'I'M DEVASTATED.' TRUMP ADMINISTRATION GUTS MILLIONS FROM HEALTH PROGRAMS IN FRESNO COUNTY

Danielle Bergstrom, Fresnoland

This story was originally published by Fresnoland, a nonprofit news organization.

PHOTO CREDIT: WIX

Fresno County officials notified nearly a dozen nonprofits this week that $11 million in federal grants for community health have been canceled, according to a county memo acquired by Fresnoland.

The immediate cuts – effective March 24 – are a result of the Trump Administration’s move this week to cancel more than $12 billion in funding to the Centers for Disease Control and Prevention. 

Across Fresno County, a nascent network of about 120 community health workers for rural communities, farmworkers, and some of Fresno’s poorest neighborhoods took direct hits.

“I’m devastated,” said Yolanda Randles, executive director for the West Family Fresno Resource Center, who had to lay off seven community health workers in southwest Fresno on Friday, due to the funding cuts.

“I feel sorry for the government. They’re so naive. They [farmworkers] feed all of these people and they’re stiffing their faces,” said Manuel Cunha, president of the Nisei Farmers’ League, whose $340,000 grant to deliver testing kits and education materials to farmworkers was cut short.

Fresno County’s community health worker network was built with federal funds during the early days of the coronavirus pandemic. Community health workers don’t just link residents with information about vaccines and disease prevention, they also help them navigate healthcare enrollment, get them transportation to appointments, and link them to food and housing resources.

UCSF Fresno received some of the funds to launch 200 mobile health clinics in rural parts of the community, providing early detection and treatment for chronic disease, in addition to routine vaccinations.

The network has been essential for the county to build relationships in communities that have language, transportation and information barriers – especially rural parts of the county, according to Joe Prado, assistant director of public health for Fresno County.

“When we see issues brewing in the emergency room, we communicate with our community health worker network to get the word out,” he said, referring to recent measles and avian bird flu outbreaks.

Fresno County has been recognized for its innovative approach to making sure people with the highest risk factors for chronic disease in the region – the disabled, the elderly, farmworkers and people of color – are connected with more preventative resources, rather than just relying on emergency care.

“For someone in Huron to get to their doctors’ appointment in Fresno, it can cost $100 for a taxi. So we’re making sure people can get support,” said Sarait Martinez, executive director of Centro Binacional para el Desarrollo Indígena Oaxaqueño, an organization that serves indigenous communities in the valley.

Community health workers are often residents from the community who can more easily build trust with those who need it.

Martinez’ organization is often providing interpretation support for a variety of indigenous and Mixtec dialects rarely found in the county’s healthcare system.

“They’re the frontline workers that actually help to carry out prevention, because they’re connecting people to the immediate resources where they’re not getting stressed and their mental health is being preserved because they found food or got their utility turned on and paid,” said Genoveva Islas, executive director of Cultiva La Salud. 

Cultiva had two grants – one to address health disparities, another as part of the Fresno Community Health Innovation Partnership – or FCHIP – hub, that funded 12 community health workers in Parlier, Orange Cove, Easton, Sanger, and south Fresno neighborhoods.

Each community worker had a caseload of about 30 residents per month.

Islas said she’s trying to find additional resources to keep the workers on staff, even if their hours are reduced, for the next few months, because she’s afraid to lose a critical workforce that’s been trained for the last five years.

“My staff knows much more than I could ever hope to know about the application processes for MediCal, food delivery programs, the utility payment supports that exist in the community, right? All of that is a huge loss,” said Genoveva Islas, executive director of Cultiva La Salud. 

Other organizations impacted include the Valley Center for the Blind and Reading and Beyond. Centro La Familia, The Fresno Center, and the Black Wellness and Prosperity Center are also impacted as subgrantees to FCHIP, the regional public health collaborative.

The goal was always to use the federal funds for community health workers as startup capital – Prado said they just didn’t expect the resources to dissipate so quickly.

“When you lose this type of significant public health infrastructure over a short period, yes, there’s going to be more risk. At the same time, I’m very hopeful that as a community, we can come together and find other resources and reach out to other groups to be able to keep some of this infrastructure in place,” said Prado.

Some of the community organizations have had luck negotiating with healthcare plans to reimburse some of the support community health workers provide, as they divert people away from emergency rooms towards preventative care, like Exceptional Parents Unlimited, who work with families that have children with disabilities, whose community workers are also supported through CalAIM, a program of MediCal.

Not all organizations that have community health workers can rely on CalAIM, at least in the short term, said Islas. 

She said that her organization, and other small nonprofits, don’t have readily trained staff to navigate the complexities of MediCal billing.

Not to mention that the state’s MediCal program – which 53% of Fresno County residents rely on for health care – is facing potential cuts from both the state and federal government. 

Prado said that the county is working on bringing a contract to the Board of Supervisors in April for additional funding that has been negotiated with managed care plans. They’re also in talks with national and local private philanthropy to help plug some of the gaps created through the loss of federal funds.

Supervisor Luis Chavez said he’s working to bring community organizations and county leaders together to triage the situation.

“At the county we’ve built a great public health system. The progress they’re making is in jeopardy. People will get hurt, and this will cost them their lives,” Chavez said.

“We would be so much better off as a society if we just simply invested in caring for people to stay well instead of caring for people when they’re sick, right? And that’s the beauty of the community health worker,” emphasized Islas.

Correction: An earlier version of this story said that the public health department is bringing a contract to the Board of Supervisors in April with funding from philanthropy. The contract is for funding from managed care plans, not philanthropy.

Fresnoland’s Pablo Orihuela contributed to this report.

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