OUTCOME AREA: STRONG SAFETY NET

JEWISH VOCATIONAL SERVICE

Jewish Vocational Service (JVS) serves a central role in assisting refugees and immigrants in Kansas City, Mo. As the largest refugee resettlement agency in the metro area, JVS provides an array of social services touching every aspect of helping refugees and immigrants secure basic health, housing, employment and other assistance to help newcomers establish themselves and their families in the U.S.

JVS’s health and wellness services encompass intensive case management and care navigation to help refugees and immigrants access health and mental health care and other services to reduce the gap between consumer needs and health care. The health and wellness team, which includes a refugee medical coordinator and social workers, provides care coordination services to refugees from more than a dozen countries each year. The REACH Foundation awarded JVS a $37,632 Care Coordination grant in 2017 to provide culturally competent care coordination services for this population group. JVS also received a $50,000 core partner grant in 2017, awarded to organizations whose work is aligned with the foundation’s focus on access to health coverage and care through the safety net.

Within this project, care coordination goes beyond scheduling appointments for medical care – it entails basic education about health care systems and how clinics and hospitals work; how to speak with doctors and communicate needs and concerns; and outlining what clients can ask for and expect. JVS’s refugee medical coordinator serves as a trusted cultural liaison to help the client learn about health and social services in their new home community, and build their capacity to advocate for family’s health needs.

On a busy day at JVS, Amy Mocker, the refugee medical coordinator, and an interpreter sit with a woman from the Democratic Republic of the Congo to discuss upcoming health care appointments. The mother is expecting a child within a few weeks and has multiple questions about what will happen at these medical visits. Mocker walks her through a list of upcoming medical appointments and discusses the woman’s transportation needs. The conversation flows through one of JVS’s interpreters, who speaks with the client in Swahili. The client shares her concerns about a particular interpreter at the hospital and asks Mocker to help her secure an interpreter with whom she feels more comfortable. Beyond basic health care questions, Mocker discusses additional items related to preparing for the baby’s arrival: Access to a phone for urgent needs; a transportation plan; availability of a crib and other baby items; care of the other children when the mother goes to the hospital for delivery; and making sure the mother has her health care documents handy. Even with an interpreter, there is a sense of familiarity and ease between Mocker and the client.

JVS staff note that many of the arriving refugees have complex health care needs, requiring a higher level of coordination. In 2017, the project served 107 clients.

Best practices with refugees has shown that intensive case management can decrease alienation, fear and anxiety, and barriers to services. In addition, refugees and immigrants can be at higher risk for certain health conditions as a result of their migration and resettlement. JVS considers care coordination crucial to the health and well-being of their clients. Agency staff note that many arriving refugees have a range of health care needs that require immediate attention – something that care navigation can help resolve. Addressing health is critical to helping the adults find and begin jobs, care for their children and be self-sufficient. Mental health conditions and trauma are prevalent in refugee communities, so care coordination can help in securing those services for more complex needs.

JVS’s intake processes include an overall assessment of identified needs and the development of service plans. Due to language barriers, JVS schedules the first few health care appointments and accompanies the clients to build comfort with the process. JVS assists consumers with obtaining health benefits. Care coordination also includes regular check-ins with clients to ensure they obtained the services they needed and to assess their experience. Information collected from these conversations help staff update service plans for that individual and household.

Mocker said the process of talking through service plans and the client’s health care experience is crucial to building their clients’ capacity to utilize the health care system more effectively. Care coordination services minimize confusion, disappointment or conflicts and miscommunication between health providers and the client. By continuously collecting, and reflecting, on client feedback, JVS can share that information with local health providers so that they can improve their care delivery. “The better we are at eliminating barriers, the more easily our clients will be able to manage their health needs themselves. These skills will help them achieve a higher quality of life and meet their own goals of becoming successful members of our community.”