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"How can continuity of care be improved for immigrants, refugees, and…
"How can
continuity of care
be improved for immigrants, refugees, and newcomers in Alberta after
emergency visits
, and
initial government-required health assessments
?"
Immigration Economics
33.#ImmigrationMatters: Canada’s immigration track record :classical_building:
Immigrants account for
32% of all business owners
32. Surge in Refugee Healthcare Costs Strains Canada’s System
:newspaper:
$411 million to fund the Interim Federal Health Program (IFHP)
34.Feds want $411 million to cover refugee health care as the number of new arrivals soars
:newspaper:
Sevenfold increase
in refugee health-care costs in the last eight years
35.*
36.
Immigrants account for 1 in 4 health care sector workers.
:hospital:
25% of registered nurses
42% of nurse aides and related occupations
43% of pharmacists
37% of physicians
45% of dentists
61% of dental
29.Canada has a doctor shortage, but thousands of foreign-trained physicians already here still face barriers :newspaper::red_cross:
Expensive test,
limited residency spots
, no options in Canada to meet requirements
Need for Less Red Tape :red_cross:
Politics - Changing Rhetoric :classical_building:
21. Anti-immigrant politics is fueling hate toward South Asian people in Canada
:newspaper:
22.Canada launches ad campaign warning newcomers claiming asylum is ‘not easy’
:newspaper:
20.One of the World’s Most Immigrant-Friendly Countries Is Changing Course
:newspaper:
Current Primary Care Services & Community-Based Programs
52.Alberta's new primary care agency to launch by Nov. 1 in health overhaul :newspaper: :hospital:
"We've created a new organization, but the real decisions on funding and on training will remain in the minister's office."
Primary Care Alberta will work to
improve access
to providers like family doctors and nurse practitioners, create
new primary care models
and increase access to
after-hours care through virtual means.
53.Calgary Refugee Health Clinic could shut down with majority of funding pulled, doctor warns :red_cross:
:newspaper:
57.
Mosaic’s Refugee Health Clinic
:unlock:
Women’s health
: family planning, pregnancy and postpartum care, and ob/gyn :baby:
Family health:
tropical diseases, annual exams, preventative care, acute medical issues, health education, help accessing social services and interpreters, dental, and optometry :family:
Children’s health:
full primary care, immunizations, nutrition services, and a pediatric specialty clinic :children_crossing:
Mental health:
help with sleep disorders, depressed mood, anxiety, a psychiatrist specialty clinic, psychology and shared mental health sessions :face_with_head_bandage:
Transition services:
after two years (or sooner), we connect patients to a family doctor in their community :link:
54.Edmonton Immigrant Services Association (EISA) :unlock: :speaking_head_in_silhouette:
Settlement Services, Support Services, ESL Class, Community integration
55.New Canadians Health Centre :unlock: :female-doctor::skin-tone-4: :male-doctor::skin-tone-4:
Provides coordinated and multidisciplinary refugee-centered primary health care
56.Refugee Health Coalition :unlock: :bridge_at_night:
Address the unique barriers that refugees face in the healthcare system in Edmonton.
Aims to bridge the gap between community organizations and the healthcare system.
43.Immigrant Services Calgary :unlock: :construction_worker::skin-tone-6:
Ensure families and individuals have the support needed to successfully begin a new chapter of their lives in Canada.
Insight on daily life in Canada, guide for Calgary job market, building sense of belonging in Canada, assessing English language skills, and learning about government benefits and community resources
Risk of Deportations :airplane:
Initial Government-Required Assessment (IME) :mag:
8.
Interim Federal Health Program: What is covered
:classical_building:
Medical support needed for safe travel
Registered Medavie Blue Cross providers
Determine client eligibility before providing services
Basic coverage (in-patient and out-patient hospital services, services from health care professionals licensed in Canada, Vaccinations including pre- and post-natal care, laboratory, diagnostic and ambulance services)
Supplemental coverage (limited vision and urgent dental care, limited services from allied health care practitioners, limited assistive devices)
One Immigration Medical Exam (IME)
Policy - Access
17.
Medical Inadmissibility :no_entry:
Danger to public health
Danger to public safety
Excessive demand on health or social services
19.
Immigration Law Section of the Canadian Bar Association
:classical_building:
Resolving limitations on operationalizing excessive demand policy
Reducing the number of overturned
excessive demand cases
Enforcing mitigation plans undertaken by applicants in their
signed declarations of ability and intent
Immigration and Refugee Protection Act (S.C. 2001, c. 27) :classical_building:
18.*
13.Health Care Coverage for Refugees
:classical_building::
Signed Confirmation of Permanent Resident document or a Permanent Resident Card issued by Immigration, Refugee and Citizenship Canada (IRCC)
Apply for Healthcare Coverage
16.
Alberta Health Care Insurance Plan
:unlock:
15.Health Care Coverage for Temporary Resident
s
:classical_building:
Establish residency
Buy or rent a home intend to live in for a minimum of 12 consecutive months
Have an acceptable Canada entry document issued by Immigration, Refugees and Citizenship Canada (IRCC) or the Canada Border Services Agency (CBSA) (Study permit, work permit (over 6 months), notice of decision letter)
The document must have a minimum of 6 months remaining until the expiry date
14.
Canadian Children of Non Eligible Parents
:classical_building:
The child has a Canadian birth certificate or Canadian citizenship card/certificate
The parent claims intent to live in province for a minimum of 12 months the parent provides proof of residency
The child is not claiming residency or obtaining benefits under a claim of residency in another province, territory, or country
The child or parent is not a tourist, transient, or visitor to Alberta
9.IFHP Outline of Services :unlock:
10.IFHP Benefit Grid - Supplemental Coverage :unlock:
12.Dental Benefit Grid :unlock:
11.Just for You - Immigrants :unlock:
Research - Barriers
46.Adjusting the Canadian Healthcare System to Meet Newcomer Needs :fountain_pen: :maple_leaf:
Responsive, accessible services
Increasing
cultural competence
Targeted newcomer health services
Increasing awareness of health services
Newcomer engagement in planning and partnerships
44.Barriers and Facilitators to Health Care for Newcomers :confused: :male-doctor::skin-tone-5:
Problems with eligibility and entitlement
Emergency or not? A
care gap for the uninsured
Lack of care provider knowledge and skills
Patient
unfamiliarity
with new systems
Mistrust
of government and services
45.Newcomers Navigating Healthcare :speaking_head_in_silhouette:
Newcomer patients often
feel unheard and might avoid
healthcare services.
Existing healthcare systems are often
inequitable
and are
not easy to understand and use
for newcomers.
Different health, social, and community services are
not well integrated
.
Provide patient-and-family-culturally sensitive,
trauma-and-violence-informed care :blue_book:
47.Empowerment and integration of refugee women: a transdisciplinary approach :fountain_pen: :womens:
"
Gender-focused
approach is essential for providing tailored integration support"
Use trained interpreters :speaking_head_in_silhouette: :speech_balloon:
Provide more time for newcomers’ during initial medical
appointments :timer_clock:
Bridge physical and mental health :runner::skin-tone-2: :face_with_head_bandage:
48.The Immigrant and Refugee Mental Health Project :computer: :female-doctor:
Provide
online training
, tools and resources to settlement, social and
health service professionals
working with immigrants and refugees
Simplify healthcare systems :hospital:
39.How can you improve your mental health as a newcomer?
Most common challenges Newcomers Experience
Housing :house_buildings:
Employment :construction_worker:
Mental health difficulties :face_with_head_bandage:
Technological- Innovative ways in overcoming barriers :iphone:
40.Interpreter services and effect on healthcare - a systematic review of the impact of different types of interpreters on patient outcome :fountain_pen: :speech_balloon:
In-person
Professional interpreters
resulted in the greatest satisfaction and best communication outcome for patients.
Relational interpreters
can provide valuable insights
I have seen this as a repeated issue in hospital, due to time constraints :timer_clock:
41.Clicking into healthcare: How newcomers to Canada perceive and experience virtual care :fountain_pen: :eyes:
-
Health care was often not a first priority
for newcomers as they prioritize housing, employment, and enrolling their children in school.
e-COMPASS project, which will co-design and test an intervention to
address compassion fatigue
in refugee-serving community organization
Creating model that
engage diverse voices
to redesign the diagnostic phase of cancer care, informed by the
lived experiences
of Black, Francophone, and newcomer communities.
42.Can Digital Health Improve Healthcare Access for Migrants :newspaper: :iphone:
Communication through
video calls
, and patients can do
self-helping measurements or monitoring
with applications on a smartphone
Digital REACH Initiative
(coordinate a regional roadmap
for digital health to deliver quality health services and public health regulation to migrants and border communities)
Health
information dissemination and online counselling and interventions
, which were delivered online through social media and conferencing applications (e.g., Telegram, WhatsApp, Facebook, WeChat, Twitter, and Zoom)
Youth Barriers
38.Immigrant, refugee youth end up in ER for mental health care more than others: study :newspaper: :face_with_head_bandage:
- “First point of contact”
37.Cultural distance and emotional problems among immigrant and refugee youth in Canada: Findings from the New Canadian Child and Youth Study (NCCYS)
:fountain_pen::face_with_head_bandage:
Family environment variables, particularly
parental depression and harsh parenting
, accounted for about one third of the effect of Cultural Distance
Immigrant youth from culturally distant backgrounds were more likely to
perceive discrimination
than youth from culturally closer backgrounds
The longer youth from culturally distant backgrounds lived in Canada, the
worse their mental health tended to b
e: for youth from culturally closer backgrounds, the opposite was true.
What is Continuity of Care?
"Continuity of care is about improving Albertans’ health through stronger,
ongoing
relationships with their family physician or nurse practitioner and team, increased
information sharing
and enhanced
care coordination.
"
*
Primary Care Resources
2. 811 Health Link
:unlock: :iphone:
4. Harm Reduction
:<3:
7.Medical Home :house_buildings:
:
3. 211 Alberta
:unlock: :phone::face_with_head_bandage:
5.
Find A Doctor
:male-doctor::skin-tone-4: :female-doctor::skin-tone-3:
:unlock:
Clinical's Gender & Language
6.
Primary Healthcare Panel Reports
:mag:
Information on their patients’
continuity
, as well as valuable data on screening and vaccination rates, chronic conditions, pharmaceutical use, and
emergency and hospital visits
Availability of Care Provider :female-doctor::skin-tone-6:
Long Wait Time :timer_clock::
23.
Patients
,
providers
suffer as ERs are
overwhelmed
yet again: CMA
:speech_balloon:
26.Insight: Why are patients spending 22 hours in the emergency room waiting for a hospital bed?
:timer_clock: :newspaper:
Only 23% of patients were
admitted within eight hours
, meeting the provincial target time. :timer_clock:
An estimated 6.5 million Canadians don’t have a family doctor. One-third of people who do find it
difficult to book an appointment
. :male-doctor::skin-tone-6: :female-doctor::skin-tone-4:
30.Hospital Occupancy
:bed:
July - September 2024
Foothills (Calgary) 94%
Royal Alexandra (Edmonton) 97%
University of Alberta Hospital (Edmonton) 110%
24.1 in 7 visits to the emergency department are for conditions that could potentially have been managed in primary care
:newspaper:
27.'I don't think I'll last': How Canada's emergency room crisis could be killing thousands
:newspaper: :timer_clock:
28.Why ERs are under intense pressure across Canada — and how to help fix them
Canada is facing a
critical shortage of family doctors
51.Access to primary care: Many Canadians face challenges :hospital: :mag:
1 in 7 visits to the ED were conditioned that could potentially be
managed in primary care
Over half of these could potentially be managed virtually
17% of Canadian Adult do
not have regular health care provider
74% of Canadians Adult are
not able to get a same- or next day appointmen
t to see a doctor or a nurse
77% of Canadian Adults do
not find it easy
to access medical care in the evening or weekend or holidays
25.Why patients are waiting so long in emergency rooms across Canada
:timer_clock: :newspaper:
Primary Care Physician Shortage :female-doctor::skin-tone-5:
31.Meet some of the 6 million Canadians who don't have a family doctor :newspaper: :red_cross:
Canadians waiting over
3 years on waiting lists
, population getting
older
, there needs to be
more residencies spots
After our initial
government mandated baby immunization
, me and my sister did not have a family doctor for the first three years of our life. My
mom did not know any English
and
my dad was working everyday
. The necessity for a family doctor only arise after I turned three and was not speaking anywhere near as many word as my sisters. Fortunately, after completing ESL classes and a
referral from a family friend
I was able to see my first family doctors, who connected us with a
specialist
, where I discovered I had hearing loss.
50.Access to healthcare :hospital:
Fundamental human right for all, including refugees. Ensuring that refugees have access to healthcare is a top priority for UNHCR
Sustainable Development Goal
(SDG) 3, :earth_americas: “To ensure healthy lives and promote well-being for all at all ages”
49.WHO Recommendations on Migrant Healthcare :earth_americas:
Universal Health Coverage (UHC)
fully accessible
be language and culture sensitive
be able to monitor the health needs of refugees and migrants and evaluate the efficacy of interventions.
Language Barrier
