Poster Presentations (Group I)

1. [Brief description]

This presentation highlights Minneapolis’ Hennepin County Public Health Clinic’s (HCPHC) encompassing clinic-wide protocol developed to provide culturally competent care for new refugees while addressing the multitude of barriers they experience in accessing care.

2. [Successes]

HCPHC successfully screens over 2000 refugees on an annual basis. They achieve a 95% screening rate of all the refugees referred to them for care. This success is reflected in each component of their clinic-wide protocol:

• Support staff ensure families are in the right place at the right time.  Their role is to contact patients for appointments, check insurance status, follow-up with failed appointments and order medical interpreters. 
• Transportation.  Support staff are dedicated to ensuring families make their appointment.  Staff members discuss transportation options and order taxi cabs as needed.  Families receive reminder calls and if late, follow up calls are made to problem solve or reschedule.
• Medical records staff are responsible for obtaining overseas medical records, immunization records, data entry, and filling out health department forms.
• Nurses are responsible for the initial part of the screening visits which include initiating screening per protocols, conducting interviews, explaining the health screening process, and assessing for acute health problems. 
• Providers review overseas medical records, assess health risks and current health status, order screening tests for infectious diseases and treat as needed. Primary care problem list and preventive health care services are initiated. Clients are referred to primary care for onging services.  Providers also monitor aggregate screening results for population specific disease patterns. 
• Public Health Nurses connect clients to primary care and social services.  Home visits provide further support. Acute and chronic health condition outcomes are followed.

3. [Challenges]

Challenges for HCPHC:  

• Multiple insurance plans may be assigned within the same family unit. 
• Transportation and interpreter services are not always reimbursed.
• Unpredictable and varying arrival rates of refugee families to the county complicate staffing.

Socio-economic challenges affecting refugees:

• Individuals within a family have different information and understanding about healthcare systems.
• Coordination issues arise when families break apart or live separately in transient housing.
• Elderly clients without family need extra assistance navigating referrals.
• Work or housing needs may cause clients to move out of the county before their evaluation is complete.

As a public health clinic, HCPHC views it as their role to address these challenges by offering extra support whenever possible, by serving as a connector to social services outside the healthcare system. 

4. [Practical advice]

Key to success: “Having the right people in the right place at the right time”

HCPHC’s success lies in its ability to provide a seamless public health encounter for new refugees.  On average, this clinic provides care to over 2000 refugees annually, which is often over half of Minnesota’s total refugee arrivals.  Their mission is multi-faceted.  HCPHC’s protocol addresses barriers at every level of the health screening process, from getting patients to the clinic, to educating patients about the health system, to linking them to primary and follow-up care.