Speech #910129981

Mr. President. I submit an amendment to S. 2660. a bill to extend and otherwise amend certain expiring provisions of the Public Health Service Act for migrant health services. that would provide for participation of the migrant agricultural worker in program development and implementation. I am today proposing that section 310 of the Public Health Service Act. which provides money for migratory farmworkers health care. be amended by adding language that will guarantee participation by the target population in the development and implementation of migrant health programs. The Migrant Health Act was passed in 1962 with the avowed purpose of providing health care for migrant farmworkers. Before passage of the act. adequate health care was the exception rather than the rule for migrant families. Migrant farmworker families were excluded from traditional health services taken for granted by all the rest of society. Now. through 116 project grants in 36 States. physicians and hospitals are involved in upgrading the health of farmworkers. The present appropriation of $8 million limits provision of service to only about onethird of the target population. and in many instances. even those services are inadequate or incomplete because of the shortage of funds. Although the act is improving health care services for migrants. recent hearings in Washington and in the Rio Grande Valley of Texas on the extension of the act. point up the need to involve the consumer population in project development and implementation. Too often Federal funds are not being used to their fullest advantage. A lack of knowledge on the part of migrants about available facilities and program components still prevails. Many programs lack an adequate outreach component. Too often programs do not take into account the total poverty of migrant families. so that health care is not mauched with services to meet related needs of food. shelter. clothing. and other famiiy reeds. Special effort and innovation in organizing and delivering services to make them more accessible for the use of geographically and socially isolated migrants is often lacking. Some programs have not explored the possibility of developing new sources of personnel to supplement available professional personnel. such as aides drawn from among migrant families. Some programs are in the hands of local. county. or State health departments that are insensitive to the needs of migrants or operate heedless of the dignity of the individual. Many local public health programs are already starved for funds. and thus use Migrant Health Act funds to operate their regular programs. Programs are often entwined with legal and policy exclusions from certain local services. Language problems often cause confusion in the delivery of needed services. and staff members are often not bilingual in areas where Spanish is the prevailing tongue. In other instances. health care was not related to the needs of the individual or the family. Experts have documented the fact that greater attention to preventive medicine might obviate the high costs of curing advanced stages of disease. I am convinced that insufficient health care for the rural poor and the migrant will remain the rule. rather than the exception. until we tap the vast wisdom. understanding. loyalty. and pride of the poor. It is the poor themselves who know most abcut the details and the solution to their predicament. My amendment represents a modest. inexpensive device for guaranteeing that those who are excluded from health care be permitted to participate in the development and implementation of programs that are intended to improve their health.