URGENT - Support for Ontario's Refugees: Proposed changes to OHIP eligibility requirements

UPDATE on response from Minister’s office:

Organizers of the letter below confirmed that the issue has been resolved and the efforts to impose the 90 day wait were withdrawn, thanks to the support of the Toronto Refugee Health Network in mobilizing so quickly on this issue.

Please read this important letter from Meb Rashid at Access Alliance Multicultural Community Health Centre. I will continue to post updates on this situation on the blog.

The letter of support is attached below:

Many of you may have heard that there is a proposal circulating that may lead to a change in the residency period required for refugees before they are eligible for OHIP. Currently refugees, both government assisted refugees and accepted refugee claimants, are exempt from the 90 day residency requirement and thus receive OHIP soon upon arrival (or as soon as a refugee claim is accepted in the case of claimants). There is currently a proposal to impose this 90 day wait on refugees. This proposal is likely due to the assumption that the Interim Federal Health program can provide adequate insurance during these first three months.

Those of us that work with refugees recognize that IFH cannot provide adequate health insurance. We also believe that it becomes critical for refugees to obtain adequate assessments as well as preventative services soon upon arrival. This benefits not only the refugees but we also believe it is in the best interests of the rest of Ontario society.

We are confident that the provincial government will not proceed with these proposed changes if they become aware of the issues involved. We believe that they will be considering these changes in an upcoming committee meeting that may be on Jan. 29^th. We have drafted a letter that we are hoping to have supported by as many health care providers as possible. We will pass this on to committee members as we are certain that they will be interested in the consequences of such changes. At present we would like to have as many MD’s, RN’s, RNEC’s, dietitians, social workers, dental professionals etc.. sign off on this letter as possible. Please send me your name, title and affiliations (optional) if you would like to support the attached letter. Also feel free to forward this email to anyone you feel would be interested.

We are also encouraging people to contact members of the Health Education and Social Policy Committee (http://www.premier.gov.on.ca/team/committee.asp?Team=13 ). They may not yet be aware of this upcoming proposal but we would like to have them ready to comment on it when it is presented to them likely later this month. I have attached a document that has their contact numbers.

Thank you all for your support.

Meb Rashid

____________________________________________________________

Jan 12, 2009



To Whom It May Concern,


We are a group of Ontario health care providers from numerous different disciplines. It has come to our attention that there are legislative changes proposed by the provincial government that will impose a 90 day residency requirement on refugees that arrive in Ontario. We are deeply concerned about this current proposal and are writing this letter to document our concerns.

We strongly believe that refugees comprise some of the most vulnerable members of our society. Many of us have had the privilege of working with refugee patients soon upon arrival in Ontario. The majority of these patients have lived through very severe physical and mental trauma. Many have lost family members or have suffered from torture. Nevertheless they usually arrive in Ontario with immense optimism and a tremendous commitment to rebuild their lives. Despite the numerous cultural, economic and social challenges, many refugees flourish upon arrival in Ontario.

We are tremendously disappointed at the attempt to impose a 90 day wait to obtain provincial health insurance upon this group. We feel strongly that refugees should be provided with health assessments soon upon arrival in Ontario. Early assessment allows for the identification of subclinical illnesses and for the implementation of preventative strategies. We feel this will facilitate the integration of newly arrived refugees and will also serve to identify illness at a point before treatments become more expensive. Early assessment also serves for public health concerns to be addressed. For example, identification of people that may be carrying tuberculosis may allow for treatment before active tuberculosis becomes an issue. Detection of hepatitis B carriers may allow for vaccination of contacts before they are infected. We believe that any impediment to accessing health care, particularly in the early periods of migration, will delay the diagnosis of illness. This does not serve the interests of refugees nor the rest of Ontario society.

We recognize that there are other forms of health insurance coverage. The costs of private insurance make it unrealistic for refugees. The Interim Federal Health (IFH) program is available to refugees soon upon arrival in Canada. We want to draw your attention to the perceived limitations of this program. Many physicians and other institutions do not accept IFH and it becomes an unreasonable expectation for newly arrived refugees to be able to negotiate the health care system when their coverage is denied by a health care provider. We are concerned that these refugees will not have their concerns addressed until their OHIP coverage takes effect. IFH is a program that provides emergency services. Many health care workers will not access it for services such as immunizations, TB testing or even what they perceive as minor illnesses. Unfortunately some of these minor illnesses can lead to more severe illnesses if not addressed early. Delaying preventative interventions can also result in significant illnesses. We do not feel that IFH can provide the insurance coverage to provide adequate health care to this group.

We are asking you to carefully consider this proposed change. We feel strongly that refugees should be entitled to provincial health insurance upon arrival in Ontario. We believe that this government is sensitive to the plight of this vulnerable population and we are confident that you will reconsider your decision.

Sincerely,