Refugee Health Program: Humanitarian Parolee Health Resources

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As Wisconsin welcomes new humanitarian parolees to our state, it is important for providers to have the knowledge and resources to provide informed care. Since April 2022, sponsorship programs enable individuals from the countries below to come to the United States under the immigration status humanitarian parole.

  • Ukraine
  • Cuba
  • Haiti
  • Nicaragua
  • Venezuela

Humanitarian parole is a discretionary benefit granted by the Department of Homeland Security (DHS) to certain noncitizens to allow them to enter and temporarily stay in the United States for specific reasons. Immigration parole is different from criminal parole. There is no relationship to the criminal justice usage of the word parole.

Humanitarian parolees from Ukraine, Cuba, Haiti, Nicaragua, and Venezuela entering through sponsorship programs must attest to receiving certain vaccinations before they travel to the United States and then go through a medical screening for tuberculosis (TB) within 90-days of their arrival. This includes a TB blood test.

The TB blood test, also called an Interferon Gamma Release Assay or IGRA, is a way to find out if you have TB germs in your body. The TB blood test can be done instead of a TB skin test (Mantoux). There are two kinds of TB blood tests: QuantiFERON®-TB or T-SPOT®TB.

Vaccine Requirements
Vaccination attestation means each person must attest to having received at least one dose of a measles, polio, and Food and Drug Administration (FDA)-approved COVID-19 vaccines. They are not required to be vaccinated against other diseases as a condition of their humanitarian parole (see USCIS Vaccination and TB Attestation for more information: U4U | CHNV)

Translated health resources and culturally informed care

  • Uniting for Ukraine Vaccine Attestation: A U.S. Citizenship and Immigration Services webpage. It has information on pre-travel vaccine attestations for Ukrainians. It also lists the vaccines required for refugees within 90 days of arrival.

Translated TB resources

Information on TB and vaccine attestation

Other resources

  • Uniting for Ukraine: Department of Homeland Security's webpage. It provides an overview of Uniting for Ukraine and frequently asked questions.
  • Ukrainian Clinical Guidance: A publication from the Minnesota Center of Excellence in Newcomer Health. It outlines health screening recommendations for providers who work with people arriving from Ukraine.
  • Psychological First Aid: A Switchboard webinar on psychological first aid in the context of the events in Ukraine. It includes the basics of psychological first aid and cultural information on Ukraine.
  • Uniting for Ukraine Overview and FAQ: Department of Homeland Security's webpage that provides an overview of Uniting for Ukraine and frequently asked questions.
  • Cultural Backgrounder: Refugees from Ukraine: Guide on refugees from Ukraine from the International Rescue Committee

Want to find out how you can help Ukrainian arrivals? Go to the Wisconsin Department of Children and Families website to learn more.

Only certain humanitarian parolees are eligible for Office of Refugee Resettlement (ORR) Benefits. Eligibility also depends on other rules, like income requirements. Populations from Ukraine, Cuba, and Haiti, which may be eligible for ORR Benefits include:

  • Ukrainian Humanitarian Parolees (includes other people who last regularly resided in Ukraine and are arriving through the United for Ukraine Program)
  • Cuban and Haitian Humanitarian Parolees (and others who are also considered Cuban/Haitian Entrants)

Some ORR benefits and services are time limited. It is important to apply right away. Learn more about applying for ORR benefits and services.

Eligibility for BadgerCare Plus and Medicaid varies for people with humanitarian parole. Some are immediately eligible, some have a five-year waiting period, and others are not eligible. It depends on the specific type of parole, the date the individual was paroled into the U.S., and the length of parole. Eligibility also depends on other rules, like income requirements.

  • Children (less than 19 years old) and pregnant people may be eligible for BadgerCare Plus or Medicaid.
  • Adults, who are also eligible for ORR benefits or have been a humanitarian parolee for at least five years, may be eligible for BadgerCare Plus or Medicaid.
  • Adults who are unable to get BadgerCare Plus or Medicaid can get health insurance through the Marketplace at HealthCare.gov.
  • Children can also get coverage on the Marketplace if they’re not eligible for BadgerCare Plus or Medicaid because their household has too much income.
  • Some humanitarian parolees may be able to get coverage for life threatening conditions through Emergency Services

How to apply for BadgerCare Plus, Medicaid or Emergency Services

You can apply for benefits and programs online, by phone, by mail, or in person at your agency. If you read or write in a language other than English or Spanish, you will need to apply by calling your agency or submitting a paper application.

How to apply for Marketplace Health Insurance
The Marketplace has tax credits and cost sharing reductions to make coverage more affordable.

Need help?

Contact Covering Wisconsin, a free resource that helps connect Wisconsin residents with health insurance, including BadgerCare Plus, Medicaid, and Marketplace, as well as other programs that support health.

Humanitarian parolees can apply for work authorization and a Social Security number.

To get help obtaining work authorization or a Social Security number check out the Department of Children and Families website.

Resources for clinicians

Translated health resources and culturally informed care

These newcomers are not screened for TB prior to arrival in the United States and must attest to screening with an interferon gamma release assay (IGRA) result within 90 days after arrival. Tuberculin skin tests (TSTs) are not accepted. The Wisconsin Department of Health Services will not be able to provide local jurisdictions with information about humanitarian parolees, including TB status.

Health department personnel who provide TB testing may be the first point of contact with the U.S. healthcare system for these individuals. If eligible for insurance, parolees should be encouraged to first apply for Medicaid. If not eligible, providers are encouraged to refer them to Federally Qualified Health Clinics or other local healthcare providers serving uninsured populations for basic healthcare.

Both confirmed and suspected cases of active tuberculosis are category I conditions, reportable immediately to the patient’s local public health officer. Both confirmed and suspected latent tuberculosis infection are category II conditions, reportable to the patient’s local public health department within 72 hours of recognition of a case or a suspected case. Please see the Wisconsin Tuberculosis Program webpage on reporting for more information.

TB Incidence Rates, 2021*
CountryTB Incidence (per 100,000)MDR/RR-TB Incidence (per 100,000)Ɨ
Cuba6.80.4
Haiti1598
Nicaragua450.78
Venezuela472
United States2.60.05

*WHO Global Tuberculosis Programme, 2021

ƗRR is TB resistant to rifampicin®; MDR is TB resistant to R + isoniazid

For humanitarian parolees resettled in Wisconsin presenting to clinics or local health departments for TB screening, the Wisconsin Tuberculosis Program and Refugee Health Program recommends the following TB screening components are completed:

  • Symptom screening for tuberculosis for all individuals of all ages.
    • Persistent cough lasting more than 10 days and one or more of the following: coughing up blood, fever, night sweats, unexplained weight loss, or fatigue.
  • Chest radiographs for persons aged 6 months and older if positive IGRA or symptom screen.
    • CXR postero-anterior (PA) view for those ≥10 years of age.
    • Anterior to posterior (AP) or PA view and lateral view for those <10 years of age.
  • Medical examination for persons with positive IGRAs, abnormal chest radiographs consistent with tuberculosis, or positive symptom screening.
  • Respiratory sampling if indicated by the chest radiograph, medical examination, or symptom screening

If not eligible for federal medical assistance, the Wisconsin Tuberculosis Program may be able to help. Contact your Local Health Department for more information.

Culturally informed care

Mental health

Resources from The National Child Traumatic Stress Network

Other resources

Refugees may apply for a green card (adjustment of status) once in the United States. Refugees only need to have a Civil Surgeon review and ensure their vaccinations are up to date. All refugee-based adjustment applicants must submit the vaccination record portion of Form I-693.

Who to contact for help

Questions?

Glossary

 
Last revised August 21, 2024