Speech #910142133

Mr. Speaker. this bill provides for a 3year extension of the migrant health program with an authorization level of $20 million for 1971. $25 million for 1972. and $30 million for 1973. This bill also broadens the definition of the program beneficiaries to include other seasonal agricultural workers. In passing the Migrant Health Act. Congress recognized the obstacles faced by domestic migratory farmworkers and their families in obtaining health care. The migrant families share the health problems typical of other lowincome minority groups who live in poor housing. lack education. and lack knowledge of good health concepts and practices. Added to these problems are the ones created by their mobilitylack of attachment to any one community. frequent rejection by the same communities that depend on their labor. and transiency which restricts their access to the health services made available to needy community residents. In addition. community health services are often provided at times which conflict with the migrants work schedule and at urban centers usually far removed from the places where they work or live temporarily. The migrant families are poor and cannot afford to purchase the medical care they need. In addition. many communities which need their labor for brief periods have meager health resources which are severely overtaxed by a periodic influx of migrants. As a result of longterm neglect. the health needs of migrants far exceed those of the general population. The total migrant population is estimated at approximately 1 million persons including workers and their families. During each 12month period. they work and live for several months in more than 900 of the Nations 3.000 counties. The migrant health projects have demonstrated that interest in meeting the health needs of migrant families exists in many communities across the Nation. and that States and communities are ready and willing to put forth effort and funds to make health services accessible to a temporary influx of migrants if they are encouraged to do so by the availability of outside financial and technical assistance in meeting a problem that no single State or community can meet alone. These grantassisted projects are communitybased in the fullest sense of the term. The philosophy of the program is to encourage and to help the community recognize and assume its responsibility to include migrants in its planning and provision of health services. making whatever adaptations are necessary to serve them effectively. These projects are not demonstration or pilot projects. They provide urgently needed direct medical care to migrant farmworkers and their families. Family health service clinics. serviced by nearly 1.000 physicians. are operating seasonally or year round in more than 225 locations in or near large concentrations of migrant workers and families. Last year. migrants made 210.000 visits to project physicians. and 28.000 visits to project dentists. In addition. nurses made 160.000 casefinding and health counseling visits to labor camps. other migrant home sites. schools. and migrant daycare centers. Projects have working agreements with 170 community hospitals in which over 3.600 migrants were hospitalized. Interproject communication systems are being established to provide a capacity for continuity of care for migrant people as they move from place to place. The program stresses flexibility in the scheduling of services to make them available at times and places where they can be effectively used. Physicians and nurses drive many miles. often over rough roads. to hold night clinics at points where migrants are concentrated. Health aides. recruited from the migrant community. work in the camps to interpret the service to those unaccustomed to seeking and using medical care. In some localities. the number of migrants is small and they are widely scattered. In lieu of formal clinics. the project may set up a nursing program for regular camp visits for casefinding. referral of migrants to local physicians offices. and arrangements for patient transportation. if necessary. This type of referral arrangement is often used to supplement family health clinics by providing services between clinic sessions. Although progress is continually being made in the provision of health services to migrants. it is estimated that in the past year. health services reached only about one out of every three migrant workers. And they were reached typically for only about 3 to 6 months of the year. Even for the people with whom the program makes contact. the services are typically less than adequate.