Refugee Health Quarterly

December 2024

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• Greetings from the Refugee Health Team
• Data and Surveillance
• Welcome Corps
• Changes to Benefit Eligibility for Ukrainian Humanitarian Parolees
• Community Spotlight: M Health Fairview Clinic – Bethesda
• International Health Update
• Announcements
• Upcoming Events
• Contact Us

Greetings from the Refugee Health Team

It’s been a busy year for resettlement in Minnesota and across the country. In Fiscal Year (FY) 2024 (Oct. 1, 2023 - Sept. 30, 2024), the U.S. welcomed 100,034 refugees – the highest number in more than 30 years! Minnesota welcomed 2,990 of these refugees through an increasingly diverse set of pathways. We have seen innovation in refugee resettlement, from diversification of humanitarian protection statuses to new programs such as Welcome Corps and Virtual Reception and Placement (R&P). It is thanks to the adaptability and dedication of our partners that we have been able to welcome this record number of arrivals and provide the support they need.

It is too early to say how the presidential administration change will affect refugee resettlement numbers and operations in FY2025 and beyond. However, we will continue to support newcomers in Minnesota and will keep our partners apprised of any changes. In the meantime, keep up the good work as we all continue our critical task of welcoming new arrivals to our state – together.

Thank you for your partnership. We look forward to our ongoing collaboration!

Data and Surveillance

2023 Refugee Arrivals and Health Assessment Results

From Jan. 1, 2023 through Dec. 31, 2023, 2,229 individuals arrived to Minnesota as refugees, special immigrant visa (SIV) holders, asylees, Afghan parolees, or certified victims of human trafficking. The majority (2,045) of these arrived with a refugee visa. The most common countries of origin among these arrivals were Somalia (653), Democratic Republic of Congo (242), and Burma (205).

Among these 2,229 arrivals, 2,102 were eligible for a post-arrival Refugee Health Assessment (RHA) and 2,066 (98%) received an RHA. Select results from the RHA are highlighted in the table below.

In addition to the arrivals above, our program was notified of 991 Ukrainian humanitarian parolees and 54 Cuban/Haitian Entrants who arrived in Minnesota during 2023. While these individuals are eligible for refugee benefits, our program does not receive systematic notification of these arrivals. Those who are referred to our program are then referred to local public health and screening clinics for required post-arrival testing and a post-arrival RHA.

Health Status of New Refugees*, Minnesota, 2023
Total number of health screenings: 2,066 (98% of 2,102 eligible refugees)

*Includes primary refugees, asylees, Afghan parolees, Special Immigrant Visa holders, and certified victims of human trafficking
**Persons with LTBI (QFT+ or ≥ 10mm induration w/ normal CXR). An additional 5 had suspect or confirmed TB disease.
***Positive for Hepatitis B surface antigen (HBsAg)
****Positive for at least one intestinal parasite infection
*****Children <17 years old (859 screened); Lead Level ≥5 ug/dL
******Adults 18+ years old (N_Minnesota = 1,155 screened); Screened positive for mental health concerns using any mental health screening tool(s)

2024 Preliminary Refugee Arrivals (January to September)

From Jan. 1, 2024 through Sept. 30, 2024, 2,713 individuals arrived to Minnesota as refugees, SIV holders, asylees, Afghan parolees, or certified victims of human trafficking (these data are preliminary). The majority (2,343) arrived with a refugee visa. The most common countries of origin among these arrivals were Somalia (969), Afghanistan (410), and Burma (179). Additionally, our program was notified of 674 Ukrainian humanitarian parolees and 22 Cuban/Haitian entrants who arrived in Minnesota during the same time period.

Welcome Corps

In the past few months, there has been a notable increase in refugee arrivals through Welcome Corps, the private refugee sponsorship program launched in early 2023. Many recent Welcome Corps arrivals are sponsored by people they know, and Minnesota continues to lead the country in private sponsor group applications. Access information and resources for supporting Welcome Corps arrivals in Minnesota at Refugee Health Community Partners and Sponsors and Refugee Welcome Collective: State-by-State Resources for Newcomers and Sponsors. Learn more at Welcome Corps.

Changes to Benefit Eligibility for Ukrainian Humanitarian Parolees

As part of the Uniting for Ukraine program, the Office of Refugee Resettlement (ORR) provided refugee benefits and services to eligible Ukrainian humanitarian parolees. However, due to current policy, Ukrainian humanitarian parolees who are paroled into the U.S. on or after Oct. 1, 2024, are not eligible for refugee benefits and services, including the refugee health assessment. Certain Ukrainian humanitarian parolees arriving to join immediate family members who have been previously paroled into the U.S. may be able to continue to receive federal public benefits and refugee resettlement services. Refer to ORR: Ukrainian Humanitarian Parolees Eligible for ORR Benefits and Services Policy Letter 22-13 for details.

Health insurance
Please advise all Ukrainian humanitarian parolees to apply for health insurance (MNsure) to determine their eligibility. MNSure Navigators are available to help with this application.

Refugee health assessment (RHA)
Unless Ukrainian humanitarian parolees have active medical assistance (MA) or are ORR eligible, please do not schedule the RHA.

Required tuberculosis (TB) screening
Ukrainian humanitarian parolees will still need to complete their required tuberculosis (TB) testing and immunizations for immigration purposes: USCIS: Uniting for Ukraine Vaccine Attestation.

Submitting Requests for TB screening and RHA
Submit requests for Ukrainian humanitarian parolees who want TB screening or, if eligible, the RHA, using the New Arrival Notification and Screening Referral form. We will assist Ukrainian humanitarian parolees in accessing TB screening and immunizations or, if eligible, the RHA.

Those who submit New Arrival Notification and Screening Referral forms for ineligible Ukrainian humanitarian parolees will receive an email with information about the TB screening requirements, resources for applying for health insurance, additional community resources, and TB screening and immunization information specific to the newcomers’ county of residence. Most sponsors or newcomers will not need to wait for a call from their local public health department. Now, they will have the information they need to schedule their TB screening and immunizations themselves.

Questions may be directed to refugeehealth@state.mn.us.

Community Spotlight: M Health Fairview Clinic – Bethesda

M Health Fairview Clinic – Bethesda is a family medicine clinic in the Frogtown neighborhood of St. Paul. Bethesda has partnered with the Minnesota Department of Health Refugee Health Program for many years to perform refugee health assessments (RHA), a comprehensive medical exam offered to all new refugees within 90 days after arrival. Many of these visits are performed by resident physicians practicing at Bethesda through the Woodwinds Hospital Family Medicine Residency Program. Refugee newcomers often stay at Bethesda Clinic for primary care, giving residents the opportunity to provide ongoing care to these patients and bring this knowledge to their next practice.

Former Bethesda residents have taken their passion for refugee health around Minnesota. We now partner with former Bethesda residents in several counties across the state, where they have been instrumental in bringing their new clinics into Minnesota’s RHA infrastructure. We asked Dr. Madeleine Grosland-Sather, practicing at Allina Health Shakopee Clinic, and Dr. Sarah Halloran, currently at Allina Health Eagan Clinic, how their experience at Bethesda informs the work they do today.

What draws you to refugee health?

Dr. Grosland-Sather: It is so rewarding to take care of these lovely families who have had awful luck in the hand of life they were dealt. Refugees are some of the most vulnerable people in the world, and I feel a strong calling to be able to welcome them to the U.S. and help in whatever way I can. My great-grandparents came to the U.S. from Norway looking for better opportunities. Unless they have Native American heritage, the majority of Americans have that same story at some point in their family tree. We are a nation of immigrants and refugees, and I feel patriotic pride to be able to help us continue that American tradition. I have also been able to meet and become the primary care doctor of some incredibly strong and resilient people – they amaze me with their strength and grace in the face of huge adversities in the past. 

Dr. Halloran: Refugee health allows me to learn about new cultures/backgrounds, care for often marginalized populations, and also get to know the people who live in our community. Patients are generally grateful for their care and have stories and perspectives to share. I often learn so much from them. 

How did your work at Bethesda Clinic inform the care you give to refugee patients today?

Dr. Grosland-Sather: Bethesda gave me great training on refugee and global health in general. I came out of training very confident in my ability to manage immunity titers, H. pylori, latent TB, and many other conditions not regularly seen in the U.S. that otherwise would have been overwhelming to learn on my own. 

Dr. Halloran: Bethesda trained me to deal with populations that are very different from my own. It gave me the basic medical knowledge but more importantly the tools to address and understand more social/environmental issues that can also affect care. I am so grateful for my Bethesda family. I learned so much and am grateful I get to continue this journey. 

Interested in learning more about what it takes to become a RHA clinic? Reach out to us at refugeehealth@state.mn.us!

International Health Update

Staying Safe During Holiday Travel

There are numerous holidays that are celebrated over the winter season – including Lunar New Year, Christmas, Hmong New Year, and Hanukkah – and many reasons for gathering with our loved ones in the next few months! For many Minnesotans, this may mean traveling to another state or to another country to visit friends and relatives. Traveling during the winter season brings with it specific health and safety considerations. Add these items to your to-do list to make sure you can make the most of your travel plans:

• Get the latest influenza and COVID-19 vaccines.
• Visit a travel clinic, even if you are traveling last minute. Find a clinic at International Travel Health Clinics Serving Minnesota Residents.
• Check to make sure you have the right medications and vaccinations for your travel destination. The last thing you want to do is get sick on your trip! For more information, visit Guidance for Travelers: International Travel & Infectious Disease.
• Pack smart! Your travel destination may have different weather than Minnesota winters – don’t forget to bring sunscreen and EPA-approved insect repellant at Find the Repellant that is Right for You.

Wherever you are headed this holiday season, our International Health team wishes you safe travels!

New Plan Ahead Before Travel webpage

If you have an international trip planned and aren’t sure where to get started with travel health, check out MDH’s new Plan Ahead Before You Travel webpage! It lays out what to do in two easy steps and provides a month-by-month checklist to follow when planning your trip abroad. 

Submit Your Organization to Directories for Organizations Serving Diverse Communities

Did you know the Minnesota Department of Health’s Refugee Health Program and Infectious Disease Equity and Engagement Unit developed three directories for organizations serving diverse communities? They include: Health Services, Diverse Media, and Community-Based Organizations. In each one, you will find instructions for searching, navigating, and downloading information found in the directories.

If your organization is not currently in the directory but would like to participate, please visit Directories for Organizations Serving Diverse Communities for more information. Please click on the directory you would like to participate in and complete a quick form. If you have any questions, please reach out to health.idee@state.mn.us.

Announcements

Community Health Worker Solutions

Community Health Worker Solutions (CHW Solutions) is an exciting new resource that is available to Office of Refugee Resettlement-eligible newcomers. The organization is part of the Minnesota Department of Human Services Resettlement Programs Office’s Resettlement Network. CHW Solutions provides health education and outreach and individualized health supports focused on accessing needed health services, gaining skills in managing health conditions, and navigating health systems. CHW Solutions also provides health insurance enrollment services, including MNSure Navigation services and access to the designated process for refugees not connected to resettlement agencies. To learn more, visit the CHW Solutions website. CHW Solutions can be contacted at 612-870-3600 or ashleywilliams@chwsolutions.com.

Interpreter Vendor Directory for Rare Languages

The Minnesota Center of Excellence in Newcomer Health maintains a directory of vendors that offer interpretation services for languages not commonly spoken in the U.S., or "rare languages." The Interpreter Vendor Directory for Rare Languages is intended to be used by community partners, health care providers, and others in need of rare language interpretation services. Please use the Interpreter Vendor Directory for Rare Languages Form to suggest languages to add and/or to provide information about vendors that offer interpretation services for rare languages. New submissions may be added to the directory after verification. You may access the current directory via the form.

Resources from the Minnesota Department of Human Services

Visit the Minnesota Department of Human Services library of resources in multiple languages. This library includes translated versions of the State of Minnesota’s Welcome Guide for Newcomers and Refugee and Immigrant Helpline flyer.

Upcoming Events

Note: No meetings in July, August, November and December 2025. If you have any questions or comments, please reach out to cynthia.trevino@state.mn.us.

Minnesota Center of Excellence in Newcomer Health (MN COE)

Tune in on Thursday, Dec. 12, from 1 to 2:30 p.m. CT for our next MN COE webinar, Haitian Culture and Health Screening Considerations.

Learning objectives:

• Describe the history of migration of Haitians to the United States, and current drivers of migration.
• Discuss potential health issues and disparities of Haitians residing in the U.S.
• List three required or recommended components of medical screening/care for Haitian new arrivals.
• Describe two health care access problems faced by Haitians in the U.S.
• Identify at least three cultural considerations when providing care for Haitians in the United States.

To keep up to date with future MN COE webinars, announcements, and events, subscribe to our newsletter:

MN COE – ECHO Colorado Newcomer Series

The 2024 ECHO series ends in December! This monthly series is designed to increase medical providers' knowledge of the resettlement and health issues of newcomers, including refugee, immigrant, and migrant (RIM) populations. The next webinar is focused on Visiting Friends and Relatives Travelers on Dec. 10, 2024. Learn more and register at ECHO Colorado: Newcomer Health. To access resources and for 2025 information, visit the Newcomer Health ECHO Resource Page.

Contact Us

Thank you for your partnership. We look forward to our ongoing collaboration!

For more information or questions, please contact the Minnesota Department of Health Refugee Health Program at refugeehealth@state.mn.us or 651-201-5414.

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