Kim Rook Outreach Coordinator MPH Coordinator Pavani Ram Director Office of Global Health Initiatives Associate Professor Jessica Scates Coordinator Office of Global Health Initiatives Paul Wietig Vice President ID: 179377
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Culturally Engaged Health Care in Buffalo, NY
Kim Rook, Outreach Coordinator, MPH Coordinator
Pavani Ram, Director, Office of Global Health Initiatives, Associate Professor
Jessica Scates, Coordinator, Office of Global Health Initiatives
Paul Wietig, Vice President,
Interprofessional
Education
University at Buffalo School of Public Health and Health Professions
June 19, 2014Slide2Slide3
Data extracted from the Worldwide Refugee Admissions Processing System (WRAPS)
Arrivals by State for
the Reporting Period of 1-October-2013 through 30-April-2014Data
Texas
3888
California
3237
New York
2256Slide4
Refugees resettled in New York State
*Federal Fiscal Year 2013
New York State Bureau of Refugee and Immigrant Assistance
Total: 3829Slide5
Sites of Refugee Resettlement in NY
*Federal Fiscal Year 2013
New York State Bureau of Refugee and Immigrant Assistance
Erie County welcomes 36% of refugees in New York State!Slide6
Background and Objectives
Refugee health in Buffalo
UB/Community engagement
Refugee Health SummitSlide7
Refugee
County department of health
State department of health
Primary care providers
Community organizations
Insurers
Funding organizations
Medicaid
State bureau of refugee and immigrant assistance
Medical specialists
Resettlement agency
Refugee leaders
UniversitySlide8
Health Needs & Gaps
Lead
poisoning
Trauma and
tortureSTIs/STDsTuberculosis
DiabetesCancerMental illness – depressionSuicide
Other chronic conditions
Health needs
to addressSlide9
Buffalo Public Schools
Burmese Community Support Center
Catholic Charities of Buffalo
Community Health Center of Buffalo
H.E.A.L. International
International Institute of BuffaloJericho Road Community Health Center
Jewish Family Service of Buffalo & Erie CountyJourney’s End Refugee Services, Inc.
Neighborhood Health CenterNew York State Department of Health
Planning Committee Members
University at Buffalo
Global Health Initiative GSA
Office of Global Health Initiatives Office of
Interprofessional
Education
Office of Public Health Practice
School of Dental Medicine
School of Management
School of Medicine & Biomedical Sciences
School of Nursing
School of Pharmacy and Pharmaceutical Sciences
School of Public Health & Health Professions
School of Social WorkSlide10
Education
Buffalo Public Schools
Refugee Community Support
Burmese Community Support Center
H.E.A.L. International
Resettlement Agencies Catholic Charities of Buffalo
Jewish
Family Service of Buffalo & Erie County Journey’s End Refugee Services, Inc.
International Institute of Buffalo
Primary Care Provision and Health Assessments Community Health Center of Buffalo
Jericho Road Community Health Center Neighborhood Health Center
Planning Committee Members
Health Department
New
York State Department of Health
University at Buffalo
Global Health Initiative GSA
Office of Global Health Initiatives
Office of
Interprofessional
Education
Office of Public Health Practice
School of Dental Medicine
School of Management
School of Medicine & Biomedical Sciences
School of Nursing
School of Pharmacy and Pharmaceutical Sciences
School of Public Health & Health Professions
School of Social WorkSlide11
Refugee Health Summit
Goal:
E
xamine
barriers and explore solutions to culturally engaged health care provision for refugees in
Buffalo Objectives:
Describe
existing barriers of culturally engaged health care provision for stakeholder groups in WNYL
earn about successful models to providing engaged health care for refugees in Buffalo and beyond
Identify potential linkages and spark collaborations to adapt and implement solutions to expand culturally engaged health care for refugees in BuffaloSlide12
Summit Program
12:30-1:00 Introduction
1:00-2:00 Panel
2:00-3:00 Share Fair
3:00-4:00 Informational talks
4:00-4:30 Next steps4:45-5:00 Dinner 5:30-6:30 Breakout groups
6:30-7:15 Large group reporting and discussion7:15-7:30 ClosingSlide13
Panelists
Bishnu
Adhikari
Employment Specialist, Journey’s End Refugee Services, Inc.
Denise
Phillips Beehag
Director of Refugee and Employment
Services, International Institute of Buffalo
Cheryl Brown Refugee Health Program, Public
Health Representative II, New York State Department of Health, Western Region
Oma
Chapagain
Bhutanese
Nepali Community
Member
Dianne M.
Loomis
Associate
Clinical
Professor, School
of
Nursing, Department
of Family
Medicine, University
at Buffalo
Chan
Myae
Thu
Client
Services
Coordinator, Burmese
Community Support Center
Refugees
Resettlement agencies
Providers
StateSlide14
Culture
Trust
Language
Religion
Gender
Definitions of good and poor health
Health as a priority
Preventive health vs. curative
Interpretation
Accessing personal health information
Accessing preventive careAccessing knowledge about prevention
Translating medical termsNon-verbal language
Mental health
History of trauma
The doctor and other ‘authority’ figures
Power within the family
Many other issues as well…Slide15
Access to medical care (primary care)
Cultural unfamiliarity among providers
Grouping refugees into one generalizable group
Health insurance Language
Mental health and screeningBarriers to HealthcareSlide16
Dr. Myron Glick Dr. Kim Griswold Jim Sutton, RPA-C
Informational TalksSlide17
Rochester
Model
RSMI – Remote Simultaneous Medical Interpreting
Empowered oversight committeeCoordinated providers and care
Jericho Road Community Health Care ModelHire a diverse staff, encourage diversity
Invest in community relationshipsBuilt walk-ins into the system
Models for Community Engagement & CareSlide18
Mental Health Provision
Train bi-lingual / bi-cultural mental health care providers
Adjust screening methods
Increase mental health value among refugees
Ethnic community support groupsBurmese Community Support CenterOthers:
BhutaneseIraqiModels for Community
Engagement & CareSlide19Slide20
Coordination of stakeholders
Mentorship of providers
Mobilizing human capital / leadership among refugee community
InterpretationImproving linkages of care, addressing gaps in care
Breakouts to Address BarriersSlide21
Coordination of stakeholders
Day-to-day agency partnerships through agreements
Community-based steering committee or council
Annual summit to reassess
Culturally engaged healthcare assessment available online
Provider mentorship, educationReferral / map app and web based resources
Hiring of bilingual health providers and front office staffRelocate specialists to primary care locations
Culturally engaged health care grand rounds
Solutions to BarriersSlide22
Refugee mentorship, education, leadership
Platform for ethnic community-based support organizations
Identify leaders in the community for continued education training
Interpreter services
RSMI (UN-like headsets)
Interpretation phone apps
Hire local community members and bi-lingual employeesWeb-based portal with language resources
Educate providers in second languages
Solutions to BarriersSlide23
Improving linkages of care, addressing gaps
Health-e-Link health assessment
Mental health providers in community health centers
Mapping system addressing transportation issues
Referral
/ map appAgency partnerships
Health education – preventive care
Solutions to BarriersSlide24Slide25
110 registrants, 130 participants
30 agencies and University Schools
Collaborations among agencies and refugee maximizes resources
Meaningful interagency relationships
Task forces and action plans createdUB will be leader in steering committee, exploration of interpretation models, among other areas
TakeawaysSlide26
Improving Linkages of Care (10)
Mentorship
of Providers (15)
Coordination of Stakeholders (7)Mobilizing
of Human Capital (4)Interpretation (5)TakeawaysSlide27
Dissemination of Refugee Health Summit Report
E
xploratory meeting with Refugee Advocates (June)
Task force developmentHealth for Refugee Populations Course
Next StepsSlide28
Solidify University at Buffalo’s role moving forward
School of Pharmacy continuing education
School of Social Work build capacity and linkages
School of Public Health provide field placementIT involvement
Recruitment of talent from the refugee communityBest practice research and assessments
Next StepsSlide29
Acknowledgements:
Office of Global Health Initiatives
Dr. Pavani Ram
Jessica Scates
Dr. Arthur GoshinSchool of Public Health and Health Professions
UB Office of Interprofessional Education Dr. Paul Wietig
Community Agencies
Thank You