Aug, 21, 2020

Essential Workers in Challenging Environments: How States Are Working to Protect Farmworkers

Marissa Korn and Sonia Pandit, State Health and Value Strategies

While efforts to reduce the spread of COVID-19 have been difficult in all environments, the conditions for those working in agricultural production raise additional challenges. Migrant and seasonal farmworkers, many of whom travel as crops ripen throughout the spring and summer, live and work under conditions that even before COVID-19 posed risks to their safety and wellbeing.  

Research conducted by the Michigan Farmworker Project points to a number of factors that place farmworkers at a higher risk for COVID-19. Many agricultural workers have limited or no access to health care and work irregular hours that make it challenging to obtain care. Those working on farms may also lack easy access to clean restrooms as well as water and soap for handwashing. Additionally, many agricultural workers are unable to physically isolate, working during the day in crowded spaces such as crop packing plants and living at night in densely packed labor camp housing with shared bedrooms and bathrooms. These risks also raise key health equity concerns, as 83 percent of the farmworker population is Hispanic – a population that has been hospitalized by COVID-19 at higher rates than white Americans. Many farmworkers are also undocumented and lack the formal legal protections enjoyed by most workers, further threatening their safety.

Yet in the context of these elevated risks, farmworkers continue to support the U.S. food supply chain. In March, the federal government designated farmworkers as essential workers, emphasizing that they play a critical role in supporting the country’s infrastructure and that they have a duty to maintain their normal work schedules. Policymakers have therefore grappled with how to protect workers who are instrumental to maintaining Americans’ food security but whose work environment makes them particularly vulnerable to COVID-19. While the Centers for Disease Control and U.S. Department of Labor released guidance for agricultural workers and employers, states have taken a range of different approaches to protect farmworkers in the context of these unprecedented challenges.

This expert perspective will examine these approaches, providing a survey of state and local policies and outlining some key themes and recommendations for policymakers as they work to support agricultural workers and stem the spread of COVID-19.

Actions Taken by States and Municipalities

Issuing Guidance for Agricultural Employers to Implement Safety Measures

Michigan: On June 1, the Governor of Michigan released an executive order establishing temporary new requirements related to working and housing conditions for migrant and seasonal agricultural workers. The executive order requires all owners and operators of employer-provided migrant housing camps to provide camp residents with the same protections that employees in work settings receive. The state is also requiring camp owners and operators to provide separate housing, dining, and bathroom facilities for COVID-19 confirmed residents, ensure that relevant employees have proper personal protective equipment (PPE), and arrange for residents suspected of being infected with COVID-19 to be evaluated by a medical professional through the local health department or Federally Qualified Health Center. On August 3, Michigan Department of Health and Human Services (MDHHS) Director Robert Gordon issued an Emergency Order requiring COVID-19 testing for agricultural and food processing employees. Employers and housing operators must complete a plan by August 10 for how they will conduct testing in compliance with the order, which includes one-time baseline testing and testing for new workers prior to any in-person work. Completion of baseline testing and implementation of ongoing testing is required no later than August 24. MDHHS also released a guidance document for employers providing step-by-step information on how employers can complete testing and highlighting resources like grant funding and insurance coverage through Medicaid that can provide financial support for testing.

New Jersey: In partnership with the New Jersey Department of Agriculture and the New Jersey Department of Labor and Workforce Development, the state’s Department of Health issued interim guidance for migrant and seasonal farmworkers, their employers, and housing providers. The guidance outlines best practices to maintain the health and safety of farmworkers in areas ranging from transportation to protective equipment access to housing. The state is also partnering with Federally Qualified Health Centers to improve access to care, although some farms and growers have opted not to participate, as compliance is not mandated. The guidance also calls for employer collaboration with state agencies to identify culturally, linguistically, and literacy-level appropriate posters and education materials for workers and emphasizes that COVID-19 testing and treatment costs will not be charged to the employer or worker.     

Washington: The Governor of Washington issued a proclamation requiring agricultural employers to comply with new requirements focused on improving the safety of farmworkers. These requirements include daily employee temperature checks, ensuring timely access to COVID-19 tests for symptomatic employees with transportation provided, and the implementation of physical distancing plans for indoor worksites. It also requires agricultural employers to test their workforce broadly when health officials identify an outbreak that passes certain thresholds. The proclamation prohibits agricultural employers from continuing to operate unless they comply with all provisions in the requirements.  

Wisconsin The Governor of Wisconsin issued an emergency order outlining additional safety measures with which employers at migrant labor camps must comply. These safety measures, which are enforceable by local law enforcement, include disinfecting high-touch areas daily, separate transportation and living arrangements for workers exhibiting COVID-19 symptoms, and informational posting requirements in English and any other language spoken by camp occupants.

Partnering with Community-Based Organizations and Directing Resources to At-Risk Communities

Oregon: The state of Oregon has worked to prioritize farmworker safety by directing approximately one million KN95 masks and 5,000 gallons of hand sanitizer to farmworkers and agricultural producers. In addition, Oregon is funding outreach and education by providing grants to community-based organizations with experience working with migrant and seasonal farm workers. The state has also allocated $10 million for a Quarantine Fund to help workers take the time needed to seek care and recover safely. Additionally, in May, the Oregon Health Authority and the Oregon Occupational Health and Safety Division released guidance for agricultural businesses in the state outlining COVID-19 prevention measures focused on employment, housing, and transportation settings. The guidance emphasizes workers’ rights to a safe work environment and that employers cannot retaliate against workers who report workplace health concerns.

Texas: Texas proactively connected families in the agricultural sector to the Medicaid program, which is now acting as a lifeline to families impacted by the pandemic. Through Medicaid managed care organization performance metrics, the state of Texas incentivizes Medicaid health and dental plans to engage in effective outreach to children of migrant farmers. The state evaluates plans based on their collaboration efforts with community-based organizations serving migrant farm workers, as well as their outreach and identification strategies.  

Immokalee, Florida: The Collier County Department of Health partnered with Doctors without Borders /Médecins Sans Frontières (MSF), the Braden Clinic, the Healthcare Network of Southwest Florida, and the Coalition of Immokalee Workers to expand testing access and implement a public education campaign for members of Florida’s largest farmworker community. Officials established free mobile testing clinics to bring care directly to the community and increased testing availability by adding evenings and weekends to accommodate agricultural workers’ unpredictable and demanding work schedules. In addition to selecting accessible locations within the community, the clinics offered services in English, Spanish, and Haitian Creole. To aid their public education efforts, health promoters interfaced directly with the community to provide public health information on reducing community transmission. Officials emphasized the importance of public education efforts, given that many workers eventually migrate north and travel into other regions in the country.

Key Considerations

The above scan of actions taken by state and local governments emphasize the importance of clear employer guidance, community partnerships, and tailored outreach. Below are some key considerations that are present in state and local policies focused on supporting farmworkers and sustaining food supply chains.

Provide tailored and culturally appropriate educational materials to farmworkers in both work and living settings. Public education content should employ national culturally and linguistically appropriate services (CLAS) standards, as emphasized in New Jersey’s guidance. Outreach materials should also reject victim blaming and stigmatizing suggestions that infection rates are somehow linked to poor hygiene. Additionally, given that many farmworkers are undocumented or live in mixed-status families, materials should proactively address workers’ concerns around immigration status by emphasizing that information gathered will not be used for immigration enforcement purposes. (xanax)

Expand testing and treatment access by considering barriers due to language, transportation issues, and long workdays. Extend clinic hours to evenings and weekends to accommodate agricultural workers’ long workdays, as done in Immokalee, Florida. Additionally, encourage the selection of convenient, walkable locations within the community and ensure that testing center staff speak the language spoken by those being served.

Strive for effective implementation of safety measures by mandating employer compliance. Rather than providing guidance, states or municipalities can use local law enforcement, fines, or closure threats to encourage farms to implement safety measures and protect workers, as done by Wisconsin and Washington. There could also be opportunities to build relationships with farm owners. An outbreak impacts a farm’s bottom line, which may incentivize farms to prioritize safety measures.    

Encourage partnerships with local actors to build trust and expand access to care. Encouraging agricultural employers to partner with local health departments, community-based organizations, and Federally Qualified Health Centers to provide care and conduct outreach can expand access to care in trusted and safe settings. Oregon, Michigan, and Immokalee have emphasized the importance of partnerships with local actors to achieve such goals.