Last updated July 2013
Health Pathways for people living in
Community Detention in Victoria
This project was commissioned by Foundation House
Research and Policy Program who would like to
acknowledge their funders the
Sidney Myer Fund and William Buckland Foundation
Summary
This presentation includes an overview of:
• the Community Detention Program,
• health services on Christmas Island and detention facilities,
• health orientation and health supports for people in Community
Detention,
• information and contact details for International Health and
Medical Services (IHMS) providers,
• organisations who support people in Community Detention, and
• resources and referral pathways.
Definitions
Asylum Seeker
• An 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
• Refugee protection visas are
granted if someone is found to
have “a well founded fear of
persecution on the grounds of
race, religion, nationality or
membership of a particular
social group or political
opinion”
Australian Humanitarian Program
20,003 humanitarian visas
were granted in 2012-13
2012-13 intake included:
12,512 offshore visas
were granted (including
Refugee, Emergency Rescue,
Global Special Humanitarian
and Women at Risk visas).
7,491 onshore visas were
granted ( to people who have
applied for protection in
Australia)
Boat Arrivals
Irregular Maritime Arrivals (IMAs)
 Afghanistan, Sri Lanka, Iran  Torture and trauma
experiences are common
and Iraq currently main
countries of origin
 May have had poor access
to previous health care
 In 2011-12:
 85% people that arrive by
 People who arrive in
boat were men or boys on
Australia without a valid
their own*
visa are placed in
 17% of people that arrive by
mandatory detention
boat were unaccompanied
 Time in detention can affect
minors*
health outcomes
*DIAC Annual Report 2011-12
Location of detention facilities
Average
Time
Spent in
Detention
Period Detained
Total
7 days or less
45
% of
Total
0.5%
8 days - 31 days
1104
12.2%
32 days - 91 days
3576
39.5%
92 days - 182 days
2648
29.2%
Length of Time in
Detention as at 31
Dec 2012
183 days - 365 days
763
8.4%
366 days - 547 days
171
1.9%
548 days - 730 days
161
1.8%
Greater than 730 days 591
Total
9059
6.5%
100%
Source: DIAC, Immigration Detention Statistics Summary, 31 December 2012
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
Asylum seeker in the
community; Bridging Visa A or
Bridging Visa E
People who have arrived by boat
(IMA) (and those that arrive by
plane without a valid visa)
Mandatory Detention (including
Community Detention)
Asylum seeker in the community;
Bridging Visa E
Permanent
Protection
Visa 866
or granted a non
humanitarian
visa.
Repatriation
to country of
origin.
Permanent
Protection
Visa 866 or
another visa.
Repatriation to
country of
origin.
Community Detention (CD)
• CD is a form of immigration detention which allows
people to reside in the community without an escort
• Does not give a person any lawful status in Australia
• Does not give the same rights and entitlements as
person living in the community on a visa
• People in CD are not allowed to work
• Conditions include a mandatory requirement to report
regularly to the Department of Immigration and
Citizenship (DIAC)
Community Detention (CD) contd
• People are released from Immigration Detention to
Community Detention following health, security and
identity checks that occur in immigration detention
facilities.
• People in CD are often women and families,
unaccompanied minors and men assessed as
vulnerable.
• Clients live in broader community in rented
accommodation.
Access to Healthcare in Victoria
 The International Health and Medical Services
(IHMS) is contracted by DIAC to provide health
services to people in detention, including community
detention
 People in CD have access to health providers
through IHMS
 DIAC through IHMS will reimburse any Victorian
Public Health services
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
Well women’s check
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.
Health Discharge Summary
from health service at detention facility
 Health summary provided to
 Fitness to travel is
clients, Red Cross and
completed
AMES in large white
 Advice given to client on
envelope
ongoing /post-arrival health
 Explanation in their own
care needs when they
language of the importance
leave immigration
of documents
detention
Bridging Visa E/OCt 2012
Housing and support services
Some organisations have direct
contracts with Department of
Immigration and Citizenship:
 Red Cross
 Anglicare
 Mackillop Family Services
 AMES
 Wesley Mission
 Life Without Barriers
 Hotham Mission
Red Cross also sub
contracts
 Berry Street
 Mackillop Family
Services
 Anglicare Victoria
 AMES
 Wesley Mission
 Life Without Barriers
 Hotham Mission
Housing and support services
Support agencies provide;
 Housing
 Income support
 People that arrived before 13th of August receive 70%
Centrelink benefits
 People that arrived after 13th of August receive 60% Centrelink
benefits
 Case management
Review
• People are released from Immigration Detention to
Community Detention following health, security and identity
checks that occur in immigration detention facilities.
• People in CD are often women and families, unaccompanied
minors and men assessed as vulnerable.
• Legally still in detention, no visa status.
• Have freedom of movement.
• Clients live in broader community in rented accommodation.
• CD services are managed by Australian Red Cross, AMES
and other providers.
• CD include housing, income support and case management.
Healthcare for people in CD
 Not eligible for Medicare.
 Health services provided by International Health and
Medical Services (IHMS).
 Clients should carry IHMS card to identify status.
 IHMS subcontracts General Practices to provide services
to this group.
 Specialist services need to have approval from IHMS to
provide services (the wait for this approval can be
lengthy).
Healthcare contd
 People in CD have access to Victorian Department of
Health hospital services. IHMS reimbursement funding is
available for these services.
 ALL services approved by IHMS are paid for by IHMS,
not by the agency or the Victorian Government.
 Support services will arrange first General Practice
appointment.
 People in CD will have completed a health check, ASK
FOR THIS INFORMATION.
IHMS identity card
 Full cost recovery model from IHMS
 Sample client ID card
Health Telephone Support Line
• IHMS 24 hour telephone hotline called the Community
Detention Assistance Desk (CDAD).
• The CDAD is staffed by IHMS admin staff as well as
clinicians (nurses and doctors)
• Assists service providers to access client’s medical
history and details.
• Any IHMS provider can contact the hotline regarding CD
clients, with the client's consent
Community Detention Assistance
Desk
Phone:
1800 725 518 case workers
1800 689 295 health professionals
Fax: (02) 9086 9875
Email: cdad@ihms.com.au
Health services funding for CD
Fee for service paid by IHMS
Hospital admitted and non admitted patients
Ambulance
Primary and Community Health
General Practice
Immunisation services
Drugs and Alcohol
Pharmaceuticals
Mental Health
Aged support services
Aids and equipment
INTERPRETER SERVICES
Torture & trauma counselling funded directly
by DIAC.
Funded
by IHMS
Specialist
services, dental
and optometry
requires
separate
approval by
IHMS & DIAC
through client
case manager
Billing arrangements with IHMS
 Contact Community Detention Desk: ph 1800 689 295 or
email cdad@ihms.com.au
 Invoices should be submitted to IHMS on last business
day of each month.
 Itemised GP notes need to accompany invoices
 Services partnering with IHMS will receive training on
how to be a provider
Vesna Courtot
IHMS Health Services Coordinator Victoria
Mobile: 0427 905 955
vesna.courtot@ihms.com.au
Health Orientation
for people in Community Detention
• People in Community Detention have minimal health
services orientation.
• Case worker arranges first GP appointment.
• REMIND client to take Health Discharge Assessment to
appointment.
• Interpreters should be arranged by case worker funded
by IHMS.
Coordinating Care
Role of Community Detention Service Provider
Assist clients
to make first
GP
appointment.
Submit Care
Plan and
amendments
to DIAC
Community
Detention
Service
Provider
then
Encourage
independent
access to GP
appointments
Contact IHMS
for general
enquiries on
client’s behalf
Pathways from community detention
Asylum Seekers in
Community Detention
Failed visa
application
Clients returned
to Immigration
Detention Centre
or to their country
of origin
Visa application not
yet resolved however
person no longer
needs to be in
community detention
Asylum Seeker on
Bridging Visa E (BVE)
Medicare eligible
No Work rights if
arrived after 13 Aug
2012
* See BVE PowerPoint
Found to meet
criteria for visa
Protection Visa
866
Medicare eligible
or alternate visas
which may have
different
entitlements
Other Health Supports
• Refugee Health Nurses in Community Health Services
can provide support for assessment and referral.
• Refugee Health Fellows can provide clinical advice and
training for health practitioners.
• Specialist Hospital services. GP referral only.
• Foundation House counseling
• All details on :
www.refugeehealthnetwork.org.au
Community Detention/Oct 2012
Extra resources
Victorian Refugee Health Network
http://refugeehealthnetwork.org.au
The Victorian Refugee Health Network Asylum Seeker fact sheet
http://www.ergpa.com.au/images/_uploads/20120622_fas_asylum_see
ker_final.pdf
Red Cross Fact Sheet Community Detention
http://www.redcross.org.au/files/Community_Detention__Fact_Sheet.pdf
Department of Immigration and Citizenship(DIAC) fact sheet
community detention
http://www.immi.gov.au/media/fact-sheets/83acommunity-detention.htm
Extra resources contd
DIAC Boat Arrivals information
http://www.immi.gov.au/ima/
Queries to DIAC about community placement of people in detention
communityplacements@immi.gov.au
DIAC information about the process for protection assessment
http://www.immi.gov.au/ima/english/
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 DIAC
Citizenship
Community Detention Services
CDSP
Community Detention
CD
Irregular Maritime Arrivals
IMA
Permanent Protection Visa
PPV
Special Humanitarian Program
SHP
All care has been taken to ensure that the information in this
presentation is correct (as at Feb 2013). If any errors are identified or
you have other queries please contact
info@refugeehealthnetwork.org.au