Refugee Health Technical Assistance Center
Affordable Care Act Update: New Data Standards for Demographic Measures   
The U.S. Department of Health and Human Services (HHS) announced the
final data collection standards for race, ethnicity, primary language, sex, and disability status that will apply to HHS-sponsored health surveys. These standards are required by Section 4302 of the Affordable Care Act.   

Affordable Care Act wordsSection 4302 of the Affordable Care Act is particularly relevant to understanding and responding to racial and ethnic health disparities. Refugees are at risk of disparities in disease burden and accessing care. Identifying these disparities and effectively targeting and monitoring efforts to reduce them has been challenging due to the lack of specificity, uniformity, and quality in data collection and reporting procedures. Learn more about ACA Section 4302 on the RHTAC website.    

Field Notes: Mental Health in Bhutan

 Dr. Samantha Stewart, Attending Psychiatrist at the Bellevue/NYU Program for Survivors of Torture and member of the Refugee Health Technical Assistance Center's leadership team, recently returned from a 5-week volunteer field experience at the national hospital of Bhutan. While the patients and staff Dr. Stewart worked with were predominantly from the majority Buddhist population (which is ethnically and culturally different from the Bhutanese refugees resettled in the U.S.) her observations may provide context for U.S. clinicians and refugee service providers on Bhutan's mental health system.


Taboos around suicide and mental health, as well as a shortage of mental health information, prevent Bhutanese from accessing care even when they are in distress. The media typically does not report on suicides and the official public discourse emphasizes the happiness of the Bhutanese people. This silence about mental health issues, coupled with the country's modernization and urbanization, may be exacerbating the stressors from rapid social and economic change. Migration to the capital for education and jobs results in many individuals living outside the traditional structure of an extended family, leaving a gap in social support that manifests in the widespread impression that divorce, domestic violence, drug and alcohol use, mental illness, and even suicide may be on the rise. As traditional sources of social support are less available, the country's mental health infrastructure is not robust enough to fill the void.


Bhutan currently has three psychiatrists for a population of about 800,000. For the majority of Bhutanese, mental health treatment would be most easily accessed through trained health workers who provide outreach in difficult to access, low-resource villages. Yet the nurses and physicians who specialize in mental health identified the need for additional training among this important cadre because most health workers have only minimal understanding of mental health diagnoses and no formal counseling skills. Systemic changes in mental health workforce development and stigma reduction are needed to increase Bhutanese people's access to and utilization of mental health care.

Don't Miss Our Upcoming Webinars!


Clinical Care for Refugees with HIV Infection
Wednesday, November 30, 2011
1:00 PM - 2:30 PM EST
 Presenter: Sondra Crosby, MD, Co-Director of the Boston Center for Refugee Health and Human Rights at Boston Medical Center. Details: This webinar will explore screening refugees for HIV infection and clinical care for HIV-positive refugees. The target audience is clinicians, primary care doctors, and refugee health coordinators.
Register now >

The Refugee Health Orientation Continuum: Overseas and Domestic Perspectives
Monday, December 5, 2011
2:00 PM - 3:30 PM EST 
Presented by: The Cultural Orientation Resource Center (COR) at the Center for Applied Linguistics in partnership with RHTAC. Details: This webinar will address the health component of orientation, as delivered overseas and within the domestic resettlement context. Speakers from overseas Cultural Orientation programs will address a variety of health-related orientation issues, while current approaches and challenges to health orientation in the U.S. will be addressed by a domestic panelist.
Register now >
Funding Opportunities   
Prevention of Violence and Trauma of Women and Girls
Due December 7, 2011. 
Funding is available for activities and events in support of Prevention of Violence and Trauma of Women and Girls (VAW) in the United States and its affiliated territories and tribal nations. The purpose of this funding announcement is to seek projects which increase awareness of violence and trauma affecting women and girls, offer prevention strategies and messages, and promote trauma-informed care to decrease violence against women and girls and promote recovery and resiliency.
Letter of Intent due December 19, 2011. Applications due January 27, 2012. The Health Care Innovation Challenge will award up to $1 billion in grants to applicants who will implement the most compelling new ideas to deliver better health, improved care and lower costs to people enrolled in Medicare, Medicaid and CHIP, particularly those with the highest health care needs.
Preferred Communities Program
Due March 1, 2012.
Funding to support the resettlement of newly arriving refugees in Preferred Communities where they have ample opportunities for early employment and sustained economic independence and to address special populations who need intensive case management, culturally and linguistically appropriate linkages, and coordination with other service providers to improve their access to services. 

Ethnic Community Self Help Program
Due March 13, 2012. Funding for ethnic community based and faith-based organizations to strengthen organized ethnic communities comprised and representative of refugee populations to ensure ongoing support and services to refugees within five years after initial resettlement. The populations targeted for services and benefits in the application must represent refugee communities which have arrived in the U.S. within the last five years (no earlier than 2005).

Standing Announcement for Supplemental Services for Recently Arrived Refugees
Due March 16, 2012.
Funding of the Supplemental Services for Recently Arrived Refugees program to provide services to newly arriving refugees or sudden and unexpected large secondary migration of refugees where communities are not sufficiently prepared in terms of linguistic or culturally appropriate services and/or do not have sufficient service capacity. This program is solely in support of newly arriving refugees (i.e. within the last two years) and/or sudden or unexpected secondary migration. 
Call for Proposals


African Refugees and Immigrant Lives: Conflict, Consequences, and Contributions - Call for Workshop Proposals 
Due December 16, 2011.
Ethiopian Community Development Council is issuing a call for workshop proposals for the 18th Annual National Conference to be held May 2 - 4, 2012 in Arlington, VA. Learn more about the session categories and how to apply. For questions,
contact Tessie Ajala, Project Coordinator, at [email protected].

RHTAC is a project of the Refugee and Immigrant Health Program, Massachusetts Department of Public Health, in collaboration with the Center for Refugee Trauma and Resilience at Children's Hospital Boston, the Bellevue/NYU Program for Survivors of Torture, Sauti Yetu Center for African Women, the Cultural Orientation Resource Center at Center for Applied Linguistics, and John Snow Research and Training Institute, Inc.  RHTAC is funded by the Office of Refugee Resettlement, Administration for Children and Families, Department of Health and Human Services. Grant #90RB0042.  


For more information, please contact 617 983 6589 or write [email protected]

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Revised Medical Examination and Vaccination Record Form

U.S. Citizenship and Immigration Services (2011).

Updated version of Form 1-693, which is used to report results of medical examinations for those seeking certain immigration benefits.  


Centers for Disease Control and Prevention (2011).

This screening is used to identify refugees with nutritional deficiencies that require further evaluation and/or treatment.


Low Income Home Energy Assistance Program (LIHEAP)
U.S. Department of Health and Human Services Administration for Children & Families (2011).
The Low Income Home Energy Assistance Program (LIHEAP) assists low income households in meeting their immediate home energy needs. 

New Project SOAR Website

Project for Strengthening Organizations Assisting Refugees (2011).  

Project SOAR is an initiative of the International Rescue Committee, in partnership with the Nationalities Service Center.     


Seasonal Flu Materials for Refugees

Centers for Disease Control and Prevention (2011).
These materials are designed to improve knowledge of seasonal flu in refugee populations and available in 11 languages.


Free Online Training Opportunity: Quick Health Data Online 101

U.S. DHHS Office on Women's Health (OWH)

Register now for upcoming trainings to learn more about the OWH  online health information system, which contains data on demographics, mortality, reproductive and maternal health, disease incidence and access to care.


MDH Refugee Health Lending Library  

Minnesota Department of Public Health 
This library includes over 180 videos about refugee populations and health issues that are sortable by language and topic.


Webinar Archives    

Domestic Refugee Health Screening Models and Clinical Guidelines

October 26, 2011

New resource: Includes slides, transcripts, and audience questions and answers. 


Addressing the Mental Health Needs of Refugees in Primary Care Settings

July 27, 2011


HIV and Refugee Resettlement  

June 23, 2011

Suicide Among Refugees: Understanding the Social and Cultural Context for Prevention Strategies

May 17, 2011