Culturally Engaged Health Care in Buffalo, NY
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Transcript of Culturally Engaged Health Care in Buffalo, NY
Culturally Engaged Health Care in Buffalo, NY
Kim Rook, Outreach Coordinator, MPH CoordinatorPavani Ram, Director, Office of Global Health Initiatives, Associate Professor
Jessica Scates, Coordinator, Office of Global Health InitiativesPaul Wietig, Vice President, Interprofessional Education
University at Buffalo School of Public Health and Health Professions
June 19, 2014
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 2256
Refugees resettled in New York State
*Federal Fiscal Year 2013 New York State Bureau of Refugee and Immigrant Assistance
Total: 3829
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!
Background and Objectives
• Refugee health in Buffalo• UB/Community engagement• Refugee Health Summit
Refugee
County department
of health
State departme
nt of health
Primary care
providersCommunity organizatio
ns
Insurers
Funding organizatio
ns
Medicaid
State bureau of refugee and immigrant assistance
Medical specialists
Resettlement agency
Refugee leaders
University
Health Needs & Gaps
Lead poisoningTrauma and tortureSTIs/STDsTuberculosis
DiabetesCancerMental illness – depressionSuicideOther chronic conditions
Health needs to address
EducationBuffalo Public Schools
Refugee Community SupportBurmese Community
Support CenterH.E.A.L. International
Resettlement AgenciesCatholic Charities of BuffaloJewish Family Service of
Buffalo & Erie CountyJourney’s End Refugee
Services, Inc.International Institute of
BuffaloPrimary Care Provision and Health Assessments
Community Health Center of Buffalo
Jericho Road Community Health Center
Neighborhood Health Center
Planning Committee Members
Health DepartmentNew York State Department
of HealthUniversity at Buffalo
Global Health Initiative GSAOffice of Global Health
InitiativesOffice of Interprofessional
EducationOffice of Public Health
PracticeSchool of Dental MedicineSchool of ManagementSchool of Medicine &
Biomedical SciencesSchool of NursingSchool of Pharmacy and
Pharmaceutical SciencesSchool of Public Health &
Health ProfessionsSchool of Social Work
Refugee Health Summit
Goal: Examine 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 WNY• Learn 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 Buffalo
Summit Program
12:30-1:00 Introduction1:00-2:00 Panel2:00-3:00 Share Fair3:00-4:00 Informational talks4:00-4:30 Next steps4:45-5:00 Dinner 5:30-6:30 Breakout groups6:30-7:15 Large group reporting and discussion7:15-7:30 Closing
PanelistsBishnu 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
RefugeesResettlement agencies
ProvidersState
Culture TrustLanguage
Religion
Gender
Definitions of good and poor
health
Health as a priority
Preventive health vs. curative
Interpretation
Accessing personal health
information
Accessing preventive care
Accessing knowledge
about prevention
Translating medical terms
Non-verbal language
Mental health
History of trauma
The doctor and other ‘authority’
figures
Power within the family
Many other issues as well…
• Access to medical care (primary care)• Cultural unfamiliarity among providers• Grouping refugees into one generalizable
group• Health insurance • Language• Mental health and screening
Barriers to Healthcare
Dr. Myron Glick Dr. Kim Griswold Jim Sutton, RPA-C
Informational Talks
• Rochester Model RSMI – Remote Simultaneous Medical Interpreting Empowered oversight committee Coordinated providers and care
Jericho Road Community Health Care Model Hire a diverse staff, encourage diversity Invest in community relationships Built walk-ins into the system
Models for Community Engagement & Care
• Mental Health Provision• Train bi-lingual / bi-cultural mental health care providers• Adjust screening methods• Increase mental health value among refugees
• Ethnic community support groups Burmese Community Support Center Others:
BhutaneseIraqi
Models for Community Engagement & Care
• Coordination of stakeholders• Mentorship of providers• Mobilizing human capital / leadership among
refugee community• Interpretation• Improving linkages of care, addressing gaps
in care
Breakouts to Address Barriers
• 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, education- Referral / map app and web based resources- Hiring of bilingual health providers and front office
staff- Relocate specialists to primary care locations- Culturally engaged health care grand rounds
Solutions to Barriers
• 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 employees- Web-based portal with language resources- Educate providers in second languages
Solutions to Barriers
• 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 app- Agency partnerships- Health education – preventive care
Solutions to Barriers
• 110 registrants, 130 participants• 30 agencies and University Schools• Collaborations among agencies and refugee
maximizes resources• Meaningful interagency relationships• Task forces and action plans created• UB will be leader in steering committee,
exploration of interpretation models, among other areas
Takeaways
• Improving Linkages of Care (10)• Mentorship of Providers (15)• Coordination of Stakeholders (7)• Mobilizing of Human Capital (4)• Interpretation (5)
Takeaways
• Dissemination of Refugee Health Summit Report• Exploratory meeting with Refugee Advocates
(June)• Task force development• Health for Refugee Populations Course
Next Steps
• 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 placement• IT involvement• Recruitment of talent from the refugee community• Best practice research and assessments
Next Steps
Acknowledgements:
Office of Global Health InitiativesDr. Pavani RamJessica ScatesDr. Arthur Goshin
School of Public Health and Health Professions
UB Office of Interprofessional EducationDr. Paul Wietig
Community Agencies
Thank You