Temporary public policy to exempt in-Canada protected persons from the Immigration Medical Examination requirement when applying for permanent residence

Background

To protect the health and safety of Canadians, paragraph 16(2)(b) of the Immigration and Refugee Protection Act (the Act) requires that all foreign nationals who make an application under the Act submit to an Immigration Medical Examination to determine whether they have a medical condition that would render them inadmissible on health grounds. The requirement in paragraph 16(2)(b) of the Act is subject to regulatory provisions in the Immigration and Refugee Protection Regulations (the Regulations) that further define this requirement. Paragraph 30(1)(a) of the Regulations specifies that all applicants for permanent residence, including protected persons and their family members who are included in the protected person’s application to remain in Canada as a permanent resident, must undergo an Immigration Medical Examination.

As part of departmental efforts to streamline application processing requirements where there is known duplication of data collection among applicants who have previously applied to IRCC through a different stream, the Immigration Medical Examination process for in-Canada Protected Persons has been identified as an area where operational efficiencies could be gained without introducing significant public health and program integrity risks.

To inform this assessment, the Department conducted a review of risk factors related to in-Canada Protected Persons. It is known that applicants:

• undergo an Immigration Medical Examination pursuant to subparagraph 30(1)(a)(v) of the Regulations, when claiming refugee protection in Canada, and are therefore a pre-screened population;
• are not assessed for health conditions that might reasonably be expected to cause excessive demand on health or social services in light of the exemption from the excessive demand inadmissibility applicable to this group of foreign nationals, pursuant to paragraphs 38(2)(c) and (d) of the Act; and
• may be unlikely to have spent significant time (i.e., six consecutive months) outside of Canada while awaiting a decision on their claim for refugee protection or their Pre-Removal Risk Assessment (PRRA).

In addition, at the time of their initial medical examination as asylum claimants, those with history of previously treated tuberculosis or suspected latent tuberculosis are referred to provincial/territorial public health authorities for medical surveillance. This requirement helps to prevent spread of the disease within Canada and ensures that applicants who may be a potential risk to public health are integrated into Canada’s health-care system.

Based on these factors, the department has determined that the risk of exempting in-Canada Protected Persons from the requirement to undergo a subsequent Immigration Medical Examination is low from a public health perspective.

Public Policy Considerations

This temporary public policy seeks to exempt eligible low-risk in-Canada Protected Persons and their eligible accompanying family members who are in Canada from the requirement to undergo a subsequent Immigration Medical Examination as part of their application for permanent residence, as currently prescribed in the Act and Regulations. It is considered an interim measure while the Department examines Regulatory amendments.

This temporary public policy builds on a risk-based approach to health screening, whereby screening is commensurate with the level of risk that an applicant poses. This is a more facilitative process than requiring applicants to undergo more than one Immigration Medical Examination, regardless of individual risk. The objective of this priority remains to facilitate immigration to Canada while continuing to manage the health risks associated with migration.

In addition to leaning the Immigration Medical Examination process and easing the compliance burden for low-risk protected persons, this public policy aims to support potentially vulnerable applicants that may lack sufficient financial resources to pay the Immigration Medical Examination fees, thereby facilitating better client service and supporting faster application timelines, ensuring protected persons can more quickly obtain permanent residence and the benefits that this status affords.

Therefore, I hereby establish that, pursuant to my authority under section 25.2 of the Act, there are sufficient public policy considerations to justify the granting of an exemption from the requirements of the provisions of the Act and the Regulations listed below to foreign nationals who meet the following conditions (eligibility requirements).

Conditions (Eligibility Requirements)

Based on the public policy considerations, delegated officers may grant an exemption from the requirement to submit to an Immigration Medical Examination if:

The foreign national (principal applicant):

• Received a positive decision on their refugee claim by the Immigration and Refugee Board of Canada and was determined to be a Convention Refugee or Person in Need of Protection; or,
• Received a positive decision on their PRRA application from IRCC and was granted Protected Person status.

And,

• Submits an application for permanent residence on or after the date this public policy takes effect, or has a pending application and has not yet started the Immigration Medical Examination, as part of their application for permanent residence in Canada.
• Has a previously completed Immigration Medical Examination on file, regardless of whether the associated medical certificate has expired; and
• Received a medical assessment on their initial Immigration Medical Examination coded as:
  1. M1: indicating that they pose no danger to public health and public safety; or
  2. M3: indicating that they have a health condition present but is not expected to place an excessive demand on health or social services; or
  3. M2 or M2/3: indicating that they are a potential risk to public health, but have complied with their requirement to report to provincial/territorial health authorities for medical surveillance; and,
• Has not resided or stayed for a total period in excess of six months in an area that the Minister determines has a higher incidence of serious communicable disease than Canada (i.e., identified on IRCC’s tuberculosis designated country and territory list) since their initial Immigration Medical Examination.

For greater certainty, on account of potentially heightened risk to public health or public safety, foreign nationals who have not complied with an initial Immigration Medical Examination or any required medical surveillance, and those with any other Medical code (than specified above) on their Immigration Medical Examination that identifies an inadmissibility would not be eligible under this public policy.

Requirements under the provisions of the Act and Regulations for which an exemption may be granted:

• Paragraph 16(2)(b) of the Act – In the case of a foreign national who makes an application, subject to the Regulations, the requirement for that foreign national to submit to a medical examination
• Subparagraph 30(1)(a)(i) of the Regulations – For the purposes of paragraph 16(2)(b) of the Act, the requirement for a foreign national who is a protected person and who is applying to remain in Canada as a permanent resident, as well as their family members, whether accompanying or not, who are included in such application, to submit to a medical examination
• Subparagraph 72(1)(e)(iii) of the Regulations – The requirement for a foreign national in Canada, in order to become a permanent resident, to establish that, following an examination, they hold a medical certificate — based on the most recent medical examination to which they were required to submit under paragraph 16(2)(b) of the Act and which took place within the previous 12 months — that indicates that their health condition is not likely to be a danger to public health or public safety and, unless subsection 38(2) of the Act applies, is not reasonably expected to cause excessive demand

Family Members

A family member of the principal applicant, who is a protected person, must meet the following eligibility criteria to be granted an exemption from the requirement to submit to an Immigration Medical Examination:

• Be included in the principal applicant’s application to remain in Canada as a permanent resident;
• Be an accompanying family member of the principal applicant;
• Have a previously completed Immigration Medical Examination on file, regardless of whether the associated medical certificate has expired; and
• Received a medical assessment on their initial Immigration Medical Examination coded as:
  1. M1: indicating that they pose no danger to public health and public safety; or
  2. M3: indicating that they have a health condition present but is not expected to place an excessive demand on health or social services; or
  3. M2 or M2/3: indicating that they are a potential risk to public health, but have complied with their requirement to report to provincial/territorial health authorities for medical surveillance; and,
• Be residing in Canada and have not resided or stayed for a total period in excess of six months in an area that the Minister determines has a higher incidence of serious communicable disease than Canada (i.e., identified on IRCC’s tuberculosis designated country and territory list) since their initial Immigration Medical Examination.

For greater certainty, on account of potentially heightened risk to public health or public safety, if these family members have not complied with an initial Immigration Medical Examination or any required medical surveillance, and those with any other Medical code (than specified above) on their Immigration Medical Examination that identifies an inadmissibility, they would not be eligible under this public policy.

Family members are defined as persons who meet the definition of a “family member” in subsection 1(3) of the Regulations as assessed by a delegated officer.

Family members of the principal applicant who are residing abroad and who are included in the protected person’s application to remain in Canada as a permanent resident fall outside the scope of this public policy and are not exempted from the requirement to undergo an Immigration Medical Examination.

Pursuant to paragraph 30(1)(e) of the Regulations, a family member of a protected person who is not included in the protected person’s application to remain in Canada as a permanent resident is exempted from the requirement to submit to a medical examination for the purpose of paragraph 16(2)(b) of the Act.

Pursuant to subsection 42(1) of the Act, permanent residence may be granted to protected persons in Canada regardless of the admissibility of their family members, including those overseas.

Other Statutory Eligibility and Admissibility Requirements

Principal applicants and their family members eligible under this public policy are subject to all other statutory eligibility and admissibility requirements not addressed herein, including the requirement not to be inadmissible on criminal and security grounds.

Start date and End date

This temporary public policy takes effect on the date on which it is signed and ends once regulatory changes come into force, or when revoked by the Minister.