Nebraska’s Collaboration in Nebraska’s Collaboration in Working with Refugee Working with Refugee

PopulationsPopulationsKristin Gall, RN, BSN, MSNKristin Gall, RN, BSN, MSNCommunity Health Nurse IIICommunity Health Nurse III

Nebraska Department of Health and Human ServicesNebraska Department of Health and Human ServicesLincoln, NebraskaLincoln, Nebraska

Nebraska’s TB ProgramNebraska’s TB Program

Rural StateRural State Limited StaffLimited Staff Local Health DepartmentsLocal Health Departments

OmahaOmaha LincolnLincoln Rural Rural

Foreign Born in NebraskaForeign Born in Nebraska RefugeesRefugees

301 in Fiscal Year 2006301 in Fiscal Year 2006 490 in Fiscal Year 2007490 in Fiscal Year 2007

Secondary MigrantsSecondary Migrants FamiliesFamilies JobsJobs

• Meat Packing PlantsMeat Packing Plants

(Department of State, 2008)(Department of State, 2008)

Tuberculosis in Nebraska Foreign Born vs Active Cases

2003-2007

01020304050

2003 2004 2005 2006 2007

Foreign Born Active Cases

Refugee Challenges Accessing Refugee Challenges Accessing Health CareHealth Care

Complex American Health SystemComplex American Health System Work Focused EnvironmentWork Focused Environment LanguageLanguage Lack of ResourcesLack of Resources Lack of KnowledgeLack of Knowledge

Reasons for Education Among Reasons for Education Among AgenciesAgencies

FearFear Lack of InformationLack of Information Local Health Department RequestLocal Health Department Request Need Determined by State TB ProgramNeed Determined by State TB Program

Collaboration with Refugee Task Collaboration with Refugee Task ForceForce

Refugee Resettlement StaffRefugee Resettlement Staff Refugee Community Refugee Community Local Organizations Local Organizations Nebraska Refugee Resettlement Nebraska Refugee Resettlement

CoordinatorCoordinator Karen PardeKaren Parde

Local Health Department StaffLocal Health Department Staff

CollegesColleges

Foreign Born StudentsForeign Born Students Policy NeedPolicy Need ““TB On the College Campus”TB On the College Campus” Staff Helping StudentsStaff Helping Students

Target TB Education for Groups Target TB Education for Groups that Serve Refugees in that Serve Refugees in

CommunitiesCommunities Lexington, NebraskaLexington, Nebraska

Community Members (School, Hospital, Community Members (School, Hospital, Health and Human Service Workers)Health and Human Service Workers)

Health Department and Local ProvidersHealth Department and Local Providers ClinicClinic State Quarterly MeetingsState Quarterly Meetings

Meat Packing Plant CollaborationMeat Packing Plant Collaboration

““Red Meat” EducationRed Meat” Education Basic TB InformationBasic TB Information Contact InvestigationContact Investigation Refugee Background InformationRefugee Background Information Screening RequirementsScreening Requirements

Contacts with Meat Packing PlantContacts with Meat Packing Plant

Education for Direct Care StaffEducation for Direct Care Staff

Refugee Resettlement Staff Refugee Resettlement Staff Basic TB InformationBasic TB Information

Employment First GroupEmployment First Group Arbor GroupArbor Group

Health Care ProvidersHealth Care Providers Creighton-Florence Clinic, OmahaCreighton-Florence Clinic, Omaha

QuantiFERONQuantiFERON®®-TB Gold Update-TB Gold Update• University of Nebraska Public Health LabUniversity of Nebraska Public Health Lab• State PresenceState Presence• Pilot StudyPilot Study

Local ConferencesLocal Conferences Local Health DepartmentsLocal Health Departments

Collaboration between StatesCollaboration between States Minnesota Minnesota

Website for Language MaterialsWebsite for Language Materials DVD (audio and visual)DVD (audio and visual)

Future GoalsFuture Goals Correctional FacilitiesCorrectional Facilities Minnesota DVD DistributionMinnesota DVD Distribution Quarterly Conference CallsQuarterly Conference Calls