Health In Action: The Community Health Worker Program for the Open Door Clinic, Middlebury, Vermont Open Access

Conlon, Kelsey Thomas (2015)

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Due to the passing of the Affordable Care Act (ACA), there are more options for health insurance for all residents and citizens of the United States, but the ACA does not provide insurance options for the undocumented people in the United States, leaving over 9 million undocumented Latinos involuntarily uninsured. Furthermore, with the growing need for workers in the agriculture industry, undocumented Latino workers are starting to populate areas where they have never lived before. Vermont, because of its huge dairy industry has become one of the new destinations for undocumented farm workers. Because of the lack of diversity in Vermont and its proximity to Canadian border patrol, the undocumented population suffers from unique barriers to care. The Open Door Clinic, a free clinic in Middlebury that serves all of Addison Country, Vermont, serves as a health clinic for the uninsured population in southern Vermont. With this influx of new undocumented workers and a new trend of these workers remaining longer in Vermont, the Open Door Clinic has slowly transformed into a makeshift medical home for many Latinos in this area. With this change in its community role, Open Door sought to change programing to establish stronger relationships between the Latino population and local communities to facilitate preventive health behaviors and access to medical care. Using Middlebury College students and prominent Latino farm worker community members, the Open Door Clinic created and implemented a Community Health Worker Program. The following document provides an overview of the literature of the barriers to health of the Vermont undocumented farm worker population, the frameworks that guided program design, the Community Health Worker training and education curriculum, the implementation strategy, and the monitoring and evaluation protocol.

Table of Contents

Abstract. 3

Background. 4

Methods. 11

Introduction to the Community Health Worker Program. 13

Assessment. 24

Limitations. 27

Conclusion. 30

Works Cited. 31

Appendix 1: Timeline. 34

Appendix 2: Log Frame. 35

Appendix 3: Health Worker Curriculum. 40

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