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Ir 3 medical

IR 3 Medical
A Medical surveillance handout: Inactive tuberculosis . Error! Bookmark not defined.
IR 3 Medical
Updates to chapter
Listing by date:
Date: 2011-02-24
Updated version of the Medical Surveillance Handout for Inactive Tuberculosis or other Urgent Complex Non-Infectious Tuberculosis replaces the older version in Appendix A. Date: 2010-04-22
Changes were made to telephone numbers listed in Appendices A and B. Date: 2009-11-24
Minor changes were made to telephone numbers listed in appendices A and B for British Columbia. 2008-06-26
Minor modifications were made to reflect a branch name change from “Medical Services Branch” to “Health Management Branch.” 2008-05-20
The website address was corrected in section 1 of chapter IR 3. 2007-04-20
Minor modifications were done in Appendix A, “Medical Surveillance Handout: Inactive tuberculosis”. The contact telephone number for Saskatchewan has been changed. Minor modifications were done in Appendix B, “Medical Surveillance Handout: Syphilis”. The contact telephone number for Nunavut has been changed 2007-01-24
Amended Appendices A and B: Medical Surveillance Handouts for tuberculosis and syphilis with new contact telephone numbers for Manitoba. 2006-11-24
Amended Appendices A and B: Medical Surveillance Handouts for tuberculosis and syphilis with new contact telephone numbers for Saskatchewan. 2005-10-12
Some amendments have been made to IR 3 relating to the Medical Services Branch restructure and to CIC/CBSA shared responsibilities. Appendices A and B: Medical Surveillance Handouts for tuberculosis and syphilis have been amended with a new contact telephone number for New Brunswick. 2004-02-26
The telephone number for the Public health authorities in Canada for tuberculosis in the province of Manitoba has been changed to (204) 787-2384. 2003-08-01
A minor wording change was made to the medical surveillance handouts. IR 3 Medical
2003-07-24
IR 3 has been updated to incorporate the new medical assessment coding for excessive demand exempt cases, new medical surveillance information handouts, and information on the Interim Federal Health program. 2003-01-09
Section 7 - "Consideration of Medical Validity Extension for In-Canada Cases." This section has been added to the chapter to permit the extension of medical validity for certain in- Canada cases. IR 3 Medical
Medical examination requirements for temporary residents (tourists,
students and temporary foreign workers)

(Includes occupational basis for medical examination of temporary foreign workers) http://www.cic.gc.ca/english/information/medical/medexams-temp.asp Designated country/territory list
http://www.cic.gc.ca/english/visit/dcl.html Medical surveillance/public health contacts
For instructions on medical surveillance procedures, please refer to Medical Procedures, OP 15, Section 10 and the following Operational Memoranda (OP 02-13, IP 02-03, PE 02-11): http://cicintranet/CICExplore/1976archive/english/guides/om-nso/2002/op/op02-13.htm The medical surveillance handouts referred to in the above OMs have been updated and are attached as Appendix A (Inactive tuberculosis) and Appendix B (Syphilis). Medical surveillance inquiries should be directed to: Interim Federal Health (IFH) Program
This section provides information on the IFH program and replaces Operational Memorandum IP 98-16 (REVISED December 1999). Background
The purpose of the Interim Federal Health (IFH) program is to give effect to a 1957 Order-in-Council that authorizes the Federal Government to pay for in-Canada health care for certain migrants who are unable to pay for expenses related to urgent and essential services. Coverage is provided pending their qualification for other means of payment. At this time, this applies principally to refugee protection claimants, individuals in the Pre-Removal Risk Assessment IR 3 Medical
(PRRA) process, CIC detainees and protected persons including Convention Refugees and members of the Humanitarian–protected Persons Abroad Classes. Until April 1, 1995, Health Canada was responsible for the administration of these funds through the Non-Insured Health Benefit Program. On that day, the mandate was transferred to Citizenship and Immigration Canada to be administered through the IFH program, which continues to provide this humanitarian service. IFH has a transitional role only and is not designed to offer the same comprehensive medical coverage as provincial health insurance. Eligibility for the IFH Program
The following clients will be eligible for the IFH program if they are unable to pay for their health care services and if they are not covered by a private or public health care plan. The determination of the “unable to pay” status is left to either the port-of-entry officer or to the immigration officer’s discretion, depending on the circumstances. 1) Refugee protection claimant and their in-Canada dependent children, other than one who: • is not eligible to have a claim determined by the Refugee Division; • has abandoned or withdrawn their claim to refugee status; or • was determined, under the Act as it read immediately before February 1, 1993, to have no credible basis for a claim to refugee status. 2) Applicants for a pre-removal risk assessment (PRRA) upon application and during the in-Canada process. 3) A refugee protection claimant who has received a negative decision from the Refugee Protection Division (RPD) of the Immigration Refugee Board (IRB) while legally in Canada unless the person is granted the right to apply for landing; 4) Protected person (determined in Canada – CR8) and his/her in-Canada dependent children (DR1s) for the duration of the qualifying waiting period imposed by the health care plan of their province of residence (maximum three (3) months after determination). 5) Repeat immigration medicals requested under IRPA for protected persons are covered under IFH. CR8s who no longer have IFH eligibility should be issued an IMM 1017E with the code OPM machine-written in the “category of applicant” box. 6) All refugees and persons in similar circumstances selected abroad: • Convention Refugees Abroad Class (CR1,CR4, CR5, CRS, CRG, CRC) • Source Country Class (RS1, RSS, RSG, RSC,RS4, RS5) • Country of Asylum Class (RAS, RAG,RAC, RA4, RA5) IFH is provided to all members of the above classes during the period covered by the
Resettlement Assistance Program (RAP) or the period covered by a private sponsorship.
Once access to provincial health insurance (90 days wait maximum) is gained, the individual
will only be eligible for limited coverage under IFH (Appendices C/D) for the duration of the
RAP or for the duration of the private sponsorship as applicable.
Note: Privately sponsored and government-assisted Convention Refugees or members of the
Humanitarian-protected Persons Abroad Classes are not eligible for provincial and municipal social assistance during their sponsorship period. Although they benefit from provincial health care plans, their prescription medications, dental care and other such medical needs are not covered by the provinces during this time period. Consequently, the IFH Program extends partial heath coverage. IR 3 Medical
7) Individual detained by the Canada Border Services Agency. Determining eligibility to the IFH Program (comment: pending the outcome of a recent
Refugee Branch initiative to have IFH given to individuals before full examination at first
contact with CIC)

To determine whether a refugee claimant qualifies for IFH, the port-of-entry or immigration officer will ascertain the status of the claim, ask the claimant whether he/she is in a position to pay for health care or is eligible for private or public health insurance. If the claimant indicates a need for coverage and the port-of-entry or immigration officer is otherwise satisfied that the applicant qualifies, eligibility will be given without further investigation. Individuals in the other eligible immigration categories will also need to demonstrate a lack of funds as above. Benefits
• essential health services for the treatment and prevention of serious medical/dental conditions (including immunizations and other vital preventative medical care); • essential prescription medications, and non prescription life saving medications; • contraception, prenatal and obstetrical care; and • the Immigration Medical Examination for individuals who are unable to pay for it. The following two paragraphs will be printed on forms giving access to IFH and will advise the clients as to when benefits will no longer be available to them: The above-mentioned person is eligible for benefits under the Interim Federal Health (IFH) program as described on the attached list. Eligibility will continue until… (day/month/year)…but may be revoked before, should the holder qualify for private or public health insurance or otherwise ceases to be eligible. I, the undersigned, declare that I require assistance for medical care and that should my circumstance change or should I qualify for any other form of medical coverage, I will no longer seek to obtain benefits under the IFH program. • the "Interim Federal Health Certificate" which is FOSS-generated and is printed on IMM
1442B, FOSS Full Document. It contains basic identification and the paragraphs noted above. It bears the client’s photograph, and signature. • the “Refugee Protection Claimant Document” which is FOSS-generated and is printed on
IMM 1442B. It provides an option to add the two paragraphs that confirm the client’s eligibility for, and access to, IFH. (The above forms will confer IFH eligibility, usually for twelve (12) months or for an adjusted period as determined by the immigration officer.) Eligible clients are entitled to the services listed on Appendices C/D.
Offices will issue these appendices as necessary for distribution to eligible clients. Please note that these appendices have been updated and must replace previous versions effective immediately. IR 3 Medical
It is the intent of the program to limit the number of times a client should communicate with a port-
of-entry or immigration officer with regard to coverage under IFH. To this end, the document
giving access to coverage will be issued to the eligible client on the first contact with port-of-entry
or immigration authorities or as soon as possible after. The procedures below have been written
according to the client’s status in Canada.
IFH eligible groups
A) To be issued the "Refugee Protection Claimant Document" or the “Interim Federal Health
Certificate”
:
Refugee claimants – Claim on or after April 1, 1995
A person who submits the appropriate information to an inland office is issued, as applicable,
a "Refugee Protection Claimant Document" or the “Interim Federal Health Certificate”
form. The statement "eligible for IFH" will appear in the relevant module in FOSS. Before
issuing the document, the officer will determine whether the claimant is eligible for medical
coverage under IFH (see heading "Determining eligibility to IFH" above) and if so, will enter
"Y" in the "eligible for IFH" field. The relevant paragraphs will then be printed on the
document. The expiry date on the IMM 1442B will be one year from the date of issuance or
another date as set by the port of entry or immigration officer. This document will be given to
the claimant along with a list of benefits (Appendices C/D).
When a claimant is issued a "Refugee Protection Claimant Document" or the “Interim
Federal Health Certificate”
form at the port of entry, the officer will ascertain whether the
claimant is eligible for medical coverage under IFH (see “Inland procedures” above). These
forms provide an option to add the two paragraphs that confirm the client’s eligibility for, and
access to, IFH (for one (1) year or other period) (attach Appendices C/ D).
B) The following groups will be issued an "Interim Federal Health Certificate of eligibility" form
to which will be attached the list of benefits that they are entitled to (Appendices C/D). Eligibility
will usually be granted for twelve (12) months renewable. The following clients will fall into this
group:
1) Convention refugee abroad class, source country class and country of asylum class: including those issued temporary resident permits (In certain provinces, a 90-day waiting period is imposed by the province before applicants can get provincial health insurance. The "eligibility until" date will be 12 months or the anticipated date that payments under the RAP end.) 2) Convention refugees determined in Canada: Convention refugees determined in Canada
currently become immediately eligible for provincial health coverage in Ontario, Quebec,
Newfoundland, Yukon and the Prairie provinces. In British Columbia, the Northwest Territories,
New Brunswick, Prince Edward Island and Nova Scotia, Convention refugees will be covered by
provincial health care plans no later than three (3) months after CR determination. Pending
medical coverage under a provincial plan, CR8s will continue to use the “Refugee Protection
Claimant Document”
bearing the eligibility paragraphs or an "IFH certificate" for renewal (attach
Appendices C/D).
Note: Convention refugees determined in Canada and their in-Canada dependent children who have
provincial health insurance are not eligible for any IFH benefits. 3) Baby born in Canada to a Convention refugee or refugee claimant: In the case of a baby
born in Canada to an IFH program eligible mother, an IFH certificate will be issued upon
IR 3 Medical
presentation of the hospital birth declaration or birth certificate. (This does not apply to Ontario or British Columbia or Quebec – refer to the section "Eligibility for IFH.") These dependent children are entitled to the same benefits as the mother (attach appendices C/D). 4) Refused refugee claimants awaiting removal or protected persons under the new PRRA
regulation (suggest a shorter IFH eligibility period such as 6 months):
These persons will be
given an Interim Federal Health Certificate bearing the client’s photograph which will be valid for
twelve (12) months or less (attach Appendices C/D).
5) Extensions: Some individuals will need an extension of their eligibility to the program
because their claim/permanent residence application is still being processed. Provided that the
applicant is eligible (refer to "determination of eligibility" above) an extension may be granted for
the estimated period of time that it will take to finalize the case but not for more than twelve (12)
months at a time. Issue an IFH certificate of eligibility (attach Appendices C/D).
Note: To avoid gaps in medical coverage, backdate the eligibility to the day after the last day of eligibility
C) Persons detained by Citizenship and Immigration: No forms are issued to these individuals. Entitlement is determined on a case by a case basis and is addressed accordingly. Billing Information
Medical bills will be forwarded for payment by the health care provider only to: FAS Benefit Administrators Ltd. 9707 – 110 Street, 9th Floor Edmonton, Alberta T5K 3T4 Medical bills received at Canada immigration centres or at ports of entry should be returned to sender with a note advising of the above address. Claims submitted by clients will not be honoured. Designated medical practitioners worldwide
http://www.cic.gc.ca/english/contacts/medical.html Correspondence with Health Management Branch
Correspondence unrelated to medical examinations
All correspondence concerning matters of policy or procedure will be addressed to: IR 3 Medical
Correspondence related to medical examinations
All correspondence relating to medical examinations, diagnoses or medical assessments in individual cases in Canada will be addressed to: Correspondence on medical surveillance issues should be addressed specifically to:
Consideration of medical validity extension for in-Canada cases
Medical validity (the period over which the immigration medical examination is valid) is now twelve months from the date of the immigration medical examination. Concerns have been expressed about expired medical validity for in-Canada applicants. Consequently, a procedure has been developed whereby Health Management Branch officers will give consideration to extending medical validity for certain in-Canada cases. The medical validity extension procedure is: • Where an officer realizes that an applicant’s medical validity has expired, the officer should refer the case to Health Management Branch (HMB) at the following e-mail address: medical.extension@cic.gc.ca Note: Please refer only those cases in which the immigration medical examination has been conducted
less than 24 months (2 years) from the date of the request for extension. All other cases will automatically require a new medical examination. • The medical case will be reviewed by HMB and a decision regarding medical validity extension or the requirement for a new medical examination will be provided to the requesting officer within ten (10) working days. If a medical validity extension is granted, it will generally be for a period of twelve (12) months from the date of the request for extension. IR 3 Medical
Amendment of medical assessment coding for excessive demand exempt
(EDE) applicants

Background
Since the IRPA proclamation on June 28, 2002, excessive demand exempt (EDE) applicants have
been given the medical coding of M7, together with D8. The linked M7, D8 medical coding has
been problematic for several reasons. In order to correct this problem, a new system of medical
profiling follows. Therefore, as of June 20, 2003, the M7, D8 medical coding will be replaced
by a double digit M coding for EDE applicants.

Medical coding and it amendments
For CAIPS, FOSS, and IMS users:
• the three admissible EDE categories will be coded as M19, M29 or M39; • an M56 code has been added (not related to EDE but provides for the possibility of medical inadmissibility on public safety and excessive demand grounds); • medical code H, T, D, and E will automatically default to “1”; • an automatic validity date for EDE cases coded M19, M29, or M39 will occur on the primary screen in CAIPS for all admissible cases; and • where EDE cases are coded M29 or M39, a field to enter the associated International Classification of Diseases (ICD) code is available. For IMS users only:
• two standard medical narratives to IMS have been added: ♦ “This applicant has been assessed as an excessive demand exempt applicant. Any change in immigration category requires a repeat medical examination.” ♦ “This applicant has ___________________ which may require significant health and/or social services if the applicant were granted entry to Canada. This person has been assessed as an excessive demand exempt applicant. Any change of immigration category requires a repeat medical examination.” For CAIPS users only:
Added in CAIPS is a message for visa/immigration staff to read the medical narrative for cases identified by an M2, M29, M3 and M39. This will help staff identify important medical information concerning possible medical surveillance and health/social services requirements. For CAIPS and CPC system users only:
For EDE applicants, the IMM 1017E, printed by CAIPS and at CPC, will now be printed the “EDE/ EFE”. This will ease in recognition for the medical practitioner. Medically admissible cases
• Medical code H, T, D, and E will automatically default to “1”. Only the M and S medical codes IR 3 Medical
• For admissible EDE applicants, the M coding will always include 1111Is this the intended • Non-EDE applicants who are assessed as having no identified health condition will still be coded M1.
• EDE applicants who are assessed as having no identified health condition will be coded M19.
• Non-EDE applicants who require medical surveillance and who have no other identified health condition will still be coded M2, with the appropriate medical surveillance S code.
• EDE applicants who require medical surveillance and who have no other identified health condition will be coded M29, with the appropriate medical surveillance S code.
• Non-EDE applicants who require medical surveillance and who are identified with another health condition(s) not considered likely to create excessive demand on in-Canada health or
social services will still be coded M23, with the appropriate medical surveillance S code.
• Non-EDE applicants with identified health condition(s) not considered likely to create excessive demand on in-Canada health or social services will still be coded M3.
• EDE applicants with identified health condition(s) that will require health or social services in Canada will be coded M39, unless medical surveillance is also required; Under this
circumstance, a M29 will be used.
Note: The M39 coding may apply to applicants who have a health condition that is likely to require very
significant health or social services in Canada. Visa/ immigration officers must discuss such cases with Health Management Branch when an applicant is re-categorized to a non-EDE immigration category. MEDICALLY ADMISSIBLE CASES
‘S’ code
‘M’ code
Current or
changed

Public
health
risk

IR 3 Medical
Medically inadmissible cases
• Medical code H, T, D, and E will automatically default to “1”. • EDE cases, if assessed medically inadmissible (danger to public health and/or danger to public safety), will be coded the same as non-EDE cases. • It is not possible to have more than two numbers in the M coding. However, it is possible (though extremely rare) for a non-EDE applicant to be deemed medically inadmissible on three grounds: danger to public health (M4), danger to public safety (M6), and excessive demand (M5). In such circumstances, the medical assessment code would be M46, with the excessive demand (M5) information included in the medical narrative. MEDICALLY INADMISSIBLE CASES
‘S’ code
‘M’ code
Current or
changed

Public
health
risk

Medical assessment coding
CRITERIA
CRITERION
STATEMENT1
STATEMENT2,
H, D, T and E
(Non
excessive

(Excessive
applicants)
applicants)
M1 No health
admission for medical reasons under A38(1). IR 3 Medical
S2 Medical
2.02 Medical
2.04 Medical
surveillance for
treated positive
syphilis
serology.
condition for which the degree of risk to public health is not sufficient to exclude admission under A38(1)(a), AND has a condition for which the potential demand on health or social services is not sufficient to exclude admission under A38(1)(c). IR 3 Medical
condition that is likely to be a danger to public health to such an extent that the applicant is inadmissible under A38(1)(a). condition that might reasonably be expected to cause excessive demand on health or social services to such an extent that the applicant is inadmissible under A38(1)(c). condition that is likely to represent a danger to public safety to such an extent that the applicant is inadmissible under A38(1)(b). condition that is likely to represent a danger to public health to such an extent that the applicant is inadmissible under A38(1)(a), AND has a condition that might reasonably be expected to cause excessive demand on IR 3 Medical
health or social services to such an extent that the applicant is inadmissible under A38(1)(c). condition that is likely to represent a danger to public health to such an extent that the applicant is inadmissible under A38(1)(a), AND has a condition that is likely to represent a danger to public safety to such an extent that the applicant is inadmissible under A38(1)(b). condition that might reasonably be expected to cause excessive demand on health or social services to such an extent that the applicant is inadmissible under A38(1)(c), AND has a condition that is likely to represent a danger to public safety to such an extent that the applicant is inadmissible under IR 3 Medical
1) It is not possible to have more than two numbers in the M coding. However, it is possible (though extremely rare) for a non-EDE applicant to be deemed medically inadmissible on three grounds: danger to public health (M4), danger to public safety (M6), and excessive demand (M5). In such circumstances, the medical assessment code would be M46, with the excessive demand (M5) information included in the medical narrative. 2) EDE applicants who require medical surveillance and who are identified with another health
condition(s) that will likely require health and social services in Canada, will be coded M29, with
the appropriate S code. Hence, it is imperative that visa/immigration officers read the medical
narratives of EDE cases coded M29, since they may contain important details about the identified
medical condition(s).
3) EDE applicants, if assessed medically inadmissible (danger to public health and/or danger to public safety), are coded the same as non-EDE cases. Appendix
A Medical Surveillance Handout: Inactive Tuberculosis or other
Complex Non-Infectious Tuberculosis
Your immigration medical exam for entry to Canada shows that you have inactive tuberculosis (TB) or a
form of complex non-infectious tuberculosis. This means that you either
• received treatment for TB in the past or • have been exposed to TB bacteria and your body’s defences have contained the infection. To prevent inactive TB from becoming active, early follow-up and ongoing monitoring of your condition is important. Active TB can easily be spread to other people through coughing or sneezing. For your own health, and to protect the health of your family and the public, you must contact a public
health authority in the province or territory where you live.
You will find the telephone number you
need in the chart below.
You must contact the public health authority within the time shown in the checked box: thirty (30) days of entering Canada.
seven (7) days of entering Canada.
(Time depends on the type of TB you have.) If your first language is not English or French, you may wish to ask someone to help you make this phone call. IR 3 Medical
The public health authority will ask you for information on your “Medical Surveillance Undertaking” form (IMM 0535B). This form was given to you either by the Visa Officer with your other other immigration papers, or by the Officer at the port of entry (airport). You will be given a date, time and location for your follow-up appointment, which you must attend. Please
take your “Medical Surveillance Undertaking” form and this handout to the appointment.
You may
be denied Canadian citizenship until you provide proof that you complied with the medical terms and
conditions of your request to live in Canada.
If you change your address or telephone number before the public health follow-up is completed, you must provide updated information to the public health authority in your area and to Citizenship and Immigration Canada by contacting the CIC Call Centre at 1-888-242-2100 (toll free) or by accessing CIC’s on-line services (www.cic.gc.ca) . Tuberculosis (TB) information
During your medical exam for entry to Canada, the doctors found that you have inactive TB. TB is a disease caused by a bacteria and it can be treated. When a person has active TB in the lungs and throat, it can spread to other people through coughing and/or sneezing. You may not know when you got TB and you may not have any TB symptoms. Inactive TB does not make you feel sick. While you do not have active TB now, you may still be in danger of getting it at some time in your life. Some medical conditions including diabetes, hepatitis, kidney disease, HIV/AIDS, addictions (including tobacco smoking), malnourishment, and pregnancy increase the risk of inactive TB becoming active. Signs and symptoms of active TB may include: • prolonged fever and/or cough, • coughing up blood, • sweats at night or afternoon, • constant tiredness, and • loss of weight and loss of appetite. To make sure you stay healthy, you need to see doctors or nurses who know a lot about TB. They will tell you what you need to do. Public health authorities in Canada for TB:
IR 3 Medical
*Quebec: The Public Health Department will contact you by mail with information on medical follow up.
You do not need to phone the Public Health Department unless your address changes, or if you have not
heard anything from them after one month. In these cases, please contact them at (514) 528-2400 ext.
3881.
IR 3 Medical
Appendix
B Medical surveillance handout: Syphilis
Your immigration medical examination has shown that you have evidence of previous syphilis infection that has been treated prior to entering Canada. Syphilis is a disease of public health concern because persons with active syphilis can transmit this disease to other people. To maintain your own health, and to protect your family members and people in Canada,
you must telephone a public health authority in your province/territory of residence, unless
you are living in Quebec.* You are required to telephone the public health authority within
thirty (30) days of entering Canada, or if you are already living in Canada, within thirty (30)
days of receiving this handout.
Please see below for public health authority telephone numbers
and instructions if your province of residence is Quebec.*
If you do not speak English or French, you may wish to ask someone to help you make this telephone call. When you telephone the public health authority, they will ask you for information on your “Medical Surveillance Undertaking” form (IMM 0535B) which you should have available at the time you make the telephone call. You will be instructed where and when you must attend for your follow-up appointment. Please
take your IMM 0535B and this handout with you at that time.

If you change your address or telephone number before the public health follow-up is completed, you are required to provide updated information to the public health authority in your area. Public health authorities in Canada for syphilis:
*Quebec: The Public Health Department will contact you by mail with information on medical
follow up. There is no need to telephone the Public Health Department unless there is a change in
address or if, after one month, you have not heard anything from them. If you have a change of
address or you have not heard from the Health Department after one month, telephone (514) 528-
2400 ext. 3881.
IR 3 Medical
Syphilis information
Syphilis is a disease spread from one person to another by sexual intercourse. A pregnant woman who has infectious syphilis can pass the infection to her unborn child. The 1st stage has painless open sores, usually around the genitals or mouth, which generally
appear three weeks after exposure.
The 2nd stage occurs four to ten weeks later with flu-like symptoms and a rash on the palms of
the hands, soles of the feet or entire body.
Both the first and second stages are highly infectious and may go unnoticed. This may last up to one year. Latent syphilis is a resting state, which is non-infectious. Even without treatment, the symptoms
go away but the disease can progress over several years to the last stage.
Tertiary syphilis is the last stage and may result in heart disease, nerve and brain damage, or
death.
While you do not have serious syphilis now, it may get worse at some time in your life. To make sure that this does not happen, you need to see doctors or nurses who know a lot about syphilis so that they can tell you whether there is anything else you need to do to stay healthy. To begin this process, you must contact a public health authority in the province/territory where you live. Please refer to the information in this handout for instructions. IR 3 Medical
Appendix
C Interim federal health program (IFH) information for health professionals
Benefits: Medical
Services covered without CIC approval
• Essential health services only for the treatment and prevention of serious medical/dental • Contraception, prenatal and obstetrical care. • Essential CPS prescription medications (or life supporting over-the-counter drugs such as insulin or nitro). Must be lowest cost alternatives. Only drugs featured on the IFH medication list found at “www.fasadmin.com” are covered without prior approval. • Professional fees as per applicable provincial health care plan. Fee codes (where applicable) must be supplied. Invoices must be submitted within six months of service. • The Immigration Medical Examination is performed by an authorized Designated Medical Practitioner – reimbursed only for IFH eligible individuals who cannot afford the costs. Services covered with CIC approval only
• Complete physical examination/ counselling services by a general practitioner. • Ambulance/medical transport (unless emergency). • Diagnostic services (surgical, laboratory, or x-ray) when no significant medical short-term • Certain high cost medications (e.g. Imitrex, Accutane, Interferon and Lamisil). • Plastic surgery for esthetic purposes. • Elective surgery (e.g. hernia repair, joint replacements). • High cost procedures (e.g. organ transplantations). • Office-based psychotherapy by a psychiatrist after the initial consultation. • Psychotherapy by psychologists/general practitioners. • Prosthetic or mechanical devices including hearing devices. IR 3 Medical
• Eyewear. Visual acuity tests needed for all patients. Requests for prior approval must be submitted by mail or fax to:
Director, Program Management and Control, Services not covered under the IFH Program
• Infertility investigations and treatment. • Routine circumcision of the newborn. • Most over-the-counter medications even when written on a doctor’s prescription. Invoices to be sent by the health care providers only to:
T5K 3T4 / fax: 780 452 5388 / email : info@fasadmin.com (NB: if FAS does not already possess patient’s eligibility, you must send a copy of the eligibility document. The health provider can check this by telephone at 1-800-770-2998) IR 3 Medical
Appendix
D Refugee dental care regulations
ONLY EMERGENCY DENTAL SERVICES COVERED – (defined as urgent procedures to
alleviate pain, active infection, hemorrhage, and/or the results of oral trauma).
A maximum coverage of $400 exists during the patient’s eligibility period. A maximum of two teeth may be treated per visit. Dentists may verify the remaining funds available for a refugee by calling toll free 1-800-770-2998. If the limit has been exceeded, special approval must be obtained prior to the provision of services. This funding is intended to cover only the following: • Emergency exams (limit of once per six months per office). Complete oral exams and recall • Panoramic radiograph OR eight peri-apical X-rays (but not both) will be allowed during the entire eligibility period. X-rays must be clear, discernible and properly labelled or they will be returned. Bite-wing X-rays are not a covered expense. • Prior approved permanent fillings are restricted to: 1) non-bonded amalgam on molars and bicuspids 2) bonded composite resin fillings on anterior teeth. Fillings will be paid on a continuous basis only. Routine dental treatment and incipient decay not observable in the X-ray are not covered. • Scaling and root planing are not covered. • Uncomplicated extractions (two- teeth maximum per visit). Complex extractions require pre- treatment radiographs and pre- determinations. • Drug prescriptions (only those needed to treat emergency conditions). • Prosthetics covered with prior approval only: transitional partial dentures. Relining for
dentures will be considered only after six months of placement of transitional dentures. All prosthetic requests should be accompanied by a completed « dental predetermination form » and submitted with either eight peri-apical X-rays or a panoramic X-ray. • All anaesthetic care must be submitted for predetermination. For anaesthetics involving patients under the age of 13 years, four units may be approved. For patients aged 13 and older, up to eight units may be approved. Exclusions to dental care:
• permanent prosthetics and orthodontics; • intravenous sedation and nitrous oxide; • prophylaxis and flouride treatments; IR 3 Medical
Payments will be made at 100% of the applicable current general practitioner provincial/territorial dental fee guide (lowest applicable fee). Predetermination requests should be mailed (with X-rays and all relevant fee codes) to FAS Benefit Administrators Ltd.

Source: http://overseastudent.ca/migratetocanada/IMMGuide/CICManual/ir/ir03-eng.pdf

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FEBRILE NEUTROPENIA IN PAEDIATRIC PERIPHERAL BLOOD STEM CELL TRANSPLANTATION, IN -VITRO SENSITIVITY DATA AND CLINICAL RESPONSE TO EMPIRICAL ANTIBIOTIC THERAPY Ansari SH, Nasim S, Ahmed A, Irfan M, Ishaque A, Farzana T, Panjwani VK, Taj M and Shamsi TS ABSTRACT Objective: To find the in-vitro sensitivity data and clinical response in order to determine the changes required in empiric a

zit-bb.de

Landesamt für Soziales und Versorgung des Landes Brandenburg Service de protection contre les infections Notice sur la grippe 1. L’agent pathogène La grippe est une infection aiguë des voies respiratoires fortement contagieuse qui se transmet par les virus de la grippe. Peu avant que les symptômes ne se fassent sentir, la contagiosité est très grande. Les viru

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