NURS-FPX 6618 Assessment 2 Instructions: Mobilizing Care for an Immigrant Population Essay

NURS-FPX 6618 Assessment 2 Instructions: Mobilizing Care for an Immigrant Population Essay

Mobilizing Care for an Immigrant Population

Migration is a profound social determinant of health (SDOH) that significantly affects immigrants’ access to quality care. According to Martinez-Donate et al. (2020), immigrants are often susceptible to discrimination, poverty, violence, and stress associated with acculturation. Despite these challenges, the population of immigrants has been on a steady upsurge in the last decades. Batalova, Marry Hanna & Christopher (2021) argue that the number of immigrants in the United States surpassed 44 million in 2019. A rapidly increasing population of immigrants living in the United States corresponds to a higher demand for population-centered care and the need to address poor social determinants of health that expose immigrants to disparate access to quality and timely care. More essentially, it is vital to consider the challenges that affect undocumented immigrants. Ornelas et al. (2020) contend that approximately 11 million immigrants live in the country and face significant limitations regarding access to care and quality of life. Therefore, this paper presents a plan for mobilizing care for Latino immigrants. It focuses on the health needs of the selected population, characteristics that define them, current organizational policies that provide health for immigrants and refugees, and assumptions regarding Latino immigrants.

Health Care Needs of the Latino Immigrant Population

The Latino population represents the steadily-growing ethnic minority group in the United States, considering the country’s proximity to countries like Mexico, Honduras, Nicaragua, El Salvador, and Guatemala. While the Latino population is ever-growing, immigrants account for about 34% of the population (Ornelas et al., 2020). Many Latino immigrants lack the vital documents necessary for residency authorization (about 18%) (Cabral & Cuevas, 2020). Also, approximately 50% of immigrants from Latin countries like Mexico grapple with uninsurance, underinsurance, and limited access to quality health services (Gómez et al., 2019). These factors significantly affect Latino immigrants’ quality of life and health status.

Besides limited access to care, uninsurance, and underinsurance, Latino immigrants struggle with multiple health concerns exacerbated by unfavorable social determinants of health. Gómez et al. (2019) argue that low educational attainment, unemployment, poverty, and work-related stress are among the factors that contribute to the poor health status of Latino immigrants. Consistent with these determinants of health, this population grapples with a high prevalence of mental health conditions, increased risk of unhealthy behaviors like smoking, and chronic conditions. According to Ornelas et al. (2020), mental health conditions among Latino immigrants emanate from exposure to traumatic events, employment stress, chronic financial pressure, and limited access to social support systems. These challenges require organizational-level policies and interagency care coordination practices to improve the population’s health outcomes.

Characteristics that Define Latino Immigrant Population

Despite challenges facing Latino immigrants, they exhibit various cultural characteristics and values that provide a strong incentive for improving health outcomes. Among the most profound cultural beliefs and norms are familism (familismo) and education (educación). According to Cycyk & Hammer (2018), the familism cultural perspective emphasizes family units as the basis of social relationships. It focuses on honoring and prioritizing supportive family-based relationships and interconnectedness. Familism underpins other values, including individual responsibility, honor, respect, interpersonal cohesion, and unity (Corona et al., 2019). On the other hand, the “educación” cultural dimension encompasses the moral obligation to educate children about ethical behaviors, including obedience, responsibility, and respect (Cycyk & Hammer, 2018). The two core beliefs influence the health and wellness of Latino immigrants by contributing to resilience, promoting healthy behaviors, and capitalizing on the role of interpersonal connections and social support.

Organizations and Stakeholders who Must Participate in Caring for Latino Immigrants

Inter-organizational collaboration and team-based approach are profound in promoting care for Latino immigrants. In this case, an interagency approach can promote the effective improvement of medical and non-medical factors influencing population health, including educational policies, income, social security, and social conditions (Alderwick et al., 2021). When coordinating care for Latino immigrants, it is essential to engage organizations and stakeholders, including the federal and state governments, private and public insurance providers, volunteer groups, non-governmental organizations, community-based organizations such as religious institutions, and healthcare professionals. Healthcare professionals like nurses, physicians, pharmacists, and social workers can provide fundamental care to immigrants, spearhead research activities, influence policies, safeguard the population’s right to equity, and advocate for social justice (Gunn, Somani & Muntaner, 2021). Therefore, they must participate in all-concerted policies and efforts to improve immigrants’ health.

Current Organizational Policies for Providing Healthcare to Immigrants and Refugees in the United States

The institutional-level policies for providing care to immigrants align with the current legislation and laws that protect and guarantee access to quality care for vulnerable populations. These policies include incorporating telehealth technology into health promotion programs to provide preventive healthcare services to rural underserved communities. This policy is consistent with the Juntos Por la Salud initiative facilitated by the US/Mexico Border Health Communication (CSFMEU). According to Gómez et al. (2019), this bilateral initiative aims to alleviate barriers to healthcare by providing culturally responsive services, addressing affordability gaps, and applying linguistically appropriate communication approaches. Besides the telehealth policy, the organization aligns its services with the Emergency Medical Treatment and Labor Act (EMTALA) of 1986. In this case, the organization encourages appropriate screening, stabilization, and transferring of patients with emergent conditions regardless of their ability to pay or insurance status (McKenna et al., 2018). This policy is essential in addressing affordability barriers and preventing structural discrimination of vulnerable populations, including undocumented immigrants.

Assumptions and Biases Associated with Latino Immigrants

Latino immigrants face discrimination through residential segregation, racism, and structural discrimination. According to Szaflarski & Bauldry (2019), these forms of discrimination result in disparate access to education, healthcare, employment opportunities, and social services. Uninformed assumptions and negative biases contribute to racism and discrimination. For example, Latino immigrants are susceptible to political rhetoric and anti-immigrant sentiments that stereotype them as criminals, people of lower social status, and drug and substance abusers (Ornelas et al., 2020). These factors expose immigrants to stringent migration policies, targeted arrests by police, and violence.

Besides these assumptions and biases, language differences contribute to disparate access to quality care for Latino immigrants. According to Oh et al. (2020), Spanish-speaking Latinos grapple with limited English proficiency, meaning they face challenges when interacting with healthcare professionals. Further, the language barrier affects individual willingness to seek professional care and adherence to treatment interventions. Also, limited English proficiency affects people’s self-esteem and reduces motivation to collaborate with healthcare professionals. Therefore, it is essential to consider the language barrier as a profound determinant of health in Latino immigrants.

Two US Healthcare Policies, National Initiatives, or Pieces of Legislation that Guide Current Standards of Care for Immigrants and Refugee Populations

The Affordable Care Act (ACA) of 2010 and the Emergency Medical Treatment and Labor Act (EMTALA) of 1986 remain landmark policies that promote the care of vulnerable populations, including immigrants. According to Ornelas et al. (2020), ACA significantly increased access to health insurance coverage to uninsured people through Medicaid expansion and state insurance exchanges. On the other hand, EMTALA strives to prevent the tendency to refuse to treat patients who cannot pay for treatment. This policy requires healthcare entities to screen, stabilize, and coordinate transfers regardless of the patient’s ability to pay or insurance status (McKenna et al., 2018). The two regulations are profound in eliminating affordability barriers and enhancing health equity. However, undocumented immigrants face exclusion from these policies, presenting the need to address documentation issues to guarantee policies’ optimal outcomes.

The Rationale for Addressing the Healthcare Needs of the Latino Immigrant Population

Interagency interventions for addressing the health needs of Latino immigrants are crucial in promoting health equity, preventing the prevalence of chronic conditions, especially mental health disorders, and improving social determinants of health. Ornelas et al. (2020) argue that multiagency interventions should improve access to timely care, eliminate affordability barriers, incorporate people’s cultural contexts into practices, and connect undocumented immigrants with consistent primary care. These strategies can significantly improve immigrants’ health and wellness.

Although interagency interventions are consistent with the need to improve immigrant health, conducting a comprehensive community needs assessment using appropriate tools is essential. A SWOT analysis can identify community-based strengths, weaknesses, opportunities, and threats (Behzadifar et al., 2023). For example, the strengths of Latino immigrants include core cultural beliefs and values that promote interpersonal connectedness. Weaknesses may include limited access to insurance coverage, lack of documentation, and social determinants of health contributing to disparate access to care. Thirdly, opportunities for a care mobilizing plan are the likelihood of leveraging advanced technologies to improve access to care and the role of for-profit and non-profit organizations in coordinating care. Finally, potential threats to a care mobilizing plan include the persistent fear of deportation, stringent migration policies, and uninformed assumptions and biases contributing to racism and structural discrimination.

Conclusion

Latino immigrants grapple with multiple challenges that significantly affect their health and wellness. For example, this population is susceptible to prevalent mental health conditions exacerbated by exposure to traumatic events, violence, low social status, and financial pressure. Therefore, mobilizing care is essential for addressing population health needs and improving immigrants’ health outcomes. An interagency approach is vital when mobilizing care for Latino immigrants since it strengthens the role of organizations and stakeholders.

References

Alderwick, H., Hutchings, A., Briggs, A., & Mays, N. (2021). The impacts of collaboration between local health care and non-health care organizations and factors shaping how they work: A systematic review of reviews. BMC Public Health, 21(1). https://doi.org/10.1186/s12889-021-10630-1

Behzadifar, M., Ghanbari, M. K., Azari, S., Bakhtiari, A., Rahimi, S., Ehsanzadeh, S. J., Sharafkhani, N., Moridi, S., & Bragazzi, N. L. (2023). A SWOT analysis of the development of health technology assessment in Iran. PLOS ONE, 18(3), e0283663. https://doi.org/10.1371/journal.pone.0283663

Cabral, J., & Cuevas, A. G. (2020). Health inequities among Latinos/Hispanics: Documentation status as a determinant of health. Journal of Racial and Ethnic Health Disparities, 7(5). https://doi.org/10.1007/s40615-020-00710-0

Corona, K., Campos, B., Rook, K. S., Biegler, K., & Sorkin, D. H. (2019). Do cultural values have a role in health equity? A study of Latina mothers and daughters. Cultural Diversity and Ethnic Minority Psychology, 25(1), 65–72. https://doi.org/10.1037/cdp0000262

Cycyk, L. M., & Hammer, C. S. (2018). Beliefs, values, and practices of Mexican immigrant families towards language and learning in toddlerhood: Setting the foundation for early childhood education. Early Childhood Research Quarterly. https://doi.org/10.1016/j.ecresq.2018.09.009

Doshi, M., Lopez, W. D., Mesa, H., Bryce, R., Rabinowitz, E., Rion, R., & Fleming, P. J. (2020). Barriers & facilitators to healthcare and social services among undocumented Latino(a)/Latinx immigrant clients: Perspectives from frontline service providers in Southeast Michigan. PLOS ONE, 15(6), e0233839. https://doi.org/10.1371/journal.pone.0233839

Gómez, M. G. R., López Jaramillo, A. M., Svarch, A., Tonda, J., Lara, J., Anderson, E. J., & Rosales, C. (2019). Together for health: An initiative to access health services for the Hispanic/Mexican population living in the United States. Frontiers in Public Health, 7. https://doi.org/10.3389/fpubh.2019.00273

Gunn, V., Somani, R., & Muntaner, C. (2021). Health care workers and migrant health: Pre- and post-COVID-19 considerations for reviewing and expanding the research agenda. Journal of Migration and Health, 4, 100048. https://doi.org/10.1016/j.jmh.2021.100048

Levesque, J. B. J. B., Mary Hanna, and Christopher. (2021, February 9). Frequently requested statistics on immigrants and immigration in the United States. Migration Policy Institute. https://www.migrationpolicy.org/article/frequently-requested-statistics-immigrants-and-immigration-united-states-2020

Martinez-Donate, A. P., Verdecias, N., Zhang, X., Jesús Eduardo, G.-F., Asadi-Gonzalez, A. A., Guendelman, S., Amuedo-Dorantes, C., & Rangel, G. (2020). Health profile and health care access of Mexican migration flows traversing the northern border of Mexico. Medical Care, 58(5), 474–482. https://doi.org/10.1097/mlr.0000000000001300

McKenna, R. M., Purtle, J., L. Nelson, K., H. Roby, D., Regenstein, M., & N. Ortega, A. (2018). Examining EMTALA in the era of the patient protection and Affordable Care Act. AIMS Public Health, 5(4), 366–377. https://doi.org/10.3934/publichealth.2018.4.366

Oh, H., Trinh, M. P., Vang, C., & Becerra, D. (2020). Addressing barriers to primary care access for Latinos in the U.S.: An agent-based model. Journal of the Society for Social Work and Research, 11(2), 165–184. https://doi.org/10.1086/708616

Ornelas, I. J., Yamanis, T. J., & Ruiz, R. A. (2020). The health of undocumented Latinx immigrants: What we know and future directions. Annual Review of Public Health, 41(1), 289–308. https://doi.org/10.1146/annurev-publhealth-040119-094211

Szaflarski, M., & Bauldry, S. (2019). The effects of perceived discrimination on immigrant and refugee physical and mental health. Immigration and Health, 19, 173–204. https://doi.org/10.1108/s1057-629020190000019009

Instructions 

Develop a project plan to mobilize coordinated care for an immigrant or refugee population. Then, draft a 4-5 page organizational policy addressing care for this group, informed by the project plan, that meets current standards of practice. Note: The assessments in this course build upon the work you have completed in the previous assessments. Therefore, complete the assessments in the order in which they are presented.

The United States’ evolving diversity brings prospects and challenges for health care providers, health care systems, and policymakers to produce and deliver culturally-competent services for immigrant and refugee populations. For example, improving health outcomes for undocumented immigrant populations present unique and often difficult challenges for care coordinators at all levels. New arrivals in a community bring with them different cultural backgrounds, beliefs, perceptions, and biases that may influence their seeking access to care and exacerbate health disparities. In addition, they may struggle to navigate a complex and sometimes bewildering health care system.

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This assessment provides an opportunity for you to examine an undocumented immigrant population of your choice, develop a project plan to address their care coordination needs, and craft an organizational policy addressing care that meets current standards of practice.

Note: Your work in Assessment 1 will inform your work in this assessment. Therefore, complete the assessments in the order in which they are presented.

Preparation

For this assessment, you will assume the role of Director of Care Coordination in the same practice setting you chose for Assessment 1. Within this context, you will develop a project plan to provide health care for an undocumented immigrant or refugee population of your choice. The population may be of local, national, or international interest, but must not have obtained permanent U.S. residency status.

After completing your project plan, you will then compose an organizational policy that addresses care for this group. Note:  As you revise your writing, check out the resources listed on the Writing Center’s Writing Support page..

Requirements

For this assessment:

Develop a project plan to mobilize coordinated care for an undocumented immigrant or refugee population. Use the care coordination project plan you developed in Assessment 1 as a model for your project plan in this assessment. Include, in your plan, whatever information is appropriate for the specific population you have chosen to address.

Compose an organizational policy addressing care for this group, informed by your project plan, that meets current standards of practice.

Project Plan and Policy Document Format and Length

Format your project plan and policy document using APA style.

Use the APA Style Paper Tutorial [DOCX] to help you in writing and formatting your documents. There is not page length requirement for your project plan but be sure to include:

A title page and references page. An abstract is not required.

A running head on all pages.

Appropriate section headings.

Your policy document should be 4–5 pages in length, not including the title page and references page.

Supporting Evidence

Cite a combined total of 6–8 sources of scholarly or professional evidence to support your project plan and policy document.

Developing Your Project Plan and Policy Document

Note: The requirements outlined below correspond to the grading criteria in the scoring guide. Be sure that, at a minimum, you address each criterion. You may also want to read the Mobilizing Care for an Immigrant Population scoring guide to better understand how each criterion will be assessed.

Project Plan

Provide a rationale for addressing the health care needs of the chosen undocumented immigrant or refugee population.

Explain why you chose this particular population for your project plan.

What criteria did you apply to your selection?

Assess the health care needs of the chosen population.

Apply a project management tool or model (SWOT, AI, Six Sigma) that you are familiar with or use in your organization.

What evidence supports your conclusions?

Identify the organizations and stakeholders who must participate in caring for the chosen population.

Consider coordinated care on a local, state, national, or international level, as applicable.

Policy Document

Describe the characteristics that define the chosen population.

Provide demographic information, such as the age, gender(s), location, social, psychological, economic, political, cultural, or other characteristics of the population that you believe are important.

Interpret current policies in your organization for providing health care for immigrants and refugees who do not have permanent resident status in the United States.

What are the key policy elements that guide practice?

Do the policies and practices keep pace with environmental changes and current legislation?

Analyze assumptions and biases associated with a particular immigrant or refugee population, and the influence of culture and linguistic differences on access to care.

Do any of the assumptions have merit?

What assumptions or biases might be particularly pernicious or harmful as the basis for decision making?

How can culture and linguistic differences affect access to care?

Evaluate two U.S. health care policies, national initiatives, or pieces of legislation that provide guidance on current standards of care for immigrant or refugee populations.

Do these policies, initiatives, or laws guarantee fair and ethical treatment?

Do they provide a sufficient basis for guiding professional practice in the provision of safe, high-quality, and equitable care?

Communications and Information Literacy

Write clearly and concisely, using correct grammar and mechanics.

Express your main points and conclusions coherently.

Proofread your writing to minimize errors that could distract readers and make it difficult to focus on the substance of your evaluation.

Support main points, claims, and conclusions with relevant and credible evidence, correctly formatting citations and references using APA style.

Is your supporting evidence clear and explicit?

How or why does particular evidence support a claim?

Will your audience see the connections?

Additional Requirements

Be sure that you have used the APA Style Paper Tutorial [DOCX] to format your project plan and policy document. Also, be sure that each document includes:

 

A title page and references page.

A running head on all pages.

Appropriate section headings.

In addition, be sure that:

Your policy document is approximately 4–5 pages in length, not including the title page and references page.

You have cited a combined total of 6–8 sources of relevant and credible scholarly or professional evidence to support your project plan and policy document.

Portfolio Prompt: You may choose to save your project plan and policy document to your ePortfolio.

Competencies Measured

By successfully completing this assessment, you will demonstrate your proficiency in the following course competencies and assessment criteria:

Competency 1: Propose a project for change, for a community or population, within a care coordination setting.

Provide the rationale for addressing the health care needs of a particular immigrant or refugee population.

Describe the characteristics that define a particular immigrant or refugee population.

Interpret current organizational policies for providing health care to immigrants and refugees in the United States.

Competency 2: Align care coordination resources with community health care needs.

Assess the health care needs of a particular immigrant or refugee population.

Competency 3: Apply project management best practices to affect ethical practice and support positive health outcomes in the delivery of safe, culturally competent care in compliance with applicable regulatory requirements.

Analyze assumptions and biases associated with a particular immigrant or refugee population and the influence of culture and linguistic differences on access to care.

 

Evaluate two U

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.S. health care policies, national initiatives, or pieces of legislation that provide guidance on current standards of care for immigrant and refugee populations.

Competency 4: Identify ways in which the care coordinator leader supports collaboration between key stakeholders in the care coordination process.

Identify the organizations and stakeholders who must participate in caring for a particular immigrant or refugee population.

Competency 5: Communicate effectively with diverse audiences, in an appropriate form and style, consistent with applicable organizational, professional, and scholarly standards.

Write clearly and concisely, using correct grammar and mechanics.

Support main points, claims, and conclusions with relevant and credible evidence, correctly formatting citations and references using APA style.