Jason Pace is the Farm Services Manager at the Community Health Partnership of Illinois (CHP). He oversees health outreach programs located in clinics and service sites throughout Northern and Central Illinois. The program provides services for an often overlooked group- seasonal migrant workers and their families. Through Community Commons’ Health Needs Assessments he has been able to easily pull data that’s needed to tailor outreach programs for migrant workers in the communities they live and work.
Thanks for joining us Jason! Could you start off by telling us about Community Health Partnership of Illinois?
Absolutely, we are a network of federally qualified health centers in Illinois. We have six separate clinic areas and we get special funding as a federally qualified health center that serves migrant and seasonal farm workers. So each of our clinics has the capacity to provide basic medical services, has a doctor on staff. So the nature of our work is fairly seasonal given the fact that migrant seasonal workers that do farm work are mainly in the states during the summertime and fall. But we have two areas that serve the broader public at large as long as they are a certain level below the poverty level, and we provide a sliding fee scale based on income to all of our patients. What I do here is run our community outreach program.
What does a typical day look like for you in that position?
I’m sure you hear this a lot, but no day is the same here. But primary responsibilities I have are mainly equipping my staff- which each site has an outreach coordinator- and they’re in charge of community health workers. They do preventative education, they share information on the services we provide other community resources such as food banks, food stamps, things like that. And they’ll also help link people back into the clinic. We also visit work sites and housing sites to do health risk assessment which is basically checking blood pressure, glucose level, and asking some screening questions to see if any community members might be at risk for any kind of health abnormality. And then we’ll usually provide a brief education, a pamphlet of information on how they can improve their health- and then, if necessary getting them into our clinic.
My responsibility also includes working with other clinics throughout the state of Illinois to set up voucher referral systems, so if we run into people who aren’t immediately near one of our clinics, we can still find care for them nearby and still have a discounted rate they can afford. Another thing that I’m in charge of is developing our educational curriculum, making sure it’s updated. We’ve had a biannual training with my staff where we review best practices with adult education, view updates under the Affordable Health Care Act, new strategies for finding new patients and things like that- so it’s very supportive and administrative. Part of the reason for using Community Commons is that every three years we have our community needs assessments where we do our surveys with focus groups, informal interviews and online surveys as well as acquiring secondary data, providing recommendations for a strategic plan and also look for areas where we can improve overall.
You said you use Community Commons for the health needs assessment, could you explain that a little bit more? What were you looking at specifically?
Absolutely, I think the most useful thing was the health indicator report that we were able to run. So within Community Commons, we divided up our research through you guys in four distinct areas: through the demographics where we look at families with children, families with limited English capabilities, foreign-born populations and population geographic mobility. And then we looked at socio economic factors, median income, financial assistance and populations below the federal poverty level, unemployment rates, families without a motor vehicle, so we looked at physical environment, the food access and access to public transportation and then critical care issues like access to primary care, HIV screening, access to health centers like ourselves, barriers to primary care providers, and frequency of ambulatory services. And I was able to find a lot of that in Community Commons.
We pulled all this data out and then we organized them into our own spreadsheet, like a spreadsheet on health behavior indicators, which looked at tobacco usage, alcohol consumption, the socioeconomic factors I mentioned earlier. We also look at other uninsured levels, income inequality, high school graduation rates, things like that.
Community Commons is a hub of a lot of different data that typically we would have to go somewhere else to dig out, but you can actually search it on here. It works really well as a clearinghouse of different data sources that we can figure out what works best for us and what matches what we’re looking for. I think that’s really helpful. We are funded by HRSA and have access to some really great resources they provide us, but that’s also included in your data too so it’s helpful for us to go through Community Commons and pull out a lot of this information and compare it together. It’s just if we wanted to do some more digging we can always use the sources you guys provide to actually look at the original data.
You look at a lot of different indicators for migrant workers. Can you describe what specific issues they face?
I think the biggest difference between their lives versus ours is that it is very mobile. A lot of our patients most of the year are out of Texas, maybe even Mexico or throughout the US. And what we see, especially in the middle of Illinois, is a lot of them come here around mid-June, early July and may stay for like a month or so then they’ll go up into Michigan and come back in September. A lot of the dependence is based on the need for their work and a lot of that depends on the weather. Last year, we had so much rain in the spring that a lot of the farm workers didn’t come up here until much later than they normally would. It’s not a very predictable lifestyle. A lot are actually not native English speakers. It’s one of the more marginalized communities in the US.
There’s a lot of opportunity for exploitation unfortunately. What we see sometimes is crew leaders who are in charge of recruitment and job placement in larger companies will often times mislead people about the wages that might be offered or how easy the labor is going to be, so there is a lot of room for exploitation there unfortunately and we do our best to work with legal and try to address those issues. We do our best.
And in terms of health issues?
They have high rates of hypertension and diabetes and that’s definitely the biggest health concern that we see, mainly because, a lot of times they’ll work up to 7 days a week and 12-hour days. It’s really, really cruel. So a lot of times, people do get days off and depending on where you work, you could get Saturdays off as well, but it’s still definitely 12-hour days. It’s completely dependent on the amount of work you get done and not necessarily the hours you put up. And I’m not sure if you’re familiar with the agriculture sector in general, but they have certain exceptions that the labor force doesn’t get. They don’t get overtime pay. It’s probably one of the least regulated workforces.
And that was actually one of my questions: do the same labor laws apply to migrant workers?
Great question, unfortunately not. Ever since the Fair Labor Standards Act, there was actually a distinction within that bill that would not cover agriculture work. I think traditionally, it’s always been that case in the agriculture sector. They find a lot of extra labor in terms of documented and undocumented migrant workers. It also depends on the company. We work with everyone from small mom and pop shops to bigger groceries to a group like Monsanto. Depending on the size and the administration that’s head of it, it might offer insurance. Some do, especially if they’re full-time, but one exception to that is workers are considered seasonal and this is actually a case in other areas of the states. Maybe they’ll work two months out of the year but then two months in off-season because they’re not paying full time employees at that point. And a lot of the reasons for funding migrant seasonal workers in general is to kill that gap.
Do migrant workers travel with their families? How does it impact them?
We’re seeing that more and more. It used to mainly just be single guys that would travel and it really just depends, but a lot of times they’ll bring family, depending on what they’re a part of. One of our partnerships in Illinois is with the Migrant Headstart Program and the Migrant Education Program. They provide separate classes for students who are from migrant families. For the most part, a child’s education is very feeble. A lot of times, they’ll miss the end of their school year, they miss a lot. And these education programs, they’ll basically do a summer school for K through 12 and they’ll try and provide some learning classes to help people catch up. But what we’ll do in our partnership is, one day out of December, we’ll do a dental exam, lots of health screening and physicals will be provided as well.