Latinos In Franklin County Fighting To Save Public Health Interpreter’s Job

Veronica Guerrero’s voice has been a lifeline for Spanish speakers in Franklin County for more than 20 years.

The longtime Spanish language interpreter/health navigator for the Hampton-based Franklin County Public Health has done everything from breaking down Medicaid applications to making sure children get their required vaccinations. She even helped one woman find a way to pay for her cancer treatment, according to her advocates.

“We need our only bilingual person,” said Hampton resident Marciela Rodriguez. 

Latinos make up about 16% of Franklin County’s population and, per capita, it has the seventh-highest concentration of Latinos of any of Iowa’s 99 counties—and members of the community say Guerrero provides an invaluable service to them. 

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However, in December, Guerrero was told her position was being eliminated. In the months since, Franklin County’s Latino residents have campaigned to save her job by attending public meetings, holding rallies, and even organizing boycotts.

Franklin County Latino residents gather near the county courthouse in Hampton in support of Veronica Guerrero.

Rodriguez is one of the main advocates fighting to keep Guerroro’s position intact. She explained why Guerrero is so important to Hampton and Franklin County’s growing Latino population.

“We have people that are US citizens, but they don’t speak English—some of them don’t even know how to write or read—and we have a lot of children that have autism, disabilities, we have a lot of heart problems, cancer, stuff like that, so how are you going to remove the only person that we have for public health,” Rodriquez said. 

Guerrero is the only fluent Spanish speaker on the six-person Franklin County Public Health staff. She is also the only one who is losing their job on June 30, which marks the end of the fiscal year.

According to county records, Guerrero was an hourly employee who was slated to work 35 hours a week at a rate of $22.60 an hour. Last year, Guerrero earned $40,707.93, which made her the fourth-highest paid person in the six-person office. Franklin County Public Health had a budget of about $1.4 million in the 2021-22 fiscal year. 

Before the 2014-15 fiscal year, Guerrero’s salary was paid for by the Together 4 Families nonprofit until that funding ran out on June 30, 2015, according to Franklin County. The county did not specify if Together 4 Families paid Guerrero’s full salary or a portion of it.

Guerrero’s position was then funded via the county and a $10,000 Local Public Health Services Grant from the Iowa Department of Public Health. So in 2021, the grant covered only about a fourth of Guerrero’s nearly $41,000 salary while the county paid the rest as well as her benefits.

However, the county says that in November 2021 it was told interpretive services were no longer covered by the state grant. This would seem to contradict the state’s usage guidelines for the grant that specifically mention “culturally appropriate” services being covered under it.

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As part of the grant, a local public health agency consults with Community Health Consultants—who are state employees—to “develop quality and effective services that are community-driven, culturally appropriate and responsive to their Community Health Needs Assessment and Health Improvement Plan and consistent with federal or state regulations and/or funding requirements.”

Sara Ekstrand, a spokesperson for the Iowa Department of Public Health, also confirmed that the grant can indeed be used for interpretation services.

“Local Public Health Services funds can be used by local boards of health to assure the provision of core public health functions and essential public health services in every county,” she said in an email.

“Interpretation services for population health promotion services is an allowable use of the essential public health dollars appropriated in the State HHS budget. Local Boards of Health make spending determinations for the essential public health dollars within their county.”

When asked if the state ever issued any edict in November that would give counties an indication they couldn’t use the grant for interpretation services, Ekstrand said the state’s updated service agreement with providers would not prohibit that.

“In November of 2021, IDPH shared terms for the new services agreements that would be effective July 1, 2022,” she said. “Portions of staff salaries are an allowable expense, including interpretation services for population health promotion services.”

While Veronica Guerrero has not said anything publicly about her situation, her husband, Juan, has questions. In particular, he wants to know why county officials keep blaming the state for cutting his wife’s job when Franklin County already pays three-fourths of her salary

“They are trying to make it sound like all of her money came from grant money and that the county never really funded her at all, but she’s a county employee,” he said. 

“They are making it sound like all she did was this Hispanic stuff—you know, the translator—but she’s also clerical. She’s there in the office answering phones, opening the building, closing down the building.”

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Michael Nolte, who chairs the Franklin County Board of Supervisors and sits on the county’s board of health, said he doesn’t think Veronica Guerrero’s position qualifies for the funding since her job is a hybrid position.

“Interpreter service and navigator are two different positions, really,” he said.

When Starting Line told him that interpretation services do qualify for state funding, he said “that’s not what we were told.” Nolte declined to answer more questions citing legal reasons; however, Starting Line was unable to find any litigation between the county and Guerrero in the state court system. 

Rodriguez and others have tried to appeal directly to Nolte and other county officials during the public forum periods at board of supervisors’ meetings. She first made a case for Guerrero during the May 2 meeting but was told the board could take no action since it wasn’t on the agenda.

Rodriguez got herself placed on the May 9 agenda. She was slated to speak at 10:15 a.m. and, according to meeting minutes, Nolte left the meeting at 10:10 a.m. Still, Rodriguez and others told the board why Guerrero deserved to keep her job, but they noted Nolte’s absence.

“If we don’t have her, then what are we going to do,” Rodriguez recalled asking the remaining board members. “They just stared at me. They didn’t say anything. We felt discriminated [against] since we first spoke with them, [it’s] like they don’t care.

“We told them, ‘Hey, we are your community. Your community, Franklin County, is growing with the Hispanic community. The businesses that we have here have grown because we are here too. It’s grown, we’re growing, we’re growing together; we need to have our public health.'”

Franklin County’s Latino population growth.

According to the minutes from that May 9 meeting, the county’s response was that La Luz Centro Cultural, a Hampton-based nonprofit that promotes cultural awareness and diversity in the community, could provide translation services.  It also suggested that hospitals and clinics could provide translators through apps and phone services.

Rodriguez pushed back on the quality of those alternate options.

“You think I’m going to go to the pharmacy here on the corner [where] they don’t have no bilingual people and say ‘Hold on, let me call 1-800 Translator and see if they answer,’” she said. “And it’s hard to get a translator on 1-800. I told them, ‘Have you tried it? Have you tried to call 1-800 Translator? And then when you try it, let me know how hard it is.’”

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La Luz also pushed back on the county assuming it can do what Guerrero or another dedicated translator does for the Latino community in terms of health care. An attorney for the organization read a letter to the board that spelled out the necessity of the position.

“La Luz Centro Cultural is not equipped to serve as a Health Navigator and/or a medical translator for Franklin County Public Health,” the letter read. “The importance of having a Bilingual Health Navigator position in the county’s health department goes beyond the capabilities of a nonprofit institution. Therefore, La Luz Centro Cultural is advocating for the continuance of a Franklin County Health Department navigator.”

The letter from La Luz also noted most of Franklin County’s Spanish-speaking population receives their health care through public health.

Juan Guerrero said the family is still trying to figure out what they are going to do next, but he also feels bad that so many people who depend on his wife as a means to access health care will no longer be able to do so.

“We feel like we’ve been wronged but, right now, it’s not about her; it’s about the community,” he said. “They are being wronged.”

by Ty Rushing
06/16/22

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