Immigrant Health Service

Asylum seekers

  • Background

    An asylum seeker is someone who has applied for refugee status and who is awaiting a decision on this application. Asylum seekers in Australia can broadly be divided by:

    • Whether they have a valid visa on arrival - this determines whether they are (or have been) subject to mandatory detention. 
      • Boat arrivals without a valid visa (subject to mandatory detention)
      • Plane arrivals without a valid visa or plane arrivals who do not clear immigration (subject to mandatory detention)
      • Plane arrivals who clear immigration (i.e. on a valid student or travel visa - not subject to mandatory detention)
    • Their date of arrival - this determines how they are processed and whether they are subject to offshore processing/resettlement
      • People who arrived by boat without a visa after 13 Aug 2012 (and before 19 Jul 2013) could be subject to offshore processing and offshore settlement
      • People who arrived by boat without a visa after 19 Jul 2013 were subject to offshore processing and offshore settlement. Some of this group remained in detention on Christmas Island or the mainland, and then were included in the 'Legacy caseload' and remained in Australia
      • People who arrived by boat without a visa between 13 Aug 2012 and 1 Jan 2014 will have their protection claims processed under the new Fast Track Assessment process. See schema fast track process and RACS flowchart of asylum claim process (Dec 2015).
    • Their stage in the protection claim process
      • There were substantial delays in processing protection claims for people who arrived after Aug 2012 - processing halted between Sep 2013 and May 2015
      • The stages in the protection claim process can be broadly divided as
        1. Assessment by the Department of Immigration and Border Protection (DIBP) 
        2. Review of negative DIBP decision 
        3. Judicial review of refusal by appeal body; and
        4. Review within the judicial system
      • People who have had their claims assessed and declined at all stages of review may be described as 'finally determined'.

    See: Refugee policy and timeline.

    Groups of asylum seekers include:

    • Asylum seekers in held (locked) immigration detention (As of 2017, the detention population is approximately one third people who arrived by boat without a valid visa, one third criminal cancellations and one third 'other', the last children were released from detention in Apr 2016)
    • Asylum seekers in community detention (now predominantly people transferred back from Nauru and Manus Island for medical reasons)
    • Asylum seekers in the community
      • People on a Bridging visa E (BVE) who are awaiting a decision on their protection claim - usually people who arrived by boat without a valid visa and have spent time in held detention. 
      • People who arrived with a valid visa (i.e. by plane) and have claimed asylum (people in this group may also be on bridging visas, which generally revert to the conditions of their substantive visa, they may also be on a BVE) - see  IAA (plane arrival) caseload (Apr 2016)
      • People who have had an initial (or later) claim rejected and are in a review process, or awaiting judicial review/outcomes - this group will increase in size going forwards. 

    Asylum seeker identification

    There are several means of identifying asylum seeker status; also see information on the DIBP Immicards

    Asylum seekers found to be owed Australia's protection (i.e. granted refugee status)

    Prior to 13 Aug 2012, people who were successful in their asylum claim were granted a Protection visa (subclass 866). This visa grants permanent residency, work rights, Centrelink eligibility, Medicare and settlement support; therefore 866 visa holders are no longer asylum seekers. People who arrived before 13 August 2012 whose claims were not finalised, are subject to retrospective application of Temporary Protection Visas (TPV).

    People on Temporary Protection Visas (TPV) - TPVs were proposed for reintroduction in October 2013 - see NSW Refugee Advice and Casework Service (RACS) Factsheet and the Victorian Refugee Health Network Asylum seeker fact sheet from that time. Legislation changes in Dec 2014 allowed TPVs to proceed, reintroducing the TPV 785 (XD) and introducing a new form of 'Safe Haven Enterprise' (SHEV) Visa - see DIBP TPV and SHEV, and Protection Application Information and Guides (PAIG). SHEV became available in July 2015 and arrangements included Victoria from Oct 2016. Also see RILC fact sheet - SHEV, and Department of Social Services - TPV entitlements.

    Numbers

    In 2017, in Victoria there are: 

    • 210 people (approximately one third asylum seekers) in Immigration detention (Maribyrnong) or Immigration transit accommodation (MITA) (30 April 2017)
    • 200 asylum seekers in Community Detention (of a national total of 566) (30 April 2017)
    • 10,031 asylum seekers on BVEs in December 2016 (of a national total of 25,810 BVE holders in the community at that time; 23,573 BVE holders nationally in March 2016)
    • Approximately 1800 non-IMA asylum seekers living in the community.

      Asylum seeker health screening

      All asylum seeker groups have a health assessment – either in held detention (through IHMS), or in the community after release from detention as part of refugee health care, or by BUPA (contracted by DIBP).

      • For adults and adolescents 15 years and older this comprises: CXR, limited blood testing including FBE; HIV, hepatitis B, hepatitis C and syphilis screening
      • For children less than 15 years this comprises: CXR for children 11 years and older. Additional health screening was introduced in mid-2014 for children <15 years in held detention - details are not available, although clinical experience suggests this is similar to adult screening
      • Additional tuberculosis (TB) screening is provided for people in held detention with known TB exposure (en-route to Australia or in detention) - interferon-gamma-release assay (IGRA) screening in adolescents/adults, and IGRA or Mantoux testing in children. Protocols were not clear, and it is important to check what has (or has not) been completed
      • Immunisation catch-up is provided for people in held detention (with all Australian schedule vaccines including varicella vaccine and HPV; and additional vaccines including hepatitis A and influenza). Immunisation catch-up delivery was patchy through early 2013, coverage improved from mid-2013, although available evidence suggests the majority of individuals released from detention still required catch-up vaccinations at the time of release.
      • Detention health checks are recorded in the IHMS Health Discharge Assessment (HDA) - all people released from held detention should have a copy of their HDA. Initially these HDA were available through the Community Detention Assistance Desk (CDAD) - 1800 725 518. In recent months, this information has no longer been available through CDAD, and IHMS have advised completing a freedom of information (FOI) request to DIBP.

      Health assessments - letters requesting BUPA health assessments 2017

      As of late 2016 and early 2017, asylum seeker clients have been sent pro forma letters from DIBP requesting health examinations as part of the legacy caseload processing - to be completed at BUPA Medical Visa Services. Key details include:

      • The letters come from 'Mark' (no surname given) position number 60008795, Temporary Protection Visa Assessment Branch, PO Box 25 Belconnen, ACT 2616
      • These letters have been sent to individuals where there was no record of IHMS screening being completed
      • They provide a list of codes, although the letters do not provide detail on what the codes are - The codes listed are: 501=medical examination, 502=CXR, 707=HIV blood test, 708=hepatitis B serology, 716=hepatitis C serology, 712=syphilis and 719=IGRA testing 
      • The letter asks people to bring copies of any previous letters/reports to their BUPA visit
      • Bupa fee schedules are available, these are substantial costs to asylum seeker families. Health assessment fees are reimbursed by the SRSS provider - although the letter does not clarify this - (note people seeking asylum will not have SRSS if they are working)
      • Previous test results will be accepted by the DIBP - please complete this spreadsheet with consent and email to health@border.gov.au (i.e. tests completed after release from detention can be used for the health assessment) 
      • There is complexity for TB screening with the BUPA assessments - TB screening tests are likely to stay positive, and individuals may have been managed and completed treatment for LTBI and then be re-referred for a positive screening test - we are seeking clarification on the processes to manage this situation.

      Access to supports (health, housing, education, work rights)

      Access to services, workrights, and Medicare for the different asylum seeker groups (and those on a TPV) is shown in Table 1. 

      • Medicare cards for all BVE holders expired at the end of 2014.  This was related to the Commonwealth Health Insurance Act 1973 and administrative procedures that allow (time-limited) access for asylum seekers to Medicare.  Medicare access was extended for another 3 years; however, all BVE clients need to renew their Medicare card when their BVE expires. People with expired BVEs are not eligible for Medicare until their BVE is reissued. BVE duration has been short (often 3-6 months) across 2016-17.
      • Work rights were permitted for BVE holders after the legislation changes in Dec 2014. The restriction on work rights was lifted as BVE were renewed (i.e. work rights were granted when BVE were renewed after Dec 2014). In practice, BVE durations became very short over 2016-17 which precluded employment. 
      Group of asylum
      seekers
      Visa
      status
      Health Housing Work rights Income
      support   
      Education Case support, legal access
      Held detention No status IHMS,
      no Medicare
      Detained No

      No No longer relevant, previously primary and secondary (routine school access 6/2014 on CI)

      DIBP. Able to engage legal assistance under the Migration Act

      Community detention No status IHMS pays for
      services, assigned GP and pharmacy, no Medicare
      Provided by
      DIBP
      No = 60% 
      Special 
      Benefit, utilities paid through DIBP
      Kindergarten, primary, secondary and language school

      Red Cross, Life without Barriers, contracted by DIBP. SRSS band 2-3. Able to engage legal assistance under the Migration Act. Generally no funded legal assistance - see PAIG, some applicants have been eligible for assistance through the Primary Application Information Service (PAIS)

      BVE
      in community
      BVE Medicare tied
      to having
      valid BVE
      6 weeks support
      then private
      rental
      Yes (from
      12/2014, with
      renewal of BVE)
      = 89%
      Newstart
      or Special
      Benefit



      Kindergarten, primary, secondary and language school.

      Tertiary education at international student rates

      Life without Barriers, AMES, Red Cross. SRSS band 4-6. Band 4 = transition, Band 5 = vulnerable, Band 6 = majority. Generally no funded legal assistance - see PAIG, some applicants are eligible for assistance through the Primary Application Information Service (PAIS)

      TPV
      in community (i.e refugee status, no longer an asylum seeker)
      SHEV, TPV, THC
      Medicare Private rental



      Yes Centrelink eligible, conditions on SHEV visa Not eligible for settlement support
      'Non-IMA' - asylum seekers who arrive by plane with a valid visa BVA, 
      BVC
      or BVE
      Medicare eligible
      if visa holds
      workrights
      Varies No

      Kindergarten, 
      primary, secondary 
      and language school,
      fees may be
      charged, depending
      on entry visa 

      Tertiary education as above

      Often no case support, may be eligible for SRSS and Red Cross support, may get case support through ASRC. May be eligible for IAAAS if meet disadvantage criteria

      After claim
      rejected
      Varies depending on stage of decision Often no Medicare, recent indication Medicare retained if protection claim not submitted Varies, generally not, recent indication work rights retained if protection claim not submitted No - SRSS payments stop after 1 week unless Band 5 approved Usually no case support; some legacy caseload asylum seekers may be eligible for band 5 support and ongoing SRSS income support. Not eligible for funded legal assistance


      SRSS - Status Resolution Support Services is the program that provides supports to non-citizens as their immigration status is resolved. SRSS replaces the previous CAS – Community Assistance Support (changed to band 5) and ASAS – Asylum Seeker Assistance Scheme (changed to band 6). 

      Fast track assessment process

      Fast track assessment process final


      Resources

      Immigrant health resources. Updated May 2017. Contact: georgia.paxton@rch.org.au