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, 2014
Arrivals by State for the Reporting Period of 1-October-2013 through 30-April-2014Data
Texas 3888
California 3237
New York 2256
Data extracted from the Worldwide Refugee Admissions Processing System (WRAPS)
Refugees resettled in New York
State
Total: 3829
*Federal Fiscal Year 2013
New York State Bureau of Refugee and Immigrant Assistance
Sites of Refugee Resettlement in NY
Erie County welcomes
36% of refugees in New
York State!
*Federal Fiscal Year 2013
New York State Bureau of Refugee and Immigrant Assistance
Background and Objectives
• Refugee health in Buffalo
• UB/Community engagement
• Refugee Health Summit
State
department
of health
University
Medicaid
County
department of
health
Resettlement
agency
Funding
organizations
Refugee
Insurers
Medical
specialists
Refugee
leaders
Primary care
providers
Community
organizations
State bureau of
refugee and
immigrant assistance
Health Needs & Gaps
Health needs
to address
Lead poisoning
Trauma and torture
STIs/STDs
Tuberculosis
Diabetes
Cancer
Mental illness – depression
Suicide
Other chronic conditions
Planning Committee Members
Education
Health Department
Buffalo Public Schools
New York State Department of Health
Refugee Community Support
University at Buffalo
Burmese Community Support Center
Global Health Initiative GSA
H.E.A.L. International
Office of Global Health Initiatives
Resettlement Agencies
Office of Interprofessional Education
Catholic Charities of Buffalo
Office of Public Health Practice
Jewish Family Service of Buffalo & Erie County School of Dental Medicine
Journey’s End Refugee Services, Inc.
School of Management
International Institute of Buffalo
School of Medicine & Biomedical Sciences
Primary Care Provision and Health Assessments School of Nursing
Community Health Center of Buffalo
School of Pharmacy and Pharmaceutical Sciences
Jericho Road Community Health Center
School of Public Health & Health Professions
Neighborhood Health Center
School 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
1:00-2:00
2:00-3:00
3:00-4:00
4:00-4:30
4:45-5:00
5:30-6:30
6:30-7:15
7:15-7:30
Introduction
Panel
Share Fair
Informational talks
Next steps
Dinner
Breakout groups
Large group reporting and discussion
Closing
Panelists
Bishnu Adhikari
Employment Specialist,
Journey’s End Refugee Services, Inc.
Refugees
Resettlement agencies
Providers
State
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
Culture
Language
Trust
Interpretation
Religion
Gender
Definitions of good
and poor health
Health as a priority
Preventive health vs.
curative
Accessing personal
health information
Accessing preventive
care
Accessing knowledge
about prevention
Translating medical
terms
Non-verbal language
Many other issues as well…
Mental health
History of trauma
The doctor and other
‘authority’ figures
Power within the
family
Barriers to Healthcare
•
•
•
•
•
•
Access to medical care (primary care)
Cultural unfamiliarity among providers
Grouping refugees into one generalizable group
Health insurance
Language
Mental health and screening
Informational Talks
Dr. Myron Glick
Dr. Kim Griswold
Jim Sutton, RPA-C
Models for Community
Engagement & Care
• 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:
Bhutanese
Iraqi
Breakouts to Address Barriers
• Coordination of stakeholders
• Mentorship of providers
• Mobilizing human capital / leadership among refugee
community
• Interpretation
• Improving linkages of care, addressing gaps in care
Solutions to Barriers
• Coordination of stakeholders
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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
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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
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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
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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
Takeaways
• 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)
Next Steps
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•
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•
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
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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
Acknowledgements:
Thank You
Office of Global Health Initiatives
Dr. Pavani Ram
Jessica Scates
Dr. Arthur Goshin
School of Public Health and Health Professions
UB Office of Interprofessional Education
Dr. Paul Wietig
Community Agencies