They are committed to maintaining a financially stable organization, through efficient resource management and efforts to outside funding. In order to do so, they recruit personnel who promote and advocate the aforementioned goals and philosophies of CSVS. For their system, their patients health is the most crucial objective. CSVS desires to effectively continue to serve its mission to deliver exceptional health care services to the Monterey County. History & Background CSVS was founded in 1980, due to concerns brought up by a group of local community members.
This group aspired to ensure that basic health care was accessible to all residents of Monterey County, centering their efforts towards families working in the agriculture industry. CSVS is the major provider of primary health care for farmworkers in the Salinas Valley. Entirely committed to the community it serves, during its first seven years of existence, the number of patients increased significantly and by 2000, CSVS had established a system of eight clinics located in small communities. This makes for greatly reducing travel time for their patients.
Each of the respective clinics delivers all-inclusive primary care services to families salaried by the agriculture industry. Furthermore, it includes dentistry and an in-patient hospital for the farmworker community. These clinics offer a broad range of services, including family practice, women’s health, preventive medicine, internal medicine, pediatrics, laboratory services, dental care, and health outreach and education. Unfortunately, CSVS does not provide mental health services. In 2004, CSVS clinics provided over 112,000 patient encounters, working with 35,000 active patients.
In Monterey County’s 3,324 square miles, approximately 85% of its population now lives within fifteen minutes of a CSVS site (Clinica de Salud del Valle de Salinas, 2012). CSVS constructed a suitably-trained staff from the communities corresponding to the area that they serve. Additionally, medical assistants from the clinics provide health education, outreach, and diabetes and blood pressure screenings at health fairs, and community events across the valley. Given that the majority of CSVS patients and their families are farmworkers, most medical providers speak Spanish.
Populations as such, are often underserved and disproportionately impacted by every day diseases. Their medical assistants deliver assistance with translations when needed. Although the staff at CSVS may offer translation to the patients, they may not be truly trained to do so. This is a very important part of the process in delivering an acceptable standard of care because it will ultimately affect the quality and accuracy of care. In order to prevent medical errors, the staff should have to go through some type of training and at minimum take a medical terminology class in Spanish.
By doing so, they will expand their knowledge in the appropriate use and context of the English to Spanish translation. Incentives to do so, by their employers (in this case CSVS), are encouraged in order to serve the farm worker community with the equivalent standard of care that any English-speaking individual receives. [Section II] Issue/Problem Cultural and economic barriers that impede farmworkers access to healthcare in the Salinas Valley will be addressed. Certain barriers to obtaining access to healthcare that will be discussed are include speaking a different language and financial constraints.
Communication is vital to providing adequate care to patients, regardless of the language spoken. Generally, the farmworkers have limited literacy in their native language; hence, they are often limited in literacy and English-speaking ability, as well. In addition, they also lack familiarity and understanding of the U. S. system. Moreover, the newly arrived individuals have little to no experience with the institutions of this country, so much that even everyday undertakings prove to be complicated. Along with the aforementioned, farmworkers have financial constraints to obtain health care access.
It is challenging to not only hire, but retain, competent bilingual physicians, nurses and medical assistants because of low salaries and the elevated cost of living in the area. The cost of living in Salinas is 23. 9% greater than the national average (Living Here. (n. d. )). I propose the bringing of health care providers from Mexico. This will benefit CSVS in achieving their mission and delivering optimal care for their patients. Not only will these providers have cultural sensitivity and be able to clearly communicate with the farmworkers, but they will help hinder the possible mistakes made when patients bring their own translator.
It is not enough that the provider speaks Spanish. Ideally, the provider will speak Spanish, work in the community, and not only understand, but respect the cultural context of the grievances and conditions the patients express. With the purpose of successfully communicating with their provider, the patients bring in the comadre, neighbor, or a child who has no knowledge of medical conditions, much less the appropriate context of the translation. The inability to communicate properly with healthcare providers affects both the quality of care, as well as the relationship between the patient and the provider.
This can be frequently observed, as miscommunications occur. These miscommunications lead to misunderstandings about the doctor’s instructions and medicine usage/dosage. Rebuilding those relationships is a tough feat, as this leaves the patients resentful and upset and with no desire to go back into the office. The providers gain experience with the community over the years, but this can drive patients away in the process. It is of vital importance for the farmworkers to have fluency in English in order to have a successful transition to living in the U. S. As shown in Table 1(Marcelli, E. A. , & Pastor, M. ), the vast majority of East Salinas population from 2008-2012 have limited English skills.
Among those age five years or older, an average of 44 percent speak English well. The percentage incorporates four immigrant statuses: immigrant, naturalized immigrant, authorized immigrant and unauthorized immigrant. Granted that majority of this community may not be fluently literate in either Spanish or English, providers cannot rely on printed material for in order to educate, prevent, or outreach efforts.
In conjunction with that, it is difficult for this community to read, much less understand the instructions and indications that result from their doctor’s appointment. These people find themselves overwhelmed by the paperwork required to apply for health care or fill out for public assistance. This results in having to spend more money in the effort to effectively employ the education or outreach. Having staff readily available to help them fill out papers is another way to help CSVS.
They could hire a floater, dedicated to simply helping patients out with paperwork, so they will not have to resort to asking the medical assistants at the front desk that already have to man the desk and carry out their daily duties and responsibilities. By improving the cultural and linguistic competency among the healthcare providers, such as bringing over practicing physicians from Mexico, will help bring together the gap that continues to discourage farmworkers from getting the appropriate health care they need.
Also, increasing the availability of medically trained individuals in Spanish who are in charge of health promotion, education, and outreach efforts. Financial constraints are also an area of worry when it comes to access to health care for the farmworkers throughout the valley. Health Resources & Services Administration data (2015) indicates that the incomes of 82 percent of CSVS patients fall below 100 percent of the poverty lines; patients that fall below 200 percent of the poverty line are at 98 percent. In order to help the majority of the community they serve, CSVS accepts all patients in need of their services.
This is good because according to CSVS (2012): We will expand access to our services… by providing excellent care, by addressing our patients’ needs, by maintaining a sliding fee scale and by establishing clinics and delivering services in areas with the most need. Through efficient resource management and aggressive efforts to seek outside funding, we are committed to maintaining financial stability. (Home) CSVS offers payment plans and use a sliding fee scale; however, that can bring negative repercussions.
They are willing to see patients that cannot pay in order to not turn them down, this willingness to treat patients impacts their finances. If they desire to keep helping the community they should consider the fact that they need to carefully review the expenditures. The financial health of CSVS is vital to continue to perform their mission/vision statement. If they burn through their funds, they could eventually face the risk of having to shut down. This would be detrimental to the community, overall. This is an assumption on my part, not supported by research.
