The North Carolina Farmworker Health Program (NCFHP) is a statewide Migrant Health Voucher Program within the Office of Rural Health. As opposed to a free-standing health center, NCFHP works with local agencies to provide care throughout the state to meet the needs of geographical areas with localized densities of farmworkers. NCFHP responds to gaps in health care that would otherwise prevent farmworkers from accessing needed care.
Our particular model relies heavily on enabling services, including outreach, case management and health education, as we have learned that strong outreach and case management services are an essential component of linking farmworkers with appropriate services.
NCFHP strives to achieve its mission through the following core activities/strategies:
- Funding local agencies and reimbursing private providers to increase access to health care and dental services for farmworkers and their families
- Building capacity, through training and technical assistance, to increase the provision of quality, culturally and linguistically appropriate services for farmworker families
- Building relationships and collaborations to connect and leverage resources in the community
We envision a comprehensive network of health care professionals that provides culturally appropriate and accessible health services, empowering farmworkers and their families to live healthy lives as valued members of informed and inclusive communities.
Why focus on farmworkers?
Farm work is consistently ranked among the most dangerous occupations in the United States, and farmworkers experience occupational health risks such as pesticide exposure, heat-related illness, green tobacco sickness, musculoskeletal injury, and skin and eye conditions.
Farmworkers also suffer from chronic illnesses such as diabetes and hypertension, as do other low-income populations.
Geographic and social isolation, traumatic migration experiences, discrimination, and culture shock put farmworkers at risk for mental health problems. In our 2015 patient population, 89% of farmworkers and family members were uninsured.
Farmworkers face barriers to care, including limited availability of healthcare services in rural areas, cost, transportation, clinic hours, and limited language capacity. Few farmworkers are eligible for public assistance programs and the majority lack health insurance.
How our contract sites serve farmworkers
Our outreach workers find farmworkers at migrant camps and in communities and assess farmworker health issues. Outreach workers refer farmworkers to primary and specialty providers, and support farmworkers in getting the care they need by offering enabling services such as interpretation, transportation, and case management. At some sites, mobile medical teams provide medical services in the field.
Outreach teams also provide health education about preventive care, health care resources, and broader community resources, link farmworkers with resources in the community, and respond to farmworker concerns by adapting programming to meet expressed needs.
The North Carolina Farmworker Health Program is a vital component to the state of North Carolina’s safety net. Without the support that the North Carolina Farmworker Health Program provides, our state’s most vulnerable and underserved population would never gain access to healthcare services.”
–Nathan Dollar, Former Outreach Coordinator, Vecinos Inc, and current Board Member
How our office supports our contract sites
The North Carolina Farmworker Health Program (NCFHP) provides funding for outreach workers at contract sites to coordinate and carry out enabling services. At some sites, we also fund medical services. The central office provides training for our partners, disseminating best practices for outreach, patient care, advocacy, and community building.
Monitoring and evaluation of site processes and outcomes is managed by the central office, which guides program strategy development as well as continuous quality improvement processes for medical and enabling indicators.
The central office also provides technical assistance on topics such as data management, health education resources, compliance with patient confidentiality protocols (HIPAA), regional partnerships, and quality of care. Our team also collaborates with local universities and community organizations to facilitate training, placement, and support of volunteers and interns.
Our 2015 patient population
We serve migrant farmworkers who have traveled within the last two years to find agricultural work (both within the U.S. and from outside the U.S.).
We also serve seasonal farmworkers, who maintain a permanent residence and work in agriculture on a seasonal basis.
Farmworker families, including spouses and children of farmworkers, are served by the program.
2015 cost of care
Our program strives for cost efficient care by working with the strong rural health care network in North Carolina. Our sites are housed in county health departments, hospitals, community health centers, and non-profit agencies, allowing us to leverage existing resources such as facilities and support staff. In this way we are able to target funding to our core activities: assessing migrant and seasonal farmworkers and linking them with health care services.
The 340B drug pricing program is a federal program that allows designated healthcare entities to purchase drugs at a discounted rate. NCFHP has been a 340B entity since 2008. In 2015, through partnerships with local pharmacies and health contract sites across the state, NCFHP spent approximately $41,155 for medications that would normally cost an estimated $507,585, saving $466,430 in prescription reimbursement expense, while maintaining an affordable co-pay of $4 per prescription for farmworkers.