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PA refugee resettlement PROGRAM Consultation Conference June 13 - 14, 2012. PA Refugee health program Asresu Misikir, Dr.Ph., MPH Epidemiologist & Refugee Health Program Coo.
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PA refugee resettlement PROGRAM Consultation Conference June 13 - 14, 2012 PA Refugee health program Asresu Misikir, Dr.Ph., MPH Epidemiologist & Refugee Health Program Coo. Bureau of Epidemiology Division of Infectious Disease Epidemiology, Refugee Health Program Section
Presentation points : • PA Refugee Health Program (PA RHP) overview • Statistical Information • Accomplishments • Future Plan PA RHP_AM 2012
Program Objectives: • To assess the current health status of all newly arriving refugees and identify health problems not identified during or developing after overseas medical exam • To ensure follow-up of refugees with conditions identified during the overseas medical exam or subsequently and provide treatment and referral PA RHP_AM, 2012
Program Tasks: • Coordination of care • Training and Health Education • Develop Electronic Reporting System and Provide Technical Supports • Collaborations • Increase Public Awareness • Site Monitoring • Identify of Potential health risks • Documentations & Produce Reports PA RHP_AM 2012
Refugee Health Assessment (RHA) Primary Components: • Medical history and physical exam • Immunization (children and adult) • Tuberculosis (TB) Screening • Sexually Transmitted Infection (STI)/HIV Screening • Hepatitis B Screening • Intestinal Parasite & Malaria Screening • Mental Health Screening • Childhood Blood lead Test • Referral of Chronic diseases PA RHP_AM 2011 PA RHP_AM 2012
Refugee Population Served by RHP • Refugees • Asylees • Parolee/Cuban/Haitian Entrants • Amerasians • Victims of Human Trafficking • Unaccompanied Alien Children • Survivors of Torture PA RHP_AM 2012
Health Care Providers By Region Erie McKean Potter Tioga Bradford Susquehanna Warren Wayne Crawford Forest Lackawanna Elk Wyoming Sullivan Cameron Venango Lycoming Pike Mercer Clinton Luzerne Clarion Jefferson Columbia Monroe Lawrence Clearfield Montour Union Butler Carbon Centre Armstrong Northumberland Snyder Northampton Beaver Indiana Mifflin Schuylkill Lehigh Cambria Juniata Allegheny Blair Bucks Perry Dauphin Berks Lebanon Huntingdon Westmoreland Montgomery Cumberland Washington Chester Bedford Fulton Somerset Fayette Greene Lancaster Philadelphia Delaware Franklin Adams York Health CARE Providers (20) Active Health Care Providers PA RHP_AM 2011 PA RHP_AM 2012
II. STATISTICAL INFORMATION • Notifications of Arrival • Health Screening Status PA RHP_AM 2011 PA RHP_AM 2012
Figure 1 Total Newly Arriving Refugees by States in 2011 N=56,419 Source: ORR annual refugee arrivals report, 2011. These data excludes secondary migrants PA RHP_AM 2012
Figure 2 Trends of Newly Arriving Refugees in PA from 2009 - 2011 Sources: CDC EDN Data (2008-2011) http://www.acf.hhs.gov/program/orr/data/state_profiles.htm. Date includes secondary migrants PA RHP_AM 2012
Figure 3 Newly Arriving Refugees in PA by Country of Origin, 2011 N=3303 Note: Refugees came from 59 different countries; Source – CDC EDN, 2011 PA_RHP_AM, 2012
Figure 4 Percent of Newly Arriving Refugees in PA by Country of Origin(Region) in PA 2011 Note: Among refugees who came from East-South Asia Region, 46% came from Bhutan, 24% from Nepal, and 7% from Myanmar. PA_RHP_AM, 2012
Figure 5 Percent of Newly Arriving Refugees by Sex and Age Group in PA, 2010 and 2011 Sex PA RHP_AM 2012
Figure 6 Newly Arriving Refugees by County in PA 2011 Erie McKean Potter Tioga Bradford Susquehanna Warren Wayne Crawford Forest Lackawanna Elk Wyoming Sullivan Cameron Venango Lycoming Pike Mercer Clinton Luzerne Clarion Jefferson Columbia Monroe Lawrence Clearfield Montour Union Butler Carbon Centre Armstrong Northumberland Snyder Northampton Beaver Indiana Mifflin Schuylkill Lehigh Cambria Juniata Allegheny Blair Bucks Perry Dauphin Berks Lebanon Huntingdon Westmoreland Montgomery Cumberland Washington Chester Bedford Fulton Somerset Fayette Greene Lancaster Philadelphia Delaware Franklin Adams York Legend: <10 Refugees 11- 50 Refugees >51 - 100 Refugees >101 Refugees Note: Refugees and Eligible Immigrants reside in 36 counties in PA, 2011
Figure 7 Refugees Who were Diagnosed with TB Conditions Overseas and Resettled in PA from 2009 - 2011 PA RHP_AM 2012
Figure 8 Refugees Who Completed Health Screening in PA, 2010 and 2011 Note: Refugees who reside in Philadelphia are excluded since reports were not received. PA RHP_AM 2012
Figure. 9 Percent of Refugees Who Completed Health Screening by Type of Services in PA 2011 N= 1,733 PA RHP_AM 2012
Figure 10 Refugees Who Received Referral & Interpretation Services in PA, 2011 PA RHP_AM 2012
Figure 11 Refugees who were Referred for Other Health Conditions in 2011 PA RHP_AM 2012
Figure 12 Type of Languages Used during Health Screening PA RHP_AM 2012
III. Accomplishments in 2011 • Coordination of Health Care: • Increased number of HCP from 5 to 10 • Increased health screening rate by 32% • Integrated mental health screening • Deployed two Refugee Case Mangers • Obtained Refugee Preventive Health Grant PA RHP_AM 2012 PA RHP_AM 2011
Cont.: • Electronic Reporting System of PA RH eSHARE development process continues • Training and Public Awareness • 300 Educational materials on refugee health distributed • 4 conference calls with HCP were conducted • Produced Annual report 2011 made available at • ARHC website to the Public at the national level • Site monitoring Protocol Developed. • One site monitoring was done PA RHP_AM 2012
Cont.: • Participated in 4 Regional Refugee Resettlement Collaborative meetings • Developed good communication and working Relationship with HCP and Local VOLAGS PA RHP_AM 2012
IV. Future Plans • Enhance Coordination of Health Care • Epidemiological Refugees Tracking system development and make it access to all concerns • Provide Technical support and Immigration Legal Update • Training and Health Promotion PA RHP_AM 2012
Cont., Future Plans • Develop link with academic Institutes • Identify and study potential health risk among refugees • Continue active collaborative work with Key Partners • Conduct Site Monitoring • Documentation and Producing Reports PA RHP_AM 2012
Reference: • PA, Department of Public Welfare, Refugee Resettlement Program (RRP) http://www.state.pa.us • PA, Department of Health Bureau of Epidemiology, Division of Infectious Disease Epidemiology, Refugee Health Program Section.http://www.dpw.state.pa.us/ • CDC, Division of Global Migration and Quarantine: http://www.cdc.gov/ncidod/dg/refugee/fag/fag.htm • Department of State Human Health service, Office of Refugee Resettlement: http://www.acf.hhs.gov/program/orr • United States Citizenship and Immigration Services(USCIS) http://www.uscis.gov • Public Health Services Act: http://www.os.dhhs.gov/about/opdivs/phs.html and http://www.usphs.gov/AboutUs/mission.aspx). PA RHP_AM 2012
Q & A THNAKS