Talking Total Farmer Health – AgriSafe Podcast

Every month, AgriSafe’s “Talking Total Farmer Health” podcast explores the latest news from health and safety experts in agriculture. Randy McKinney, LPCA’s Healthcare Technology & Innovations Manager, joined the podcast this month to discuss the barriers that face agricultural workers and the ways that rural telehealth can assist in bridging gaps in healthcare for farmers.

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Transcript: Rural Telehealth Part 1 of 2

Linda Emanuel: Welcome to the Talking Total Farmer Health podcast from AgriSafe Network. At AgriSafe, we work to protect the people that feed the world by supporting the health and safety professionals, ensuring access to preventative services for farm families and the agriculture community.

It can be difficult finding time to take off from the farm, especially when it means travelling a decent amount chunk of time to see a healthcare professional. Thankfully, Telehealth has come a long way in helping increase access to services, and lower that burden of travel and time away from the farm. But it also has changed the scope of these visits, when you aren’t going into an office to have that face-to-face interaction. So today, we are going to talk about telehealth.

Well, hello listeners. It is my pleasure today to introduce you to Mr. Randy McKinney. So, Randy, please introduce yourself and let us know a little bit about your work.

Randy McKinney: I sure will, Linda. And thank you very much for having me today. I’m grateful for this opportunity. I am Randy McKinney. I have over 25 years of healthcare and management experience. I work currently for the Louisiana Primary Care Association as the Healthcare Technology and Innovations Manager. This is the membership for Louisiana’s Community Health Centers, which are also known as federally qualified health centers. Prior to my coming to work for LPCA, I was fortunate to have worked as an administrator in a small rural health clinic, Bienville Family Clinic in Arcadia, Louisiana. Prior to this, I was a practice management consultant in the Louisiana Department of Health, and I’ve been a licensed nursing home administrator for almost 30 years.

During the time that I was at Bienville Family Clinic, I was fortunate to be able to work in collaboration with the Bienville Parish School Board, where we received the 2019 National Rural Health Association’s Outstanding Program Award for our work in providing telemedicine services in Bienville Parish Schools. So if I have a claim to fame, I would guess that that’s it. And so of course that was pre-COVID. We didn’t know a lot about telehealth, pre-COVID. And so we had work to do in marketing our program from the standpoint of education and having to explain to to the public, to the parents, to the children, to the educators what telehealth was. So that’s kind of brought me to where I am today.

Linda: Well, what a great, deep, rich history in healthcare. And as well as this new approach that our listeners are wanting to learn more about, I’m wanting to learn more about as a nurse as well. I know there is some new information coming out about how nurses can be involved in telehealth, so I’m excited for our visit today. So we know that telehealth offers an approach to healthcare to redesign and enhance medical care specifically for our rural and frontier communities. So, tell us how you’re specifically involved in your role now with Telehealth.

Randy: I now assist Louisiana’s federally qualified health centers with telehealth, with setting up telehealth health systems and platforms, with how to run a telehealth visit, for generating ideas, keeping in mind that different clinics workflows may differ and patients differ. And so one of the things that I try to accentuate is the need to meet the patient wherever they’re at in the telehealth world and to help them to understand what telehealth is and how it can help them to improve their health outcomes.

Linda: That is awesome. I love how we’re evolving our healthcare and how we approach and how we deliver care. I think the pandemic definitely brought up real quickly the need for those of us that live rural and everywhere really that the importance of telehealth. So there are some interchangeable terms out there when we talk about telehealth, share some of those terms that folks may hear.

Randy: Well, absolutely. You know, we have heard telehealth. We hear telemedicine. Sometimes we hear audio video visits. And those are kind of the same things. Telemedicine, specifically under some definitions, is the practice of medicine remotely using technology where telehealth is a more all-inclusive term that includes remote education, it can include remote patient monitoring and general assistance from day to day that patients may need, absent a clinical visit with a provider.

Linda: I see. telemedicine and telehealth. Okay, got that. Tell us how telehealth may increase access and improve safety and quality of care. And is it as effective as a face-to-face health service?

Randy: Well, first of all, I’ll say this, that we we all know that there are some things we can do on telehealth and some things that we can’t do. We know that we cannot, provider cannot provide an open heart surgery through telehealth. So we back away from that and and we go with what we can do and how we can help patients based on one, the patient’s level of comfort with a telehealth type of communication, a telemedicine visit, and also the provider’s level of comfort with a telemedicine visit. For an example, a patient may have a lower right abdominal quadrant pain and describe that pain in such a way on a telehealth visit where it is a real time audio video visit where the provider may be comfortable enough between what the patient tells the provider and the nonverbal cues that the provider can see, how the patient looks, whether they look healthy or not, how or whether or not they’re they’re experiencing pain. Sometimes a patient may not say I’m in pain, but a grimace when a patient touches their maybe lower right abdomen might show the doctor that this is more than just maybe a stomach ache. And so at that point, the doctor may not be comfortable with making a decision on a telehealth platform. And with that, he or she may ask the patient to either go to the nearest emergency room or to come into the office so that he can physically or she can physically lay their hands on that patient to provide the care.

So it is about not only patient level of comfort, but provider level of comfort. And we have to respect each other’s level of comfort whenever we’re dealing with telehealth from the standpoint of safety and security, of course. Many patients may have been injured or they may be suffering from some type of illness, such as gout or arthritis, that may render them unable to be mobile at all times with this. The patient may be at risk just moving from their house to their car, driving to the provider’s office, getting out, getting into the provider’s office and then into a waiting room and then into an exam room and then out of that and then maybe to the pharmacy and back home. Of course, if the patient is able to have a visit from the comfort of their home, it may be one less painful for them. But as well, it may be much safer for them, particularly if they may be at risk of falling and having another injury, you know, to manifest itself, trying to get to the patient visit for an illness. So we don’t want to make things worse. We always want to make things better. And so with that, telehealth may be the appropriate mode of service delivery even more than in person.

Linda: Now, so what I’m hearing from you is that it’s up to the provider and the patient really to discuss what’s best. And sometimes telehealth is appropriate and maybe sometimes a face-to-face visit is more appropriate.

Randy: Absolutely.

Linda: All right. What healthcare services are available within telehealth, and are there some certain services you can only get in person? And we touched a little bit about that. But can you expand on what’s available for telehealth?

Randy: Absolutely. Telehealth can be the service delivery mode for many types of medical and dental services as well as for mental health services. While we all know that medical providers again cannot perform surgeries through telehealth, there are many, many primary care services that can be provided through telehealth. Providers can treat common colds and flu like symptoms and other minor types of illnesses through telehealth. And this can be especially important and critical during times such as flu season, when it’s important that we not come in contact with others who we may give the flu to. Or perhaps we don’t have the flu. We go into a clinic and it’s full of people that do have the flu and they transmit it to us. You know, it’s just a part of life that we’ve all been used to. But there’s one way to prevent the spread of disease – a telehealth visit in our homes or even in the nursing home environment or in our schools can prevent the spreading of infectious disease to others who may be present…

Also, telehealth delivery may be applicable for some types of dental visits. Some screenings, of course, can be accomplished through telehealth using a presenter or a hygienist. But initial visits for tooth and gum pain, including circumstances where the gums may be bleeding or there may be tooth sensitivity, could be treated through telehealth, particularly when in-clinic appointments may not be available or after hours. Even dentist could make recommendations for treatments and even prescribe certain pain medications for pain or infection until an in house appointment could be conducted. And also, I feel that telehealth works extremely well with mental health and counseling visits. Just as with all telehealth visits, patients can remain in the quietness of their home in a private location where they can maintain their dignity or even in a quiet office in the workspace that could be private or in any location that that could afford privacy for a patient to have a conversation with a mental or behavioral health provider. Often we associate mental or behavioral health visits with with negative thoughts, but many times there are all of us in one way or another that need mental health services. We need somebody to talk to. And perhaps there are things that we’re not comfortable telling our family members and even and and but we would be comfortable telling a counselor, perhaps.

Linda: Oh, yeah. And we definitely here at AgriSafe, staff are working hard to talk more about mental health and how it impacts our physical health. The total farmer health, really it’s a model that we drive most of our work from. And so I can totally understand where if you were able to talk to a mental health provider in the comforts of your own home where you maybe felt less vulnerable, that those visits could be a little bit more meaningful and as well as improving the access to care. What I’m hearing from you, too, is that there’s an easier access, maybe quicker access to care, especially for those of us that may have to drive an hour to a metropolitan area to seek care, so.

Randy: Absolutely. And you know, if we’re in our own environments, you know, I think there is always an increased level of comfort. We all have concerns and life problems that we have to deal with every day. And for me as an individual, I’d much rather deal with those, if possible, from from the comfort of my home rather than having to go into an office where I might feel at risk, you know, of something I’m saying maybe getting out or somebody hearing it through the walls. And also, I think this this can be a helpful thought to as we tackle sexually transmitted disease concerns, many don’t want to go into clinics to talk about this. They don’t want to maybe see staff members that they know. Generally to us with rural, there always is a connotation that we know people in the town that we’re in because it’s a small area. I was raised in a very small town and I would have been very uncomfortable going into my local clinic and telling an individual who I had known most of my life who I knew well and personally, hey, you know, I think I may have a sexually transmitted disease of some sort or I’ve got something going on, you know, from the standpoint of mental health that I need to talk to about to someone about. And I think if that the home environment just makes us more at ease overall and talking about the things that we need to talk about with our providers that can affect us for the rest of our lives and can improve the quality of the rest of our life.

Linda: Well said. So what can folks expect during a telehealth visit with their provider in terms of professional and legal standards of confidentiality? I think about ethics, communication, and then cultural considerations.

Randy: Yes, certainly. Certainly with telehealth. Cultural considerations should be taken into account. One of our concerns, of course, are the of the many languages that are spoken in our country. You know, we’re we’re moving more more toward Hispanic populations and other populations that speak different languages. And and one of the things that we’re able to do with telehealth to help that is that we can have interpreters available. Some providers do have language interpreters available that they can bring in onto the telehealth call so that both parties can understand what is being communicated in an effective way to provide for the best potential outcome for the patient and for the treatment plan that the doctor enact for the patient.

Linda: That’s great. Do you know any barriers to accessing telehealth among rural communities?

Randy: Well, sure, there are some barriers, as with anything accessing telehealth and our in our rural communities, especially in what I call a community that’s remote, far away from the center of town, let’s say, is the issue of connectivity. And many of us have cell phones, but we know that there are some places that even cell phones coverage is poor in our country and our nation. So, you know, there may be times that we have to move around in our house to get a connection. But what we need to know about telehealth is that telehealth does not necessarily take a booming ultrafast internet connection. We can generally conduct a telehealth visit using our smartphone with with 3G, 4G, 5G, whatever it is that we have in our area. Even with dial up. Another barrier might be with us. It might be within ourselves. Our level of comfort in having a telehealth visit. Even with the onset of the pandemic, there still may be many today who have not experienced a telehealth visit because of their level of comfort. But what I would hope that if there are those out there who don’t feel comfortable with it, that they would at least consider giving telehealth delivery a good faith. Try at least one time. They may find it easier and more accessible and they may really like it. And also it’s easier a lot of times to to get an appointment for a telehealth visit than it is to to have a walk in maybe where you have to wait two hours, where you’re walked in on a walk in, or if you, you know, pick up the phone and try to get a call, it may be two days.

But, you may be able to find a provider who can who can answer a telehealth visit within just a few minutes or within within the hour. Again, in our program in Bienville Parish schools, we found that at first a few parents weren’t too comfortable with this telehealth thing. So after trying it though, and they realized that one thing, they did not have to leave work to go and pick up their child at school, take them to the doctor, go then. And you know, the wait that goes on with that, go then and get a prescription and then take them home and get back to work in any way you look at it, whether you’re in a rural area or whether you’re in a metropolitan area, that can be a minimum of a four hour issue. There are many of us who don’t have leave if we don’t have sick leave or we don’t have some type of leave that we can use to take care of our children, then if we have to leave work, we may not receive pay for that four hours or it may be an entire day that we don’t receive pay for. And then that that us not being able to receive pay may equate to even other problems that we have our lack of ability to pay for food, our lack of ability to pay for the medical care that we all need. So telehealth visits can help in in many other ways, not just with the logistics, but also economically speaking.

One of the things that we did on our telehealth visits and and everybody, every agricultural worker, every farmer, everyone in America should keep this in mind that if you need somebody, a family member, your your spouse, husband, to be on the telehealth visit with you, even though they’re not in the physical room with you or with the provider. Also think it would we wouldn’t be doing justice if we didn’t mention specialty care. Um, some of our best cancer care is in Houston and in larger metropolitan areas and here in in the area that I live in, which is rural north Louisiana, we’re 5 to 6 hours from Houston. But if I could, once my my cancer has been diagnosed, if I could, telehealth up to a provider in Houston, that specialty provider may be able to devise a plan for me to get my treatment maybe within an hour. Of where my home is, rather than within six hours where I might have to get on a plane to fly or drive six hours. None of us with a debilitating illness that is tiring us out need to be tired more because we have to be transported somewhere to get our care. So we have to think at the big picture, not only primary care, but also our specialty care. There are ways that telehealth can help us with that also.

Linda: So what I’m really thinking about here is you’re explaining all these great nuances of telehealth is that we can have more successful patient outcomes as well as greater patient satisfaction because like you said, the easier access to care and you get to maybe get that initial visit done with the specialist and then be able to receive that ongoing treatment more locally. So then you’re more around your people as well as the services that surround that specific treatment. So yeah, really interesting.

It is truly wonderful to see how telehealth can help reduce barriers to accessing healthcare services, along with many other benefits! We’re going to end here for today, but keep your eyes peeled for our next episode, where we continue our discussion with Randy and address how to make the most out of your telehealth visits!

Transcript: Rural Telehealth Part 2 of 2

Linda: Hey listeners – we left off last episode talking with Mr. Randy McKinney about what exactly constitutes telehealth. And in today’s episode, we’re going to wrap up that conversation. If somehow you missed the first part, go back and listen now! I promise we’ll be right here waiting once you’ve caught up… And if you’re still here, well, then let’s begin!

I know that it can be daunting to try something new for the first time, those unknowns that can cause hesitation. Talking to your doctor or healthcare provider just on a video or phone call is vastly different than sitting in the exam room with them. But regardless of whether it’s your first time in a telehealth visit, or whether you are a telehealth pro, we have tips for how to make the most out of your visit! As well as tips for finding a telehealth provider. But first, Randy has a story that he wants to share about why he’s so passionate about rural telehealth.

Randy: So in my younger years, it’s been over 50 years now. one of my first jobs as a teenager was working at the local funeral home in our town. And I can remember so many times going out, especially to remote areas where where people lived in very rural areas…

And I can remember going out to to numerous homes out in the rural areas and to to perhaps go out to make a first call for the funeral home. And the the spouse, and it was a wife at the times that I remember would be crying and just talking to us about how it was it that her husband had been having chest pains for weeks, 2 to 3 weeks, and that she’d been trying to get him to go in and to get seen about; to see what it was that was causing it. And he wouldn’t do it. She couldn’t get him to do it. So, you know, just one of the things that I’ve just taken with me since my childhood is the fact that if something happens and you’re having chest pains or you have a a massive headache like you’ve never had before, get to the telephone, tell somebody to call, ensure that first responders are on their way.

Today, we’ve got something available in most rural areas that we didn’t have 50 years ago, and that’s the helicopter that can medevac us out to the major medical centers. Even if we have an aortic aneurysm, which is essentially a blood vessel in the chest that has either burst or is getting ready to burst. And but we have to dial that phone. We have to make that first step. And if we don’t do that, it can cost us our lives. And so we want to do what it takes to take care for our of ourselves. Certainly, you know, if we’re worrying about, well, I’ve got to get the watering done in the morning or I’ve got to I’ve got to be sure that the fields are plowed in the morning. One thing thing’s for sure that if you’re not there to to take care of that, if you’re not alive, you’re not going to be able to take care of that crop, nor next year’s crop. So I just encourage each of you to, if you have something like that, that that feels critical. It probably is. It’s better to to get help than to not.

Linda: Absolutely, Randy. Your story definitely hits close to home, and I’m sure many of our listeners will be nodding their heads in agreement, that they too have experienced something similar – maybe they know someone who has had a relatable experience. Thank you for sharing that, Randy. You know, it is so easy to get wrapped up in the work that needs to be done, to lose sight of taking care of our health first. But you’re right – if we put off our healthcare too long, or in a critical instance, we won’t be there anyway to get the work done.

So, okay, so for those folks who are thinking, you know, maybe telehealth is a route I’d like to go. Any advice for people wanting to find a new telehealth provider?

Randy: Well, absolutely. First, if you contact your provider, many providers since, uh, since Covid or have a telehealth platform available. But if if your provider does not and you’d like to have a telehealth visit, there are a couple of options. One is to contact, of course, another provider or contact your nearest community health center or federally qualified health center in your area. Most health centers have telehealth platforms already that they’re operating off of. These community health centers have often received special funding to improve your access to them and to the communities that they serve. So most of them will will have one. But there is another alternative, also. Many of our insurance plans have providers who will provide a telehealth visit. Often these are at no cost. And when I say no cost, I mean no deductible and no co-pay…

And you may have to call your benefit specialist, the 800 number on your insurance card, to find out if that’s available. But more often than not, it is available today by insurance company.

Linda: Yeah, that’s great too, because of course, when we think about farmers and ranchers and all the costs that they have just to operate a successful farm business, and then you think about the life, their lifestyle and their living needs, costs. If there’s a discount, absolutely. I’m sure that they would certainly take advantage of it in that 800 number on those insurance cards can also give you a wealth of information. So. So use it. Are there any differences in using insurance or any special payment options such as grants or discounts for people living in rural areas when it comes to telehealth?

Randy: There are none that I know of, uh, right off of the top of my head. But where the real value of using telehealth is at is in getting primary care faster. So that, of course, we have deductibles and co-pays oftentimes. The less treatment that we have to have, the earlier that we catch disease progress, the less that’s going to cost us in co-pays and deductibles in the long run. So I think that’s how we save money. It’s just by insuring ourselves, making the promise to ourselves that we’re going to give ourselves the best possible primary care and that we’re going to get it as soon as we can rather than waiting later to get it.

Linda: I hear you. I hear you. You’re speaking to the choir a little bit because getting these farmers and ranchers to get into a clinic, that means they’d have to leave their their place of business, their farm or ranch, and they’ll put it off because, you know, it might get better tomorrow. I just don’t have time right now to to tend to to what my body needs or my mental health needs. So are there any other tips you want to share? Some resources for our folks?

Randy: Well, just one. Given what we’ve already talked about, I would suggest that that if you’re out there, you’re in a rural area, you’re an agricultural worker or you’re a teacher, a school teacher, it doesn’t matter. I would suggest that if you’re a little maybe uncomfortable with having a telehealth visit, that you go ahead and schedule one, give it a good faith. Try, as I said earlier. And one of the things that might help you to overcome some discomfort is calling your clinic and asking them if they could do a test run with you over their telehealth platform before your visit to be sure that you can connect to them.

I think that would go a long way in making us more comfortable. And and then the other thing that I want us to remember is patience, is that there are certain guidelines around federal laws and the dispensing of controlled substances. There are laws in place that require an in-person visit, in some cases before dispensing a controlled substance. So if your provider, your doctor, your mental health provider or even a dentist for pain, if he was to tell you, well, I cannot give you this particular substance for pain without an in-person visit, first, please understand why that that is federal law for certain drugs and medications.

Linda: Yeah, absolutely. Again, those federal laws are put in place for our health and safety, as you know. And so it’s yeah, it’s good information to keep that in mind as we think about opioid misuse and the misuse of of many medications. So what should people have ready with them for their telehealth service or their visit?

Randy: Well, if you’re going to have a telehealth visit with a with a, let’s say, a mental health provider, really there’s nothing that you need to do other than ensure that you’re in a quiet place with minimal interruptions. Remember that conversations with your medical or behavioral health providers might need to be private. So if you’re anticipate discussing sensitive topics, you might want to find a private location in your home or even in your car or at a trusted friend’s home. One of the things for any type of telehealth visit, we need to try to turn off all of the noise makers that are in our environment. This may include televisions or radios, cooling units or ceiling fans. Also, if we have children that need care, we need to ensure that that they’re placed in somebody’s care during our telehealth visit. And of course, many of us have pets and in rural areas, that’s almost one of our hallmarks to have a pet, a cat, a dog, birds. But we need to be sure that they’re safe and they’re in a place where they would not disturb our visit. And one of the things that I would suggest, if possible, if the patient as a patient, if we could sit in front of a solid-colored background rather than in front of cluttered colored backgrounds for clearest video.

Also, we should try to stay away from windows or other light sources that are behind us. We need to try to to make sure that light is in front of us more than behind us. Our providers need to get as clear a look at us as they can. And of course, if we’re using a smartphone, we’d want to have some kind of a bracket or something that we could set it on on our table or a desk in front of us so that it’s not moving around. Uh, this is not usually a concern if we’re using a laptop computer because we have a camera generally that’s mounted, but it would also be advisable to have a good bright flashlight available with charged batteries in case there’s some type of lesion or a spot, a mold or something on your a area of your body that you want to show your doctor. And he may ask you to adjust the light so that he or she can see it better. And if you’re in a situation where it might be difficult for you to to do this for yourself, if you’re comfortable, you may want to have a trusted friend or relative with you, uh, perhaps a spouse to help you to adjust the camera or the screen so that you can see so that the provider can see you and so that you have the ability to focus on what you need to tell your provider.

And also, if we know that we may have to remove a partial article of clothing or let’s say we have a a lesion or a spot on the upper part of our arm, for example, we want to be sure that we’re wearing loose clothing so that we can easily pull that up and the provider can see it…

Linda: That’s very true, great advice so far. Now, is there anything specific our listeners should have on hand for their appointment?

Randy: Um, one of the things we need to do is be sure that we have everything written down that we need to tell our doctor, our medical provider. And I say, Doctor, this could be a nurse practitioner, it could be a physician assistant. But we need to be sure that we make the most of our medical visit just like we do when we’re in that office. We only may have ten minutes, so we have to make the most of it. We want to be sure that we have a list of our current medications. We should include any prescriptions that we have, any supplements, vitamins, anything that we’re taking they need to know about. And of course need to be sure that we have our allergies listed, especially if it’s a first visit….

And if we’re using our smartphones, we need to be sure that they are fully charged before we start our visit. And we need to also expect that our provider may want to make an emergency plan with us. Let’s say I’m talking to my provider about the fact that I may be having chest pains or a bad pain in my head that may be symptomatic of a stroke or of a heart attack. And let’s say something did happen and I became unconscious during that visit. My provider would need to know how to get help to me, how to get first responders to me. So if I’m the provider and I see that my patient has passed out. If I dial 911, I’m going to get the first responders in my county or parish and not the ones in the county or parish necessarily where the patient is at. So with that, I might expect my provider to to ask me for my exact location, my exact physical address that I’m at now, because there’s always a presumption that the patient may have moved to another location other than their home to have the visit.

So if something happens, we want our provider to know how to get help to us. So they might ask us what county we’re in or parish they might ask us for the for the seven digit number of the the law enforcement agency or the first responder agency. If we know that and it’s available, we would certainly want to have that for them so that they could make a call to the appropriate agencies to assist us if something should occur. And last but not least, of course, you would need to have your identification copy of your driver’s license or other ID as well as your Medicare, Medicaid or other insurance cards. Remember, this is a medical visit and we need to be able to provide the same information as we would provide if we walked in the door of a clinic and and had a medical visit. And the first thing they’ll ask you for every time you go in almost is your ID and your your insurance card. So those are things that we need to to be sure that we we have handy during our telehealth visit.

Linda: Those are some great tips. Some of those things I hadn’t even thought about, like the emergency plan. Right. And how 911 works. Well, this has been more than enlightening. Randy, is there anything else that you’d like to add to the conversation?

Randy: I don’t think so, other than just encouraging people to do their best to get the best Internet connection that you can in your home, so or on your telephone so that you can have a telehealth visit that is meaningful and that can help you to improve your health, or at least to keep you at the health status that you are at currently so that you can continue serving people by by working, especially in agriculture. A lot of times we don’t think about the agricultural workers and how how they contribute to our well-being, not only our mental well-being, but our physical well-being. We have to get proper nutrients in life or we’re going to get sick. So we you know, we understand the value of the agricultural worker and what it means to us and what the farm and rural America means to all of the rest of us, whether we are rural or in a metropolitan area. And we’re grateful for your service. And we want to be sure that you get the best healthcare possible. And we just want to encourage you to take whatever steps you need to take and know that telehealth is one viable option. And by all means, if you’re just not going to do a telehealth visit, that’s okay to get to your doctor and take care of yourself as best you can.

Linda: What a great way to close. Thank you, Randy. Thank you very much for your time. And we look forward maybe to some future visits as telehealth continues to evolve and we evolve with it.

Randy: Absolutely. And again, Linda, thank you for having me. I’m blessed for this opportunity.

Linda: Oh, you’re more than welcome.

Thank you again for tuning in to another episode. Be sure to subscribe to this podcast to hear more from AgriSafe on the health and safety issues impacting agricultural workers. If you’d like to suggest topics, or have a story you’d like to share, contact us by email at, and title your email “TTFH Podcast.” You can also get our attention by using the #TTFHPod on Twitter! To see more from AgriSafe, including webinars and our newsletter, visit

This episode was created by AgriSafe Network, directed by Laura Siegel, hosted Linda Emanuel, edited by Matt McKenney for, with special guest Randy McKinney.