Catholic Multicultural Center formally launches the Medical Advocacy Integration program

The incorporation of different services to better and appropriately assist the most vulnerable is a unique example of how immigrant integration can be beneficial to a community. The Catholic Multicultural Center in Madison, Wisconsin envisions living in a community where residents welcome America’s newest citizens while providing necessary services to immigrants. They believe this work ensures a healthy and secure life, which could improve the well-being of families and future generations.

The Catholic Multicultural Center, or CMC, uses a holistic approach to promote immigrant integration. Immigration services coordinator Janice Beers and her colleagues launched the Medical Advocacy Integration Program to address the recent increase in denied naturalization applications stemming from incorrectly completed N-648 medical exception forms. The form requests that people be exempt from completing the English and civics test due to physical or developmental disabilities or mental impairment. The form is submitted when individuals are filing the N-400 form to naturalize. Clients often had their applications filed with the help of family members, advocates or legal representatives with little to no experience in N-648 advocacy.

With 29 years of experience in social services and advocacy, Beers grew concerned as increasingly, many of her older refugee clients returned to her office seeking assistance after receiving notice that their N-648 forms had been rejected. This was especially troublesome after the 1996 federal welfare reform provisions, which stated that refugees older than 65 needed to have naturalized within seven years of arriving in the United States or risk losing all of their benefit — including supplemental security income. CMC is the only nonprofit in Madison that has supported immigrants at all stages of the immigration process, serving clients from 63 different countries.

In an effort to overcome this barrier, Beers reached out to Kevin Fehr, Medical Director at Access Community Health, a community clinic that provides services to uninsured and low-income patients. Beers began hosting presentations to the staff and provided knowledge about the N-400 application for naturalization filing process, including filing the N-648, and what specific information U.S. Citizenship and Immigration Services, or USCIS, needed before approving an application. With samples of approved and rejected medical exception forms, staff were able to distinguish the necessary information to include while completing these forms on the patients’ behalf. Fehr was excited for the opportunity to better equip his team with knowledge of these forms and noted by having these presentations, his team could better advocate for patients. 

Prior to launching the Medical Advocacy Integration Project, Beers would accompany clients during their medical appointments and assist in N-648 advocacy. Beers represented a 67-year Bhutanese refugee in January, when her application was denied after two interviews with USCIS. Bhakta, the client’s son, said: “my mom’s citizenship application was approved in January 2019 — exactly seven years from when she entered the United States. Thanks to CMC staff, my mom was able to maintain her supplemental security income and have access to health care.”

After formally launching the program in April, Beers has partnered with other local clinics in the area such as SSM Health, UW Health and GHC partners and local psychologists. Beers anticipates this program will continue to expand to other communities seeking to benefit from such integrated services. 

CLINIC applauds the Catholic Multicultural Center and their partners for their commitment to integrate services for the community. Email us at to tell us how your community is promoting integration.