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Improving Healthcare Service Models for Migrant Families

Mercedes Hernández is the Child and Family Health Manager at East Coast Migrant Head Start Project. This is her experience at this year’s East Coast Migrant Stream Forum.

Last week, ECMHSP was invited to participate at the East Coast Migrant Stream Forum. This year’s forum took place on October 13-15, 2016 at the Deauville Beach Resort in Miami, Florida.

Mercedes Hernández, the Child and Family Health Manager at East Coast Migrant Head Start Project, poses with presenter Ricardo Garay, Health Network Manager for the Migrant Clinicians Network.

Mercedes Hernández, the Child and Family Health Manager at East Coast Migrant Head Start Project, poses with presenter Ricardo Garay, Health Network Manager for the Migrant Clinicians Network.


Begun by North Carolina Community Health Center Association in 1988, the Forum is the oldest annual conference dedicated to improving health outcomes and health care delivery to migrant and seasonal farmworkers and their families on the East Coast. It was created for health care providers, outreach workers and front-line staff that are employed by federally-funded Migrant and Community Health Centers.

As the Child and Family Health Manager at ECMHSP, I was invited to facilitate a session with Ricardo Garay, Health Network Manager for the Migrant Clinicians Network. The title of the presentation was, “Clinical Coordination for Patients On the Move: Lessons and Barriers in Establishing Continuity of Care”.

The presentation focused on the Migrant Clinicians Network’s Health Network. The purpose of the Health Network is to eliminate mobility as an obstacle for continuity of health care. For clinics, Health Network provides patient referrals, outcome reports, outreach staff integration, and updated medical records as patients move from one location to another. For patients, Health Network offers culturally appropriate services that promote engagement and health education. They have staff that speak Spanish and Haitian Creole, and they can assist in identifying transportation alternatives, among other things. This model has been very successful in ensuring mobile patients are able to receive complete culturally competent tuberculosis treatment. Now the model is being adapted to support patients with other conditions to ensure they have continuity of care as they move in search of agricultural work.

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The session, led by Ricardo Garay of the MCN, discussed the barriers faced when serving a mobile population and the solutions provided by the MCN Health Network.


The migrant farmworker families ECMHSP serves are mobile; live in hard-to-reach rural areas; earn extremely low wages; and work long hours every day. Often times, farmworker families depend on our Head Start centers to provide healthcare services and treatments. I would like to explore the possibility of adapting the model presented by the Migrant Clinicians Network to assist in the transfer of our children’s health information as family’s migrate from state to state following the harvests. We could reduce the rates of over-immunizations, facilitate the enrollment process, and ensure appropriate follow-up to health services.

Our work in strengthening our partnerships and improving our health services continued beyond the workshop. During the conference I was able to connect with farmworker health programs, migrant clinics and university professors who are working with farmworkers and have an interest in strengthening their partnerships with migrant and seasonal Head Start centers. I am looking forward to engaging with these partners to support the health services for the migrant and seasonal farmworker families we serve.

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