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HEALTH AND SOCIAL SERVICES CONFERENCE AUGUST 18-21, 2013

"Bright New Day- Trends and Services for North Carolina Newcomers". HEALTH AND SOCIAL SERVICES CONFERENCE AUGUST 18-21, 2013. Welcome to Conference Attendees. Recognition of: First Time Attendees Refugee Resettlement Agency Staff Local or State Government Agency Employees

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HEALTH AND SOCIAL SERVICES CONFERENCE AUGUST 18-21, 2013

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  1. "Bright New Day- Trends and Services for North Carolina Newcomers" HEALTH AND SOCIAL SERVICESCONFERENCE AUGUST 18-21, 2013

  2. Welcome to Conference Attendees Recognition of: First Time Attendees Refugee Resettlement Agency Staff Local or State Government Agency Employees Public Health, Social Services, Community College, Ethnic Community Organization, Health care provider or Non-profit Service Agency Faith-based organization, Community Foundation, Employer, Volunteer, or newcomer or individual involved with helping refugees in any capacity

  3. Looking Back Ten (2003) and Five (2008) Years Ago Looking Back to 2003 (10 years ago) FFY2002/2003 Trends Resettlement heavily impacted by terrorist attack on 9/11/01; numbers of arrivals low overall except in NC due to Montagnard large group resettlement of 900 Montagnards. Special Immigrant Visa Holder Category established SIV’s (3%), Haitian evacuees Country of origin from in FY03 from Vietnam-Montagnard (25%), Ukraine (11%), Liberia (9%), Conference Theme- “It was the Best of Times, It was the Worst of Times”

  4. Trends in 2012 and 2013 US RAP more diverse than ever with over 69 nationalities in 92 countries. Shift in in FY12-13, majority from Burma, Bhutan, and Iraq; Enhanced Security Measures resulted in decreased arrivals in FY11 and FY12. More arrivals with special needs/medical problems More mobility/ increase in out migration Change in Groups Served- Fewer asylees (27% in FY03, now 3%), increased #’s of Victims of Human Trafficking and UA children Conference Theme- “Bright New Day”

  5. Refugees Asylees Cuban and Haitian entrants/parolees Special Immigrant Visa holders from Iraq or Afganistan Victims of Human Trafficking Victims of Domestic Violence or Torture Vietnamese Amerasians Lawful Permanent Residents (LPR)who were admitted originally as one of the above in the past. Eligible Recipients of RAP Eligible Recipients for RAP Services

  6. Top 10 States with Highest # of Arrivals in FFY12 Texas- 5,623 California- 4,975 New York 3,531 Pennsylvania 2,974 Florida 2,903 Georgia 2,635 Michigan 2,587 Arizona 2,173 Washington 2,135 North Carolina 2,128

  7. SFY 2013 Arrivals by Immigration Status

  8. Regions of OriginNew Arrivals

  9. Federal Fiscal Year 2013 Arrivals through PRM – As of June 30, 2013

  10. Resettlement CountiesIn the 3 past SFYs, refugees have been received by 34 different NC counties: 21 diff. counties in SFY11, 15 diff. counties in SFY12 and 26 diff. counties in SFY13 Alleghan y Gates Ashe Surr y Curr ituc k Nor thampton Stok es Roc kingham P erson Camden Cas w ell V ance W arren Her tf ord P asquotank Wilk es Gr anville ville W atauga Halif ax P erquimans Y adkin orsyth F Or ange F r anklin A v er y Guilf ord Chowan Mitchell Ber tie Durham Nash Alamance Edgecombe Caldw ell Ale xander Da vie Madison Y ance y T yrrell Mar tin Dare W ak e W ashington Iredell Bur k e Da vidson Wilson Randolph Chatham Cata wba Buncombe Ro w an McDo w ell Pitt Beauf or t Ha yw ood Johnston Hyde Sw ain Greene Lee Rutherf ord Cabarr us Henderson Har nett W a yne Gr aham Stanly Lenoir P olk Gaston Moore J ac kson Cle v eland Montgomer y Cr a v en Mec klenb urg T r ansylv ania Macon Cherok ee P amlico Cumber land Cla y Richmond Sampson Hok e Union Jones Anson Duplin Onslo w Scotland Car teret Robeson Bladen P ender Columbus Ne w Hano v er Br uns wic k Received at least 1 refugee (<30) Received less than 100 Received less than 500 Received less than 1000 Received less than 2000 Received more than 2000

  11. NC Refugee Assistance Program Refugee Cash (RCA) & Refugee Medical (RMA) Usage and Cost

  12. NC Refugee Assistance Program Refugee Cash (RCA) and Refugee Medical (RMA) Usage and Cost During Federal Fiscal Year (FFY) 2012 (October 1, 2011 to September 30, 2012), approximately 879 individuals received Refugee Cash Assistance at a cost of $557,130. Approximately 1,600 individuals received Refugee Medical Assistance at a cost of $1,656,149.

  13. Refugee Assistance Program – Social Services (RAP-SS)FY 2012 Funding $2,074,089 Based on a total NC population of 4,681 out of a total US population of 189,674 and total funding level of $84,401,513 which was 2.4%.

  14. NC Services To Elderly Program Project Period = 09/30/2012 to 09/29/2015Total Budget for Current Federal Fiscal Year = $100,000 Objectives of the Services to Older Refugees Accessing mainstream aging services, acquisition of the English language and Citizenship and Civics Instruction, Naturalization Services, Transportation and Interpretation, nutritional measl. Provided without regard to income for those refugees who are age 60 or older Charlotte Current Providers: Mecklenburg Senior Center Senior Resources of Guilford

  15. County Breakdown of Senior (65+) ArrivalsJuly ‘10 - June ‘13

  16. NORTH CAROLINA REFUGEE SCHOOL IMPACT Grant Project Period = 09/15/2012 to 08/14/2014 Budget=$253,743 The central purpose of the Refugee School Impact grant is to assist refugee children with their academic performance and social adjustment to schools as well as to provide parental support services to parents regarding their participation in their child’s educational progress. Programs are geared toward school completion, acceptable academic performance, and the creation of opportunities to encourage full participation of refugee children and their parents in a wide range of school activities. Eligible sub-recipients are selected through analysis of arrival statistics of school-aged refugee children from U.S. Department of State data, in order to target county school districts that are most impacted by newly-arrived refugee children. SFY2013/14 SI Providers Include: 1.) Catholic Charities Diocese of Charlotte – Charlotte 2.) Church World Service – Durham 3.) Guilford County Public School System 4.) Interfaith Refugee Ministry – New Bern 5.) Lutheran Services Carolinas – Raleigh

  17. County Breakdown of School Age ArrivalsJuly ‘10 - June ‘13

  18. NC TARGETED ASSISTANCEPROGRAM & FUNDING $431,957 SFY13/14 TAG PROVIDERS: 1.) African Services Coalition – Greensboro 2.) Carolina Refugee Resettlement Agency, Inc. 3.) Montagnard Dega Association – Greensboro FY13 YTD Statistics Job placements- 430 Average FT Wage- $8.76 FT placements with Health Benefits- 100% 90 Day Retention Rate- 82% Vocational Skills Training- 133 Employability Services- 596

  19. North Carolina State Refugee OfficeContact Information NameE-Mail Telephone Number Marlene S. Myers, NC State Refugee Coordinator 919-527-6304 Marlene.Myers@dhhs.nc.gov Gail Andersen, Consultant 919-527-6302 Gail.AndersEn@dhhs.nc.gov Lynne Little, Consultant 919-527-6303 Lynne.Little@dhhs.nc.gov Patricia Priest, Consultant 919-527-6305 Patricia.Priest@dhhs.nc.gov Jamie Mills, Consultant 919-527-6334 Edward.Mills@dhhs.nc.gov DSS Main Number: 919-527-6300 Fax Number: 919-334-1265 Website:http://www.ncdhhs.gov/dss/refugee/

  20. North Carolina Refugee Health Program NC Department of Health & Human Services Division of Public Health Epidemiology Section Communicable Disease Branch Jennifer Reed Morillo NC Refugee Health Coordinator Jean-Marie Maillard, MD, MSc Medical Director

  21. Local Refugee Health Representation12 Local Health Departments/30 Staffers • Alamance County(Burl) • Buncombe County(Ashv) • Carteret • Craven (New Bern) • Durham • Forsyth (W-S) • Guilford (Gso, HPt) • Mecklenburg (Charlt) • New Hanover (Wilm) • Orange (Carrb) • Robeson (Lumberton) • Wayne (Mt. Olive)

  22. Program Overview Mission To ensure that health conditions of newly arrived refugees that could affect the public health, the individual refugee’s health, or impede the effective resettlement and economic self-sufficiency of refugees are promptly identified and treated.

  23. Program OverviewApproach & Funding Funding: Refugee Preventive Health Grant from the Office of Refugee Resettlement Two-tier approach: State and Local

  24. Program OverviewState support includes… • Notification, coordination and oversight of statewide refugee health assessments • Technical assistance • Data collection and analysis • Allocation and monitoring of federal pass-through funds to the main refugee-receiving health departments

  25. Program OverviewLocal funding • 7 major resettlement county health departments receive a small amount of contract administrative funds (total funding for past 3 years to 7 counties = $200,000) • Based on # of prior year arrivals and # of those reported screened and projected # of arrivals • Funds are allowable and typically used toward salaries of staff providing assessments, data collection and reporting, interpreters, equipment and lab supplies and generally for things not covered by Medicaid or Refugee Medical Assistance

  26. Health Screening Process • 99% of refugee health assessments in NC are performed either in full or in part/begun in local health departments/public health departments • Complete health assessments are typically provided in 2-3 scheduled clinic visits (tuberculosis, vaccinations)

  27. Components of the Refugee Health Assessment • Medical History • Screening for communicable diseases and vaccinations • Follow up for conditions identified overseas • Physical exam • Treatment and/or referral for further medical evaluation

  28. Highlights for Local Health DepartmentsJuly ‘10 – June ’13 North Carolina Local Health Departments reported providing 6,046 refugee health assessments.

  29. Highlights for Local Health DepartmentsJuly ‘10 – June ‘13 Goal: Initiate assessment for at least 60% of new refugee arrivals within 30 days: Actual results: 35% w/in 30 days Goal: Initiate assessment for at least 95% of new refugee arrivals within 90 days: Actual results: 91% w/in 90 days

  30. Major Screening Findings(% of those screened)July ‘10 – June ‘13

  31. Numbers of Health Serious ConditionsDiagnosed During Physical ExamsJuly ‘10 – June ’13Based on a reported total of 3,545 screened • 498 (14%) refugee arrivals had at least one non-infectious health problem identified requiring treatment or referral • 178 (5%) had at least 2 problems • 47 (1%) had at least 3 problems

  32. See Refugee Health Table • NC Highlights and Significant Findings • Health posters & translated educational materials • Listing of Local health department contacts

  33. Please Join our Public Health and Wellness Track Presentations MondayAfternoon Workshops #1 & 2: Health Providers Round Table Discussion – closed session for clinicians and health department staff only Workshop #3: Mental health and wellness Tuesday Afternoon Workshop #1: Federal Updates on Refugee Health and Health Coverage Issues Workshop #2: Refugee Health in the Community Workshop #3: Refugees and Emergency Preparedness Planning

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