Lack of familiarity with insurance - Insurance is not part of health care delivery in their native country. Cultural Issues - Managed Care is a difficult and new concept for immigrants. Language Barriers - lack of available printed material at appropriate literacy levels and lack of interpreter services. Too many procedures and processes to deal with once in the system, and racism and general poor treatment. Complaints of general discourteousness at local DSS offices.
Population needs to be educated about the importance of preventive services.
Ability to document income as people are paid in cash or work seasonally. Family income can fluctuate widely form month to month. Difficult to get them to stay enrolled. There is an obvious language barrier. Solutions Recommended by Advocates and States Break out sessions were conducted with States, advocates, and community based organizations represented at the conference.