.Health Care Financing issues

[Guest guest]

Thanks to for the offer of assistance and suport, and to Alice for

the plug on the EGROUP and the Stream Forums. I am very gratified

by the continued enthusiasm and committment to the farmworker population

demonstrated by the activity on this egroup.

One of NCFH's most important agenda issues is the inclusion of eligible

farmworkers as participants in CHIP and Medicaid wherever possible. We

realize that this does not provide health care financing for undocumented

or recent immigrants, however any farmworker that has health care financing

frees up resources for those who do not.

Do any of you as researchers have an interest in looking at the coverage

rates for this population? I know that the CIRS study has great data

on this topic, are any of you aware of any other studies of 3rd party coverage

for farmworkers?

Bobbi

Lighthall wrote:

To the migrant health community:

It is my sincere hope that the results of the California Agricultural

Workers Health Survey and the Binational Health Survey, and the

subsequent

press coverage they have engendered, be fully exploited in making

the case

for more funding for migrant and community health clinics, and

more such

clinics nationwide. It is extremely important at this critical

juncture,

while Congress debates this funding, that this striking body of

empirical

evidence be put to good use.

It is also extremely important that the poor health conditions of

farmworkers overall, as found in the CAWHS, be in no way associated

with the

performance of the community and migrant clinic system. The

clinics and

their staffs are doing great, often heroic work with limited funds.

And, as

witnessed in Tamara's message below, are operating in an often

hostile

employer environment with workers who about half the time are undocumented.

The real issue here is, imagine just how appalling things would

be without

this system of subsidized care on the part of clinics that are

striving

towards excellence in multi-cultural health care delivery!

I have had the

pleasure of meeting many of you in the past several years and I

have been

impressed time and time again by your dedication to the health

of our

nation's farmworkers.

I would like to go on record as offering our organizational resources

to

aid, in whatever way we can, the fight to secure more federal funding.

I

would like to particularly direct this offer to NACHC, NCFH, FJF,

and any

other organizations who are leading this fight.

Sincerely,

Lighthall Ph.D.

Executive Director

California Institute for Rural Studies

P.O. Box 2143 (U.S. Mail)

221 G Street, Suite 204

, CA 95616

Tel: (530)756-6555

Fax: (530)756-7429

dlighthall@...

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

From: Tamara F. Cummings [mailto:tcummin@...]

Sent: Monday, May 14, 2001 10:24 AM

Subject: RE: [ ] Digest Number 210

As a result of the story that ran in the NY Times on Fear and Poverty

of

Migrant Farm Workers living in the U.S., I'd like to share our

experience

with taking medical services to migrant camps and migrant farm

workers in

our area. We are a community/migrant clinic based in north San

Diego County.

We recently expanded our mobile clinic program from 4 hours, 3

times per

week to 8 hours, 3 times per week.

Our CEO, Irma Cota is a member of the California Endowment task

force that

addresses the issues of health care needs of migrant farmworkers;

and as a

community and migrant clinic, we are aware of the medical needs

of migrant

farm workers (diabetes medication, high blood pressure, anemia,

flu, STDs,

etc.), but we are often met with resistance when we approach growers,

and

foremen about providing medical services onsite. Although growers

provide

little in terms of health care to their farm workers, they do not

always

welcome community assistance.

Another concern for us is the lack of transportation that workers

face. It

is often risky for them to drive to the nearest community clinic,

and few

growers are willing to take sick workers to health care providers

unless it

is a critical condition. We have 8 community clinics; all of them

are

located on a bus route; and 50% of our staff is bi-lingual, and

bi-cultural.

We are one of three community clinics in this area of the county,

and yet

together we are still unable to care for migrants who live within

a few

miles of a health center.

We do not stand alone in our attempts to take medical care to migrant

farm

workers who need it; other community-based and faith-based organizations

have seen the need and are working to improve migrant farm workers'

ability

to access a variety of resources and services. Yet we cannot force

our way

into migrant camps and farms/nurseries where these men and women

work. One

way, we can begin curtailing these health disparities, is to have

growers,

migrant farm workers and community clinics collaborate honestly,

and openly.

And this kind of collaboration is imperative.

Tamara F. Cummings

Marketing Operations Manager

North County Health Services

150 Valpreda Road

San Marcos, CA 92069

Tel.: (760) 736-8634

Fax: (760) 736-6753

Email: tcummin@...

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

From:

[mailto: ]

Sent: Monday, May 14, 2001 2:32 AM

Subject: [ ] Digest Number 210

To Post a message, send it to: Groups

To Unsubscribe, send a blank message to:

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------------------------------------------------------------------------

There are 2 messages in this issue.

Topics in this digest:

1. NYTimes.com Article: Fear and

Poverty Sicken Many Migrant Workers

in U.S.

From:

Don Villarejo <donfarm@...>

2. RE: NYTimes.com Article: Fear

and Poverty Sicken Many Migrant

Workers in U.S.

From:

" Lighthall" <dlighthall@...>

________________________________________________________________________

________________________________________________________________________

Message: 1

Date: Sun, 13 May 2001 20:09:51 -0700

From: Don Villarejo <donfarm@...>

Subject: NYTimes.com Article: Fear and Poverty Sicken Many Migrant

Workers

in U.S.

Hi Everyone - The following story ran in the Sunday, May 13, 2001,

issues

of the New York Times. It is based on the California Agricultural

Worker

Health Survey.

Don Villarejo

>Fear and Poverty Sicken Many Migrant Workers in U.S.

>

>

>By STEVEN GREENHOUSE

>

>

>

>CUTLER, Calif. - Francisco Plaza, a 35-year-old farm worker from

>Mexico, made a rare visit to a doctor last year after he suddenly

>lost a lot of weight. The doctor told him that he had diabetes

and

>ordered him to take two medications that cost $134 a month.

>

> But Mr. Plaza, who prunes fruit trees for $6.25 an hour, often

>skips his medicine, saying he cannot afford it after paying for

>food and rent.

>

> "Some months he doesn't get much work, so it's hard to afford,"

>his wife, lva, said at their modest home in this Central Valley

>farm town. "When he doesn't work, he doesn't buy his medicine."

>

> Mr. Plaza, who has lived in the United States for four years,

is

>in the same bind as many other Mexican farm workers who live more

>or less permanently in the United States. While federal clinics

for

>migrants are supposed to serve all indigent farm workers, illegal

>immigrants shun them because they do not qualify for state Medicaid

>coverage and fear discovery of their illegal status. (Almost half

>of the migrant farm workers are in the country illegally.) Farm

>workers often do not see doctors until their condition is so dire

>that they must go to emergency rooms, which are not permitted

to

>turn them away.

>

> "A situation we see every day is a terrible diabetic who can't

>afford the $200 a month for medicine, and that person ends up

with

>renal failure," Dr. Sablan, who runs a clinic for farm

>workers in Firebaugh, Calif., said. "Then they're able to get

a

>state health insurance card and dialysis. That's $1 million a

>year."

>

> Diabetes, high blood pressure and anemia occur at higher rates

>among California's 700,000 immigrant farm workers, mainly from

>Mexico, than among Americans, and the workers' health worsens

the

>longer they stay in the United States.

>

> A study to be released this month found that poor diet and

>infrequent visits to doctors make the health of longtime migrant

>farm workers considerably worse than that of those who have just

>arrived, even after accounting for differences in age.

>

> Preliminary findings by the California Policy Research Center

in

>Berkeley indicate that illegal immigrant farm workers, newly

>arrived from Mexico, have far lower cholesterol, lower blood

>pressure and less obesity than do farm workers who have lived

here

>legally for a while.

>

> "It's an appalling picture," said K. Ross, president of

the

>California Endowment, a foundation specializing in health issues.

>"These are people who help keep food prices low for American

>families, and I have a hard time figuring out why their health

>status should be so poor."

>

> Many things complicate the farm workers' health, including

>unfamiliarity with American medicine and a lack of exercise in

the

>long stretches they are unemployed. A poor diet is a key to their

>high rates of diabetes, high blood pressure and anemia, researchers

>say, and it gets worse as the migrants combine American fast food

>with the staples of tacos and refried beans. Other factors are

the

>lack of money and insurance.

>

> A study released last November found that the women, 36 percent

of

>the migrants, were far more likely than the men to visit doctors,

>largely because pregnant farm workers, even illegal immigrants,

>qualify for state health insurance. Indigent men here illegally

do

>not qualify except for medical emergencies. The median income

of

>the 971 farm workers in the November study, sponsored by the

>California Endowment, was less than $10,000 a year.

>

> Many growers acknowledge that their workers' health is

>substandard, but they blame an inferior health system in Mexico

and

>the failure of the workers to take care of themselves. Many growers

>say they cannot afford to provide insurance.

>

> But many growers agree with advocates for the workers that the

>federal system of community and migrant health clinics is

>inadequate.

>

> "The situation is harder because there aren't enough health

>professionals in many of these rural areas," Don Dressler,

>president of insurance services for the Western Growers

>Association, said.

>

> These concerns have made an impression on the Bush administration,

>which has proposed a 10 percent, or $124 million, increase next

>year for the nation's 3,400 community health clinics, including

its

>400 migrant health clinics. Advocates for the workers applaud

that,

>but are unhappy that Mr. Bush has proposed reducing money to train

>doctors in underserved rural areas.

>

> Farm owners say they want laws that will make it easier to provide

>discounted health insurance through grower associations for

>documented and undocumented workers alike.

>

> And like many farm workers, growers favor having more

>government-sponsored mobile health clinics visit farms. For many

>farm workers, simply getting to a clinic is an obstacle - the

>clinics are often far away, the workers generally do not own cars,

>and buses rarely run between farm communities.

>

> Don Villarejo, founder of the California Institute of Rural

>Studies, which conducted the November study, said the state,

>growers and workers should contribute to a health program. He

>proposes assessing a few cents per bushel of produce to help

>finance the program.

>

> "For another nickel a head of lettuce, we could raise wages by

40

>percent and provide health insurance," he said.

>

> Yovana Cisneros Espindola, 23, the wife of an undocumented farm

>worker from Mexico, was fortunate, because of her pregnancy, to

>have state health insurance last year when she suffered her first

>multiple sclerosis attack, which temporarily blinded her. Her

child

>was born last November, and she no longer has insurance and cannot

>afford the pills needed to slow the advance of the disease. They

>cost $10,000 a year.

>

> linda Avitia, a worker with Catholic Charities, wrote to

the

>Biogen pharmaceutical company, which agreed to give Ms. Cisneros

>the medication for three months and to consider renewing the gift.

>

> Ms. Cisneros's husband, Francisco, hardly ever sees a doctor.

>

>

>"It's too expensive," Mr. Cisneros said at their dark, crowded

>apartment in Visalia, Calif. "Even if I have a bad fever, I go

to

>work anyway. If I miss work to go to a doctor, how am I going

to

>pay for food for my family?"

>

>http://www.nytimes.com/2001/05/13/national/13LABO.html?ex=990807442ei=1 & en=

d9bea1d675a1fc52

>

Don Villarejo, PhD

P.O. Box 381

, CA 95617

(530)756-6545 voice & facsimile

________________________________________________________________________

________________________________________________________________________

Message: 2

Date: Sun, 13 May 2001 21:42:35 -0700

From: " Lighthall" <dlighthall@...>

Subject: RE: NYTimes.com Article: Fear and Poverty Sicken Many

Migrant

Workers in U.S.

HI Don:

The story was great although I was upset the way the CPRC credit

was

written--sounds like they did the research!

Was this the plan?

Regards,

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

From: Don Villarejo [mailto:donfarm@...]

Sent: Sunday, May 13, 2001 8:10 PM

Subject: [ ] NYTimes.com Article: Fear and

Poverty

Sicken Many Migrant Workers in U.S.

Hi Everyone - The following story ran in the Sunday, May 13, 2001,

issues

of the New York Times. It is based on the California Agricultural

Worker

Health Survey.

Don Villarejo

>Fear and Poverty Sicken Many Migrant Workers in U.S.

>

>

>By STEVEN GREENHOUSE

>

>

>

>CUTLER, Calif. - Francisco Plaza, a 35-year-old farm worker from

>Mexico, made a rare visit to a doctor last year after he suddenly

>lost a lot of weight. The doctor told him that he had diabetes

and

>ordered him to take two medications that cost $134 a month.

>

> But Mr. Plaza, who prunes fruit trees for $6.25 an hour, often

>skips his medicine, saying he cannot afford it after paying for

>food and rent.

>

> "Some months he doesn't get much work, so it's hard to afford,"

>his wife, lva, said at their modest home in this Central Valley

>farm town. "When he doesn't work, he doesn't buy his medicine."

>

> Mr. Plaza, who has lived in the United States for four years,

is

>in the same bind as many other Mexican farm workers who live more

>or less permanently in the United States. While federal clinics

for

>migrants are supposed to serve all indigent farm workers, illegal

>immigrants shun them because they do not qualify for state Medicaid

>coverage and fear discovery of their illegal status. (Almost half

>of the migrant farm workers are in the country illegally.) Farm

>workers often do not see doctors until their condition is so dire

>that they must go to emergency rooms, which are not permitted

to

>turn them away.

>

> "A situation we see every day is a terrible diabetic who can't

>afford the $200 a month for medicine, and that person ends up

with

>renal failure," Dr. Sablan, who runs a clinic for farm

>workers in Firebaugh, Calif., said. "Then they're able to get

a

>state health insurance card and dialysis. That's $1 million a

>year."

>

> Diabetes, high blood pressure and anemia occur at higher rates

>among California's 700,000 immigrant farm workers, mainly from

>Mexico, than among Americans, and the workers' health worsens

the

>longer they stay in the United States.

>

> A study to be released this month found that poor diet and

>infrequent visits to doctors make the health of longtime migrant

>farm workers considerably worse than that of those who have just

>arrived, even after accounting for differences in age.

>

> Preliminary findings by the California Policy Research Center

in

>Berkeley indicate that illegal immigrant farm workers, newly

>arrived from Mexico, have far lower cholesterol, lower blood

>pressure and less obesity than do farm workers who have lived

here

>legally for a while.

>

> "It's an appalling picture," said K. Ross, president of

the

>California Endowment, a foundation specializing in health issues.

>"These are people who help keep food prices low for American

>families, and I have a hard time figuring out why their health

>status should be so poor."

>

> Many things complicate the farm workers' health, including

>unfamiliarity with American medicine and a lack of exercise in

the

>long stretches they are unemployed. A poor diet is a key to their

>high rates of diabetes, high blood pressure and anemia, researchers

>say, and it gets worse as the migrants combine American fast food

>with the staples of tacos and refried beans. Other factors are

the

>lack of money and insurance.

>

> A study released last November found that the women, 36 percent

of

>the migrants, were far more likely than the men to visit doctors,

>largely because pregnant farm workers, even illegal immigrants,

>qualify for state health insurance. Indigent men here illegally

do

>not qualify except for medical emergencies. The median income

of

>the 971 farm workers in the November study, sponsored by the

>California Endowment, was less than $10,000 a year.

>

> Many growers acknowledge that their workers' health is

>substandard, but they blame an inferior health system in Mexico

and

>the failure of the workers to take care of themselves. Many growers

>say they cannot afford to provide insurance.

>

> But many growers agree with advocates for the workers that the

>federal system of community and migrant health clinics is

>inadequate.

>

> "The situation is harder because there aren't enough health

>professionals in many of these rural areas," Don Dressler,

>president of insurance services for the Western Growers

>Association, said.

>

> These concerns have made an impression on the Bush administration,

>which has proposed a 10 percent, or $124 million, increase next

>year for the nation's 3,400 community health clinics, including

its

>400 migrant health clinics. Advocates for the workers applaud

that,

>but are unhappy that Mr. Bush has proposed reducing money to train

>doctors in underserved rural areas.

>

> Farm owners say they want laws that will make it easier to provide

>discounted health insurance through grower associations for

>documented and undocumented workers alike.

>

> And like many farm workers, growers favor having more

>government-sponsored mobile health clinics visit farms. For many

>farm workers, simply getting to a clinic is an obstacle - the

>clinics are often far away, the workers generally do not own cars,

>and buses rarely run between farm communities.

>

> Don Villarejo, founder of the California Institute of Rural

>Studies, which conducted the November study, said the state,

>growers and workers should contribute to a health program. He

>proposes assessing a few cents per bushel of produce to help

>finance the program.

>

> "For another nickel a head of lettuce, we could raise wages by

40

>percent and provide health insurance," he said.

>

> Yovana Cisneros Espindola, 23, the wife of an undocumented farm

>worker from Mexico, was fortunate, because of her pregnancy, to

>have state health insurance last year when she suffered her first

>multiple sclerosis attack, which temporarily blinded her. Her

child

>was born last November, and she no longer has insurance and cannot

>afford the pills needed to slow the advance of the disease. They

>cost $10,000 a year.

>

> linda Avitia, a worker with Catholic Charities, wrote to

the

>Biogen pharmaceutical company, which agreed to give Ms. Cisneros

>the medication for three months and to consider renewing the gift.

>

> Ms. Cisneros's husband, Francisco, hardly ever sees a doctor.

>

>

>"It's too expensive," Mr. Cisneros said at their dark, crowded

>apartment in Visalia, Calif. "Even if I have a bad fever, I go

to

>work anyway. If I miss work to go to a doctor, how am I going

to

>pay for food for my family?"

>

>http://www.nytimes.com/2001/05/13/national/13LABO.html?ex=990807442ei=1 & en=

d9bea1d675a1fc52

>

Don Villarejo, PhD

P.O. Box 381

, CA 95617

(530)756-6545 voice & facsimile

To Post a message, send it to: Groups

To Unsubscribe, send a blank message to:

-unsubscribe