4U supporter applications, receiving 2% of nation s total. [Note about 20,000 Ukrainians arrived in the U.S. prior to the U4U program] *data as of 7/15
NOTE: NOTE: Not Not the number of expected U4U arrivals. the number of expected U4U arrivals. Allegan 9 Ingham 19 Monroe 6 Antrim 2 Iron 13 Muskegon 2 Barry 2 Isabella 7 Oakland Oakland 691 691 Benzie 1 Kalamazoo 13 Otsego 5 Berrien 15 Kalkaska 1 Ottawa 11 U4U Supporter Applications* Michigan Counties Calhoun 2 Kent 46 Saginaw 1 Chippewa 1 Lapeer 3 Saint Clair 1 Clinton 2 Lenawee 5 Saint Joseph 2 Eaton 6 Livingston 20 Shiawassee 1 Genesee 7 Mackinac 5 Tuscola 1 Grand Traverse 28 Macomb Macomb 647 647 Van Buren 1 Hillsdale 4 Marquette 9 Washtenaw 61 Houghton 17 Midland 2 Wayne Wayne 293 293 Oakland, Macomb and Wayne Counties account for 82% Michigan applications Huron 3 Missaukee 9 Wexford 5 82% of *data as of 7/15
Office of Global Michigan Coordinating with Ukrainian coalitions in SEMI to communicate benefit eligibility, resources available for this pop., and create new programing Federal funding arriving soon to support school and mental health programs Communicating health requirements and considerations with LHDs, refugee clinics, FQHCs, and other health partners Creating partnerships in regions where refugees are typically not resettled
MI Refugee Health Clinics Clinic Location Clinic Location Clinic or Provider Name Clinic or Provider Name Contact Contact Hayfa Aziz 248-559-1990 hayfaa@myacc.org Dearborn Warren Arab American and Chaldean Council (ACC) Marisa Stieber 734-769-0209 mstieber@jfsannarbor.org Jewish Family Services of Washtenaw County through St. Joe s Health System Ann Arbor Izabela Wackowski-Norris 517-887-4302 (Forest) 517-887-4305 (Cedar) iwackowski@ingham.org Forest Community Health Center Cedar Community Health Center (pediatrics) Lansing Josh Potter 616-632-7197 joshua.potter@kentcountymi.gov Grand Rapids Kent County Health Department Kalamazoo Family Health Center rms@fhckzoo.com Jennifer Markos 269-969-6387 jmarkos@calhouncountymi.gov Battle Creek Calhoun County Health Department
How to Help In Wayne/Oakland/Macomb Counties refer to Samaritas (refugee resettlement agency) and ACC (refugee health clinic) Refer to refugee health clinics for medical exam, IGRAs, and vaccinations Share the Michigan factsheet (English, Ukrainian, Russian) Questions: LEO-RefugeeServices@michigan.gov
Resources General General Ukrainian Humanitarian Parolees in Michigan Benefits for Ukrainian Humanitarian Parolees USCIS and DHS Uniting for Ukraine sites Cultural Quick Reference Guide: Ukraine (SNTC) Health Considerations Health Considerations CDC Interim Clinical Considerations for Providers Caring for Newcomers from Ukraine Clinicians Caring for Ukrainian Arrivals Refugee Health Exam U4U health attestation example Documenting Vaccination Pink Book: VPDs in Multiple Languages Tuberculosis Tuberculosis Q&A About TB - Booklet (CDC) (PDF) Ukrainian (PDF) General TB Information Fact Sheet (CDC) (PDF)| Ukrainian (PDF) 12-Dose Regimen for Latent TB Infection Medication- Tracker And Symptom Checklist (CDC)(PDF)| Ukrainian 12-Dose Regimen for Latent TB Infection- Patient Education Brochure (CDC) (PDF) | Ukrainian You Can Prevent Tuberculosis:A Patient Educational Handout (SNTC)| Ukrainian You can have TB and Feel Healthy (Massachusetts Dept. of Health) | Ukrainian | Russian You have TB Infection (Massachusetts Dept. of Health) | Ukrainian | Russian How to take your TB medicine (Massachusetts Dept. of Health) | Ukrainian | Russian Keep taking your TB medicine (Massachusetts Dept. of Health) | Ukrainian | Russian Helen McGuirk State Refugee Health Coordinator mcguirkh@michigan.gov 517-256-4250
