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Agricultural Giant Takes Lead in Keeping Workers Healthy

DELANO — Paramount Agribusinesses comprises the largest farming operation of tree crops in the world: almonds, pistachios and clementines. Now its companies are betting on a different kind of productivity: keeping a workforce healthy in California’s Central Valley by offering free on-site medical care.

“We’re backing up the healthy products we create by offering our employees much better than standard coverage,” said Danny Garcia, director of human resources at Paramount Citrus.

In return, the company benefits from fewer sick days, better productivity and improved morale. Paramount companies also offer employees health insurance.

“If people feel like they’re part of a company, invested in the company, that pays off. We have a lot higher retention rate, better, more consistent work,” said Garcia. While the company can’t know yet whether the venture saves money in the long run, it is already making gains in terms of its employee base, he added.

“I think this is a great idea,” said Kevin Hamilton, deputy chief of programs at Clinica Sierra Vista, a health care organization for underserved populations. “I love to see employers taking responsibility for the health care of employees especially if they’re not eligible for the Affordable Care Act.” He said community health centers in California have long been interested in partnering with agricultural providers.

Farmworker advocates said a few other agriculture-related companies in California offer similar programs. Western Growers Assurance Trust has a low-cost clinic in Salinas for its employees. The Reiter Affiliated Companies, growers of Driscoll’s Berries, fund three low-cost clinics that serve workers and their family members in Watsonville, Santa Maria and Oxnard.

Easier Access to Health Care

The agricultural giant, partnering with Kaiser Permanente, recently opened a 1,500-square-foot health and wellness center at its clementine plant in Delano and a temporary facility at its almond-processing plant in Lost Hills.

“We live in a rural community. It’s hard for employees to find quality and consistent health care,” said Garcia. “We thought, let’s solve the problems before you’re stuck in an ambulance.”

By having a health clinic on site, employees don’t have to spend time and money waiting in a private doctor’s office. It’s also more likely they’ll go to the doctor. “To have to take a half day off can be a financial burden,” said Garcia. Now employees and their families can make an appointment the same day they need to be seen, get in and out quickly, and even get a prescription delivered to the work site. 

The Paramount Health Centers by Kaiser Permanente provide everything a primary care practice offers, according to company officials: office visits, lab work, immunizations, disease management and follow-up care. Parents can bring their kids for school physicals or well-baby checkups. Paramount foots the bill, a hefty $2 million annually.

“The best way to sum it up is it really feels more like medical care 30 years ago where the doctor is kind of like your friend,” said Garcia. “Everybody knows and interacts with the medical staff. They eat in our lunchrooms.”

Sharon Peters, chief administrator for Kaiser Permanente in Kern County, said the partnership with Paramount works “because the values are very aligned — with the goal of improving the health of communities.” And there’s a natural connection to secondary care, she added, because Kaiser is one of the health insurance providers for employees who opt for some level of health care coverage through the company. Employees and their families don’t have to be insured to visit the clinic.

Peters said this is not Kaiser’s first on-site health center for workers. Fontana Medical Center in Southern California provides a similar service to California Steel Industries.

For Kaiser, modern on-site clinics for employees are a sort of cyclical milestone. Kaiser Permanente was born out of the need to have on-site health care services at the steel mills and shipyards that belonged to Henry Kaiser in the 1940s and 50s.

From Baseline Screenings to Case Management

Kaiser is doing baseline health screenings for every full-time and part-time employee. The findings indicate that 90% of the mostly Latino employee population needs some kind of health intervention. Some of the more common health issues include asthma, pre-diabetes or diabetes, hypertension, high cholesterol and obesity.

Kaiser can use this information to create health regimens for each individual and to offer educational materials and classes that target these issues. We have “the ability through case management to really pay attention to these folks,” said Peters. “It’s exciting for us to begin to know the population and know what we can do to improve their health lives.”

The baseline screenings are important because they allow the medical personnel to monitor and track health issues that in the past might have led to an employee missing work. For instance, if hypertension is controlled, it reduces absenteeism, said Peters.

The on-site health centers see all Paramount employees, some of whom are Kaiser members. Other clinic patients are covered by other insurers or have no insurance.

Addressing Language and Cultural Barriers

“We don’t see every employer taking this step,” said Danielle Davis, area director of account management for Kaiser Permanente, Kern County. “They’re trying to take on some challenges that are big and difficult to work through.” These include language and cultural barriers as well as differing perceptions about health care.

“One of the things we’re doing is trying to address employees’ viewpoint about health care, that you access it when you’re healthy and not just when you’re sick,” said Davis.

One of the pillars of Paramount’s efforts is wellness in the workplace and at home. “We’re trying to encourage employees to visit for preventative care and use the center as a resource,” said Garcia.

A full-time health educator and a part-time bilingual doctor split their work at both centers, which also have a full-time physician assistant, a registered nurse and a licensed vocational nurse.

Peters said that as employees begin to meet the providers and have positive experiences, they typically urge others to go. “That word of mouth is important to us. Building the relationship is critical,” she said. “The biggest issue is about trust.” 

A Healthy Workforce Benefits Business

As many as 8,000 Central Valley employees and their families could use the centers. This includes workers from sister companies, Paramount Farming and POM Wonderful in Del Ray. Del Ray is about an hour and 20 minutes away from Delano, so it’s unlikely workers would drive that far for care. The hope is that another health center will be built in Del Ray in the future, said Garcia.

“We’re not in a position to change the medical industry, but we are in a position to affect the employees who work for us,” he said. The effort can start affecting thousands of people, from when they are young, he said.

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