Nebraska’s Collaboration in Working with Refugee Populations Kristin Gall, RN, BSN, MSN Community Health Nurse III Nebraska Department of Health and Human Services Lincoln, Nebraska

Nebraska’s TB Program  Rural State  Limited Staff  Local Health Departments Omaha Omaha Lincoln Lincoln Rural Rural

Foreign Born in Nebraska  Refugees 301 in Fiscal Year in Fiscal Year in Fiscal Year in Fiscal Year 2007  Secondary Migrants Families Families Jobs Jobs Meat Packing PlantsMeat Packing Plants (Department of State, 2008)

Refugee Challenges Accessing Health Care  Complex American Health System  Work Focused Environment  Language  Lack of Resources  Lack of Knowledge

Reasons for Education Among Agencies  Fear  Lack of Information  Local Health Department Request  Need Determined by State TB Program

Collaboration with Refugee Task Force  Refugee Resettlement Staff  Refugee Community  Local Organizations  Nebraska Refugee Resettlement Coordinator Karen Parde Karen Parde  Local Health Department Staff

Colleges  Foreign Born Students  Policy Need  “TB On the College Campus”  Staff Helping Students

Target TB Education for Groups that Serve Refugees in Communities  Lexington, Nebraska Community Members (School, Hospital, Health and Human Service Workers) Community Members (School, Hospital, Health and Human Service Workers) Health Department and Local Providers Health Department and Local Providers Clinic Clinic State Quarterly Meetings State Quarterly Meetings

Meat Packing Plant Collaboration  “Red Meat” Education Basic TB Information Basic TB Information Contact Investigation Contact Investigation Refugee Background Information Refugee Background Information Screening Requirements Screening Requirements  Contacts with Meat Packing Plant

Education for Direct Care Staff  Refugee Resettlement Staff Basic TB Information Basic TB Information  Employment First Group Arbor Group Arbor Group

Health Care Providers  Creighton-Florence Clinic, Omaha QuantiFERON®-TB Gold Update QuantiFERON®-TB Gold Update University of Nebraska Public Health LabUniversity of Nebraska Public Health Lab State PresenceState Presence Pilot StudyPilot Study  Local Conferences  Local Health Departments

Collaboration between States  Minnesota Website for Language Materials Website for Language Materials DVD (audio and visual) DVD (audio and visual)

Future Goals  Correctional Facilities  Minnesota DVD Distribution  Quarterly Conference Calls