Grant Proposal: New

Arrivals Institute
Sana Ansari & Elizabeth Qua Lynch
HEA 702

Table of Contents
Organizational Overview ..2
Problem Statement.....3
Program Goal and Objectives ...6
Budget....7
Budget Justification....8
Case Manager Job Description .....10

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ORGANIZATIONAL OVERVIEW
The New Arrivals Institute (NAI) promotes immigrant and refugee self-sufficiency and
integration into life in the U.S. by providing ESOL teaching, vocational education training,
community orientation classes, and citizenship classes. Classes are offered Monday-Friday
during the mornings and evenings in order to accommodate students work schedules. Two
congregational nurses provide basic health checkups and referrals to doctor appointments twice a
week. NAI serves approximately 500 refugees and immigrants each fiscal year and maintains
consistent interaction with students long after their services with the resettlement agency ends.
NAI is known by providers as the go-to-agency for immigrant and refugee services, since
services that NAI provides extend beyond a refugees initial case management services at the
refugee resettlement agency.

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PROBLEM STATEMENT
Broad Societal Need
The Piedmont Triad is home to a growing population of refugees from throughout the world. The
Triad itself comprises the largest concentration of Montagnard refugees outside of Vietnam; in
2008, their numbers were roughly 7,000. Meanwhile, North Carolina as a whole has the fourth
largest population of Hmong refugees, with 15,000 of them resettling here by 2008. The last
decade has seen an influx of refugees from Burma, Bhutan, Iraq, and African countries including
the Democratic Republic of Congo, Eritrea, Somalia, and Sudan.
Specific Concerns of Refugees in Guilford County
A review of health assessment records of refugees resettled in Guilford County found a large
range of chronic conditions, including heart disease, diabetes, hypertension, poor oral care, and
vision problems. Many also suffer mental health concerns, such as post-traumatic stress disorder
(PTSD) and depression, resulting from trauma in their homelands. Refugees also carry a burden
of infectious diseases, such as latent tuberculosis and parasites due to previous exposures and
circumstances of their migration.
The health concerns facing refugees are often unique to their place of origin. For example,
refugees from Burma frequently have poor personal hygiene care, Bhutanese refugees experience
high levels of depression and have suicide rates that are three times higher than the general
public, and refugees from Iraq and the DRC generally experience high rates of trauma and
PTSD.
Despite Greensboros myriad of resources available to refugees and immigrants, there is a gap in
health services that target chronic disease management and mental health care. Refugees are
usually coming from camps and enclosed areas that have little to no available health
services. Because of these past experiences, they may not be aware of any current health
concerns nor know how to properly manage their health.
Refugee Resettlement in the United States
Once refugees arrive to the U.S., they are enrolled in the Reception and Placement (R&P)
program in which they receive intensive case management for their initial six months. Health
services that are required during the R&P period include: helping refugees apply for EBT
benefits and Medicaid, taking refugees to their health screening appointments, and getting
refugees connected with a primary care doctor. Refugee resettlement agencies have limited
funding to spend on each refugee family and therefore emphasize economic self-sufficiency
above all else. Refugees are enrolled into one of three employment programs: Refugee Cash
Assistance, the Matching Grant (M&G) and Temporary Assistance to Needy Families (TANF).
Employment staff members work closely with each refugee adult until they are hired. As
refugees gain employment and work full time schedules, their interactions with their resettlement
case managers decrease. Refugees may need help accessing health services such as: scheduling
medical appointments, getting their prescriptions filled, traveling to medical appointments,
finding appropriate medical providers, and understanding their Medicaid coverage. However,
refugees find themselves busy with work and unable to find someone to help them.
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Case Study: A Refugees Story

Meera, a 40 year old widow from Bhutan who spoke little English, arrived to the United States in
2006 with her 4 children of grade school ages. Meera began receiving assistance from a local
refugee resettlement agency through the R&P Program and was referred to the M&G Program
for employment assistance. Meera, like many others, was introduced to not only a new way of
living but a new pallet of foods once moving to the States. Meera quickly developed diabetes and
her children gained an unhealthy amount of weight, while the family had an extremely
minimalistic income. Meeras health worsened and she was prescribed insulin to help manage
her symptoms. Along with insulin came a new diet regimen, blood glucose testing strips,
needles, etc. ---all of which Meera did not understand how to use.
Struggling to provide for her family, she attempted to recertify her EBT benefits at the local
Department of Social Services, but was unfortunately denied services because staff were unable
to communicate the instructions of how to fill out the paperwork. Meera then enrolled in ESOL
classes at the New Arrivals Institute (NAI). Over time, she learned to hold a minimal
conversation and was able to find employment as a janitor. Once Meera began working, she was
no longer eligible to receive funding from the resettlement agency. Meera became increasingly
stressed and began to slip into a state of depression, while simultaneously experiencing
extremely high peaks in her glucose levels. Six months later, her glucose levels reached an alltime high, prompting her into a diabetic coma and passing away due to complications three
weeks later. Meeras 4 children were left alone with no family members around to provide for
them.
Perhaps if Meera had a health case manager following up with her medical appointments and
ensuring that she took her insulin/medication properly and consumed a healthy diet, she would
not have had a diabetic coma. Instead, Meera would have managed her diabetes symptoms,
received food stamp assistance, and possibly passed along knowledge of healthy living practices
to her children, which could have assisted them with losing weight and preventing the long term
health consequences of obesity and poor diet.
New Arrivals Institute
Stories like Meeras are common at NAI. With NAIs programs being 5 days per week, staff
members have more direct contact with refugees than resettlement agencies. Because of this
constant interaction, NAIs staff is more accessible and refugees feel comfortable asking them
for assistance. NAIs staff has noticed an increased necessity for health case management
addressing chronic disease management, nutritional instruction, and assistance in navigating the
healthcare system, like Meeras case.
Proposed Solution
Because refugees make up a substantial portion of the overall population of Guilford County,
improving their health will create vibrant and healthier communities, while generating a more
economically productive workforce. NAI hopes to hire a full-time healthcare worker to fill in the
gap of services to this population. The approach that NAI wants to take in solving this problem is
unique in Guilford County. Similar ESOL organizations that serve the same population do not
offer specific health case management. NAI has been the first organization to pioneer this effort,
and their past success is evidence that a permanent health worker will benefit the
immigrant/refugee population at large. In the past, NAI offered case management through the
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assistance of interns. The interns were successful but because they were temporary workers, their
effectiveness was limited. The refugees need consistency and direct contact when they are in
need of assistance. A health worker will provide the long-term consistency and stability needed.
Such services will lead to an increased population of immigrants and refugees learning to
manage their health concerns, navigate the health field, and become acclimated to life in the
United States.

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PROGRAM GOAL AND OBJECTIVES

Non-Measurable Goal:
Increase health case management services for refugees beyond the initial reception and
placement phase in Guilford County
Measurable Objectives:
1. Promote adoption of healthy behaviors through health promotion and disease prevention
strategies
Case Manager will develop health education curriculum and translate health
information into various refugee languages (e.g. Arabic, Burmese, Karen, Nepali,
and Swahili).
Case Manager will teach health education classes to refugee clients on various
topics including nutrition, chronic diseases, and prevention strategies (i.e.
tobacco, alcohol use, etc.)
Case Manager will teach chronic disease management (if applicable) by providing
one-on-one follow-up
Setting up easy to follow medication schedule
Teaching clients how to use medical supplies (ex. insulin needles and
strips, blood pressure monitors)
2. Increase awareness of refugee health needs to health providers
Case Manager will conduct/attend monthly meetings with health providers to
advocate for refugee health needs
Case Manager will work with interpreters to translate patient intake paperwork
Case Manager will advocate for the use of interpreter services during medical
appointments with clients
3. Increase refugee access to health services
Case Manager will assist clients with reapplication of EBT and Medicaid services
Case Manager will assist clients in navigating the healthcare system
locating service providers that meet the clients needs
assisting clients in scheduling medical appointments
developing a laminated info/fact card with clients pertinent information,
(name, age, address, physicians contact info, languages spoken, health
concerns)
following up with clients after their appointments to ensure that clients
understand doctors orders

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BUDGET
Annual Budget for Year 1
Expenses
Personnel Salaries
Executive Director
Case Manager
Interpreters

Estimated Dollar Amount

$5,500
$40,000
$4,000

Office Space
Office Rent / Utilities

$3,600

Equipment
Computer + Printer
Work Cell Phone
Medical Supplies

$1,500
$800
$1,000

Travel
Mileage

$560

Training
Registration Fees
Training Materials

$1,000
$400

Other
Outreach/Printing
Office Supplies
Total

$500
$1,200
$60,060

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BUDGET JUSTIFICATION
1. Executive Director - The director will provide oversight to the case manager utilizing X
percent of her time. Total salary and benefits are calculated as:
Salary

$4,160

FICA

$318.24

Unemployment

$570.096

Wks Comp

$120

Health Insurance $240

Total

$5,408.336

2. Health Case Manager - This is a new position at NAI. The individual will either have a
Masters in Public Health or Masters in Social Work. This position will be funded 100%
through this grant. Total salary and benefits are calculated as follows:
Salary

$32,760

FICA

$2,506.14

Unemployment

$570.096

Wks Comp

$300

Health Insurance $3,600

Total

$39,736.236

3. Interpreters - Interpreters will be paid $20/hour to translate health documents into other
refugee languages and assist in translating conversations between clients and the case
manager as needed. It is estimated that the total hours an interpreter will be utilized is 200,
which equals $4,000.
4. Office Rent/Utilities - This will cover the overhead costs that NAI will incur due to having a
new staff member at the agency. The estimated annual cost will be $300 per month, which
equals $3,600.
5. Computer / Printer - This will cover the costs of purchasing a computer and printer for the
case manager. The total costs will be $1,000 for a laptop and $500 for a printer, which equals
$1,500.
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6. Work Phone - This will cover the costs of purchasing a work cell phone. This will be used
to communicate with other staff, clients, and community partners. The total costs will be
$200 for a cell phone and $50 per month for phone service (talk, text, and internet), which
equals $800.
7. Medical Supplies - This will cover the costs of purchasing BP monitors, sugar testing strips,
etc. which will be utilized during health classes. The estimated yearly cost is $1,000.
8. Mileage- The case manager will travel to the sites where meetings and trainings will be
conducted. Mileage is calculated at the current state rate of $0.56/mile. The estimated yearly
cost is $560.
9. Registration Fees - This will cover the cost of registration fees for any trainings/conferences
that the case manager attends. The estimated yearly cost is $1,000.
10. Training Materials - This will cover the cost of educational materials that the case manager
will purchase at trainings/conferences. The estimated yearly cost is $400.
11. Outreach / Printing - This will cover the cost of printing materials such as pamphlets and
brochures. These will be distributed to clients to increase their knowledge of health concerns
and community partners to increase their knowledge and awareness of refugee needs. The
estimated yearly cost is $500.
12. Office Supplies - This will cover the cost of ink, paper, pens, pencils, lamentation machine,
and other supplies as needed by the case manager. The estimated yearly cost is $1,200.

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JOB DESCRIPTION

Job Title: Community Health Worker/Case Manager

Supervisor: Executive Director
Exempt/Non-exempt: Non-Exempt
Summary (A brief description that summarizes the purpose and objectives of the position.):
Assist individuals and communities in adopting healthy behaviors while helping to conduct
outreach and advocate for individuals and community health needs while establishing resource
and referral processes. Activities include: education, guidance, and outreach to improve health
outcomes in underserved communities, education and outreach regarding health insurance,
enrollment of residents into appropriate health care and community programs.
Essential Functions (List the tasks, duties, and responsibilities of the position.)
Work with the Executive Director and Outreach Director in performing outreach to both the
refugee and health care provider communities.
Establish resource and referral processes to positively impact refugee communities and expand
their access to and use of the local health care system.
Provide information and referral services for clients.
Act as a Health Navigator and Health Advocate for individual clients and families.
Develop lessons with the Executive Director that meets the needs of the students and the goals of
the program
Teach Health Education classes
Develop Health tools that can be used by refugees and health care providers to improve overall
health outcomes.
Complete community partner paperwork and testing as needed
Conduct quarterly reports

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Keep accurate records on individual student attendance and progress in Case Notes and RIS
Supervisory Responsibilities, if any (The scope of the persons authority, including the positions
that report to the incumbent.):
Supervise volunteers assisting with the health related services program

Working Conditions (please complete the information listed below):

Usual office conditions
Usual office conditions with occasional exposure to some undesirable elements*

*List the undesirable elements with the percent of the work day exposed to the elements.
1. Possible exposure to undesirable elements during health appointments

___10__%

2. ______________________________________________________________
_______%
3. _________________________________________________________
_______%
Physical Effort (please complete the information listed below):
The job duties require lifting or moving moderate to heavy materials as a regular part of the job.

No
*List the activity requiring physical effort, the weight or effort required (in pounds) and the
percent of the work day spent in actual, hand-on movement of weight:
Activity
Weight of Materials

% of day

1. ____________________________________________
________

_____________

2. ____________________________________________
________

_____________

Minimum Job Requirements:

Education: Bachelors or equivalent experience in social work or public health
Experience: Assisting non-native English speakers with accessing health and/or case management
services. Teaching non-native English Speakers, Designing Competency Based Curriculum
Specific skills/abilities: Knowledge of how to navigate the health care system, liaison with service
providers, developing resource and/or referral processes, developing and presenting lesson plans
and curriculum.
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Specialized knowledge, licenses, etc.: Must be able to use MS Office and RIS database
Success Factors (Personal characteristics that contribute to an individuals ability to excel):
A Community Health Worker must enjoy working with clients of varying Educational and
Ethnic backgrounds and have the ability to evaluate client needs and develop a plan to meet
those needs. S/he should be comfortable working as a liaison between clients and community
health providers and developing referral processes. S/he must be able to design and
implement Health Education curriculum and also be able to work with volunteers and
receive guidance from the Executive Director.

This job description is not an employment contract. New Arrivals Institute reserves the right to
alter the job description at any time without notice.

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