Lighthall D. Best practices for migrant workers: community health care by private clinics for migrant farmworkers: the case of the Sablan Medical Clinic.Davis, CA: California Institute for Rural Studies; 2000.
This report underscores the lack of access to affordable health care among migrant workers, who are particularly vulnerable to hazardous conditions in their work. Among the health problems migrant workers face are 1) very low wages, resulting in an inability to pay for their own health care; 2) lack of employer-provided health care; 3) lack of transportation, compounded by geographic isolation, to public clinics and hospitals; 4) undocumented immigration status, compounded by lack of formal education and English-language skills; 5) an inability to claim workers' compensation for maladies related to pesticide exposure or incremental musculoskeletal damage; 6) very high incidence rates of diabetes, reflecting genetic predisposition and worsened by poor preventative education, early diagnosis, and maintenance care; and 7) bureaucratic inflexibility that make it difficult to gain year-round eligibility to programs such as Medi-Cal or to access care in a new location.
One example of a private rural clinic that addresses many of the barriers to migrant health care is the Sablan Medical Clinic in Fresno County, California. The two doctors who run it have overcome the bureaucratic red tape involved in securing Medi-Cal reimbursement; offer access to a range of public and private supplemental programs for migrant health care (Healthy Families, breast cancer early detection, free medications from pharmaceutical donations, Child Health Disability Program, etc.); have hired and trained bilingual staff from the local population, invested in learning Spanish language skills for themselves; and have extended hours and open access to walk-ins to maximize accessibility and minimize use of emergency rooms among the farmworker population. The major lesson to be drawn from this best practice clinic is that private clinics inaccessible to federal reimbursement can overcome this and other constraints to serve such low-income and culturally isolated populations. The authors point to the overwhelming need for reform to better support the infrastructure of health care access in migrant farmworker communities.
 |
 |
 |