{"id":23427,"date":"2024-05-15T14:52:57","date_gmt":"2024-05-15T21:52:57","guid":{"rendered":"https:\/\/peninsula360press.com\/?p=23427"},"modified":"2024-07-06T13:19:35","modified_gmt":"2024-07-06T20:19:35","slug":"medical-care-for-immigrants","status":"publish","type":"post","link":"https:\/\/peninsula360press.com\/en\/medical-care-for-immigrants\/","title":{"rendered":"Providing health care to immigrants on California\u2019s \u201clast frontier\u201d"},"content":{"rendered":"

Farmworkers in a remote corner of Northern California say they have never heard of the state's efforts to expand health insurance to undocumented residents.<\/span><\/em><\/p>\n

\"Providing
Above: Alvaro Urrea Olivares at the entrance to the mobile home park where he and about 50 migrant farmworkers live in Smith River, Del Norte County. (Credit: Manuel Ortiz)<\/figcaption><\/figure>\n

SMITH RIVER, California<\/strong> \u2013 \u00c1lvaro Urrea Olivares has a soft, pleasant voice. At 45, his weathered hands reveal decades of work in the lily fields that drive the local economy in this small community in the far north of California.<\/span><\/p>\n

Smith River is not just rural, residents say, it's remote, rural, California's last frontier, and it's here that the state's plan to expand access to health care to all residents is being tested.<\/span><\/p>\n

\u201cI don\u2019t have a house. Other people help me here. They help me find work; they give me food and I sleep in my car. It\u2019s not as bad as those who sleep outdoors,\u201d explains Urrea, nicknamed Caballo, pointing to an abandoned BMW.<\/span><\/p>\n

Packed with blankets and personal belongings, the car is parked amid a row of trailers housing about 50 farmworkers and their families. The vast majority are from Veracruz, Jalisco or, in Urrea\u2019s case, Guanajuato. At the park entrance is a yellow sign that reads: \u201cWelcome to Smith River. Easter Lily Capital of the World.\u201d<\/span><\/p>\n

\"\"
A sign welcomes visitors to this small mobile home park located on Smith River in rural Del Norte County. The park is home to migrant farmworkers and their families, many of whom work in the Easter lily fields surrounding the area. (Credit: Peter Schurmann)<\/figcaption><\/figure>\n

In years past, migrants \u2014 many of them undocumented \u2014 would come and go with the lily harvest, returning to Mexico in the fall and then returning to Smith River in the spring to plant. But as border restrictions tightened, many remained in what has become a permanent community. Between planting and harvesting, residents turn to day jobs to survive.\u00a0<\/span><\/p>\n

\u201cIt\u2019s expensive here,\u201d Urrea continues in Spanish. \u201cWhen people don\u2019t have work, they can\u2019t pay the rent. I\u2019ve been sleeping in this car for three years.\u201d<\/span><\/p>\n

Manuel Ortiz reports on the lack of information about Medi-Cal eligibility available to farmworkers in Smith River, Del Norte County, for the radio show Por la Libre. (Spanish only. Click here.) Click here to read an English transcript<\/a>).<\/span><\/i><\/p>\n

Starting January 1, California made Medi-Cal, the state\u2019s version of Medicaid, available to all residents regardless of immigration status. At the same time, it has also dramatically expanded Medi-Cal services to include help with things like nutrition, mental health and housing support, among other needs.\u00a0<\/span><\/p>\n

But news of the expansion has yet to reach farmworkers here, many of whom are uninsured and would potentially qualify.<\/span><\/p>\n

\u201cDon\u2019t get sick here\u201d<\/b><\/h2>\n

\u201cI got pretty sick a few years ago. They wouldn\u2019t cover my medications,\u201d Urrea says, referring to the clinic she went to for treatment in Crescent City, 15 miles south. \u201cNowadays I don\u2019t have much work and I don\u2019t have money to pay. So I buy pills at the store when I get sick.\u201d\u00a0<\/span><\/p>\n

Pills in the store. It's a phrase you hear from other trailer park residents when asked about their health.\u00a0<\/span><\/p>\n

\u201cI don\u2019t know how to get insurance,\u201d says Tino (who did not want to give his last name). Tino, who is in his 30s, has lived here in one of the trailers for two years. \u201cI got sick three months ago and I just took some pills.\u201d He adds: \u201cWe are Latinos, immigrants\u2026 It\u2019s not easy for us to get insurance.\u201d<\/span><\/p>\n

\"\"
\u00c1lvaro Urrea Olivares in the car where he has been sleeping for three years. \u201cIt is expensive here. When people don\u2019t have work, they can\u2019t pay the rent,\u201d he says. (Credit: Manuel Ortiz)<\/figcaption><\/figure>\n

Smith River is located in the northwestern corner of Del Norte County, a sparsely populated corner of Northern California sandwiched between Humboldt County to the south, the Oregon border to the north, vast forests to the east, and the Pacific to the west. Latinos here make up only 20 percent of the overall population (which is mostly white, with a significant Native American presence), though they make up the vast majority of the region\u2019s agricultural workforce.\u00a0<\/span><\/p>\n

And as in many communities here, there is (at least among the farmworkers interviewed for this article) an instinctive distrust of government. Don\u2019t depend on the state. If you get sick, it\u2019s up to you. Or, as one resident commented, \u201cYou better not get sick here.\u201d<\/span><\/p>\n

Spreading the word<\/b><\/h2>\n

Kathleen Moreno directs outreach and enrollment for Open Door Community Health Center, which operates 12 clinics in Del Norte and neighboring Humboldt counties.<\/span><\/p>\n

\u201cThere are people who have not had access to medical care since they have been here,\u201d she says, \u201cand so some of their health conditions are terrifying and out of control.\u201d<\/span><\/p>\n

As a federally qualified health center (FQHC), Open Door is one of nearly three dozen organizations in 48 of California\u2019s 58 counties that are part of the Navigators Health Enrollment Project, launched by the California Department of Health Care Services (DHCS) to help bring information about Medi-Cal eligibility to local communities. The initiative will run through mid-2026.\u00a0<\/span><\/p>\n

Doing so in places like Del Norte, where distances are long and resources are few, is not without its challenges.<\/span><\/p>\n

\"\"
The car Urrea sleeps in was provided by a resident of the trailer park, home to about 50 farmworkers and their families, many of them uninsured and unaware of California's efforts to extend health care to all residents regardless of immigration status. (Credit: Manuel Ortiz)<\/figcaption><\/figure>\n

\u201cThere is no easy channel of communication up here,\u201d said Moreno, who lives in Crescent City. There are no local Spanish-language radio stations, no newspapers, and Internet access is limited in some areas, he said. \u201cIt\u2019s been like this since I\u2019ve lived here for 18 years.\u201d<\/span><\/p>\n

Open Door relies on informational posts on platforms like Facebook, presentations at local health fairs and community events, and community health workers, also known as Latino Health Coordinators, of which two cover Del Norte and three for all of Humboldt.<\/span><\/p>\n

Moreno oversees their work. \u201cTheir success has been largely based on trust and word-of-mouth referrals\u2026 once a family realizes they can trust our coordinators, they tell their family.\u201d<\/span><\/p>\n

But going directly to the farms has been a challenge, Moreno says. \u201cObviously, we can\u2019t stop work and the farm owners weren\u2019t thrilled about having people on the farms. So, we posted in the break rooms and brought a healthy snack so everyone could come in and chat. But lunch breaks are short \u2014 half an hour \u2014 and then it\u2019s back to work.\u201d<\/span><\/p>\n

Open Door also scanned patient records from 2022 and 2023 to see who had previously accessed care but was uninsured. These individuals were enrolled in emergency Medi-Cal and are now eligible for full-scope Medi-Cal under the current expansion, though many may not be aware of this fact, Moreno acknowledges.\u00a0\u00a0<\/span><\/p>\n

\"\"
Residents gather at the local laundry, where Urrea goes to escape the cold. People here say the laundry is one of the only communal gathering places for the farmworkers who live here. (Credit: Manuel Ortiz)<\/figcaption><\/figure>\n

Another key barrier is the lack of public transportation. The closest clinic to Smith River is in Crescent City. For serious medical needs, patients must travel to Redding, a four-hour drive south, or San Francisco, a six-hour drive.<\/span><\/p>\n

There\u2019s also a shortage of providers. \u201cIt\u2019s really hard to find providers who want to live and work in Crescent City. Sometimes we find a great provider and they stay. Most of the time, they leave,\u201d Moreno says, noting that there\u2019s only one ophthalmologist in Crescent City who sees Medi-Cal patients, and his waiting list is at capacity.<\/span><\/p>\n

The policy increases mistrust as undocumented residents have to weigh their health care needs against fears of stirring up anti-immigrant sentiment and jeopardizing their path to citizenship or legal residency by accessing public benefits, which under the previous administration could be grounds for deportation.\u00a0<\/span><\/p>\n

\u201cThat\u2019s a real concern for people,\u201d Moreno says. \u201cWe heard from one person who said, \u2018If my information gets out and I get deported, at least I\u2019ll have access to health care.\u2019\u201d<\/span><\/p>\n

\u201cYou have to take care of yourself\u201d<\/b><\/h2>\n
\"\"
Urrea has lived in Smith River since he first arrived from Mexico more than 30 years ago. (Credit: Manuel Ortiz)<\/figcaption><\/figure>\n

Back in Smith River, trailer park residents were sometimes unaware and uncertain about the current Medi-Cal expansion.\u00a0<\/span><\/p>\n

\u201cI had never heard of Medi-Cal,\u201d says Alberto Hernandez, a native of Chiapas who has lived here for the past 11 months. When asked what he does when he gets sick, he shrugs. \u201cI don\u2019t know\u2026 it\u2019s very expensive here. Maybe go back to Mexico.\u201d<\/span><\/p>\n

Anancio Hernandez works as a local chef. \u201cA month or two ago I had some pain. But I kept working, even though I was sick,\u201d he says. \u201cI don\u2019t have insurance, so I didn\u2019t go to the hospital.\u201d Asked if he would sign up for Medi-Cal if given the chance, he nodded. \u201cI\u2019ll go look into it to see if this opportunity exists.\u201d\u00a0<\/span><\/p>\n

For his part, Urrea shares that his mother, who also lives in Del Norte, was recently hospitalized after suffering a stroke. She lost sight in her left eye, he says. Like him, she does not have insurance.\u00a0<\/span><\/p>\n

And while his affection for the community and the region is clear (he's eager to show visitors the local beaches, where he says he sometimes goes to clear his head), he is clear-eyed about the challenges.<\/span><\/p>\n

\u201cWhen you're dying, you have to take care of yourself. That's the bad thing about it.\u201d<\/span><\/p>\n

 <\/p>\n

Additional information by Manuel Ortiz.<\/span><\/p>\n

This is the second in a series looking at Medi-Cal expansion in rural Northern California. You can read the first part here here<\/a>. This project is a collaboration between EMS<\/a> and Peninsula 360 Press and was funded by the California Health Equity Impact Fund 2024<\/a> from the USC Annenberg Health Center.<\/span><\/i><\/p>\n

You may be interested in:<\/strong> Almost $6 million are approved for housing for agricultural workers in San Mateo<\/a><\/em><\/p>","protected":false},"excerpt":{"rendered":"

Trabajadores agr\u00edcolas en un rinc\u00f3n remoto del norte de California dicen que nunca han o\u00eddo hablar de los esfuerzos del estado para ampliar el seguro m\u00e9dico a los residentes indocumentados. SMITH RIVER, California \u2013 \u00c1lvaro Urrea Olivares tiene una voz suave y agradable. A sus 45 a\u00f1os, sus curtidas manos revelan d\u00e9cadas de trabajo en […]<\/p>","protected":false},"author":18,"featured_media":23428,"comment_status":"open","ping_status":"open","sticky":false,"template":"","format":"standard","meta":{"footnotes":""},"categories":[14,118,311],"tags":[],"class_list":{"0":"post-23427","1":"post","2":"type-post","3":"status-publish","4":"format-standard","5":"has-post-thumbnail","7":"category-cover","8":"category-migracion","9":"category-norcal"},"_links":{"self":[{"href":"https:\/\/peninsula360press.com\/en\/wp-json\/wp\/v2\/posts\/23427","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/peninsula360press.com\/en\/wp-json\/wp\/v2\/posts"}],"about":[{"href":"https:\/\/peninsula360press.com\/en\/wp-json\/wp\/v2\/types\/post"}],"author":[{"embeddable":true,"href":"https:\/\/peninsula360press.com\/en\/wp-json\/wp\/v2\/users\/18"}],"replies":[{"embeddable":true,"href":"https:\/\/peninsula360press.com\/en\/wp-json\/wp\/v2\/comments?post=23427"}],"version-history":[{"count":1,"href":"https:\/\/peninsula360press.com\/en\/wp-json\/wp\/v2\/posts\/23427\/revisions"}],"predecessor-version":[{"id":23434,"href":"https:\/\/peninsula360press.com\/en\/wp-json\/wp\/v2\/posts\/23427\/revisions\/23434"}],"wp:featuredmedia":[{"embeddable":true,"href":"https:\/\/peninsula360press.com\/en\/wp-json\/wp\/v2\/media\/23428"}],"wp:attachment":[{"href":"https:\/\/peninsula360press.com\/en\/wp-json\/wp\/v2\/media?parent=23427"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/peninsula360press.com\/en\/wp-json\/wp\/v2\/categories?post=23427"},{"taxonomy":"post_tag","embeddable":true,"href":"https:\/\/peninsula360press.com\/en\/wp-json\/wp\/v2\/tags?post=23427"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}