(1) Identifying resources for immigrant cancer patients:

We have developed a Directory of Cancer Services for immigrant patients, which we have used extensively to assist patients.  In the coming months, we will build on this Directory and post it online in a searchable format.

If you would like to add your organization to our Directory, or have suggestions for additional resources, please email us at portalproject@med.nyu.edu

(2) Training providers on the availability of these resources, as well as the barriers faced by immigrant patients:

We completed needs assessments to determine the cancer providers’ current knowledge, attitudes, and skills in providing care to immigrant patients.  Based on our findings, we have developed a training seminar for cancer providers on the availability and scope of cancer resources for immigrants, and on how to provide effective cancer care to the immigrant cancer patient, including issues of navigating cultural and linguistic barriers. 

(3) Assisting immigrant cancer patients in navigating their care and support services, including access to radiation therapy:

A major component of this project is to reach out to immigrants who have cancer but are facing difficulties meeting the demands of the disease.  To date, over 200 patients have been assisted in navigating their care and support services, and in accessing resources they need and for which they are eligible.  Services include: helping to identify resources for cancer care, register at hospital-based clinics, fulfill interpretation requests, resolve housing issues, seek legal assistance, procure financial assistance, obtain food, obtain Medicaid, start treatment, end unnecessary treatment, resolve bills, connect with support groups, obtain transportation including to radiation therapy, and enter into hospice care. 

If you or anybody you know is an immigrant with cancer and is in need of assistance, please contact us at portalproject@med.nyu.edu, or by phone at 212.263.8783.

In addition, on April 11th, 2007 we held a forum entitled: “Immigrant Cancer Access: A Discussion on the Portal Project.”  50 people from over 20 organizations in the New York area came together to discuss the issues surrounding access to an adequate standard of care for Immigrant Cancer Patients.  This new Network will continue to meet quarterly. For more information, including minutes of the meeting, and to join our “Immigrant Cancer Access Network” listserve, please email: vidya putcha@med.nyu.edu

Slides from the April 11th Discussion are available here:

Advocacy

The CHPIC project aims to leverage advocacy at the state and federal levels to foster legislative sensitivity to immigrant issues and concerns. The promotion of change at a systemic level complements outreach efforts. Specifically, CHPIC has conducted advocacy on immigrant health insurance concerns i.e. confidentiality, and implications for legalization and citizenship.

Public charge is a term used by the Immigration and Naturalization Services (INS) to describe persons who cannot support themselves and who depend on public benefits for their support. Widespread confusion over public charge had long deterred many eligible people from enrolling in social services programs. CHPIC has effectively advocated to bring public charge issues to the forefront of the immigration agenda, influencing the release of guidance surrounding this issue from the White House in May 1999. The guidance declared that the use of Medicaid, CHP, or other health services by immigrants or their families will not affect their immigration status.

CHPIC has successfully advocated with the New York State Department of Health (NYSDOH) for changes in the unified CHP/Medicaid application to provide greater confidentiality protections for immigrants, and to ensure that the form is sensitive to cultural and immigration issues.

Although the public charge issue has been resolved, some insurance concerns still persist, such as sponsor deeming for Medicaid. If an immigrant family has been sponsored into the U.S. after December 19, 1997, its sponsor's income can be 'deemed' available to the immigrant family when it applies for Medicaid, and will be considered to determine whether the family members meet Medicaid's financial eligibility criteria. If family members were sponsored into the US under the new affidavit of support (the I-864), they may be asked to disclose why their sponsor cannot continue to support them. Furthermore, for families sponsored under the new affidavit of support (I-864), the sponsor is responsible for the repayment of Medicaid dollars used by the family. CHPIC is continuing to advocate at the federal and state levels to obtain resolution for the sponsor deeming issue.

Materials Development

At the beginning of the CHPIC project, the only CHP educational materials available were NYSDOH CHP brochures and health plan brochures. These did not specifically address immigrant issues, nor were they in immigrants' languages. CHPIC developed CHP/Medicaid immigrant-specific brochures through an extensive community-based process: a team of concerned organizations was formed to develop the brochure blueprint and content; the brochure was translated and back-translated into several languages (Chinese, Spanish, Bengali, Haitian Creole); and focus groups were conducted with the community at various points during brochure development. This has been a unique and important contribution to the process of ensuring access to health care for all children in New York.

Outreach and Education

The CHPIC project has conducted intensive outreach to non-English proficient immigrant communities in Queens directly and through partnerships with organizations and schools. Education about insurance, managed care, and CHP/Medicaid has been conducted at non-healthcare sites, such as consulates and religious institutions, English as Second Language (ESL) classes, grocery stores, banks, and beauty salons.