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Removing
Barriers to Farmworker Participation in SCHIP and Medicaid
Farmworkers are a mobile high risk, high need and hard to
reach working poor population thought to have the worst overall
health status in the nation. Although eligible to participate
in safety net programs, including Medicaid and the State Child
Health Insurance Program (SCHIP), farmworkers under utilize
these programs. The low rate of farmworker participation is
due to health systems problems in the regulation and administration
of child health insurance programs that make it difficult
for farmworkers to obtain or retain access to benefits.
State regulatory policies often contribute to the problem
by failing to accommodate the special access needs of farmworkers
in their planning processes. Farmworkers could benefit greatly
from the outreach and enrollment effort currently surrounding
the SCHIP. However, special efforts to remove access barriers
are required at the national, state and community levels if
the enrollment efforts are to be successful in allowing farmworker
participation in both the SCHIP and Medicaid programs.
In 1998, The National Center for Farmworker Health, Inc.
(NCFH) received funding from the HRSA Bureau of Maternal Child
Health to implement a three-tiered program to remove barriers
and increase farmworker participation in SCHIP and Medicaid.
At the community level, the NCFH provides technical assistance
to migrant and community health centers and other local social
service organizations as well as SCHIP/Medicaid screening/referral
to migrant farmworkers through its toll-free line, Call for
Health. A collection of case histories of actual farmworkers
cases is also being collected through the Call for Health
Program to illustrate the barriers and challenges faced by
the farmworker population as they attempt to participate in
these programs.
At the state level, the NCFH is working with Primary Care
Associations and Organizations (PCAs and PCOs) and the Bureau
of Primary Care Migrant Health Branch to collect information
regarding farmworker participation in these programs and identify
barriers within specific states to assist state leaders in
addressing these issues. In addition, NCFH conducts presentations
to assist states in identifying where the issues lie (local,
state or national level). One of the key strategies for impacting
and overcoming the barriers to farmworker participation in
SCHIP and Medicaid is the understanding of the barriers and
at which level they can be impacted. In pursuit of this understanding,
NCFH has developed the Removing Barriers for Farmworkers:
Access to SCHIP and Medicaid Curriculum, and has developed
two fact sheets (one for providers and the other a bilingual
fact sheet for farmworkers). These materials are available
through both our web site and through the NCFH Resource Center.
Both the curriculum and the fact sheets may be downloaded
and copied for distribution.
The national level involves the formulation of federal recommendations
based on the experiences and results obtained from the work
completed at the community and state levels, as well as work
with other national organizations.
For more information, contact Sylvia Partida (
).
This is a NCFH project with support from US Department of Health and Human Services (HRSA) Maternal and Child Health Bureau (MCHB).
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