Program (SORP) Senior Action Council June 2018 1 Who is a - - PowerPoint PPT Presentation

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

1

Senior Action Council June 2018

Who is a Refugee?

Refugees are those persons of special humanitarian concern who have fled their country of

• rigin because they have

suffered persecution or have a well-founded fear of persecution on account of their race, religion, nationality, political opinion

• r membership in a particular

social group

Their governments are unwilling or unable to protect them.

2

Who is an Immigrant?

A person who legally comes to live permanently in a foreign country

3

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

5

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

7

8

9

10

11

12

http://www.culturalorientation.net/providing-orientation/toolkit/providing-orientation- videos/seniors

13

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

UN refugee camp, Eastern Nepal

Photographs by Ben Saul (1999) http://www.geocities.com/ben_saul/BhutaneseRefugees.html

15 15

16

17

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

Refugee Resettlement Web Links

 Center for Applied Linguistics (CAL)

http://www.cal.org/



Bridging Refugee Youth & Children Services (BRYCS) http://www.brycs.org/

 UNHCR - The United Nations Refugee Agency

http://www.unhcr.org/

 Bureau of Population, Refugees and Migration (PRM)

http://www.state.gov/g/prm/

 Office of Refugee Resettlement (ORR)

http://www.acf.hhs.gov/programs/orr/

 United States Conference of Catholic Bishops – Migration & Refugee Services

(USCCB) http://www.usccb.org/mrs/

 Church World Service - Immigration & Refugee Programs (CWS)

http://www.churchworldservice.org/Immigration/index.html

 New York State's Bureau of Refugee Immigrant Assistance (BRIA)

http://www.otda.state.ny.us/main/bria/default.htm

 Refugee Council USA

http://www.rcusa.org/

19

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

Afghanistan, 71, 10% Bhutan, 92, 13% Burma, 39, 5% Burundi, 10, 1% Congo, 10, 1% Cuba, 119, 17%

• Dem. Republic

Congo, 25, 4% Eritrea, 11, 2% Iraq, 71, 10% Somalia, 138, 20% Syria, 43, 6% Ukraine, 63, 9% Other , 11, 2%

Refugee Rochester Arrivals - 703 10/1/2016 - 9/30/2017

Other 2 -Cameroon 3 - Ivory Coast 1 - Liberia 2 - Nepal 1 - Pakistan 1 - Sudan 1 - Tigryan 21

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

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

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

Common health problems

 Children

 Anemia  Lead elevation  Parasites and worms

 Adults

 Hepatitis B  TB exposure (PPD +)  Malaria  War injuries/amputations  PTSD/ Depression

25

Differences in Health Care Systems

 Prescriptions and pharmacies  Appointments  Mostly acute care -little preventive  Little counselling, mostly drugs  Poor nutrition

26

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

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

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

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

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

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

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

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

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

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

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

Challenges with participants

 Eligibility – age  Tracking – addresses/names/DOB  Trust  Short term and limited options  Citizenship obtainment  Insurance issues  Isolation  Housing

38

Right turns:

• Presentations
• Community celebrations
• Senior group
• Relationships
• Hiring right staff
• Support for community screening events
• Expansion of NYConnects and transportation

services

39

Success with participants

 Cleaning training  CDPAS advocacy  Powerful Tools for Caregivers session  Advocacy with landlords  Waivers  Transportation

40

Replication?

 Limitations of Funding  Alternatives:

 Language service options  Education of general public  Connections to community groups

 Faith communities, ethnic, ESL classes, schools

41

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

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

• ther populations – have access to a Language Phone

Line

 Create safe spaces for gathering and strengthen

community understanding of cultures and experience

43

Video clips:

44

Thank You!!!!

Contact Info: Jennifer McDermott, Aging Services Catholic Family Center 55 Troup St Rochester, NY 14608 Email: JMcDermott@cfcrochester.org Phone: 585-546-7220 x4002

45