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Note: An Annual Comprehensive Review, as required by §7 of the Federal Advisory Committee Act, is conducted each year on committee data entered for the previous fiscal year (referred to as the reporting year). The data for the reporting year is not considered verified until this review is complete and the data is moved to history for an agency/department. See the Data From Previous Years section at the bottom of this page for the committee’s historical, verified data.

HHS - 949 - National Advisory Council on Migrant Health - Statutory (Congress Created)


Committee NameNational Advisory Council on Migrant HealthAgency NameDepartment of Health and Human Services
Fiscal Year2020Committee Number949
Original Establishment Date7/29/1975Committee StatusChartered
Actual Termination Date Committee URL
New Committee This FYNoPresidential Appointments*No
Terminated This FYNoMax Number of Members*15
Current Charter Date11/29/1993Designated Fed Officer Position Title*Public Health Analyst, Office of Policy and Program Development, Bureau of Primary Health Care, Health Resources and Services Administration, 5600 Fishers Lane, Rockville, MD 20857
Date Of Renewal Charter Designated Federal Officer Prefix
Projected Termination Date Designated Federal Officer First Name*Esther
Exempt From Renewal*YesDesignated Federal Officer Middle Name
Specific Termination AuthorityDesignated Federal Officer Last Name*Paul
Establishment Authority*Statutory (Congress Created)Designated Federal Officer SuffixMBBS, MA, MPH
Specific Establishment Authority*42 U.S.C. 218Designated Federal Officer Phone*(301) 594-4496
Effective Date Of Authority*7/29/1975Designated Federal Officer Fax*(301) 594-4497
Exempt From EO 13875 Discretionary CmteNot ApplicableDesignated Federal Officer Email*
Committee Type*Continuing
Committee Function*National Policy Issue Advisory Board


Agency Recommendation*Continue
Legislation to Terminate RequiredYes
Legislation Status 
How does cmte accomplish its purpose?*The National Advisory Council on Migrant Health (NACMH/Council) holds two meetings each fiscal year (FY). At each meeting, it reviews information and data on the health care status and services provided to US migrant and seasonal agricultural workers (MSAWs) and their families. NACMH then makes recommendations to the Secretary, Department of Health and Human Services (HHS). The first meeting for FY 2020 was held in Rockville, MD on November 6–7, 2019, at the HRSA headquarters. The second meeting was scheduled to be held in Longmont, Colorado, to provide NACMH an opportunity to receive MSAW testimonies on issues that impact their health. However, as a result of the COVID-19 public health emergency (PHE), the meeting was scheduled and announced in the Federal Register twice, but had to be cancelled each time. Therefore the Council had only one meeting in FY 2020. Nevertheless, even though the Council could not hold its second meeting, it fulfilled its charge on July 21, 2020, by sending a letter of recommendations to the Secretary, on MSAWs health concerns during the PHE. This summary highlights the recommendations regarding the impact of COVID 19 on MSAWs, first. Subsequently, the November 2019 recommendations will be summarized.
Recommendation (R) 1: COVID-19 TESTING: The Centers for Disease Control (CDC) and Department of Labor (DOL) issued COVID-19 interim, joint guidance for mitigation of risks for spread in agriculture does not require mandatory testing. Without mandatory testing and enforcement, cases will rise, and the responsibility to care will fall on community and migrant health centers (C/MHCs). NACMH Recommends: (a) Bureau of Primary Health Care (BPHC) partner with CDC and DOL to formulate uniform, federally-mandated and enforceable policies and procedures, including COVID-19 testing, for MSAW’s; (b) Procedures and policies be developed in consultation with state, local, health and occupational medicine professionals; (c) Federally-mandated policies and procedures require, at minimum, free, weekly worksite testing for all MSAWs; (d) C/MHC policies and procedures to ensure health protections for MSAW’s.
R II: SUPPORT MSAW SERVING HEALTH CENTERS: C/MHC’s receive additional support and technical assistance to address the unique needs of MSAW’s, including: (a). Extra costs from preventive measures to protect on site patients; (b). Assistance with acquisition of personal protective equipment (PPE), and COVID-19 testing kits; and (c). Promoting access using mobile response units and telehealth. Additionally, health center closures and reductions in funding be suspended until the pandemic ends.
R III: SAFE HOUSING AND CHILD CARE: MSAWs and children are disproportionately impacted by crowded farmworker housing, and PHE school and daycare closures. NACMH recommends: (1) HRSA collaborate with USDA Rural Housing Services for safe MSAW group housing that: (a) Allows spacing of farmworker beds, living areas, kitchens, bathroom, etc.; (b) Implements capacity limits informed by public health standards; (c) Maintains CDC compliant ventilation and disinfection protocols; (d) Separate housing for families, and high-risk COVID vulnerable MSAWs; (e) Temporary isolation quarters for COVID-19 positive or ill MSAWs; and (f) Supplemental housing to allow for social distancing. (2) HRSA leverage its partnership with Head Start to provide no-cost, safe childcare; and incentivize MHCs to consider migrant child care as another line of business.
(1) HRSA partner with DOL to expand the National Agricultural Survey (NAWS) to include H-2A and all MSAWs that meet the OMB definition of agriculture in all its branches, based on the NAICS, to gain insight into their demographic conditions. (2) The Families First Coronavirus Response Act (FFCRA) provided free COVID-19 testing is unavailable to H-2A workers, hence HRSA conduct outreach to support testing, and follow-up care.
(1) Overcome COVID 19 PPE shortages for MSAWs working with pesticides.
(2) FFCRA entitled 80 hours of emergency paid sick leave and at least 10-12 weeks of paid emergency child care leave be extended to MSAWs who are not H-2A visa holders, and MSAWs who work for employers with workforce less than 50, and over 500 employees, to cover farmworkers regardless of the size their employer’s farm.
At the November 2019 meeting, recognizing the unique nature of MSAW health concerns, the Council encouraged the Secretary to initiate a “Healthy Farmworker 2030” effort, as a part of the National Healthy People 2030 objectives. NACMH made three overarching recommendations to align with HRSA objectives as follows.
C/MHCs currently serve 1 million of the approximately 2.5 - 3 million MSAWs in the US. NACMH recommends: (a). HRSA tailor its accountability procedures, to ensure MHCs meet their funding related MSAW patient projections; (b). MHCs provide care that meets MSAWs unique needs, inclusive of effective outreach, transportation, and a nominal fee from the patient’s perspective; (c). HRSA design and test new models of MSAW focused value based care; (d). HRSA collect data to assess the impact of enabling services funding on MSAW health status; and (e). HRSA collaborate with DOL to promote access to new/unserved MSAWs.
NACMH recommends: 1. HRSA partner with DOL to: (a). Monitor MSAW population demographic shifts to accurately project future health care needs, and support health centers to best serve the local MSAW population; (b). to establish a MSAW H2-A visa holder registry to address their health care needs; (c). to ensure NAWS includes all MSAWs that meet NAICS statutory definition of agriculture. 2. HRSA establish an interagency work group to collate/expand farmworker pertinent data to inform and monitor health interventions at the federal level. 3. Health centers establish local partnerships with industry, growers and labor contractors to increase access to care for MSAWs.
R III: HHS LEAD STRUCTURAL INTERVENTIONS TO ADDRESS HEALTH DISPARITIES: Future social determinants of health screening and interventions be prioritized at the national, HHS and HRSA levels. 1. At the HHS level, a Healthy Farmworker 2030 initiative including HHS led cross agency collaboration between the Departments of Labor, Agriculture, Justice, and Education to address MSAW health disparities and poor health outcomes. 2. At the HRSA level: (a). Establish collaborations with federal and non-federal partners engaged in anti-harassment efforts to better serve MSAWs; (b). Ensure access to health and enabling services; (c). Combat human rights violations in agriculture by improving victim identification; 3. Leverage data to better characterize the relationship between unmet social needs and health outcomes.
How is membership balanced?*The Council consists of governing board members from migrant and community health centers, farmworkers, a farmer and individuals experienced in research, the medical sciences or the administration of health programs. Most of the members are active locally and statewide on various councils and planning committees. They have diverse backgrounds and experiences. The Council also has geographic representation from the three migrant farmworker streams (east coast, mid-west, and west coast), to enable an understanding of geographic/regional MSAW health and welfare concerns.
How frequent & relevant are cmte mtgs?*The NACMH Charter requires that the Council meet bi-annually at the call of the Chair and with the advance approval of the Designated Federal Official. In FY 2020, the Council was able to have only one face-to-face meeting, held in Rockville, MD. The second meeting was scheduled to be held in Longmont, Colorado, to provide NACMH members an opportunity to receive testimonies from MSAWs and gain a firsthand understanding of the issues that impact their health. This meeting was scheduled and announced in the Federal Register twice, but had to be cancelled on account of the national public health emergency. The location and timing of the meetings varies in order to facilitate opportunities for the Council members to meet significant stakeholders, working in different aspects of healthcare provision to MSAWs and their families. The opportunity to hear testimonies from MSAWs and their families provides the Council with valuable information towards the development of recommendations for the Secretary of HHS.
Why advice can't be obtained elsewhere?*There are no other federal programs that specifically address the health needs of migratory and seasonal agricultural workers and their families with representation from governing boards and patients of migrant and community health centers. Most other groups have a primary focus in a specific area (e.g., education, agriculture, housing, etc.). The authorizing legislation for the Council defines its make-up and ensures that it consist of a majority of individuals who are directly involved in the governance of migrant health centers. The Council is charged with advising, consulting with, and making recommendations to the Secretary of the Department of Health and Human Services and the Administrator of the Health Resources and Services Administration regarding the organization, operation, selection, and funding of migrant health centers and other entities funded under section 330(g) of the Public Health Service (PHS) Act (42 U.S.C. §254b).The NACMH Charter requires that the Council consist of fifteen members including the Chair and Vice-Chair. All members serve four-year terms. Twelve Council members are required to be governing board members of migrant health centers and other entities assisted under section 254(b) of the PHS Act, at least nine of which must be patient board members. Three Council members must be individuals qualified by training and experience in the medical sciences or in the administration of health programs.
Why close or partially close meetings?N/A
Recommendation RemarksThe NACMH held its first and only meeting for FY 2020 in Rockville, Maryland on November 6–7, 2019, at the HRSA headquarters. The recommendations to the Secretary of HHS for the November meeting were submitted on January 10, 2020. The second meeting was scheduled to be held in Longmont, Colorado, to provide NACMH members an opportunity to receive testimonies from MSAWs, to learn about the issues that impact their health, firsthand. This meeting was scheduled and announced in the Federal Register twice, but had to be cancelled. Nevertheless, even though the Council could not meet, it fulfilled its charge on July 21, 2020, by sending a letter of recommendations to the Secretary, on MSAWs health concerns during the PHE.


Outcome Improvement To Health Or Safety*YesAction Reorganize Priorities*Yes
Outcome Trust In GovernmentYesAction Reallocate ResourcesNo
Outcome Major Policy ChangesYesAction Issued New RegulationsNo
Outcome Advance In Scientific ResearchNoAction Proposed LegislationNo
Outcome Effective Grant MakingYesAction Approved Grants Or Other PaymentsNo
Outcome Improved Service DeliveryYesAction OtherNo
Outcome Increased Customer SatisfactionYesAction CommentThe recommendations from the Council provide the Secretary of HHS and the Administrator of HRSA with valuable information to establish strategic priorities for services provided at migrant health centers.
Outcome Implement Laws/Reg RequirementsYesGrants Review*No
Outcome OtherNoNumber Of Grants Reviewed0
Outcome CommentNANumber Of Grants Recommended0
Cost Savings*Unable to DetermineDollar Value Of Grants Recommended$0.00
Cost Savings CommentNAGrants Review CommentN/A
Number Of Recommendations*443Access Contact Designated Fed. Officer*Yes
Number Of Recommendations CommentThis Council has made the decision to limit the number of recommendations to those that impact the organization, operation, selection, and funding of migrant health centers as well as other health center programs. The Reports tab contain the list of recommendations and attachments.Access Agency WebsiteYes
% of Recs Fully Implemented*60.00%Access Committee WebsiteYes
% of Recs Fully Implemented CommentSome of the recommendations made were beyond the Secretary's authority. Other recommendations were not feasible to implement at that time.Access GSA FACA WebsiteYes
% of Recs Partially Implemented*40.00%Access PublicationsNo
% of Recs Partially Implemented CommentSome of the recommendations were modified to better align with the goals and strategic plan of HHS.Access OtherNo
Agency Feedback*YesAccess CommentN/A
Agency Feedback Comment*The BPHC Associate Administrator, managers and the Designated Federal Official provide updates to the Council members on HHS/HRSA/BPHC policies and programs impacting migratory and seasonal agricultural workers and their families. These updates are addressed during face-to-face meetings and technical assistance conference calls. The HRSA Administrator also responds to the NACMH letter of recommendations by official correspondence.Narrative Description*The NACMH supports the Agency's mission to improve the Nation's health by providing recommendations that assist the Secretary of HHS and HRSA Administrator in improving the delivery of quality health care and enabling services to migratory and seasonal agricultural workers and their families.
Hide Section - COSTS


Payments to Non-Federal Members*$10,400.00Est Payments to Non-Fed Members Next FY*$24,000.00
Payments to Federal Members*$0.00Est. Payments to Fed Members Next FY*$0.00
Payments to Federal Staff*$215,079.00Estimated Payments to Federal Staff*$224,855.00
Payments to Consultants*$0.00Est. Payments to Consultants Next FY*$0.00
Travel Reimb. For Non-Federal Members*$19,271.00Est Travel Reimb Non-Fed Members nextFY*$41,541.00
Travel Reimb. For Federal Members*$0.00Est Travel Reimb For Fed Members*$0.00
Travel Reimb. For Federal Staff*$0.00Est. Travel Reimb to Fed Staff Next FY*$5,100.00
Travel Reimb. For Consultants*$0.00Est Travel Reimb to Consultants Next FY*$0.00
Other Costs$18,997.00Est. Other Costs Next FY*$98,064.00
Total Costs$263,747.00Est. Total Next FY*$393,560.00
Federal Staff Support (FTE)*1.25Est. Fed Staff Support Next FY*1.25
Cost RemarksThe other costs for FY 2020 are lower than projected costs for FY 2021, because as a result of the COVID 19 pandemic and resulting travel restrictions the Council had to cancel the second in-person meeting for the FY, and had only one in-person meeting in November 2019, which was held at the HRSA Headquarters. Other costs include the blanket purchase agreement under which the logistics for NACMH meetings occur.Est Cost RemarksThe projected other costs include the blanket purchase agreement under which the logistics for 2021 NACMH meetings will occur includes the cost for two in-person meetings, one of which will occur offsite from HRSA Headquarters. Additionally, NACMH anticipates having 15 instead of 13 members, which increases all non-federal costs listed.
Hide Section - Interest Areas

Interest Areas

Health Care
Medical Education
Medical Practitioners
Physical Fitness
Public Health
Occupational Safety and Health
Workforce and Occupations
Health and Health Research
Medicine and Dentistry


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Data from Previous Years

ActionCommittee System IDCommittee NameFiscal Year
 COM-036579National Advisory Council on Migrant Health2019
 COM-034787National Advisory Council on Migrant Health2018
 COM-001874National Advisory Council on Migrant Health2017
 COM-002370National Advisory Council on Migrant Health2016
 COM-003798National Advisory Council on Migrant Health2015
 COM-004562National Advisory Council on Migrant Health2014
 COM-006097National Advisory Council on Migrant Health2013
 COM-006624National Advisory Council on Migrant Health2012
 COM-008213National Advisory Council on Migrant Health2011
 COM-008702National Advisory Council on Migrant Health2010
 COM-010400National Advisory Council on Migrant Health2009
 COM-010681National Advisory Council on Migrant Health2008
 COM-012221National Advisory Council on Migrant Health2007
 COM-012891National Advisory Council on Migrant Health2006
 COM-013792National Advisory Council on Migrant Health2005
 COM-014494National Advisory Council on Migrant Health2004
 COM-015840National Advisory Council on Migrant Health2003
 COM-016759National Advisory Council on Migrant Health2002
 COM-017600National Advisory Council on Migrant Health2001
 COM-018385National Advisory Council on Migrant Health2000
 COM-019537National Advisory Council on Migrant Health1999
 COM-020629National Advisory Council on Migrant Health1998
 COM-021449National Advisory Council on Migrant Health1997