CHC sliding scale and farmworker access

[Guest guest]

There is another access issue for farmworkers which arises when they

present at Community Health Centers. If their income is annualized

using their current weekly or monthly wage for a family of 1 (their

current income is fairly high, but they will only work a few months at

that salary; their family is in Mexico and is not counted in the family

size determination even though the worker is indeed supporting them),

they sometimes place fairly high on the sliding scale fee scale and are

asked to pay a large percentage of their charges. This can come to $70

for an extended visit or physical exam - sometimes farmworkers refuse to

return for follow-up care because of the fees they would incur.

How do CHCs generally deal with this issue?

Deb Norton

FARMWORKER STUDY/REPORT INCLUDED IN HEALTH CENTER REAUTHORIZATION

PACKAGE

Victory will Raise Public Awareness of Coverage Barriers Faced by

Farmworkers and their Families

In a great victory for America's farmworkers, the final agreement on the

Health Centers reauthorization package includes a provision requiring

the

Department of Health and Human Services (HHS) to study problems and

barriers

experienced by farmworkers and their families under Medicaid and the

State

Children's Health Insurance Program. The provision also requires HHS to

report to the President and Congress (no later than 1 year after the

date of

enactment) on possible legislative and administrative solutions to

overcome

these barriers.

The Farmworker Study/Report was a legislative priority for America's

Migrant

Health Centers and the National Association of Community Health Centers

(NACHC). Earlier this year, NACHC approached Representatives Fred Upton

(R-MI) and Bart Stupak (D-MI) to introduce legislation establishing a

commission to examine barriers that farmworkers and their families face

in

gaining access to Medicaid and SCHIP and propose solutions on how to

solve

them. The language included in the final version of the reauthorization

package is substantially similar to the Upton/Stupak legislation.

NACHC wishes to thank all health centers that contacted their

Representatives on behalf of the Farmworker Study/Report. NACHC also

strongly thanks Representatives Upton and Stupak for their leadership

and

the House and Senate conferees who included the study/report provision

in

the final package.

The bill number for the final agreement on the Health Care Safety Net

Amendments of 2002 is S.1533. The House of Representatives passed this

legislation on Wednesday afternoon. NACHC is urging all health centers

to

contact their Senators to urge them to " clear " S.1533 right now, before

Congress recesses.

Koppen

Director, Health Care Financing Policy

Division of Federal, State and Public Affairs

National Association of Community Health Centers

2001 L Street, NW Suite 300

Washington, DC 20036

(202) 296-2175

(202) 296-3526 (F)

(202) 669-8023 ©

ckoppen@...

www.nachc.com

[Guest guest]

An additional question regarding sliding scale applications at CHC's and

hospitals is whether the farmworker may include dependent family members who

are not living in the household, for example a parent supporting her 5

children in Mexico. Is the number in the family 1 or 6?

I heard from my administrator that if a farmworker lives in

employer-provided housing, ie a camp, that they automatically qualify for

our CHC's full slide. On the sliding scale application form I sign that the

client fits into this category, and make sure the employer's name is

specified. This has been a very recent change, but so far I have not had

any problems getting clients into the sliding scale program. I don't have

the documentation stating this change of rules, however.

Esther

Migrant Health Coordinator

Rural Health Outreach Program

County, VA

esther_miller@...

>From: Deborah Norton <Deborah.Norton@...>

>Reply-

> Groups

>Subject: [ ] CHC sliding scale and farmworker access

>Date: Thu, 17 Oct 2002 11:22:38 -0400

>

>There is another access issue for farmworkers which arises when they

>present at Community Health Centers. If their income is annualized

>using their current weekly or monthly wage for a family of 1 (their

>current income is fairly high, but they will only work a few months at

>that salary; their family is in Mexico and is not counted in the family

>size determination even though the worker is indeed supporting them),

>they sometimes place fairly high on the sliding scale fee scale and are

>asked to pay a large percentage of their charges. This can come to $70

>for an extended visit or physical exam - sometimes farmworkers refuse to

>return for follow-up care because of the fees they would incur.

>

>How do CHCs generally deal with this issue?

>

>Deb Norton

>

>

>FARMWORKER STUDY/REPORT INCLUDED IN HEALTH CENTER REAUTHORIZATION

>PACKAGE

>Victory will Raise Public Awareness of Coverage Barriers Faced by

>Farmworkers and their Families

>

>In a great victory for America's farmworkers, the final agreement on the

>

>Health Centers reauthorization package includes a provision requiring

>the

>Department of Health and Human Services (HHS) to study problems and

>barriers

>experienced by farmworkers and their families under Medicaid and the

>State

>Children's Health Insurance Program. The provision also requires HHS to

>

>report to the President and Congress (no later than 1 year after the

>date of

>enactment) on possible legislative and administrative solutions to

>overcome

>these barriers.

>

>The Farmworker Study/Report was a legislative priority for America's

>Migrant

>Health Centers and the National Association of Community Health Centers

>(NACHC). Earlier this year, NACHC approached Representatives Fred Upton

>

>(R-MI) and Bart Stupak (D-MI) to introduce legislation establishing a

>commission to examine barriers that farmworkers and their families face

>in

>gaining access to Medicaid and SCHIP and propose solutions on how to

>solve

>them. The language included in the final version of the reauthorization

>

>package is substantially similar to the Upton/Stupak legislation.

>

>NACHC wishes to thank all health centers that contacted their

>Representatives on behalf of the Farmworker Study/Report. NACHC also

>strongly thanks Representatives Upton and Stupak for their leadership

>and

>the House and Senate conferees who included the study/report provision

>in

>the final package.

>

>The bill number for the final agreement on the Health Care Safety Net

>Amendments of 2002 is S.1533. The House of Representatives passed this

>legislation on Wednesday afternoon. NACHC is urging all health centers

>to

>contact their Senators to urge them to " clear " S.1533 right now, before

>Congress recesses.

>

> Koppen

>Director, Health Care Financing Policy

>Division of Federal, State and Public Affairs

>National Association of Community Health Centers

>2001 L Street, NW Suite 300

>Washington, DC 20036

>(202) 296-2175

>(202) 296-3526 (F)

>(202) 669-8023 ©

>ckoppen@...

>www.nachc.com

>

>

_________________________________________________________________

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[Guest guest]

Doesn't each community health center have it's own fee structure and

policies? Maybe NACHC has general guidelines but I do know that

centers have a certain amount of autonomy when it comes to setting

fees.

I think the discussion of what health centers do is useful because it is

probably variable - which means that as researchers, we need to be aware

of local situations when we assess " access to care. "

A

At 04:08 PM 10/17/2002 +0000, you wrote:

An additional question regarding

sliding scale applications at CHC's and

hospitals is whether the farmworker may include dependent family members

who

are not living in the household, for example a parent supporting her 5

children in Mexico. Is the number in the family 1 or 6?

I heard from my administrator that if a farmworker lives in

employer-provided housing, ie a camp, that they automatically qualify for

our CHC's full slide. On the sliding scale application form I sign

that the

client fits into this category, and make sure the employer's name is

specified. This has been a very recent change, but so far I have

not had

any problems getting clients into the sliding scale program. I

don't have

the documentation stating this change of rules, however.

Esther

Migrant Health Coordinator

Rural Health Outreach Program

County, VA

esther_miller@...

>From: Deborah Norton <Deborah.Norton@...>

>Reply-

> Groups

>Subject: [ ] CHC sliding scale and farmworker

access

>Date: Thu, 17 Oct 2002 11:22:38 -0400

>

>There is another access issue for farmworkers which arises when

they

>present at Community Health Centers. If their income is

annualized

>using their current weekly or monthly wage for a family of 1

(their

>current income is fairly high, but they will only work a few months

at

>that salary; their family is in Mexico and is not counted in

the family

>size determination even though the worker is indeed supporting

them),

>they sometimes place fairly high on the sliding scale fee scale and

are

>asked to pay a large percentage of their charges. This can come

to $70

>for an extended visit or physical exam - sometimes farmworkers refuse

to

>return for follow-up care because of the fees they would incur.

>

>How do CHCs generally deal with this issue?

>

>Deb Norton

>

>

>FARMWORKER STUDY/REPORT INCLUDED IN HEALTH CENTER

REAUTHORIZATION

>PACKAGE

>Victory will Raise Public Awareness of Coverage Barriers Faced

by

>Farmworkers and their Families

>

>In a great victory for America's farmworkers, the final agreement on

the

>

>Health Centers reauthorization package includes a provision

requiring

>the

>Department of Health and Human Services (HHS) to study problems

and

>barriers

>experienced by farmworkers and their families under Medicaid and

the

>State

>Children's Health Insurance Program. The provision also

requires HHS to

>

>report to the President and Congress (no later than 1 year after

the

>date of

>enactment) on possible legislative and administrative solutions

to

>overcome

>these barriers.

>

>The Farmworker Study/Report was a legislative priority for

America's

>Migrant

>Health Centers and the National Association of Community Health

Centers

>(NACHC). Earlier this year, NACHC approached Representatives

Fred Upton

>

>(R-MI) and Bart Stupak (D-MI) to introduce legislation establishing

a

>commission to examine barriers that farmworkers and their families

face

>in

>gaining access to Medicaid and SCHIP and propose solutions on how

to

>solve

>them. The language included in the final version of the

reauthorization

>

>package is substantially similar to the Upton/Stupak

legislation.

>

>NACHC wishes to thank all health centers that contacted their

>Representatives on behalf of the Farmworker Study/Report. NACHC

also

>strongly thanks Representatives Upton and Stupak for their

leadership

>and

>the House and Senate conferees who included the study/report

provision

>in

>the final package.

>

>The bill number for the final agreement on the Health Care Safety

Net

>Amendments of 2002 is S.1533. The House of Representatives

passed this

>legislation on Wednesday afternoon. NACHC is urging all health

centers

>to

>contact their Senators to urge them to " clear " S.1533 right

now, before

>Congress recesses.

>

> Koppen

>Director, Health Care Financing Policy

>Division of Federal, State and Public Affairs

>National Association of Community Health Centers

>2001 L Street, NW Suite 300

>Washington, DC 20036

>(202) 296-2175

>(202) 296-3526 (F)

>(202) 669-8023 ©

>ckoppen@...

>www.nachc.com

>

>

_________________________________________________________________

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