1. MIGRANT HEALTH CENTER ADVOCACY 101 Tools for engaging and empowering your farmworker patient populations in the issues that affect them.

2. WHAT ARE FEDERALLY QUALIFIED HEALTH CENTERS AND WHY ARE THEY IMPORTANT?

3. KEY CHARACTERISTICS OF HEALTH CENTERS Health Centers, aka Federally Qualified Health Centers (FQHCs) Not-for-profit Provide a wide variety of services needed in the community Located in or serve a high need community Directed by the community (51% must be patients) Treat patients regardless of ability to pay Sourece: NACHC http://www.healthcenterweek.com/client/America's%20Health%20Centers%20March%202014.pdfhttp://www.healthcenterweek.com/client/America's%20Health%20Centers%20March%202014.pdf

4. WHO ARE HEALTH CENTER PATIENTS? Health Centers are the health care home for 24 million Americans 1 of 7 of the uninsured –1 of 5 the uninsured with low incomes 1 of 7 of those on Medicaid 1 of 3 of those living in poverty –1 of 4 of minorities living in poverty 1 of 7 of people living in rural areas 1 of 3 (or 923,400) of farmworkers 1 of 3 (1.1 million) of the homeless Source: NACHC http://www.healthcenterweek.com/client/America's%20Health%20Centers%20March%202014.pdfhttp://www.healthcenterweek.com/client/America's%20Health%20Centers%20March%202014.pdf

5. WHY SUPPORT HEALTH CENTERS? VALUE Health Centers save over $1,200 per patient annually. 99% of surveyed patients report that they are satisfied with the care they receive. JOBS In 2012, Health Centers employed more than 160,000 full-time employees. LOCAL Health Centers are locally-owned and directed by patient majority boards. MONEY Nationwide, there are many more applications for Health Center funding every year than there are grants available – there's still a need for more Health Centers! Source: NACHC http://www.healthcenterweek.com/client/America's%20Health%20Centers%20March%202014.pdfhttp://www.healthcenterweek.com/client/America's%20Health%20Centers%20March%202014.pdf

6. AMERICA’S VOICE FOR COMMUNITY HEALTH CARE National Association of Community Health Centers Mission: To promote the provision of high quality, comprehensive and affordable health care that is coordinated, culturally and linguistically competent, and community directed for all medically underserved people. Learn more about NACHC: www.NACHC.orgwww.NACHC.org

7. CFAHC, A PROJECT OF NACHC Campaign For America’s Health Centers Mission: To do everything we can to stop threats to health centers and health center patients! We want to provide a way for every health center, every patient and every community that has or needs a health center to act to preserve, strengthen and expand America’s Health Centers. Join us! http://www.saveourchcs.org/join-the-campaign.cfm http://www.saveourchcs.org/join-the-campaign.cfm

8. A strong history HEALTH CENTERS AND FARMWORKERS

9. MIGRANT HEALTH CENTERS HAVE SERVED FARMWORKERS FOR OVER 50 YEARS Migrant Health Centers (MHCs) have been serving farmworkers for over 50 years. President Kennedy began the MHC program in 1962 via the Migrant Health Act. MHCs serve about a third of this country’s farmworkers. There are currently 165 MHCs serving farmworkers through over 700 sites. http://www.ncfh.org/?pid=6 hrsa.gov http://i.usatoday.net/news/_photos/2012/06/06/Fear-keeps-migrants-from-getting-health- care-8H1KAFG5-x-large.jpg

10. http://1.bp.blogspot.com/- SmL2yuy8I9A/Tlfcw75hMnI/AAAAAAAAACA/acSbTvrHBkw/s1600/DSC04018.JPG THE NUMBER OF FARMWORKER PATIENTS IN HEALTH CENTERS HAS INCREASED STEADILY

11. FARMWORKERS FACE MANY BARRIERS, INCLUDING... 1.Access to health care including health insurance and providers 2.Immigration concerns 3.Agricultural law and workplace safety standards 4.And many more!

12. HEALTH CENTERS AND FARMWORKERS CAN SUPPORT EACH OTHER IN THEIR ADVOCACY Farmworkers are an important part of the Health Center patient population and mission. They represent one of the most important reasons for the existence of Health Centers. Advocates for Health Centers can and DO improve access to care. Sometimes, we have to fight for what we need. http://www.ncfh.org/?pid=6 Advocates Patients $$ Funding

13. HOW CAN YOU ACHIEVE YOUR ADVOCACY GOALS AT YOUR MHC?

14. FIRST, IT’S IMPORTANT TO STAY INFORMED... It’s easy! www.saveourchcs.org Facebook.com/ cfahc @CFAHC #FQHC TEXT HEALTHCENTER to 69866

15. ... AND THEN YOU HAVE TO TAKE ACTION. Share something on FB or Twitter, forward an email Sign a petition Send an email to a Member of Congress Call a Member of Congress Organize an event (and invite elected officials) You always have to spread the word.

16. WE NEED TO ADVOCATE TO AFFECT POLICY Policy decisions do not happen in a vacuum. Health policy is about people – tell your MHC’s stories to get buy-in from policy makers. Advocacy is not just lobbying. You have to get policymakers to pay attention and get legislators to vote for your MHC. Legislative decisions ALWAYS involve politics. What good is perfect policy that never becomes law?

17. EFFECTIVE ADVOCACY REQUIRES ACTION Simply discussing issues, challenges, and plans is NOT effective advocacy. To be an effective advocate and attain your goals you MUST... –make advocacy an ongoing commitment and priority. –translate discussions, plans, and passions into moveable actions. –make your voice and perspective heard and understood.

18. EFFECTIVE ADVOCACY IS POWER Power is NOT measured by the number of advocates on a list. Power is NOT measured by the number of small (or even large) victories you win every now and then. Power must be measured by the ability to successfully advance your own agenda and to make it unthinkable that any other political or special interest would ever want to take you on.

19. "POWER IS GETTING PEOPLE OR GROUPS TO DO SOMETHING THEY DON'T WANT TO DO.” - Leslie H. Gelb

20. IS IT OKAY TO DO ADVOCACY AT MY MHC?

21. YES! Health Centers, their staff, and their patients can and SHOULD advocate for the issues that are important.

22. THE RULES OF MHC ADVOCACY DO Send action alerts Circulate petitions Educate elected officials Thank elected officials (not near election day) Voter registration and education Educate candidates Remind people to vote DON’T x Endorse a candidate for office x Give resources to candidates x Rate candidates on your issue x Tell people how to vote x Show like or dislike for a political party

23. SUCCESSFUL ADVOCACY REQUIRES A GOOD PLAN You must know... What you want – be specific Who your targets are – which people have the real power Who your allies and opponents are –Which people and organizations should be on your side? –Who will actively try to stop you? Why? What you want from your allies and what they will want from you

24. ESTABLISH WHAT WORKS AT YOUR MHC AND IN YOUR COMMUNITY Essentials For Empowering Your Farmworker Patients Through Advocacy: –Stay informed- provide board members, staff, patients, and community partners regular updates and reports on what’s happening in D.C. and your state capital and how it could affect their MHC. –Make a commitment: make advocacy a standing item on the agenda at every board meeting. –Recognition- publicly recognize and thank both officials and Health Center Advocates who sign up for our advocacy network and who take effective action.sign up for our advocacy network –Patient Involvement- don’t be afraid to include your patients! Find ways to involve patients in as many advocacy activities as possible.

25. Your level of commitment is directly related to your ability to make an impact. You must demonstrate personal commitment to your issues if you expect to receive the support and commitment of your officials and community members.

26. BEST PRACTICES FOR CULTURALY COMPETENT ADVOCACY

27. CONSIDER THE ISSUES YOU WANT TO EXPLORE Federal – advocate for Health Center funding and other federal issues via the Campaign for America’s Health Centers. State – connect with your state’s primary care association (PCA) to join with other Health Centers in your state Local – think about any issues affecting your patients related to parks and recreation, public transportation, law enforcement, and more. Other – combat myths circulating among your patient population or work with a local employer to improve its treatment of your farmworker patients.

28. CONSIDER THE CHARACTERISTICS OF YOUR COMMUNITY AND FARMWORKER POPULATION Immigration status Comfort with technology Isolation, spread, and migration pattern Political environment Language and dialect

29. CONSIDER THE BEST METHOD TO ENGAGE YOUR FAMROWKER PATIENTS Communication tool – Should you take advantage of technology? Text or email? Or should you spread the word via word-of-mouth, fliers, or posters? Message – Do you need to be wary of a lack of trust among your farmworker community? Should you reinforce the urgency of an issue? Language – What is the most widely spoken language among your farmworkers? Is there a particular dialect they tend to speak? Action step – What would your farmworkers be comfortable doing to get involved?

30. OUR SUCCESS (AND FUTURE) WILL DEPEND ON THE STRENGTH OF ADVOCACY! Advocacy cannot just be a clinical or social work act for individual patients, to succeed it MUST be a responsibility of leaders for their communities!