The coalition of ethnic groups that is reshaping refugee funding

Feb 10

Feb 10 The coalition of ethnic groups that is reshaping refugee funding

The coalition of ethnic groups that is reshaping refugee funding

By Aryana Noroozi, The Groundtruth Project, January 19, 2022

Special rules: This story is part of “Here to Stay,” a multimedia reporting series on solutions the resettlement of migrants and refugees amid the global migration crisis. The series is produced by The GroundTruth Project, with support from the MacArthur Foundation, Luce Foundation and Solutions Journalism Network

Photos usable. word count: 3269

SAN DIEGO – Abraham Tessema arrived in San Diego in 1992 from his native Eritrea. He was 19 years old and looking for a better future, but unlike most new arrivals he didn’t choose his new home. He was a refugee, among thousands of others placed in a city with one of the largest populations of resettled refugees in the United States.

Although he earned a bachelors in biochemistry and research science from the University of California San Diego, and then an MBA from the University of Phoenix, Tessema found his calling in helping fellow members of the Ethiopian and Eritrean diaspora adjust to life in the U.S.

In 2016, he founded the Refugee Assistance Center, an ethnic community-based organization, or ECBO, assisting with the community’s social assimilation and direct service needs – anything from transportation to translation and tutorial services for housing and education, as well as job placement. Through it, Tessema has helped hundreds settle in the San Diego area.

While some refugees remain plugged in with the resettlement agency networks that provided assistance upon arrival, many find themselves on their own after 90 days. Many look to ECBO leaders as trusted sources for guidance.

Despite his experience, Tessema, now 48, realized that to be more effective, his support organization needed help of its own.

Tessema found the assistance he was looking for in the San Diego Refugee Communities Coalition (SDRCC), an alliance of 13 organizations representing 15 different ethnic groups in the area—ranging from Somalis and Syrians to Haitians and Burmese—that developed a unique model to reshape the way funding is allocated to serve and represent San Diego’s refugee communities.

“It’s something we needed as a small organization and a community,” said Tessema. “Before we were single organizations that didn’t know each other and had overlapping programs. It wasn’t beneficial to the community at large.” He says that the model allows for the organizations to know who provides what services and then to refer community members depending on need. “We’re working as partners more than anything,” he added.

The coalition’s founder and facilitator, Amina Sheik Mohamed, a refugee herself, sees the role of the group as being bridge builders, “in between the community and the mainstream institutions,” including the state and county government, large donors and resettlement agencies. In the current system, ECBOs struggle to compete for their resources amongst larger, well-funded nonprofit organizations, who for example, can afford a culturally competent grant writer, if not an entire department, explained Sheik Mohamed. Meanwhile, under-funded ECBOs like those in the coalition often have a single director or part-time volunteer staff, working across the community assisting with direct needs, while applying for grants on top of the demands of full-time jobs.

In some cases, language is also a barrier for leaders. Coalition members told GroundTruth that some in leadership do not speak English as their primary language, making it more difficult to craft complex grant proposals on their own.

The coalition aims to fill such gaps by making members aware of the work of their peers, and the issues and places where their interests overlap.

To allow a fair distribution of resources, the 11 members that make up the coalition settled on a structure where their leaders would have equal voice and vote in decisions such as who will participate in what funding opportunities and how that funding will then get distributed. Sheik Mohamed and Valerie Nash, a consultant for the coalition, serve as facilitators, putting plans into action by presenting the group with funding opportunities, assisting in the application process, and building each individual organization’s capacities.

“We are able to apply for grants as a coalition. The funders could hear us better as opposed to by ourselves,” said Tessema. “We have collective skills to benefit the community.” Through this leadership structure, the coalition is able to access funding opportunities they wouldn’t have otherwise, overcoming their lack of personnel and technical expertise while still giving them the ability to continue doing what they do best: serve their communities.

Tessema says that being a part of the coalition has done more than introduce and pool resources, it has also functioned as a network of services, which he says helped his community through the trauma of recently losing two members to suicide. “We didn’t know where to turn,” he recalled. “(The coalition) sent us the resources: what could be done, where members could go and benefit from existing programs,” he said.

“As a coalition, we have some ideas, but we are also organic in terms of emerging issues or opportunities,” Sheik Mohamed said. Flexibility is critical to not only the group’s success but their survival, and nothing proved this more than the pandemic.

Six months into this collaborative experiment, COVID-19 presented a new set of challenges and lessons that the group believes will shape their alliance for years to come, and, maybe, provide a blueprint for ECBOs in other cities to follow.

Thriving in survival mode

While San Diego’s refugee communities differ culturally and linguistically, with over 21 languages spoken among them, COVID-19 exacerbated long-standing hardships shared by resettled refugees: affording rent and other necessities, maintaining adequate access to healthcare and adapting to life and culture in the U.S. Many work in the service sector and found themselves out of a job when businesses closed, while those who still had employment worked jobs designated essential, which could also come with a higher risk of contracting the virus.

“We get all kinds of questions, we’re at the frontlines of this,” Tessema said of his community’s experience of the pandemic. “Many Africans are cautious of vaccinations, asking, ‘Is it safe? Should we do it? What are the consequences?’”

In August 2020, the coalition secured a contract from the San Diego County Health and Human Services Agency’s COVID-19 Outreach and Education program to build a culturally competent health workforce. The $51,000 they received each month up until December 2021 was distributed among eight of the ECBOs, enabling them to employ 18 health workers, among whom a total of 21 languages are spoken. Paid a minimum salary of $20 an hour, these health workers help develop Zoom webinars and create videos to educate the community on COVID-19 and vaccinations.

In July 2021, the Health Resources and Services Administration (HRSA) awarded SDRCC a $1million grant to continue supporting the community health workers in increasing COVID-19 vaccine access. This funding extends the position of their community health workers through July 2022 and also embeds two workers to serve as liaisons to the refugee communities within the University California San Diego Health and Family Health Centers.

“I think the county saw that there was a disconnect between its public health awareness efforts and the communities it was trying to reach because of linguistic challenges and challenges of not knowing the community or leaders,” said SDRCC member Ramah Awad, the director of the The Arab Community Center, in December 2020.

Thanks to the county grant obtained through the coalition, the Arab Community Center, also known as the Majdal Center, was able to hire a part-time community health worker to translate and disseminate health resources such as infection and caregiver protocol and, most recently, vaccination information. “I think they’re more responsive to us as Arabic speakers and as community workers than they would be to a county official,” Awad said.

Previously, one of SDRCC’s primary goals was to build the economic self-sufficiency and sustainability of refugee communities. But as the number of COVID-19 infections increased, the coalition’s goals needed to shift. “The hierarchy of needs is shifted from, ‘Let’s focus on long-term stability and success’ to ‘We need to make sure these people don’t get evicted,’” said Nash, the coalition’s consultant and facilitator.

Their change of focus came with an unexpected benefit: It proved to San Diego County and other large funders the impact that a culturally competent workforce can have on a community, particularly during a health crisis.

Maggie Ramsberger, Chief of San Diego County Health and Human Services Agency, who previously oversaw the Community Action Partnership at the Office of Refugee Coordination, believes that a cohesive feedback loop between the community health workers and leaders to gather data and hear directly from residents is important to fix the disconnect between public health efforts and refugee communities.

“Refugee populations and U.S. naturalized citizens may have a distrust of government, depending on the circumstances that led them to be a refugee so we’d work to partner with them to build trust,” she said.

The state also recognized the results of this culturally competent workforce. In February 2021, SDRCC received news of 12 full-time and 25 part time federally-funded and state-distributed crisis counselor positions.

“We are creating opportunities we didn’t even dream of, making a workforce,” said Nash. “We don’t have social workers and therapists speaking Swahili. They’re going to get FEMA certification and the ability to advance their career in this pipeline.”

Through the program, the crisis workers developed a first-of-its kind, warmline, that members of the refugee communities can call in times of distress, to be connected to a message in their language and leave a message of their own. They will receive a call back within 24 hours from a crisis counselor who speaks their language. Funding for the program was extended until February 2022 and SDRCC expects it to renew.

As the virus continued to disproportionately affect refugee communities, the SDRCC members needed to assess the damage the pandemic had inflicted to understand where to focus their efforts. That is where the idea for the coalition’s COVID-19 Refugee Community Impact Report was born.

Verbally administered in 12 languages, the survey found that the participating 306 families were most concerned about the barrier to health care access imposed by COVID-19. Nearly a third of the family members canceled or missed health appointments during the pandemic, stemming from a fear of contracting the virus, adding to a list of existing obstacles like language, transportation limitations and difficulties navigating the American medical system. In October 2021, another survey was administered focusing on the topics of vaccination, housing and mental health. The results are slated to be published in February 2022.

In the Fall of 2020 when the first survey results were finalized, the distrust of vaccines wasn’t at the top of the coalition’s list of priorities, but the data indicated the need to immediately get ahead of the problem.

The coalition has conducted focus groups with the community health workers to understand and factor in beliefs, attitudes and hesitations relating to COVID-19 and vaccination efforts. Currently, SDRCC is working with San Diego County to provide input into their vaccination messaging and outreach campaigns, to ensure that they are culturally accessible and inclusive. They are also receiving support from the county with vaccination site assistance.

Having actionable data in hand also helped change the way ECBOs receive resources, said Sheik Mohamed. Before, SDRCC members had to fit their communities’ problems into the parameters of a grant. Normally, funders decide what issues they want to tackle and invite ECBOs to apply, but now with anecdotal evidence, SDRCC has been able to identify the most urgent problems and foster a conversation.

Sheik Mohamed said that multiple funders have reached out to her asking what can be done. “The question we normally get is ‘Is this a problem for the community?’” Typically she would say yes, wouldn’t have the data to back it up.“But now we’re right there, reaching out for or even creating the opportunities.”

‘Left out or treated like an afterthought’

SDRCC’s methods target the bureaucratic systems that aim to support the refugee population but have failed to reach them with funding and representation. In the U.S., county systems are responsible for many services and both federal and state funding for these services is allocated within different service branches. San Diego County’s adopted budget for the fiscal year 2021-2022 was announced at $7.23 billion. Of this, $2.8 million was allocated to health and human services, a 12.2% increase from the previous year, while there was a 10.4% increase for the entire adopted budget Fiscal Year 2021-22 from Fiscal Year 2020-21.

The county distributes this money primarily through contracting services for community programming with non-governmental organizations. This is done by putting out a “request for proposal,” or RFP. The request can be for any service, from infrastructure construction from contracting companies, to counseling, recovery, or food security programming. The county commissions outside contractors for these needs because they fall outside of the government’s direct expertise and capabilities.

Though these contracts are divided by geographic region, the county will try to hire bilingual providers in regions where a second language such as Arabic or Spanish, is predominant.

Here’s where the disconnect happens: Instead of managing many small contracts which could better target and serve various ethnic communities, the county often commissions a handful larger ones that range from $500,000 to $80 million.

Then there’s the issue of community size: 3,220 refugees arrived in San Diego County between the fiscal years 2017 and 2021, according to county refugee arrival data. While this number does not account for refugees who migrate to San Diego after initially resettling in another city, Nash believes that even if those numbers were included, it wouldn’t be enough to register on the radar of officials in a county of 3.5 million people.

“They were somehow meant to fit into these bigger constructs, and they were either left out or treated like an afterthought,” said Nash. “So the county never treated the refugee community as a priority community.”

Replicating the model

In the wake of the August 2021 Afghan refugee crisis, the coalition added it’s thirteenth member, the Afghan Community Culture Center. The organization opened a center where they provide the community with their needs upon arrival including cash assistance, crisis counseling, accessing benefits and housing needs.

Though SDRCC has yet to have conversations about what the model may develop into in the long term, Sheik Mohamed says a goal is to strengthen the coalition’s capacity to receive and internally manage larger amounts of funding, as well as new members. Reaching that goal might come sooner than expected.

In April 2021, SDRCC in partnership with Local Initiatives Support Corporation, or LISC, was awarded a $1 million Social Entrepreneurs for Economic Development (SEED) grant that funded a one-year program. Meeting weekly to train ten business coaches from ten different communities, these coaches could then teach that information to their community. The 150 graduates from the program are in the process of developing their business plans and now eligible for small business grants , of up to $7,500. SDRCC anticipates they will receive funding for this program again in 2022, which demonstrates the impact of community initiatives.

Additionally, SDRCC is finalizing a contract with the Legal Aid Society and San Diego Eviction Prevention Coalition to address the housing crisis. The group has legal aid and resources but they face challenges with reaching people that need these services. Through this program, SDRCC will help bridge the gap.

But the group is eager to share the model beyond San Diego and have had conversations at the state level about doing so.

“We feel like this could be replicated statewide, not to mention other areas, too, but for sure in California, we’re hoping at some point that we will be able to take this to that,” said Sheik Mohamed.

In 2021 she presented plans in other cities in California with significant refugee populations and thinks the UCSD Refugee Health Unit could help provide the backbone of support and technical assistance, beginning in areas with universities. “Everyone is excited but I think it’s just the opportunity and resources are not there yet,” Sheik Mohamed said.

Abdi Abdillahi, the San Diego County Refugee Coordinator, believes SDRCC’s model could transfer well to other parts of the country with refugee communities, but thinks increased knowledge about the county’s contracting system among the ECBOs could be a point of improvement. “The piece they’re missing is they don’t have a large contracting expertise and how to provide it to a large community of refugees, they do have all the other ingredients and knowledge about the services,” Abdillahi said in December 2020.

Ramsberger, Chief of San Diego County Health and Human Services Agency, expressed that this challenge of ECBOs and contracting often comes from the size and magnitude of the county and the services it provides. She mentioned a program already in the works, RISE San Diego, which aims to educate small organizations on building the internal management to take on government contracts. “We’re trying to work with these organizations to find technical solutions and develop training programs,” she said.

Though these contracts are divided by geographic region, the county will try to hire bilingual providers in regions where a second language such as Arabic or Spanish, is predominant.

In the meantime Ramsberger believes subcontracting is a solution for ECBOs to gain contracting expertise and access resources. “When organizations are able to start as subcontractors they’re able to get experience without taking a risk,” she said.

Nash voiced the group’s concern about funding for the community health workforce, crisis counselors and vaccination efforts that expire in July 2022. She said COVID highlighted pre-existing health access inequities and they’re not going away.

“We have infrastructure and workforce built and everyone agrees that there is a need for this workforce,” she said. “But the problem we might have is the system might not be able to adapt fast enough.” She wonders if a government entity will recognize the need for the health workers before July.

“If we’ve learned anything it’s that something will show up. We just have to be flexible and able to respond quickly.”

Internally, the coalition’s facilitators are helping their members gain experience by delegating functions. “We’re asking, ‘Do you need me for this? Do this part and send this to me,’” Sheik Mohamed said. While the group sees measurable success, enough to encourage growth, their vision for scalability isn’t about size.

“We’re not about getting bigger. It’s more about getting better,” Nash said. “So that’s a very important distinction. It’s more about scaling to do better work when it comes to mental health, when it comes to economic stability, when it comes to jobs and housing,” said Nash.