From a Labor of Love towards a Center of Excellence: Scaling the Cambridge Health Alliance Asylum Program (CHAAP)

Type: Poster Presentation
Date: September 2023


Anika Kumar, Jessica Santos, Emily Hahn, Eleanor Emery, Diya Kallivayalil, Gaurab Basu, Sara Snyder (Sept 2023). “From a Labor of Love towards a Center of Excellence: Scaling the Cambridge Health Alliance Asylum Program (CHAAP). Presented at the 2023 CHA Academic Poster Session (poster). Boston, MA.


Forced resettlement is a critical driver of migration. Asylum seekers experience difficult migration journeys and face a complex legal system upon arrival. As such, there is a significant backlog of asylum claims and high denial rates amid a growing international crisis (1). Today, 1.6 million asylum seekers wait for a hearing with an average wait time of 1,621 days (2,3). 

From 2021-2022, Massachusetts had the second largest increase in backlogs and the second lowest grant rates (15%) compared to the national average (4). Last month, Governor Healey declared a state of emergency, sounding the alarm about migrant needs amidst depleted housing resources and overwhelmed shelter systems (5).

The Cambridge Health Alliance Asylum Program (CHAAP) has provided forensic medical evaluations (FMEs) for asylum seekers since the early 1990s (officially since 2021). FMEs substantiate asylum claims and increase the likelihood of being granted asylum twofold (6). In 2023, CHAAP implemented a resident training-mentorship elective to increase FME provider capacity through partnerships with the Cambridge Health Alliance Foundation (CHAF) and the Center for Health Equity (CHEEA). The Leah Zallman Center for Immigrant Health Research (LZC) assesses the impact and scalability of CHA’s elective through key informant interviews and resident feedback. 

Initial findings reveal: (1) the value and impact of FMEs, (2) the critical yet unsustainable drivers of CHAAP, and (2) the challenges and program needs, including funding and increased capacity. CHAAP plays a small but vital role in the migrant health landscape by assisting asylum seekers and training providers. We believe CHA could make a greater impact and become a leader in addressing Massachusetts’ migrant crisis given its legacy and commitment to serving disadvantaged and culturally and linguistically diverse patients. We conclude with recommendations that would move CHAAP from a labor of love towards a regional center of excellence in asylum medicine and immigrant health.   



  1. NO END IN SIGHT: Why Migrants Give Up on Their U.S. Immigration Cases. SOUTHERN POVERTY LAW CENTER; 2018:1-48.
  2. A Sober Assessment of the Growing U.S. Asylum Backlog. Published 2022. Accessed August 13, 2023.
  3. Meissner D, Hipsman F, Aleinikoff TA. The U.S. Asylum System in Crisis: Charting a Way Forward. Migration Policy Institute; 2018.
  4. Lives in Limbo: How the Boston Asylum Office Fails Asylum Seekers. Refugee and Human Rights Clinic at the University of Maine School of Law, Immigrant Legal Advocacy Project, American Civil Liberties Union of Maine, and Basileus Zeno, Ph.D. Political Science at Amherst College; 2022:3-31.
  5. Governor Healey Declares State of Emergency, Calls for Support for Newly Arriving Migrant Families | Accessed August 29, 2023.
  6. Atkinson HG, Wyka K, Hampton K, et al. Impact of forensic medical evaluations on immigration relief grant rates and correlates of outcomes in the United States. J Forensic Leg Med. 2021;84:102272. doi:10.1016/j.jflm.2021.102272
View Presentation