To improve access to specialized disability assessments for U.S. citizenship applicants with cognitive and psychiatric conditions, a primary care clinic at Boston Medical Center's Immigrant and Refugee Health Center implemented an innovative embedded neuropsychological assessment program. This program supports primary care providers by offering specialized evaluations for patients seeking a Medical Certification for Disability Exception (Form N-648), which is necessary for naturalization if the applicant seeks an exception from demonstrating English language proficiency and U.S. history and civics knowledge. The initiative included cognitive screening tools, direct referrals for neuropsychological assessments, and a multidisciplinary team approach. Over two years, the program provided crucial assessments to 34 patients, with 36% qualifying for N-648 forms through specialized testing despite initially normal cognitive screenings. This innovation highlights the value of integrating neuropsychological services within primary care.
Improving Access to Disability Assessment for US Citizenship Applicants in Primary Care: An Embedded Neuropsychological Assessment Innovation
Joelle T. Taknint, PhD, et al
Boston University Chobanian & Avedisian School of Medicine, Boston, Massachusetts
Immigrant & Refugee Health Center, Boston Medical Center, Boston, Massachusetts
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