*National executive teleconference summaries below.
RHeaNA brings together key representatives from each state and territory working within the policy, clinical and public health realms of refugee health. It was born out of the inaugural National Refugee Primary Health Care conference held in Brisbane in November 2008. It aims to:
- inform and support the development of quality holistic health care for refugees in Australia across all health sectors in all jurisdictions
- provide advice to policy-makers at Commonwealth and State/Territory level on current and emerging issues in refugee health in Australia
- provide a forum for exchange of information between providers of refugee health care and other relevant stakeholders across Australia.
- One of the first achievements of RHeaNA was a submission to the 2009 review of the National Primary Health Care Strategy.
The Victorian Refugee Health Network, along with other state representatives, shares information about local trends, challenges, service innovations and research at quarterly RHeaNA executive teleconferences. Should you wish to communicate some information to the RHeaNA executive email .
Victoria’s current executive members are:
- Lindy Marlow, Statewide Refugee Health Program Facilitator (RHeaNA Chair)
- Georgie Paxton, Head Immigrant Health, Royal Children’s Hospital
- Sue Casey, Manager, Sector Development and Partnerships, The Victorian Foundation for Survivors of Torture
- I-Hao Cheng, Adjunct Research Fellow, Southern Academic Primary Care Research Unit, Monash University
For further information visit RHeaNA’s website.
Executive national teleconference summaries (held quarterly)
Tuesday 19 June 2018
Executive members discussed the unresolved issue of interpreting services for allied health providing MBS billable services. It was felt that it may be time to raise awareness of this issue again and seek a solution.
Systems to notify appropriate medical personal about new arrivals with serious medical issues were discussed, recognising that a number of people arrive outside of regular clinic hours. The Department of Home Affairs is seeking to pass alerts directly to medical personal as well as through the Department of Social Services to settlement providers.
The RHeaNA ‘face-to-face’ meeting will be held in Melbourne on 3 August 2018, more information about the agenda to follow.
Tuesday 10 April 2018
Executive members discussed issues around HAPlite system and information flow. The introduction of HAPlite is more straight forward in some state/territories and not for others. Queensland wrote a letter to the Department of Social Services to request an extension of the interim arrangements.
The executive discuss the imminent changes in the Status Resolution Support Services and the impact this may have on people seeking asylum. The impact of short bridging visas on accessing Medicare and work rights was also raised.
An update about National Disability Insurance Scheme was provided that included the various challenges for access across the states and within each state.
Some states are pursuing advocacy around access to IGRA screening for people from refugee backgrounds.
Tuesday 6 February 2018
The Department of Home Affairs presented information about the HAPlite (immigration health database). Home Affairs hope to expand access to the database to all refugee health service providers from March 2018. Each state is considering how the database may be implemented in their jurisdiction. Humanitarian Settlement Providers will be able to provide a person’s HAP ID to health services to assist in locating records in the database. It is more complex to implement HAPlite in states with decentralised refugee health models like Victoria and Queensland.
Queensland is leading advocacy calling for an expansion in the Medicare Benefit Schedule access to IGRA to all people from refugee backgrounds to assist with TB screening for new arrivals.
Tuesday 24 October 2017
Executive members provided updates on service delivery and key issues in each state and territory. Themes included increased demand for services, increases in clients with complex health needs and issues related to access to latent tuberculosis (LTBI) screening. Some states reported that access to LTBI screening is difficult. Medicare rebates for Quantiferon Gold do not currently extend to all humanitarian entrants. Some RHeaNA executive members reported state funded LTBI screening. Joint advocacy was discussed and key TB contacts for each state will be circulated to executive members.
The 2018 RHeaNA face to face meeting was discussed, however no date has yet been set.
Lindy Marlow completed her term as the Chair of the RHeaNA executive and was thanked for her contributions. Dr Christine Phillips from ACT will chair for the next two year term.
Wednesday 29 March 2017 – annual ‘face to face’ meeting, Sydney
Representatives from states and territories summarised service provision models and shared key imperatives and challenges. Members continue to report complex needs among people arriving from Syria and Iraq, including chronic disease, people arriving with disabilities and older people. Concerns were raised about new arrivals’ ability to access disability services, particularly the NDIS. RHeaNA agreed to document case studies of barriers to accessing the NDIS for people from refugee backgrounds living with a disability to inform advice to the Commonwealth. Concerns were also raised about meeting the needs of the growing cohort of people seeking asylum who are becoming Medicare ineligible after a negative decision on their asylum claim. Members discussed setting an agenda for RHeaNA into the future, including opportunities for collaborative communication, joint advocacy work and engagement with other local and national networks. The need to attract funding for a RHeaNA secretariat was raised.
Tuesday 6 December 2016
Refugee health services in all states and territories continue to be busy seeing large numbers of arrivals from Syria and Iraq. Members reported complex health presentations amongst people arriving from this cohort, including chronic diseases, disability and frail elderly adults. There have been increases in clinics, staffing, and new services introduced in various states to meet the increased demand. In addition to increased funding allocations in NSW and Victoria, Queensland Health has allocated an additional $489,000 to refugee health over 2016/17 to assist with the increase in arrivals.
Members reported that when new arrivals move within or between states early in their settlement, this has implications for transfer of client information, unfinished on-arrival health assessments, and access to health and case management services. The Refugee Nurses of Australia (RNA) Interstate Transfer template has been designed to facilitate continuity of refugee health nurse care for clients who move between states and territories within Australia.
Members from all states and territories expressed concern about access to healthcare for the growing number of people seeking asylum who have a refusal decision affirmed by the Immigration Assessment Authority, and subsequently will not have access to Medicare. This was matter will be discussed at the first meeting in 2017.
Other issues discussed included:
- The inability of most refugee-background clients to pay fees charged by private general practices for release of medical records.
- Reduction of state-funded disability services as the NDIS is rolled out, and gaps this may create for people from refugee backgrounds – ie. those who do not meet the NDIS disability thresholds, and people who do not meet the residency requirement for NDIS services (people seeking asylum, people on TPV/SHEVs).
- The importance of health services staying engaged with settlement providers to ensure case managers are aware of appropriate refugee health referral options, especially when there is high staff turnover and new organisations tendering to deliver settlement services.
Tuesday 13th September 2016
Refugee health services in all states and territories reported high numbers of clients arriving from the Syrian and Iraqi cohort. The NSW and Victorian governments have allocated additional funding for health services to support the resettlement of people escaping humanitarian crises in Syria and Iraq – $32 million over four years in NSW and $11 million over 4 years in Victoria.
Australian Primary Health Networks (PHNs) have established a national refugee health community of practice. South Eastern Melbourne PHN is convening the group. Currently, North West Melbourne PHN, South Eastern Melbourne PHN, Eastern Melbourne PHN, Western Victoria PHN, Brisbane South PHN, Darling Downs & West Moreton PHN, South Western Sydney PHN, Nepean Blue Mountains PHN, Murrumbidgee PHN, ACT PHN, Country SA PHN, NT PHN have expressed interest in participating.
The Refugee Nurses of Australia (RNA) will be launched at the National Nursing Forum in Melbourne in October. RNA has developed an Interstate Transfer template for clients who move between states and territories within Australia. The form will facilitate information sharing between health services, and assist in linking clients with a refugee health nurse nearby to where they will be living. The referral form includes the client’s basic contact details only, and does NOT include client medical records which will only be forwarded after a signed ‘consent for release of information’ has been received from the new health care provider.
The group discussed the upcoming redesign of Australia’s humanitarian settlement services. The Department of Social Services (DSS) is merging the Humanitarian Settlement Services (HSS) and Complex Case Support (CCS) programs into a single program, the Humanitarian Settlement Program (HSP). DSS has called for tenders to deliver the new HSP, and will conduct co-design workshops to develop the model for the HSP with shortlisted tender respondents. RHeaNA members discussed the importance of health services participating the redesign, and discussed ways that RHeaNA could contribute to this process.
Tuesday 24th May 2016
State representatives sent written updates in advance which assisted the flow of the meeting. This process was endorsed and will continue in future national executive teleconferences.
A number of Australian health professional are presenting at the North American Refugee Health Conference (12-14 June 2016, Niagara Falls NY), including:
- Asylum Seeker Health Orientation and Triage Model for Northern and Western
Metropolitan Melbourne: Attending to the Complex Needs of Asylum Seekers Recently
Released from Immigration Detention Centres in Australia
Amelia Tauoqooqo, Jamad Hersi, Lindy Marlow, Bernice Murphy, Sue Casey, May Maloney, Peter Spink
- The Impacts of Adversity: Understanding the Complex Social and Psychological Reasons
for Asylum Seekers and Refugees Attendance at Primary Health Care Services
Katrina Anderson, Janine Rowse, Christine Phillips, Brian Chan
- Critical Case Analysis of Adverse Events Associated with Failure to use Interpreters for
Non-English Speaking Patients of Refugee Background
Katrina Anderson, Janine Rowse, Christine Phillips
Refugee Nurses Australia have ratified their Terms of Reference. They are working on an initiative to reduce clinical risk when clients are transferred between states, focusing on clients with complex health needs.
NSW and Victoria are both doing work to better understand the impact of the introduction of the National Disability Insurance Scheme (NDIS) on people from refugee backgrounds. There are specific concerns about funding for interpreters and case coordination which is often essential for people who are newly arrived from refugee backgrounds.
Those involved in the development of the Recommendations for comprehensive post-arrival health assessment for people from refugee-like backgrounds were congratulated. The interdisciplinary approach and extensive consultation was highlighted as a strength of the Recommendations which were launched in April at the Australasian Society for Infectious Diseases annual scientific meeting. More about the launch HERE.
Victoria advised that the Commonwealth Department of Health has funded an update of the guide Promoting Refugee Health. The project will take 8 months, and will include the creation of a website, and a print run of approximately 3000 desktop guides and 1500 books. There will be a national advisory group for this project.
RHeaNA also discussed the impact of No Jab, No Pay immunisation policy on families from refugee backgrounds. It was noted that service providers have had a significant increase in workload to update Australian Childhood Immunisation Register records.
Tuesday 1st March 2016
All states have been receiving lower than usual numbers of people arriving through the offshore program. All states are also preparing for the new intake of people escaping the conflicts in Syria and Iraq.
NSW Refugee Health Program is completing some work considering the impact of NDIS on people from refugee backgrounds. National Disability Insurance Scheme (NDIS) roll out will be a standing agenda item on the quarterly teleconferences.
Queensland Government launched a Refugee Health and Wellbeing Framework on 18 March, available HERE.
The RACGP Specific Interest Group in Refugee Health is updating the the active learning module about Refugee Health first developed by Foundation House.
Refugee Nurses Australia are developing their Terms of Reference; the group provides a national network for advocacy, information sharing and documenting the scope of practice of refugee health nurses.
Tuesday 20th October 2015
Aesen Thambiran’s (Western Australia) and Donata Sackey (Queensland) were both thanked for their contribution to the RHeaNA as chair and deputy chair, along with Brooke Gentry for her administrative support. Aesen has accepted the position as chair of the RACGP Special Interest Group in Refugee Health.
All states and territories reported that they had reduced numbers entering through the Humanitarian Settlement Support program. All jurisdictions are planning and preparing for the increased number of humanitarian arrivals escaping conflicts in Syria and Iraq. Many had met with Paris Aristotle, Chair of the Refugee Resettlement Advisory Council for a briefing and discuss national and local planning.
A new national network for Refugee Health Nurses is being established. On Nov 11 2015 nurses from around the country will discuss the membership and structure of the group. One or two people from each state will participate in the meeting.
RHeaNA Executive Members were reminded the the Medical Benefits Schedule (MBS) Taskforce is currently undertaking a consultation. Members were encourage to provide feedback about some of the barriers and enablers to the provision of care for people from refugee backgrounds. To read more about the MBS Review Taskforce click HERE.
Tuesday 21st July 2015
A national teleconference of the RHeaNA executive was held on Tuesday 21st July 2015, with representation from all states. There have been some changes on the executive in South Australia (SA) and in Tasmania due to staff changes. Jill Benson (SA), the most recent resignation from RHeaNA executive, was recognised for her contribution to the group.
The group discussed RHeaNA’s executive structure, governance and succession plan. Lindy Marlow Refugee Health Program Coordinator, Victoria, has volunteered to be the next chair in October. The executive are waiting for a nomination for deputy-chair. Membership will be managed through states, the website will be updated to reflect this.
Refugee health services are engaging with the new Primary Health Networks (PHN). Queensland reported positive engagement with their new PHNs who will continue to support the Refugee Health Connect. Likewise the Northern Territory PHN continues to include Refugee Health in their program of work. Other states are arranging meetings with PHNs.
The 5th Asia-Pacific Region Conference of the International Union Against Tuberculosis and Lung Disease will be held in Sydney in August-September, for more information click HERE. Preliminary discussion are also taking place about a Refugee Health National/International conference in 2017.
Tuesday 21st April 2015
A national teleconference of the RHeaNA executive was held on Tuesday 21st April 2015, with representation from most states. Offshore humanitarian arrivals where reportedly low amongst all the states, with some expectation that there would be an increase of arrival as the end of the financial year approaches in order to meet the annual quota. Services also spoke about management of patients who are asylum seekers in the context of reduced case work support and the recommencement of status determination processes for many of those who arrived by boat.
A brief update was provided about the Australasian Society for Infectious Diseases (ASID) guidelines revision (Previously titled “Diagnosis, management and prevention of infections in recently arrived refugees”). The Royal Australian College of General Practitioners Special Interest Group in Refugee Health and some RHeaNA members are involved in writing and reviewing chapters of the guidelines which will have a greater primary care focus.
Victoria raised concerns about the reduction in private pathology providers offering Tuberculin Skin Testing (Mantoux), which is creating significant access issues.
Innovations in practice were shared, with one service trialling video conferencing interpreters to reduce face-to-face interpreting costs. NSW Refugee Health Service reported that they are continuing to add languages to their online appointment translation tool. Click HERE to access the tool.