Background
The Increase Access to Care for Ag Workers (IAC) program is a learning collaborative that goes hand in hand with the Ag Worker Access 2020 Campaign, a national initiative launched in 2015 to increase access to quality healthcare for America’s Agricultural workers and their families.  At the time of the Campaign’s launch, health centers were seeing a decrease in the number of Ag Workers being served and not keeping pace with the increases in 330g (Migrant Health) funding.  Health Center staff and other advocates knew that more could be done to increase access to quality care for Ag Workers and their families – The result was the Ag Worker Access 2020 Campaign.
 
About the Program
The IAC Program was designed to assist health centers in accurately identifying, registering and reporting their patients….We know that Ag workers are being served, but are not always asked the right questions and, therefore, often not identified as Ag workers.
 
Through this program, consisting of training, quarterly network calls, and support, NCFH has been able to help health centers modify their current systems and registration processes to demonstrate their effectiveness.  As a result, participating heath center patient registration teams are implementing the steps necessary to identify and accurately report Ag workers when they register.
 
In addition to participation in training sessions and quarterly calls, these health centers also provide their UDS information to NCFH twice a year; the purpose of this is to help us track and measure the outcomes of the changes being implemented as part of the Program.
 
Learning Collaborative Participation
Our Program members include Primary Care Associations (PCAs), Health Care Controlled Networks (HCCNs), and Health Centers (HCs).  Our common goal for the Increase Access to Care Program is to continue to increase access to care for Agriculture workers in their service areas through sharing of knowledge, tools, and resources.  In our work, as in most industries, time is limited, and we truly believe that by being sources of information for each other and sharing what has worked in accomplishing our goals, we can all be successful. 
 
Are you interested in joining the IAC Learning Collaborative?  Contact us! 

​In September, HRSA expects to award supplemental funding to health centers that have an established partnership with organizations that are awarded through the fiscal year (FY) 2018 Behavioral Health Workforce Education and Training (BHWET) Program (HRSA-18-112). Up to 50 health centers are expected to receive $200,000 per year for two years to increase access to quality opioid use disorder and other substance use disorder treatment through behavioral health professional and paraprofessional training.
 
For health centers to be considered for this funding, a memorandum of agreement or understanding must be signed by the health center and included in the partnering organization’s application to HRSA-18-112 by Friday, July 6.
 
Health centers can access additional information, including a list of eligible BHWET applicants, on the FY 2018 Enhancing Behavioral Health Workforce Supplemental Funding Opportunity for Health Centers Technical Assistance website. 

On May 2, 2018, more than 150 health center staff and Ag worker advocates gathered at the NACHC Conference on Ag Worker Health General Session in San Antonio to celebrate victories in increasing access to care for America’s agricultural workers and their families.  3 years earlier, also in San Antonio at this same conference, the Ag Worker Access 2020 Campaign was launched in response to a mutual concern for this special population. 
 
Since the inception of the Campaign, UDS numbers have been steadily increasing, thanks to the commitment and investment by health centers in addressing Ag worker social determinants of health.  According to UDS data, 957,529 Ag workers and their families were served in 2016, an increase of 47,357 over 2015, which is definitely reason to celebrate!
 
During this interactive session, participants were led in an exercise by NCFH staff to create "Victory Circles" celebrating and documenting health centers’ strategies contributing to this nationwide increase in access. Participants at each table were asked to discuss and then document activities that they were doing/had done to increase access to care. Participants were then encouraged to share their achievements with the full group attending the session. 
 
Additionally, NCFH announced its first annual Increase Access to Care Promising Practices Awards winners, Sea Mar Community Health Centers (WA) and Altura Centers for Health (CA). Both health centers have been active participants in NCFH’s Increase Access to Care Program, designed to assist health centers in accurately identifying, registering and reporting their Ag worker patients.  Both health centers were acknowledged for their innovative approaches to increasing access to care for Ag Workers and their families.
 
Finally, also as part of the celebration, 10 lucky participants received an artwork print from NCFH’s Commemorative Artwork series.
 

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The National Center for Farmworker Health unveiled the original of the 2018 Annual Commemorative Artwork on May 2, 2018 in San Antonio, TX, at the National Association of Community Health Centers’ (NACHC) Annual Conference on Agricultural Worker Health.
 
Florida based artist Adorable Monique has produced “Tierra Bendecida,” which celebrates the traditions, beliefs and identity of the agricultural worker population.
 
This framed original has been donated to NCFH and is now available for auction to the highest bidder.  One hundred percent of the sale of this painting will support awards to Health Centers for outstanding success in increasing access to patient care and to Health Center staff for scholarships and educational advancements.
 
Our auction is being hosted by 32auctions.com. Simply create a free profile in order to bid.
 
Bidding will end on Sunday, May 13that 12:00am Central time.

 
Click Here to Join the Auction

 

Going into this year’s (Midwest Stream Forum) Health Conference I didn’t know what to expect.  I was extremely excited to hear the conference would be held in Grand Rapids, Michigan.  While attending each conference session I met new people who were from different parts of the U.S.  I was amazed to see so many people gathered for the same purpose, I would hear each individual speak so passionately about their occupation, their purpose, what their goals were, and what they hope to do for their Health Center in the years to come.  Some of these centers had things like mobile dental units, mobile labs, and providers that would go out to the fields and see their patients.  It was amazing to hear that these centers would go that extra mile to ensure these Agricultural workers knew they had dental and medical services available to them.  Hearing these things were even possible lit a fire inside me to say I want that for my Community, I want to go that extra mile.
 
As each session went on I would hear the speakers talk about migrant workers, H2A workers and seasonal workers.  To my surprise, I didn’t even know the difference between them.  These people spoke to us about the workers and their struggles, struggles like physical abuse, sexual abuse, mental issues, pesticide exposure, food insecurity, homelessness...the list continued.
 
Going to bed at night I had all these facts running through my mind.  I went back to the days when I was a little girl; my father would work a full time job in one of the big manufacturing companies here in our community.  Once his shift was over he would head out to the fields to help pick and sack vegetables; he would’ve been considered a seasonal worker.  I didn’t understand at that time he needed to do this to help provide that extra money our family needed.  Just like most of these men, women, even children who work from early morning to late at night in the hot sun to help provide for their families to still live in poverty at the end of the day.
 
These agricultural workers are the heart of our food pyramid--What are we doing to help keep them healthy?  Our Health Centers are available to them, but how many of them know that? How many of these workers are afraid to come to our Health Center, in fear of deportation...Most of these people would rather suffer than be forced to leave their families, wouldn't you do the same? It is our job, not only as health care workers, but as family, to get the word out to these workers that we are here and we do stand for them.  Let’s help these people live longer lives, let’s help stop their suffering, not only for the workers but for their families just the same.
 
Ask me why I care and I will tell you I care for the person that helps supply our stores with food for my children to eat, I care for those children out in those fields forced to work for less than minimum wage, I care for the mothers and fathers who put their lives at risk every day to support their families just like my father did for me.
 
I was asked to bring something back that I could share with my fellow coworkers...Of everything I have written, I hope I brought back that fire.  The fire that says yes we can do this, yes we will stand for these families and make the noise to let them know we are here and we will work for them just like they do for us every day.

-- Joshlynn Sandoval, RDA

Diabetes affects more than 30 million Americans in the United States. One of the main challenges is many health centers struggle to properly diagnosed patients with diabetes. Join us for this third webinar of our Diabetes in Special and Vulnerable Population: A National Learning Series focusing specifically on diabetes and those affected by it. This webinar will explore diabetes prevention and care strategies across the lifespan. Presenters will discuss standards of care in the screening and prevention for children, adults, and the elderly, sharing experiences from the field. Presenters will also engage participants around case examples of successful diabetes prevention programs, adult clinical treatment, and geriatrics care focused on vulnerable populations of children and adults of all ages. Presenters will connect participant with resources to outreach opportunities and tools they can apply and adapt for their own health centers.

Speakers:

• Gina Trignani-Kirk, Director of Training and Capacity Building, Health Promotion Council
• Andrea Vettori, Nurse Practitioner, PHMC Mary Howard Health Center
• Tanicia Daley, Pediatric Endocrinologist, Egleston Hospital Children's Healthcare of Atlanta
• Elena Toschi, MD, Endocrinologist, Joslin Diabetes Center

Diabetes in Special and Vulnerable Populations: A National Learning Series
Wednesday, November 29
11:00 a.m.-12:00 p.m. PST / 2:00-3:00 p.m. EST

Diabetes affects more than 30 million people in the United States. Multi-tiered efforts to prevent, treat and manage diabetes are critical in reducing the burden of diabetes, particularly for medically underserved racial and ethnic minority populations. In addition to higher prevalence, ethnic and racial minority patients with diabetes have higher mortality and higher rates of diabetic complications. Join us for this kick off webinar of a national learning series on effective strategies to prevent, treat, and manage diabetes among special and vulnerable Health Center Program patients. This session will explore important lessons learned from the National Diabetes Collaborative, which made impressive gains in improving diabetes care for the most vulnerable. Faculty will discuss how to incorporate some of the most important lessons of the collaborative into current efforts to diagnose, treat and manage diabetes most effectively.

Register »

This year’s Midwest Stream Forum for Agricultural Worker Health Closing Plenary in Grand Rapids, MI, was a celebration of health centers’ accomplishment of serving 957,529 agricultural workers and their families in 2016, an increase of 47,357 over 2015.
 
Participants were lead in an exercise, facilitated by NCFH CEO, Bobbi Ryder, to create a Victory Circle celebrating and, documenting health centers’ strategies contributing to this nationwide increase in access. Participants at each table were asked to discuss and then document one activity that they were doing/had done to increase access to care. Representatives from each table then shared their achievements with the full group attending the closing plenary. 
 

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​The following are individual responses, by state reflecting a significant in investment in addressing the social determinants of health for this very special population.
 
California

• Train staff on the definition of “Agricultural Worker”
• Collaboration with local agencies that outreach to the local agri-community
• Expansion of Dental Program
• Implementation of transportation for patients
• Patient transportation at no cost for 2 counties – expanding
• Implementation of promotoras in new county areas
• Obtained funding to reach Ag workers (insurance/health care access)

 
Colorado

• Developed a fact sheet for employers to know the services we provide for their employees
• Identified and trained our staff on all branches of ag
• Began using our mobile unit for medical & dental

 
Illinois

• Launched our AG Worker Access 2017 Campaign ad incentivized staff (Bonus) and included it in their individual performance measures
• Partnerships with other providers to expand services like HIV and other STDs to serve farmworkers better
• Take clinicians to the MSAWs

 
Kansas

• Visit employers of farmworkers to get new families
• Interpreter
• Reporting Data
• Case management

  
Maine

• When we realized we had high demand at some camps, we increased the # of mobile clinics

 
Michigan

• Partnership with LLEAD to fund to cover patient fees
• SPN Diabetes Self-Management Program Classes
• Establish rapport with growers to increase service access
• Participated in camp out events with other organizations for maximum outreach!
• Expanded services to the camps with mobile buses
• Medical, dental & behavioral health collaboration to fulfill complete medical needs
• Hired a promotora
• Transport migrant workers to clinic
• Help them with services like eye doctors, specialist
• Identify camps
• Use of electronic translators at FQHC
• Increased transportation and access to mammography
• Multiple dental providers on our new dental bus
• Traveling important information folder for each family (Accordion folder for each)
• Hired Spanish speaking nutrition instructor to offer classes in community
• Added migrant community health worker and outreach specialist
• Creating a welcoming atmosphere, (example, played familiar music during in camp mobile clinics)
• TV ads inviting all to FQHC nationally
• Increase awareness of available health center services
• Outreach team was largely made up of internal staff who were already committed to our ag worker community
• Lending a compassionate ear to all encountered
• Mobile clinic (Health Screenings)
• Expanded medical services to include pediatric care
• Spanish/English bilingual CHWs
• Mobile dentistry services

 
North Carolina

• Making Dental & Diabetes Health accessible
• Bringing mobile clinic to camps
• Implement mobile laboratory services during outreach

 
Oklahoma

• Outreach

 
Oregon

• Streamlined intake process

 
Pennsylvania

• Biweekly Physician’s Assistant. for camp visits

 
Texas

• Increased collaboration with MSAW departments at the following organizations: ISD; Head Start Centers; Workforce
• Eliminate barriers to register them to our clinics through navigation
• Extending outreach services to schools & Ag site
• Extending clinical & dental hours
• Distribuimos volantes con información para los trabajadores del campo y para toda la comunidad donde proporcionaron la información de todos los servicios de la clínica
• Distributed flyers with info for workers and community with clinic information
• Look for sponsors to provide them a comfortable sleeping environment
• Outreach to Ag sites
• SWART transportation
• Extended hours and open Saturdays
• Monthly employee training

 
Participants documented their achievements on circles provided for this purpose which were then displayed as a visual graphic surrounding the 2003 Commemorative Artwork poster by Austin Artist, Lyrae Perry. NCFH expressed its appreciation to those who stayed through the last session on the last day and contributed to this graphic display, by awarding a Giclée fine art print of “Vigilando el Futuro” to one lucky participant at each of 10 tables via hidden chair tags.
 
As promised, an 8x10 photograph of the graphic display was personally presented to BPHC leaders, Jim Macrae and Tonya Bowers the following week as a collective demonstration of front line commitment to increasing access to quality care for this essential Ag labor workforce.
 
What has your health center done to increase access to care for Ag workers and their families?  Please let us know so we may share with other health centers, and continue to build on the momentum of our 2016 increase in access.

The U.S. Centers for Disease Control and Prevention is sharing the following recommendation to help communities to avoid additional dangers after hurricanes.

• Do not drive through flooded areas and standing water. Turn around, don’t drown!
• Avoid Carbon Monoxide (CO) poisoning. Keep the generator at least 20 ft outside door/window. Don't grill inside. Fumes can kill.
• Use bottled, boiled, or treated water for drinking, cooking, and personal hygiene.
• Throw away perishable foods—like meat, seafood, milk, and eggs—that have not been refrigerated properly due to power outages or have come in contact with floodwater.
• If it’s hot, move to a cool place, take sips of water, and take cool showers.
• Throw away any drugs that may have been contaminated with floodwater.  
• If you are pregnant, drink lots of clean water and get plenty of rest—especially when you are sick.
• Call SAMHSA's Disaster Distress Hotline at 1-800-985-5990 or text TalkWithUs to 66746 if you need counseling support. For assistance in Spanish you can call or text HABLANOS at 1-212-461-4635.

For more tips on how you can stay safe after the hurricane visit:
English: https://www.cdc.gov/disasters/hurricanes/after.html
Spanish: https://www.cdc.gov/es/disasters/hurricanes/after.html