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Hey, what's up? This is Corey Deanna Lewis, founder of Healthy Project Media and the host of the Healthy Project Podcast. Join me as I speak with change makers who are doing the work and sharing their stories, insights and innovations to close gaps in healthcare for everyone.

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Hello everybody, thank you for listening and watching the Healthy Project Podcast. I'm your host, Corey Deion Lewis. This is a special episode from our My City, My Health Conference. We have this platform called Ask a Pro, where we have people in the audience ask questions to the panelists. And this year, they really used it. That's good. And it was almost so many questions, it was like, hey.

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I want to get these questions answered is not going to happen. We answered some of the questions, but not all of them, but taking this opportunity to connect with the professionals.

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to go further with some of the questions that weren't answered, some that were, but maybe able to kind of expand on them. Today we have the CEO of Proteus who wasn't there, but she had a, Emily did her thing. It was great. She rocked it. Daniel Zennel here, CEO of Proteus. Thank you so much, Daniel, for being here. I really appreciate it. Thanks for having me. Happy to be here. Yes.

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Thanks for watching!

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the clinic side of thing, but I know there's more to Proteus. So before we get into some of the questions, Nace, can you tell us a little bit about yourself, Proteus, and yeah, what gets you up in the morning? Yeah, well, Proteus has been around. We just celebrated our 45th anniversary last year, which is wild to think about an organization like that that has been around for such a long time. So we began in 1979 by Proteus of California. So back then there were these early states that received federal funding.

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to really focus on farm worker access to job training and education assistance and so states like Texas and California got their states off the ground and then the federal government has them to get other states off the ground because it was across the entire country so Proteus in California still the same name exists it's kind of a sibling organization but they came to Iowa to get us started and then in 1983 we broke off and became our own separate nonprofit and so we've been

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been doing our thing independently since 83, but providing services to farm workers since then. And the grant that we were started to as an organization, we still have today, it's now called the National Farm Worker Jobs Program funded by the United States Department of Labor. And we implement that grant not only in Iowa, but in Indiana and Nebraska. And it really focuses on helping lower income farm workers who are experiencing barriers

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We help them get connected to upskill, find access to, we provide education assistance, tuition, other kind of wraparound services. Some of our participants get paid to go to school. They get a stipend to help cover some of their basic living expenses. We provide kind of case management to connect them to other resources. So if there are things that...

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prevent them from achieving their goal. Obviously we're human and things come our way. That are challenges. And so if they need access to gas, childcare, rent, utilities, housing, we can either pay for those services or get them connected to the resource that will. And we've really focused on more of those shorter term programs, so CDL, welding, nursing, in particular industries that are in demand and really have a high success rate

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highly employed and we follow them for a year after they exit our program. Most of them over 90% are typically in that job still and a lot of them come into our program making less than a hundred percent of poverty and once they exit are making forty thousand plus dollars a year. So a huge return on investment and these are individuals that are now contributing to the tax base which then pays it forward so that we can help more farm workers get access to those specific resources. So that's one large

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grant that we receive and one big program that we provide across all three states for farm workers. And in addition to that, we also do health and safety trainings across all three states where we physically go to where farm workers are at and provide them with what we call life-saving information to help them prevent heat stroke and heat stress, as well as teaching them about the exposures to pesticides.

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across the three states. And we want to see more because unfortunately with the extreme climate conditions that we're continuing to see, we're still seeing farm workers die. And these are young farm workers. Just a couple of years ago, we lost a farm worker in his 30s due to heat stroke. Because of the heat. Correct. And so we do this in a way that is meeting people where they're at. We use pictures. We are using...

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a lot of activities so that they're learning better and understanding that there's varying literacy levels. And so.

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a lot of oral education as well in Spanish and English with the farm workers that we're seeing. And so a huge program that we do across all three states connected to that we do a long sleeve shirt drive in the spring so that we can pass out long sleeve shirts to farm workers. It's a great barrier to sun, but also to pesticides. In the summer, we do a water for farmer farm workers campaign where we raise money to purchase hydroflask so that we can distribute those to farm workers to help with them preventing heat stroke.

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And then in addition to all those things, we also are a federally qualified health center here in Iowa, specifically focused on farm worker health. So we have.

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our agricultural health program. So we're just like another FQHC, but our specific scope of care is for farm workers, people in agriculture or anyone in their household. And so I tell people that we have the most unique healthcare delivery model in the entire country because we have our brick and mortar clinics, but most of our care is mobile. And so we take our team, set up temporary clinics, either on site where they're working or we'll partner with a local church or library, anyone who will give us free space

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We'll use it and we set up clinic sometimes 7 p.m. At night. We'll see as many as we can

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Sometimes it's too late in the evening because I'm sure the hours of the workers are so different and a lot of them don't get PTO So they can take time off to take care of themselves get the access to care that they need and so our whole model is really About eliminating as many barriers to care as possible because these are individuals who are putting foot on all of our tables And they deserve access to health care 100% I feel like what you just described with the the multiple things that you are is

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Definition of what health equity is like close your closing gaps just not Providing a service for the for the time they need it, but like really closing gaps in their whole life Yes really I Completely agree. I think we yeah our whole organization is all about health equity for sure. Yes, so

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I must, the majority of the population that you serve, immigrant health or immigrant population, from what I'm understanding, it's not just.

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Some of like black immigrants as well are a part of that as right. Or like it's just not Hispanic population, right? But it's kind of changing a little bit. So we, we serve all farm workers, period. Period. No matter. Yeah. It doesn't matter. Like some of our programs have specific parameters on who is eligible. So like for our workforce training program, education assistance, there has, there is a required work authorization that we have to capture for everything else.

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There's no, like legally we can't ask the question for our health program and so we're serving all farm workers period So we know that that means We're serving people like me who grew up on a farm not only worked for my dad but worked for other local farmers I would have qualified for our services and we serve still a large number of people like me across all three states But then we also serve International migrants those who are coming from Central America

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Guatemala, Honduras, El Salvador, Mexico. But then we're also serving a large number of international H2A workers, which is coming here specifically on an agricultural work visa. And we're seeing more come from South Africa, from Haiti, but most of them are coming from a particular place in Mexico. And that number has increased, and we've seen a double in the last, more than double in the last five to 10 years, where there's probably 5,000 plus H2A visa workers coming to work

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in Iowa every year. And then we also have our domestic migrants who are coming typically from, at least in this area, coming from the valley in southern Texas and some of them settle here. So we're seeing individuals who are migrants, who are transient, but then they sometimes settle here and they make Iowa their permanent kind of full-time home and everything in between. So it's quite fascinating and interesting to think about the gamut of who we can and

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But it's typically more diverse and more robust than I think people assume just based on what they how they would define a... Oh yeah, no that's real that's real. So it sounds like you know you had there's there's two... My City My Health we focused on immigrant health you know that was that was the panel that Emily was on. Yes. And...

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You had, I'm gonna say you were the CEO during the COVID pandemic. Yes. And now with some of the challenges with immigrant population in our, in our country now, you're at that, you're at the head of doing that too. Yes. First of all, mentally, how are you? Like, how do you get through managing? Cause that's a lot to manage and to strategize and plan for. Yeah. I.

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It's a lot and it is a unique position to be in. And I think oftentimes we think CEOs maybe have access to so many things, but oftentimes it feels like you're on an island because you can't.

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Like I want to be real and vulnerable with my team, but there's also things that I want them to feel like I have my own kind of stuff together, you know, and carrying the team forward in a way that is, um, mindful and strategic. And I think I, I do that to a certain degree, but there's times where

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it can be lonely. And so I think that's where connecting with other people who are in positions like me and getting together, having conversation, kind of talking through how we're doing in a real way is really critical, really important because I want my team to know that I have my stuff together, which I feel like most of the time I do. I mean, we can't be perfect. I'm not perfect by any means. I definitely have things to work on, but I try to keep a call

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from.

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diplomatic, strategic approach where they feel safe and secure in their, in their work and appreciated and all the things. Um, but it just takes a lot of intentionality in everything that we do to take care of ourselves. Yep. 100%. So I'm gonna get into some of these questions and for the people listening or watching, I usually, so for some people, this may not be, uh, great cause people like to play.

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plan, but the reason why I'm like, well, these were off the cuff questions in the moment. So let's just recreate that energy. I love that. So that's what, that's what we're doing with, there we are. So you know, one of the questions that was asked was, you know, strategies to implement to combat the dehumanization and demonizing of immigrant communities. So like what, what are your thoughts on?

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What is that plan, is there a strategy for that? I think for sure. I think an easy, maybe not easy, but I think a very intentional, simple way of doing that first is using human-centered language and recognizing that.

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These are human beings who are doing the best that they can to take care of their families. And I think so many, everybody should be able to empathize with that period. Doing the best they can to take care of their families. And for them, that means leaving a place that has been home and going to some place that they can't even imagine oftentimes, and then to be vilified and demonized.

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for these simple things of just trying to do the best they can to take care of their families. And you're doing some of the hardest work. Correct and so yes. So we, I think within our organization we always are trying to whenever we talk to anybody remind them where their food comes from.

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So I challenge everybody listening, like think about if you had breakfast today, if you had a snack lunch, dinner, and going forward, pausing and reflecting on where that food that you are eating right now came from. And all of it started with the hands of farm workers. And these are individuals who are working in the most extreme conditions, long hours, extreme, extreme heat, extreme cold. Uh, oftentimes without.

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appreciation, or time off, or benefits, low wages sometimes, and...

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Still, these are some of the most positive people I've had the privilege to interact with. They are so appreciative of all the services we provide. Literally will give their shirt off their back to us. We had a provider one time who commented on a farm worker's shirt. I think they were wearing like a band that the provider like loved and they're like, oh my gosh, I love your shirt. They literally took off their shirt and gave it to the provider. We have farm workers who bring us food.

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Like some of them have their own little gardens and they'll bring food for our staff because they are so appreciative of the services we provide. And so.

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Sharing those stories, I think stories are a way to humanize people too. Oh yeah. And helping people realize that even though we oftentimes sit, there's so many Iowans who don't realize the thousands of migrants, immigrants who are living in the shadows in their communities in the summer for maybe a few weeks, a few months, because they are working literally sunrise to sunset. So they're leaving before it's light out and coming home when it's dark out.

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smaller communities across Iowa, but helping them understand that they play such a critical role in all of our lives. Personally, by the food we eat, fashion, fuel, all the F words that we can think of, fun, I mean, liquor, alcohol, farm workers play a role in. But then also just thinking about our general economy, our agricultural economy, if we did not have immigrant farm workers, it would be devastating.

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I think that is so important, even for me, even for someone that I acknowledge that that, look, I tried to detest when I was in high school. I did one day, bro. Yeah. I was like, let me stick to basketball. Do something different. Let me go with the high V and go get carts. But it's important, I think, for everybody to take a, just take a breath and just realize the work that.

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you don't want to do somebody is doing with a smile on their face. And this is mad disrespectful. Yeah. So like treat someone that way. Yeah. One of the, one of the questions, you know, my city, my health is heavy in healthcare, the attendees. So one of the questions that came up specifically to healthcare was around translators and translation. One question was about,

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how do we utilize or find certified translators? And then one was talking about translation and artificial intelligence and using artificial intelligence for translation. What are your thoughts? First, we'll tackle the first one. And I've had this experience too. I had a patient, I was seeing a pediatric patient.

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who was translating for her mom. And I know what I was telling her, she was not telling her mom, right? Because we didn't have a translator available. But one, what are your thoughts on the translation piece from the healthcare side of things? I think it's, I mean, it's so critical and so important to...

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use the best tools and resources we have available to us. And sometimes budgets are limiting. I get that. And, um, we gotta just kind of make do with what we have, right? But I do think it's important for healthcare providers, especially to really invest in the resources that are going to be the most professional. But then also I think

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utilize a strategy similar to the work that you do and your like work, but kind of how we approach our work is hiring people from the community who look like them, who understand the needs of the community and speak the language. And so, um, I think it's so important to, to do that and to not rely on family members. It puts, it puts kids, especially who I think are oftentimes,

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the ones that are providing the interpretation at visits in a really tough place for their parents and family as a whole and so utilizing language line if that's something that you want to use if you don't have like physical people that can provide that service I think

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looking at different options that you might have, but then maybe consulting with their number of nonprofits and other kind of businesses that provide interpretation services that you can maybe pull in one off if you know that you're going to be seeing more individuals that that's maybe a conversation you can have. But most of our positions that are direct facing to the farm workers are, we require to be bilingual in English and Spanish so that they can speak the language.

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I would, we call our positions different things, but a lot of our health-facing individuals act as promotoras, community health workers, and I think that's a good model to also use. Like they can serve as interpreter, but they can then connect them to the resources they need at the same time. Yeah, the community health workers don't change the game. If companies really invest in it and take, that's a great, that's a great position. You know, I'm really, I'm really interested

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in the AI conversation when it comes to translation because you have two sides. There's people that's like, no we can't use it because the AI translation is not great or we've seen it translate differently and sometimes that is true because different you know one Spanish-speaking person maybe from here and something there's so many nuances and differences but there are other people that are like I used it and this person was so grateful because now they can read their medication and know what it means and what it says.

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But what is that happy medium when it comes to using AI for some of these services? I think that's a great question that I feel like we're going to probably grapple with over the next few years because I think both with a live interpreter and with AI interpretation, both have risks involved with them where there's always going to be the potential for human error.

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is hearing things and then spitting out information. I do think the AI interpretation type of in translation service that we've seen has improved immensely. Oh yeah. How it's capturing information and sharing information. I do think there's probably a lot of healthcare providers like us who don't necessarily want to be the...

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leaders in it, but kind of the like early adopters is like once we have more information and better best practices around all of this on how we can move the needle in providing greater access. I think we're definitely wanting to continue this conversation, but I think it's going to be probably something that we're going to continue to solve over time. Yeah, it'll take some time. I don't think it's going anywhere. It's not going anywhere. It's not going anywhere. So and I being

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healthcare for the past eight years, I understand it's one of those where you just wait until, you know, you just wait and then when something's three years old, it'd be brand new to healthcare. So, and that can be frustrating when you're trying to serve patients in the now. So like, I can see where that frustration is. For sure.

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Next question is, you know, what are some ways organizations can prepare for challenges that will arise from, you know, these mass deportations that we keep hearing about? Well, I think there's, I think you know, I just took a deep breath with that question. I think there's, there's a lot of unknowns with what to expect with the incoming.

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administration and new congress uh... i think obviously we need to plan for all different types of scenarios and i think the anxieties and worry are real because this this this administration feels a little bit different than the one point oh administration where there's

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more ability to do things this time. And so I think there the worry out there is completely valid and we need to have these conversations to plan for some of the potential things that could happen. But we also saw on the last go around a lot of talk and no action. And so I, I would anticipate that there's going to be a lot of smoke and mirrors of look over here.

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kind of thing, but I do think that there will be some things that unfortunately will be devastating for our country, for immigrants, especially in our country. So I think having internal conversations with your staff and team on what would this mean to us as an organization, what would this mean for the people we are serving, and how can we continue to be a resource for them. And so we'll continue to have those

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internal conversations and strategizing on what this could mean for us and for the people that we serve, the farm workers that we serve, and how can we get the farm workers with the information they need to make the most informed decisions that are gonna impact them and their families. And so I think it's gonna be a probably constant evolution of conversations that we'll be having, but I think it's important to, we need to have these conversations now in preparation for it.

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notice or seen has any of the farm workers that you you work with have they brought up any of these concerns is this something that you know once once it was kind of in the air you just hit the groundwork running to start having that conversation like what has that experience been like I think for some for sure and I mean we saw how

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immigrants were portrayed in the previous administration too, or his previous administration. So I think there's some carryover from that. But I think in general, there's always been, for many families, this fear out there because of...

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either mixed status households or not having documents in order to navigate systems in a meaningful way. And so I think, yes, it probably is heightened, but there's always been this level of fear in general because of just the environment as a whole. Right. That makes sense. So two different challenges, but I kind of brought up the pandemic

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a potential challenge or whatever, however you want to call it, two different things, but still really impactful with a piece of the population that you serve. Are there similar approaches that you're taking now to really what you took from the first one talking about the pandemic or COVID-19 to now?

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I think for sure and as an organization we've always historically had bipartisan support for the work that we do and the federal grants that we receive and so we're definitely appreciative of both sides of the aisle being supportive, being champions of this work and so we'll continue to engage our federal delegation, our state delegation and making sure that we are educating them on the farm worker needs that we are seeing on the ground and I think

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using our experience from COVID of not shying away from who is in positions of power and using our

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our strategies and our connections to connect with them so that we can get access to the most resources possible to provide to the farm workers' needs that we're seeing on the ground. And so one example that we've talked about a lot in the past is just our approach to COVID in how disproportionately impacted meat processing workers at the beginning, that kind of ignited a desire and need for us to really strategize around the arrival

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of thousands of migrants coming to our state. And so we were able to, through connections, get meetings with governor's office, state hygienic lab, homeland security, workforce development, public health at the time, and strategize a testing plan for migrants upon arrival. And we had some additional funding to pay for hotels for migrants or for farm workers who tested positive, who were migrants upon arrival, so that we could isolate them in a safe manner.

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We provided them with two hot meals a day, provided them with daily calls and health care access so that we could monitor them. And the one thing in my career at Prodys that I'm probably most proud of, out of all of the thousands of migrants that summer we tested, zero died. Nice.

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And so I think being willing to engage, I think there's a lot of obvious fear and maybe retreat from the...

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incoming administration, but I think we need to continue to engage and have conversations. And I recognize that not everybody's willing and able to like compartmentalize feelings, emotions, all of those things. And so I think it's important to like engage when we can or utilize others who can engage on behalf.

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so that we can make sure that the needs are being at the forefront. Right, the 100%. I want to go back to something you said earlier, because I'm just curious. You talked about how you guys raise funds to give farm workers long sleeves to protect from the sun and from pesticides. And I'm curious about the health implications from just that. Like...

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Is there a number of, is cancer, that's the first thing that came to my mind was like, I wonder how many health care, or when the farm workers got cancer because they didn't have a long sleeve or because of they're constantly in those fields. Have you seen any of that, or is that something you guys do look at? It's hard to. Yeah, I know, that's the first thing I thought of. It's a great question. I think that's like the.

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Excuse me, I think that's one of the challenges, but also appreciation for like public health in general. Like you don't really know the impact you have on some of these really important strategies because we'll never know like, yeah, writing long sleeve shirts, did it prevent cancer? I will say we are leaning into doing more.

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cancer screenings and prevention. So we're, we're, we've partnered with care for yourself, which is our state breast and cervical cancer screening program. And so we provide.

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breast and cervical cancer screenings to our farm worker patients. And through that program, they're able to get access to other cancer services and resources. So fortunately or unfortunately we've detected cancer and a few farm worker women who were able to get the access to treatment and care are now in remission. So that's been really positive to see. And a new kind of focus right now and into this next year that we're really leaning into more of is doing more.

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rectal cancer screenings. So we have a partnership with Cologard to do those at home colorectal cancer screenings. And so we're pushing those and then we have a relationship with an institution who is who has offered to provide some colonoscopies for those who potentially could test positive from those Cologard tests. So we're leaning into doing more of that but I think continue to expand

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the cancer prevention screening and access to resources is something we'll continue to look into. Yeah. With your role, do you feel like, I feel like partnership, just being in public health is so important in the multiple partnerships. Can you talk a little bit about how those partnerships, obviously the, what you just talked about the Kola Guard and all, like that's, that's amazing. But why are those partnerships so important?

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We would not be able to do most of the things that we're able to do without partners. I mean, I call the agriculture employers our partners. They're allowing us to come on site so that their workers can get access to care. But I think...

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Like University of Iowa has been a huge partner of ours on a number of projects. We did a large, we've done a large number of research projects with them and even got published in a couple of peer reviewed articles on our COVID-19 work that they collaborated with us on so that we can share some of our learnings with others, because there's really not a ton of research out there specifically on farm workers. And so they've been a crucial partner of ours.

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but connecting with primary care association, the Association of Farmworker Opportunities Program, Migrant Clinicians Network, National Center for Farmworker Health on a more kind of global standpoint, but then also connecting with like I will legal aid who has a farmworker outreach program, our state monitor advocate who really focuses on monitoring the needs of farmworkers in Iowa, our workforce development outreach workers

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in between. We can't do everything alone. We can't do everything. Right. And so it's all about finding all of the partners that we can really fit to make farm workers needs accessible. No, that's real. I love that. The longer, I haven't been in the space for a very long time. Space as far as like, you know, public health or the work I do. I've been at one place for a long time, but now as I'm trying to understand, like, you know, you can't have public health

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of what it feels like, you know, like I want to do something, but this person does that better. So I'm like, it's connecting the dots, like kind of how you said, and I'm like, oh, this all, this all plays a huge role. Well, one thing I've failed to mention about our health program is we also are a voucher program, which makes us even more unique. So we kind of.

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kind of serve as like a third party payer. So if our farm workers have other needs, whether it's dental or vision or other specialty care, we are constantly working on building our partner list where we have MOUs with other healthcare providers where we can make direct referrals and then pay for all or part of that service through a voucher.

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And in some of those visits were able to transport them there provide interpretation at that visit and so it's Creating a better experience as well for the farm workers was transportation just for anybody's a huge Determined social determinants health. So man that is that's a big one. Yes, man. Okay, you guys are doing everything A lot of things the team is incredible everything

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Awesome. You know, and just from what I understand about you, this comes from like this role was almost kind of meant for you. Like you were, this is like your thing, right? You were on the farm, now you're working with farm workers. Like how has that been for you? It's been a wild full circle moment. I really didn't, so I've worked at Proteus twice in my career. The first time around I was just kind of looking for

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a case manager type of role with a bit more responsibility and Proteus had a position open we now call them career coaches so that's the first job at Proteus that I had back in 2007.

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So it's kind of serendipitous that I found Proteus, or it found me, I don't know, and then kind of became regional director, overseeing various programs, became our kind of grant writer in addition to that at the time. So I wrote the grants to help us expand it to Nebraska and Indiana. And then I tell people I had to leave in order to develop some skills to bring back. And so I came back in, I left in 14, came back in August of 2019.

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in this position, but yeah, it's definitely full circle because of my, not only my experience of working in the fields and obviously...

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as we talked farm workers, they all shapes and sizes, everything in between. And so my experience is my experience, which doesn't always equate to every farm workers experience. And so I recognize that and also kind of in reflection, appreciate my own personal.

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Experience of not only doing farm work, but at the time in my childhood also accessing public assistance programs similar to like what proteus provides where I always go into my works and Using food stamps like I can still like

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remember the smell of physical food stamps. Right. And so I really credit those programs that provided my family, what we needed to allow me to develop into the person I am today and the leader I am today. And so without them, I would not really be here in this role. I don't think. And so it's my kind of way of giving back and paying it forward because we, we really don't know the

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we have on farm workers, we can kind of hypothesize. And Emily Mendez does an incredible story of how that has impacted her personal family by produce, providing care to her in-laws who were migrants at the time. And so it definitely is this full circle moment, but I also recognize that I also have a lot of growth to do and am always working to.

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be a better advocate and do the things I need to do in order to open more doors, more resources for farmers. Love it, love it. Daniel, thank you so much for your time today. I really appreciate it. Thank you. You answered the off the cuff questions very well. I'm very happy. Thank you. For anybody that's listening that wants to learn more, and I will make sure that I put a lot of these links in the description of the episode, but if there's anybody that wants to connect with you and learn more about Proteus,

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Where can they reach and find you at? Producing.net is a great place to start, but you can find us in all the social medias. So we're on YouTube, LinkedIn, Facebook, Instagram, and...

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You can find me on LinkedIn. Would love to connect with anyone that's willing to partner or explore partnership or collaboration. And also would love to talk about like sponsorship donations because we need more money to do more things to provide more resources for farm workers. 100%. Again, Daniel, thank you so much for your time. Everybody, thank you for listening to the Healthy Project podcast. Please like, subscribe, review. It really does help amplify the conversation to get to more people to educate more

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what we're doing. So again, this is Corey Deion Lewis with the Healthy Project Podcast. I'll let you next time. Hey, thanks for joining us on the Healthy Project Podcast. At Healthy Project Media, our mission is to connect with the next generation of health leaders and innovators. If you're interested in advertising with us or exploring collaboration opportunities, please reach out at hello at heal

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We look forward to growing this community together. Until next time, keep pushing the boundaries of health.