	Immigrant and Refugee Resettlement: Resettlement Practice with Separated and Unaccompanied Children; Transition Services; Immigration, Citizenship and Naturalization Legal Assistance Services

Introduction

Administration and Management

Service Delivery Administration Standards

Service Standards

PA-IRR 1: Collaborative, Culturally,Competent Outreach

Effective, culturally competent outreach strategies connect potential service recipients with accurate, timely information about community resources and service availability and eligibility.

Interpretation: Culturally competent outreach includes knowledge and use of effective ways to reach individuals and families with limited English proficiency, limited education, low income level, fear of authorities, and limited understanding of how to pursue health and education services.

NA The agency provides only legal services.

PA-IRR 1.01

Agencies provide accurate information about service eligibility and availability directly and in cooperation with community service providers and individuals who dispense reliable information and have links to bona fide sources of information.

Interpretation: Agencies engaged in outreach activities should be aware that individuals in some communities misrepresent their ability to provide competent service and legal assistance, for example, “notarios” in U.S. Mexican-American communities. In such cases, loss of immigrants’ and refugees’ funds, documents, and status occurs when individuals mislead, require payment of inappropriate fees for services performed, and fail to document and follow-up actions in a timely manner. Agencies serving individuals who may be in need have an obligation to promote access to reputable services that provide full explanations of fees, and possible risks and benefits of services for the entire family.

Research Note: A two-phase qualitative study of agency implementation of laws sensitive to immigration status concludes that simplifying application procedures, overcoming language barriers, and conducting outreach in immigrant communities are important but not sufficient to expand access to or restoration of benefits, including health care. Involving immigrant communities and community-based organizations is considered essential, particularly when lack of trust is an issue for improving access and outcomes.

Research Note: An emerging body of professional literature has identified resource sharing, cross training strategies, and network development in the tradition of community building as most promising for increasing local knowledge and the most beneficial use of limited resources. The goal of cross training is to increase communication and knowledge between groups, thereby increasing effectiveness of service provision. The practice is advanced in some parts of the country through development of local and regional mechanisms to bring together public agencies, service providers, and refugee community based organization representatives to explain their structure, objectives, needs, and resources. One aim has been to create informal service provider networks with a common incentive to work together.

PA-IRR 1.02

Individuals who conduct outreach activities remain current about public assistance programs provided by community-based organizations open to all persons without regard to immigration status.

Interpretation: Agencies should be aware that some public assistance programs provided by community-based organizations have been designated by the U.S. Attorney General as open to all persons without regard to immigration status, including undocumented immigrants. Providers of services should be aware that battered immigrant women and children have been singled out for additional protection; therefore, agencies serving immigrant victims of domestic violence, sexual assault and trafficking can seek funding to provide assistance to “underserved populations.” Shelters, transitional housing programs, and domestic violence programs that receive federal funding can and must provide emergency shelter, transitional housing up to two years, and domestic violence service to all battered women, including those who are undocumented.

Agencies should be aware that non-profit legal assistance organizations receiving funding from the federal government, while barred from using federal dollars to assist most immigrants who are non-citizens, may use non-Legal Services Corporation (LCS) money to provide free legal services to certain groups of battered immigrants regardless of immigration status, including victims of domestic violence.

Research Note: A two year small scale study of Asian bi-cultural mental health clinic services use by Fuzhouneze immigrants confirms a strong association between undocumented status and poorer mental health outcome.

PA-IRR 1.03

Agencies use current local, regional, and state aggregate information about greatest immigrant and refugee needs and factors that limit access to services:

to prioritize and target outreach efforts; and
plan appropriate, flexible outreach activities.

Research Note: A small scale chart review and clinician survey study of client characteristics and bi-cultural mental health clinic service use by undocumented Fuzhouneze, indicate low client insight about illness, consistent with poor discharge planning results leading to re-hospitalization. The study found lack of insurance and low levels of support from and use of community and rehabilitation services for all groups. Suggested ways to improve direct services include increasing staff cultural expertise, and improving client access to services with flexible schedules and follow-up that take into account clients’ employment.

Research Note: Immigration employment studies find that immigrants hold a disproportionate number of jobs in small business, labor, service or trades that do not offer employer paid health insurance, including benefit use by adults with children. Implications for practice include combining outreach and service through offers of assistance with accessing health insurance for children.

Research Note: A survey of nine widely dispersed large metropolitan refugee health programs found that newcomer refugees were screened routinely for infectious diseases, but not chronic conditions, and raised questions about access to health related information, health prevention education, and sufficiency of resources.

Research Note: A quantitative study using household survey data for immigrant and U.S. born Mexican-Americans, and data on service providers most often used by those seeking help for mental health problems, found use of folk or natural healers was not as common a practice as indicated in earlier ethnographic studies. Female gender and knowing where to obtain treatment were two factors most strongly associated with seeking service, and most referrals came from medical practitioners not mental health providers, such as social workers and psychologists.

PA-IRR 1.04

The agency’s outreach activities take into account cultural barriers, lack of familiarity, and communication difficulties that can prevent the pursuit of needed mental health and health care services and support by immigrant school age youth.

Interpretation: The agency will develop and use partnerships with schools, community leaders, and public health agencies to understand unique perspectives and common factors that influence use of services by different immigrant groups. Public health strategies for reaching undocumented immigrants can be of interest to agencies that promote preventive care and early detection and treatment of communicable diseases.

PA-IRR 1.05

The agency participates as a resource for information in non-stigmatizing public awareness activities attended by reticent or otherwise socially isolated individuals and families.

Interpretation: Facilities and events that could be used heavily by immigrants include hospital emergency and mental health clinic settings, ethnic social and recreational activities, employment and housing information meetings, and community meals or gatherings for fellowship.

QUICK JUMP TO


	PURPOSE: Immigrants and refugees acquire the cross-cultural information, skills, and social support network needed to gain stability, make a positive personal and social adjustment, maintain family connections and well-being, and achieve educational, economic and civic participation goals.

RELATED FILES


	IMMIGRANT An individual not born in the United States, Puerto Rico, or an outlying US territory, who migrates from his/her country of nationality or any country in which they last habitually resided and chooses to seek a better economic, social or religious life abroad. Immigrants, and children of immigrants, can be citizens, Legal Permanent Residents "a step toward naturalization as a US citizen" or non-citizens, either legal or undocumented without legal status.


	REFUGEE Those who flee their home country because of persecution or a well-founded fear of persecution due to race, religion, nationality, membership in a particular social group, or political opinion and are unable or unwilling to return to, or avail themselves of, their home country.


	FAMILY Two or more people who consider themselves family and who assume obligations, functions, and responsibilities generally essential to healthy family life. Child care and child socialization, income support, long-term care, and other caregiving are among the functions of family life. The definition of "family" will rest with an individual's indication of who plays a family member role, including current or former foster family, adoptive family, extended family members, fictive kin, or significant others. Organizations that believe family is the central constellation in a child's life, and that family attachments are of primary importance for human development, will strive to work with professional staff to develop a common understanding of "family."


	OUTREACH Contact initiated by a provider to identify persons in need of services, to provide information to them about services and benefits, and to encourage the use of appropriate services.


	SERVICE RECIPIENT The individuals, groups, organizations, or communities that use, receive, or benefit from programs and services. Service recipients can include consumers, patients, family members, legal guardians, advocates, public/private organizations, employers, and purchasers. All are regarded as significant stakeholders served in a variety of agencies and practice settings.


	COMMUNITY A specific group of people living in the same locality and who may share a common culture, values, and norms. Communities can also be defined by race, religion, ethnicity, age, occupation, political status, tribal affiliation, interest in particular problems or outcomes, or other common bonds. The term "community" encompasses worksites, schools, tribes, residential neighborhoods, business districts, recreational areas, and health and human service sites.


	SERVICE One or more organization-operated programs or activities that have a common general objective and deploy the organization's material and human resources in a planned and systematic manner. An organization that publicly promotes or identifies itself in writing as offering a service, is licensed to deliver a service, assigns personnel and/or space to a service, or allocates financial resources to a service is considered to offer that service.


	ELIGIBILITY The degree to which an individual, family, group, or community meets the specific criteria and qualifications required to receive goods, benefits, or services.


	DISPENSE The act of processing a drug for delivery to a client pursuant to a practitioner's order. Dispensing medications includes the following: checking the directions on the label against the directions on the prescription or order to determine accuracy; selecting the drug from stock to fill the order; counting, measuring, compounding, or preparing the drug; placing the drug from stock into the proper container; affixing the label to the container; and adding any required notations to a written prescription.


	CASE A general term used to designate clients (including individuals, families, and groups) served by an organization for purposes of monitoring the provision of services. A foster care case is generally based on the placement of an individual child, although casework for the child may include services to the child's family. A child protective services case is based on an entire family household if a family assessment model is used; otherwise a case is defined as a child.


	TRAINING Instruction so as to make fit, qualified, or proficient in a skill or body of knowledge.


	PRACTICE Established actions or ways of proceeding in the regular performance of organizational duties. Policies and procedures often guide practice.


	OBJECTIVE A sub-goal stated in operational terms, i.e., a statement that makes clear what expected results are to be measured or assessed.


	CLIENT See service recipient.


	PROGRAM A system of services offered by an organization. For example, an organization providing a mental health service may offer several mental health programs to different populations, e.g., a mental health program for adolescent teens. The word "program" can be used interchangeably with the word "service" or to describe specific programs.


	PLANNING The process of specifying objectives, evaluating the means for their achievement, and exercising deliberate decision making about appropriate courses of action.


	PREVENTION Actions taken to minimize and/or eliminate social, psychological, or other conditions. Prevention can occur at the individual, group, community, and societal levels and enhances opportunities to achieve positive fulfillment.


	REFERRALS Resource suggestions provided to consumers to address problems or needs that are beyond the scope of the organization's mission.


	PSYCHOLOGIST A qualified professional who has a doctoral degree from a program of psychology accredited by or recognized as meeting the standards set by the American Psychological Association. A master's degree in psychology is an acceptable credential for the provision of counseling services provided that licensure is attained.