Preparedness Needs of Migrant & Seasonal Farm Workers Michael Meit, MA, MPH Co-Director Craig Holden, MPH, MBA Research Analyst
Thinking About the Problem There are around 3.5 million migrant workers currently living in the United States. The majority lack authorization to work legally in the U.S. (53%). Emergency planning for migrant and seasonal workers is tricky given varying work authorization/immigration status. Migrant and seasonal workers often have families living with them in the United States who also require emergency response services.
Migrant Workers and Health Numerous factors coalesce to restrict migrant and seasonal farm workers' access to health care: cultural and linguistic barriers, limited economic resources, lack of political clout, and distrust of outsiders. In 2000, 85% of migrant and seasonal farm workers were uninsured, and 90% of their children were uninsured. A Kaiser study estimated that the median income for migrant and seasonal farm workers in 2000 was $6,250. Workers without dependent children are not eligible for Medicaid.
Emergency Preparedness Issues Language and citizenship are two critical characteristics that can complicate migrant and seasonal farm workers' access to traditional services. Noncitizen workers (especially those living here illegally) may feel threatened by govt.-run response efforts. Effective communication is vital to efficient emergency response. The Cambridge Advanced Practice Center, in collaboration with local and state public health professionals, developed pictorial signs that can be used in an emergency to communicate information to non-english speakers.
Emergency Preparedness Issues What is the propensity of migrant and seasonal workers to follow public health orders? Could feelings of distrust lead to non-adherence? How should you plan for your community to address needs of this population? Does your community have less available housing for evacuees than your data may indicate? Is your infrastructure more strained? What transportation resources or needs may migrant and seasonal workers have. What other unique needs will this group have in an emergency scenario?
Project Development This guide focuses on the concerns specific to migrant and seasonal farm workers Includes findings from an expert panel and appendices with tools developed by communities working with migrant and seasonal farm workers The guide was conceptualized as an offshoot of a preparedness guide developed last year for rural communities
Methodology Convened panel of 14 experts familiar with the migrant and seasonal farm worker community and preparedness concerns Experts represented the following areas: Emergency preparedness Public health Social services Legal services Advocacy groups Migrant centers Local farmers Dept. of Labor
Methodology Cont. Panelists participated in a 5-hour moderated discussion. The discussion was divided into three planning stages: Pre-event Event Post-event
Panel findings synthesized into set of guidelines Intended audience: Rural preparedness planners (local health depts., emergency managers, etc.) Social Service agencies Policy makers Final Product
Insert snapshot of migrant guide on this page 10
General recommendations General issues planners must keep in mind when formulating response plans
Today s Discussion Review the Migrant and Seasonal Farm Workers Emergency Preparedness Planning Guide Discuss recommendations/guidelines and complications that could arise in specific scenarios. Discuss implications for planning to address the unique needs of migrant and seasonal farm workers.
Pre-Event
Response Partners Volunteers Communications Pre- Event Regional Coordination Training/ Exercising Needs Vulnerability Assessment
Response Partners Local public health and emergency preparedness Churches Daycares Head Start Program Law enforcement Farm Bureau Non-profits Immigration and Customs Enforcement (ICE) Social services Local farmers Legal agencies Farm workers education ESL Organizations Are these the right groups for your community? Are there other entities that you would include? Do you know your local farmers, and can you engage them in planning efforts?
Response Partners Cont. Encourage local Sheriff s Office and other law enforcements to take on a more invisible role when interacting with seasonal and migrant farm workers in times of crisis Incorporate regional farmers into the local business continuity plan Establish an agreement or memorandum for local farmers to contribute shelter space Need for language appropriate resources What is your relationship with local law enforcement? Has public health participated in development of business continuity planning?
Volunteers Consider recruitment from the following entities: Hospitals Farms Firefighters Meals on Wheels Farm Bureaus EMS and Ambulance Corps Medical Reserve Corps Migrant health clinics Service clubs (Lion s Club, Kiwanis, Rotary Club, etc.) Are these the right recruitment venues for your community? What suggestions do you have for engaging them?
Skill sets needed: Cultural competency Bilingualism Medical skills Volunteers Experience working with migrant and seasonal farm worker community Do you have existing lists of volunteers in your community? Do you know their skill sets?
Regional Coordination Mutual Aid issues figure out ahead of time consider union rules, liability protection, standard practices, political differences, etc. Consider agreements needed to establish official partnerships with legal enforcement and immigration authorities to prevent causing anxiety among migrant and seasonal farm worker community What additional recommendations would you include?
Regional Coordination Multi-farm Mutual Aid agreement to set stipulations on supplies, food, transportation and housing Consider a voucher program to aid in finding housing and transportation Could you do this in your community?
Vulnerability Assessment Assess community s vulnerability to various emergency scenarios; consider added pressure of undocumented residents Compose preliminary profile of health status of migrant and seasonal farm workers in the region Assess transportation and housing situation Consider needs of churches that may care for this community during an emergency Determine how best to communicate emergency notifications to the migrant and seasonal farm worker population Have you conducted any of these activities? What did you find? What other aspects of a community or region would you take into account during a vulnerability assessment?
Training and Exercising Needs Test ability to determine the number of migrant and seasonal farm workers in your community in a 24-hour period Consider training farmers in public health preparedness Make an attempt to involve migrant and seasonal farm workers in the trainings, despite the potential difficulty of this endeavor Do you have access to farmers and/or migrant workers to engage them in this way?
Communications Ensure that you have a contact person that the migrant and seasonal farm worker community trusts that can serve as a go-between Consider various communications channels available in your community (radio, TV, cell phones, etc.) Be sure to incorporate culturally sensitive messages Have you had experience communicating public health messages to migrant and seasonal workers in your community?
Event
Shelter Needs Incident Command System (ICS) State/Fed Assistance Legal Considerations Event Communications Direct Health and Social Service Needs Indirect Health and Social Service Needs Addressing Resident Concerns
Incident Command System (ICS) Develop a process to identify Incident Command Leaders who can address scenarios involving migrant and seasonal farm workers Alternatively, select an Emergency Management Director and task them with creating a communications plan to reach this population Do you know who would provide leadership for emergencies involving and/or affecting migrant and seasonal workers?
Communications Two-way communication needed to connect migrant and seasonal farm workers and officials Have risk communication information in multiple languages on file Consider roles community partners could play in getting out the message they may have better relationships with this community Does your communications plan include outreach to migrant and seasonal workers? If so, what special considerations are included to reach migrant and seasonal workers?
Direct Health and Social Service Needs Develop plan to deploy needed supplies for migrant and seasonal farm workers Create strategic plan to coordinate activities of public health, LHDs, childcare agencies and EDs in the event of a disease outbreak among migrant and seasonal farm workers Strategically locate supplies where migrant and seasonal workers can obtain them easily
Direct Health and Social Service Needs Cont. Document resources available in local pharmaceutical and food warehouses Set up a triage site to address health concerns Ensure that staff and volunteers have some mental health or incident stress management training Are you prepared to deliver these types of services to migrant and seasonal workers?
Indirect Health and Social Service Needs Prepare a plan for providing social services, taking into account cultural and language differences Have sufficient supplies to meet the needs of the chronically ill What other indirect health and social service needs would you anticipate?
Addressing Shelter Needs Migrant and seasonal farm workers may be hesitant to use public shelters Trusted individuals should educate this community on the safety of public shelters from ICE; effective risk communications are crucial Prevent families from being separated Are your shelters prepared to anticipate migrant and seasonal workers?
Resident Needs Create plan for resource allocation to prevent competition between permanent residents and migrant and seasonal farm workers for resources Identify and address potential safety concerns among migrant and seasonal farm workers and the area residents How will your residents react to resources being allocated to migrant and seasonal workers? Are there mitigation strategies if problems are anticipated?
State and Federal Assistance Know procedure for making a request ahead of time so that you re sure to have the proper documentation Prepare contingency plans in the event that assistance is delayed or unavailable Be aware that it will be more difficult to obtain assistance to help undocumented workers How long could your community remain selfsufficient to address the needs of residents and migrant and seasonal workers?
Legal Considerations Confirm a legal process to authorize an official to commandeer and distribute resources Establish a plan to work with ICE officials to keep migrant and seasonal farm workers safe and unafraid of repercussions Be sure public health officers know what power they have to ration, isolate and quarantine Establish a plan to communicate with non-english speakers using pictograms or other non-verbal communication Are you familiar with the legal requirements in your communities that may affect the delivery of services to both residents and migrant and seasonal workers?
Post-Event
Recoup losses Post- Event Working with Federal and State Gov t Post-event assessment
Post-Event Assessment Assess impact on migrant and seasonal farm worker community Create an after-action report assign recommended improvements to specific people and entities and follow up to confirm implementation! Communicate back to the community at large about what went well and what will change if there is a next time Do you regularly conduct post-event assessments and create after action reports?
Recoup Losses Assist those who suffered hardship migrant and seasonal farm workers will need items such as clothing and transportation to move to their job (consider gas tokens) Explore the role of employer in recovering lost items/supplies via federal reimbursement or insurance Remember that communities with large undocumented populations will need more resources than official estimates suggest Are there mechanisms for you to provide support and resources to migrant and seasonal workers?
Working with Fed and State Gov t Be aware of political realities! Craft messages articulating importance of migrant and seasonal farm worker population to region s economy Develop trusted relationship with ICE Explore other sources of funding to assist migrant and seasonal farm workers (specific examples listed in Guide) Have you had experience with ICE? Was it positive or negative?
Questions? Comments?
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Questions Please contact: Michael Meit, MA, MPH Co-Director Walsh Center for Rural Health Analysis NORC at the University of Chicago 4350 East West Hwy, Suite 800 Bethesda, MD 20814 PH: 301-634-9324 Fax: 301-634-9301 Email: meit-michael@norc.org 44