North Carolina is home to more than 150,000 farmworkers — but only one in five have healthcare. Cirlo Castillo is one of them.
Castillo is in the middle of his 24th season at Hart-T-Tree Farms near the Virginia border. As farm manager, he looks after the trees and the other workers. He’s participating in a new healthcare program between the farm owners and a local healthcare practice in Ashe County.
“To be part of the program is to know what one has, to know if I am really sick or have some sort of illness and to know what I need to be healthy,” Castillo said.
The farm covers the $55 membership fee for all of the workers at the farm to join Elevation Health, the local primary care practice. Now in its second year, the partnership grants the workers, who are mostly from Mexico and working in North Carolina on temporary visas, something rare: access to regular healthcare.
Carrie McClain owns and operates Hart-T-Tree Farms.
“I've always been trying to figure out how we as a small business can offer healthcare to people,” McClain said.
Migrant farmworkers can purchase their own healthcare, but for many, navigating the complex system in the United States is nearly impossible. Approximately 85% of farmworkers in the U.S. have no health insurance.
In the past, Castillo and other workers went to the local urgent care or hospital when they got hurt. With no regular appointments, they only saw a doctor when it was absolutely necessary. Communication could be difficult, as many of the workers only speak Spanish, and McClain wanted something more personal.
“I just really wanted a partner which we could call when there were issues that came up with these guys,” McClain said. “They don't know who to go to either.”
Maggi Birdsell, the co-founder and dietician at Elevation Health, and others from the practice visited the farm when the program started last year to talk to the workers about their services and preventative care. They also did new patent intake and blood work for workers who wanted to join.
“Care can happen– doesn't have to happen within our four walls,” Birdsell said.
There are 29 workers on the farm this season. 17 are signed up. McClain and her husband, Jeff, decided to join them.
“[We joined] to have our own personal experience of what it's like as a patient, so that we can know from our own experience, not just what guys are saying,” Jeff McClain said.
Castillo said he’s noticed a difference in the kind of care he receives at Elevation Health.
“It’s a lot better to have the clinic,” Castillo said. “I can trust the clinic and it’s a lot better because if someone goes to the hospital, it’s not the same, and here, the people are very kind and they take very good care of you.”
Raul, who is from Mexico, has been working on the farm for three seasons. This is his first with healthcare.
“Us as workers we almost never go to a doctor,” Raul said. “When the clinic came in, it made it a lot easier to go there or to let them know that something is bothering us. They give us medicine and they check what it is we have.”
The Charlotte-based Camino Research Institute reported last month that Latinos across the state experience significant barriers to health care, and access to preventative services and Spanish-speaking doctors is an urgent need.
Elevation Health’s practitioners rely on interpreters for their Spanish-speaking patients, but they still deal with communication issues and other challenges.
“The difference is you have two parties willing to work through them to find us a small solution for our scenario,” Birdsell said.
The McClains are committed to funding Raul and the others’ memberships. They also cover any additional costs like labs or other tests.
Funding for this partnership originally came from a USDA grant. It was frozen, and then unfrozen earlier this year. The McClains aren’t sure if the grant will be renewed, but they plan to continue the partnership either way.
“Overall, the cost of participating in this healthcare program is less than like a payroll for us,” McClain said. “So I think it's worth it.”
One year in and looking forward to his annual physical, Raul feels more secure in his overall well-being.
“I consider it to be something very good for us, for the workers, that they are concerned about our health so that we can be healthy.”
Raul, Castillo and the rest of the workers at Hart-T-Tree Farms can count themselves as some of the rare one in five farmworkers with healthcare. For the hundreds of thousands of other workers on North Carolina farms, access to preventative care, Spanish-speaking doctors and widespread care remains a work in progress.
“We believe every person, regardless of where they're coming from, should have access to good quality healthcare,” Birsdell said.
