Hudson Valley Migrant Health (HVMH) (a Public Health Service program) collaborated with the Center for Disease Control (CDC) and the New York State Department of Health (NYSDOH) on a study of the incidence of sexually transmitted diseases and tuberculosis among migrant farmworkers in the mid-Hudson region of New York. CDC research personnel screened 115 migrant workers from August 31 to September 12, 1992, distributed results, and initiated treatment. HVMH assumed primary responsibility for follow-up. Other agencies offered support during both phases of the study. Screening results indicated a 36 percent tuberculosis positivity, 6 percent HIV positivity, and 32 percent syphilis positivity. In addition, 32 percent lacked immunity to the Hepatitis B virus. Barriers to providing screening and health care include: (1) limited hours of access both by farmworkers to health care, and by providers to farmworkers because of work schedules; (2) underdeveloped linkages with county departments of health; (3) travel distances and lack of transportation for follow-up; (4) inefficient transfer of medical information upstream and downstream; and (5) limited staff and financial resources of HVMH for the extensive follow-up required. Nine recommendations are offered; they include adopting more positive attitudes toward farmworkers; improving collaboration and coordination among agencies; coordinating interstate Medicaid coverage; establishing outreach, health education, translation, and transportation services; and increasing the role of the Public Health Service. (KS)