FORT LUPTON, Colo. -- Colorado's community health centers have had to shift gears during the coronavirus pandemic to ensure migrant workers, who harvest the food for dinner tables across the nation, have access to health care.

In addition to increased on-site checkups and distributing Personal Protective Equipment, Deborah Salazar, migrant health director with Salud Family Health Centers, said telehealth services have been critical for workers out in the fields from sunrise to sunset on the state's eastern plains.

"And so for them to actually have to take off time to go somewhere to wait for the doctor, to get into the visit, and then go back somewhere - and especially if transportation is an issue - this is perfect for them," Salazar said.

Many migrant workers were slow to seek care, even when they had COVID-related symptoms, because they couldn't afford not to work. When workers became eligible for paid sick leave after the state issued a guidance that would compensate employers with tax credits, health center staff played a big role helping employers implement the policy.

Dante Gonzales, director of program operations at Valley-Wide Health Systems, said relationships built over the years with community leaders trusted by workers in the San Luis Valley was key for connecting workers with care during the health crisis. He said from March through August, health center staff were able to bump up their outreach efforts by nearly 50% over the same time period in the previous year.

"While people were running away, locking themselves up, this team has just stepped up, went out there, partnered with the community, and made sure that we were doing our best to still give access and touch base with all these individuals that need to be assessed," Gonzales said.

Salazar said the integrated health care model pioneered by Federally Qualified Health Centers, which puts medical, mental and dental care under the same roof, continues to put providers in a good position to meet shifting needs.

"Access to behavioral health right now is as important as the medical side of things, because people are scared," Salazar said. "Having access to that behavioral health piece, for the general population as well as the agricultural workers, is really important."

Additional information and guidance from the state for agricultural workers navigating the pandemic is available at COVID19.colorado.gov.


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As part of World AIDS Day, a report finds through treatment, patients are able to suppress HIV - the virus that causes AIDS.

According to data from the Ryan White HIV/AIDS Program, in New York, almost 89% of people receiving medical care are virally suppressed.

While this is a little lower than the national average of 89.7%, it's an improvement since the disease reached its peak.

Dr. Laura Cheever - associate administrator of the HIV/AIDS Bureau at the federal Health Resources and Services Administration - described what makes viral suppression so important in fighting HIV/AIDS.

"We do not have a cure for HIV or a vaccine, but we have all the tools we need to end the HIV epidemic in the United States," said Cheever. "For someone who gets tested and started on medication and takes them every day, they can achieve what we call viral suppression - which means they're not cured, but we can't measure the virus in their body."

With viral suppression, a person with HIV can live a near-normal life and cannot transmit the disease sexually.

Cheever said one of the most important points about the disease is that anyone can get it - so anyone who is sexually active should be tested for HIV regularly.

And despite the major developments made in treating HIV/AIDS, there's still plenty of work to be done.

Cheever said she finds some of that work is getting people who test positive for HIV started on medical treatment - which means getting more people tested is a top priority.

"The work that's really in front of us is, first, getting people tested," said Cheever. "As I've said, one in eight people with HIV in this country don't know they have it, because they haven't been tested. For people that are tested and do not have HIV infections but are at high risk for acquiring it, they can be started on PrEP, pre-exposure prophylaxis."

She added that stigmas about HIV and AIDS persist, one of which is homophobia.

But with new treatment options available, people with HIV can live long and healthy lives.

Not everybody gets a holiday break, especially caregivers, but advocates of paid family medical leave in Maine say momentum is building for a plan to pass in the upcoming legislative session.

With Democrats in charge at the Statehouse and a ballot initiative which has already gained nearly 70,000 signatures, Mainers could get up to 16 weeks of paid medical leave a year.

Bridget Quinn, associate state director of advocacy and outreach for AARP Maine, said the pandemic exposed the difficulties many Americans face when a medical emergency strikes.

"Caring for a loved one shouldn't mean losing pay and risking your financial security, or even your job," Quinn asserted. "You should be able to do both and care for a loved one, while being able to remain in the workforce."

Maine has the oldest overall population of any state in the U.S. Quinn said by supporting caregivers, more Mainers can age in place and reduce reliance on taxpayer-funded long-term care facilities.

Studies show working women continue to do the majority of caretaking, whether for a new baby, a sick child or elderly parents, providing 20 hours of unpaid care a week, on average. Three-quarters of working mothers with low incomes report losing pay when they miss work to care for family.

Quinn pointed out the lack of a statewide paid leave plan can create greater financial hardships for women down the road, or cause them to simply leave the workforce.

"That can be time that you're not contributing to programs like Social Security, or benefiting from a retirement savings plan that maybe your employer could have," Quinn noted.

If approved, Maine would join 11 states and the District of Columbia offering paid family and medical leave, funded through a combination of employer and employee payroll taxes.

Maine lawmakers approved a bill last year creating a commission to study the issue, which is expected to release its recommendations next month.

Oregon nurses are urging state lawmakers to make hospitals better and safer places to work.

With the 2023 legislative session just around the corner, the Oregon Nurses Association is calling for changes to ensure minimum staffing standards based on patient numbers and accountability for hospitals so there are enough nurses on the floor.

Matt Calzia, director of nursing practice and professional development for the Oregon Nurses Association, said the lack of staffing has real implications for patients. For instance, if a nurse goes on break for lunch, another nurse assumes care of their patients, doubling the other nurse's workload during that time.

"So when you've just had knee surgery and if that period of time falls when you need your next pain medication dose, it may be delayed because right now your nurse actually has eight patients instead of four," Calzia explained.

Calzia pointed out turnover is higher now than during the Delta wave of the pandemic because nurses are burned out. According to the union, turnover was 2% in 2021.

Sean Kolmer, senior vice president of policy and strategy for the Oregon Association of Hospitals and Health Systems, countered under the union's proposal, "community hospitals will have no choice but to reduce access to services if they are unable to hire enough staff" and argued there is a staffing shortage in the state.

Paige Spence, director of government relations for the Oregon Nurses Association, said along with minimum safe staffing requirements, the union proposal would ensure Oregon's current staffing law is enforceable and provide accountability when nurses make complaints. In addition, Spence emphasized an annual review of the staffing plan would include the number of missed meal and rest breaks over the past year.

"To ensure that the staffing levels going forward are robust enough to accommodate nurses' abilities to take the rest break which they need for sanity and physical well-being, and also are entitled to by law," Spence stated.

Calzia refuted claims the state has a shortage of nurses.

"It's not a pipeline issue; it's a turnover issue," Calzia stressed. "You have more nurses leaving the bedside than you can get in, and then you're just burning through them."