Refugee Service Coordination Case Study Page 1 of 7
Refugee Service Coordination Case study
Details of PCP contact
Name of PCP Central West Gippsland Primary Care Partnership
Contact Person Selena Gillham
Position/Title Acting Executive Officer
Phone No. (03) 5127 9159
Email Address [email protected]
Identified Partners
Partner Organisation Roles and responsibilities
with regard to the project Contact person details (name, position) Central West Gippsland
Primary Care Partnership (CWGPCP)
Day to day management of Project
Debra Carnduff
Refugee Service Coordination Project Worker (author) Latrobe Community Health
Service (LCHS)
Auspice the Planning
Committee, Responsibility for financial obligations and insurance cover
Michelle Crosby
Manager Health Promotion &
Education
Central West Gippsland Division of General Practice (CWGDoGP)
Assistance with design of the mapping tool and support to GP practices to complete this
Marg Bogart
Practice Capacity Coordinator
Case Study Title Refugee Service Coordination Project
Summary/Abstract (200 words)
Latrobe City has welcomed many new refugee families since 2006 with an estimated 450 to 600 now residing in the region.
The local community health service was funded to establish a Refugee Health Nurse (RHN) Program in recognition of the challenges of meeting the diverse and complex health and wellbeing needs of these new arrivals. As part of this funding CWGPCP developed and promoted effective service coordination models to support refugees. Three major issues were addressed through the Project.
Improved access for refugees to health services – Refugees have increased their use of health services (250% increase in usage at LCHS) including GPs with the primary benefit being the improved transition, settlement and adjustment of refugees to our community and improved health outcomes.
Improved understanding of agency roles and service provision processes – Services have defined their roles and responsibilities and developed processes of collaboration with other service providers.
Increased awareness of refugee health issues – this project has delivered increased knowledge and understanding of the refugee’s journey, the basic supports needed for the community to integrate and an understanding of the multiple and complex health needs that many of the refugees present with.
Background
Name of Project Refugee Health Service Coordination Project Priority goal
To improve access to services and health outcomes for refugees in Latrobe City.
Priority issue(s) Improved access to health services
Improved understanding of agency roles and service provision processes
Increased awareness of refugee health issues Target group Refugees and Humanitarian Entrants (New Arrivals) Background
Secondary migration of Sudanese humanitarian entrants to Latrobe Valley had emerged as a significant issue as
identified by the Central West Gippsland Planning Committee in late 2007 and early 2008. Department of Immigration and Citizenship (DIAC) agreed that the needs of new settlers to Gippsland had emerged as a priority.
To support health services in meeting the diverse and complex health and wellbeing needs of these new arrivals to the Region LCHS was funded for the RHN program. CWGPCP was funded as part of this program to develop and promote effective service coordination models to support refugee clients.
A Refugee Service Coordination Project Worker was
appointed to map health services and develop clear referral pathways. This worker was supported by Health West to guide and facilitate the development and implementation of the Latrobe Project.
The Project Worker designed a data collection tool in collaboration with CWGPCP, LCHS and the CWGDoGP to cover all areas of service coordination and delivery. Nearly 50 agencies were approached to collect data on the services they offered to people from a refugee or humanitarian background seeking support and/or assistance.
A Refugee Health Pamphlet was also designed and widely distributed to highlight support offered under the Project, in collaboration with the RHN program at LCHS.
A Refugee Health and Wellbeing Plan was presented to the Refugee Health Working Group, project arm of the Central West Gippsland (Latrobe) Settlement Committee.
Improving the health and wellbeing of refugees in Latrobe City is a goal under the CWGPCP strategic priority. The refugee service coordination project is a strategy under the objectives of increase the capacity of health and community organisations to work with diverse groups and more
specifically refugees and improve access to needed services.
Objectives
The Project’s key objectives included:
Service mapping and pathway development Raising awareness of refugee health issues Identification of training needs
Refugee Service Coordination Case Study Page 3 of 7 Project participants
As part of the project, a list of identified agencies was assembled through discussions with PCP partner agencies. Service providers who contributed to the Project were :
Latrobe Regional Hospital o Director of Nursing
o General Manager, Sub-Acute Services o General Manager, Support Services o Manager, Infection Control
o Manager, Social Work o Group Manager, Acute Care o Unit Manager, Maternity
- Maternity Staff - Outreach Midwife o Sexual Health Clinic
o Manager, Accident and Emergency I-Med Imaging
Gippsland Pathology Breastscreen
Central West Gippsland Division of General Practice o General Practice Clinics
Gippsland Multicultural Services Department of Human Services Latrobe Community Health Service
o Manager, Counselling Services
o Manager, Health Promotion and Community Education - Mental Health Promotion Officer
- Community Nurses o Manager, Dental Services o Manager, Consumer Services
- Service Access Officers o Manager, Service Coordination o Allied Health Team
Latrobe City Council (LCC)
o General Manager, Community Liveability o Manager Child and Family Services
- Family Services Officer
o Manager, Community Capacity Building o Manager, Community Health and Wellbeing o Children Services Coordinators
- Pre-School Program - Childcare
- Maternal and Child Health Program
Maternal and Child Health Nurses
Enhanced Maternal and Child Health Nurse
- Mayor and Chair of Latrobe Settlement Planning Committee o Community Development Facilitator
o Community Engagement Officer, Refugee Action Plan Good Beginnings
Noah’s Ark Office of Housing
Community Housing Ltd Quantum Support Services
o Family Services Coordinator o Youth Services Coordinator o Manager
o Housing Services Coordinator Anglicare
o Refugee Minor Program Berry Street
o Manager
o Cultural Liaison Officer o Employment and Support Relationships Australia
Department of Education o ESL Coordinator o ESL teachers o School Nurse GippsTAFE
o ESL Teacher o ESL Team Leader
Gippsland Employment and Transitional Training (GETT Centre) Centrelink
o Multicultural Services Officer
Gippsland Employment and Skills Training (GEST) Victoria Police
GippSport
HealthWest Service Coordination Project Worker Adult Migrant Education Service (AMES)
Foundation House DIAC
Latrobe Valley Mental Health Service Headspace
Gippsland Women’s Health Service The Smith Family
Victorian EyeCare Service Sudanese Community Leaders
Methodology and approach
The Project Worker developed a Data Collection Tool under the guidance of CWGPCP, LCHS and CWGDoGP. Information sourced from Agencies targeted (see above) included details about:
Cost for services
Refugee Service Coordination Case Study Page 5 of 7 What interpreter services were used?
Service Coordination tools used o Referrals in and out o Initial Needs Identification o Any assessment needs
o Health Service Directories used Referral point to gain services
Specific issues encountered in delivering services to refugees including:
o Access o Referral
o Care coordination o Refugee specific
o Health service information
The data collected formed the basis of the Refugee Health and Wellbeing Mapping Plan.
The CWDoGP encouraged all GP members to participate in the collection of data and issued the collection tool via their network which included all GP Clinics in Latrobe City and Baw Baw Shire. The Division ensured that the final Plan was GP user-friendly and was an essential link to GPs across the Region. The Service Coordination Project Worker and the RHN participated in training delivered by the Division to GP Clinic staff on Refugee Specific Care.
With the support of the CWGDoGP, information from the Service Coordination Project and the RHN Program was distributed via their network to encourage improved care coordination between GPs and other health providers.
The Project Worker also supported the CWGDoGP in resourcing information for developing a Refugee Specific Link on their website.
During the process of collecting data, the Project Worker was able to distribute supportive resources and information to build the capacity of agencies to deliver culturally appropriate health services. The Worker raised awareness and knowledge about the importance of the need to coordinate the delivery of services to their refugee clients. It was also an
opportunity to promote the use of interpreters in ensuring clear communication between agency and client, leading to more effective outcomes for both parties.
A number of cultural awareness training sessions were delivered to key service providers with the support of the RHN, ensuring a clear understanding of the RHN’s role in supporting service delivery to refugee clients. Sessions were delivered to Maternity staff at LRH, Allied Health at LCHS and Managers and Staff at LCC.
Results
Impacts and outcomes
The Project was instrumental in highlighting to service providers the importance of culturally appropriate service delivery and care. Service providers and refugee clients alike benefit by the introduction of improved service coordination.
The Project was key in encouraging LCHS to appoint, in the first instance, culturally appropriate Service Access Workers, before appointing a New Arrivals Worker (Sudanese). The New Arrivals Worker, who is multi-lingual, assists refugee clients seeking health and wellbeing support, including emergency relief, education, housing and welfare support.
The Project Worker was relocated in 2010 to LCHS’s Refugee Health unit to progress the issues that were identified through the data collected and to support the full utilisation of the RHN position.
LCHS has more recently received funding from DIAC’s
Settlement Grants Program and employed a Project Worker to provide Orientation to Australia, Developing Communities and Integration SGP services to all eligible clients in the Latrobe Valley. These services include mentoring and community development, activities promoting a greater participation in sport, employment related programs and a housing education project.
A key success of this Project has been the number of Sudanese humanitarian arrivals that have accessed LCHS services across Gippsland. The 2010 Quality of Care Report from LCHS confirms that there were 19 clients in 2008 with an increase to 49 utilising the service in 2009. This trend is expected to continue and even double in 2010. The Service is building stronger community relations and providing
information that is relevant and easy to understand.
Status and
sustainability The project has developed a Mapping Plan which is an ongoing tool that can be annually updated as funding streams and services change. The tool is a useful orientation resource for agencies to use when new staff are appointed to positions of service access.
The data collected by the project has also been developed into a resource that can and has been utilised for the distribution of valuable refugee specific resources through an email link.
That data is currently being developed into a Refugee Specific Service list of health and wellbeing resources in a form that details the name of the organisation, its primary role, contact details and referral points, as well as detailing costs and whether interpreter or refugee specific services are available.
The Refugee Health Project Worker has consolidated the service coordination role into her position, and continues to raise awareness and knowledge about the importance of a collaborative approach to service delivery. The Project
Worker, working alongside the RHN and New Arrivals Worker, continue to support other agencies in meeting the specific demands of the refugee client.
Conclusions
Key agencies providing health and wellbeing support, including LCC, Centrelink, LRH and CWGDoGP are collaborating to deliver culturally sensitive services.
Health Education Sessions and other health promotion activities continue to be delivered directly to the refugee community. Topics of interest are discussed and relevant translated resources are provided in an ongoing effort to improve and promote the need for health awareness. Service providers are invited to join these sessions or host them with the Refugee Health Team’s support.
The effectiveness of the Project has contributed to the increase in people from a refugee background accessing LCHS for services and support. There has been an increase of over 250% with high numbers accessing services across all areas of care, including dental, community nursing, emergency relief, counselling and orientation support from the New Arrivals Worker. The RHN continues to work alongside GPs and other service providers in ensuring that clients receive holistic support in meeting multi-disciplinary demands for
Refugee Service Coordination Case Study Page 7 of 7 treatment and services.
There have been challenges to the Project. Data collected from agencies identified a continued reluctance by services to access interpreter services. This issue remains a key task to address. The Refugee Health Team at LCHS continues to offer cultural awareness training and support, including how to use an interpreter effectively.
There also continues to be a reluctance to introduce any refugee specific service, believing that generic delivery of services is effective. The Project Worker continues to advocate for enhanced culturally appropriate communication, coordination and referral pathways
between local primary care and specialist care providers. This will improve access for refugee clients, especially for those clients with multiple and complex health care needs.
Service coordination continues to be advocated through the Refugee Health Working Group under the Latrobe Settlement Committee. The Group has developed a Strategic Plan that has been drawn from information resourced from the Refugee Service Coordination Project and includes collaborative strategies to increase the capacity of services to meet their duty of care to their refugee clients. The Group will continue to identify the barriers to effective and culturally competent service delivery and work towards addressing those barriers.
References:
LCHS 2010 Quality of Care Report
http://lchs.com.au/assets/files/Quality%20of%20Care%20Report/LCHS_Quality_of_Care_R eport_2010.pdf
