Health Pathways for Asylum Seekers on Bridging Visa E (BVE)

What are Bridging Visas and how do asylum

seekers on BVEs access health care in Queensland?

Information applies to asylum seekers who arrive by boat prior to 19th July 2013

Resource developed by:

Acknowledgement: This resource is based on the Health Pathways for

Asylum Seekers on BVE, developed by the Victorian Refugee Health network

Contents:

• Overview and definition of BVE

• Income/housing and case work support

• Health Services on Christmas Island and other Detention facilities

• Health services provision and supports

• Resources available

Definitions: Asylum Seeker

• Asylum seeker is a person who has applied for a refugee protection visa

• They are waiting for a decision on this application

Refugee

• A refugee is someone whose asylum claim has been successful and who has received a refugee protection visa

• Protection visa grants if someone is found to have “a well founded fear of persecution on grounds of race, religion, nationality or membership of a particular social group or political opinion”

Australian Humanitarian Program

13,759 visa grants in 2011-12

(Increasing to 20,000 in 2012-13 )

2011-12 intake included:

6,004 Refugee (offshore) category visas granted 7,755 Other humanitarian visas, including

• 714 Special Humanitarian Visa ( SHP)

• 7,041 Onshore Visas granted (who have applied for protection in Australia)

Irregular Maritime Arrivals (IMAs) Boat Arrivals

In 2011-12:

85% people that arrive by boat were men or boys on their own*

17% of people that arrive by boat were unaccompanied minors*

(* DIAC Annual Report 2011-12)

Source: http://www.immi.gov.au/managing-australias-borders/detention/facilities/

Average time spent in detention

Period Detained Total % of Total

7 days or less 0 0

8 days - 31 days 2 0

32 days - 91 days 14 1

92 days - 182 days 491 18

183 days - 365 days 1711 62

366 days - 547 days 150 5

548 days - 730 days 3 3

Greater than 730 days 300 11

Total 8797 100

Length of time in detention as at 30 April 2013 Source: DIAC Immigration Detention Statistics Summary, 30 April ‘13

Permanent protection in Australia Arriving by boat or plane – asylum pathways

Non Irregular Maritime Arrivals (Non IMAs) arrive by air with a valid visa and subsequently apply for protection

People who have arrived by boat (IMA) (and those that arrive by plane without a valid visa)

Asylum seeker in the community; Bridging Visa E

Permanent Protection Visa 866 or another visa.

Asylum seeker in the community; Bridging Visa A or Bridging Visa E

Permanent Protection Visa 866 or granted a non humanitarian visa.

Mandatory Detention (including Community Detention)

Repatriation to country of origin.

Repatriation to country of origin.

IMA Pathway

IMAs: Community Support programs for asylum seekers (who arrived by boat); CD and BVE arrangements

DIAC v.4 May 2013

What is a Bridging Visa E(BVE)? A BVE is a Temporary Visa

that is held by Asylum seekers whilst they are awaiting the result of their claim for permanent protection in Australia

People on BVEs can remain lawfully within Australia

Asylum seekers who arrived in Australia by boat prior to 13 August 2012 are allowed to work in Australia (work rights) and are Medicare eligible.

(work Medicare )

Asylum seekers who arrived in Australia by boat on or after 13 August 2012 have NO work rights, but are Medicare eligible.

(work Medicare ) • Asylum seekers who arrive post 19th July 2013 will be

transferred to PNG and settled in PNG

Bridging Visa E(BVE) contd

BVE holders live in the community following health, security and identity checks.

BVE holders: have typically been men on their own. Unaccompanied minors, women, families and more vulnerable men were placed in the Community Detention program.

From May 2013, BVs are being expanded to include families*

Bridging Visa E

Overview of access and rights

Work rights NO – those who arrived after 13 Aug 2012 YES – those who arrived prior to 13 Aug 2012

Medicare eligibility YES

Provision of Pharmaceuticals

YES – ASAS and CAS will reimburse to health care card level. NO – if not receiving ASAS or CAS

Torture and Trauma Counselling

YES

Housing Initial transitional housing for 6 weeks and then assistance to find private rental.

Financial No Centrelink. If eligible for CAS or ASAS income support equivalent to 89% of Centrelink payment.

How long are BVEs granted for? BVEs remain in effect while a

person’s permanent protection case is being resolved

Length of BVE may vary

BVE holders are expected to abide by all visa conditions

If they fail to abide they are liable for visa cancellation and risk being returned to detention

Bridging Visa E/Oct 2012

What happens once a person is released from detention onto a

BVE?

Transitional CAS First 6 weeks of support in the community

CAS stands for Community Assistance Support.

Transitional CAS is provided by Red Cross or MDA or ACCESS Services in Qld (for 6 weeks)

Clients are directly referred from the Department of Immigration and Detention (DIAC) to this program

Group orientation and individual case work support

Income support including living allowance and rent assistance (equivalent to 89% of Centrelink payments)

Transitional CAS contd

First 6 weeks of support in the community

Housing support: emergency short term accommodation for clients who are unable to stay with community links - then support to access the private rental market.

Health and welfare support

PBS prescription medication eligibility

After six weeks people are then assessed by DIAC, who determine ongoing support options

Clients circumstances are regularly reviewed

Support following initial six weeks • During the fifth week of transition DIAC assess clients’

ongoing needs post 6 weeks.

• Following the initial support by Transitional Community Assistance Support stream, DIAC could refer to:

• Community Assistance Support (CAS) as an ‘ongoing’ client

• Asylum Seekers Assistance Scheme (ASAS)

• No Program – this is where clients do not meet the eligibility criteria for either CAS Ongoing or ASAS or are able to provide for themselves so receive neither CAS or ASAS

Asylum Seeker Assistance Scheme (ASAS)

ASAS is administered by the Australian Red Cross and MDA

and ACCESS Services in Qld

Support through ASAS can include:

• Financial support

• Referral for basic health, welfare support and torture and trauma counseling

Clients who have been previously assessed as NOT requiring CAS or ASAS by DIAC can self-refer to ASAS

Bridging Visa E/Oct 2012

CAS Ongoing Eligibility criteria:

On a bridging visa

Serious physical or mental health issue

Elderly and unable to support self

Serious family issues

Support includes:

case work support

financial assistance (89% of Centrelink)

medicine

material aid

referral to other services including torture and trauma counselling

Can people on BVEs choose where they live?

BVE holders can choose where they live.

DIAC approval is required to move between states in the first 6 weeks after being released from detention

BVE holders are required to advise DIAC of where they live and when they change address

BVE holders have no access to public housing so use private rental market

In many cases BVE holders live with family or friends in overcrowded circumstances

Review Some asylum seekers are

released from detention facilities on a BVE (Bridging Visa E).

These people live in the community following health, security and identity checks.

BVE holders receive 6 weeks financial support through the Transitional Community Assistance Support scheme

After a six week period people are reliant on finding housing in the private rental market

Health screen on Christmas Island Provider: International Health and Medical Services

(IHMS)

Screened for TB and other serious illness immediately on arrival

Chest X rays

Initial Health Assessment

Mental Health Assessment

Child Health Assessment

Pregnancy test for all women > 14 years

Antenatal care

Dental care

No further medical tests unless requested by client

People may be transferred to another Immigration Detention Facility and health issues followed up as they arise.

IHMS Routine Testing on arrival to Australia:

CXR

HIV

Hep B

Hep C

Syphilis

Mental State Examination- IHMS Mental Health Team

Urinalysis

Clinical Observations

GP Physical Examination- completion Form 26- further investigations may be ordered following same e.g. FBC, LFTs

The routine testing for children is currently under review and TBA.

Health Discharge Summary from health service at detention facility

Fitness to travel is completed

Advice given to client on ongoing /post-arrival health care needs when they leave immigration detention

Health summary provided to clients (Red Cross, MDA and ACCESS) in large white envelope

Explanation in their own language of the importance of documents

Bridging Visa E/Oct 2012

Transfer of health information for people with mental health issues

• Especially relevant for people on anti–depressants, anti-anxiety meds, sleeping tablets and pain killers.

• Information on medical condition contained in health summary.

• Client should be given up to 14 days medication on departure from detention.

Bridging Visa E/Oct 2012

Health pathway for people on Bridging Visa E

Health checks on arrival at Christmas

Island

Primary health

services in detention on request from client

Health summaries provided by

IHMS to clients, Red

Cross or AMES

Health assessment &

care by GP

Medicare eligible

•Follow up as required ?

•Primary health ? •Specialist health? •Mental health ? •Torture and

Trauma counselling ? •Sexual health?

•Vision? •Oral health?

Detention Centre In the community

Health Telephone Support Line • IHMS 24 hour telephone hotline called the Community

Detention Assistance Desk (CDAD).

• Queries about BVE client’s health discharge and transitional information can be directed to the CDAD desk.

• The CDAD is staffed by IHMS admin staff as well as clinicians (nurses and doctors)

Community Detention Assistance Desk Phone:

1800 725 518 case workers 1800 689 295 health professionals

Fax: (02) 9086 9875 Email: cdad@ihms.com.au

On arrival in Qld

Basic health orientation by Red Cross, Multicultural Development Association (MDA) or ACCESS staff on arrival in Qld

Case Managers advise client of information on medical services and hospitals.

Referral and assistance to first GP if necessary.

Access to health services for BVE holders

• Medicare eligible regardless of protection visa process

• All BVE holders informed of their eligibility

• Do have access to public health services e.g. mental health

• Specialist health care - some clients eligible under ASAS and CAS program for further assistance

• Clients recommended to carry their interim Medicare cards with them at all times

• Pharmaceuticals – reimbursement to rate of Health Care Card holders (if they are receiving ASAS and CAS)

Health Services which BVE holders can access

Hospitals Ambulance General Practice Immunisation services Drug and Alcohol Pharmaceuticals Mental Health Torture and trauma counselling services Aged Support services Aids and equipment Sexual health services

Provision of Torture & Trauma Counseling to Clients supported by CAS and ASAS

• DIAC Policy recognises the need to offer specialist assessment, and if necessary treatment, by an independent Torture and Trauma service.

• FASSTT is the peak body for T&T services in Australia. Specialist T&T assessments and treatment recommended under this policy should be provided by a FASSTT service, unless there are exceptional circumstances.

• Torture and trauma services affiliated with FASSTT can provide an account of any indications of T&T; results of screening procedures for formal disorders; and advice on the most appropriate action for care and support.

• CAS Clients: DIAC Case Managers are authorised to approve a maximum of six sessions per services request (where price is within their approval limit)

• ASAS Clients (with no DIAC Case Manager): a health service request from the ASAS service provider to DIAC National required for all T&T Counselling requests (for a max of 6 sessions)

• Clients who self refer (or referred by a community member): should be advised to speak to their Service Provider who will complete the process to obtain approval for assessment or session.

• Ongoing treatment: after the initial six sessions, an updated supporting letter from Services outlining need for ongoing sessions.

For more information contact: community.assistance.support@immi.gov.au

Extra resources Asylum Explained; Asylum Centre Resource Centre http://www.asylumexplained.asrc.org.au/?page_id=916

Victorian Refugee Health Network http://www.refugeehealtnetwork.org.au

Asylum Seeker fact sheet; Victorian Refugee Health Network website http://www.ergpa.com.au/images/_uploads/20120622_fas_asylum_seeker_final.pdf

Asylum Seeker Assistance Scheme (ASAS); Australian Red Cross http://www.redcross.org.au/asylum-seeker-assistance-scheme.aspx

Community Assistance Support (CAS); Australian Red Cross http://www.redcross.org.au/files/20120816_CAS_FACTSHEET.pdf

Extra resources contd Community Assistance Support;(CAS) Transitional Support; Australian Red Cross http://www.redcross.org.au/files/20120816_CAST_FACTSHEET.pdf

Asylum Seeker Dental access policy ;Department of Health http://www.health.vic.gov.au/dentistry/downloads/eligibility_priority_access_policy.pdf

Refugee Oral Health Fact sheet ; Victorian Refugee Health Network website http//www.refugeehealthnetwotk.org.au

DIAC; Boat Arrivals information http://www.immi.gov.au/ima/

Promoting Refugee Health Guide , Victorian Refugee Health Network website http://www.refugeehealthnetwork.org.au

Glossary Asylum Seeker Assistance Scheme ASAS

Adult Multicultural Education Services AMES

Bridging Visa E BVE

Christmas Island CI

Community Assistance Support CAS

Commonwealth Department of Immigration and Citizenship

DIAC

Community Detention Services CDSP

Community Detention CD

Irregular Maritime Arrivals IMA

Permanent Protection Visa PPV

Special Humanitarian Program SHP