The new Family Health Centers Americana will have eight exams rooms, dedicated spaces for Refugee Health Screenings and for immunizations.  The current building has just four exams rooms, which limits the number of staff who can physically work in the building.

Refugee Health Screenings
Increasing the physical capacity will allow Family Health Centers – Americana to conduct more Refugee Health Screenings. Currently, FHC-Americana is screening up to 27 new Refugee clients each week under the two-visit Refugee Health Assessment (RHA) model (Labs and Nursing Visit followed one week later by a Provider Visit and Physical Exam). This allows for FHC to accommodate approximate 100 individuals per month, and 1,200 per year – far less than the needs presented by the over 9,800 RHA-eligible clients who arrived to Louisville in fiscal year 2023.

Adult Refugee Immunizations
Since January 2020, FHC has collaborated with the Kentucky Office for Refugees to provide adult immunizations that are required for immigration purposes to refugee-eligible clients. Currently, these vaccines are initiated during the RHA visits at FHC – Americana and can be completed during limited monthly Vaccine Clinics held on Saturday mornings.  Often, other community primary care providers do not carry these vaccines nor are they always covered by standard health insurance.  Refugee clients may receive them free of cost through this partnership with FHC within their first full year in the United States. This Americana renovation would offer additional space to provide clients with their adult vaccines during regular operating hours, and would allow for the program to grow, potentially providing Adjustment of Status vaccines to folks with other immigration statuses, as well.

Primary Care Services 
We dream of being able to offer ongoing medical services to any client who has their RHA at FHC-Americana who would like to stay, but with our current space and staffing limitations, we oftentimes are unable to get them all back in for timely follow-up or urgent care needs. Similarly, it is hard for other newcomers or residents in the areas surrounding Americana to get established with us due to a lack of New Patient appointment availability.  With the Americana renovation, we will be able to use the additional exam rooms to allow for more medical providers to work each day, expanding our capacity for Primary Care Services.

[1] Refugee Resettlement in Louisville, Quarterly Community Consultation, December 2023

The Americana Campus is trauma-informed.  The Americana World Community Center is a backbone agency for the Trauma Resiliency Academy, and offers free training for community partners.  FHC- Americana and Survivors of Torture Services (STS) staff members have been trained in the Healing Encounters approach, which strives for trauma-informed, linguistically appropriate, and culturally responsive care. We recognize that our health and mental health services must work to restore dignity, choice, and trust for our clients. Clients feel safe on the Americana campus and it is an ideal place for integrated health, mental health, and social services. It is a shared priority to renovate the physical space to be trauma-informed as well.

FHC-Americana, as a primary care medical and behavioral health provider, with specialized health programs and services for Refugees, has space needs similar to a traditional medical office, with additional needs for support services. Care Team members like Refugee-focused Community Health Workers, Care Coordinators and Referral Clerks help patients navigate health and social service systems, overcome transportation barriers, and address the social determinants of health. Allowing room for this holistic approach to care is crucial.

The Survivors of Torture Services and behavioral health services will be co-located in a quiet, calming space for patients. Having integrated behavioral health helps clients meet their social and emotional needs in a familiar and destigmatized space.  The patients of Survivors of Torture Services are trauma survivors, and often have symptoms related to PTSD, such as fear of crowds, anxiety, and depression. Purposefully, this space will not feel or look clinical, but will be designed to feel warm and safe.

Family Health Centers-Americana staff work tirelessly to provide high quality care and to meet the unique needs of their clients, despite the inadequate conditions of their current clinic and offices. All would agree that the staff and patients deserve a space for comprehensive care that embodies dignity and respect to everyone.

Louisville benefits greatly from the contributions of and presence of our immigrant and refugee neighbors.  Louisville began receiving refugees in 1975, at the end of the Vietnam War, through Catholic Charities and the Archdiocese of Louisville. Since that time, Louisville, known as a Compassionate City, has continued a strong tradition of welcoming. Immigrants add to our cultural and social fabric and are key to our economic future and growth as a city.

According to 2022 American Community Survey (ACS) data, more than 67,000 persons in Louisville are foreign born, making up 8.6% of our total population[1]. Without the arrival of international migrants to our city/county, Louisville would have lost more than 4,000 residents during that time. Declines in population lead to a lower tax-base, lower service delivery and infrastructure support, and a smaller work force, all of which can weaken or slow the local economy.

The majority of immigrants/foreign-born residents (71%) in our community are between 25-64 years old, and are filling important jobs during a time where many sectors are facing labor shortages; locally immigrants and refugees are filling jobs in construction (7.3%) Manufacturing (16%), Transportation/warehousing (12.5%), and educational, health and social services jobs (16%)[1]. Having a robust work force helps attract new businesses to our community and helps current businesses as well.

For many newcomers, their entry into health care may come via a Refugee Health Screening at FHC-Americana. They may participate in the English as a Second Language or GED classes at the Americana Community Center or have children in the After School Program there. This campus plays a vital role in helping Louisville’s newest neighbors thrive.

[1] American Community Survey, 2022 5-year estimates, Selected Characteristics of the Native and foreign-Born Populations, Jefferson County, Kentucky

Across Family Health Centers, we have signs translated into our top 5 languages that read “Everyone is Welcome Here.” Nowhere is that motto taken more to heart than at FHC-Americana and on the Americana Campus as a whole. We know that in order to be truly welcoming, we must earn the trust of the communities we serve by providing compassionate and equitable care.

While Louisville is made stronger by a myriad of refugee and immigrant serving agencies and not-for-profits, AWCC and FHC are unique in our abilities to serve a wide range of community members and to do so for longer periods of time than some of our sister agencies. While eligibility criteria for some services may be governed by grant funders and the federal Office for Refugee Resettlement, our mix of funding, Federally Qualified Community Health Centers status, and partnerships with the AWCC, allow us to be expansive and equitable in our approach.

Through 16 years of providing healthcare out of tiny modular spaces, our team has grown agile, and we strive to always consider the ways in which our clients prefer to be cared for as we craft policies and procedures. We know that providing culturally effective care means more than just adjusting for cultural differences and yet keeping the system the same! We’ve been able to adapt and grow over the years, adding programing, being more holistic, and hiring multilingual and multicultural staff.

We’ve also learned that solid partnerships with organizations like the AWCC, JCPS, the Kentucky Office for Refugees, La Casita Center, local refugee resettlement agencies, the UL Kent School, Louisville Metro Department for Public Health and Wellness, and other refugee health and mental health providers help us to include community voice as we shape and reshape our services.

FHC-Americana’s services provide a significant public health benefit to Louisville. Refugee Health Assessments help identify physical and mental health conditions and facilitate access to specialty care for our newest neighbors. FHC-Americana provides needed medical and behavioral health care, but also support services like interpretation and care coordination that are crucial for individuals unfamiliar with the English language and how the U.S. health care system works. Further, our services are not time-limited. Family Health Centers cares for our patients throughout their lifetime.

The Survivors of Torture Services (STS) program is a comprehensive service to refugees and immigrants who have experienced torture in their home countries. We provide a safe, welcoming, confidential, trauma-informed and culturally-appropriate setting where survivors can begin the healing process. Moreover, we provide a place for community; we offer survivors the opportunity to reclaim safety, capability, productivity, and hope. Survivors of Torture Services include:

• Direct mental health and psychiatric services
• Social service and medical care coordination
• Legal service referrals

Similar to the STS model of care, since the Spring of 2023, FHC-Americana has been partnering with the UL Kent School of Social Work on their Supporting Transition of Afghans into Resettlement (STAR) Program. This Program is intended to assist Afghans Impacted by Combat who were evacuated to the United States in the period between August 2021 – September 2023, or their immediate family members who may have joined them later.  FHC-Americana’s role in the project is to provide specialized, culturally-appropriate medical and mental health services.

All of these health and wellness services, uniquely housed in the same building as the Americana World Community Center will help build a thriving and healthy Louisville.