Initiative on Asian Americans and Pacific Islanders Blog

  • Reaching Out to Underserved AAPI Communities in Pima County, Arizona

    Howard Eng

    Howard Eng is being honored as a Health in the AAPI Community Champion of Change.

    The Pima County AAPI Navigator Program’s primary goal is to reduce the number Asian American and Pacific Islander (AAPI) uninsured in Pima County, Arizona. To accomplish this goal, the program uses both general and specified community cultural, linguistically and appropriate literacy level outreach approaches. The Program works with AAPI community leaders and partners to identify the most appropriate and effective public education and outreach approaches that can be used to reach their communities’ uninsured.

    There are many challenges in outreaching to the AAPI populations in Pima County. Some of these include: (1) the AAPI populations are scattered throughout a very large county (larger than New Jersey); (2) many of the AAPI communities are not receptive to outsider interactions; (3) cultural and language barriers; (4) lack of awareness about health coverage availability; (5) limited health literacy; (6) do not see the urgency or the need for health coverage; and (7) even with subsidized coverage with the Health Insurance Marketplace for some AAPI families, it still may not be affordable.

    To overcome many of these challenges, the Navigator Program works closely with AAPI community leaders and partners to determine if there is a need for Program assistance to outreach to the uninsured. If there is a need for assistance, the community leaders help to identify the most appropriate and effective public education and outreach approaches that can be used to reached their communities’ uninsured. The program uses cultural, linguistically and appropriate literacy level outreach approaches as well as work within the community culture and structure (e.g., giving public presentations to AAPI community and faith-based groups in English and their preferred language, if needed and providing Marketplace and other health care coverage information booths at AAPI community events). It takes time and patience to overcome the challenges and requires a long term approach in establishing a strong working relationship with the communities. 

    Looking past open enrollment, from December 2013 to August 2014, the Navigator Program plans to outreach 7 to 8 different Asian American and Pacific Islander communities in Pima County. The Program outreached to the Bhutanese community in December 2013, Marshallese community in January 2014, Filipino and Chinese communities in February-March, and plans to begin outreach to the Asian Indian community in April.

    Howard Eng is Assistant Professor and Director of the Southwest Border Rural Health Research Center, Center for Rural Health, The University of Arizona College of Public Health

  • Reaching Rural Hmong Communities

    Bruce Thao

    Bruce Thao is being honored as a Health in the AAPI Community Champion of Change.

    My family arrived in the United States in December of 1975—greeted by winter in Iowa. Like many other Hmong refugee families, they struggled through poverty, learning a new language, and navigating a maze of systems seemingly built to keep them away from the very services they needed. My parents are proud and resilient and were able to make a better life for us despite having just survived war, refugee camps and leaving all they’ve ever known behind. It is this resilience and indomitable spirit which drives me and my work with Hmong American Partnership (HAP) and its subsidiary, Hmong National Development (HND).

    Though the Hmong have come a long way having been in the U.S. for almost 40 years, we still have far to go. In 2010, 1 in 4 Hmong families lived in poverty, which is one of the highest rates across race and ethnic groups in America. In addition, the Hmong community has disproportionately low educational attainment rates and high rates of death from cancer and incidence of other ailments such as Hepatitis B, stroke, diabetes and gout. These health disparities can partly be attributed to a lack of health insurance and not receiving preventative care. By the time they are in front of a doctor they may be in stage 4 of liver or breast cancer.

    When the Affordable Care Act passed, HAP and HND knew we had to get information out to our communities, particularly for the growing Hmong communities in Minnesota, California, and the South. While states like California, Minnesota and Wisconsin continue to have the highest Hmong populations (over 200,000 in these three states), we have seen an exponential increase in the Hmong population in the South (now over 20,000 Hmong in southern states). They are located in rural communities that do not have the capacity or infrastructure to provide healthcare outreach or education to the Hmong.

    The majority of the Hmong in the South lack health insurance, many had never heard of the Affordable Care Act, and are illiterate in both Hmong and English. So we knew we had a tough task to tackle. In Arkansas, Missouri and North Carolina, HND conducted outreach and created relationships between Hmong community leaders, enrollment agencies and healthcare providers, identifying language assistance and interpreters where available. Through community meetings and conference lines, we connected communities across states and rural areas to educate them. To date we have provided education and outreach to over 500 Hmong farmers and families in the South that otherwise have been unreachable by mainstream agencies.

    The keys to our success lie in leveraging community leaders and ethnic media and the power of word of mouth. Our history as a persecuted ethnic minority group has forced us to rely on oral tradition to carry our heritage and our identity. We utilize radio, conference lines, word of mouth and the power of story to get the word out to our communities to know that there are resources available and ways to receive healthcare. Our combined national efforts have resulted in close to 20,000 Hmong and other Southeast Asians learning about the Affordable Care Act and over 2,000 receiving healthcare coverage across the country.

    Bruce Thao is Director of Programs for Hmong American Partnership (HAP) and Hmong National Development (HND).

  • Helping AAPI Immigrants and Refugees in Pennsylvania Get Covered

    Amy Jones

    Amy Jones is being honored as a Health in the AAPI Community Champion of Change.

    The Affordable Care Act provided a long-awaited opportunity for many Americans to finally get affordable health insurance. With over 50,000 uninsured Asian Americans, Native Hawaiian and Pacific Islanders (AAPI) living in Pennsylvania, 45% of whom lived in Philadelphia, the Affordable Care Act was a turning point for our communities. However, we also anticipated that due to language barriers, low-literacy, confusion about the policy and application process, limited computer skills, and lack of someone who spoke their language to provide in-person enrollment support, many immigrants/refugees would be unaware of the Affordable Care Act and how it would impact them.

    In the winter of 2013, SEAMAAC was awarded a grant to engage partner organizations and Asian immigrant/refugee community members around the issue of health care access and health insurance enrollment in Philadelphia. In the spring, we began reaching out to community-based organizations (CBO), faith-based organizations and leaders, local and national advocacy organizations, health care providers, community leaders, small businesses, and physicians, professors, and students from local universities to prepare for the first Open Enrollment Period. Over the summer, we worked with this group to conduct an assessment to gauge the communities’ awareness of the Affordable Care Act, their questions, and their suggestions for outreach, education, and enrollment support. We used a literature review, focus groups, and key informant interviews to conduct this assessment.

    The results of this community assessment helped us design appropriate enrollment and community education/outreach strategies. SEAMAAC and partners created outreach and education materials (translated into Chinese, Vietnamese, Laotian, Nepali, Indonesian, Burmese, Karen, and Chin). We worked closely with Nationalities Services Center, to design educational workshops that other CBOs and leaders could use in their communities. From October 2013 to March 2014, SEAMAAC staff conducted 16 Community workshops educating over 700 immigrant/refugee community members. We have educated almost 1,300 community members through general community outreach, and nearly 30,000 through media sources.

    In the fall, SEAMAAC became a Certified Application Counselor (CAC) Organization. However, we knew that we could not help enroll everyone by ourselves. In collaboration with Jefferson University and Nationalities Services Center, we conducted a CAC Training for bilingual staff and community leaders ensuring that there were CACs in Philadelphia bilingual in English and Mandarin, Vietnamese, Khmer, Indonesian, Laotian, Hmong, Thai, Nepali, Burmese, Karen, and Chin. SEAMAAC and partners also engaged local Navigator organizations to ensure that they held office hours in immigrant and refugee communities. Throughout Open Enrollment, SEAMAAC CACs and Navigators groups assisted over 450 immigrant/refugee families apply for health insurance through the Marketplace.

    Amy Jones is the Director of Health & Social Services for Southeast Asian Mutual Assistance Association Coalition (SEAMAAC), Inc.

  • Creating Partnerships and Coalitions to Serve a Diverse Community

    Teresa A. Crawford

    Teresita Batayola is being honored as a Health in the AAPI Community Champion of Change.

    Forty one years ago, idealistic community volunteers and student activists came together to create a free clinic for low-income, isolated Chinese and Filipino elderly in Seattle’s Chinatown-International District.  As waves of immigrants and refugees sought refuge and a home in the Seattle area, ICHS stepped up to embrace new populations with high-quality, affordable healthcare.  That tradition of activism, volunteerism and inclusiveness continues to be vibrant today.

    During the movement for health care reform and the passage of the Affordable Care Act, ICHS networked with coalitions around the state to organize, provide patient stories and testimonies, and contact national and state legislators.  Once the Affordable Care Act passed, ICHS advocated for Washington State’s adoption of expanded Medicaid and the establishment of the State’s Benefit Exchange through postcard and phone-in campaigns, meetings with elected officials, patient stories, media visibility, and engagement of non-traditional health care partners. However, elation for Washington’s decision to expand Medicaid and create a Health Benefit Exchange was short-lived as ICHS quickly shifted gears to prepare for outreach and enrollment. 

    ICHS knew that enrolling patients, families and community members into the new programs would be a challenge due to the number of immigrants and refugees who had limited English proficiency, varying immigration status, the mixed eligibility for members in the same family, the lack of understanding about insurance and western health care, and uneven financial abilities to maintain coverage.  Nevertheless, the ICHS team of community advocates, health educators, eligibility workers and others began planning outreach and enrollment even with the uncertainty of any funding available.  Thankfully, ICHS successfully obtained funding from the federal government and a private foundation to hire 6 In-Person Assisters.  ICHS leveraged the funding to obtain training and certification for 25 staffs to provide in-person assistance. 

    ICHS’ in-person assisters, community advocates, health educators, and eligibility workers worked to actively help anyone learn about health reform and apply for insurance. All of these staff are bilingual and bi-cultural and provide enrollment support in at least one Asian or Pacific Island language, including Cantonese, Khmer, Korean, Mandarin, Punjabi, Samoan, and Vietnamese. ICHS also partnered with community based organizations, faith-based organizations, grocery stores, community centers, and libraries to meet the community need, sending staffs to train others and scheduling field enrollment sessions in addition to appointments in ICHS clinics.  An example of a key partnership is with the City of Bellevue’s mini City Hall located in a shopping center.  The mini City Hall provided space for the in-person assister and assistance with Russian and Spanish languages, while another partner, Chinese Information and Service Center, provided Chinese interpretation.  ICHS staffs remained positive throughout enrollment even when faced with the challenges of appointments longer than an hour due to interpretation and the complexity of individual or family status, combined with the technical challenges of the Exchange.

    Teresita Batayola is the Chief Executive Officer of International Community Health Services (ICHS) in Seattle, Washington.

  • They Helped Build a Railroad−and a Nation: Honoring the Chinese Railroad Workers

    Ed. note: This is cross-posted from the United States Department of Labor.

    Chinese Railroad Workers Poster

    (by United States Department of Labor)

    One hundred forty-five years ago tomorrow, May 10, the word “DONE” was telegraphed to Washington D.C., sending word that the final spike had been driven in to complete the First Transcontinental Railroad. It was one of the most remarkable engineering feats of the 19th century, connecting the country from coast-to-coast, facilitating commerce and opening the door for massive economic expansion. Before its completion, cross-country travel took six months. The railroad reduced it to a single week.

    But too often lost in discussions of this awe-inspiring achievement is the contribution of the approximately 12,000 Chinese laborers who took on the grueling task of completing the western section of the track.

  • “We Are Beyond”: Celebrating AAPI Heritage Month at Our Opening Ceremony with Vice President Joe Biden

    Vice President Biden Addresses AAPI Heritage Month Opening Ceremony

    Vice President Joe Biden addresses the Asian American and Pacific Islander Heritage Month Opening Ceremony, at the U.S. Department of the Interior in Washington, D.C., May 6, 2014. May 6, 2014. (Official White House Photo by David Lieneman)

    This week, the White House Initiative on Asian Americans and Pacific Islanders and the U.S. Department of the Interior hosted the 2014 Opening Ceremony for AAPI Heritage Month. The Opening Ceremony was the first in a series of events to celebrate Asian American and Pacific Islander (AAPI) Heritage Month.

    We were honored to be joined by Vice President Joe Biden, who spoke about the importance of the growing AAPI demographic, and the pressing need for immigration reform. As Congressman Mike Honda, Chair Emeritus of the Congressional Asian Pacific American Caucus (CAPAC), and Congresswoman Judy Chu, Chair of CAPAC, remarked, the Vice President has been one of the biggest advocates for the AAPI community. We were also honored to be joined by Rhea Suh, the Assistant Secretary for Policy, Management, and Budget at the U.S. Department of the Interior, and Chris Lu, the Deputy Secretary for the U.S. Department Labor, and a former chair of the Initiative. To watch the video click here.

    For me, the most exciting part of the event was to be ceremonially sworn into the President’s Advisory Commission on AAPIs. The Commission, which is charged with improving the quality of life for AAPIs through increased participation and access to federal programs, advises the President on innovative ways to engage AAPIs across the country. During the event, U.S. Circuit Judge Sri Srinivasan ceremonially swore in 14 new and two returning Commissioners.

    U.S. Circuit Judge Sri Srinivasan ceremonially swears in members of the President's Advisory Commission on AAPIs

    U.S. Circuit Judge Sri Srinivasan ceremonially swore in 14 new and two returning members of the President’s Advisory Commission on Asian Americans and Pacific Islanders, May 6, 2014. (by Edmund Chiang)

    To open the program, the Initiative’s Executive Director Kiran Ahuja and Deputy Director Audrey Buehring led an interactive monologue to highlight the Initiative’s work and included a social media “selfie” with Commissioners and audience members.

    This year’s theme for AAPI Heritage Month was “I Am Beyond,” a phrase that captures the aspirations of the American spirit and the rich and complex diversity of the AAPI community. In light of the theme, DJ Yoon, the Executive Director of the National Korean American Service & Education Consortium, Maulik Pancholy, an acclaimed film, television, and stage actor, Helen Zia, an influential activist and journalist, Mary A.Y. Okada, the President of Guam Community College, and Konrad Ng, the Director of the Smithsonian Asian Pacific American Center, participated in a panel discussion about “I Am Beyond.” In addition, spoken word artists George Yamazawa Jr. and Maxie Moua, ukulele singer Kama Hopkins, dancer Mike Song, and beatboxer KRNFX performed their own interpretations of the theme.  

    Smithsonian Asian Pacific American Center Director Konrad Ng Moderates a Panel

    Smithsonian Asian Pacific American Center Director Konrad Ng moderates a panel with actor Maulik Pancholy, activist and journalist Helen Zia, and National Korean American Service & Education Consortium Executive Director DJ Yoon, and President of Guam Community College Mary A.Y. Okaha to discuss the “I Am Beyond” theme, May 6, 2014. (by Gaolunha Vang)

    Dancer Mike Song and beatboxer KRNFX perform at AAPI Heritage Month Opening Ceremony

    Dancer Mike Song and beatboxer KRNFX perform during the AAPI Heritage Month Opening Ceremony, May 6, 2014. (by Gaolunha Vang)

    AAPI Heritage Month serves as an opportunity to celebrate and re-dedicate ourselves to the ongoing work of improving the community. As a returning Commissioner, I am deeply grateful to the previous Commission, and the leadership of former Chair Daphne Kwok. To highlight this Commission’s tremendous work, a report on its accomplishments was released this week. In the last four years, we’ve hosted over 200 national gatherings, roundtables, opening dialogues, and workshops, reached more than 30,000 people, held 24 federal agencies accountable through annual Federal Agency Plans, and launched the Regional Interagency Working Group as a platform to connect regional federal representatives with local community leaders. Within the past four years, the AAPI population established itself as a civically engaged and politically important community. However, we know that there is much work to be done. As the new Chair of the Commission, we will continue to build upon our efforts by opening the doors of government to the AAPI community. Together, the community will push towards better health, immigration policy, education, and jobs. Together, we will be beyond.

    Dr. Tung Nguyen is Chair of the President’s Advisory Commission on Asian Americans and Pacific Islanders.