Opening access for Burmese and Karen immigrant and refugee populations in California: A blueprint for integrated health service expansion to emerging Asian communities

In the last decade, an annual average of 350,000 to 450,000 Asian Legal Permanent Residents entered the US, while a steady increase in Asian refugees also occurred, with over fifty thousand in 2010.  Of these refugees, an exponential influx from Burma occurred, from 128 in FY 2002 to nearly 17, 000 in FY 2011.  In FY 2010 and FY 2011, refugees from Burma constituted the largest single group being resettled in the US.  They began to arrive in the San Francisco Bay Area in increasing numbers in 2007.  An estimated 500 have resettled in this area, especially in Oakland of Alameda County. Asian Health Services (AHS) is a federally qualified health center (FQHC) that provides culturally and linguistically competent health care to low-income, un- and under-insured patients, including the Asian American and Pacific Islander (AAPI) communities across Alameda County, California.  In 2010, AHS opened a clinic which expanded access in an organized way to emerging Burmese/Karen refugees, providing primary care, integrated dental and behavioral healthcare, with on-site language and cultural interpreters.  There are now over four hundred patients from Burma enrolled. Rooted in its dual mission of service and advocacy, AHS’ decision to expand culturally and linguistically competent services to these communities reflects a commitment to achieving health equity for the AAPI population.  Rather than waiting for a threshold percentage of individual patients to enroll before creating programs specific to the needs of these communities, this article will describe an intentional process of leading inclusion of new communities into primary care at an FQHC.