Health clinics stand to lose federal funding for underserved populations

Health clinics stand to lose federal funding for underserved populations
Migrant farm workers harvest sunflowers in Carlsbad. Employment opportunities for many migrant workers is limited to fieldwork and day labor. Photo by Promise Yee

VISTA — Vista Community Clinic has served North County migrant farm workers for close to 30 years. Clinic CEO Fernando Sañudo said the community clinic has an outstanding reputation for its migrant worker health program, but now stands to lose 70 percent of its federal funding along with other clinics.

Congress is considering severely reducing funds because more patients now have medical coverage through Covered California and Medical.

This leaves out migrant farm workers and others who do not qualify for health insurance.

“There’s currently what we’re calling the fiscal cliff,” Sañudo said. “That congress if they don’t reappropriate the funds into these health centers, we have the risk of losing 70 percent of our federal dollars.”

Consequences of loss of funds are outreach services and health education programs for migrant workers and other underserved patients would be reduced or stopped. Sañudo said without a county health department to provide these services they could become nonexistent.

Sañudo said the majority of North County migrant farm workers are men who are working to make money to send home to their families. Most are from rural villages of Oaxaca, Mexico, have a limited education, and speak a native dialect.

In the U.S. they earn minimum wage as field workers and day laborers, which often limits their housing options to make shift encampment structures pieced together from scrap wood and sheets of plastic.

The health risks are high for this vulnerable population. In addition to the toil of manual labor and lack of quality housing, they have limited access to fresh water, and most of their food comes from lunch trucks that stop at the job site.

Getting medical attention is something migrant farm workers are reluctant to do unless it is a severe emergency. Home remedies are often tried, and in some cases penicillin and syringes are requested and brought to them by food truck drivers.

Vista Community Clinic began outreach services to agriculture fields and encampments in the 1990s. Sañudo was one of the first outreach workers. He said it took awhile to establish trust.

Now migrant workers recognize the clinic van that stops in weekly to pick up workers and transport them to the clinic for healthcare and treatment of chronic conditions. At the clinic they are provided the same medical, specialist and prescription services as other patients.

Outreach services to connect them with clinic healthcare are costly and time consuming for staff, but without these services, it is unlikely migrant workers would seek healthcare that ensures their health and helps prevent the spread of communicable diseases.

“It’s very different from downtown San Diego or L.A., we have to drive to the scene,” Sañudo said. “It’s quite a distance to reach the population.”

A loss of federal funds would also reduce or eliminate doctor education loan repayment programs, which provide an incentive for doctors to work in underserved, high need clinics.

Congress is expected to make a funding decision by Sept. 30.

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