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 Public Health, Social Services, Community College, Ethnic Community Organization, Health care provider or Nonprofit Service Agency • Faith-based organization, Community Foundation, Employer, Volunteer, or newcomer or individual involved with helping refugees in any capacity
Looking Back Looking Back to 2003 (10 years ago) Ten (2003) and Five (2008) 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 VietnamMontagnard (25%), Ukraine (11%), Liberia (9%), Conference Theme- “It was the Best of Times, It was the Worst of Times”
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 ServedFewer asylees (27% in FY03, now 3%), increased #’s of Victims of Human Trafficking and UA children
Conference Theme- “Bright New Day”
Eligible for RAP EligibleRecipients Recipients of Services RAP • • • • • • • •
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.
Top 10 States with Highest # of Arrivals in FFY12 TexasCaliforniaNew York Pennsylvania Florida Georgia Michigan Arizona Washington North Carolina
5,623 4,975 3,531 2,974 2,903 2,635 2,587 2,173 2,135 2,128
SFY 2013 Arrivals by Immigration Status IMMIGRATION STATUS
TOTAL ARRIVALS
PERCENTAGE
2,774
89%
Cuban/Haitian Entrant and Parolee
132
4%
Iraqi/Afghan Special Immigrant Visa Holder
37
1%
Asylees
85
3%
Victim of Human Trafficking
1
0.1%
Unaccompanied Alien Children
11
0.4%
3,044
100%
Refugee Secondary Migrant – Refugee 79
TOTAL
Regions of Origin
New Arrivals
Federal Fiscal Year 2013 Arrivals through PRM – As of June 30, 2013 Region
Admission Ceiling
U.S. Admissions
NC Admissions
Africa
12,000
11,708
340
East Asia
17,000
12,261
771
Europe
2,000
513
24
Latin America/Caribbean
5,000
3,117
84
Near East/South Asia
31,000
23,660
584
TOTALS
73,000
51,259
1803
(Regional Subtotal)
(70.22% of Ceiling)
(3.5% of U.S. Admissions)
1,467
New Arrivals by Regions of Origin - SFY 2003, 2008, & 2013
1,113
1400
1,124
1600
1200
SFY 2013 - 3,044 SFY 2008 - 2,163 SFY 2003 - 1,258
1000
275 106 90
212 54
24 90
200
238
288 308
400
508
600
568
800
Latin America
East Asia
Near East/South Asia
Europe
Africa
0
New Arrivals for SFY 2003 - By Country of Origin (Top Seven Countries) 600
534
500 400 300
Number of New Arrivals (1,258) 83
65
65
65
54
47
Colombia
DRC
Ukraine
Moldova
Liberia
100
Bosnia & Herzegovina
200
Vietnam
0
New Arrivals for SFY 2013 - By Country of Origin (Top Seven Countries) 1,200
1,063
1,000 800 590
600
Number of New Arrivals (3,044)
430
400 116
106
82
DRC
Sudan
200
Eritrea
235
Cuba
Iraq
Bhutan
Burma
0
Resettlement Counties In 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 Ashe Watauga
Alleghan y
Surry
Yance y Cata wba
Buncombe McDow ell
Cherok ee
Orange
Guilford
Davidson Ro w an
Rutherford
Jac kson Macon
Henderson P olk
Transylv ania
Cle veland
Cabarrus Gaston
Mecklenb urg
Cla y
Union
Halifax
Randolph
Edgecombe
Stanly Montgomery
Anson
Harnett
Moore
Richmond
Pitt
Johnston
Lee
Hoke
P amlico Sampson
Duplin
Bladen
Received at least 1 refugee (<30) Received less than 500 Received less than 1000
Received less than 2000 Received more than 2000
Cr a v en Jones
Onslo w Robeson
Beaufort
Wa yne Lenoir
Cumber land
WashingtonTyrrell
Greene
Scotland
Received less than 100
Martin
Wilson
Chatham
Chowan
Ber tie
Nash
Wak e
P ender Columbus Bruns wic k
New Hano ver
Currituck Camden
P asquotank P erquimans
Franklin
Durham
Alamance
Hayw ood
Sw ain Graham
Forsyth
Davie
Iredell
Gates Northampton Hertford
Vance Warren
Granville ville
Yadkin
Caldw ellAlexander Bur ke
Roc kingham Cas w ell P erson
Wilkes
Aver y Mitchell Madison
Stokes
Car teret
Hyde
Dare
New Arrivals for SFY 2013 by NC County NC County
Number of New Arrivals
Alamance Buncombe Cabarrus Caldwell Carteret Catawba Cleveland Craven Cumberland Davidson Duplin Durham Forsyth Gaston Guilford Iredell
10 28 7 1 14 3 2 206 5 1 1 264 59 3 741 1
TOTAL
Number of NC County New Arrivals Johnston Lincoln Macon Mecklenburg New Hanover Northampton Onslow Orange Randolph Robeson Sampson Stanly Union Vance Wake Warren Wayne 3,044
4 3 1 853 79 1 1 78 12 1 2 1 2 1 643 1 15
NC Refugee Assistance Program Refugee Cash (RCA) & Refugee Medical (RMA) Usage and Cost FFY2012 RCA Trimester Recipients
RMA Recipients
1st
349
656
2nd
233
421
3rd
297
522
Total
879
1599
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.
Refugee Assistance Program â&#x20AC;&#x201C; 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%.
NC Services To Elderly Program Project Period = 09/30/2012 to 09/29/2015 Total 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
County Breakdown of Senior (65+) Arrivals July ‘10 - June ‘13
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 subrecipients 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
County Breakdown of School Age Arrivals July ‘10 - June ‘13
NC TARGETED ASSISTANCE PROGRAM & 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
90 80 70 60 East West North
50 40 30 20 10 0
C
1st
o n s Qtru l t a n t :
2nd Qtr 3rd Qtr 4th Qtr
Name
North Carolina State Refugee Office Contact Information E-Mail
Telephone Number
Marlene S. Myers, NC State Refugee Coordinator Marlene.Myers@dhhs.nc.gov Gail Andersen, Consultant Gail.AndersEn@dhhs.nc.gov Lynne Little, Consultant Lynne.Little@dhhs.nc.gov Patricia Priest, Consultant Patricia.Priest@dhhs.nc.gov Jamie Mills, Consultant Edward.Mills@dhhs.nc.gov DSS Main Number: Fax Number: Website:
http://www.ncdhhs.gov/dss/refugee/
919-527-6304 919-527-6302 919-527-6303 919-527-6305 919-527-6334 919-527-6300 919-334-1265
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
Local Refugee Health Representation 12 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)
Program Overview Mission To ensure that health conditions of newly arrived refugees that could affect the public health, the individual refugeeâ&#x20AC;&#x2122;s health, or impede the effective resettlement and economic selfsufficiency of refugees are promptly identified and treated.
Program Overview Approach & Funding
Funding: Refugee Preventive Health Grant from the Office of Refugee Resettlement Two-tier approach: State and Local
Program Overview State 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 refugeereceiving health departments
Program Overview Local funding â&#x20AC;˘ 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) â&#x20AC;˘ Based on # of prior year arrivals and # of those reported screened and projected # of arrivals â&#x20AC;˘ 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
Health Screening Process â&#x20AC;˘ 99% of refugee health assessments in NC are performed either in full or in part/begun in local health departments/public health departments â&#x20AC;˘ Complete health assessments are typically provided in 2-3 scheduled clinic visits (tuberculosis, vaccinations)
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
Highlights for Local Health Departments July ‘10 – June ’13
North Carolina Local Health Departments reported providing 6,046 refugee health assessments.
Highlights for Local Health Departments July ‘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
Major Screening Findings (% of those screened)
July ‘10 – June ‘13
Numbers of Health Serious Conditions Diagnosed During Physical Exams July ‘10 – June ’13 Based 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
See Refugee Health Table • NC Highlights and Significant Findings • Health posters & translated educational materials • Listing of Local health department contacts
Please Join our Public Health and Wellness Track Presentations Monday Afternoon Workshops #1 & 2: Health Providers Round Table Discussion â&#x20AC;&#x201C; 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