Download Advocacy for new americans: Helping youth coming from

ADVOCACY FOR NEW
AMERICANS:
HELPING YOUTH COMING FROM REFUGEE
BACKGROUNDS
Presented by:
Alexx Goeller
Refugee Youth Services Coordinator
Refugee Services Office
SESSION OBJECTIVES
• Basic understanding of refugees and the refugee
process
• Refugee landscape here in Utah
• Potential solutions, best practices and resources for
working with refugee youth and their families
WHO IS A REFUGEE?
A refugee is a person forced to flee his or her country
due to persecution based on religion, race,
nationality, political opinion or
membership in a particular social group.
Most refugees are women and children.
IMMIGRANT OR REFUGEE?
An immigrant
voluntarily leaves
his or her native
country to seek a
more prosperous
life. Some
immigrants come
legally while others
do not.
•
•
•
A refugee flees his or
her country. They are
then legally brought to
the United States by
the U.S. Department
of State for the
purposes of
protection.
Refugees may become permanent residents after one year.
They may apply for citizenship after five years.
All refugees may legally work in the U.S. upon arrival.
HOW MANY REFUGEES ARE IN THE
WORLD TODAY?
There are approximately
21,300,000
refugees in the world today.
Less than 1% will be resettled in a third country, like
the United States.
THREE DURABLE SOLUTIONS
1. Voluntary repatriation: refugees can return
to their home country because situation has
improved
2. Local integration: refugees resettle in a
nearby host country with an ability to work
legally
3. Resettlement in a third country: refugees
resettle in a third country
WHO IS RESPONSIBLE FOR RESETTLEMENT IN
THE UNITED STATES?
The Department of State determines which refugees resettle in the U.S. and
oversees the refugee admissions process.
The International Office of Migration purchases the initial plane ticket and
coordinates travel. This is a loan that refugees are required to pay back
The Department of Homeland Security coordinates security background
checks with the FBI, CIA, Department of Defense and Department of
State.
The Office of Refugee Resettlement (ORR) is responsible for coordinating
domestic resettlement in the United States after arrival.
HOW MANY REFUGEES
ARE IN UTAH?
Of the 85,000 refugees
being resettled in the United
States, about 1,150 will
resettle in Utah.
It is estimated that there are
60,000 refugees, including
U.S.- born children, currently
living in Utah from more than
20 countries.
UTAH REFUGEE SERVICES
Governor Jon M. Huntsman established the Utah State
Refugee Services Office (RSO) in 2008.
• RSO resides within the Department of Workforce Services.
• The mission of RSO is to improve the lives of Utah refugees
by maximizing integration, coordinating refugee services,
and managing federal funding.
• RSO provides leadership in service coordination, connection
with community leaders policy review, advocacy, resource
development and management of all essential refugee
services in Utah.
The Department of Workforce Services offers
various benefits for refugees:
• Cash Assistance (for the first eight months in the United
States through the Family Employment Program - FEP)
•
•
•
•
•
Food Stamps
Medical Assistance (Medicaid and Medicare)
Child Care Assistance
Employment Services
Case Management (for two years)
There are two resettlement agencies (VolAgs) in Utah
that bring in new refugees assigned by the Dept. of State:
Each resettles approximately 550 refugees annually.
Resettlement Core Services
Within the first 90 days:
•
Reception and Placement

Airport Pickup

Housing

Food

$900 for housing needs
Case Management
•
Cultural & Employment Orientations
•
Job Placement
•
Health Screenings
•
Application assistance for Benefits & Social Security Card
•
School Enrollment (i-94, FERPA, proof of housing, immunizations)
•
Selective Services Registration
•
And more!
•
WHERE ARE REFUGEES LIVING?
Resettlement areas
 Granite District –
Primary
 Salt Lake District –
Secondary
 Canyons + Murray
School Districts –
Secondary
 Sandy and Provo areas –
Foster and adoptive
families
 Ogden District
Areas of second
migration
 Cache Valley area –
Working meat packing
plants
 Heber Valley area –
Working in laundry
plants
BARRIERS FOR REFUGEE FAMILIES
●
Filling out forms – difference of forms (i-94s for birth
certificate)
●
Interrupted or informal education
●
Testing requirements
●
School options
●
Communication with schools
●
Graduation requirements
●
Acquisition of transcripts
●
School rules and dress codes
●
Mental/Emotional distress
ASSETS OF REFUGEE FAMILES
● Increase diversity
● Bring new perspectives & experiences
● Cultural ambassadors (language, religion, food,
clothing …)
● Eager to learn; educational appreciation
● Multi-Lingual and Bi-cultural social skills
● Perseverance and resilience through adversity
WAYS TO HELP
● Determine which agency they’re affiliated with and utilize those
resources!
● Assist with carpool/Set-Up carpool systems
● Engage with refugee families
● Educate yourself about refugees, their backgrounds and traumarelated behaviors
● Volunteer with refugee serving agencies
● Allow a refugee parent to shadow you
● Attend vibrant cultural community events
● Keep these families in mind for various school-related events
● Invite/Encourage refugee parents to be involved in local PTA and
other after-school related events
● Ask questions, be welcoming
BEST PRACTICES
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•
•
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Clayton Middle School
Tumaini Center
Roosevelt Elementary
Technology
Inter-agency Collaboration
uen.org/advocacy
RESOURCES
•
•
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Refugee Services Office (RSO) refugee.Utah.gov
Refugee Education Initiative –
therefugeeeducationinitiative.org
Refugee Backgrounders from BRYCS,
IRC and Cultural Orientation Resource
Center (COR) – brycs.org;
culturalorientation.net
Internationals Network –
internationalsnps.org/resources/
School District Liaisons – Contact
Alexx for their information
Transitions for Refugee Youth (TRY)
Evening Program –
csme.Utah.edu/try-2
•
International Rescue Committee
(IRC) – rescue.org/us-program/ussalt-lake-city-ut
•
Catholic Community Services (CCS)
– ccsutah.org
•
Asian Association of Utah (AAU) –
aau-slc.org
•
UN Refugee Agency (UNHCR) –
unhcr.org
•
English Skills Learning Center
(ESLC) – eslcenter.org
•
Migration Policy Institute (MPI) –
migrationpolicy.org
•
National Child Traumatic Stress
Network – nctsn.org
QUESTIONS?
Refugee Services
Office
Alexx Goeller
801-347-3218
[email protected]
refugee.utah.gov
UTAH REFUGEE HEALTH PROGRAM
Objectives:
 Explain overseas medical evaluation process.
 Review domestic health screening.
 Review common health conditions.
OVERSEAS MEDICAL EVALUATION
Evaluate the physical and mental
health status prior to departure to
United States.
OVERSEAS MEDICAL EVALUATION
 Under the authority of the Secretary of Health
and Human services and the Immigration and
Nationality Act and the Public Health Service
Act.
 CDC Division of Global Migration and
Quarantine provide screening guidelines.
 Conducted by panel physicians selected by
Department of State consular officials.
OVERSEAS MEDICAL EVALUATION
Purpose:
Screens for conditions that may prevent admission to
the United States.
Assess health needs and related resettlement needs.
Assess fitness to travel and medical requirements for
travel.
Improve the health of refugees experiencing
resettlement.
<#>
OVERSEAS MEDICAL EVALUATION
Timeline:
Most medical documentation is only valid for 6
months.
Medical Examination: initial exam; vaccinations
Out-processing: TB/other investigations and
treatment; vaccinations; management of complex
medical cases
Travel request
Pre-departure medical screening (72 hours prior to
departure): presumptive treatment
Pre-Embarkation Check
<#>
DOMESTIC HEALTH SCREENING
Domestic Health Screening
The Federal Refugee Act of 1980 created a uniform system of
services for refugees in the United States.
The purpose of the domestic screening is to “reduce the spread of
infectious disease, ensure ailments are identified and treated,
promote preventive health practices, and to ensure good health
practices facilitate successful integration and self-sufficiency.
Each and every newly arriving refugee is entitled to a complete healthscreening exam in the first 30 days of arrival.
Address immediate health needs
Referral for follow up care
Introduction to the American health care system
DOMESTIC HEALTH SCREENING
P H Y S I C A L E X A M - A D D R E S S E S
H E A L T H C O N C E R N S A N D I S S U E S
I N T H E F O L L O W I N G A R E A S :
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Cardiology
Dermatology
Endocrinology
ENT
Genitourinary
GI
Hematology
Musculoskeletal
Neurology
Nutrition
Obstetrics
Ophthalmology
Pulmonology
Preventive (family planning, tobacco)
Screenings: hearing, dental, and vision
S
F
D
D
D
C R E E N I N G A N D T E S T I N G - A S S E S S
O R S E X U A L L Y - T R A N S M I T T E D
I S E A S E S , P A R A S I T E S ,
E F I C I E N C I E S A N D C H R O N I C
I S E A S E I N C L U D I N G :
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HIV
Hepatitis B
Hepatitis C
Syphilis
Schistosomiasis
Strongyloides
Giardia
Anemia
Diabetes
Other intestinal parasites
DOMESTIC HEALTH SCREENING
Domestic Health Screening
Immunizations- the U.S. Advisory Committee on Immunization Practices (ACIP)
vaccination requirements do not apply to refugees at the time of their initial
admission to the U.S; however, refugees must meet the vaccination requirements
when applying for adjustment of status or permanent resident status in the U.S.
(one year or more after arrival).
Presumptive Treatment-for parasites known to be common to specific regions from
which refugees are arriving specifically Schistosomiasis (Praziquantel) and
Strongyloides (Ivermectin).
DOMESTIC HEALTH SCREENING
Domestic Health Screening
TB Screening-targeted testing for latent TB infection (LTBI) primarily using
QuantiFERONâ-TB Gold (QFT-G), which is an alternate testing method for the
tuberculin skin test (TST) and offers increased specificity and sensitivity. TST may be
used if QFT-G blood draw is unsuccessful or if the QFT-G is indeterminate.
DOMESTIC HEALTH SCREENING
Reportable Conditions in Refugee Arrivals, Utah
January 1, 2010-December 31, 2015
9000
8000
7000
6000
5000
4000
3000
2000
1000
0
8317
8134
5111
4595
2288
1831
2243
1281
27
*Includes-syphilis, gonorrhea, chlamydia
**Includes-strongyloides, schistosomiasis, giardia, B hominis and
other
***Test < 10 yrs; positive is > 10 UG/DL
197
33
26
173
15
Tested
Positive
DOMESTIC HEALTH SCREENING
Identified Conditions in Refugee Child (<19) Arrivals, Utah
October 1, 2015-August 31, 2016
130
85
35
34
23
Pulmonolo…
30
Ophthalm…
Hematology
GI
Genitourin…
ENT/Heari…
Endocrinol…
Dermatolo…
Dental
4
21
Nutrition
35
22
Neurology
43
26
OB-GYN
74
Musculosk…
81
Mental…
68
Cardiovasc…
140
120
100
80
60
40
20
0
DOMESTIC HEALTH SCREENINGPSYCHOLOGICAL DISTRESS
“Identifying mental illness in refugees poses multiple challenges to providers and
organizations…These challenges range, from technical aspects of language barriers
and accessibility, to phenomenological questions such as the definition of mental
illness across cultures.”
Nature of refugee experience contributes to psychological distress and poorer
emotional wellness.
Risk factors exist along the resettlement continuum:
Pre-migration: age, gender, education, rural vs urban, region of origin,
trauma/torture, death of a relative
Migration: being detained, time spent in camp, adjudication process/length,
incidence of torture
Post-migration: communication barriers, housing, restricted economic
opportunities, separated from family, physical health needs, social isolation
DOMESTIC HEALTH SCREENINGPSYCHOLOGICAL DISTRESS
 Challenge to clearly understand level psychological distress among refugee
population
Prevalence studies tend to have selection bias due to the setting of the study
Epidemiological studies attempt to address selection bias, but encounter
communication difficulties, stigma and local beliefs about mental health
 Study found that 125 different screening and diagnostic tools existed in English
 CDC states that studies have shown high prevalence of depression, posttraumatic stress disorder (PTSD), panic attacks, somatization, and traumatic
brain injuries in refugees
DOMESTIC HEALTH SCREENINGPSYCHOLOGICAL DISTRESS
Mental Screening & Referrals Refugee Arrivals <19 y/o , Utah
October 1, 2015-August 31, 2016
140
127
120
100
80
60
50
47
40
20
0
Screened
Referred
Accepted
CONTACT INFORMATION
Amelia Self, MSW
State Refugee Health Coordinator
Manager, Prevention, Treatment and Care Program
Utah Department of Health
801-538-6221
[email protected]