Migrant Health Service, Inc. 810 4 th Ave S, Suite 101 Moorhead, MN 56560 218-236-6502 or 800-842-8693 Fax: 218-236-6507 www.migranthealthservice.org
History and General Info Founded in 1973 Private non profit organization, directed by a board of directors, some of which are/were patients currently using services at our centers Migrant Health Service, Inc. (MHSI) has 10 clinics/sites located in Minnesota and North Dakota Nurse-managed voucher program
History and General Info cont. Funding sources: Health Services Resources Administration (75-80%) MN Dept. of Public Safety, MN Dept. Human Services, ND Dept. of Public Instruction, Various foundations Third party payers (Medicaid and insurance-less than 5% overall) Patient fees (less than 2% overall)
The Basics on Migrant Health Everyone qualifies for our office visits, as well as free referrals to resources like social services, food pantries, legal services, and victim advocacy services Most MHSI office visits cost less than the average office visit at a mainstream clinic in this area Community Health Specialists can help people enroll in public assistance and/or charity care programs to help them reduce their health care costs at another hospital/clinic
Demographic Insight Among MHSI patients: 86% are below 100% FPL 87% are uninsured 70% identify as migrant farmworkers 13% are hypertensive 10% are diabetic In 2011, MHSI served more than 6900 patients Source: 2011 UDS Report
Farmworker Status Includes Families/dependents of migratory or seasonal farmworkers People who have not traveled for work but who have been farmworkers in the past 24 months People who meet the definition regardless of visa or immigration status
Specifics on Our Sites 5 year-round clinics or sites Grafton, ND; Crookston, MN (victim advocacy services only), and Moorhead, Rochester, and Willmar, MN 2 mobile units and 3 seasonal clinics, open from 2-5 months each summer North and South Mobile Units travel the Red River and Minnesota River valleys, respectively Seasonal clinics in Glencoe*, Olivia*, and Owatonna* area (MN)
North Dakota Health Center
Minnesota Health Centers
MHSI Programs Primary Care Prenatal Chronic Disease Case Management and Voucher Referrals Victim Advocacy Services Battered Women s Program and Sexual Assault Intervention Project
Prenatal Program Program Goals Provide personalized nursing care, education, and case management focused on the individual needs of each woman Case management and support services may include referrals for dental care, WIC, or other services in the local community Provide culturally sensitive prenatal education and referrals to area medical providers for continued prenatal care
Chronic Disease Program Purpose Statement To continue to redesign our health centers for providing care to clients with chronic disease MHSI will accomplish this by making changes in the following areas: Community Relationships Client Self-Management Delivery Systems Decision Support Clinical Information Systems
Patients at a diabetes support group meeting in Texas.
Chronic Disease Program Diabetes program piloted in six MHSI sites Initiated a registry system based on the Health Disparities Collaborative (HDC) key measures and the American Diabetes Association (ADA) Clinical Practice Recommendations Program was revised and expanded to all sites Became member of the National HDC Diabetes Collaborative Diabetes Lay Educators (DLE s) established Expanded to Cardiovascular Disease Collaborative Changed name to Chronic Disease Program
A diabetes educator providing instructions to patients on how to use a glucometer to measure blood sugar at a cluster clinic.
Challenges Health Coverage- 90% of farm worker population are uninsured; most don t qualify for state insurance programs No paid time off for appointments Language barriers-most only speak and/or read spanish, over 50% requested assistance with translation
Bathroom facilities at Migrant Grass Camps in southern Minnesota. Baños en los campos para migrantes en el sur de Minnesota.
Challenges cont. Seeking health care services- Most patients wait for medical and dental appointments til the end of the work season or school is done, i.e.: hard to arrange preventative care services. Continuity of Care- most patients are seasonal and/or migratory and don t have a primary care physician.
Housing at migrant grass camps in southern Minnesota. Viviendas en los campos para migrantes en el sur de Minnesota.
Housing at migrant grass camps in southern Minnesota. Viviendas en los campos para migrantes en el sur de Minnesota.
Registration Process Registration for MHSI programs can be done in person or over the phone No proof of income is required we ask only for an oral statement of household/family annual income Patient information needs to be updated every year, even if they ve registered with us before
How MHSI provides access Health centers are staffed with a combination of providers (MD, PA, and NP) at year round centers Nurses, bilingual outreach workers, and bilingual office managers at each location Bilingual community health specialists at some of the year round health centers
How MHSI provides access cont. Health centers provide: Health assessments Health education Follow-up Case management CLIA waived lab services Home visit option Outreach activities in the communities Extended hour services
How MHSI provides access cont. Voucher referrals for other services, i.e.: x-ray, dental, pharmacy, and other services not provided at our centers In addition MHSI staff coordinates care and service for farm workers with many organization and agencies throughout the service area including: school programs, Head Start, Title One, WIC services, public health programs, area health providers, food shelves, clothing and housing support, etc.
Cluster Clinics One stop shop diabetic patients can receive all annual care in one evening Based on ADA standards of care Able to complete all stations in less than 2 hours 1. Visual Acuity 2. Diabetes Educator 3. Dietician 4. Dental Hygienist 5. Dilated Eye Exam 6. Pharmacist
Voucher Referrals MHSI is one of only about 20 voucher programs in the nation Vouchers are available for patients to see doctors and specialists, and also available for laboratory tests, x-rays, and dental services Patients can see a doctor or specialist for as little as $10
Migrant Health Voucher Program For those who meet these guidelines, we offer vouchers to help reduce the cost of health care: Ag work has been patient s primary source of income during the past 24 months, or is currently patient s primary source of income Patient doesn t have health insurance (some exceptions apply) Patient s income is under 200% of the Federal Poverty Guidelines (FPL)
Migrant Health Voucher Program (cont.) Vouchers can cover part of the cost of: Emergency and preventive dental services X-rays, EKG s, and readings for these services Select prescription medications Office visits at other clinics, including specialist visits Lab tests and readings Other services, as indicated
Resources www.migranthealthservice.org www.ncfh.org- National Center for Farm Workers Health