1. 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

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

3. Foreign Born in Nebraska  Refugees 301 in Fiscal Year 2006 301 in Fiscal Year 2006 490 in Fiscal Year 2007 490 in Fiscal Year 2007  Secondary Migrants Families Families Jobs Jobs Meat Packing PlantsMeat Packing Plants (Department of State, 2008)

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

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

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

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

9. 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

10. 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

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

12. 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

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

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