RE: RE: funding for health centers

[Guest guest]

Does anyone know if there is a clinic in Canton Georgia that serves migrants

that would not be eligible for state medicaid services. I would appreciate any

info. it name address, phone number.

Thanks Neander

[Guest guest]

Just to add a footnote to Adolfo's suggestion about third party payors.

I'm sure that clinics do think about enrolling their patients in Medicaid

or CHIP when they are eligible for such benefits, but those programs are

restricted to certain legal US residents or citizens. A third party payor

program that is not restricted by immigration status (in except in Maine)

is workers compensation. In California, in particular, all agricultural

workers are covered by workers comp. Some clinics have been reluctant to

accept workers comp because they are reluctant to do the paperwork. But

this is another potential income stream which should be considered. Where

possible, clinics should accept workers comp because it helps the

farmworkers. Farmworkers who otherwise end up in a hospital emergency

room, may end up with a big debt.

At 03:00 PM 5/24/2001 -0400, Mata, Adolfo wrote:

>, and others,

>

>The Bureau of Primary Health Care funding allocation formula for health

>center base budget adjustments (increases) does take into account

>demonstrated increases in migrant/seasonal users served and level of

> " uncompensated care " provided, in addition to other variables. There was an

>increase in the community health centers federal appropriations, in the FY

>2001 budget. Of course the need is always greater.

>

>All community/migrant health centers, are eligible for base adjustments

>provided they meet certain criteria established by the Bureau with input in

>the form of recommendations from the Migrant Funding Allocation Work Group,

>convened regularly by the Bureau. Elia Gallardo from the California PCA is a

>member of this workgroup. Of course, Sequoia has to compete with all other

>migrant programs across the country and Puerto Rico for new migrant and

>community health dollars. The competition is tough.

>

>Enrollment of ALL ELIGIBLE (not just migrant and seasonal agricultural

>workers) of health center users in such programs as Medicaid and State

>Children's Health Insurance Programs, in addition other forms of third party

>reimbursement programs is one way to stretch migrant health dollars to

>served the truly " uninsured " , " underserved " and " ineligible " for public

>assistance programs such as single migrant farmworker men. If, a migrant

>health center has any questions, they should contact Ersek, Acting

>Chief, Migrant Health Branch, 301.594-4303. can also be reached by

>email: gersek@...

>

>Adolfo Mata, Director

>Hispanic Health Initiative

>Office of the Director/Bureau of Primary Health Care

>Health Resources and Services Administration/US DHHS

>4350 East-West Hwy, 11th FL

>Bethesda, land 20814

>(301) 594-4976

>amata@...

>

>

>

>

>

>-----Original Message-----

>From: Lighthall [mailto:dlighthall@...]

>Sent: Wednesday, May 23, 2001 6:27 PM

>Mata, Adolfo

>Cc: Migrant_Health_Research; SF Sequoia Community Health Foundation

>Subject: FW: funding for health centers

>

>

>Hi Adolfo and others:

>

>This (message below from the Sequoia clinic in Fresno) seems like a classic

>quandary for the clinic trying to do the right thing. Any thoughts? Any

>help coming down the pike at the federal level? Things don't look too great

>here in California for more state support, both in terms of the downturn in

>the stock market, which really hits our income tax intake, and the energy

>crisis.

>

>Regards,

>

>

>

>-----Original Message-----

>From: Laurie Primavera [mailto:lauriep1@...]

>Sent: Wednesday, May 23, 2001 3:16 PM

>dlighthall@...

>Subject: funding for health centers

>

>

>Hi - I have been unable to attend CVHN meetings and needed to talk with

>you. We were most honored at Sequoia to have the Endowment unveil the

>suffering in silence studies. We, at Sequoia have maintained an expanded

>hour program for two years that increases access to farmworkers on weekends

>and nights at three clinics. Higher utilization of males, better show rates

>with single car transport, etc. Many benefits to expanded hours for

>farmworkers. Downside-it attracts higher uncompensated care-probably those

>farm workers who are not documented and/or males who simply do not qualify

>for medical.

>

>We are reducing our hours, leaving our largest site open sat, sun and

>evenings in hopes to get some funding. I have been unable to access support

>for this program- foundations want to give seed money and want to know it is

>sustainable. Without additional state, federal support, we are incurring

>much higher uncompensated care when we reach the population your study

>addressed. Can you help me with funding access or ideas? Thanks

>

>

>To Post a message, send it to: Groups

>

>To Unsubscribe, send a blank message to:

-unsubscribe

>

>

[Guest guest]

--

We have heard anecdotally from farm workers that some CA clinics have been

hesitant to evaluate their workers comp cases because of payment issues. Do

you know of any systematic documentation of this problem?

Rupali Das, MD, MPH

Occupational Health Branch

California Department of Health Services

1515 Clay St., Suite 1901

Oakland, CA 94612

tel. (510) 622-4300 fax (510) 622-4310

rdas@...

> ----------

> From:

> Reply

> Sent: Friday, May 25, 2001 6:53 AM

> ; ' Lighthall'

> Cc: Migrant_Health_Research; SF Sequoia Community Health Foundation

> Subject: Re: [ ] RE: funding for health centers

>

> Just to add a footnote to Adolfo's suggestion about third party payors.

> I'm sure that clinics do think about enrolling their patients in Medicaid

> or CHIP when they are eligible for such benefits, but those programs are

> restricted to certain legal US residents or citizens. A third party payor

> program that is not restricted by immigration status (in except in Maine)

> is workers compensation. In California, in particular, all agricultural

> workers are covered by workers comp. Some clinics have been reluctant to

> accept workers comp because they are reluctant to do the paperwork. But

> this is another potential income stream which should be considered. Where

> possible, clinics should accept workers comp because it helps the

> farmworkers. Farmworkers who otherwise end up in a hospital emergency

> room, may end up with a big debt.

>

> At 03:00 PM 5/24/2001 -0400, Mata, Adolfo wrote:

> >, and others,

> >

> >The Bureau of Primary Health Care funding allocation formula for health

> >center base budget adjustments (increases) does take into account

> >demonstrated increases in migrant/seasonal users served and level of

> > " uncompensated care " provided, in addition to other variables. There was

> an

> >increase in the community health centers federal appropriations, in the

> FY

> >2001 budget. Of course the need is always greater.

> >

> >All community/migrant health centers, are eligible for base adjustments

> >provided they meet certain criteria established by the Bureau with input

> in

> >the form of recommendations from the Migrant Funding Allocation Work

> Group,

> >convened regularly by the Bureau. Elia Gallardo from the California PCA

> is a

> >member of this workgroup. Of course, Sequoia has to compete with all

> other

> >migrant programs across the country and Puerto Rico for new migrant and

> >community health dollars. The competition is tough.

> >

> >Enrollment of ALL ELIGIBLE (not just migrant and seasonal agricultural

> >workers) of health center users in such programs as Medicaid and State

> >Children's Health Insurance Programs, in addition other forms of third

> party

> >reimbursement programs is one way to stretch migrant health dollars to

> >served the truly " uninsured " , " underserved " and " ineligible " for public

> >assistance programs such as single migrant farmworker men. If, a migrant

> >health center has any questions, they should contact Ersek, Acting

> >Chief, Migrant Health Branch, 301.594-4303. can also be reached

> by

> >email: gersek@...

> >

> >Adolfo Mata, Director

> >Hispanic Health Initiative

> >Office of the Director/Bureau of Primary Health Care

> >Health Resources and Services Administration/US DHHS

> >4350 East-West Hwy, 11th FL

> >Bethesda, land 20814

> >(301) 594-4976

> >amata@...

> >

> >

> >

> >

> >

> >-----Original Message-----

> >From: Lighthall [mailto:dlighthall@...]

> >Sent: Wednesday, May 23, 2001 6:27 PM

> >Mata, Adolfo

> >Cc: Migrant_Health_Research; SF Sequoia Community Health Foundation

> >Subject: FW: funding for health centers

> >

> >

> >Hi Adolfo and others:

> >

> >This (message below from the Sequoia clinic in Fresno) seems like a

> classic

> >quandary for the clinic trying to do the right thing. Any thoughts? Any

> >help coming down the pike at the federal level? Things don't look too

> great

> >here in California for more state support, both in terms of the downturn

> in

> >the stock market, which really hits our income tax intake, and the energy

> >crisis.

> >

> >Regards,

> >

> >

> >

> >-----Original Message-----

> >From: Laurie Primavera [mailto:lauriep1@...]

> >Sent: Wednesday, May 23, 2001 3:16 PM

> >dlighthall@...

> >Subject: funding for health centers

> >

> >

> >Hi - I have been unable to attend CVHN meetings and needed to talk

> with

> >you. We were most honored at Sequoia to have the Endowment unveil the

> >suffering in silence studies. We, at Sequoia have maintained an expanded

> >hour program for two years that increases access to farmworkers on

> weekends

> >and nights at three clinics. Higher utilization of males, better show

> rates

> >with single car transport, etc. Many benefits to expanded hours for

>

> >farmworkers. Downside-it attracts higher uncompensated care-probably

> those

> >farm workers who are not documented and/or males who simply do not

> qualify

> >for medical.

> >

> >We are reducing our hours, leaving our largest site open sat, sun and

> >evenings in hopes to get some funding. I have been unable to access

> support

> >for this program- foundations want to give seed money and want to know it

> is

> >sustainable. Without additional state, federal support, we are incurring

> >much higher uncompensated care when we reach the population your study

> >addressed. Can you help me with funding access or ideas? Thanks

> >

> >

> >To Post a message, send it to: Groups

> >

> >To Unsubscribe, send a blank message to:

> -unsubscribe

> >

> >

[Guest guest]

An additional comment on workers' comp as an income stream for clinics.

The paperwork for work comp billing is no more onerous than that for

CHDP or Medi-Cal, although the perception of greater complexity does

exist. Also, though CAlif ag workers are covered by workers' comp,

some report that they are actively discouraged from claiming workers'

comp-related medical needs because of their employers' claims

volume/severity rating -induced worker's comp premium increases. Much

workers' comp care is actually provided through Medi-Cal/federally

funded clinics for those insureds who may not disclose the true

mechanism of injury for fear of losing their job.

Oliva

Family Support Network, Oakdale

> Just to add a footnote to Adolfo's suggestion about third party

payors.

> I'm sure that clinics do think about enrolling their patients in

Medicaid

> or CHIP when they are eligible for such benefits, but those programs

are

> restricted to certain legal US residents or citizens. A third party

payor

> program that is not restricted by immigration status (in except in

Maine)

> is workers compensation. In California, in particular, all

agricultural

> workers are covered by workers comp. Some clinics have been

reluctant to

> accept workers comp because they are reluctant to do the paperwork.

But

> this is another potential income stream which should be considered.

Where

> possible, clinics should accept workers comp because it helps the

> farmworkers. Farmworkers who otherwise end up in a hospital emergency

> room, may end up with a big debt.

>

> At 03:00 PM 5/24/2001 -0400, Mata, Adolfo wrote:

> >, and others,

> >

> >The Bureau of Primary Health Care funding allocation formula for

health

> >center base budget adjustments (increases) does take into account

> >demonstrated increases in migrant/seasonal users served and level of

> > " uncompensated care " provided, in addition to other variables.

There was an

> >increase in the community health centers federal appropriations, in

the FY

> >2001 budget. Of course the need is always greater.

> >

> >All community/migrant health centers, are eligible for base

adjustments

> >provided they meet certain criteria established by the Bureau with

input in

> >the form of recommendations from the Migrant Funding Allocation Work

Group,

> >convened regularly by the Bureau. Elia Gallardo from the California

PCA is a

> >member of this workgroup. Of course, Sequoia has to compete with all

other

> >migrant programs across the country and Puerto Rico for new migrant

and

> >community health dollars. The competition is tough.

> >

> >Enrollment of ALL ELIGIBLE (not just migrant and seasonal

agricultural

> >workers) of health center users in such programs as Medicaid and

State

> >Children's Health Insurance Programs, in addition other forms of

third party

> >reimbursement programs is one way to stretch migrant health dollars

to

> >served the truly " uninsured " , " underserved " and " ineligible " for

public

> >assistance programs such as single migrant farmworker men. If, a

migrant

> >health center has any questions, they should contact Ersek,

Acting

> >Chief, Migrant Health Branch, 301.594-4303. can also be

reached by

> >email: gersek@...

> >

> >Adolfo Mata, Director

> >Hispanic Health Initiative

> >Office of the Director/Bureau of Primary Health Care

> >Health Resources and Services Administration/US DHHS

> >4350 East-West Hwy, 11th FL

> >Bethesda, land 20814

> >(301) 594-4976

> >amata@...

> >

> >

> >

> >

> >

> >-----Original Message-----

> >From: Lighthall [mailto:dlighthall@...]

> >Sent: Wednesday, May 23, 2001 6:27 PM

> >Mata, Adolfo

> >Cc: Migrant_Health_Research; SF Sequoia Community Health Foundation

> >Subject: FW: funding for health centers

> >

> >

> >Hi Adolfo and others:

> >

> >This (message below from the Sequoia clinic in Fresno) seems like a

classic

> >quandary for the clinic trying to do the right thing. Any

thoughts? Any

> >help coming down the pike at the federal level? Things don't look

too great

> >here in California for more state support, both in terms of the

downturn in

> >the stock market, which really hits our income tax intake, and the

energy

> >crisis.

> >

> >Regards,

> >

> >

> >

> >-----Original Message-----

> >From: Laurie Primavera [mailto:lauriep1@...]

> >Sent: Wednesday, May 23, 2001 3:16 PM

> >dlighthall@...

> >Subject: funding for health centers

> >

> >

> >Hi - I have been unable to attend CVHN meetings and needed to

talk with

> >you. We were most honored at Sequoia to have the Endowment unveil

the

> >suffering in silence studies. We, at Sequoia have maintained an

expanded

> >hour program for two years that increases access to farmworkers on

weekends

> >and nights at three clinics. Higher utilization of males, better

show rates

> >with single car transport, etc. Many benefits to expanded hours for

>

> >farmworkers. Downside-it attracts higher uncompensated care-

probably those

> >farm workers who are not documented and/or males who simply do not

qualify

> >for medical.

> >

> >We are reducing our hours, leaving our largest site open sat, sun and

> >evenings in hopes to get some funding. I have been unable to access

support

> >for this program- foundations want to give seed money and want to

know it is

> >sustainable. Without additional state, federal support, we are

incurring

> >much higher uncompensated care when we reach the population your

study

> >addressed. Can you help me with funding access or ideas? Thanks

> >

> >

> >To Post a message, send it to:

Groups

> >

> >To Unsubscribe, send a blank message to:

> -unsubscribe

> >

> >

[Guest guest]

Hi,

I, too, have heard only anecdotal reports of clinics which are not handling

workers comp cases. But, in the instance that came to my attention in a

timely way, I called the clinic director directly and he confirmed that the

clinic would not accept workers comp cases. Hope this is helpful.

At 09:04 AM 5/25/2001 -0700, you wrote:

>--

>

>We have heard anecdotally from farm workers that some CA clinics have been

>hesitant to evaluate their workers comp cases because of payment issues. Do

>you know of any systematic documentation of this problem?

>

>

>Rupali Das, MD, MPH

>Occupational Health Branch

>California Department of Health Services

>1515 Clay St., Suite 1901

>Oakland, CA 94612

>tel. (510) 622-4300 fax (510) 622-4310

>rdas@...

>

>> ----------

>> From:

>> Reply

>> Sent: Friday, May 25, 2001 6:53 AM

>> ; ' Lighthall'

>> Cc: Migrant_Health_Research; SF Sequoia Community Health Foundation

>> Subject: Re: [ ] RE: funding for health centers

>>

>> Just to add a footnote to Adolfo's suggestion about third party payors.

>> I'm sure that clinics do think about enrolling their patients in Medicaid

>> or CHIP when they are eligible for such benefits, but those programs are

>> restricted to certain legal US residents or citizens. A third party payor

>> program that is not restricted by immigration status (in except in Maine)

>> is workers compensation. In California, in particular, all agricultural

>> workers are covered by workers comp. Some clinics have been reluctant to

>> accept workers comp because they are reluctant to do the paperwork. But

>> this is another potential income stream which should be considered. Where

>> possible, clinics should accept workers comp because it helps the

>> farmworkers. Farmworkers who otherwise end up in a hospital emergency

>> room, may end up with a big debt.

>>

>> At 03:00 PM 5/24/2001 -0400, Mata, Adolfo wrote:

>> >, and others,

>> >

>> >The Bureau of Primary Health Care funding allocation formula for health

>> >center base budget adjustments (increases) does take into account

>> >demonstrated increases in migrant/seasonal users served and level of

>> > " uncompensated care " provided, in addition to other variables. There was

>> an

>> >increase in the community health centers federal appropriations, in the

>> FY

>> >2001 budget. Of course the need is always greater.

>> >

>> >All community/migrant health centers, are eligible for base adjustments

>> >provided they meet certain criteria established by the Bureau with input

>> in

>> >the form of recommendations from the Migrant Funding Allocation Work

>> Group,

>> >convened regularly by the Bureau. Elia Gallardo from the California PCA

>> is a

>> >member of this workgroup. Of course, Sequoia has to compete with all

>> other

>> >migrant programs across the country and Puerto Rico for new migrant and

>> >community health dollars. The competition is tough.

>> >

>> >Enrollment of ALL ELIGIBLE (not just migrant and seasonal agricultural

>> >workers) of health center users in such programs as Medicaid and State

>> >Children's Health Insurance Programs, in addition other forms of third

>> party

>> >reimbursement programs is one way to stretch migrant health dollars to

>> >served the truly " uninsured " , " underserved " and " ineligible " for public

>> >assistance programs such as single migrant farmworker men. If, a migrant

>> >health center has any questions, they should contact Ersek, Acting

>> >Chief, Migrant Health Branch, 301.594-4303. can also be reached

>> by

>> >email: gersek@...

>> >

>> >Adolfo Mata, Director

>> >Hispanic Health Initiative

>> >Office of the Director/Bureau of Primary Health Care

>> >Health Resources and Services Administration/US DHHS

>> >4350 East-West Hwy, 11th FL

>> >Bethesda, land 20814

>> >(301) 594-4976

>> >amata@...

>> >

>> >

>> >

>> >

>> >

>> >-----Original Message-----

>> >From: Lighthall [mailto:dlighthall@...]

>> >Sent: Wednesday, May 23, 2001 6:27 PM

>> >Mata, Adolfo

>> >Cc: Migrant_Health_Research; SF Sequoia Community Health Foundation

>> >Subject: FW: funding for health centers

>> >

>> >

>> >Hi Adolfo and others:

>> >

>> >This (message below from the Sequoia clinic in Fresno) seems like a

>> classic

>> >quandary for the clinic trying to do the right thing. Any thoughts? Any

>> >help coming down the pike at the federal level? Things don't look too

>> great

>> >here in California for more state support, both in terms of the downturn

>> in

>> >the stock market, which really hits our income tax intake, and the energy

>> >crisis.

>> >

>> >Regards,

>> >

>> >

>> >

>> >-----Original Message-----

>> >From: Laurie Primavera [mailto:lauriep1@...]

>> >Sent: Wednesday, May 23, 2001 3:16 PM

>> >dlighthall@...

>> >Subject: funding for health centers

>> >

>> >

>> >Hi - I have been unable to attend CVHN meetings and needed to talk

>> with

>> >you. We were most honored at Sequoia to have the Endowment unveil the

>> >suffering in silence studies. We, at Sequoia have maintained an expanded

>> >hour program for two years that increases access to farmworkers on

>> weekends

>> >and nights at three clinics. Higher utilization of males, better show

>> rates

>> >with single car transport, etc. Many benefits to expanded hours for

>>

>> >farmworkers. Downside-it attracts higher uncompensated care-probably

>> those

>> >farm workers who are not documented and/or males who simply do not

>> qualify

>> >for medical.

>> >

>> >We are reducing our hours, leaving our largest site open sat, sun and

>> >evenings in hopes to get some funding. I have been unable to access

>> support

>> >for this program- foundations want to give seed money and want to know it

>> is

>> >sustainable. Without additional state, federal support, we are incurring

>> >much higher uncompensated care when we reach the population your study

>> >addressed. Can you help me with funding access or ideas? Thanks

>> >

>> >

>> >To Post a message, send it to: Groups

>> >

>> >To Unsubscribe, send a blank message to:

>> -unsubscribe

>> >

>> >

[Guest guest]

All (but the most enlightened) employers discourage their employees from

filing workers comp claims. Since farmworkers are especially vulnerable,

it's not hard to intimidate them out of filing these claims. However,

state laws are available to protect workers who are fired in retaliation

for filing workers comp claims. Workers who are afraid on this account,

should be referred to their local legal services agency for help. I'm glad

to hear that some of you are handling workers comp claims -- and I hope

more will follow suit.

At 09:09 AM 5/25/2001 -0700, you wrote:

>An additional comment on workers' comp as an income stream for clinics.

>The paperwork for work comp billing is no more onerous than that for

>CHDP or Medi-Cal, although the perception of greater complexity does

>exist. Also, though CAlif ag workers are covered by workers' comp,

>some report that they are actively discouraged from claiming workers'

>comp-related medical needs because of their employers' claims

>volume/severity rating -induced worker's comp premium increases. Much

>workers' comp care is actually provided through Medi-Cal/federally

>funded clinics for those insureds who may not disclose the true

>mechanism of injury for fear of losing their job.

>

> Oliva

>Family Support Network, Oakdale

>

>> Just to add a footnote to Adolfo's suggestion about third party

>payors.

>> I'm sure that clinics do think about enrolling their patients in

>Medicaid

>> or CHIP when they are eligible for such benefits, but those programs

>are

>> restricted to certain legal US residents or citizens. A third party

>payor

>> program that is not restricted by immigration status (in except in

>Maine)

>> is workers compensation. In California, in particular, all

>agricultural

>> workers are covered by workers comp. Some clinics have been

>reluctant to

>> accept workers comp because they are reluctant to do the paperwork.

>But

>> this is another potential income stream which should be considered.

>Where

>> possible, clinics should accept workers comp because it helps the

>> farmworkers. Farmworkers who otherwise end up in a hospital emergency

>> room, may end up with a big debt.

>>

>> At 03:00 PM 5/24/2001 -0400, Mata, Adolfo wrote:

>> >, and others,

>> >

>> >The Bureau of Primary Health Care funding allocation formula for

>health

>> >center base budget adjustments (increases) does take into account

>> >demonstrated increases in migrant/seasonal users served and level of

>> > " uncompensated care " provided, in addition to other variables.

>There was an

>> >increase in the community health centers federal appropriations, in

>the FY

>> >2001 budget. Of course the need is always greater.

>> >

>> >All community/migrant health centers, are eligible for base

>adjustments

>> >provided they meet certain criteria established by the Bureau with

>input in

>> >the form of recommendations from the Migrant Funding Allocation Work

>Group,

>> >convened regularly by the Bureau. Elia Gallardo from the California

>PCA is a

>> >member of this workgroup. Of course, Sequoia has to compete with all

>other

>> >migrant programs across the country and Puerto Rico for new migrant

>and

>> >community health dollars. The competition is tough.

>> >

>> >Enrollment of ALL ELIGIBLE (not just migrant and seasonal

>agricultural

>> >workers) of health center users in such programs as Medicaid and

>State

>> >Children's Health Insurance Programs, in addition other forms of

>third party

>> >reimbursement programs is one way to stretch migrant health dollars

>to

>> >served the truly " uninsured " , " underserved " and " ineligible " for

>public

>> >assistance programs such as single migrant farmworker men. If, a

>migrant

>> >health center has any questions, they should contact Ersek,

>Acting

>> >Chief, Migrant Health Branch, 301.594-4303. can also be

>reached by

>> >email: gersek@...

>> >

>> >Adolfo Mata, Director

>> >Hispanic Health Initiative

>> >Office of the Director/Bureau of Primary Health Care

>> >Health Resources and Services Administration/US DHHS

>> >4350 East-West Hwy, 11th FL

>> >Bethesda, land 20814

>> >(301) 594-4976

>> >amata@...

>> >

>> >

>> >

>> >

>> >

>> >-----Original Message-----

>> >From: Lighthall [mailto:dlighthall@...]

>> >Sent: Wednesday, May 23, 2001 6:27 PM

>> >Mata, Adolfo

>> >Cc: Migrant_Health_Research; SF Sequoia Community Health Foundation

>> >Subject: FW: funding for health centers

>> >

>> >

>> >Hi Adolfo and others:

>> >

>> >This (message below from the Sequoia clinic in Fresno) seems like a

>classic

>> >quandary for the clinic trying to do the right thing. Any

>thoughts? Any

>> >help coming down the pike at the federal level? Things don't look

>too great

>> >here in California for more state support, both in terms of the

>downturn in

>> >the stock market, which really hits our income tax intake, and the

>energy

>> >crisis.

>> >

>> >Regards,

>> >

>> >

>> >

>> >-----Original Message-----

>> >From: Laurie Primavera [mailto:lauriep1@...]

>> >Sent: Wednesday, May 23, 2001 3:16 PM

>> >dlighthall@...

>> >Subject: funding for health centers

>> >

>> >

>> >Hi - I have been unable to attend CVHN meetings and needed to

>talk with

>> >you. We were most honored at Sequoia to have the Endowment unveil

>the

>> >suffering in silence studies. We, at Sequoia have maintained an

>expanded

>> >hour program for two years that increases access to farmworkers on

>weekends

>> >and nights at three clinics. Higher utilization of males, better

>show rates

>> >with single car transport, etc. Many benefits to expanded hours for

>>

>> >farmworkers. Downside-it attracts higher uncompensated care-

>probably those

>> >farm workers who are not documented and/or males who simply do not

>qualify

>> >for medical.

>> >

>> >We are reducing our hours, leaving our largest site open sat, sun and

>> >evenings in hopes to get some funding. I have been unable to access

>support

>> >for this program- foundations want to give seed money and want to

>know it is

>> >sustainable. Without additional state, federal support, we are

>incurring

>> >much higher uncompensated care when we reach the population your

>study

>> >addressed. Can you help me with funding access or ideas? Thanks

>> >

>> >

>> >To Post a message, send it to:

> Groups

>> >

>> >To Unsubscribe, send a blank message to:

>> -unsubscribe

>> >

>> >

[Guest guest]

Elia Gallardo,

Are you aware of this happening in California?

Adolfo

-----Original Message-----

From: [mailto:sdavis@...]

Sent: Friday, May 25, 2001 3:20 PM

Subject: RE: [ ] RE: funding for health centers

Hi,

I, too, have heard only anecdotal reports of clinics which are not handling

workers comp cases. But, in the instance that came to my attention in a

timely way, I called the clinic director directly and he confirmed that the

clinic would not accept workers comp cases. Hope this is helpful.

At 09:04 AM 5/25/2001 -0700, you wrote:

>--

>

>We have heard anecdotally from farm workers that some CA clinics have been

>hesitant to evaluate their workers comp cases because of payment issues. Do

>you know of any systematic documentation of this problem?

>

>

>Rupali Das, MD, MPH

>Occupational Health Branch

>California Department of Health Services

>1515 Clay St., Suite 1901

>Oakland, CA 94612

>tel. (510) 622-4300 fax (510) 622-4310

>rdas@...

>

>> ----------

>> From:

>> Reply

>> Sent: Friday, May 25, 2001 6:53 AM

>> ; ' Lighthall'

>> Cc: Migrant_Health_Research; SF Sequoia Community Health Foundation

>> Subject: Re: [ ] RE: funding for health centers

>>

>> Just to add a footnote to Adolfo's suggestion about third party payors.

>> I'm sure that clinics do think about enrolling their patients in Medicaid

>> or CHIP when they are eligible for such benefits, but those programs are

>> restricted to certain legal US residents or citizens. A third party

payor

>> program that is not restricted by immigration status (in except in Maine)

>> is workers compensation. In California, in particular, all agricultural

>> workers are covered by workers comp. Some clinics have been reluctant to

>> accept workers comp because they are reluctant to do the paperwork. But

>> this is another potential income stream which should be considered.

Where

>> possible, clinics should accept workers comp because it helps the

>> farmworkers. Farmworkers who otherwise end up in a hospital emergency

>> room, may end up with a big debt.

>>

>> At 03:00 PM 5/24/2001 -0400, Mata, Adolfo wrote:

>> >, and others,

>> >

>> >The Bureau of Primary Health Care funding allocation formula for health

>> >center base budget adjustments (increases) does take into account

>> >demonstrated increases in migrant/seasonal users served and level of

>> > " uncompensated care " provided, in addition to other variables. There

was

>> an

>> >increase in the community health centers federal appropriations, in the

>> FY

>> >2001 budget. Of course the need is always greater.

>> >

>> >All community/migrant health centers, are eligible for base adjustments

>> >provided they meet certain criteria established by the Bureau with input

>> in

>> >the form of recommendations from the Migrant Funding Allocation Work

>> Group,

>> >convened regularly by the Bureau. Elia Gallardo from the California PCA

>> is a

>> >member of this workgroup. Of course, Sequoia has to compete with all

>> other

>> >migrant programs across the country and Puerto Rico for new migrant and

>> >community health dollars. The competition is tough.

>> >

>> >Enrollment of ALL ELIGIBLE (not just migrant and seasonal agricultural

>> >workers) of health center users in such programs as Medicaid and State

>> >Children's Health Insurance Programs, in addition other forms of third

>> party

>> >reimbursement programs is one way to stretch migrant health dollars to

>> >served the truly " uninsured " , " underserved " and " ineligible " for public

>> >assistance programs such as single migrant farmworker men. If, a

migrant

>> >health center has any questions, they should contact Ersek,

Acting

>> >Chief, Migrant Health Branch, 301.594-4303. can also be reached

>> by

>> >email: gersek@...

>> >

>> >Adolfo Mata, Director

>> >Hispanic Health Initiative

>> >Office of the Director/Bureau of Primary Health Care

>> >Health Resources and Services Administration/US DHHS

>> >4350 East-West Hwy, 11th FL

>> >Bethesda, land 20814

>> >(301) 594-4976

>> >amata@...

>> >

>> >

>> >

>> >

>> >

>> >-----Original Message-----

>> >From: Lighthall [mailto:dlighthall@...]

>> >Sent: Wednesday, May 23, 2001 6:27 PM

>> >Mata, Adolfo

>> >Cc: Migrant_Health_Research; SF Sequoia Community Health Foundation

>> >Subject: FW: funding for health centers

>> >

>> >

>> >Hi Adolfo and others:

>> >

>> >This (message below from the Sequoia clinic in Fresno) seems like a

>> classic

>> >quandary for the clinic trying to do the right thing. Any thoughts?

Any

>> >help coming down the pike at the federal level? Things don't look too

>> great

>> >here in California for more state support, both in terms of the downturn

>> in

>> >the stock market, which really hits our income tax intake, and the

energy

>> >crisis.

>> >

>> >Regards,

>> >

>> >

>> >

>> >-----Original Message-----

>> >From: Laurie Primavera [mailto:lauriep1@...]

>> >Sent: Wednesday, May 23, 2001 3:16 PM

>> >dlighthall@...

>> >Subject: funding for health centers

>> >

>> >

>> >Hi - I have been unable to attend CVHN meetings and needed to talk

>> with

>> >you. We were most honored at Sequoia to have the Endowment unveil the

>> >suffering in silence studies. We, at Sequoia have maintained an

expanded

>> >hour program for two years that increases access to farmworkers on

>> weekends

>> >and nights at three clinics. Higher utilization of males, better show

>> rates

>> >with single car transport, etc. Many benefits to expanded hours for

>>

>> >farmworkers. Downside-it attracts higher uncompensated care-probably

>> those

>> >farm workers who are not documented and/or males who simply do not

>> qualify

>> >for medical.

>> >

>> >We are reducing our hours, leaving our largest site open sat, sun and

>> >evenings in hopes to get some funding. I have been unable to access

>> support

>> >for this program- foundations want to give seed money and want to know

it

>> is

>> >sustainable. Without additional state, federal support, we are

incurring

>> >much higher uncompensated care when we reach the population your study

>> >addressed. Can you help me with funding access or ideas? Thanks

>> >

>> >

>> >To Post a message, send it to: Groups

>> >

>> >To Unsubscribe, send a blank message to:

>> -unsubscribe

>> >

>> >

[Guest guest]

,

Thanks for pointing this out. I strongly suspect that migrant/community

health centers are providing a significant amount of uncompensated care

related to occupational injuries and exposure to pesticides, etc. Would be

great to hear from clinics that are doing a good job in this area and what

their experiences has been as well as that of the workers.

Adolfo Mata

-----Original Message-----

From: [mailto:sdavis@...]

Sent: Friday, May 25, 2001 9:54 AM

; ' Lighthall'

Cc: Migrant_Health_Research; SF Sequoia Community Health Foundation

Subject: Re: [ ] RE: funding for health centers

Just to add a footnote to Adolfo's suggestion about third party payors.

I'm sure that clinics do think about enrolling their patients in Medicaid

or CHIP when they are eligible for such benefits, but those programs are

restricted to certain legal US residents or citizens. A third party payor

program that is not restricted by immigration status (in except in Maine)

is workers compensation. In California, in particular, all agricultural

workers are covered by workers comp. Some clinics have been reluctant to

accept workers comp because they are reluctant to do the paperwork. But

this is another potential income stream which should be considered. Where

possible, clinics should accept workers comp because it helps the

farmworkers. Farmworkers who otherwise end up in a hospital emergency

room, may end up with a big debt.

At 03:00 PM 5/24/2001 -0400, Mata, Adolfo wrote:

>, and others,

>

>The Bureau of Primary Health Care funding allocation formula for health

>center base budget adjustments (increases) does take into account

>demonstrated increases in migrant/seasonal users served and level of

> " uncompensated care " provided, in addition to other variables. There was

an

>increase in the community health centers federal appropriations, in the FY

>2001 budget. Of course the need is always greater.

>

>All community/migrant health centers, are eligible for base adjustments

>provided they meet certain criteria established by the Bureau with input in

>the form of recommendations from the Migrant Funding Allocation Work Group,

>convened regularly by the Bureau. Elia Gallardo from the California PCA is

a

>member of this workgroup. Of course, Sequoia has to compete with all other

>migrant programs across the country and Puerto Rico for new migrant and

>community health dollars. The competition is tough.

>

>Enrollment of ALL ELIGIBLE (not just migrant and seasonal agricultural

>workers) of health center users in such programs as Medicaid and State

>Children's Health Insurance Programs, in addition other forms of third

party

>reimbursement programs is one way to stretch migrant health dollars to

>served the truly " uninsured " , " underserved " and " ineligible " for public

>assistance programs such as single migrant farmworker men. If, a migrant

>health center has any questions, they should contact Ersek, Acting

>Chief, Migrant Health Branch, 301.594-4303. can also be reached by

>email: gersek@...

>

>Adolfo Mata, Director

>Hispanic Health Initiative

>Office of the Director/Bureau of Primary Health Care

>Health Resources and Services Administration/US DHHS

>4350 East-West Hwy, 11th FL

>Bethesda, land 20814

>(301) 594-4976

>amata@...

>

>

>

>

>

>-----Original Message-----

>From: Lighthall [mailto:dlighthall@...]

>Sent: Wednesday, May 23, 2001 6:27 PM

>Mata, Adolfo

>Cc: Migrant_Health_Research; SF Sequoia Community Health Foundation

>Subject: FW: funding for health centers

>

>

>Hi Adolfo and others:

>

>This (message below from the Sequoia clinic in Fresno) seems like a classic

>quandary for the clinic trying to do the right thing. Any thoughts? Any

>help coming down the pike at the federal level? Things don't look too

great

>here in California for more state support, both in terms of the downturn in

>the stock market, which really hits our income tax intake, and the energy

>crisis.

>

>Regards,

>

>

>

>-----Original Message-----

>From: Laurie Primavera [mailto:lauriep1@...]

>Sent: Wednesday, May 23, 2001 3:16 PM

>dlighthall@...

>Subject: funding for health centers

>

>

>Hi - I have been unable to attend CVHN meetings and needed to talk

with

>you. We were most honored at Sequoia to have the Endowment unveil the

>suffering in silence studies. We, at Sequoia have maintained an expanded

>hour program for two years that increases access to farmworkers on weekends

>and nights at three clinics. Higher utilization of males, better show

rates

>with single car transport, etc. Many benefits to expanded hours for

>farmworkers. Downside-it attracts higher uncompensated care-probably those

>farm workers who are not documented and/or males who simply do not qualify

>for medical.

>

>We are reducing our hours, leaving our largest site open sat, sun and

>evenings in hopes to get some funding. I have been unable to access

support

>for this program- foundations want to give seed money and want to know it

is

>sustainable. Without additional state, federal support, we are incurring

>much higher uncompensated care when we reach the population your study

>addressed. Can you help me with funding access or ideas? Thanks

>

>

>To Post a message, send it to: Groups

>

>To Unsubscribe, send a blank message to:

-unsubscribe

>

>

[Guest guest]

Adolfo,

Since you asked, and I had a conversation about this one incident a

while back…

No incidents, beyond this one incident has been brought to my attention. So

at this point, I am unclear about information beyond this.

I will say, however, that as with all migrant health centers nationwide,

California's migrant health centers have as their primary mission to serve

farmworkers, a predominantly uninsured population. California community and

migrant health centers served over 300,000 farmworkers, providing over 1

million encounters in 1999 and they had to come up with the resources to pay

for this level of service.

I will admit that I am not familiar with worker's comp, but I am assuming

that worker's comp would pay for some of this care…if the cause were work

related. If worker's comp does help cover the cost of serving a

predominantly uninsured population, then our non-profit community health

centers have tremendous incentive to seek out this funding. I have never

seen my folks turn their backs on resources to assist them in their mission

unless there was an extremely good reason. Is there? Again, I am not

familiar with worker's comp and at this point, I have no tangible reason to

believe that our health centers are not taking advantage of these resources.

I guess primarily, I am confused by the dialogue and would like to hear more

than anecdotes because of my lack of background on this…I would appreciate

hearing what worker's comp does and what it doesn't…..what is required to

secure worker's comp payments and if there are any good resources that I can

give to anyone that, like I, is confused by this conversation.

Elia

-----Original Message-----

From: Mata, Adolfo [mailto:amata@...]

Sent: Friday, May 25, 2001 12:38 PM

' '

Subject: RE: [ ] RE: funding for health centers

Elia Gallardo,

Are you aware of this happening in California?

Adolfo

-----Original Message-----

From: [mailto:sdavis@...]

Sent: Friday, May 25, 2001 3:20 PM

Subject: RE: [ ] RE: funding for health centers

Hi,

I, too, have heard only anecdotal reports of clinics which are not handling

workers comp cases. But, in the instance that came to my attention in a

timely way, I called the clinic director directly and he confirmed that the

clinic would not accept workers comp cases. Hope this is helpful.

At 09:04 AM 5/25/2001 -0700, you wrote:

>--

>

>We have heard anecdotally from farm workers that some CA clinics have been

>hesitant to evaluate their workers comp cases because of payment issues. Do

>you know of any systematic documentation of this problem?

>

>

>Rupali Das, MD, MPH

>Occupational Health Branch

>California Department of Health Services

>1515 Clay St., Suite 1901

>Oakland, CA 94612

>tel. (510) 622-4300 fax (510) 622-4310

>rdas@...

>

>> ----------

>> From:

>> Reply

>> Sent: Friday, May 25, 2001 6:53 AM

>> ; ' Lighthall'

>> Cc: Migrant_Health_Research; SF Sequoia Community Health Foundation

>> Subject: Re: [ ] RE: funding for health centers

>>

>> Just to add a footnote to Adolfo's suggestion about third party payors.

>> I'm sure that clinics do think about enrolling their patients in Medicaid

>> or CHIP when they are eligible for such benefits, but those programs are

>> restricted to certain legal US residents or citizens. A third party

payor

>> program that is not restricted by immigration status (in except in Maine)

>> is workers compensation. In California, in particular, all agricultural

>> workers are covered by workers comp. Some clinics have been reluctant to

>> accept workers comp because they are reluctant to do the paperwork. But

>> this is another potential income stream which should be considered.

Where

>> possible, clinics should accept workers comp because it helps the

>> farmworkers. Farmworkers who otherwise end up in a hospital emergency

>> room, may end up with a big debt.

>>

>> At 03:00 PM 5/24/2001 -0400, Mata, Adolfo wrote:

>> >, and others,

>> >

>> >The Bureau of Primary Health Care funding allocation formula for health

>> >center base budget adjustments (increases) does take into account

>> >demonstrated increases in migrant/seasonal users served and level of

>> > " uncompensated care " provided, in addition to other variables. There

was

>> an

>> >increase in the community health centers federal appropriations, in the

>> FY

>> >2001 budget. Of course the need is always greater.

>> >

>> >All community/migrant health centers, are eligible for base adjustments

>> >provided they meet certain criteria established by the Bureau with input

>> in

>> >the form of recommendations from the Migrant Funding Allocation Work

>> Group,

>> >convened regularly by the Bureau. Elia Gallardo from the California PCA

>> is a

>> >member of this workgroup. Of course, Sequoia has to compete with all

>> other

>> >migrant programs across the country and Puerto Rico for new migrant and

>> >community health dollars. The competition is tough.

>> >

>> >Enrollment of ALL ELIGIBLE (not just migrant and seasonal agricultural

>> >workers) of health center users in such programs as Medicaid and State

>> >Children's Health Insurance Programs, in addition other forms of third

>> party

>> >reimbursement programs is one way to stretch migrant health dollars to

>> >served the truly " uninsured " , " underserved " and " ineligible " for public

>> >assistance programs such as single migrant farmworker men. If, a

migrant

>> >health center has any questions, they should contact Ersek,

Acting

>> >Chief, Migrant Health Branch, 301.594-4303. can also be reached

>> by

>> >email: gersek@...

>> >

>> >Adolfo Mata, Director

>> >Hispanic Health Initiative

>> >Office of the Director/Bureau of Primary Health Care

>> >Health Resources and Services Administration/US DHHS

>> >4350 East-West Hwy, 11th FL

>> >Bethesda, land 20814

>> >(301) 594-4976

>> >amata@...

>> >

>> >

>> >

>> >

>> >

>> >-----Original Message-----

>> >From: Lighthall [mailto:dlighthall@...]

>> >Sent: Wednesday, May 23, 2001 6:27 PM

>> >Mata, Adolfo

>> >Cc: Migrant_Health_Research; SF Sequoia Community Health Foundation

>> >Subject: FW: funding for health centers

>> >

>> >

>> >Hi Adolfo and others:

>> >

>> >This (message below from the Sequoia clinic in Fresno) seems like a

>> classic

>> >quandary for the clinic trying to do the right thing. Any thoughts?

Any

>> >help coming down the pike at the federal level? Things don't look too

>> great

>> >here in California for more state support, both in terms of the downturn

>> in

>> >the stock market, which really hits our income tax intake, and the

energy

>> >crisis.

>> >

>> >Regards,

>> >

>> >

>> >

>> >-----Original Message-----

>> >From: Laurie Primavera [mailto:lauriep1@...]

>> >Sent: Wednesday, May 23, 2001 3:16 PM

>> >dlighthall@...

>> >Subject: funding for health centers

>> >

>> >

>> >Hi - I have been unable to attend CVHN meetings and needed to talk

>> with

>> >you. We were most honored at Sequoia to have the Endowment unveil the

>> >suffering in silence studies. We, at Sequoia have maintained an

expanded

>> >hour program for two years that increases access to farmworkers on

>> weekends

>> >and nights at three clinics. Higher utilization of males, better show

>> rates

>> >with single car transport, etc. Many benefits to expanded hours for

>>

>> >farmworkers. Downside-it attracts higher uncompensated care-probably

>> those

>> >farm workers who are not documented and/or males who simply do not

>> qualify

>> >for medical.

>> >

>> >We are reducing our hours, leaving our largest site open sat, sun and

>> >evenings in hopes to get some funding. I have been unable to access

>> support

>> >for this program- foundations want to give seed money and want to know

it

>> is

>> >sustainable. Without additional state, federal support, we are

incurring

>> >much higher uncompensated care when we reach the population your study

>> >addressed. Can you help me with funding access or ideas? Thanks

>> >

>> >

>> >To Post a message, send it to: Groups

>> >

>> >To Unsubscribe, send a blank message to:

>> -unsubscribe

>> >

>> >

[Guest guest]

Hi Elia and Adolfo,

Let's not demonize or defend anyone for a moment and just talk fact and

perceptions. There is definitely a perception out there that workers comp

is a difficult time-consuming system to deal with. While some hassle is

definitely involved, much of the problem is due to the fact that people are

unfamiliar with it and haven't used it. (In general, big disputes and

delays arise around issues of permanent disability or very expensive

treatments. Clinics won't tend to see patients in those categories. For

the more run of the mill injuries that are covered, clinics could help

workers file claims. If a claim is not disputed, the payment system works

reasonably well. Payments levels vary by state.

Calfornia is a good place to try to work to get more clinics involved in

workers comp because all farmworkers are covered. One hurtle that has to

be overcome is that workers have to designate a doctor in advance -- or the

employer picks the doctor. There is also a process for changing doctors

(if the worker isn't satisfied with the employer's doctor) but it is more

cumbersome. So, clinics would want to learn how to do these claims and

encourage their patients to sign a form designating the clinic as their

doctor in the event of a problem.

Workers comp is governed by state law. Thus, each state is a little

different. I have written a manual which provides an overview of workers

comp and a little about the state law of each state. (I could send you a

copy if you want to see it). But a follow-up workshop should be done in

each state which takes the specific forms of that state, and goes thru the

necessary process so that a clinic could be up and running with this. Such

a workshop could be done by Elia's group or NACHC (or FJF). We would only

do it if we got money for it because I would want to hire as a consultant a

current insurance claims evaluator -- who could really explain what will

get your claim through.

Remember, we are all on the same side...

At 04:47 PM 5/29/2001 -0700, you wrote:

>Adolfo,

>

>Since you asked, and I had a conversation about this one incident a

>while back…

>No incidents, beyond this one incident has been brought to my attention. So

>at this point, I am unclear about information beyond this.

>

>I will say, however, that as with all migrant health centers nationwide,

>California's migrant health centers have as their primary mission to serve

>farmworkers, a predominantly uninsured population. California community and

>migrant health centers served over 300,000 farmworkers, providing over 1

>million encounters in 1999 and they had to come up with the resources to pay

>for this level of service.

>

>I will admit that I am not familiar with worker's comp, but I am assuming

>that worker's comp would pay for some of this care…if the cause were work

>related. If worker's comp does help cover the cost of serving a

>predominantly uninsured population, then our non-profit community health

>centers have tremendous incentive to seek out this funding. I have never

>seen my folks turn their backs on resources to assist them in their mission

>unless there was an extremely good reason. Is there? Again, I am not

>familiar with worker's comp and at this point, I have no tangible reason to

>believe that our health centers are not taking advantage of these resources.

>

>I guess primarily, I am confused by the dialogue and would like to hear more

>than anecdotes because of my lack of background on this…I would appreciate

>hearing what worker's comp does and what it doesn't…..what is required to

>secure worker's comp payments and if there are any good resources that I can

>give to anyone that, like I, is confused by this conversation.

>

>Elia

>

>-----Original Message-----

>From: Mata, Adolfo [mailto:amata@...]

>Sent: Friday, May 25, 2001 12:38 PM

>' '

>Subject: RE: [ ] RE: funding for health centers

>

>Elia Gallardo,

>

>Are you aware of this happening in California?

>

>Adolfo

>

>

>

>-----Original Message-----

>From: [mailto:sdavis@...]

>Sent: Friday, May 25, 2001 3:20 PM

>

>Subject: RE: [ ] RE: funding for health centers

>

>

>Hi,

>

>I, too, have heard only anecdotal reports of clinics which are not handling

>workers comp cases. But, in the instance that came to my attention in a

>timely way, I called the clinic director directly and he confirmed that the

>clinic would not accept workers comp cases. Hope this is helpful.

>

>

>At 09:04 AM 5/25/2001 -0700, you wrote:

>>--

>>

>>We have heard anecdotally from farm workers that some CA clinics have been

>>hesitant to evaluate their workers comp cases because of payment issues. Do

>>you know of any systematic documentation of this problem?

>>

>>

>>Rupali Das, MD, MPH

>>Occupational Health Branch

>>California Department of Health Services

>>1515 Clay St., Suite 1901

>>Oakland, CA 94612

>>tel. (510) 622-4300 fax (510) 622-4310

>>rdas@...

>>

>>> ----------

>>> From:

>>> Reply

>>> Sent: Friday, May 25, 2001 6:53 AM

>>> ; ' Lighthall'

>>> Cc: Migrant_Health_Research; SF Sequoia Community Health Foundation

>>> Subject: Re: [ ] RE: funding for health centers

>>>

>>> Just to add a footnote to Adolfo's suggestion about third party payors.

>>> I'm sure that clinics do think about enrolling their patients in Medicaid

>>> or CHIP when they are eligible for such benefits, but those programs are

>>> restricted to certain legal US residents or citizens. A third party

>payor

>>> program that is not restricted by immigration status (in except in Maine)

>>> is workers compensation. In California, in particular, all agricultural

>>> workers are covered by workers comp. Some clinics have been reluctant to

>>> accept workers comp because they are reluctant to do the paperwork. But

>>> this is another potential income stream which should be considered.

>Where

>>> possible, clinics should accept workers comp because it helps the

>>> farmworkers. Farmworkers who otherwise end up in a hospital emergency

>>> room, may end up with a big debt.

>>>

>>> At 03:00 PM 5/24/2001 -0400, Mata, Adolfo wrote:

>>> >, and others,

>>> >

>>> >The Bureau of Primary Health Care funding allocation formula for health

>>> >center base budget adjustments (increases) does take into account

>>> >demonstrated increases in migrant/seasonal users served and level of

>>> > " uncompensated care " provided, in addition to other variables. There

>was

>>> an

>>> >increase in the community health centers federal appropriations, in the

>>> FY

>>> >2001 budget. Of course the need is always greater.

>>> >

>>> >All community/migrant health centers, are eligible for base adjustments

>>> >provided they meet certain criteria established by the Bureau with input

>>> in

>>> >the form of recommendations from the Migrant Funding Allocation Work

>>> Group,

>>> >convened regularly by the Bureau. Elia Gallardo from the California PCA

>>> is a

>>> >member of this workgroup. Of course, Sequoia has to compete with all

>>> other

>>> >migrant programs across the country and Puerto Rico for new migrant and

>>> >community health dollars. The competition is tough.

>>> >

>>> >Enrollment of ALL ELIGIBLE (not just migrant and seasonal agricultural

>>> >workers) of health center users in such programs as Medicaid and State

>>> >Children's Health Insurance Programs, in addition other forms of third

>>> party

>>> >reimbursement programs is one way to stretch migrant health dollars to

>>> >served the truly " uninsured " , " underserved " and " ineligible " for public

>

>>> >assistance programs such as single migrant farmworker men. If, a

>migrant

>>> >health center has any questions, they should contact Ersek,

>Acting

>>> >Chief, Migrant Health Branch, 301.594-4303. can also be reached

>>> by

>>> >email: gersek@...

>>> >

>>> >Adolfo Mata, Director

>>> >Hispanic Health Initiative

>>> >Office of the Director/Bureau of Primary Health Care

>>> >Health Resources and Services Administration/US DHHS

>>> >4350 East-West Hwy, 11th FL

>>> >Bethesda, land 20814

>>> >(301) 594-4976

>>> >amata@...

>>> >

>>> >

>>> >

>>> >

>>> >

>>> >-----Original Message-----

>>> >From: Lighthall [mailto:dlighthall@...]

>>> >Sent: Wednesday, May 23, 2001 6:27 PM

>>> >Mata, Adolfo

>>> >Cc: Migrant_Health_Research; SF Sequoia Community Health Foundation

>>> >Subject: FW: funding for health centers

>>> >

>>> >

>>> >Hi Adolfo and others:

>>> >

>>> >This (message below from the Sequoia clinic in Fresno) seems like a

>>> classic

>>> >quandary for the clinic trying to do the right thing. Any thoughts?

>Any

>>> >help coming down the pike at the federal level? Things don't look too

>>> great

>>> >here in California for more state support, both in terms of the downturn

>>> in

>>> >the stock market, which really hits our income tax intake, and the

>energy

>>> >crisis.

>>> >

>>> >Regards,

>>> >

>>> >

>>> >

>>> >-----Original Message-----

>>> >From: Laurie Primavera [mailto:lauriep1@...]

>>> >Sent: Wednesday, May 23, 2001 3:16 PM

>>> >dlighthall@...

>>> >Subject: funding for health centers

>>> >

>>> >

>>> >Hi - I have been unable to attend CVHN meetings and needed to talk

>>> with

>>> >you. We were most honored at Sequoia to have the Endowment unveil the

>>> >suffering in silence studies. We, at Sequoia have maintained an

>expanded

>>> >hour program for two years that increases access to farmworkers on

>>> weekends

>>> >and nights at three clinics. Higher utilization of males, better show

>>> rates

>>> >with single car transport, etc. Many benefits to expanded hours for

>>>

>>> >farmworkers. Downside-it attracts higher uncompensated care-probably

>>> those

>>> >farm workers who are not documented and/or males who simply do not

>>> qualify

>>> >for medical.

>>> >

>>> >We are reducing our hours, leaving our largest site open sat, sun and

>>> >evenings in hopes to get some funding. I have been unable to access

>>> support

>>> >for this program- foundations want to give seed money and want to know

>it

>>> is

>>> >sustainable. Without additional state, federal support, we are

>incurring

>>> >much higher uncompensated care when we reach the population your study

>>> >addressed. Can you help me with funding access or ideas? Thanks

>>> >

>>> >

>>> >To Post a message, send it to: Groups

>>> >

>>> >To Unsubscribe, send a blank message to:

>>> -unsubscribe

>>> >

>>> >

[Guest guest]

& others:

I would be very interested in working with those of you who are interested

in this issue in California. Part of the outreach the Occupational Health

Branch conducts when doing research is to educate workers (including

farmworkers) about the workers comp system and their rights under that

system-- including filing a claim. However, this is a daunting processif the

worker has to pursue it on their own. It would be a great idea to

coordinate these efforts with insurance companies, clinics and advocates,

and others.

An upcoming forum may be of relevance: The Agricultural Labor Relations

Board in CA has been convening " Farm Worker Forums " in various part of CA.

Events have been held in Oxnard and Santa . The next one will be held

in Oceano on June 20. I have not attended these previously, but was invited

to attend the next forum (I may not attend but will probably send someone).

Representatives of various state agencies, CRLA & the Labor Commissioner

have been invited to attend, speak briefly, and answer questions. This

might be an opportunity to bring some of the issues which have been

discussed on this listserve to the public arena.

Rupali Das, MD, MPH

Occupational Health Branch

California Department of Health Services

1515 Clay St., Suite 1901

Oakland, CA 94612

tel. (510) 622-4300 fax (510) 622-4310

rdas@...

> ----------

> From:

> Reply

> Sent: Wednesday, May 30, 2001 7:14 AM

>

> Cc: amata@...

> Subject: RE: [ ] RE: funding for health centers

>

> Hi Elia and Adolfo,

>

> Let's not demonize or defend anyone for a moment and just talk fact and

> perceptions. There is definitely a perception out there that workers comp

> is a difficult time-consuming system to deal with. While some hassle is

> definitely involved, much of the problem is due to the fact that people

> are

> unfamiliar with it and haven't used it. (In general, big disputes and

> delays arise around issues of permanent disability or very expensive

> treatments. Clinics won't tend to see patients in those categories. For

> the more run of the mill injuries that are covered, clinics could help

> workers file claims. If a claim is not disputed, the payment system works

> reasonably well. Payments levels vary by state.

> Calfornia is a good place to try to work to get more clinics involved in

> workers comp because all farmworkers are covered. One hurtle that has to

> be overcome is that workers have to designate a doctor in advance -- or

> the

> employer picks the doctor. There is also a process for changing doctors

> (if the worker isn't satisfied with the employer's doctor) but it is more

> cumbersome. So, clinics would want to learn how to do these claims and

> encourage their patients to sign a form designating the clinic as their

> doctor in the event of a problem.

> Workers comp is governed by state law. Thus, each state is a little

> different. I have written a manual which provides an overview of workers

> comp and a little about the state law of each state. (I could send you a

> copy if you want to see it). But a follow-up workshop should be done in

> each state which takes the specific forms of that state, and goes thru the

> necessary process so that a clinic could be up and running with this.

> Such

> a workshop could be done by Elia's group or NACHC (or FJF). We would only

> do it if we got money for it because I would want to hire as a consultant

> a

> current insurance claims evaluator -- who could really explain what will

> get your claim through.

> Remember, we are all on the same side...

>

>

> At 04:47 PM

> 5/29/2001 -0700, you wrote:

> >Adolfo,

> >

> >Since you asked, and I had a conversation about this one

> incident a

> >while back…

> >No incidents, beyond this one incident has been brought to my attention.

> So

> >at this point, I am unclear about information beyond this.

> >

> >I will say, however, that as with all migrant health centers nationwide,

> >California's migrant health centers have as their primary mission to

> serve

> >farmworkers, a predominantly uninsured population. California community

> and

>

> >migrant health centers served over 300,000 farmworkers, providing over 1

> >million encounters in 1999 and they had to come up with the resources to

> pay

> >for this level of service.

> >

> >I will admit that I am not familiar with worker's comp, but I am assuming

> >that worker's comp would pay for some of this care…if the cause were work

> >related. If worker's comp does help cover the cost of serving a

> >predominantly uninsured population, then our non-profit community health

> >centers have tremendous incentive to seek out this funding. I have never

> >seen my folks turn their backs on resources to assist them in their

> mission

> >unless there was an extremely good reason. Is there? Again, I am not

> >familiar with worker's comp and at this point, I have no tangible reason

> to

> >believe that our health centers are not taking advantage of these

> resources.

> >

> >I guess primarily, I am confused by the dialogue and would like to hear

> more

> >than anecdotes because of my lack of background on this…I would

> appreciate

> >hearing what worker's comp does and what it doesn't…..what is required to

> >secure worker's comp payments and if there are any good resources that I

> can

> >give to anyone that, like I, is confused by this conversation.

> >

> >Elia

> >

> >-----Original Message-----

> >From: Mata, Adolfo [mailto:amata@...]

> >Sent: Friday, May 25, 2001 12:38 PM

> >' '

> >Subject: RE: [ ] RE: funding for health centers

> >

> >Elia Gallardo,

> >

> >Are you aware of this happening in California?

> >

> >Adolfo

> >

> >

> >

> >-----Original Message-----

> >From: [mailto:sdavis@...]

> >Sent: Friday, May 25, 2001 3:20 PM

> >

> >Subject: RE: [ ] RE: funding for health centers

> >

> >

> >Hi,

> >

> >I, too, have heard only anecdotal reports of clinics which are not

> handling

> >workers comp cases. But, in the instance that came to my attention in a

> >timely way, I called the clinic director directly and he confirmed that

> the

> >clinic would not accept workers comp cases. Hope this is helpful.

> >

> >

> >At 09:04 AM 5/25/2001 -0700, you wrote:

> >>--

> >>

> >>We have heard anecdotally from farm workers that some CA clinics have

> been

> >>hesitant to evaluate their workers comp cases because of payment issues.

> Do

> >>you know of any systematic documentation of this problem?

> >>

> >>

> >>Rupali Das, MD, MPH

> >>Occupational Health Branch

> >>California Department of Health Services

> >>1515 Clay St., Suite 1901

> >>Oakland, CA 94612

> >>tel. (510) 622-4300 fax (510) 622-4310

> >>rdas@...

> >>

>

> >>> ----------

> >>> From:

> >>> Reply

> >>> Sent: Friday, May 25, 2001 6:53 AM

> >>> ; ' Lighthall'

> >>> Cc: Migrant_Health_Research; SF Sequoia Community Health

> Foundation

> >>> Subject: Re: [ ] RE: funding for health centers

> >>>

> >>> Just to add a footnote to Adolfo's suggestion about third party

> payors.

> >>> I'm sure that clinics do think about enrolling their patients in

> Medicaid

> >>> or CHIP when they are eligible for such benefits, but those programs

> are

> >>> restricted to certain legal US residents or citizens. A third party

> >payor

> >>> program that is not restricted by immigration status (in except in

> Maine)

> >>> is workers compensation. In California, in particular, all

> agricultural

> >>> workers are covered by workers comp. Some clinics have been reluctant

> to

> >>> accept workers comp because they are reluctant to do the paperwork.

> But

> >>> this is another potential income stream which should be considered.

> >Where

> >>> possible, clinics should accept workers comp because it helps the

> >>> farmworkers. Farmworkers who otherwise end up in a hospital emergency

> >>> room, may end up with a big debt.

> >>>

> >>> At 03:00 PM 5/24/2001 -0400, Mata, Adolfo wrote:

> >>> >, and others,

> >>> >

> >>> >The Bureau of Primary Health Care funding allocation formula for

> health

> >>> >center base budget adjustments (increases) does take into account

> >>> >demonstrated increases in migrant/seasonal users served and level of

> >>> > " uncompensated care " provided, in addition to other variables. There

> >was

> >>> an

> >>> >increase in the community health centers federal appropriations, in

> the

> >>> FY

> >>> >2001 budget. Of course the need is always greater.

> >>> >

> >>> >All community/migrant health centers, are eligible for base

> adjustments

> >>> >provided they meet certain criteria established by the Bureau with

> input

> >>> in

> >>> >the form of recommendations from the Migrant Funding Allocation Work

> >>> Group,

> >>> >convened regularly by the Bureau. Elia Gallardo from the California

> PCA

> >>> is a

> >>> >member of this workgroup. Of course, Sequoia has to compete with all

> >>> other

> >>> >migrant programs across the country and Puerto Rico for new migrant

> and

> >>> >community health dollars. The competition is tough.

> >>> >

> >>> >Enrollment of ALL ELIGIBLE (not just migrant and seasonal

> agricultural

> >>> >workers) of health center users in such programs as Medicaid and

> State

> >>> >Children's Health Insurance Programs, in addition other forms of

> third

> >>> party

> >>> >reimbursement programs is one way to stretch migrant health dollars

> to

> >>> >served the truly " uninsured " , " underserved " and " ineligible " for

> public

> >

> >>> >assistance programs such as single migrant farmworker men. If, a

> >migrant

> >>> >health center has any questions, they should contact Ersek,

> >Acting

> >>> >Chief, Migrant Health Branch, 301.594-4303. can also be

> reached

> >>> by

> >>> >email: gersek@...

> >>> >

> >>> >Adolfo Mata, Director

> >>> >Hispanic Health Initiative

> >>> >Office of the Director/Bureau of Primary Health Care

> >>> >Health Resources and Services Administration/US DHHS

>

> >>> >4350 East-West Hwy, 11th FL

> >>> >Bethesda, land 20814

> >>> >(301) 594-4976

> >>> >amata@...

> >>> >

> >>> >

> >>> >

> >>> >

> >>> >

> >>> >-----Original Message-----

> >>> >From: Lighthall [mailto:dlighthall@...]

> >>> >Sent: Wednesday, May 23, 2001 6:27 PM

> >>> >Mata, Adolfo

> >>> >Cc: Migrant_Health_Research; SF Sequoia Community Health Foundation

> >>> >Subject: FW: funding for health centers

> >>> >

> >>> >

> >>> >Hi Adolfo and others:

> >>> >

> >>> >This (message below from the Sequoia clinic in Fresno) seems like a

> >>> classic

> >>> >quandary for the clinic trying to do the right thing. Any thoughts?

> >Any

> >>> >help coming down the pike at the federal level? Things don't look

> too

> >>> great

> >>> >here in California for more state support, both in terms of the

> downturn

> >>> in

> >>> >the stock market, which really hits our income tax intake, and the

> >energy

> >>> >crisis.

> >>> >

> >>> >Regards,

> >>> >

> >>> >

> >>> >

> >>> >-----Original Message-----

> >>> >From: Laurie Primavera [mailto:lauriep1@...]

> >>> >Sent: Wednesday, May 23, 2001 3:16 PM

> >>> >dlighthall@...

> >>> >Subject: funding for health centers

> >>> >

> >>> >

> >>> >Hi - I have been unable to attend CVHN meetings and needed to

> talk

> >>> with

> >>> >you. We were most honored at Sequoia to have the Endowment unveil

> the

> >>> >suffering in silence studies. We, at Sequoia have maintained an

> >expanded

> >>> >hour program for two years that increases access to farmworkers on

> >>> weekends

> >>> >and nights at three clinics. Higher utilization of males, better

> show

> >>> rates

> >>> >with single car transport, etc. Many benefits to expanded hours for

> >>>

> >>> >farmworkers. Downside-it attracts higher uncompensated care-probably

> >>> those

> >>> >farm workers who are not documented and/or males who simply do not

> >>> qualify

> >>> >for medical.

> >>> >

> >>> >We are reducing our hours, leaving our largest site open sat, sun and

> >>> >evenings in hopes to get some funding. I have been unable to access

> >>> support

> >>> >for this program- foundations want to give seed money and want to

> know

> >it

> >>> is

> >>> >sustainable. Without additional state, federal support, we are

> >incurring

> >>> >much higher uncompensated care when we reach the population your

> study

> >>> >addressed. Can you help me with funding access or ideas? Thanks

> >>> >

> >>> >

> >>> >To Post a message, send it to:

> Groups

> >>> >

> >>> >To Unsubscribe, send a blank message to:

> >>> -unsubscribe

> >>> >

> >>> >

[Guest guest]

Hi:

I would like to add a little note to your conversation about workers comp. At

the Call for Health program

we have had several cases where we had to help farmworkers get workers comp. The

process we use is to

contact a lawyer as soon as we know this is workers comp case. The lawyer will

make sure that the workers

rights are protected, they have also been able to find out the insurance

information on the employer and

contact them directly. Sometimes the employer will not disclose his insurance

carrier, if he has one. Many

of our patients are not even aware that they can get workers comp. In mild

cases, like a broken finger,

Call for Health through the Friends of Farmworker Families Fund has been able to

cover the bill and then

get reimbursed by workers comp at a latter date. This has made it possible to

provide immediate medical

care to the farmworker, with out the hassle of having to wait to find out if

worker comp would pay or not.

(many specialty care clinics will not see patients unless they have money up

front to pay).

If you would like more information on the cases we have worked on please give us

a call at 1-800-377-9968.

wrote:

> Hi Elia and Adolfo,

>

> Let's not demonize or defend anyone for a moment and just talk fact and

> perceptions. There is definitely a perception out there that workers comp

> is a difficult time-consuming system to deal with. While some hassle is

> definitely involved, much of the problem is due to the fact that people are

> unfamiliar with it and haven't used it. (In general, big disputes and

> delays arise around issues of permanent disability or very expensive

> treatments. Clinics won't tend to see patients in those categories. For

> the more run of the mill injuries that are covered, clinics could help

> workers file claims. If a claim is not disputed, the payment system works

> reasonably well. Payments levels vary by state.

> Calfornia is a good place to try to work to get more clinics involved in

> workers comp because all farmworkers are covered. One hurtle that has to

> be overcome is that workers have to designate a doctor in advance -- or the

> employer picks the doctor. There is also a process for changing doctors

> (if the worker isn't satisfied with the employer's doctor) but it is more

> cumbersome. So, clinics would want to learn how to do these claims and

> encourage their patients to sign a form designating the clinic as their

> doctor in the event of a problem.

> Workers comp is governed by state law. Thus, each state is a little

> different. I have written a manual which provides an overview of workers

> comp and a little about the state law of each state. (I could send you a

> copy if you want to see it). But a follow-up workshop should be done in

> each state which takes the specific forms of that state, and goes thru the

> necessary process so that a clinic could be up and running with this. Such

> a workshop could be done by Elia's group or NACHC (or FJF). We would only

> do it if we got money for it because I would want to hire as a consultant a

> current insurance claims evaluator -- who could really explain what will

> get your claim through.

> Remember, we are all on the same side...

>

>

> At 04:47 PM

5/29/2001 -0700, you wrote:

> >Adolfo,

> >

> >Since you asked, and I had a conversation about this one incident a

> >while back…

> >No incidents, beyond this one incident has been brought to my attention. So

> >at this point, I am unclear about information beyond this.

> >

> >I will say, however, that as with all migrant health centers nationwide,

> >California's migrant health centers have as their primary mission to serve

> >farmworkers, a predominantly uninsured population. California community and

>

> >migrant health centers served over 300,000 farmworkers, providing over 1

> >million encounters in 1999 and they had to come up with the resources to pay

> >for this level of service.

> >

> >I will admit that I am not familiar with worker's comp, but I am assuming

> >that worker's comp would pay for some of this care…if the cause were work

> >related. If worker's comp does help cover the cost of serving a

> >predominantly uninsured population, then our non-profit community health

> >centers have tremendous incentive to seek out this funding. I have never

> >seen my folks turn their backs on resources to assist them in their mission

> >unless there was an extremely good reason. Is there? Again, I am not

> >familiar with worker's comp and at this point, I have no tangible reason to

> >believe that our health centers are not taking advantage of these resources.

> >

> >I guess primarily, I am confused by the dialogue and would like to hear more

> >than anecdotes because of my lack of background on this…I would appreciate

> >hearing what worker's comp does and what it doesn't…..what is required to

> >secure worker's comp payments and if there are any good resources that I can

> >give to anyone that, like I, is confused by this conversation.

> >

> >Elia

> >

> >-----Original Message-----

> >From: Mata, Adolfo [mailto:amata@...]

> >Sent: Friday, May 25, 2001 12:38 PM

> > ' '

> >Subject: RE: [ ] RE: funding for health centers

> >

> >Elia Gallardo,

> >

> >Are you aware of this happening in California?

> >

> >Adolfo

> >

> >

> >

> >-----Original Message-----

> >From: [mailto:sdavis@...]

> >Sent: Friday, May 25, 2001 3:20 PM

> >

> >Subject: RE: [ ] RE: funding for health centers

> >

> >

> >Hi,

> >

> >I, too, have heard only anecdotal reports of clinics which are not handling

> >workers comp cases. But, in the instance that came to my attention in a

> >timely way, I called the clinic director directly and he confirmed that the

> >clinic would not accept workers comp cases. Hope this is helpful.

> >

> >

> >At 09:04 AM 5/25/2001 -0700, you wrote:

> >>--

> >>

> >>We have heard anecdotally from farm workers that some CA clinics have been

> >>hesitant to evaluate their workers comp cases because of payment issues. Do

> >>you know of any systematic documentation of this problem?

> >>

> >>

> >>Rupali Das, MD, MPH

> >>Occupational Health Branch

> >>California Department of Health Services

> >>1515 Clay St., Suite 1901

> >>Oakland, CA 94612

> >>tel. (510) 622-4300 fax (510) 622-4310

> >>rdas@...

> >>

>

> >>> ----------

> >>> From:

> >>> Reply

> >>> Sent: Friday, May 25, 2001 6:53 AM

> >>> ; ' Lighthall'

> >>> Cc: Migrant_Health_Research; SF Sequoia Community Health

Foundation

> >>> Subject: Re: [ ] RE: funding for health centers

> >>>

> >>> Just to add a footnote to Adolfo's suggestion about third party payors.

> >>> I'm sure that clinics do think about enrolling their patients in Medicaid

> >>> or CHIP when they are eligible for such benefits, but those programs are

> >>> restricted to certain legal US residents or citizens. A third party

> >payor

> >>> program that is not restricted by immigration status (in except in Maine)

> >>> is workers compensation. In California, in particular, all agricultural

> >>> workers are covered by workers comp. Some clinics have been reluctant to

> >>> accept workers comp because they are reluctant to do the paperwork. But

> >>> this is another potential income stream which should be considered.

> >Where

> >>> possible, clinics should accept workers comp because it helps the

> >>> farmworkers. Farmworkers who otherwise end up in a hospital emergency

> >>> room, may end up with a big debt.

> >>>

> >>> At 03:00 PM 5/24/2001 -0400, Mata, Adolfo wrote:

> >>> >, and others,

> >>> >

> >>> >The Bureau of Primary Health Care funding allocation formula for health

> >>> >center base budget adjustments (increases) does take into account

> >>> >demonstrated increases in migrant/seasonal users served and level of

> >>> > " uncompensated care " provided, in addition to other variables. There

> >was

> >>> an

> >>> >increase in the community health centers federal appropriations, in the

> >>> FY

> >>> >2001 budget. Of course the need is always greater.

> >>> >

> >>> >All community/migrant health centers, are eligible for base adjustments

> >>> >provided they meet certain criteria established by the Bureau with input

> >>> in

> >>> >the form of recommendations from the Migrant Funding Allocation Work

> >>> Group,

> >>> >convened regularly by the Bureau. Elia Gallardo from the California PCA

> >>> is a

> >>> >member of this workgroup. Of course, Sequoia has to compete with all

> >>> other

> >>> >migrant programs across the country and Puerto Rico for new migrant and

> >>> >community health dollars. The competition is tough.

> >>> >

> >>> >Enrollment of ALL ELIGIBLE (not just migrant and seasonal agricultural

> >>> >workers) of health center users in such programs as Medicaid and State

> >>> >Children's Health Insurance Programs, in addition other forms of third

> >>> party

> >>> >reimbursement programs is one way to stretch migrant health dollars to

> >>> >served the truly " uninsured " , " underserved " and " ineligible " for public

> >

> >>> >assistance programs such as single migrant farmworker men. If, a

> >migrant

> >>> >health center has any questions, they should contact Ersek,

> >Acting

> >>> >Chief, Migrant Health Branch, 301.594-4303. can also be reached

> >>> by

> >>> >email: gersek@...

> >>> >

> >>> >Adolfo Mata, Director

> >>> >Hispanic Health Initiative

> >>> >Office of the Director/Bureau of Primary Health Care

> >>> >Health Resources and Services Administration/US DHHS

>

> >>> >4350 East-West Hwy, 11th FL

> >>> >Bethesda, land 20814

> >>> >(301) 594-4976

> >>> >amata@...

> >>> >

> >>> >

> >>> >

> >>> >

> >>> >

> >>> >-----Original Message-----

> >>> >From: Lighthall [mailto:dlighthall@...]

> >>> >Sent: Wednesday, May 23, 2001 6:27 PM

> >>> >Mata, Adolfo

> >>> >Cc: Migrant_Health_Research; SF Sequoia Community Health Foundation

> >>> >Subject: FW: funding for health centers

> >>> >

> >>> >

> >>> >Hi Adolfo and others:

> >>> >

> >>> >This (message below from the Sequoia clinic in Fresno) seems like a

> >>> classic

> >>> >quandary for the clinic trying to do the right thing. Any thoughts?

> >Any

> >>> >help coming down the pike at the federal level? Things don't look too

> >>> great

> >>> >here in California for more state support, both in terms of the downturn

> >>> in

> >>> >the stock market, which really hits our income tax intake, and the

> >energy

> >>> >crisis.

> >>> >

> >>> >Regards,

> >>> >

> >>> >

> >>> >

> >>> >-----Original Message-----

> >>> >From: Laurie Primavera [mailto:lauriep1@...]

> >>> >Sent: Wednesday, May 23, 2001 3:16 PM

> >>> >dlighthall@...

> >>> >Subject: funding for health centers

> >>> >

> >>> >

> >>> >Hi - I have been unable to attend CVHN meetings and needed to talk

> >>> with

> >>> >you. We were most honored at Sequoia to have the Endowment unveil the

> >>> >suffering in silence studies. We, at Sequoia have maintained an

> >expanded

> >>> >hour program for two years that increases access to farmworkers on

> >>> weekends

> >>> >and nights at three clinics. Higher utilization of males, better show

> >>> rates

> >>> >with single car transport, etc. Many benefits to expanded hours for

> >>>

> >>> >farmworkers. Downside-it attracts higher uncompensated care-probably

> >>> those

> >>> >farm workers who are not documented and/or males who simply do not

> >>> qualify

> >>> >for medical.

> >>> >

> >>> >We are reducing our hours, leaving our largest site open sat, sun and

> >>> >evenings in hopes to get some funding. I have been unable to access

> >>> support

> >>> >for this program- foundations want to give seed money and want to know

> >it

> >>> is

> >>> >sustainable. Without additional state, federal support, we are

> >incurring

> >>> >much higher uncompensated care when we reach the population your study

> >>> >addressed. Can you help me with funding access or ideas? Thanks

> >>> >

> >>> >

> >>> >To Post a message, send it to: Groups

> >>> >

> >>> >To Unsubscribe, send a blank message to:

> >>> -unsubscribe

> >>> >

> >>> >