NURS FPX 6618 Assessment 2 Mobilizing Care For An Immigrant Population

Name

Capella university

NURS-FPX 6618 Leadership in Care Coordination

Prof. Name

Date

Mobilizing Care for an Immigrant Population

As the Director of Care Coordination (CC) at St. Mary’s Hospital (SMH), I am committed to launching a program tailored to meet the healthcare needs of undocumented Hispanic immigrants. This population encounters persistent barriers that hinder access to healthcare services, including language limitations, financial constraints, and the pervasive fear of deportation. The proposed program intends to dismantle these obstacles by cultivating a culturally responsive care environment and fostering trust within the community. Through these efforts, the program seeks to enhance health outcomes and ensure that vulnerable individuals receive timely and appropriate care, thereby improving overall community wellness.

A critical focus of this program is to address the distinctive challenges faced by undocumented Hispanic immigrants, such as higher incidences of chronic conditions like Diabetes Mellitus (DM) and Hypertension (HTN), alongside mental health concerns tied to their uncertain immigration status (Wright et al., 2024). By prioritizing preventive care, chronic disease management (CDM), and culturally sensitive mental health (MH) services, SMH can reduce avoidable hospital admissions and emergency department visits while promoting a sustainable, inclusive healthcare model. These efforts align with broader public health objectives and position SMH as a leader in equitable, community-centered care.

Rationale for Focusing on the Healthcare Needs of a Particular Immigrant Group

Recent statistics reveal that Latinos comprise nearly 19% of the U.S. population, with 57.8 million individuals identifying as such in 2016 (Perreira et al., 2020). Among them, undocumented Hispanic immigrants represent a particularly vulnerable subgroup due to their limited healthcare access. The persistent threat of deportation discourages many from seeking medical attention, an issue compounded by language barriers, financial challenges, and lack of insurance. This situation often results in untreated chronic conditions and unmet mental health needs.

This community experiences disproportionately high rates of chronic illnesses and mental health concerns, often exacerbated by socioeconomic hardships and restricted healthcare options. Addressing these disparities is critical not only for improving individual health outcomes but also for bolstering public health through decreased reliance on emergency services and improved disease management (Wright et al., 2024). By offering culturally tailored, preventive services, SMH can reduce health inequities and promote a healthier, more resilient community.

The selection of undocumented Hispanic immigrants as the target population for this program is guided by two primary considerations. Firstly, Hispanics constitute a substantial portion of the overall U.S. population, with approximately 59% of undocumented immigrants of Mexican descent (Passel, 2019). Secondly, this population experiences pronounced health disparities, including high rates of DM, HTN, and limited access to mental health services, all exacerbated by poverty and lack of insurance coverage.

Table 1

Rationale for Target Population Selection

Criteria	Explanation
Population Proportion	Hispanics represent 19% of the U.S. population (Perreira et al., 2020)
High-Risk Health Disparities	Elevated prevalence of DM, HTN, and MH issues (Wright et al., 2024)
Socioeconomic and Insurance Barriers	Low income and lack of coverage worsen health outcomes
Public Health Importance	Reducing ER visits and hospital admissions improves public health

Evaluating Healthcare Needs

An organized strategy is crucial for effectively addressing the healthcare barriers faced by undocumented Hispanic immigrants. Applying the Six Sigma DMAIC (Define, Measure, Analyze, Improve, Control) framework offers a systematic and data-driven approach to assess and improve healthcare services for this group.

Define:

In this initial phase, the core healthcare challenges are clearly outlined. Hispanic undocumented immigrants often avoid medical care due to deportation fears, language difficulties, financial hardship, and inadequate insurance (Ornelas et al., 2020). The objective is to improve primary and preventive care, enhance chronic disease and mental health services, and nurture community trust.

Measure:

Data collection plays a pivotal role in quantifying the problem and determining its scope. Relevant data includes demographic profiles, care utilization patterns, prevalence of chronic diseases, and mental health indicators. Information is gathered through surveys, focus groups, electronic health records (EHRs), and collaboration with community organizations (Funk & Lopez, 2022).

Analyze:

In this stage, root causes are identified, and areas for improvement are highlighted. Major challenges include limited English proficiency, high uninsured rates, financial limitations, cultural differences, and fear of deportation (Kronenfeld et al., 2021). Analytical tools like Pareto charts and Fishbone diagrams aid in systematically uncovering these obstacles.

Table 2

Key Barriers and Underlying Causes

Barrier	Cause
Language Barriers	Limited English proficiency affects care comprehension
Financial Hardship	High uninsured rates and low income restrict healthcare access
Fear of Deportation	Legal vulnerabilities deter healthcare-seeking behavior
Cultural Differences	Lack of culturally tailored services affects trust and adherence

Improve:

Targeted strategies are developed to address these identified challenges. Initiatives include hiring bilingual staff, offering interpreter services, creating safe healthcare spaces, implementing sliding fee scales, and providing cultural competence training for staff (White et al., 2020). Community engagement efforts, partnerships with local organizations, and pilot programs such as patient navigators and health screenings at community centers are essential for refining and expanding these interventions.

Control:

This phase ensures that improvements are maintained and progress is monitored. Ongoing evaluations of service utilization, patient satisfaction, and health outcomes, coupled with regular surveys and focus groups, provide continuous feedback. EHR monitoring of chronic disease management, consistent staff training, and securing sustainable funding through grants and partnerships support the program’s long-term success (Tsai et al., 2020).

Recognized Organizations and Stakeholders

Effective care coordination for undocumented Hispanic immigrants requires collaborative efforts from multiple stakeholders at various levels. Internationally, organizations such as Doctors Without Borders and the International Organization for Migration (IOM) contribute essential medical services and advocacy (Doctors Without Borders, 2024). Nationally, federal agencies like the Centers for Disease Control and Prevention (CDC) and the Health Resources and Services Administration (HRSA) set public health priorities, allocate funding, and support targeted programs (CDC, 2024).

At the state level, the Florida Department of Health manages statewide health initiatives and allocates resources, working alongside public health officials and frontline nurses. Locally, healthcare institutions, including SMH, provide primary care, chronic disease management, and mental health services. Regional organizations such as the Hispanic Services Council offer complementary services like legal support, translation assistance, and financial aid.

Table 3

Key Stakeholders by Level

Level	Organizations / Stakeholders
International	Doctors Without Borders, International Organization for Migration
National	CDC, HRSA, UnidosUS, National Immigration Law Center
State	Florida Department of Health, public health officials, community health nurses
Local	St. Mary’s Hospital, Hispanic Services Council, patient navigators, nonprofits

Collaborative partnerships among these entities promote integrated, patient-centered care and enable efficient resource sharing. Joint advocacy efforts and collective action improve healthcare access for undocumented immigrants while advancing inclusive public health policies (CDC, 2024).

Defining Characteristics of the Population

The undocumented Hispanic immigrant community in Tampa includes a diverse age range, primarily comprising working-age adults (18–50 years), as well as children and adolescents. Gender distribution slightly favors males, largely due to labor migration patterns (Ornelas et al., 2020). Most individuals live in urban or peri-urban areas with access to employment in sectors such as construction, hospitality, and agriculture.

Family structures often involve multigenerational households offering both emotional and financial support, though overcrowding and limited resources are common challenges. Spanish is predominantly spoken, with children frequently acting as interpreters for their families. Community ties are strong, with churches and cultural events playing central roles in maintaining social cohesion.

Economically, this group experiences significant hardship, working in low-wage, unstable positions without benefits or legal protections (Funk & Lopez, 2022). These conditions contribute to financial insecurity and make individuals vulnerable to exploitation. Politically, their undocumented status exposes them to constant legal and social insecurities, limiting access to employment, healthcare, education, and housing. Local nonprofits and advocacy organizations strive to address these gaps (Hacker et al., 2021).

Culturally, these immigrants maintain deep connections to their home traditions, including food, festivals, religious practices, and communal celebrations, with Roman Catholicism widely practiced. Religious institutions often serve as social and emotional support centers. Educationally, many adults have limited schooling, but there is a strong emphasis on improving opportunities for the next generation, despite barriers posed by immigration status and language limitations (Loganathan et al., 2023).

References

Centers for Disease Control and Prevention. (2024). CDC immigrant and refugee health. https://www.cdc.gov/immigrantrefugeehealth/index.html

Doctors Without Borders. (2024). Medical care for migrants and refugees. https://www.doctorswithoutborders.org

Funk, C., & Lopez, M. H. (2022). Latinos’ experiences with healthcare in the United States. Pew Research Center. https://www.pewresearch.org

Hacker, K., Chu, J., Leung, C., Marra, R., Pirie, A., Brahimi, M., English, M., & Beckmann, J. (2021). The impact of immigration and customs enforcement on immigrant health: Perceptions of immigrants in Everett, Massachusetts, USA. Social Science & Medicine, 73(4), 586–594. https://doi.org/10.1016/j.socscimed.2021.03.040

NURS FPX 6618 Assessment 2 Mobilizing Care For An Immigrant Population

Kronenfeld, J. J., et al. (2021). Healthcare inequalities in the United States: A comprehensive textbook. Springer.

Loganathan, T., Rui, D., Ng, C. W., & Pocock, N. S. (2023). Migrant health in the United States: A systematic review. BMC Public Health, 23(1), 342. https://doi.org/10.1186/s12889-023-15124-3

Ornelas, I. J., et al. (2020). Understanding undocumented Latino immigrants’ health needs and access to care: A qualitative study. American Journal of Public Health, 110(5), 741–747. https://doi.org/10.2105/AJPH.2020.305589

Passel, J. S. (2019). Mexican immigrants in the United States. Pew Research Center. https://www.pewresearch.org

Perreira, K. M., et al. (2020). Health care access and utilization among Latino immigrants in the United States. Journal of Health Care for the Poor and Underserved, 31(4), 1806–1830. https://doi.org/10.1353/hpu.2020.0136

Tsai, J., et al. (2020). Health outcomes of undocumented immigrants in the United States: A systematic review. Journal of Immigrant and Minority Health, 22(4), 846–859. https://doi.org/10.1007/s10903-020-01020-0

NURS FPX 6618 Assessment 2 Mobilizing Care For An Immigrant Population

White, K., et al. (2020). Disparities in healthcare access and outcomes for undocumented immigrants in the U.S.. Health Affairs, 39(7), 1176–1184. https://doi.org/10.1377/hlthaff.2020.00137