Working with Refugee Populations Services for Older Refugee Program (SORP)

Transcription

1 Working with Refugee Populations Services for Older Refugee Program (SORP) Senior Action Council June

2 Who is a Refugee? Refugees are those persons of special humanitarian concern who have fled their country of origin because they have suffered persecution or have a well-founded fear of persecution on account of their race, religion, nationality, political opinion or membership in a particular social group Their governments are unwilling or unable to protect them. 2

3 Who is an Immigrant? A person who legally comes to live permanently in a foreign country 3

4 Other categories: Asylee Entrant Amerasian Certified Trafficking Victim Confirmed Trafficking Victim Unaccompanied Refugee Minor Special Immigrant Juvenile Lawful Permanent Resident US Citizen Repatriate Non-immigrant Undocumented Alien 4

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6 Refugees-the Global Perspective 65.6 million forcibly displaced people 22.5 million refugees in 2017 (½ under the age of 18) 86% of them are hosted in developing countries Options for refugees: Repatriation-return to own country Local Integration-incorporation into society Resettlement Origin/ Host/ Resettlement countries 6

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14 Life in the Refugee Camp Security issues Employment restraints Lack of basic needs support Little education opportunity Mobility restraints Lack of health care and preventive health care Women s issues Space created for short term stay not reality 14

15 UN refugee camp, Eastern Nepal Photographs by Ben Saul (1999) 15

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18 Security Checks and Travel Preparation Refugee Support Center (RSC) Interagency Security Check Dept. of Homeland Security Biometrics Security Check Medical Checks Local Assignment VOLAG Voluntary Agency Travel (IOM International Organization for Migration) Arrival, Green Card process 18

19 Refugee Resettlement Web Links Center for Applied Linguistics (CAL) Bridging Refugee Youth & Children Services (BRYCS) UNHCR - The United Nations Refugee Agency Bureau of Population, Refugees and Migration (PRM) Office of Refugee Resettlement (ORR) United States Conference of Catholic Bishops Migration & Refugee Services (USCCB) Church World Service - Immigration & Refugee Programs (CWS) New York State's Bureau of Refugee Immigrant Assistance (BRIA) Refugee Council USA 19

20 Resettlement Programs in the US The Bridge to Self Sufficiency Basic Needs Supports for 90 days Set up safe & suitable housing, 1 week worth of groceries furnishings, $925 per person Reception at airport, take to new home, orientation to area, cultural orientation Refer adults to ESOL, children to school, TB, medical, DSS, social security, mental health, employment, etc. Connections to other Services Volunteers, faith communities, local businesses, community advocacy groups, ethnic community groups, neighborhood associations 20

21 Other 2 -Cameroon 3 - Ivory Coast 1 - Liberia 2 - Nepal 1 - Pakistan 1 - Sudan 1 - Tigryan Syria, 43, 6% Ukraine, 63, 9% Refugee Rochester Arrivals /1/2016-9/30/2017 Other, 11, 2% Afghanistan, 71, 10% Bhutan, 92, 13% Burma, 39, 5% Somalia, 138, 20% Burundi, 10, 1% Congo, 10, 1% Iraq, 71, 10% Eritrea, 11, 2% Cuba, 119, 17% Dem. Republic Congo, 25, 4% 21

22 Challenges Language barriers Mental Health: Isolation, Depression, PTSD Lack of Education / Lack of Employment Limited life skills Lack of navigation and acculturation skills Not understanding preventive health care Medical Issues: medical issues that have gone untreated for years, not understanding how to fill medication, finding appropriate providers etc. 22

23 Current Challenges Specific to Older Refugees Compounded health care issues working with pharmacies, prior poor health/nutrition, Access to appropriate adaptive equipment and/or understanding what is available Technology barriers (i.e. automated systems, internet) Lack of home care workers primary language/culturally sensitive Compounded caregiver issues Learning language ESL classes not geared to elders Limitations in mobility 23

24 Challenges in Primary Care Dr. Louise Bennett from Brown Square Health Center and the Refugees Helping Refugees agency provided the following insights after years of working in the refugee community. 24

25 Common health problems Children Anemia Lead elevation Parasites and worms Adults Hepatitis B TB exposure (PPD +) Malaria War injuries/amputations PTSD/ Depression 25

26 Differences in Health Care Systems Prescriptions and pharmacies Appointments Mostly acute care -little preventive Little counselling, mostly drugs Poor nutrition 26

27 New members of health care team Interpreters Case managers Volunteers and sponsors Refugee community leaders Health promoters Transportation providers *take steps to avoid staff burnout! 27

28 Health Outreach Challenges Developing trust Training community leaders Improving access Focusing on education Front desk, billing, nursing, and providers, administration need to be trained Cultural sensitivity cultures, religions, holidays Different names- learning pronunciation Welcoming atmosphere providing Trauma Informed Care 28

29 Challenges in Behavioral Health Appointments keeping them and communicating Phone calls and letters Interpreters Small communities- impacts the ability of sessions to be confidential Staff comfort with interpreters Prejudices between communities Dialects Roles of males and females within the different cultures Clients not comfortable using interpreter to discuss torture and war experiences 29

30 Challenges in Behavioral Health Translation of Terms self esteem, self care, internal strengths, mental health Trauma- PTSD effects all aspects of life and ability to work, the physical symptoms are connected to emotional health Prescriptions- improper use and understanding, stop taking when symptoms stop, unable to accurately report interactions/side effects Family dynamics with children as family communicators with outside world 30

31 Challenges of Behavioral Health Shame and Stigma Expectations of Treatment Expecting physical exam and a quick fix with medication Understanding MH treatment and how it is ongoing People stop treatment too early due to work, transportation, or loss of benefits Understanding the difference between clinician and a prescriber 31

32 RULE OF THUMB IN PROVIDING ANY SERVICE! Everyone is unique and has their own story. Different religions Different experiences and levels of education Different language skills Individual and family differences Different coping mechanisms 32

33 Bureau of Refugee and Immigration Assistance NYS under Office of Temporary and Disability Assistance (OTDA) 3 Year opportunity to link the Aging and Refugee service systems and connect individuals to traditional senior services. 33

34 New Grant: Services for Older Refugee Program (SORP) Individual Service Navigation: intake, assessment, and linkage to traditional senior services Cross Trainings: service partner meetings and staff/volunteer training sessions that will help in improving the process of serving older refugees Community Education Workshops: events meant to reach refugees and their families to train them about various topics and also to educate the public about refugee populations Case Management and other direct support to current refugees 34

35 Rochester Resources for SORP Established Aging Services and Refugee Resettlement Services Supportive Monroe County Office for the Aging and other senior service providers interested in improving access. Established sites where refugees gather - Mary s Place and Refugees Helping Refugees Rochester General Hospital - Refugee specific clinic with peer support and social work services Rochester Committee on Refugee Resettlement (RCORR)- monthly meetings of providers to inform each other and coordinate delivery of services 35

36 Grant information First Grant - $120K 83+ older people served by service navigation 104 Community Education events supported 82 Cross Trainings supported between service providers Second Grant- Changed focus - $60K 31+ achieved case management goals contract to date Other grants provided support for elder abuse prevention education, information and assistance for long term care issues (any age), transportation service and caregiver supports 36

37 Wrong turns: Interpretation issues Literacy limitations Hiring- caste example Onboarding- extra training about benefits/work technology/training Trust- turnover and program limits caused problems Complexity with combining grants- different funders and goals created confusion Partner administration and overestimates Delay in language phone service 37

38 Challenges with participants Eligibility age Tracking addresses/names/dob Trust Short term and limited options Citizenship obtainment Insurance issues Isolation Housing 38

39 Right turns: Presentations Community celebrations Senior group Relationships Hiring right staff Support for community screening events Expansion of NYConnects and transportation services 39

40 Success with participants Cleaning training CDPAS advocacy Powerful Tools for Caregivers session Advocacy with landlords Waivers Transportation 40

41 Replication? Limitations of Funding Alternatives: Language service options Education of general public Connections to community groups Faith communities, ethnic, ESL classes, schools 41

42 Future possibilities Community Supported Agriculture connection Innovative language skill training Improving Medicaid transportation coordination Citizenship support Extended senior programming in community neighborhoods (Social model day program) 42

43 What s Next?? Research and Soul search Use schools, ESL classes, faith communities, work training programs and cultural groups to try to reach isolated older adults Take steps to make your services more accessible to other populations have access to a Language Phone Line Create safe spaces for gathering and strengthen community understanding of cultures and experience 43

44 Video clips: 44

45 Contact Info: Jennifer McDermott, Aging Services Catholic Family Center 55 Troup St Rochester, NY Phone: x4002 Thank You!!!! 45