migrant & seasonal farmworkers in oregon pops/migrant and seasonal farmworker webi… · 1....
TRANSCRIPT
December 15, 2015
Special & Vulnerable Populations
2015 Webinar Series
Migrant & Seasonal
Farmworkers in Oregon
Before we start
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Special & Vulnerable Populations
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2016 Conferences in Portland
Today’s Learning Objectives
Understand who serves Migrant and Seasonal Farmworkers and how they track them.
Learn about the Agricultural Workers Access 2020 Campaign and how we can support it.
Discover what your Oregon colleagues are doing to engage and provide access and care to this population.
MSFW UDS Definition
A migratory agricultural worker is an individual whose principal employment is in agriculture on a seasonal basis (not year round) who establishes a temporary home for the purpose of such employment. Migratory agricultural workers are usually hired laborers who are paid piecework, hourly or daily wages.
. . . principle source of income within 24 months of last visit as well as their dependent family members who have also used the center. Dependent family members may or may not move with the worker.
MSFW UDS Definition & PRAPARE
Seasonal agricultural workers – does not establish a temporary home for purposes of employment. Includes their dependent family members.
For both categories of workers agriculture means farming in all its branches as defined by the OMB
PRAPARE Question – Social Determinants of Health Screen: At any point in the past 2 years, has seasonal or migrant work been you or your families main source of income?
CHCs with MSFW Funding
Benton & Linn Counties CHC
Clackamas County Public Health Division
Columbia River Community Health Services - Boardman
La Clinica – Medford Area
Lane County CHC
Mosaic Medical – Central Oregon (Bend, Madras, Prineville & Redmond)
Neighborhood Health Center – Beaverton, Hillsboro, Canby, & Portland
One Community Health – Hood River & The Dalles
Valley Family Health Care – Eastern Oregon (Idaho Border)
Virginia Garcia Memorial Health Center – Washington County
Yakima Valley Farm Workers Clinic – Portland, Woodburn & Hermiston
OPCA Special Populations Webpage
Improving Access to Quality Health Care for Migratory and Seasonal Agricultural Workers
National Center for Farmworker Health Presentation to the
Oregon Primary Care Association Presented by Bobbi Ryder, President & CEO, NCFH
12.15.15
© 2015,National Center for Farmworker
Health
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© 2015, National Center for Farmworker
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Welcome!
Webinar Presenter Bobbi Ryder, President & CEO, NCFH
Consultants/Trainers
Sylvia Partida NCFH, COO
Alicia Gonzales Director of Professional Services
I. Background: National & State Trends A. Current Status of Funding and Users Served
II. Turning the Curve A. Identifying and Reporting All Current MSAW Users
B. Opening Doors and Increasing Access
III. Building Capacity for Growth A. Strategies to Sustain and Fund Growth
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Webinar Presentation Outline
National Trend 2010-2013
330 g Funding MSAW Patients
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43
Mill
ion
14
Th
ou
san
d
Migrant Health Funding (ACA Trust Fund 8.6% Proportion)
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Ag Workers Served by 330g Funded MHCs
CHCs served a yearly average of 74,000 Ag Workers
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Total Estimated # of migratory and seasonal agricultural workers in the
USA: 4.5-4.6 M* Total number of MSAWs served by
C/MHCs 864,000**
**UDS 2014 *NCFH and NLDA respectively
2013 Penetration Rate
Ag Workers Served by 330g Funded MHCs
CHCs served a yearly average of 74,000 Ag Workers
© 2015, National Center for Farmworker
Health
© 2015, National Center for Farmworker
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II. Turning the Curve
A. Identifying and Reporting All Current MSAW Users Take credit where credit is due Implications of doing so: Population Accountability Future funding Meaningfulness of data in EMR and UDS Strengthen the whole C/MHC Program
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Things We Have Learned
Competing demands on Health Center Staff
EMR Adoption has created some ‘glitches’
Definitions are still confusing
Turnover at front desk demands ongoing training Established systems may need re-tooling
Examples • EMR Adoption has been a top priority, but
adds to the confusion
• No system of checks and balances between registration and health history forms in EMR
• EMR re-writes demographics each visit, no carryover of info
• EMR severs Adult children’s records from Ag Worker parent in EMR
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Health
Examples • Political sensitivity in the “ask” – Migrant vs. Ag
Worker • HRSA’s 12.1.12 clarification of definition of
Agriculture • Aged and/or Disabled former Migratory Workers
and their families • But where do you put that info? • Casual misinterpretation of statute, i.e. “families”
vs. “dependents” • Old practices die hard: M/S/O • “Migrant” and “Seasonal” are not an insurance
category 12/16/2015 23 © 2015, National Center for Farmworker
Health
Solutions
• Strengthening of Health Center Systems to evaluate and modify policies and procedures
• Provision of on-going training
• Analysis of penetration rates by county
• Asking the right questions in the right way with sensitivity to literacy levels and culture
• Clarification of federal policies and guidance
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B. Opening doors and increasing access
Re-vitalizing the “Causa” to serve the Ag Worker population
Reaching out to unserved population pockets
Defining ‘outreach and enabling’ as different from ‘outreach and enrollment’
Institutionalizing ‘outreach and enabling’
Articulating the value proposition to peers
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II. Turning the Curve
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Oregon’s Great Track Record Oregon
Trend
Year 330g Non-330g OR CHC Program
2010 11,788 1,287 13,075
2011 11,498 1,454 12,952
2012 14,204 2,419 16,623
2013 15,829 2,693 18,522
2014 16,471 3,382 19,853
Call for Action…
Ag Worker Access 2020
Ag Worker Access 2020 Goal: To Reach 2 Million
2013
790,226
2 Million
2020
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A. Ongoing dialog with HRSA & Bureau
B. Recommended further changes to UDS to bring into alignment with Statute and Regs
C. Recommending funding that recognizes growth where it occurs
D. New funding mechanisms that are sensitive to needs of applicants for uninsured population
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III. Building Capacity
Resources Available
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1. NCFH Web Site – Tools and PPT Presentations for staff training
2. NACHC My-Learning Community-Campaign Updates
3. Complimentary Webinars, archived and live
4. Conference Workshops upcoming
5. Custom designed webinars and presentations
6. 1:1 on site consultations (FFS)
7. Licensure Program and Regional Trainings for Systems Change (FFS)
8. County by County Population Estimations (FFS)
9. Farmworker Health Network (FHN)
I. Ensure accurate ID and reporting
II. Increase access to quality care
III. Build capacity to sustain growth
Approaches I. Appointment of Campaign Task Force
II. Building a network of supporters
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Campaign Strategies & Approaches Strategies
1. Support for Strategies?
2. Additional Approaches?
3. Additional Activities?
4. Building a Network or Coalition?
5. Sharing Oregon’s Successes?
6. Other?
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Discussion and Suggestions
Contact Information
I. Bobbi Ryder – CEO at NCFH
2. Joseph Gallegos – NACHC
3. My Learning Community - NACHC
http://mylearning.nachc.com
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Contact Information
NACHC’s My Learning Community: • Follow these easy steps: • 1.http://mylearning.nachc.com (no WWW) • 2.Enter your NACHC ID and password (same as what you use when
registering for NACHC events) • 3.If you do not have an NACHC id click on the “Sign Up” link • 4.Once successfully logged in go click on NACHC Communities • 5.Choose “Ag Worker Access 2020 Campaign” from the Explore
Communities drop down • • •If you have any questions or need assistance, please email Neha Desai,
Senior Knowledge Management Specialist at [email protected] or by calling her at 301-347-0400
© 2015, National Center for Farmworker
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Thank You for Your Time!
© 2015, National Center for Farmworker
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MSFW and Primary Care
Providing Care & Engaging Landowners • ¡Salud! & Virginia Garcia – Collaboration with Oregon
Winemakers, Tuality and VG to provide mobile primary care services to Oregon vineyard workers. These services are funded, through an annual auction with winemakers’ support. Contact Ignolia Duyck for [email protected], Leda Garside, [email protected], or visit http://www.saludauction.org/ for more information.
Promotoras Columbia River Health Center - CRHC has a 1.0 FTE
Promotora who is present at the local agricultural farms all year round to bridge , between migrant farmworkers and the CHC.
Contact: Sarah Nunez, [email protected].
MSFW and Insurance Enrollment
Health Insurance Agents & OE Staff • One Community Health - O&E staff maintain a strong relationship
with the local bilingual Insurance Agent to assist MSFW find affordable coverage (public and private) for themselves and family. Contact Emma Quintana for more information [email protected].
Ventanilla de Salud • Wallace Medical Concern – WMC operated Ventanilla de Salud in
Mexican Consulate to provide health outreach, referrals and insurance enrollment.
• What do you do?
National Resources
Farmworker Justice
http://www.farmworkerjustice.org
Health Outreach Partners
http://www.outreach-partners.org
MHP Salud
http://www.mhpsalud.org
Migrant Clinicians Network
http://www.migrantclinician.org
National Association of Community Health Centers
http://www.nachc.com
National Center for Farmworker Health
http://www.ncfh.org
Local Resources
Oregon Office of Equity and Inclusion
Maria Elena Castro, Rural and Migrant Health Coordinator, [email protected]
Causa
http://causaoregon.org/
Legal Aid Services of Oregon’s Farmworker Program
http://lasoregon.org/services/
Oregon Community Health Workers Association
http://www.orchwa.org/
Thank you for listening
We appreciate the time you have taken out of your day to think about this population and the care that they need.
This webinar has been recorded and will be posted to the OPCA website.
Please share any comments or questions with us.