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 :

I. PA REFUGEE HEALTH PROGRAM (PA RHP) OVERVIEW

II. STATISTICAL INFORMATION

III. ACCOMPLISHMENTS

IV. 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

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Refugee Population Served by RHP

PA RHP_AM 2012

Refugees Asylees Parolee/Cuban/Haitian Entrants Amerasians Victims of Human Trafficking Unaccompanied Alien Children Survivors of Torture

Health Care Providers By Region

Erie

ElkForest

Crawford

McKeanWarren

MercerVenango

LawrenceButler

Clarion

Beaver

Allegheny

Armstrong

Potter Tioga Bradford

CameronLycoming

Jefferson

Clearfield

Clinton

Centre

Indiana

WestmorelandWashington

CambriaBlair

Union

Snyder

Susquehanna

WyomingSullivan

Luzerne

Wayne

Lackawanna

Northumberland

Montour

Columbia

Carbon

Monroe

Pike

SchuylkillNorthampton

LehighMifflin

Juniata

DauphinPerry BerksBucks

Montgomery

Chester

Lebanon

Lancaster

Huntingdon

Bedford

Franklin Adams

Cumberland

York

Fulton

Delaware

SomersetGreene

Fayette

Health CARE Providers (20)

Philadelphia

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Active Health Care Providers

II. STATISTICAL INFORMATION

Notifications of Arrival

Health Screening Status

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Figure 1 Total Newly Arriving Refugees by States in 2011

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Source: ORR annual refugee arrivals report, 2011. These data excludes secondary migrants

N=56,419

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

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Figure 3 Newly Arriving Refugees in PA by Country of Origin, 2011

Note: Refugees came from 59 different countries; Source – CDC EDN, 2011PA_RHP_AM, 2012

N=3303

Figure 4 Percent of Newly Arriving Refugees in PA by Country of Origin(Region) in PA 2011

PA_RHP_AM, 2012

Note: Among refugees who came from East-South Asia Region, 46% came from Bhutan, 24% from Nepal, and 7% from Myanmar.

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

ElkForest

Crawford

McKeanWarren

MercerVenango

LawrenceButler

Clarion

Beaver

Allegheny

Armstrong

Potter Tioga Bradford

CameronLycoming

Jefferson

Clearfield

Clinton

Centre

Indiana

WestmorelandWashington

CambriaBlair

Union

Snyder

Susquehanna

WyomingSullivan

Luzerne

Wayne

Lackawanna

Northumberland

Montour

Columbia

Carbon

Monroe

Pike

SchuylkillNorthampton

LehighMifflin

Juniata

DauphinPerry BerksBucks

Montgomery

Chester

Lebanon

Lancaster

Huntingdon

Bedford

Franklin Adams

Cumberland

York

Fulton

Delaware

SomersetGreene

FayettePhiladelphia

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

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Figure 8 Refugees Who Completed Health Screening in PA, 2010 and 2011

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Note: Refugees who reside in Philadelphia are excluded since reports were not received .

Figure. 9 Percent of Refugees Who Completed Health Screening by Type of Services in PA 2011

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N= 1,733

Figure 10 Refugees Who Received Referral & Interpretation Services in PA, 2011

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Figure 11 Refugees who were Referred for Other Health Conditions in 2011

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Figure 12 Type of Languages Used during Health Screening

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Type of language # of Refugees

Arabic 27

Bhutan (Druk Yul) 91

Burma 29

China 1

Karen 23

Nepali 635

Russian 2

Somali 7

Spanish 33

Swahili 5

III. Accomplishments in 2011Coordination 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

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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

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Cont.:

Participated in 4 Regional Refugee Resettlement Collaborative meetings

Developed good communication and working Relationship with HCP and Local VOLAGS

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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

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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

Cont., Future Plans

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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).

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Reference:

Q & A

THNAKS