Elva Salinas knows firsthand the struggles of farm workers in Yamhill County. She was once one of them.
Her father packed up the family from their home in South Texas when she was 12 and moved them to Oregon to live in a migrant camp and make a living picking strawberries. The family later moved into a house in Yamhill County, but didn’t forget their community: her parents took blankets and food to those still languishing in the camps.
As an adult, Salinas has gotten paid to do some of the same kind of community health work that her parents did out of kindness. She worked for 10 years as an outreach worker at the Virginia Garcia Clinic in McMinnville, linking up migrant workers with that critical access clinic. Now she’s doing the same for a brand-new clinic that opened this winter in Newberg, 13 miles away.
Salinas finds new patients at nurseries and labor camps and recently accompanied a mobile medical clinic that went directly into a migrant labor camp near Cornelius in Washington County. Medical practitioners were available for basic medical needs and referrals, and an optometrist van checked people’s eyesight. Salinas distributed gift packs with hygiene products to farm workers who were tired and sweaty from long days in the fields.
The mobile unit can help farm workers get a foothold on healthcare access, but many people need brick-and-mortar clinics, and the addition of Newberg helps fill a gap in eastern Yamhill County.
“I came out of retirement for this position,” Salinas said. “I used to transport people from Newberg to the McMinnville clinic, and now it’s walking distance.”
The new clinic, a federally qualified health center, is focused on closing gaps in care for uninsured people and those with the Oregon Health Plan. Sixty-five of Virginia Garcia’s patients identify as Hispanic; 30 percent are Anglo, with African-Americans and Asian-Americans at 2 percent each.
“We are seeing patients who haven’t been seen for five years,” said Dr. Sandra Warner, who communicates with her Spanish-speaking patients with the help of her native Portuguese.
The clinic network was borne of tragedy in Oregon’s Latino community. Virginia Garcia was a 6-year-old girl, the daughter of migrant workers, who came here in 1975 from Texas only to die after a cut to her foot became infected and spread through her bloodstream. A simple wound killed her when her parents couldn’t gain access to healthcare.
Salinas grew up in Edinburg, Texas, just 16 miles from Virginia’s border hometown of Mission.
Virginia’s death became the inspiration for the first Virginia Garcia clinic in Cornelius, and the name has carried over to several others in Washington and Yamhill counties over five decades, this year with Newberg.
The new clinic, which was given seed money in a 2013 federal grant, turned an old Jazzercize studio in east Newberg into an immaculate 6,300 square-foot medical office with comforting blue pastel walls. The clinic started slow to meet the fast timeline set by the federal government, serving just a few hundred patients so far. But Virginia Garcia has plans to handle 2,400 patients to meet the demands of the Medicaid expansion, while still reaching out to the uninsured, regardless of immigration status.
“It’ll make it much easier on our members, particularly if they live in Newberg,” said Dr. Jim Rickards, the spokesman for the Yamhill Coordinated Care Organization. “Their efforts are very much in line with the Yamhill CCO.”
The clinic is conveniently located in the same building as Yamhill County Services, including a WIC office and a mental health office.
Chief Executive Officer Gil Munoz said the Newberg clinic will have one full medical team -- a physician, a nurse practitioner, two nurses, a psychologist, three nurses’ aide and the outreach worker. The other clinics under the Virginia Garcia umbrella are generally larger; the McMinnville clinic has four or five medical teams. The clinic also plans to open a dental office in July, with a dentist and part-time dental hygienist.
So far, the clinic has relied on temporary providers, which currently include Warner, a native of Brazil, and nurse practitioner Sheila Smith, who came to Oregon from the Texas border area. Munoz said they had landed a permanent physician who will start this summer.
“It’s been challenging but we have succeeded in recruiting the physician, and we feel confident that we will have a mid-level provider shortly,” said Munoz. Providers practicing in Newberg would qualify for certain tax credits aimed at rural health access.
Other Newberg clinics that accept Oregon Health Plan patients include a Providence clinic, Villa Medical Clinic and some stand-alone doctor’s offices. Munoz said Virginia Garcia is the only one focused specifically on underserved populations; 64 percent of the network’s patients are Oregon Health Plan members enrolled in coordinated care organizations. About 25 percent remain uninsured and pay on a sliding scale. Only 11 percent have Medicare or private insurance.
Smith and Warner said that Virginia Garcia had the model of care they strived for as they sought more permanent positions. “It’s a better standard of care than a private office often because of the team-based model,” said Smith, who credited having a bachelor’s-level registered nurse on staff to greatly improve the health outcomes of their patients.
Rickards said Yamhill was in the process of transitioning to a global payment model for primary care, a move that would align it with transformations at more established CCOs. Many of its providers are still paid per office visit and procedure, but by making global payments per member, he believes that some providers may be able to expand access and adopt a team-based model like at Virginia Garcia.
Chris can be reached at [email protected].
