Community Health Center: Migrant Health Services, Inc. | Grafton, North Dakota

Contact: Belinda Morin, Office Manager

Every year HOP presents the Sister Cecilia B. Abhold Award to three organizations demonstrating excellence in health outreach services to migrant and seasonal farmworkers. This year HOP was excited to present Migrant Health Services, Inc., (MHSI) the Sister Cecilia B. Abhold Award for the Midwestern Stream at the 2013 Midwest Stream Farmworker Health Forum in South Padre Island, Texas.

Five years ago, MHSI established a Patient Assistance Program (PAP) so farmworkers have access to medication that would otherwise be unaffordable. Through the PAP, MHSI works with 14 different pharmaceutical companies to provide farmworkers with medications at little to no cost. As of November 2013, there were 51 patients enrolled in the program with 40-45 patients actively participating.

Roughly 90% of patients of the patients participating in the program are migrants who leave the area for two to three months at a time. The PAP allows the clinic to dispense three months worth of medication to patients at once. This makes it easier for the patient to manage their illnesses and not disrupt treatment if they leave the area for work. Some of the most common diagnoses that are seen among the patients enrolled in the PAP are asthma, diabetes, high cholesterol and hypertension.

Eligibility for the PAP is determined by income. MHSI staff work with patients to ensure that they are eligible and help them complete the application. The application process is different for each company. On average it usually takes between 15 to 20 minutes to enroll a new patient. Most enrollments are done online and a verification form is sent via fax. Once a patient is enrolled into the program, they receive a three-month supply of medication per the provider’s orders. The medication arrives at the clinic and is given to the patient at their next visit. Patients not eligible for the PAP may be eligible to receive a $100 voucher provided by MHSI to assist in the purchase of medication.

The PAP requires significant attention to detail. A single patient might receive medications from multiple companies and the medications may all arrive at different times. MHSI has created a highly organized tracking system. This allows the staff to monitor rolling deadlines and keep track of which company is providing each medication. The staff makes sure to prepare renewal paperwork for patients so it is ready by the time the patient comes in for their next appointment.

Each staff person plays an important role in keeping the system organized and ensuring the program runs smoothly. The front desk staff assists with patient enrollment. Clinic staff contacts patients if they are due to come in to see the provider and pick up their medication. The nurses handle and organize the medication once it arrives and order refills once the patients have come in for their appointment.

The PAP has many advantages. Specifically, the clinic staff can monitor how well patients are doing with medication compliance and management of their health conditions. Because patients are required to appear every three months for a new supply, providers can address any issues and adjust medications and dosages as needed. In addition, many patients have big families and the PAP reduces the patient’s financial burden. The program provides a great opportunity for the healthcare team to provide reminders and health education to patients on a consistent basis. Many patients have expressed their gratitude for the program and help spread the word so that their co-workers, friends and family enroll as well.

This publication was made possible by grant number U30CS09743 from the Health Resources and Services Administration, Bureau of Primary Health Care. Its contents are solely the responsibility of the authors and do not necessarily represent the official views of HRSA