SPECIAL POPULATIONS TRAININGS (2 PARTS)

Transcription

1 SPECIAL POPULATIONS TRAININGS (2 PARTS) Title 42 of US Code, Chapter 6A, Section 254b Community Health (E) Migrant (G) Homeless (H) Public Housing (I) 1996 Health Centers Consolidation Act Public Health Service Act, Section 330 Administered by HRSA (BPHC), HHS

2 SPECIAL POPULATIONS TRAINING PART 1: FARMWORKERS ELIGIBILITY & VERIFICATION PROCESS

3 MIGRANT HEALTH CENTER Public Health Service Act, Section 330 (g) Migrant Health Act became law September 25, migrant health centers Federally assisted migrant health centers only reach 15-20% of MSFW Sea Mar sees farmworkers in ALL our clinic & program sites In 2014, Sea Mar s reach was only 6% of all farmworkers who are estimated to reside in these locations

4 Who are the farmworkers? Individuals who work temporarily, seasonally or migrate to work in agriculture, forestry or fisheries Includes all production, processing and support activities Agriculture includes ALL crop and animal production Agriculture, forestry or fisheries is primary source of income NCFH 2014

5 WHO ARE THE FARMWORKERS? CROPS Preparing, cultivating, growing and harvesting any commodity grown on or in soil Includes all production, processing and support activities

6 WHO ARE THE FARMWORKERS? CROPS Nurseries (family owned or operated) - potting, caring for plants Orchards; planting, picking, sorting, packing, or transporting fruits Fruits & vegetables, grains, nuts, plants, tobacco, hops Flowers, grass, alfalfa, hay or other agricultural products Forestry - planting & cultivating trees Includes Christmas Trees & other trees if harvested at least every 10 years Picking Pine needles or Spanish moss

7 WHO ARE THE FARMWORKERS? ANIMALS Taking care of any animal for consumption, breeding or fur (i.e., chickens, cows, goats, sheep, pigs, rabbits, horses, llamas, fish, shellfish) Includes aquaculture, dairy and poultry Includes all production, processing and support activities

8 WHO ARE THE FARMWORKERS? Animal production, processing and support for: Dairy farms and other animal farms Dairies -milking and other tasks Breeding or raising small animals for fur Horses breeding/boarding for breeding purposes not to rent space to others or for recreational purposes Poultry farms & hatcheries Hatching, raising, transporting, slaughter and processing Aquaculture Shellfish, salmon, shrimp, etc. Not recreational fishing or fishing in the wild (i.e., Alaska fishing boats) Processing or canning (if part of farm operations OR adjacent to farms)

9 WHO ARE THE FARMWORKERS? Includes all tasks such as: Preparing the soil Seeding, planting, thinning, irrigating, fertilizing, replacing trees Detasseling, collecting, harvesting (by machine or hand) Sorting, catching, preparing, processing Canning, preserving, packing Transporting, storing, distributing (if same farm only) Even transporting to market (if same farm) Feeding, caring, milking cows and other animals Breeding, branding, inseminating, etc. Includes farm labor contractors

10 DOES NOT INCLUDE THE FOLLOWING Landscaping Slaughterhouses or meat processing plants (unless they also grow or breed their own animals) Trucking/Timber industry Fishermen/women, hunters and processing plants NOT adjacent to farms

11 HOW FARMWORKERS IDENTIFY THEMSELVES By the name of the crop or animal By the place of agriculture En la mora In the berry Trabajo con los berries I work with berries En el frijol In the beans En la cebolla In the onions En el coliflor In cauliflower En el pepino In cucumber By agricultural activity En el campo In the field En una nurseria In the nursery Con un contratista With the contractor Con un ranchero With the farmer Cuido un rancho I take care of a farm En la lechería In a dairy By the geographic location Estoy desyerbando I weed Me voy pa California I go to California Estoy postando o clavando Tirando manguera Soy Pizcador En el empaque Poniendo ganchos Estoy señalizando Soy podador I put in posts Laying the hose I am a picker In packing Fastening plants I put up signs I prune Voy a los trabajos Me voy pa los trabajos Me voy con el contratista Sigo las corridas de Me voy pal sur Me voy a la lechuga Me voy al pepino I follow the work I follow the crops I go with the contractor I follow the crops I go to the south I go to the lettuce I go to the cucumber

12 WHO ARE THE FARMWORKERS? Anyone who currently works or has worked in agriculture, forestry or fisheries within the last 24 months Two types we document: Migrants establish a temporary home in order to work in agriculture Seasonal do NOT establish a temporary home to work in agriculture

13 WHO ARE THE FARMWORKERS? Migrants establish a temporary home in order to work in agriculture (i.e., they move away or to the area temporarily)

14 WHO ARE THE FARMWORKERS? Seasonal do NOT establish a temporary home to work in agriculture (i.e., they do not move to follow the work but may change crops or farms throughout the year) Seasonal farmworkers may do any of the following: Work temporarily in agriculture, forestry or fisheries Switch farm employers throughout the year Work year-round for same employer but their hours or schedule fluctuates based on the season

15 FAMILY MEMBERS ALSO COUNT All family members of agricultural, forestry and fishery workers are also categorized as farmworkers Family members refer to ALL members of the household regardless if they are economically independent or not. Does NOT have to be a dependent Farmworker status of family member is NOT connected to income eligibility or sliding scale Example - ANY adult family member living under same roof as farmworker family member is also classified as farmworker (includes siblings, grandparents, parents, etc).

16 AGED AND DISABLED FARMWORKERS Definition A former migrant worker who agedout or became disabled while a farmworker KEY MUST have been former MIGRANT at time of aging out or disability Family member eligibility If family members live with aged/disabled farmworker, they will classify as farmworkers too if one of the following apply: If aged/disabled farmworker is head of household If they were also living with aged/disabled farmworker at time when he/she aged out or became disabled

17 QUESTIONS NOT TO ASK Are you a Migrant? Are you a Seasonal worker? Please check either-migrant or Seasonal

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19 Flow Chart Steps to determine if your patient qualifies as Migrant or Seasonal Farmworker NO YES (1) In the past 2 years, have you or a member of your family worked in agriculture, farming, forestry or fisheries as your main source of employment? YES (1a) Have you or a member of your family stopped migrating to work in agriculture, forestry or fisheries because of disability or old age? NO You and your family members are NOT agricultural workers

20 Flow Chart Steps to determine if your patient qualifies as Migrant or Seasonal Farmworker YES (2) In the past two years, have you or a member of your family established a temporary home in order to work in agriculture, forestry or fisheries? i.e., live in trailers or houses provided by employer, hotel, or share house with others? (1a) Have you or a member of your family stopped migrating to work in agriculture, forestry or in fisheries because of disability or old age? NO YES NO You and your family members are Migrant agricultural workers

21 Flow Chart Steps to determine if your patient qualifies as Migrant or Seasonal Farmworker NO NO You and your family members are NOT agricultural workers (3) In the past two years, have you or a member of your family worked on a seasonal basis without the need to establish a temporary home? i.e., work for same farm year round but hours or income change weekly, or laid off part of the year and have to do other types of work? YES You and your family members are Seasonal agricultural workers

22 PM FARMWORKER STATUS Ask patients the correct questions that will allow you to identify their FARM WORKER STATUS Remember Aged & Disabled classified as Migrant (until new PM category)

23 LANGUAGE IMPORTANT What language do you feel the most comfortable communicating in? If farmworker or other patient is speaking Spanish, do NOT assume that Spanish is their preferred language. Many of our indigenous have limited Spanish speaking or comprehension ability.

24 You MUST note the preferred language in PM under Additional Info tab

25 CASE STUDY #1 Scenario Today, Ms. Johns is at your health center because her three children need their school physicals. Ms. Johns is not working and Mr. Johns is temporarily working in construction. The three Children have Medicaid. Actuality The Johns family travels from California to Washington State to harvest berries from April--August. At the end of August, the family travels to Oregon to work harvesting grapes. And in November they return to California. For the past 2 years has any member of this family: Worked in Agriculture? Moved to other areas to work in agriculture? Used seasonal agriculture as the main source of income? No longer able to work because of their age or disability. How should this family be classified? a. Migrant b. Seasonal c. Aged or disabled

26 CASE STUDY #1 Scenario Today, Ms. Johns is at your health center because her three children need their school physicals. Ms. Johns is not working and Mr. Johns is temporarily working in construction. The three Children have Medicaid. Actuality The Johns family travels from California to Washington State to harvest berries from April--August. At the end of August, the family travels to Oregon to work harvesting grapes. And in November they return to California. For the past 2 years has any member of this family: Worked in Agriculture? Moved to other areas to work in agriculture? Used seasonal agriculture as the main source of income? No longer able to work because of their age or disability. How should this family be classified? a. Migrant b. Seasonal c. Aged or disabled

27 CASE STUDY #2 Scenario Mr. and Ms. Garcia are at your health center because their youngest son has an ear infection. Mr. Garcia is very sick and unable to work and his wife is a homemaker. Their older son Manuel supports the family. Actuality Manuel at age 16, is the oldest son of the Garcia family. For the last 7 months, he has worked in Arizona in cucumber, lettuce and broccoli. He is planning to come home to Washington in two months and seek work in a local farm. Manuel s economic contribution supports the family. For the past 2 years has any member of this family: Worked in Agriculture? Moved to other areas to work in agriculture? Used seasonal agriculture as the main source of income? No longer able to work because of their age or disability. How should this family be classified? a. Migrant b. Seasonal c. Aged or disabled

28 CASE STUDY #2 Scenario Mr. and Ms. Garcia are at your health center because their youngest son has an ear infection. Mr. Garcia is very sick and unable to work and his wife is a homemaker. Their older son Manuel supports the family. Actuality Manuel at age 16, is the oldest son of the Garcia family. For the last 7 months, he has worked in Arizona in cucumber, lettuce and broccoli. He is planning to come home to Washington in two months and seek work in a local farm. Manuel s economic contribution supports the family. For the past 2 years has any member of this family: Worked in Agriculture? Moved to other areas to work in agriculture? Used seasonal agriculture as the main source of income? No longer able to work because of their age or disability. How should this family be classified? a. Migrant b. Seasonal c. Aged or disabled

29 CASE STUDY #3 Scenario Ms. Rodriguez is at your health center to see a doctor because her diabetes is out of control. The Rodriguez family has lived in the area since Actuality Mr. Rodriguez works driving a raspberry harvester machine, and once that job finishes he works sorting garlic. During the off season, he works as a day laborer and his job varies between agriculture and construction. In addition of taking care of the family, Ms. Rodriguez sometimes babysits some children and works cleaning houses. For the past 2 years has any member of this family: Worked in Agriculture? Moved to other areas to work in agriculture? Used seasonal agriculture as the main source of income? No longer able to work because of their age or disability. How should this family be classified? a. Migrant b. Seasonal c. Aged or disabled

30 CASE STUDY #3 Scenario Ms. Rodriguez is at your health center to see a doctor because her diabetes is out of control. The Rodriguez family has lived in the area since Actuality Mr. Rodriguez works driving a raspberry harvester machine, and once that job finishes he works sorting garlic. During the off season, he works as a day laborer and his job varies between agriculture and construction. In addition of taking care of the family, Ms. Rodriguez sometimes babysits some children and works cleaning houses. For the past 2 years has any member of this family: Worked in Agriculture? Moved to other areas to work in agriculture? Used seasonal agriculture as the main source of income? No longer able to work because of their age or disability. How should this family be classified? a. Migrant b. Seasonal c. Aged or disabled

31 CASE STUDY #4 Scenario Mrs. Lara is a 66 year old and she is at your health center today because she needs medical care. She has Medicare. She works part time at a gas station and her husband who is 69 is no longer able to work. Actuality Mrs. Lara and her husband settled in your area November, 2010 when they moved from Oregon. In Oregon, Mr. Lara worked part of the time pruning pear trees and doing several chores at a small oyster farm. Mrs. Lara used to work at a cucumber processing plant. For the past 2 years has any member of this family: Worked in Agriculture? Moved to other areas to work in agriculture? Used seasonal agriculture as the main source of income? No longer able to work because of their age or disability. How should this family be classified? a. Migrant b. Seasonal c. Aged or disabled

32 CASE STUDY #4 Scenario Mrs. Lara is a 66 year old and she is at your health center today because she needs medical care. She has Medicare. She works part time at a gas station and her husband who is 69 is no longer able to work. Actuality Mrs. Lara and her husband settled in your area November, 2010 when they moved from Oregon. In Oregon, Mr. Lara worked part of the time pruning pear trees and doing several chores at a small oyster farm. Mrs. Lara used to work at a cucumber processing plant. For the past 2 years has any member of this family: Worked in Agriculture? Moved to other areas to work in agriculture? Used seasonal agriculture as the main source of income? No longer able to work because of their age or disability. How should this family be classified? a. Migrant b. Seasonal c. Aged or disabled Need more information

33 CASE STUDY #5 Scenario Ms. Williams is at your health center because this week, her son is having frequent asthma attacks. Her son has CHPW. Actuality Ms. Williams works at a berry farm for 7 months out of the year. During those months she is in charge of the irrigation, pesticide application, pruning and harvesting. Although she wants to work more hours, she is laid-off every year at the end of the harvest season. She usually goes to visit her extended family during the time that she is not working For the past 2 years has any member of this family: Worked in Agriculture? Moved to other areas to work in agriculture? Used seasonal agriculture as the main source of income? No longer able to work because of their age or disability. How should this family be classified? a. Migrant b. Seasonal c. Aged or disabled

34 CASE STUDY #5 Scenario Ms. Williams is at your health center because this week, her son is having frequent asthma attacks. Her son has CHPW. Actuality Ms. Williams works at a berry farm for 7 months out of the year. During those months she is in charge of the irrigation, pesticide application, pruning and harvesting. Although she wants to work more hours, she is laid-off every year at the end of the harvest season. She usually goes to visit her extended family during the time that she is not working For the past 2 years has any member of this family: Worked in Agriculture? Moved to other areas to work in agriculture? Used seasonal agriculture as the main source of income? No longer able to work because of their age or disability. How should this family be classified? a. Migrant b. Seasonal c. Aged or disabled

35 FARMWORKER ELIGIBILITY QUESTIONS Within the past 2 years have you or any family member: Worked in Agriculture, Forestry or Fisheries as your main source of work? If NO: Stopped migrating because of age or disability? Moved to other areas to work in Agriculture, Forestry or Fisheries & established a temporary home? Worked in Agriculture, Forestry or Fisheries on a seasonal basis & did not establish a temporary home? Or if work for same employer, had fluctuating hours or income due to the season? Or were laid off part of year and had to do other types of work?

36 CONTACT US IF YOU HAVE ANY QUESTIONS: Colleen Pacheco, Special Populations Program Manager Marcela Suarez, Promotores Coordinator

37 NEXT STEPS NOW TAKE THE SPECIAL POPULATIONS PART 1 TEST