Family Health / La Clinica
Migrant Mobile Health
Yurany Ninco, Outreach Coordinator
Ted Kay, President & CEO
June 17, 2011
LULAC Conference - Pewaukee, WI
MISSION

Develop and deliver primary health care services and programs to
meet community health needs…(communities can be defined in
terms of special populations and/or geographic areas).

Make these accessible to all people in communities we serve

Break down barriers to care for underserved and vulnerable people,
especially Wisconsin’s migrant and seasonal farmworkers
Service Area – Mobile Unit / Other “Sites”
PINK
Mobile Unit
YELLOW
Wautoma
Barron
Columbia
Dodge
Fond du Lac
Green Lake
Jackson
Jefferson
Oconto
Outagamie
Ozaukee
Portage
St Croix
Walworth
Waushara
Portage
Waupaca
Outagamie
Winnebago
Green Lake
Marquette
Adams
Mauston
Dental Center
(SA not shown)
Adams
Juneau
Mobile Unit – Services Provided
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Health screenings
Treatment of acute illness
Medical visits
Immunizations
Mammograms (Marshfield
Mobile Mammogram Unit
limited sites)
Laboratory services
Medications
Health Education
Referrals
Voucher program
Bilingual staff
Mobile Unit – Patients 2010

Total = 737 Patients

475 men (64%)

262 women (36%)
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440 (60%) age 50 or older
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337 (46%) were returning
patients
Preventive Care
Priority Areas:
 Alcohol Consumption
 Smoking Cessation
 Screening
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Diabetes
High Blood Pressure
High Cholesterol
Colon Cancer
Protate Cancer
Cervical Cancer
Breast Cancer
HIV testing
Immunizations:
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Hepatitis B
Tdap
Pneumonia
Preventive Care - Results

Alcohol Consumption


Patient’s alcohol
consumption was
determined and for risky
behavior, education and
recommendations were
given by health aides
Smoking Status

Current smokers received
health education on risks
and information including
QUIT LINE referral and
information and QUIT
LINE Program card.
Preventive Care - Results (cont.)
Screening for Chronic Conditions
NEWLY DIAGNOSED PATIENTS

Diabetics:

Hypertensive:
11 patients
5 patients
(High Blood Pressure)
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High Cholesterol: 7 patients
Preventive Care - Results (cont.)
Cancer Screening


Colon Cancer

Target group:
Patients age 50 and older – 440 pts (60%) were eligible

Intervention:
Educate & Inform about importance of screening

Screening Test
13 patients (9.4%) received Ifob Kits (blood stool test)
Prostate Cancer

Target Group:
Male patients 50 and older – 283 pts (60%) were eligible

Intervention:
Educate & Inform about importance of screening

Screening Test:
28 patients (9.9%) received Prostate Specific Antigen test
Preventive Care – Results (cont.)
Cervical Cancer Screening

Target group
 Women ages 21 to 65
 236 women (90%) were eligible

Screening Tests Available
 Pap smear and HPV

Results
43 women (18%) had a pap smear
30 women (13%) were tested for HPV
2 pts required further exam
(colposcopy)
1 exam completed in Wisconsin
1 exam completed in Texas
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Preventive Care - Results (cont.)
Breast Cancer Screening
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Target group
 Women ages 40 to 64
 174 women (74%) were eligible
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Screening Test
 Mammogram

Results
60 (34%) completed mammogram
3 underwent follow-up biopsy
1 diagnosed with breast cancer
1 diagnosed with hyperplasia
1 pathology was benign
These were enrolled in the CAN
TRACK Program
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Preventive Care - Results (cont.)
HIV and Immunizations
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HIV:
118 patients tested - All negative
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Hepatitis B:
61 pts received 3rd dose (done)
341 pts received 1st dose
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Tdap:
218 patients received
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Pneumovax :
123 diabetic pts received
10 asthma pts received
Chronic Care
Diabetes Standard of Care


Labs
 HbA1c (once a season)
 Lipid Profile (once a season)
 Microalbumin (once a season)
 Blood Glucose (every visit)
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Medications
 Can dispense up to 3 mos.
worth of medication
 Can give prescription for up
to 1 year of medication
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Health Education
 Written info on diet and
exercise
(once a season)
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Foot Exam (once a season)
Blood Pressure Check
(every visit)
Pneumovax
Tdap
Hepatitis B
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Evaluations
 Complete Physical Exam

Immunizations
Chronic Care
Diabetes - Results
9
8
Pa
tie
nt
7
Pa
tie
nt
6
Pa
tie
nt
5
Pa
tie
nt
4
Pa
tie
nt
3
tie
nt
Pa
tie
nt
Belgium Returning Diabetic Patients
Comparison A1c 2009 vs 2010
97 (57.4%) were
returning patients
CDC Surveillance
System shows
incidence in the US
population of 7.1%
Pa
tie
nt
Pa

Patient
15
Hb A1c Level

2
2010
tie
nt
1.8% increase
from 2009
2009
Pa

14
12
10
8
6
4
2
0
1
2010 Season
169 patients (23%)
had diabetes
Hb A1c level
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Cambria Returning Diabetic patients
Comparison A1c 2009 vs 2010
10
2009
2010
5
0
patient
Chronic Care
Hypertension Standard of Care
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Labs
 Blood Glucose (once a
season)
 Blood tests as needed
Evaluations
 Complete Physical Exam
(once a season)
 Blood Pressure Check
(every visit)
Immunizations
 Tdap
 Hepatitis B

Medications
 Can dispense up to 3 mos. of
medication
 Can write prescription for up
to one year of medication

Health Education
 Written information about diet
and exercise
Chronic Care – Hypertension Results
2010 Season
279 patients
(38%) had High
Blood Pressure
250
Systolic Pressure
Reading

Be lgium Re turning Hype rte nsiv e Patie nts
Systolic Pre ssure Comparison 2009 v s 2010
200
150
2009
100
2010
50
0

2% increase
from 2009
Patient 1 Patient 2 Patient 3 Patient 4 Patient 5
Patient

169 patients
(61%) were
returning patients
Systolic Pressure
Reading
Cambria Re turning Hype rte nsiv e Patie nts
Systolic Pre ssure Comparison 2009 v s 2010
200
150
2009
100
2010
50
Patient
21
19
17
15
13
11
9
7
5
Incidence in US
population 28%
3

1
0
Chronic Care
High Cholesterol Standard of Care
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Labs
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Lipid Profile (once a season)
Blood Glucose (once a
season)
Blood Tests as needed

Medications
 Can dispense up to 6 mos. of
medication
 Can write prescription for up
to 1 year of medication

Health Education
 Written information about diet
and exercise
Evaluations
 Complete Physical Exam
(once a season)


Blood Pressure Check
(every visit)
Immunizations
 Tdap
 Hepatitis B
Chronic Care
High Cholesterol - Results

2010 Season
182 patients (25%)
had High
Cholesterol
Non-HDL Level
Cambria Returning Patients with
Hyperlipidemia Non-HDL Comparison 2009 vs
2010
200
150
2009
100
2010
50
0
Patient 1
Patient 2
Patient 3
Patient


3% increase from
2009
57% were returning
patients
Incidence in US
pop. is 36%
Fairw ater Returning Patients w ith Hyperlipidem ia Non-HDL
Com parison 2009 vs 2010
Non- HDL Level

250
200
150
100
50
0
2009
2010
Patient Patient Patient Patient Patient Patient Patient
1
2
3
4
5
6
7
Patient
Challenges
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Mental Health
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Tuberculosis
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Continuity of Care
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Health Education
Thank You!
Questions?
CONTACT
Yurany Vanessa Ninco Sanchez
Outreach Coordinator
400 S. Townline Rd.
P.O Box 1440
Wautoma, WI 54982
Phone 920-787-5514 Ext 207
yurany@famhealth.com