Increase Access To Care for Ag Workers Program
Promising Practices Award
2022

NCFH is pleased to recognize Golden Valley Health Centers, based in Merced, California, at this year’s Increase Access to Care (IAC) for Ag Workers Program Promising Practices Award recipient! 
 
Since the inception of the IAC Program in 2015, we have seen a variety of promising practices implemented at health centers that have contributed to the increase in the number of Ag Workers and their families served nationwide. Golden Valley is being recognized for their intentional focus on innovative partnerships to provide education and outreach with their Migratory and Seasonal Agricultural Worker population and other marginalized communities during the last two years around COVID-19. The Golden Valley Community Health Worker (CHW) outreach team found three successful partnership strategies that allowed them to provide access and education beyond the four walls of their health clinics. These partnerships included local marketasand carnicerias, Migrant Head Start, and social good non-profits. 
  
We see these strategies as replicable promising practices with strong commitment to this special population. 
  
Please join us in congratulating Golden Valley Health Centers!
  
Past recipients include: in 2018--Altura Centers for Health (CA) and Sea Mar Community Health Centers (WA), in 2019--Family HealthCare Network (CA), 2020 Ampla Health (CA), and in 2021--Salud Family Health Centers (CO) and Sun River Health (NY).

Promising Practices & Strategies

 Since the inception of the Ag Worker Access Campaign, we have seen a variety of great promising practices (unique, out-of-the-box ideas) implemented at health centers (HCs) that have contributed to the increase in the number of Ag workers and their families served nationwide.  The following are strategies were shared by Ag Worker Access Champions from throughout the U.S. as one of their many contributions to the Ag Worker Access Campaign initiative.  We hope these strategies will assist your increase access efforts, and would greatly appreciate you sharing your successful strategies with us, to include here as well.

OUtreach & Marketing

• We build strong relationships w/our Ag Workers & families 
• Focus groups w/farmers to get ideas that help create strategies to increase access to care 
• Outreach 
  • Outreach staff based at all health center sites
  • Clinical outreach to Camps 
  • Use of Promotoresto outreach to farmworkers
  • Enhanced outreach and follow up 
  • Reach out to H2A employers 
  • Delegating activities to coordinators so director can outreach to other partners, crew leaders, providers
  • Using a Mobile unit to provide health education 
  • Host annual health fairs to attract migrant families
  • Providing outreach with transportation
  • Increased participation in community events (Mexican Consulate, Department of Health and Environmental Control & churches)
• Marketing
• Use of pre-season door hangers w/outreach worker & clinic hours/contacts
• Development of an outreach video to showcase the potential impact of outreach to farmworkers
• Personally & individually promote services. Don’t count on a flyer
  • Networking 

Community partnerships & collaborations

• Dental & optometry partnerships
• Create partnerships with health care providers to offer continuity of care
• Formed a new relationship w/the Education Commission that offers FREE summer camp to FW children
• Collaboration w/other agencies & programs: university students 
• Working in collaboration with local departments of health
• Outreach events with partner organizations to provide HIV testing & health screenings in the FW camps
• Attend health fairs
• Partnership with Mexican and Guatemalan consulate 
• Partnership with NC Growers Association!
• Formed partnerships with local ag worker outreach organizations to expand our clinical capacity and scope
• Attended Farm Bureau meetings
• Partner w/medical school to have local clinics
• We host mobile clinics at our farms in collaboration with University of Connecticut medical students
• Health fairs with legal services 
• Recruit & train summer interns for sponsor organization in order to increase their capacity and conduct more outreach 
• Mobile clinics & telehealth services w/El Futuro (Latino mental health provider organization)
• Advocate and lobby for camp access w/sheriffs, growers, & attorney generals
• Conduct research regarding pesticides & cognitive development of FW youth for future resources
• Collaborate with health centers to offer trainings to their patients 
• Creating local partnerships to increase healthy food access
• Outreach with local farms
• Medical-legal partnerships/referrals
• Partnership with PCA voucher Program 
• Provide referrals & resources for other social services agencies

health center operations, data collection & utilization

• Case management 
• Have an employee assistance program to pay for specialty, medical equipment, transportation and other incidentals
• Making “ID” cards for workers to facilitate the registration process whenever they seek care
• Implement/improve sliding fee scale 
• Applied for grants for new vehicles for transports

workforce development

• Staffing
  • New staffing 
  • Increased staff to facilitate more service
  • Hiring health coaches to provide mental health services
  • Hire more field CHWs & increased wages for department
    
• Training
  • Increase staff training on health education & cultural competency
  • Recruit & train summer interns for sponsor organization in order to increase their capacity and conduct more outreach 
  • Learn how to negotiateMedicaid rate on different specialties
    
• Other
  • Increasing exposure to Ag worker health for medical students, pre-meds, residents, and other aspiring health professionals

addressing social determinants of health (SDOH)

• Strengthening state level organization to help ID resources & break down social barriers (legal services, Farmworker Justice)
• Providers go to migrant camps to answer questions and address simple health problems
• Transportation Access
  • Transportation for establishing a good working connection with farm owners, evening appointments
  • Provide transportation to health center
  • Provide transportation to appointments at partner clinics and hospitals, and specialist doctors
  • Provide transportation for migrant children to provide medical & dental services
  • Purchased vehicles for our outreach program to facilitate transportation to medical & dental appointments
• Access to health care services
  • Offer dental, medical, behavioral, and specialty services to Ag worker patients
  • Offer services accessible to ag workers based on needed hours, locations, languages
  • Designate blocks on Primary Care Provider’s schedule to see MSFWs on a daily basis
  • Offer dedicated medical provider to Ag workers during health center late evening clinics
  • Prioritize farmworkers when scheduling appointments 
  • Increased services to Ag workers: mental, health nutrition, peds, dental, OB/GYN, ultrasounds – All Services
  • Provide medication delivery 
  • Linkage from migrant farm worker services to HIV Program services
  • Accessible Locations
    • We have deployed the use of our mobile units to go to the farms or camp to provide services to the Ag workers in addition to that we also designated a specific outreach worker to provide outreach services to the Ag workers!
    • Providing mobile clinics where ag workers live and work - medical and dental
    • Expanded Outreach clinics to new locations
    • Flu shot clinics at farms
    • Health screening & education during lunch & dinner hours at job site
    • Telemedicine
      • Implementing telehealth behavioral health services 
      • We increased access to behavioral health to our Haitian patients using telehealth
    • Free field screenings during harvest season
    • Mobile STI/HIV testing & health education 
    • Mobile dental clinic for kids
  • Accessible Hours of Operation
    • Adjust hours of service to meet Ag worker needs
      • Extended clinic service hours
      • Evening clinics
      • Night clinics
      • Saturday clinics
    • Seasonal late clinic
    • We provide evening clinics on sight, legal, behavioral, social services 
    • Visit camps at least 2 nights every week and during lunch time 
• Language Preference or Limited English Proficiency:
  • Available after-hours nurse line in multiple languages
  • Advocate with partners to improve language access & culturally appropriate services
  • Provide translation/Interpretation services
    • Offer interpretation case management 
    • Interpret for farmworkers at dental clinic (transport & arrange appointments)
  • Bilingual providers
    • Access to free clinic with bilingual provider 
    • Bilingual behavioral health providers
  • Translate and read letters for them
• Health Education
  • Connect farmworker with health resources 
  • Provide farmworker education in the workplace
  • Providers go to migrant camps to answer questions and address simple health problems
  • HIV peer adherence educators to support & educate newly diagnosed FW & link to care
• Eligibility Assistance
  • Assist Ag workers with filling out applications for Medicaid & ACA for health care
  • Provide sliding fee program orientation
• Access to media and emerging technologies:
  • Computers and Connectivity Project: Provide hotspots, computers, and iPads to farmworkers to have access to online resources and to connect with family back home

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For questions or more info on Campaign, contact us at AgWorkerAccess@ncfh.org