Are you a service provider working with newcomer clients with disabilities? Newcomers with disabilities may be eligible for supports they do not know exist, especially if disability services were unfamiliar, stigmatized, or inaccessible in their home communities. You do not need to be an expert in every program to help! This blog post gives you four practical steps to improve your services when working with clients with disabilities.
1. Become Familiar with Available Services
The following chart provides an overview of disability-related services and supports that may be available to newcomers and where to start. For local services, it would be most helpful to identify the local points of contact. Eligibility and application processes vary by state, so make sure you confirm current requirements rather than relying on this chart alone. An important distinction to make to your clients is that accommodations generally apply regardless of immigration status, while benefits depend on the eligibility rules of each program.
| Area | Available Services | Where to Start |
|---|---|---|
| Health care | Medicaid; Home and Community-Based Services (HCBS) waivers may provide in-home care, personal assistance, and community support |
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| Income support | Supplemental Security Income (SSI) (low income, no work history required); Social Security Disability Insurance (SSDI) (based on work history) |
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| Housing | Public housing, Housing Choice Vouchers (Section 8), subsidized accessible housing |
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| Employment | Vocational rehabilitation (VR): job training, placement, job coaching, assistive technology, sometimes ESL support |
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| Independent living | Skills training, peer support, assistive technology device loans and demonstrations | |
| Children under 3 | Early Intervention under the Individuals with Disabilities Education Act (IDEA) Part C |
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| Ages 3–21 | Special education and an Individualized Education Program (IEP) under IDEA Part B, plus related services: speech-language therapy, occupational therapy and physical therapy (OT/PT), counseling, transportation, assistive technology |
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| Developmental disabilities | State developmental disabilities (DD) agencies coordinate services; state DD councils advocate for policy change | |
| Citizenship | U.S. Citizenship and Immigration Services (USCIS) disability accommodations; Form N-648 (the medical certification used to request an exception to the English and civics testing requirements for naturalization) |
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| Legal protections | Americans with Disabilities Act (ADA), Section 504 of the Rehabilitation Act of 1973, Individuals with Disabilities Education Act (IDEA), Fair Housing Act, Affordable Care Act (ACA) section 1557; Title VI of the Civil Rights Act of 1964 (language access) |
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2. Look Beyond Formal Diagnoses
Disability isn’t always visible or documented. A client may arrive with a diagnosis that isn’t recognized in the U.S.; there may be original records they can’t obtain from their country of origin or can’t translate; or they may have no diagnosis at all. Intakes that screen only for medical conditions can also miss other disabilities.
Definitions for disability also vary by system. SSA, USCIS, and the ADA each define disability differently, so a client who doesn’t meet one definition may still meet another. When possible, work from the ADA’s definition, which is broad, and reserve the narrower program definitions for determining eligibility under those specific programs.
Asking all your clients the following questions, and explaining why, helps avoid singling out a client based on an actual or perceived disability:
- “We ask everyone these questions to make sure our services are accessible. Is there anything that makes it difficult for you to participate, such as seeing, hearing, communicating, walking, remembering, concentrating, or learning?”
- “What can we change or provide that would make it easier?”
- “How do you prefer to receive and communicate information?”
Needs also change over time, so consider revisiting these questions if a client is entering a new program or if their circumstances appear to have changed.
3. Provide Relevant Accommodations and Supports
Accommodations for people with disabilities are modifications to environments, rules, or tasks that give equal access to work, school, and public places. Accommodations generally apply to all clients, while eligibility for a particular benefit or program depends on that program’s rules. A client who doesn’t qualify for a particular benefit is still entitled to an accessible resettlement process. Here are some examples of accommodations and supports you can provide:
- Communicate in plain language and use written or visual aids. Provide as much time as possible for comprehension and understanding.
- Use a person-centered starting point. Build from the client’s strengths, preferences, and goals.
- Arrange qualified interpreters. Language access and disability communication are separate needs that sometimes overlap. See Switchboard’s Introduction to Working with Interpreters.
- Ask about sign language and preferred communication method. Sign languages differ by country. If a Deaf or hard-of-hearing client uses sign language, ask which one they use and how they prefer to communicate. Note their preference and work to arrange appropriate communication support before their next appointment. The Registry of Interpreters for the Deaf is one resource you can use to search for interpreters who specialize in foreign sign languages.
- Engage families as partners where appropriate. Family members may help provide helpful information about a client’s routines, communication preferences, and support needs.
- Create an accessible environment. Consider physical spaces, forms, technology, and appointment logistics in your office. Designing accessible services for people with disabilities also improves access for all people you serve!
- Help coordinate across systems. Clients almost always participate in several systems at once, particularly clients with disabilities. Helping clients navigate multiple programs and benefits helps avoid duplication and address gaps.
4. Prepare Clients for Assessments and Referrals
Screening is often the first step toward referrals. To help clients feel less anxious, explain that a screening is not a test they can fail. The chart below covers where each type of screening comes up and what to tell your client to expect.
| Tool | Context for Screening | What Clients Can Expect |
|---|---|---|
| Refugee Health Screener-15 (RHS-15) | Often folded into the post-arrival medical screening | A 4–12 minute check for depression, anxiety, and post-traumatic stress disorder (PTSD). Not a diagnosis. A positive score leads to a behavioral health referral, not an on-the-spot treatment decision. |
| Cultural Formulation Interview (DSM-5) | Part of a behavioral health intake | Open-ended questions about how the client and how they are feeling and what they are going through. Comes before any discussion of diagnosis. No wrong answers. |
| Ages & Stages Questionnaires (ASQ-3) | Completed by a parent at a pediatric visit, Head Start, home visit, or Early Intervention | A questionnaire about the child’s skills. A low score triggers a referral for a full, free evaluation (which a parent can also request directly). |
| Vineland-3 / Adaptive Behavior Assessment System (ABAS-3) | Usually arranged through a school district evaluation or a state developmental disability agency | One or more sessions: a structured interview with a parent or caregiver, plus a rating form from a teacher or someone who knows the client well. (It is not a test the client takes.) Questions cover daily life (e.g., dressing, managing money, socializing). Used to decide services. |
Before making a referral, discuss whether the client can realistically reach the service. Transportation, cost, language access, physical accessibility, and technology are all important considerations. Most clients won’t ask for an accommodation unprompted. When you raise access needs as a matter of routine, clients are far better placed to navigate systems and speak up for themselves.
Additional Resources
Refugees and newcomers
- Understanding Disability Rights and Support for Newcomers: What Providers Need to Know — Switchboard guidance for service providers
- A Newcomer’s Guide to Disability Rights and Support in the U.S. — Client-facing resource from Settle In available in 11 languages
- Supplemental Security Income (SSI): Frequently Asked Questions for Service Providers — Switchboard
- What Works to Support Newcomers with Disabilities and Chronic Illnesses? — Switchboard evidence summary
Rights and accommodations
- Introduction to the Americans with Disabilities Act — ADA.gov
- Communicating Effectively with People with Disabilities — ADA.gov
Education
- Find Your Parent Center — Parent Training and Information Centers
- Individualized Education Plan (IEP) Process Demystified: Support for Newcomer Families — Switchboard
The IRC received competitive funding through the U.S. Department of Health and Human Services, Administration for Children and Families, Grant #90RB0053. The project is 100% financed by federal funds. The contents of this document are solely the responsibility of the authors and do not necessarily represent the official views of the U.S. Department of Health and Human Services, Administration for Children and Families.
