The document discusses the impact of the COVID-19 pandemic on agricultural workers and the efforts of the Connecticut River Valley Farmworker Health Program (CRVFHP) to care for this population. It notes that there have been over 250,000 COVID cases among US farmworkers. CRVFHP provides primary care to migrant and seasonal agricultural workers through community outreach and mobile clinics. Unique challenges in caring for these workers during the pandemic include work conditions that make social distancing and masking difficult, as well as cultural and language barriers. The role of community health workers is highlighted in communicating health information and maintaining care access. CRVFHP has focused on prevention, telehealth, testing during outbreaks, and maintaining primary care services during the pandemic.
COVID 19 Team-Based Approaches to Patient PopulationsCHC Connecticut
As presented as part of The Path Forward on Jan 28, 2021:
Stable housing and health outcomes are inextricably linked. When a patient loses housing – or is in jeopardy of losing housing– health outcomes suffer. COVID has led us to a moment of crisis. Thirty million to 40 million people in the United States face eviction. People of color are disproportionately impacted. Addressing housing as a social determinant of health is critical to achieving health equity. This webinar brings together experts from housing, healthcare and the intersection of both to share innovative short- and long-term solutions you can implement in your community.
The UN has requested Member States to include UN personnel in the national/host country COVID-19 vaccination
programmes. While confirming the inclusion of UN personnel within their national planning, most Member States
have advised that they will be providing the vaccine free of charge. The vaccine may also be available and
accessed through a primary care provider, and in many cases that cost will be covered by medical insurance.
In countries where there is no national programme in place, or in which UN personnel are not included in the
national distribution programme, the UN Department of Operational Support (DOS) has been tasked by the
Secretary-General to identify alternative arrangements for making the vaccine available. DOS is working to ensure
alternative arrangements are put in place for UN personnel.
Member States have also been requested by the Secretary-General to follow the WHO’s Values Framework and
Prioritization Roadmap for the fair and equitable allocation and prioritization of the COVID-19 vaccine.
A teaching aid on addressing hesitancy to Covid-19 vaccination. WHO has identified vaccine hesitancy as a major threat to global health. Learn more about how to work with patients, the public and communities to improve confidence in Covid-19 vaccines.
The 2019–20 coronavirus pandemic is an ongoing pandemic of coronavirus disease 2019 (COVID-19), caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2).[4] The outbreak was first identified in Wuhan, Hubei, China, in December 2019, and was recognized as a pandemic by the World Health Organization (WHO) on 11 March 2020.[5] As of 25 March, more than 422,000 cases of COVID-19 have been reported in more than 190 countries and territories, resulting in more than 18,900 deaths and more than 109,000 recoveries.
This important presentation encompasses all the vaccines of COVID at current point of time; it's mechanism of action, its efficacy data's and advantages and disadvantages
Millions of people in the United States have received COVID-19 vaccines under the most intense safety monitoring in US history. VITAS Healthcare offer an educational presentation for our partner organizations to use for their own in-house or staff training.
COVID 19 Team-Based Approaches to Patient PopulationsCHC Connecticut
As presented as part of The Path Forward on Jan 28, 2021:
Stable housing and health outcomes are inextricably linked. When a patient loses housing – or is in jeopardy of losing housing– health outcomes suffer. COVID has led us to a moment of crisis. Thirty million to 40 million people in the United States face eviction. People of color are disproportionately impacted. Addressing housing as a social determinant of health is critical to achieving health equity. This webinar brings together experts from housing, healthcare and the intersection of both to share innovative short- and long-term solutions you can implement in your community.
The UN has requested Member States to include UN personnel in the national/host country COVID-19 vaccination
programmes. While confirming the inclusion of UN personnel within their national planning, most Member States
have advised that they will be providing the vaccine free of charge. The vaccine may also be available and
accessed through a primary care provider, and in many cases that cost will be covered by medical insurance.
In countries where there is no national programme in place, or in which UN personnel are not included in the
national distribution programme, the UN Department of Operational Support (DOS) has been tasked by the
Secretary-General to identify alternative arrangements for making the vaccine available. DOS is working to ensure
alternative arrangements are put in place for UN personnel.
Member States have also been requested by the Secretary-General to follow the WHO’s Values Framework and
Prioritization Roadmap for the fair and equitable allocation and prioritization of the COVID-19 vaccine.
A teaching aid on addressing hesitancy to Covid-19 vaccination. WHO has identified vaccine hesitancy as a major threat to global health. Learn more about how to work with patients, the public and communities to improve confidence in Covid-19 vaccines.
The 2019–20 coronavirus pandemic is an ongoing pandemic of coronavirus disease 2019 (COVID-19), caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2).[4] The outbreak was first identified in Wuhan, Hubei, China, in December 2019, and was recognized as a pandemic by the World Health Organization (WHO) on 11 March 2020.[5] As of 25 March, more than 422,000 cases of COVID-19 have been reported in more than 190 countries and territories, resulting in more than 18,900 deaths and more than 109,000 recoveries.
This important presentation encompasses all the vaccines of COVID at current point of time; it's mechanism of action, its efficacy data's and advantages and disadvantages
Millions of people in the United States have received COVID-19 vaccines under the most intense safety monitoring in US history. VITAS Healthcare offer an educational presentation for our partner organizations to use for their own in-house or staff training.
The 2021 Critical Issues Series is presented by WCHL and Chapelboro.com, Duke Energy, and Durham Tech.
Speakers:
Quintana Stewart, Orange County Health Director
David Wohl, MD, UNC Health; Vice-Chair, ACTIV-2 Trial
Dr. Franklin Roye, IndyCare Health President
Jessica Thaller-Moran, Brooks Pierce Attorney
Maurice Jones, Chapel Hill Town Manager
Dwight Bassett, Chapel Hill Economic Development Director
"Looking Ahead" Post-Ebola Strategy in West Africa is the first in a series of planned webinars, where we invite knowledgeable individuals and participants to join the post-Ebola strategy in West Africa discussion.
During the webinars, experts from different backgrounds, will outline their view on the Ebola Crisis and most importantly, share their vision on what needs to be done now, and post-Ebola, to ensure aversion of further political and economic disturbances.
The fast spread of the Ebola virus has major consequences on the African countries it has hit the hardest: Guinea, Liberia, and Sierra Leone.
Besides the death tolls and associate losses, the countries are also facing great danger because of the economic consequences the virus carries.
Sierra Leone and Liberia, two of the most hit countries, have both recently come out of more than a decade of gruesome civil wars and the set back of the disease does not help with the stabilization of the economies. Their democracies are fragile and the deprivation from the Ebola crisis could be a trigger for political disruption.
The youth played a major role in those conflicts as a result of economic and social marginalization. Without a post-Ebola strategy to ensure the youth a future of economic and social stability, there may be unforeseeable instabilities.
ABOUT THE ORGANIZER:
Twenty-First Century African Youth Movement, (AYM) empowers and mobilizes Africa’s youth through employment. The AYM is dedicated to developing new and exciting enterprise opportunities for young people in Sierra Leone, to help provide young people with the confidence, power and skills they need to get themselves into employment and out of poverty.
Mobilizing Africa’s unemployed and underemployed youth is the key to the continent’s economic growth and stability. AYM works to mobilize marginalized youth through education, training, and employment, creating entrepreneurial opportunities to help move communities away from poverty, disease, and hunger. AYM aims to establish personal empowerment and community resilience by energizing the continent’s youth population, its most critical resource in the reversal of social and economic stagnation.
For more information, visit:
http://www.aym-inc.org/ebola-looking-ahead/.
AYM’s call for action:
Dr David J Baumler’s AYM Pepper Challenge: http://youtu.be/iU1Ot60mT7I
Community based COVID preparedness (CBCP) 25082021Sudhanshu39
The coronavirus pandemic has shown us a new world where the status quo no longer exists.
•‘The world has seen many crises over the past 30 years, including the Global Financial Crisis of 2007-09. Each has hit human development hard but, overall, development gains accrued globally year-on-year. COVID-19, with its triple hit to health, education, and income, may change this trend.’ UNDP Administrator Achim Steiner
• But the pandemic also shows us the wisdom of what is already inherent in the SDGs; the challenges we face cannot be dealt with in isolation or by a piecemeal approach.
• WHO COVID-19 Strategic Response and Preparedness Plan 2021 also highlights the need for coordinated response to plot a course out of the pandemic.
The COVID-19 pandemic has created several challenges for our country’s health care infrastructure, and the community health center workforce is no exception. Join us as we describe strategies to get patients back into dental care. Along with these strategies, participants will learn how to recognize challenges in dental practices, as well as how to engage the interdisciplinary care team through role redesign and integration to increase access to comprehensive care.
This power point outlines key roles of community health workers also referred to as village health teams in the fight against covid-19. We share practical experiences from ACCESS Uganda (accessuganda.org).
A preliminary proposal for an application to the Health Care Innovation Challenge sponsored by CMS. Focus of this proposal include gestational diabetes, maternal obesity, postpartum weight loss, and as well as patient engagement / health literacy
NTTAP Webinar Series - June 7, 2023: Integrating HIV Care into Training and E...CHC Connecticut
In order for health centers to provide compassionate and respectful HIV prevention, care, and treatment in comprehensive primary care settings, the clinical workforce must be knowledgeable, confident, and competent in their ability to do so.
We’ll explore the need to integrate HIV care into training and education for the clinical care team, as well as educational models to train the next generation. Using Community Health Center Inc.’s Center for Key Populations Fellowship for Nurse Practitioners (NPs) as a framework for best practices, experts will discuss how to implement specialty care for key populations in your training programs. Additionally, participants will gain awareness of the importance of training the clinical workforce on key population competencies in HIV programs (e.g. HCV, MOUD, LGBTQI+ health, homelessness, and harm reduction).
Utilizing the Readiness to Train Assessment Tool (RTAT™) To Assess Your Capac...CHC Connecticut
Improve educational training experiences at your health center by assessing your capacity and infrastructure to host health professions students.
Join the upcoming hands-on interactive activity session to learn how to utilize the Readiness to Train Assessment Tool (RTAT™). This tool was developed by HRSA-funded National Training and Technical Assistance Partners (NTTAP) at Community Health Center, Inc. (CHC) to understand organizational readiness to host health professions student training programs.
NTTAP Webinar Series - May 18, 2023: The Changing Landscape of Behavioral Hea...CHC Connecticut
The COVID-19 pandemic has resulted in significant shifts in the mode of care from face-to-face to virtual interactions. Join us as we discuss the challenges currently facing behavioral health care and at least one strategy for each. Along with these strategies, panelists will go over what integrated behavioral health care was and is before and following COVID-19, as well as what actions should be taken going forward to increase access to comprehensive care.
Panelists:
• Dr. Tim Kearney, PhD, Chief Behavioral Health Officer, Community Health Center, Inc.
• Melinda Gladden, LCSW, PMHC, Behavioral Health Clinician, Community Health Center, Inc.
• Jodi Anderson, LMFT, Virtual Telehealth Group Coordinator, Community Health Center, Inc.
NTTAP Webinar Series - April 13, 2023: Quality Improvement Strategies in a Te...CHC Connecticut
Join us for a webinar on quality improvement in team-based care!
Building a quality improvement (QI) infrastructure within team-based care is an organizational strategy that will establish a culture of continuous improvement across departments and improve quality in all domains of performance.
Participants will learn about:
• QI infrastructure
• Facilitating QI committees
• Coach training within health centers
Faculty will also provide an example of how trained coaches use QI tools to test and implement changes within an organization.
Implementation of Timely and Effective Transitional Care Management ProcessesCHC Connecticut
Join us to discuss best practices for integrating daily follow-ups for patients recently hospitalized for health emergencies. Effectively following up with patients is a critical responsibility for integrated care teams.
Experts will share how their teams respond to patients to identify care gaps and support the transition of care. Workflow descriptions will provide participants with the tools to support their work to adapt specific steps into their model of team-based care.
Panelists:
• Mary Blankson, DNP, APRN, FNP-C, FAAN, Chief Nursing Officer, Community Health Center, Inc.
• Veena Channamsetty, MD, FAAFP, Chief Medical Officer, Community Health Center, Inc.
• Bibian Ladino-Davis, Behavioral Health Coordinator, Weitzman Institute
Implement Behavioral Health Training Programs to Address a Crucial National S...CHC Connecticut
Health centers are uniquely positioned to address the unprecedented need for behavioral health services but are challenged by the workforce shortage. Participants will gain the knowledge needed to begin conceptualization of a training pathway.
Join us to discuss the considerations of sponsoring an in-house training program across all educational levels, including the benefits, program structure, design, curriculum, supervisors' role, and required resources.
Experts will provide participants with examples from practicum and postdoctoral level training programs to help them gain confidence in developing a behavioral health training pathway.
HIV Prevention: Combating PrEP Implementation ChallengesCHC Connecticut
Expert faculty present case-based scenarios illustrating common challenges to integrating HIV PrEP in primary care. As part of improving clinical workforce development, this session will delve into a variety of specific PrEP implementation challenges. Participants will leave with strategies to overcome these obstacles to establish or strengthen their PrEP program.
Panelists:
• Marwan Haddad, MD, MPH, AAHIVS, Medical Director, Center for Key Populations, Community Health Center, Inc.,
• Jeannie McIntosh, APRN, FNP-C, AAHIVS, Family Nurse Practitioner, Center for Key Populations, Community Health Center, Inc.
NTTAP Webinar Series - December 7, 2022: Advancing Team-Based Care: Enhancing...CHC Connecticut
Join us as expert faculty outline the differences between case management, care coordination and complex care management to frame up a discussion on strategies to leverage effective models for both in-person and remote services.
Expert faculty will discuss the role of the medical assistant and the nurse in care management, as well as how standing orders and delegated orders support this work. This session will discuss how telehealth and remote patient monitoring enhancements can support complex care management for patients with chronic conditions.
Participants will leave this session with the knowledge and tools to begin or enhance implementation of chronic care management by enhancing the role of the medical assistant, nurse and the technology that supports the clinical care.
Panelists:
• Mary Blankson, DNP, APRN, FNP-C, Chief Nursing Officer, Community Health Center, Inc.
• Tierney Giannotti, MPA, Senior Program Manager, Population Health, Community Health Center Inc.
NTTAP Webinar: Postgraduate NP/PA Residency: Discussing your Key Program Staf...CHC Connecticut
Expert faculty will discuss the drivers, benefits, and processes of implementing a postgraduate residency training program at your health center. This session will dive deeper into a discussion on the responsibilities of key program staff, preceptors, mentors, and faculty for successful implementation. This webinar will equip participants with a road map to go from planning to implementation and offer an opportunity for coaching support.
Panelists:
• Program Director of the Nurse Practitioner Residency Program, Charise Corsino, MA
• Clinical Program Director of the Nurse Practitioner Residency Program, Nicole Seagriff, DNP, APRN, FNP-BC
Training the Next Generation within Primary CareCHC Connecticut
This webinar discussed the various avenues of workforce development including:
• training non-clinical roles
• the value of an administrative fellowship
• the key questions to ask before establishing a fellowship at your agency
The discussion referenced CHC Chief Operating Officer Meredith Johnson and CHC Project Manager Megan Coffinbargar’s publication “Establishing an Administrative Fellowship Program: A Practical Toolkit to Support and Develop Future Community Health Center Leaders” for the National Association of Community Health Centers (NACHC).
Panelists:
• April Joy Damian, PhD, MSc, CHPM, PMP, Vice President and Director of the Weitzman Institute, Community Health Center, Inc.
• Megan Coffinbargar, MHA, Project Manager, Optimizing Virtual Care Initiative, Community Health Center, Inc.
This webinar discussed the value of chiropractic treatment as a primary care intervention. Our panelists discussed the role of chiropractic specialists in the primary care team and reviewed the integration of chiropractic services.
Panelists:
• Margaret Flinter, PhD, APRN, FAAN, Senior Vice President and Clinical Director, Community Health Center, Inc.
• Veena Channamsetty, MD, FAAFP, Chief Medical Officer, Community Health Center, Inc.
• James J. Lehman, DC, MBA, DIANM, Director of Health Sciences Postgraduate Education, University of Bridgeport, Chiropractic Orthopedist, Community Health Center, Inc.
• Lesly Valbrun, DC, MPH, MBA(c), Chiropractic Resident, University of Bridgeport, Community Health Center, Inc.
CRISPR-Cas9, a revolutionary gene-editing tool, holds immense potential to reshape medicine, agriculture, and our understanding of life. But like any powerful tool, it comes with ethical considerations.
Unveiling CRISPR: This naturally occurring bacterial defense system (crRNA & Cas9 protein) fights viruses. Scientists repurposed it for precise gene editing (correction, deletion, insertion) by targeting specific DNA sequences.
The Promise: CRISPR offers exciting possibilities:
Gene Therapy: Correcting genetic diseases like cystic fibrosis.
Agriculture: Engineering crops resistant to pests and harsh environments.
Research: Studying gene function to unlock new knowledge.
The Peril: Ethical concerns demand attention:
Off-target Effects: Unintended DNA edits can have unforeseen consequences.
Eugenics: Misusing CRISPR for designer babies raises social and ethical questions.
Equity: High costs could limit access to this potentially life-saving technology.
The Path Forward: Responsible development is crucial:
International Collaboration: Clear guidelines are needed for research and human trials.
Public Education: Open discussions ensure informed decisions about CRISPR.
Prioritize Safety and Ethics: Safety and ethical principles must be paramount.
CRISPR offers a powerful tool for a better future, but responsible development and addressing ethical concerns are essential. By prioritizing safety, fostering open dialogue, and ensuring equitable access, we can harness CRISPR's power for the benefit of all. (2998 characters)
India Clinical Trials Market: Industry Size and Growth Trends [2030] Analyzed...Kumar Satyam
According to TechSci Research report, "India Clinical Trials Market- By Region, Competition, Forecast & Opportunities, 2030F," the India Clinical Trials Market was valued at USD 2.05 billion in 2024 and is projected to grow at a compound annual growth rate (CAGR) of 8.64% through 2030. The market is driven by a variety of factors, making India an attractive destination for pharmaceutical companies and researchers. India's vast and diverse patient population, cost-effective operational environment, and a large pool of skilled medical professionals contribute significantly to the market's growth. Additionally, increasing government support in streamlining regulations and the growing prevalence of lifestyle diseases further propel the clinical trials market.
Growing Prevalence of Lifestyle Diseases
The rising incidence of lifestyle diseases such as diabetes, cardiovascular diseases, and cancer is a major trend driving the clinical trials market in India. These conditions necessitate the development and testing of new treatment methods, creating a robust demand for clinical trials. The increasing burden of these diseases highlights the need for innovative therapies and underscores the importance of India as a key player in global clinical research.
We understand the unique challenges pickleball players face and are committed to helping you stay healthy and active. In this presentation, we’ll explore the three most common pickleball injuries and provide strategies for prevention and treatment.
How many patients does case series should have In comparison to case reports.pdfpubrica101
Pubrica’s team of researchers and writers create scientific and medical research articles, which may be important resources for authors and practitioners. Pubrica medical writers assist you in creating and revising the introduction by alerting the reader to gaps in the chosen study subject. Our professionals understand the order in which the hypothesis topic is followed by the broad subject, the issue, and the backdrop.
https://pubrica.com/academy/case-study-or-series/how-many-patients-does-case-series-should-have-in-comparison-to-case-reports/
Leading the Way in Nephrology: Dr. David Greene's Work with Stem Cells for Ki...Dr. David Greene Arizona
As we watch Dr. Greene's continued efforts and research in Arizona, it's clear that stem cell therapy holds a promising key to unlocking new doors in the treatment of kidney disease. With each study and trial, we step closer to a world where kidney disease is no longer a life sentence but a treatable condition, thanks to pioneers like Dr. David Greene.
CHAPTER 1 SEMESTER V PREVENTIVE-PEDIATRICS.pdfSachin Sharma
This content provides an overview of preventive pediatrics. It defines preventive pediatrics as preventing disease and promoting children's physical, mental, and social well-being to achieve positive health. It discusses antenatal, postnatal, and social preventive pediatrics. It also covers various child health programs like immunization, breastfeeding, ICDS, and the roles of organizations like WHO, UNICEF, and nurses in preventive pediatrics.
Antibiotic Stewardship by Anushri Srivastava.pptxAnushriSrivastav
Stewardship is the act of taking good care of something.
Antimicrobial stewardship is a coordinated program that promotes the appropriate use of antimicrobials (including antibiotics), improves patient outcomes, reduces microbial resistance, and decreases the spread of infections caused by multidrug-resistant organisms.
WHO launched the Global Antimicrobial Resistance and Use Surveillance System (GLASS) in 2015 to fill knowledge gaps and inform strategies at all levels.
ACCORDING TO apic.org,
Antimicrobial stewardship is a coordinated program that promotes the appropriate use of antimicrobials (including antibiotics), improves patient outcomes, reduces microbial resistance, and decreases the spread of infections caused by multidrug-resistant organisms.
ACCORDING TO pewtrusts.org,
Antibiotic stewardship refers to efforts in doctors’ offices, hospitals, long term care facilities, and other health care settings to ensure that antibiotics are used only when necessary and appropriate
According to WHO,
Antimicrobial stewardship is a systematic approach to educate and support health care professionals to follow evidence-based guidelines for prescribing and administering antimicrobials
In 1996, John McGowan and Dale Gerding first applied the term antimicrobial stewardship, where they suggested a causal association between antimicrobial agent use and resistance. They also focused on the urgency of large-scale controlled trials of antimicrobial-use regulation employing sophisticated epidemiologic methods, molecular typing, and precise resistance mechanism analysis.
Antimicrobial Stewardship(AMS) refers to the optimal selection, dosing, and duration of antimicrobial treatment resulting in the best clinical outcome with minimal side effects to the patients and minimal impact on subsequent resistance.
According to the 2019 report, in the US, more than 2.8 million antibiotic-resistant infections occur each year, and more than 35000 people die. In addition to this, it also mentioned that 223,900 cases of Clostridoides difficile occurred in 2017, of which 12800 people died. The report did not include viruses or parasites
VISION
Being proactive
Supporting optimal animal and human health
Exploring ways to reduce overall use of antimicrobials
Using the drugs that prevent and treat disease by killing microscopic organisms in a responsible way
GOAL
to prevent the generation and spread of antimicrobial resistance (AMR). Doing so will preserve the effectiveness of these drugs in animals and humans for years to come.
being to preserve human and animal health and the effectiveness of antimicrobial medications.
to implement a multidisciplinary approach in assembling a stewardship team to include an infectious disease physician, a clinical pharmacist with infectious diseases training, infection preventionist, and a close collaboration with the staff in the clinical microbiology laboratory
to prevent antimicrobial overuse, misuse and abuse.
to minimize the developme
QA Paediatric dentistry department, Hospital Melaka 2020Azreen Aj
QA study - To improve the 6th monthly recall rate post-comprehensive dental treatment under general anaesthesia in paediatric dentistry department, Hospital Melaka
2. CME Credit
• Bridgeport Hospital Yale New Haven Health is accredited by the Connecticut State
Medical Society to sponsor continuing medical education for physicians. The
Bridgeport Hospital Yale New Haven Health designates this live activity for a
maximum of one (1) AMA PRA Category 1 CreditsTM. Physicians should claim only
credits commensurate with the extent of their participation in the various
activities.
• This activity has been planned and implemented in accordance with the Essential
Areas and policies of the Accreditation Council for Continuing Medical Education
through the joint sponsorship of Bridgeport Hospital Yale New Haven Health and
the Weitzman Institute. Bridgeport Hospital Yale New Haven Health is accredited
by the Connecticut State Medical Society to provide continuing medical education
for physicians.
• The content of this activity is not related to products or services of an ACCME-
defined commercial interest; therefore, no one in control of content has a relevant
financial relationship to disclose and there is no potential for conflicts of interest.
3. CARING FOR AGRICULTURAL WORKERS DURING
THE COVID-19 PANDEMIC
2 Dec 2020
www.americanprogress.org/
4. COVID-19 in the United States
13,714,024 cases on 12/1/20 up from 10,392,702 cases on 11/11/20 270,532 deaths
https://coronavirus.jhu.edu/map.html
5. COVID-19 in the United States
https://coronavirus.jhu.edu/covid-19-daily-video
6. COVID-19 in the United States
https://coronavirus.jhu.edu/covid-19-daily-video
9. News headlines
Pfizer-BioNTech and Moderna Vaccine Candidates under FDA review
DECEMBER 10th
-Could potentially start distributing coronavirus vaccines Dec 11th
-both highly ~95% effective in preventing COVID-19
-Both have good safety profiles: no serious safety concerns observed
11. CARING FOR AGRICULTURAL
WORKERS DURING THE COVID-19
PANDEMIC
Jeannie McIntosh, MSN, APRN, FNP-C
CHC Center for Key Populations
2 December 2020
12. BACKGROUND
• How the COVID-19 pandemic has impacted farms and migrant
and seasonal agricultural workers (MSAWs)
• About the CT River Valley Farmworker Health Program (CRVFHP)
• Unique challenges in providing primary care and COVID-19
outreach to this patient population
• Role of the community health worker (CHW)
CRVFHP
13. IMPACT OF COVID-19 ON FARMS AND MSAWs
• There have been more than 250,000 covid cases among farmworkers in US, but this
number may significantly underestimate cases among migrant and seasonal agricultural
workers (MSAWs). [1]
• Large-scale covid outbreaks have occurred at farms across the country. The largest to
date was at Foster Farms, a poultry farm in CA, where 392 workers tested positive and 8
died. [2]
• H2-A visa holders are required to get tested and quarantine for 14 days upon arrival to
US. However, a large percentage of MSAWs (up to 49% of horticulture workers, for
example) are here without visas so may not have quarantined upon arrival.
• As of September, only eight states had issued mandatory regulations for protecting
agricultural workers from exposure to COVID-19. Twenty states currently have non-
enforceable recommendations.
• Covid has had a massive impact on our agriculture industry – US farmers and ranchers
are estimated to lose approx. $20 billion in revenue in 2020.
14. Covid outbreaks on farms Cumulative covid cases on farms
FOOD AND ENVIRONMENT REPORTING NETWORK (FERN)
https://thefern.org/2020/04/mapping-covid-19-in-meat-and-food-processing-plants/
15. ABOUT CRVFHP
• Founded in 1997 and directed by the Mass League of Community Health Centers
• A voucher program funded by HRSA and the Bureau of Primary Health Care (BPHC)
• Covers primary health care for qualified MSAWs and their families along the Connecticut River Valley
in MA and CT
• Services included: medical and dental care, medications, outreach and transportation, some
specialty care through MOUs with local hospitals and clinics
• Care is offered to seasonal farmworkers during peak growing season and to greenhouse workers
year-round
• MSAW countries of origin: Jamaica and Caribbean, Mexico and Central America, West Africa,
Southeast Asia, South America
• Crops: shade tobacco (used to wrap cigars), apples, other fruits and vegetables, flowers, x-mas trees
• CHC, Inc. is one of the 9 clinics contracted to provide care through this voucher program
• Our program is embedded within CHC’s Center For Key Populations
• CHC’s CRVFHP core team:
- Director of CKP -
Family nurse practitioner
- Community based services manager - Registered nurse
- Outreach worker / clinical champion
- Health advocate
16. UNIQUE CHALLENGES IN PROVIDING CARE TO
MSAWS• Primary medical care
- Seasonal ag workers have very long work shifts, often 7 days per week
- Reluctance to report symptoms of illness for fear of missing out on work
- Language and cultural differences
- Limitations on what is covered under voucher program
- Lack of transportation and reliable phone access
- Need to establish trust and rapport in a short time
• Covid-specific medical care and counseling
- Communal living spaces
- Working in close proximity
- Limited access to sinks and bathrooms when working in field
- Difficulty wearing a mask when doing farm or greenhouse work
- MSAWs may fear getting tested, feel pressured by employer not to get
tested, or have limited access to testing in spare time
- Tech access or tech literacy barriers
- Rural health systems less equipped to handle large outbreaks
- Coordinating with local consulate officials from different countries where
rules around
testing, quarantine and travel vary
17. ROLE OF THE COMMUNITY HEALTH WORKER
Joelle Isidor, MD, CRVFHP Outreach Worker
• Advertise our services to farm owners and ag workers
• Schedule appointments
• Deliver supplies and medications
• Transport patients for appointments, labs, imaging
• Have language skills and cultural knowledge of MSAW countries of origin
• Provide health education and convey personal medical information in an accessible
and culturally appropriate way
• Facilitate communication between farm owners, ag workers and medical team
• Help connect the different contracted FQHCs to share resources
• Build trust with the ag workers
• They are essentially the glue that holds the program together!
18. MEDICAL CARE FOR MSAWs: OUR
EXPERIENCE THIS GROWING SEASON
• Covid-19 prevention efforts
• Maintaining access to primary care services
• Agency response to outbreaks
19. COVID-19 PREVENTION EFFORTS
Joelle Isidor, CRVFHP Outreach Worker
• DELIVERY OF SUPPLIES
- Masks
- Hand sanitizer
- Protective eyewear
- Food and other goods for workers in quarantine or isolation
• PREVENTATIVE EDUCATION
- Hand hygiene
- Physical distancing
- Health risks associated with covid
• FLU VACCINE CLINICS – to reduce risk of influenza co-infection
20. MAINTAINING ACCESS TO PRIMARY CARE
SERVICES• TELEHEALTH
- Cell phones and iPads distributed by CRVFHP
- Phone or video visits available 6 days per week during regular
clinic
office hours (any provider)
- 24-hour nursing triage line
• FARM-BASED OUTREACH CLINICS
- Sunday afternoon/evening 1-2 x per month
- Care provided in tents for privacy
- Outreach worker, 1 provider + 2 providers in
training (NP resident and fellow), nurse, MA
• SITE-BASED VISITS AS NEEDED
- Nurse visits for EKG, STI treatment, BP check
- Provider visits if face-to-face exam needed based on tele health
assessment
• VITALS MONITORING SUPPLIES – delivered to farms (BP monitors, pulse oximeters)
to allow for V/S assessment during tele health visits
21. AGENCY RESPONSE TO OUTBREAKS
Kasey Harding, MPH
Director of the Center for Key Populations
• MASS TESTING AT FARMS
- Rapid response at onset of outbreak
- Leveraging mobile testing supply units, workflow and team members already
experienced in large-
scale testing events sponsored by state
- Returning to retest those who initially tested negative
- Results conveyed via texts, phone calls, outreach worker visiting farms
• COUNSELING AND EDUCATION
- Consulting with local DPH, CRVFHP staff, and CHC clinical leadership to come up with
plan
- Advising farm owners on how to quarantine and isolate workers in close communal living
situations,
ex. moving those who test negative to separate barracks or nearby off-site location
- Nurse triage and tele health provider visits utilized for counseling symptomatic patients
on
supportive care measures and ED precautions
- Return-to-work guidance
- Measures to prevent repeat outbreaks (or additional spread of existing outbreak)
LESSONS LEARNED FROM MULNITE FARM OUTBREAK:
- Coordinating with DPH
- Handling media attention
22. NEXT STEPS?...
VACCINATION CLINICS
• Currently doing flu vaccine clinics at the greenhouses and farms
• Setting the stage for future covid-19 vaccine outreach clinics?
MIGRANT CLINICIAN NETWORK’S HEALTH NETWORK
• A program that provides bridge case management, medical
records transfer, and follow-up services for mobile patients.
• Founded in 1995. Thousands of patients served.
• Used to track LTBI treatment completion and chronic disease
continuity of care.
• Potential utility in tracking covid cases and connecting MSAWs to
testing resources + medical care?
23. LEARN MORE
• Brown Institute for Media Innovation. “Documenting Covid-19: The Migrant Farm Project.”
https://www.documentingcovid19.io/migrant
• Centers for Disease Control and Prevention (CDC). “Covid-19 Guidelines for Agriculture
Workers and Employers.” https://www.cdc.gov/coronavirus/2019-ncov/community/guidance-
agricultural-workers.html
• CT River Valley Farmworker Health Program (CRVFHP). http://www.crvfhp.org/
• Migrant Clinicians Network (MCN). https://www.migrantclinician.org/
• National Center for Farmworker Health, Inc. (NCFH). “COVID-19 in Rural America: Impact on
Farms & Agricultural Workers.” http://www.ncfh.org/msaws-and-covid-19.html
• Pennsylvania Action Coalition. “Examining the Impact of Covid on Community Health Centers,
Part 2.” https://www.paactioncoalition.org/about/podcast/item/601-examining-the-impact-of-
covid-on-community-health-centers-part-2.html
25. Thank You!
To learn more about The Path Forward series
WeitzmanLearning.org/the-path-forward
To view previous COVID-19 sessions:
WeitzmanLearning.org/coronavirus