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

Ag Worker Health Day is August 17th!

Join us in commemorating Agricultural Worker Health Day and share your health center's Ag Worker Health Day plans with us! Be sure to include the Ag Worker Access 2020 Campaign in your celebration! Then post your photos on our Facebook wall and be automatically entered to win a FREE poster of your choosing! 

Downloadable/printable campaign resources are available here.
Remember to use the tag #AgWorkerAccess!

 Winners will be announced live on Facebook, Friday August 18th 2pm Central Time.