URLEND Leadership Project Draft

URLEND Leadership Project

Trainee names and disciplines: Shellie Sacco, Sam Bailey, Sasha Kudin, Megan Burns

Working title of the project: Refugee Screening

Faculty Mentor for project: Nedra Christensen

Discipline Coordinators: Rich Harward, James Bekker, Lisa Samson-Fang

Brief description of project purpose and objectives:

The aim of our URLEND leadership project is to assist in improving the general health of the refugees at The HserNer Moo Center and LDS Humanitarian Center by providing basic healthcare screenings. The healthcare screenings will include hearing, dental, vision, measurement of blood sugar levels and a short physical examination. Resource options will be provided for those who need further health evaluation after the screenings. Health clinic resource information will include location, services, times of operation and financial requirements (if any). An additional goal is to develop a system in which these screenings will be provided on an annual basis to continue to assist in improving the healthcare of the refugees at these centers.

Introduction and Overview:

There are several organizations in Utah attempting to serve the needs of refugees arriving to the state. According to the State of Utah Refugee Office, between 900-1100 refugees resettle in Utah each year, and there are currently 25,000 refugees living in the state. Somali, Sudanese and Bosnian refugees have been the largest groups in past years, but there has been an increase in Bhutanese, Karen, and Iraqi refugees arriving into Utah. Nationally, more than 2 million refugees have resettled across the United States since 1970; 47% of refugees or asylum-seekers are women and girls, and 44% of refugees or asylum-seekers are under the age of 18. In Utah, the HserNer Moo Center and LDS Humanitarian Center in Salt Lake City are two organizations dedicated to assisting refugees in the transition into life in the U.S.

The HserNer Moo Center (HNMC) is a federally funded program that serves the residents of the South Parc Townhomes Apartment Complex, located in the South Salt Lake City, Utah area. Most of the residents are refugees. The community center provides the refugees with services and skills training needed for day to day living. For example, the HNMC refugees are able to learn English, are provided with tutors to help with homework, take pre-driving classes, learn social and financial skills and also participate in recreational activities.

The LDS Humanitarian Center is also located in Salt Lake City, Utah and was established in 1991. At the Humanitarian Center, worldwide emergency relief supplies are prepared and training is provided to individuals desiring assistance in developing employable skills. The majority of the individuals receiving training are refugees or immigrants. The refugees at the Center represent as many as 30 countries and approximately 20 different languages. They are being trained to join the workforce and become self-reliant. They attend classes to learn English, computer skills and customer service. Each trainee is assigned a job coach, who is there to provide individual help as needed. Training lasts up to 18 months. Good health is essential in helping them continue their efforts in joining the workforce and becoming self- reliant.

One year ago, trainees from URLEND developed a successful healthcarescreening clinic for the HNMC refugees. We will continue those trainees’ efforts to assist in the healthcare of the refugees by providing a second health care screening clinic at that location. In addition, we willexpandtheir efforts by providing additional screenings at another location, the LDS Humanitarian Center.

We will work with the social workers at the HNMC and leadership team at the LDS Humanitarian Center to identify the healthcare needs of the individuals served at the two locations. The specific goals of our project include:

We will improve our leadership skills by collaborating with the community centers and their administrators in learning the cultures, policies and programs to understand those we will serve.
We will further our leadership skills by developing a system in which a health care screening clinic is provided to the HNMC and LDS Humanitarian Center on an annual basis.
Through health screenings, identify those who need to be referred for further healthcare services.
Provide healthcare center resources to the individuals served, specificallyfor those identified through the screenings who need to be referred for further medical or healthcare assistance at low to no cost.
Provide a means of communication with the centers to inform the social workers and leadership teams to track and monitor those individuals referred for further assistance.

Methodology or Program Overview:

A needs assessment survey was administered by last year’s trainees to the participants at HNMC. The survey was used to help trainees learn more about the refugees understanding of physical health and healthcare needs that could be addressed in the healthcare screening. The results from the survey were also used as the guide for this year’s screening. This year, meetings were scheduled with administrators of both centers to determine the healthcare needs of those being served at the centers. Participants were both male and female refugees that are served at the HserNer Moo Community Center and LDS Humanitarian Center. Participants were identified and notified by Doug Wixon, a social worker at HNMC and Bill Reynolds (Director of Humanitarian Center) and Bart Hill (Development Manager) at the Humanitarian Center. All refugeesat the centers were invited to participate but they were not required to do so.

Measures or Evaluation Tools:

The screening stations were chosen upon input given from the individual centers and resources available.

A screening form was provided to each individual upon check-in at the screening. The participating individuals were instructed to take the screening form to each screening station they wanted to visit. (See attachment 1; screening forms)

Procedures:

The HserNer Moo healthcare screening was held on February 18, 2011 and the LDS Humanitarian Center screenings were held on March 4, 2011 and March 25, 2011. Each screening lasted 3 to 4 hours. The participants were offered the opportunity to receive a short physical examination, dental, hearing and blood sugar level screening. The screenings were provided at different stations set up at the centers.

The physical examination was provided by Sasha Kudin (Medical Graduate) and included:

Skin inspection, palpation of thyroid and lymph nodes of the neck, auscultation of heart and lungs along with a short screening questionnaire. Based on the results of examination, medical referrals were given and lists of low-income clinics were provided.

The dental screenings were provided by Samuel Bailey DMD and James BekkerDMD and included: Oral cancer screening, intraoral exam (caries detection, periodontal disease, etc), and recommendations/referrals for treatment. Oral hygiene and diet were discussed. A list of low income providers was provided to all participants.

The blood sugar screening was provided by Nedra Christensen and included a blood glucose screen via finger stick. Time of the last meal was recorded to assess the blood glucose level. Those outside the parameters of normal blood glucose level were noted and the centers will follow up with them with the list of free clinics.

The audiology screening was be provided by Shellie Sacco. The screening involved anotoscopic evaluation (visualization of the ear canal and tympanic membrane), tympanometry (assessment of middle ear function), and a pure tone hearing screening (frequency and intensity). As needed, Otoacoustic Emissions (OAE) testing (assessment of inner ear function) was conducted. If further testing or a medical referral was necessary, participants were given a list of providers throughout the state of Utah.

Results and Discussions

We were able to provide healthcare screenings for over a hundred individuals at the two different sites. Through these screening we were able to identify many people who were in need of further assessment. They were each given information regarding locations and costs, if any, of clinics to receive this further assessment. (See attachment 1; clinic form)

The total number of people screened equaled 139 with the ages ranging from ten months to seventy two year old. The total number of referrals made for further assessment was 335. (See attachment 3; excel spreadsheets for more detailed information and breakdown of referrals)

We are scheduling meetings with the administrators of the 2 sites to discuss the screening. We specifically want to know what went well; what can be improved upon; and most importantly, did those needing further assessment get the help they needed? We would also like to discuss a plan for setting up these screening annually.

Potential Findings and Discussion:

After participating in the screenings we were able to identify, as a group, some areas that need to be improved upon for future screenings. These included adding a vision screening, better guidance for people from station to station, more timely feedback to the centers and ways to relieve the language barrier between practitioner and patient.

Through this experience we were able to see the need for these screenings to be set up on an annual basis. We were able to recognize that multiple screenings may need to be provided per year to meet the numbers of those who would like to participate in these screenings. In a blog created for The HNM Center they expressed their desire to continue these screening clinics, they stated:

“We held a free clinic through the partnership with URLEND. Residents rushed in to get their blood, their teeth, and their hearing checked. We hope to be able to ensure a follow-up by working along with the ressetlement agencies such as IRC and CCS and Asian Association.”

We would propose that these screenings be incorporated into the URLEND program in which trainees are required to participate in a healthcare screening as part of their URLEND experience. Trainees would be required to sign up for specific dates provided, similar to signing up for the South Main presentations, and provide their professional services.

With many thanks

We are very grateful for the help of the social workers and leaders at the different centers who were more than willing to meet with us and discuss the needs of who they serve. With their guidance and assistance we were able to complete 3 successful healthcare screenings. In addition we would like to thank Nedra Christensen for her continued help in arranging these meetings and screening. We appreciate those who were also willing to participate in the screenings.

References:

Humanitarian Center. (2011). Retrieved on March 10, 2011, from

City of South Salt Lake. (1999) Retrieved on October 4, 2010, from

HNM Community & Welcome Center. Retrieved October 4, 2010, from

State of Utah Refugee Office. Retrieved April 3, 2011, from