Applicants seeking Funding
Applicants are expected to increase access to primary and preventive health care for farmworkers. This can be achieved by providing medical, dental,
and/or enabling services where access to care is limited.
NCFHP offers training and technical assistanc for new and veteran outreach staff to improve the capacity of provider in serving farmworkers.
Provide quality, accessible services
Applicants should strive to provide quality, accessible services. NCFHP healthcare sites are expected to include in their application for funding,
a plan that outlines how the grantee will work to fill gaps in health care that farmworkers face in their area. One hundred percent of NCFHP funds
are to be used providing services to agricultural farmworkers and their dependents.
There is a wide range of strategies to improve the quality of services provided to migrant and seasonal farmworkers, including provider education
about specific illnesses and injuries that are common among farmworkers, participation in peer review, and having continuous quality improvement
(CQI) measures that address the unique needs of farmworker patients.
Primary care should be provided in the evening or weekend. Care should be provided on a sliding fee scale (or minimal charge).
Provide comprehensive care
Applicants should offer comprehensive health care for migrant and seasonal farmworker patients including the delivery of preventive, acute, and chronic care.
Preventive care includes immunizations, family planning, nutrition, well-child, dental screenings, physical exams, Pap smears, and prenatal care.
Acute care includes treatment of infectious diseases, abdominal pain, sexually transmitted infections, minor injuries, and occupational illnesses such as
green tobacco sickness, contact dermatitis, and musculoskeletal strain. Chronic care includes outpatient and follow-up care for the treatment of chronic diseases like hypertension, diabetes, and depression.
As part of the effort to provide comprehensive health care, applicants are expected to include required goals and objectives from NCFHP's Health Care Plan in their application for funding.
NCFHP is required by our principal funder, the Bureau of Primary Health Care, HRSA, to have a health care plan. NCFHP's Health Care Plan includes
special initiatives to target or improve primary and preventive services relevant to farmworker health concerns in North Carolina.
Provide continuous care
Applicants should provide continuous care for farmworkers to ensure that they will not be lost to follow-up after referral for specialty care or hospitalization.
Continuity can be achieved using a case management approach, including assessment, care plan, referral and follow-up of clinical needs and social concerns.
The responsibility for continuous care remains with the grantee as long as the farmworker patient resides in the service area of the grantee.
A mechanism should be in place for tracking the care of the patient and for transferring records to another site or securing another provider when possible
as patients prepare to migrate. Nationwide referral directories are available to assist in this process.
Farmworkers must be included in after-hour coverage. Depending on the site, after-hour coverage can be addressed in a variety of ways.
At minimum, farmworker patients must be informed of steps to take if they have health needs after hours.
Hospital-based care may or may not be provided directly, but firm arrangements for those patients requiring hospitalization should be made.
Continuous care includes involvement in discharge planning and follow-up care.
Provide Culturally and Linguistically Appropriate Services
Depending on the demographic make-up of your farmworker population, contract sites are encouraged to either employ staff that represent the linguistic, cultural,
racial, and ethnic background of the farmworker population in their area or demonstrate efforts toward acquiring knowledge and skills needed
to provide culturally and linguistically appropriate services to the population.
Expectations of Sites Providing Dental Services:
- Provide dental services to migrant farmworkers and their dependents, through evening clinics, special appointment slots or through the acceptance of walk-ins.
- Provide dental services limited to preventive, basic restorative, and simple surgical procedures; particularly when services are supported through NCFHP funds.
- Screen patients for eligibility by completing the Migrant Eligibility Form.
- Have an average of at least 2 encounters per hour for agencies using the funds to hold evening or weekend dental clinics targeting migrant farmworkers.
- Request a $5.00 per visit co-payment from patients.
- Accept the contracted funds and patient co-payment as total payment for services.
(Agencies cannot bill the patient for additional costs associated
with treatment. However, agencies can charge for services requested by the patient that are beyond the scope of services covered in this contract, e.g., crowns, dentures.)
- Provide interpreter services for patients not fluent in English.
- Arrange referrals for dental needs beyond your scope of practice.
- Submit the Migrant Farmworker Dental Log to the North Carolina Farmworker Health Program on a monthly basis.
