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Policy and service delivery

Access for people seeking asylum to public health services in States and Territories across Australia

Access to health services is underpinned by legalisation and policy as below.  Asylum seekers need an Asylum Seeker Access Card as described in this link.

ACT Public Health Services

Policy: To ensure asylum seekers who are Medicare ineligible are not deterred from seeking medical care because of an inability to pay fees.

Service description: Medicare ineligible asylum seekers are entitled to full medical care including pathology, diagnostic, pharmaceutical and outpatient services in the ACT’s public hospitals, as per Health (Fees) Determination 2007 (No 1). Patients receiving these services will not be billed. Medicare ineligible asylum seekers are also given the same access as Health Care Card holders, to public dental and community health services. However, some of these may incur a cost.

Phone: 13 22 81

Asylum seekers (including those without Medicare access) are very welcome at the Companion House Medical Service and are seen at no cost. For enquiries or to make an appointment phone 02 6251 4550. You can access Companion House Medical Service by visiting the office at 41 Templeton Street, Cook, ACT.

Medicare ineligible asylum seekers are to be provided full medical care including pathology, diagnostic, pharmaceutical and outpatient services in the ACT’s public hospitals, as per Health (Fees) Determination 2007 (No 1). Patients receiving these services are not to be billed. This policy does not apply to ineligible persons who have a contract with a VMO

Medicare ineligible asylum seekers are also to be given the same access as Health Care Card holders, to public dental and community health services (some of which may incur a cost).

NSW

The NSW Policy Directive Medicare Ineligible Asylum Seekers – Provision of Specified Public Health  Services provides a new process to identify Medicare ineligible community-based asylum seekers. It also lists the services that attract a waiver of fees and instructions on what to charge when a waiver does not apply.

This Policy Directive requires NSW Health public hospitals, mental health services, NSW Ambulance and NSW Health Pathology to waive fees for the public health services specified below that are provided to community-based asylum seekers who are not eligible for Medicare:

  • Emergency care for acute medical and surgical conditions, including admission of elective surgery for conditions listed as Clinical Priority Categories 1 and 2;
  • Ambulatory and outpatient care required to maintain health status of asylum seekers with acute and chronic health conditions;
  • Maternity services, including antenatal and postnatal care;
  • Mental Health services (inpatient and community based);
  • Ambulance transport for emergencies.

To be added

In 2017 the Queensland Government approved providing vulnerable Medicare-ineligible asylum seekers with access to public health services at no charge. Refugees, detainees and people seeking asylum in Queensland who are not eligible for Medicare can access public Hospital and Health Services (HHSs)  free of charge, as set out in the Fees for Health Care Services Health Service Directive (QH-HSD-045:2016) 

Refugee Health Network Queensland Information Sheet for Health Service Providers – Access to health services for Asylum seekers in Immigration detention facilities in Brisbane (January 2021). Available on the RHNQ website via this page.

Fact Sheet regarding public healthcare access for people seeking asylum without Medicare

Translated Asylum Seeker Factsheets for people seeking asylum who do not have a Medicare Card

Medicare eligible asylum seekers have the same access to public services as everyone although are less likely to be able to access bulk-billed services if they do not have a Health Care Card (HCC).

A policy document is currently under development to enable Medicare ineligible clients to be fee waivered in the public system and given free ambulance cover.

Medicare ineligible asylum seekers can access the Refugee Health Service for free GP services, immunisation and counselling. Under the new policy, pathology services for asylum seekers will be free but not private radiology.

Currently asylum seekers do not have access to public dental services as this is for people on HCC only.

This information will be updated when the SA policy for asylum seekers access to health services is released.

Currently, persons seeking asylum in Tasmania are eligible for medical care in Tasmania in public hospitals at no cost and must produce documents to confirm immigration status either through the relevant government department or asylum support agency such as the Red Cross. According to the Tasmanian Health Service Policy, where a person eligible for treatment is hospitalised, they should have a letter of support from their supporting organisation that identifies the patient and the patient’s conditions to be treated. Services outside of the scope of this letter should not be provided without written support and approval from the organisation. Treatment should not be delayed in cases of emergency or urgent care and in these cases the outcome will be determined by the health service to bill the appropriate support group or follow the process for non-eligible asylum seekers.

Further information is available from the Tasmanian Health Service Revenue Office:

Launceston General Hospital ph: (03) 6777 6027

Royal Hobart Hospital ph: (03) 6166 8252

See also the following documents:

– A “Guide to Patient Charges” for Medicare ineligible patients is available – attached

– Tasmanian Health Service (2017) “Medicare Ineligible and Reciprocal Health Agreement – Classification and Charging [P17/000311]”

Please note: Information provided based on “Medicare Ineligible and Reciprocal Health Agreement” protocol for Tasmanian Health Service as of July 2021. Please consult directly with THS Revenue Office to discuss reduction and or/ waiver of fees. Support to navigate this can be provided via the Refugee Health Service Social Worker (0409 537922) or Clinical Nurse Consultant (0488 645336).

All Medicare ineligible people seeking asylum are to be provided full medical care in Victorian public hospitals as admitted, non-admitted or emergency patients.

This includes (but is not limited to):

  • emergency care
  • elective care
  • pathology and radiology
  • mental health services
  • pharmaceuticals (for more information please see document linked below)

For more information, please see the VIC Health Policy document “Hospital access for people seeking asylum”.

Effective from 01 August 2020, Medicare ineligible people seeking asylum in WA are to be non-chargeable for public hospital treatment.

The information below can be found on pg.16 of the WA Health Fees and Charges Manual

Medicare ineligible asylum seekers who meet the following criteria are eligible for free public hospital treatment:

  • People seeking asylum who have current or expired documentation confirming their status for asylum, such as visas e.g. bridging, humanitarian or temporary protection, ImmiCard or official paperwork from a government or non-government organisation.
  • People seeking asylum who have a government or non-government organisation representative to support their claim for asylum e.g. a representative from the Department of Human Services or Centre for Asylum Seekers, Refugees and Detainees (CARAD).

Where possible, hospitals must put mechanisms in place to prevent these persons from receiving invoices.

CARAD has suggested to WA Health other non-government organisations in the asylum seeker service sector that it would be able to provide supporting documentation of a person’s status as an asylum seeker.

WA Health have asked that a person’s financial hardship/inability to cover costs of hospital treatment be included in any supporting documentation.

As this change is very recent it may take some time for it to be fully implemented. If you know of any person seeking asylum having any difficulty accessing hospital care, please contact CARAD or the Coordinator of Revenue at the relevant Health Service (North Metro, East Metro, South Metro, and Child and Adolescent Health).

Any hospital fees incurred prior to 01 August 2020 may be able to be waived. Please contact CARAD for further advice regarding the process for this.

Refugee health nursing in regional Australia

With the Australian Government increasing the number of refugees being settled in regional Australia under the Humanitarian Settlement Program, RNA has a role in ensuring that nurses working in refugee health in regional areas are connected and supported. To work towards this aim, a panel discussion on Refugee Health Nursing in regional Australia was hosted at the RNA Forum 2019 – contributing panellists were Leanne Smedley (Refugee Health Nurse from Gateway Health in Wodonga, VIC), Michele Greenwood (Refugee/ Multicultural Health Nurse at the Refugee Health Clinic in Coffs Harbour NSW), Leeanne Schmidt (Clinical Nurse Consultant from the Metro South Refugee Health Service covering Logan/ Ipswich and Gold Coast, QLD) and Casey Hiscock (Community Refugee Health Nurse from West Wimmera Health Service, VIC).

You can watch the video of the discussion or listen to it as audio via the button below.

 

Article on integration of refugees into routine primary care in NSW.

This article discusses ways in which integrated care could improve access to primary care for people of a refugee background. 

Refugee Nurses of Australia: Terms of Reference

Aims

Provide a forum for discussion of professional, strategic and contemporary issues for nurses who work with people with a refugee background


Objectives

  1. Provide a forum for exchange of information and resources between refugee health nurses and other relevant stakeholders across Australia.
  2. Promote best practice in refugee health nursing through quality improvements, professional practice and evidenced based research
  3. Provide leadership in the development of a national refugee health nurse clinical practice framework including scope of practice, credentialing and models of care
  4. Advocate for refugee and asylum seeker issues

Chair

Sandy Eagar

Secretariat

Leeanne Schmidt

Office Holders

Elections held bi-annually.

Membership

Nurses who work with people with a refugee background


Communication

RNA will be a standing agenda item on National RHeaNA teleconference


Quorum

A quorum will exist of 50% of states/ territories + one


Meeting frequency

Quarterly via GoTo webinar

To be held two weeks prior to every national RHeaNA teleconference

Annual executive committee face-to face

Agenda and Minutes

The agenda will be disseminated five working days prior to the meeting

Agenda items, briefly outlining issue/background associated with the agenda item are to be submitted to the Chairperson (SE) not less than one week prior to the next meeting

Minutes will be disseminated within ten workings days

Minutes will record the general discussion, agreed actions and outcomes. The original signed and saved in the RNA drop box


Affiliations

Australian College of Nurses

Australian Primary Health Care Nurses Association

Refugee Health Network of Australia

TBC state and territory nursing industrial organisations


Review Date

Review TOR February 2018


Executive Committee

Initials

Name

State

KD

Kath Desmyth

VIC



VIC

SE

Sandy Eagar

NSW

MG

Michelle Greenwood

NSW

JW

Jan Williams

SA

LS

Leeanne Schmidt

QLD

MJ

Meryl Jones

QLD

EP

Erin Plumb

NT

ME

Megan Enright

ACT

JJ

Janelle Jozefiak

TAS

LJ

Lance Jarvis

WA