Access and Citizenship

CWS Durham’s role in the N-648 clinics is partially funded by Duke University Health System’s Charitable Grants Fund.

On the wall of CWS Durham’s immigration legal services office, you’ll find three bulletin boards covered in pictures of former refugees becoming U.S. citizens. For many of our clients, citizenship and the protections that come with it is a privilege that they don’t take for granted—every refugee knows all too well the dangers of statelessness. But what if a refugee is unable to pass the English and civics tests that are required to become a U.S. citizen due to an undiagnosed cognitive or physical disability?

In 2017 CWS Durham’s immigration legal services team began a partnership with a diverse group of medical students and physicians to offer no-cost medical assessments for refugees who hope to become U.S. citizens but encounter barriers due to undiagnosed cognitive or physical disabilities. These clinics bring together medical professionals to evaluate the eligibility of refugee clients for the N-648 disability waiver—a legal form exempting citizenship applicants from the English and civics test requirements.

These quarterly clinics are a vital resource for vulnerable refugee clients who are struggling to overcome barriers to citizenship. Without these free clinics, some Triangle area refugees are unable to ever become US Citizens.

There are several compounding challenges to receiving the N-648 waiver: for refugees without a primary care physician or health insurance, accessing medical help can be difficult and expensive. In addition, finding interpretation, paying fees, and navigating the required legal and medical paperwork add to the difficulty of receiving the assessment. For medical professionals, a lack of familiarity with the N-648 form prevents doctors from being more helpful.

The N-648 clinics help circumvent these obstacles by providing vulnerable clients with free access to trained medical professionals; moreover, clinics help train current and future medical providers on the importance of the N-648 assessment, how to complete it, and gives them an initial experience working in the field of Refugee Health. CWS Durham partners with the UNC Medical School Students Association, Carrboro Community Health Center, and other practitioners to make these clinics happen.

In an ideal world, eventually the clinics won’t be needed because enough doctors in the region will be aware of the need and trained on the N-648 assessment.  Until then, we are so fortunate to have community partners in the area who are generous enough to share their time serving this vulnerable and deserving population.” said Cas Cogswell, CWS Durham Immigration Counselor.

CWS Durham is proud to help provide these resources to refugees in the Triangle!