Villicana, a 44-year old Kaolin Mushroom Farms employee from Mexico, understood that treating Type II diabetes required dietary and lifestyle adjustments. He just couldn't understand what they were.

"When I found out, I was referred to a doctor who only spoke English," said Villicana, in Spanish. "And, since I'm not exactly an expert in English, it was a pretty big problem."

Now, because of La Comunidad Hispana's one-year-old Work Healthy program, Villicana not only gets the treatment and information he needs in Spanish, but he also gets it without having to leave work.

Villicana is one of more than a thousand mushroom-farm workers in southern Chester County who can take advantage of the program, funded by a four-year, $489,000 matching grant from the Robert Wood Johnson Foundation of Princeton, N.J. The money was used to provide on-site, bilingual health care for Latino immigrant workers at three mushroom farms.

Each clinic provides workers - nearly all Mexican immigrants - with primary and preventive care through a bilingual nurse practitioner and a bilingual health educator. The clinic is open two days a week at Kaolin Mushroom and two days a week at Phillips Mushroom, both in Kennett Square, and one day at ToJo Mushroom in Avondale.

The Work Healthy project is an extension of Project Salud, Comunidad's nurse-managed primary-care health center in Kennett Square, which offers bilingual and bicultural services to those in need, even if their immigration status is undocumented or they can't afford to pay.

On-site care makes a big difference to workers. "A lot of workers had not been seen by a physician in years," said Isidoro Gonzalez, executive director of La Comunidad, a 34-year-old nonprofit that provides bilingual programs in health care, education, and social services for low-income Latinos in southern Chester County.

"There were multiple barriers," he said. "First, many lacked a means of transportation. It wasn't easy to get to a doctor. And if they did go, it often meant losing a morning or even a whole day of work. Most workers would rather work and earn money than see a doctor, even if they needed to. This has given them a whole new perspective, because it's primary care available at their place of work."

At the clinics, workers pay if they have money; if they don't, they're taken care of anyway, Gonzalez said.

Esthela Zavala Luna, 37, has worked at Kaolin Mushroom Farms for three years. Before she started going to the on-site clinic, she hadn't seen a doctor in years.

"If you have to make an appointment somewhere else to see a doctor, you have to wait three or four days, and then you lose a whole day of work," Luna said in Spanish.

Because the on-site clinics are more convenient, Luna has time for physical exams and screenings.

"Before, I never had physical exams," she said. "But here they have everything I need, so I can make sure I'm healthy and get checked more frequently."

Work Healthy puts as much emphasis on health education and prevention services as it does on providing care.

"This is not just a clinic, it's a whole work-wellness package that we're offering," said Natalia Molina McKendry, Comunidad's coordinator of health and wellness services.

McKendry, who has a master's degree in public health, works with other health educators to provide bilingual monthly newsletters (included with workers' paychecks), bulletin boards, educational speakers, and health-insurance enrollment aid.

"I read the literature a lot," said Luna. "It teaches me so much. Before, I was really unhealthy. The literature explains how to be healthier, what to eat, and why it's good for you. And I make my kids eat healthier, too," she added. "I'm really grateful for all of it."

In addition to the nurses and health educators, two or three workers at each farm are trained to be promotores de salud, or health promoters.

"They are very instrumental and pivotal to the program," said Gonzalez. "They help promote services at the clinic, and kind of coach others.. . . They make sure the connections are there and that the people can access care."

One critical factor in the program has been the strong support and participation by the farm owners.

"We are all working together, with both employers and employees, and it's really broken down so many walls," said Gonzalez. "The farm owners have really done a lot. More than just monetary contributions, they have really gone out of their way to renovate the office space and clinic areas, among other things."

Mike Pia, president of Kaolin Mushroom Farms, said: "Quite a bit of logistical work was needed to structure this thing and maximize the dollars, but we're very happy with it.

"It's been very well received by our workers," he said, "and I think we're only going to see good things continue in the future."