“A Legacy of Confusion”: An Exploratory Study of Service Provision under the Reinstated Interim Federal Health Program

Abstract

Afer years of cuts, Canada’s refugee health-care program, the Interim Federal Health Program (IFHP), was fully restored in 2016. In this exploratory study, eleven semi-structured qualitative interviews were conducted with refugee service providers in the City of Ottawa to learn about their experience with the restored IFHP to date. Five themes emerged from the interviews: service provision challenges during the years of IFHP cuts; support for IFHP restoration; entitlement gaps in the current IFHP; ongoing confusion about the IFHP; and administrative barriers deterring health professionals from IFHP participation. More research is needed to determine whether the identifed challenges with the reinstated IFHP arise on a national scale.

(Re)Constructing and Resisting Irregularity: (Non)citizenship, Canada’s Interim Federal Health Program, and Access to Healthcare

“…The confusion and barriers created through the IFHP revisions came to an end in April 2016 when the program was fully restored to its pre-2012 levels under the newly elected federal Liberal government; it was further expanded in April 2017 to refugees awaiting resettlement to Canada. However, concerns continue to be raised about the healthcare barriers faced by refugee claimants and other un(der)insured and nonstatus persons (Caulford & Rahunathan, 2017;Chen, Gruben & Liew, 2018;Wright, 2018), alerting us to how this program perpetuates health inequality and contributes to the (re)irregularization of refugee claimants. In this article, I draw on critical citizenship and migration scholarship (Baines & Sharma, 2002;Castañeda, 2013;Hepworth, 2014;Isin, 2002), to highlight how the irregularity of refugee claimants was (re)constructed during the time of revisions (2012-2016) in ways that led to denied access to healthcare coverage and services.…”

Vulnerability of Asylum Seekers and Undocumented Migrants in Toronto

“…The benefits covered by the IFHP have certain limits including maximum dollar amounts. Additionally, as outlined by Chen et al (2018), there is a dearth of clear and accessible information about the IFHP (e.g., the eligibility criteria and the extent of services and treatments covered) for both patients and health-care providers. The registration, preapproval, and reimbursement processes are burdensome, contributing to some practitioners' hesitance to participate in the programme (Chen et al 2018).…”

“…Additionally, as outlined by Chen et al (2018), there is a dearth of clear and accessible information about the IFHP (e.g., the eligibility criteria and the extent of services and treatments covered) for both patients and health-care providers. The registration, preapproval, and reimbursement processes are burdensome, contributing to some practitioners' hesitance to participate in the programme (Chen et al 2018). In addition to the roadblocks related to the availability of appropriate services, asylum seekers face structural barriers (i.e., fear of financial contribution) to accessing services (Thomson et al 2015).…”

A Critical Look at Refugee Healthcare in Canada

“…Furthermore, the denial of healthcare services to refugee patients coupled with a lack of mandatory cultural training for healthcare professionals has been detrimental to the quality of life of refugees. These factors combined explain how providers refuse new refugee clients given the increased paperwork and new reimbursement processes (6).…”

“…In response, some changes such as cuts to supplementary care (i.e. vision and dental services) and the IFHP's limited drug coverage were reversed in 2014, leaving behind an aftermath of confusion among healthcare workers, organizations, and refugees themselves about the workings of the program (6).…”