Speech #900117445

Before looking at the picture nationwide. however. I would like to relate to you how the program operates in just one county In Florida. The migrant health project provides health services to the 20.000 migrant agricultural workers who work on the Palm Beach County farms annually. This is a group which consists of southern Negroes. Puerto Ricans. natives of the West Indies. Texas Mexican Americans. Cuban refugees. and Eastern seaboard caucasians. The project gives these people family health service clinics. nursing and sanitation services in the camps and other areas where they live and work. Migrant workers reside in some 136 camps in the county. A group of nine fulltime and 16 parttime employees work in the migrant camp areas to improve sanitary conditions. Over 1.958 health problems were corrected. often with the help of the migrant workers themselves. Several camps were closed. and many more were improved. Nationwide. accomplishments under the Migrant Health Act have been noteworthy. Projections for the future require additional effort. In September 1962. the Congress first authorized the Public Health Service to make grants to help communities extend health services to the migrants who help them produce and harvest their crops each year. Fiftyeight applications had been received by the Public Health Service from community sponsors before the first funds were appropriated to carry out the act in May 1963. In that first year. and in each year since that time. requests for funds have exceeded the funds available. As of June 1967. 106 migrant health projectseach serving one or more countieswere receiving grant assistance. During the year. migrant workers and family dependents made 215.000 visits to physicians and 24.000 visits to dentists under project auspices. By late June. 55 projects in 25 States had added hospital care to their services. The projects had signed agreements with 162 shortterm general hospitals to provide care for migrant patients. and an intensified program of early casefinding. medical care outside the hospital. and predischarge planning had developed in each of the 55 project areas. Migrant health projects provide not only greatly needed remedial care for workers and dependents. but also immunizations. family planning services. nutrition counseling. and referral of patients for followup services after they return to their home base. or go to other work areas. In addition. the projects work with growers and other community groups to improve housing and environmental conditions. and to develop better understanding and acceptance of migrants. Finally they work with migrants. themselves. to develop understanding and application of good homemaking and safety practices to prevent as much illness and disability as possible. In spite of the progress made. project services fall far short of making accessible to migrants the same services the rest of the Nation enjoys. As an example. if the 300.000 migrants estimated to be in one or more project areas for part of last year had used health resources at the average per capita rate for the Nation as a whole4.5 medical and 1.6 dental visits per person per yearthey would have made more than 1 million visits to physicians and nearly onehalf million visits to dentists last year. This is in contrast to the 215.000 medical and 24.000 dental visits reported by the projects. The services of existing projects are heavily utilized. However. the level of service in these existing projects is deficient in relation to the need. Moreover. more than 40055 percentof the Nations counties where migrants live and work In counties still have no project services. A further handicap to the migrant health program as it now operates is the continuing hardship to local participating hospitals resulting from the payment. on the average. of only 60 percent of total hospital costs. Making up the deficiency is extremely difficult for some communities in view of the high costs of hospital care.