1. MSFW Analysis - Maryland National Center for Farmworker Health

2. Presentation Controls Legend Next slidePrevious Slide Data County Information Return to presentation Only buttons in lower right hand corner are operational MSFW Analysis - Maryland

3. Purpose The purpose of this presentation is to conduct spatial data analysis of MSFW enumeration data to enable health planners to target limited resources to areas of greatest MSFW need. MSFW Analysis - Maryland

4. Presentation Outline Introduction State Overview Service Delivery Gaps MSFW Analysis - Maryland

5. Introduction Acronyms MSFW Enumeration Profiles Studies Rationale for State Selections Data Sources MSFW Population Categories Rationale for MSFW Population Categories MSFW Analysis - Maryland

6. Acronyms MSFW Analysis - Maryland BPHC – Bureau of Primary Health Care CHC – Community Health Center (Section 330 grantee) HRSA – Health Resources and Services Administration MHC – Migrant Health Center (Section 330 grantee) MSFW – Migrant and Seasonal Farmworker NCFH – National Center for Farmworker Health NP – Nurse Practitioner OPCRH/DHMH – Office of Primary Care and Rural Health, Department of Health and Mental Hygiene PA – Physician Assistant UDS – Uniform Data System

7. MSFW Enumeration Profiles Studies In 1998, the Bureau of Primary Health Care (BPHC) and the Environmental Protection Agency jointly funded a study to estimate MSFW populations at the county level, and awarded a grant to the National Center for Farmworker Health (NCFH). NCFH subsequently contracted with Alice C. Larson, Ph.D., to research and develop state estimates for the MSFW population in ten states: Arkansas, California, Florida, Louisiana, Maryland, Mississippi, North Carolina, Oklahoma, and Texas. MSFW Analysis - Maryland

8. Rationale for State Selections Five states were chosen because they are home to the largest MSFW populations (California, Florida, North Carolina, Texas, and Washington). The other five states (Arkansas, Louisiana, Maryland, Mississippi, and Oklahoma) were selected because they were states for which minimal data was available, and they appeared to provide a broad sample of MSFW employment environments. MSFW Analysis - Maryland

9. Data Sources MSFW numbers are taken from the MSFW Enumeration Profiles Study - Maryland, September 2000. MHC and CHC grantee site locations were taken from the BPHC web site (http://ask.hrsa.gov/pc/) in May 2003, and updated by the Office of Primary Care and Rural Health, Maryland Department of Health and Mental Hygiene, in May 2003.http://ask.hrsa.gov/pc/ User data was provided by the Health Resources and Services Administration (HRSA) and BPHC. MSFW Analysis - Maryland

10. MSFW Population Categories In this analysis, there are four county MSFW population categories: 0 to 499 500 to 999 1,000 to 1,999 2,000 and over MSFW Analysis - Maryland

11. Rationale for MSFW Population Categories The four MSFW population categories were selected based on assumptions about deriving a potential clinic user population number from a target population estimate. Potential clinics include existing CHC service sites or a new access point. A new access point is a new delivery site for the provision of comprehensive primary and preventive health care services. The two types of new access points are (1) new starts and (2) satellites. We assume that a target population will produce a 75% clinic user rate and that a clinic site requires 750 to 1,500 users (based on an average ratio of 750 users per PA/NP and 1,500 per physician). MSFW Analysis - Maryland

12. MSFW Population Category 0 - 499 Counties that have an MSFW population from 0 to 499 are assumed to have an MSFW target population sufficient only to support a user population that would account for less than 25% of the users of an existing CHC service site or a new access point. MSFW Analysis - Maryland

13. MSFW Population Category 500 - 999 Counties that have an MSFW population from 500 to 999 are assumed to have an MSFW target population sufficient to support a user population that would account for 25% to 50% of the users of an existing CHC service site or a new access point. MSFW Analysis - Maryland

14. MSFW Population Category 1,000 – 1,999 Counties that have an MSFW population from 1,000 to 1,999 are assumed to have an MSFW target population sufficient to support a user population that would account for 50% to 100% of the users of an existing CHC service site or a new access point. MSFW Analysis - Maryland

15. MSFW Population Category Over 2,000 Counties that have an MSFW population over 2,000 are assumed to have an MSFW target population sufficient to support a user population that would justify a new access point. MSFW Analysis - Maryland

16. Presentation Outline Introduction State Overview Service Delivery Gaps MSFW Analysis - Maryland

17. State Overview Maryland Data Maryland Counties MSFW Population MSFW Population – Data Map MSFW Population – Spatial Map MSFW Analysis - Maryland

18. Maryland Data AREA - 67,290 square miles. POPULATION (2000) – 5,375,156 TOTAL MSFW POPULATION – 9,522 COUNTIES – 24 counties (ranging in size from 85 to 665 square miles) CHC/MHC SITES – 3 Grantees and 12 sites CHC ONLY SITES – 9 Grantees and 28 sites MSFW Analysis - Maryland

19. Maryland Counties * * * * * * * * * * * Caroline Washington Frederick Baltimore Charles Howard Montgomery Prince Georges Allegany Garrett Talbot Queen Annes Kent Cecil Hartford Dorchester SomersetSt Marys Calvert Anne Arundel Worcester Wicomico Baltimore City Carroll MSFW Analysis - Maryland

20. MSFW Population The migrant and seasonal farmworker population is estimated at 9,522. This number includes workers and their dependents. The largest concentration of farmworkers and their families is located in the southeastern part of the state. The next slide will present this data as an overlay on the county. Data source: MSFW Enumeration Profiles Study – MD, Larson, 9/2000 MSFW Analysis - Maryland

21. MSFW Population - MD 67 59 534 312 283 155 597 731 0 330 512 465 962 44 802 1,200 519 402 243 223 448 941 23 436 Data source: MSFW Enumeration Profiles Study – MD, Larson, 9/2000 MSFW Analysis - Maryland

22. MSFW Population The next slide will depict the state’s counties organized into four categories, based on the county’s MSFW population. In addition to the three categories already described, there is a category for counties with an MSFW population below 500. MSFW Analysis - Maryland

23. MSFW Total Population State Total 9,522 Data source: MSFW Enumeration Profiles Study – MD, Larson, 9/2000 MSFW Analysis - Maryland

24. Presentation Outline Introduction State Overview Service Delivery Gaps MSFW Analysis - California

25. Service Delivery Gaps Analysis Process MHC Grantees CHC Grantees Grantee Delivery Area vs. MSFW Population Grantee Service Penetration MSFW Analysis - California

26. Analysis Process Service potential will be evaluated in the following order: MHC grantee in county CHC grantee in county MHC grantee in adjoining county CHC grantee in adjoining county MSFW Analysis - California

27. MHC Grantees There are three Migrant Health Center grantees in the state. These grantees provide services at 12 sites in 8 counties. Data source: MD OPCRH/DHMH, 5/2003 MSFW Analysis - Maryland

28. MHC Grantee Sites and Service Counties Data source: MD OPCRH/DHMH, 5/2003 MSFW Analysis - Maryland

29. MHC Grantee Sites Coverage Data source: MD OPCRH/DHMH, 5/2003 MSFW Analysis - Maryland

30. CHC Grantees There are twelve Community Health Center grantees in the state. All three of the MHC grantees are also CHC grantees. The nine additional CHC grantees provide health services at 28 sites in 6 counties. Data source: MD OPCRH/DHMH, 5/2003 MSFW Analysis - Maryland

31. CHC Grantee Sites and Service Counties Data source: MD OPCRH/DHMH, 5/2003 MSFW Analysis - Maryland

32. CHC Grantee Sites Coverage Data source: MD OPCRH/DHMH, 5/2003 MSFW Analysis - Maryland

33. MHC Grantee Service Coverage We estimate that over 67% of the MSFW population lives or works within 15 miles of the 11 MHC grantee sites. MSFW Analysis - Maryland

34. MHC Grantee Sites and MSFW Population Data sources: MD OPCRH/DHMH, 5/2003; MSFW Enumeration Profiles Study – MD, Larson, 9/2000 MSFW Analysis - Maryland

35. MHC Grantee Site Coverage of MSFW Population Data sources: MD OPCRH/DHMH, 5/2003; MSFW Enumeration Profiles Study – MD, Larson, 9/2000 MSFW Analysis - Maryland

36. MHC Grantee Service Penetration The seven MHC grantees provided services to 2,009 users 1 during 2001, which represents 21% of the estimated statewide MSFW population. The estimated MSFW population in the counties where the grantees provided health services is 5,341 2. The reported users represent over 37% penetration of this population. 1 UDS Reports - 2001, BPHC 2 MSFW Enumeration Profiles Study – MD, Larson, 9/2000 MSFW Analysis - Maryland

37. CHC Grantee Service to MSFW Population No CHC grantees report providing services to farmworkers or their families. We estimate that over 80% of the MSFW population lives or works within 15 miles of an MHC or CHC grantee site. MSFW Analysis - Maryland

38. MHC & CHC Grantee Sites and MSFW Population Data sources: MD OPCRH/DHMH, 5/2003; MSFW Enumeration Profiles Study – MD, Larson, 9/2000 MSFW Analysis - Maryland

39. MHC & CHC Grantee Coverage of MSFW Population Data sources: MD OPCRH/DHMH, 5/2003; MSFW Enumeration Profiles Study – MD, Larson, 9/2000 MSFW Analysis - Maryland

40. National Center for Farmworker Health

41. Garrett Allegany Washington Frederick Howard Carroll Baltimore Hartford Cecil Montgomery Kent Calvert Anne Arundel Prince Georges Charles St Mary Queen Annes Caroline Talbot Dorchester Womico Somerset Worcester Baltimore City MSFW Analysis - Maryland