Right now, my breathing is not too good.
I’ve been getting my black lung now, probably going on two years now.
I’m 57 years old.
I didn’t expect this, and it changed my life completely.
The Health Resources and Services Administration’s Black Lung Clinics Program awards grants to
health centers, hospitals, and other facilities that provide medical, outreach, educational,
and benefits counseling services to coal miners across the country, regardless of a miner’s
ability to pay.
The Centers for Disease Control and Prevention’s National Institute for Occupational Safety
and Health—or NIOSH--has been conducting regular health surveillance of working coal
miners since 1970.
In about the last two decades, there has been an uptick in the prevalence and severity of
black lung disease.
So the disease is complex and has a broad spectrum.
And one of the things that is actually quite troubling and concerning is the recent increase
in the prevalence of the disease, that is, the numbers of cases and also the severity
of the disease.
We’re seeing many more severe cases.
I mean it’s worse actually, it’s worse than it’s ever been.
And it’s just not small dots on the X-rays, it’s huge spots on the X-rays.
It’s miners in their thirties, some of them.
Well, it’s not an easy journey once you get the black lung, complicated part.
Once it gets complicated, it’s a lot different, you require a lot more medical help and assistance.
There’s very few places that you can find that help, and through the clinics, that’s
one place that you can find it.
Many HRSA-funded black lung clinics are located in areas with large active and retired coal
mining communities.
Clinic staff have personal ties to these communities which enables them to build trust with the
miners they serve and address these growing challenges.
Just the simple fact that when one of them comes in and introduces themselves and talks
to me about where he’s from, and I ask him, simply, “What mine did you work in?”,
and he worked with my grandfather in one of the mines and a big smile crosses their face
and you can almost see a total relaxation that they’ve realized that somebody’s
actually there that’s going to listen to them and has a little idea of what they go
through.
That means a lot to somebody that’s sick.
Just treat them like a person and don’t matter what their age.
Treat them like they’re your family.
And I feel that that’s the way I’ve been treated here.
Knowledge of the local setting has also enabled clinics to adapt their services and care delivery
models to meet the needs of their communities.
Miners’ Colfax Medical Center, located in Raton, New Mexico, reaches miners through
a mobile screening unit that travels throughout the state.
This means miners living in rural areas don’t have to travel long distances to access specialty
care.
So, instead of asking people to travel 8 hours to come see us, we go travel to their communities.
The advantage of doing that is not only it’s convenient to patients, and so we have more
people participating, but it also helps us understand the environment in which they live.
We also do telemedicine.
That means we allow patients to use telemedicine via satellite to actually have access to preventive
medicine, internal medicine, pulmonary medicine specialists.
And that really cuts down months of wait time.
Other clinics collaborate with local black lung association chapters, participate in
health fairs, and hold Miners’ Appreciation Days to spread the word about their services.
When a miner visits a HRSA-funded black lung clinic, he or she is entitled to a range of
services, including lung function testing, as well as information about the risks associated
with coal mine dust exposure.
Miners can also receive case management for conditions such as hearing loss, depression,
and cardiovascular disease.
As part of the primary care clinics that are funded by HRSA, we’ve been able to treat
patients that otherwise would not have had treatments for things like hypertension, obesity,
asthma, COPD, pulmonary diseases that include asthma and COPD.
We’ve been able to bridge the gap between specialty care and also primary care.
Without HRSA funds, we would not be able to do the primary care medical services that
we’ve been able to do thus far.
The HRSA grant for us at Bluestone in our community has been a God-send.
It enables us to be able to help the coal miners in our community that are not insured
or just doesn’t have the money to do the things that they need to do.
Even though we’re a Black Lung program, we still take care of the whole miner and
his whole family if there’s any way possible.
Well, it’s helped me considerably lot cause I lost my insurance after 2014.
And when I’d come down, and started talking with Debbie, and she helped me out cause probably
I wouldn’t even have been alive today if it hadn’t been for the clinic down here.
HRSA-funded black lung clinics also provide assistance to coal miners who file claims
for federal black lung benefits.
The Black Lung Benefits Act authorizes compensation to coal miners who are totally disabled by
pneumoconiosis resulting from their coal mine employment and to survivors of coal miners
whose deaths are attributable to the disease.
If a miner’s claim is successful, the Act provides him or her with medical coverage
for the treatment of lung diseases related to pneumoconiosis.
The Department of Labor’s Division of Coal Mine Workers Compensation Programs administers
claims filed under the Act.
Every HRSA-funded black lung clinic has a benefits counselor on staff who assists miners
with the federal black lung benefits claims process.
I feel that one of the most important things I do is help those miners apply for their
federal black lung benefits, and at the same time, I’m explaining how it works.
I'm kind of helping them learn the system…
The HRSA grant, it helps us to achieve our goals because the services that we provide
are not reimbursable.
We provide benefits counseling services that we are not able to get reimbursement from
insurances for.
There are all free services that we provide to our miners.
They go the extra mile to try to help miners and that’s not everywhere you look.
And they advise miners, they counsel them on benefits and everything, and help the miners
and give the miners confidence that they’ve got somebody helping them.
Miners applying for benefits under the Black Lung Benefits Act are entitled to a free pulmonary
evaluation by an approved Department of Labor provider and must submit an evaluation as
part of the claims process.
Many HRSA-funded black lung clinics have the ability to provide these evaluations onsite
by Department of Labor-approved providers.
We are authorized to examine miners for the presence of black lung disease, we also examine
them to see how severe the disease is, how much damage there’s been to the lungs from
that disease.
And then we have to try to make a judgment as to whether or not the miner is disabled
from that disease.
And another extremely important advantage of being a DOL examiner is that you get to
be part of a community of physicians, and attorneys, and benefits counselors who really
care deeply about miners’ health.
From medical care, to education, to outreach, to benefits counseling, HRSA’s Black Lung
Clinics Program provides vital services to thousands of coal miners and their families
every year.
Well, I don’t know what we’d do if we didn’t have a clinic like this, in the mountains,
you know.
Some people would be trying to drive miles and miles, you know, to get help if we didn’t
have this here.
I’ll have a place in my heart for these folks for the rest of my life.