1) General Advice
Check the inbox every day when you have an open case!
Always send emails from the MSHRP email when coordinating for your case. However, you can CC your personal school email so you are more easily notified when emails come in.
Stay organized! When you’re working on a case it’s easy to know what’s going on, but staying organized will help a lot if questions arise months down the road. A few tips:
Create a sub-label with the Case # (you will get this from RedCap - see below) and tag all emails relating to your case.
Include the Case # in the subject line and body of all emails
Once your case is confirmed, send confirmation emails so everyone involved (evaluator, shadower, interpreter, attorney) knows what is going on.
2) RedCap
Create a New Record on RedCap
On the left sidebar, there’s a “Add/Edit Records” link - click it, then click “Add new record”
This record will dictate your Case Number. Please remember to use this case # on ALL email correspondence for this case.
Start a Case Management form
Click on the “Case Management” button and fill out the information provided through the Squarespace form/individual email
Keep the Case Management form updated throughout the case! It helps remind you of any step you may have forgotten and also allows other MSHRP team members to see what stage the case is
Mark the case as “Open” and the form as “Incomplete”
The Case Management form can be marked as “Complete” once the case is:
Referred out to another clinic
Dropped (attorney not responding, attorney does not need an evaluation any more)
Evaluation has taken place and the final affidavit has been uploaded to the Box folder
Send the Intake Form to the attorney. This is the form the attorney will fill out to give us a more complete picture of the case.
Click on the “Intake Form” button
Click on the dropdown menu called “Survey Options” and open up the “Survey Access Code and QR code” option
Copy the Access Code to be include in the email to the attorney (see “Communications with the Attorney” below)
Once the intake form is completed by the attorney, it will be marked as complete in Redcap
3) Box
Create a unique Box folder through Log in at Box
Click on “Asylee Case Files” → New → Folder
Title the new folder with the Case # and client initials
Share the folder with the attorney as a “Viewer Uploader”, not as an Editor
4) Communications with the Attorney
Email the attorney with the Attorney Intake Template Email (under the “Email Templates” label in the MSHRP inbox)
Remember to replace all the red with the appropriate info (and change the signature to your name!)
Include the Access Code from the RedCap Intake Form (see RedCap steps above). The survey link is the same always so no need to change that.
Ensure you have shared the Box folder with the attorney (see Box steps above)
[COVID-19] If physical: ask what they are looking to document, as some physical evals can be done remotely via Zoom
If it’s scar evaluation and client is comfortable, it can be done over video if the evaluator deems it appropriate.
If not, we may be able to conduct the history portion of the eval over video/phone followed by a short in-person exam at Samuels, Selikoff, or an evaluator’s private office (the history-taking and physical evaluation don’t have to be done on the same day, but the history-taking should be done prior to the in-person physical eval)
[COVID-19] If psych:
Ask if there is any flexibility on the deadline. Sometimes attorneys give a date far in advance of the actual filing deadline; psych evals are in high demand for us so more time is always better!
Let them know we are currently conducting all psych evals remotely. Ask if the client will have access to a device they are comfortable using and if they have access to a private space for the evaluation.
Check the MSHRP inbox every day!
If the attorney does not respond within a week, send a reminder email. Ask them to respond within a set timeline (i.e. give them another week) and let them know the case will be dropped if we don’t hear back within that timeline. You’ll use your own judgment on this - if you have any questions, ask the lead CMs or message the GroupMe
If the case is due within a month, remind them within four days. They need to act fast!
If they do not respond, email them to notify them that the case is being dropped
Go to the Case Management form on RedCap, update the case status to “Dropped” and include a reason, then mark the form as “Complete”
If your attorney completes the Intake Form, you can take it to mean that we’re going to be taking the case on.
Attorneys don’t always email you to let you know once they have completed the form, so you may have to check the status of the form on Redcap.
Check the Intake Form for completeness
Make sure the attorney is seeing the client pro-bono or reduced-fee. If they are not working pro bono or at a reduced fee, please contact the lead CMs as these cases will have to be dealt with on a case by case basis.
Once the Intake Form is completed, upload a copy of it to the Box folder
On the Intake Form, click on the top drop down menu
Click “download PDF of this instrument” → “This survey with saved data (compact)”
Upload the PDF to the Box folder for the case
Immediately delete the file from your computer and empty trash
Don’t start looking for a provider until the attorney has completed the Intake Form. Unfortunately, some attorneys never complete the intake form or find an evaluator elsewhere, in which case you will then have to cancel on the providers who are very busy
5) Finding an Evaluator
General Info (All Cases):
After the attorney completes the Intake Form, work to find your provider using the Provider Spreadsheet
Check the Intake Form and make sure you look for providers with the characteristics that the client prefers (ex: gender preferences)
Check the provider spreadsheet and look at the “date last contacted” & “current/past cases” sections to identify providers who might be available
Providers often can get frustrated if we keep asking them to take cases during a time they have already said they are unavailable to a previous CM or are currently working on another case
If a recent note only says they were contacted but not the outcome (ex. accepted, denied, no response), search for that provider in the inbox to look at recent communications
It is good practice to always search for the provider’s name in the inbox just to make sure they have not been contacted recently
Please send the email requests for physical evaluations only to providers who perform physical exams and the requests for mental health evaluations only to those providers who perform mental health evaluations.
Remember to include the following information in your email to evaluators:
Case # and initials of the client (not the client's full name)
The type of forensic evaluation being requested - psychological or physical (*this is very important)
The age of the client
The date by which the affidavit is requested
For psych evaluations please reiterate that they will be done via Zoom/remotely
In the era of COVID: For physical evaluations, please note that the interview/history taking portion of the evaluation should preferentially be done over Zoom, but the physical exam should be performed in person unless the case is one in detention. The MSHRP can book a room in Samuels at Sinai West, Selikoff on Annenberg 3, or the evaluator can use their own clinic/office space.
Update the provider spreadsheet
Right after you have emailed a provider, make a note that you contacted them
Example: “contacted 10/30/20 for 12/30/20 deadline (awaiting response) - [your initials]”
Once they respond (or if they don’t respond after ~1 week), add the outcome to that note
Example: “contacted 10/30/20 for 12/30/20 deadline (accepted / denied / no response) - [your initials]”
If a provider responds saying they don’t have capacity right now, ask if you should make a note not to contact them until a certain date
Example: “contacted 10/30/20 for 12/30/20 deadline, denied & stated they were busy with job transition, do not contact until FEBRUARY 2021” (and you can color the box red)
When the provider has agreed to take the case, ask them for days & times they can see the client. Also, ask if they need us to arrange a room for them.
- COVID-19: Zoom or dial-in telephone conference
If you can’t find a provider and there’s <1 month until the affidavit deadline:
Ask the GroupMe for suggestions on who else to contact
Refer out (copy/paste the list of clinics from the Case Reject Template)
For psych, recommend that they reach out to Cornell (they have a much larger network of psych evaluators than we do) or Rochester (they have a new clinic and may have more space)
a) Psychological Cases:
For psych evaluations, you can contact 3-4 providers at a time, then if they haven’t responded in a few days, add more providers. Of course, use your discretion, especially for rush cases.
b) Physical Cases:
For physical evaluations, you can contact 1 provider at a time as we get so few physical cases that they are more likely to be available.
c) Gynecological Cases:
If the attorney is asking for a gynecological evaluation strictly for confirmation of FGM/C, then the providers listed on the “Gyn” and the “Physical and Gyn” provider spreadsheet can help.
- Providers on the “Physical and Gyn” are not OB/GYN but they have been trained to determine if FGM/C occurred. Please clarify with them what the attorney wants to ensure they are the best person the see the case
If it is a more complex gyn case, then only the providers who are OB/GYNs should see the case as they have the expertise in this area.
Contact the lead CMs or Dr. Singer for any additional questions.
For gyn evaluations, you can contact 1 provider at a time as we get so few physical cases that they are more likely to be available.
d) Pediatric Cases:
Peds cases are a little bit more complicated, especially for younger children. We have specific evaluators for pediatrics cases. Make sure you check the provider spreadsheet carefully and consult the lead CMs before you send out evaluation requests if you have questions. Most providers will not be comfortable performing evaluations on children, if it is not their area of expertise. In some cases, an adult psych evaluator may be able to see a peds psych case (especially if the client is older), but you will have to check with providers individually to determine their comfort level with peds cases.
A few possible pediatric psych evaluators:
DENA RABINOWITZ PhD
SARAH GUNDLE, PhD
SASHA BERGER, PhD
BRITTANY MCCOY, MD (can do both peds and adult psych)
Pediatric physical evaluators:
Joseph Truglio, MD
Lauren Zajac, MD
In general, you need to make sure to get the consent form completed by the parent/legal guardian. You will generally obtain this before/after the evaluation. This varies greatly based on each case though.
Due to COVID-19 restrictions and remote evaluations, we are simply having the guardian give verbal consent and documenting this on the Eval 1 form in REDCap
For in-person evals where the guardian likely accompanies the client (<18 years old), we would have the guardian type in their name and the date next to the consent signature line after the guardian reads the consent or after reading the consent to the guardian. - Phone consent requires reading the consent to the guardian as well.
If you are unable to find an evaluator to take these types of cases within a week (and if it does not seem likely that you will find an MSHRP evaluator) please refer the case to WCCHR, Columbia, or Downstate where there may be a psych evaluator who can see the client.
Contact the lead CMs or Dr. Singer for any additional questions.
e) Rush Cases:
For psychological cases, if you can’t find a provider and there is less than 1 month left, you can consider sending a blast email to all providers on the “rush email list” found on the Provider Spreadsheet – Psych Providers tab. These are providers who tend to take a lot of our cases and may be able to accommodate the request.
6) Scheduling the Evaluation
Once you’ve identified a provider, ask them for dates/times that would work for the evaluation. Once you have the provider’s availability, email the attorney/legal team to see if the date/time works for their client. Do not do this on the same email - it’s better for everyone if the CM coordinates the days and times.
Confirming the interpreter:
If the case requires an interpreter, as many do, it is the attorney's responsibility to arrange for one!
This is noted in the attorney intake email template, but attorneys may forget or overlook it. Remind the attorney of this as you work on scheduling.
The interpreter must be fluent in the language and either a professional interpreter or familiar with the requirements of acting as an interpreter:
Directly translating what the client says (not paraphrasing)
Conveying what the client says in first-person (ex. “I experienced xyz” vs. “they experienced xyz”)
Family members, friends, attorneys or others directly connected to the client or directly working on the client’s case are not considered to be qualified interpreters
If the attorney is having a difficult time arranging an interpreter, consult the lead CMs and Dr. Singer. We should not be using Pacific Interpreters for most cases, especially for Spanish. Attorneys have enough time to arrange for an in-person interpreter or to ask us for recommendations. If the language is less common, there is an issue in detention centers, time is of the essence, or there’s another reason why a phone interpreter is needed, please contact the lead CMs and Dr. Singer for additional guidance.
Dr. Nuria Mendoza nuria.mendoza@gmail.com is a highly skilled, professional medical Spanish interpreter who has worked with the MSHRP for many years. If an attorney is unable to locate a Spanish interpreter please share Nuria’s contact with the legal team. The legal team should be the one to arrange for Nuria;s services. Nuria charges a very reduced fee for pro bono or low-fee legal teams and will charge full fee for larger/ private law firms.
Students who have been trained to interpret (i.e. through EHHOP) or who are fluent in the language spoken by the client are welcome to shadow and serve as interpreters. Even if they have not received training, we can work with students who are fluent and advise them on proper interpretation techniques.
Once you’ve figured out a date & time, book a room if necessary
- All locations are on the Exam Locations tab on the Provider Spreadsheet
Some notes about locations:
COVID-19: limited capacity at Samuels (Thursday mornings & Fridays) & Selikoff (weekdays after 5pm) for in-person exam portion of physical evals
COVID-19: Zoom or dial-in telephone conference for psych evals and history portion of physical/gyn evals
Confirm the following with the attorney:
that the client has access to a quiet, private space for the evaluation
that the client has access to a stable Internet connection + an electronic device that they are comfortable using to conduct the evaluation over Zoom
Morchand is a favorite, but currently unable to accommodate us due to COVID
The Samuels Clinic & Morchand can’t usually provide space after ~5pm
IMA should be used only as a last-minute resort
Please note that Selikoff rooms do not have cellphone service. If your case requires an interpreter via phone, please ensure that the shadower will have access to a landline and/or have a backup plan for reaching the interpreter (ex: using a laptop to connect to interpreter via Zoom)
7) Finding a Shadower
It’s noted in the attorney intake email that they should let us know if their client is not comfortable with having a shadower, but I like to ask them directly just in case
If a female evaluator was requested, the shadower should be female as well
No male shadowers for FGM cases
Only the following individuals are allowed to shadow and given access to Box/RedCap:
Licensed clinicians and/or Mt Sinai residents who will be joining our provider network (will be conducting evaluations for us)
Icahn medical school students who have attended our training and are active and contributing members of the MSHRP
Students within the Mount Sinai system who have attending our training and are working with the MSHRP in an ongoing way (e.g. on a team)
Anyone who does not fit the above criteria may not have access to Box or RedCap and cannot be permitted to shadow cases for both ethical and programmatic reasons (this includes hospital research assistants or other Mount Sinai-affiliated staff and employers).
1 student + 1 faculty can shadow the same case at the same time. For cases where a new faculty evaluator may be shadowing a case prior to seeing cases solo, please remember that one student may also shadow that same case.
The only exceptions to having 2 shadowers are cases where:
A client explicitly requests to have only one or two people in the room or over Zoom in total (evaluator + one shadow)
Gyn/FGM/C cases where we also limit the number of shadows to one.
Priority should be given to students as well as providers/new evaluators who are licensed and need to shadow prior to taking cases of their own. Residents who do not have a license (usually PGY1 and 2) are welcome to shadow, space permitting.
Shadowing can occur across networks for remote cases.
Two networks: NYC-based main clinic + Remote Evaluation Network (REN)
The “To-Shadow Provider” sheet has providers for both NYC main clinic and REN listed
Please reach out to new providers in both NYC and REN when there is a remote evaluation case
If a REN provider is shadowing your case (denoted in the “network” column, reach out to the REN leads to let them know (Anna Blech, Aliza Gross, Jeanette Rios, Sheena Kalagara)
COVID-19 for an in-person evaluation:
If the shadower is a 1st or 2nd year medical student, they will need the following:
A fit-tested N95 mask
Eye covering (googles, face shield, or plastic eye coverings of some sort-- regular eyeglasses are not enough) - contact the lead CMs if you do not have eye coverings
Gloves - always available in the clinic
Students/providers will need to bring their own N95s and eye coverings to the MSHRP clinic appointment with the client.
Prior to the evaluation, ensure that students have attested to completing the compliance requirements dictated by ISMMS
To find a shadower:
Send an email saying the time, date, type of evaluation, physician, any expectations for shadower as stated by the physician
- Remember to bcc all the recipients (people on the “To-Shadow Students” and “To-Shadow Providers” tabs of the provider spreadsheet
Once you have somebody, send them the Shadowing Information Template, which should be in the “Email Templates” tab
The “Access Code” is the access code associated with the “Evaluation 1” form in RedCap for your particular case.
This can be found under the “Survey Options” dropdown tab. Please DO NOT save the Evaluation 1 form at this point. The Access Code can be obtained without saving the form.
Make sure you also share the client’s Box folder with the shadower, again as a “Viewer Uploader”
Loop the shadower into the email chain you have with the evaluator
If the evaluation date is approaching and you haven’t been able to find a shadower, try reaching out to these current 4th year medical students graduating in 2021 (lots of experience shadowing):
Schonholz, Stephanie stephanie.schonholz@icahn.mssm.edu
Rosenbluth, Emma emma.rosenbluth@icahn.mssm.edu
Sarosi, Alex alex.sarosi@icahn.mssm.edu
MacLean, Sarah sarah.maclean@icahn.mssm.edu
DiRisio, Aislyn aislyn.dirisio@icahn.mssm.edu
D'Andrea, Megan megan.dandrea@icahn.mssm.edu
Sokoloff, Lara lara.sokoloff@icahn.mssm.edu
Sikka, Neha neha.sikka@icahn.mssm.edu
Subramaniam, Varsha varsha.subramaniam@icahn.mssm.edu
Aliza Green aliza.green@icahn.mssm.edu
8) Confirmation Emails
Confirm everything with lots of emails
Email the evaluator, shadower, interpreter, & attorney together with the Evaluator/Shadower/Interpreter/Attorney Confirmation email
If you don’t have the interpreter’s contact info, make a note to the attorney to forward the evaluation details to both the client & the interpreter
If possible, ask the attorney for their phone number to include in this email (helpful in case the client doesn’t show up)
Email the evaluator & the shadower together with the Evaluator/Shadower Confirmation/Reminder template:
The shadower will already have the access code from the Shadowing Information Template, but this way the evaluator has it too
This is already in both the Shadowing Information Template & the Evaluator/Shadower Confirmation email, but make sure the evaluator & shadower know to do the following: On the Evaluation Form, for the question "Is this evaluation being conducted remotely?", please select "No". "No" must be selected for the Needs Assessment Screening to pop up.
If the evaluation is being done in person, ensure that the evaluator and shadowers have access to adequate PPE and have students complete an attestation
9) After the Evaluation
Check in with the evaluator/shadower after the evaluation by sending the “Evaluator Thank You” email template. This also reminds them of the affidavit deadline.
Make sure that the final draft is uploaded to Box by the deadline
If you see that the evaluator has completed the final affidavit (i.e. uploaded it to Box or emailed it to you directly) but are unsure if they already sent it to the attorney, ask them if they have done so or if they would like you to direct the attorney to review the affidavit in Box
Post-evaluation, if you haven’t heard anything from both the evaluator and the attorney, it could mean that they are corresponding directly with each other about the affidavit, but it may mean that the evaluator hasn’t written the affidavit
Feel free to check in to see how the affidavit writing is going. Ask if there’s anything else I can help with and remind them of the deadline. Remind them to upload the final affidavit to Box and direct the attorney to review it there.
Once the final affidavit is uploaded to Box, update the Case Management form in RedCap and mark as “Complete”
If the shadower was a new evaluator, ask them if they would now be comfortable seeing cases on their own. If so, tell the CM leads so they can complete onboarding for the new evaluator
Congrats, you’ve just completed the main part of your case!
10) Case Outcome
At 3 months and 6 months following the completion of your case, email the attorney with the Attorney Case Outcome template
Create a Case Outcome Form in RedCap and obtain the access code to include in the email (same process as in step #3, Create an Intake Form)
Once you’ve emailed the attorney: on the Case Management form in RedCap, scroll down to the Case Outcomes section and check mark the 3 months / 6 months box
Please set personal reminders for this step!
It’s important for us to keep track of whether or not our clients receive asylum and the attorney/judge’s perceptions of our affidavits
Reporting case outcomes, and any significant developments in clients’ cases, is actually listed under the responsibilities of the attorney in the Attorney Intake email -- however, few attorneys remember to reach out
11) Medical Advocacy Cases
For medical advocacy cases (i.e. chart review; not a forensic evaluation), the CM should:
Complete a case management form with relevant information for tracking purposes.
Send the intake form to the legal team for tracking purposes. Some fields may not apply and the legal team can mark as “other” or “none.”
Under the “Evaluation Information” section, the question “Is this a medical advocacy case?” must be checked as YES.