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New Orleans, La., December 18, 1967.

Senator, Chairman, Migrant Health Subcommittee,
New Senate Office Building, Washington, D.C.

DEAR SENATOR WILLIAMS: The State of Louisiana has had a migrant health program in Tangipahoa Parish for the past several years under the existing legislation. We certainly want to continue rendering services to the migrant health workers and if funds were available, we could expand the services rendered.

Our present program serves approximately 3,400 population with some remaining the year round. Our current budget is approximately $20,000, and we have requested a $33,000, budget to improve our services.

We strongly support the extension and expansion of this migrant health project. Yours very truly,

State Health Officer.

Baltimore, Md., December 19, 1967.

Chairman, Subcommittee on Migratory Labor,
U.S. Senate, Washington, D.C.

DEAR SENATOR WILLIAMS: We are in full support of Senate Bill S. 2688 which will extend the Migrant Health Act and expand the program.

During the past summer, Maryland had approximately 5000 migrant workers, accompanied by over 800 children. The medical needs of these migrants have been found to be similar to the like socio-economic groups of the counties in which these migrants work. However, their lack of knowledge of available resources and the conflict of their working hours and the hours of operation of some of the medical facilities greatly complicates the problem of fulfilling their medical needs. We presently have only one Federal migrant health grant. This is in the amount of $16,369 for the current year and is limited to Worcester County, which had less than 15% of the total migrant workers last summer. In addition, we are cooperating with a Federally funded project in West Virginia, so that an additional 9% of our migrant workers are receiving the benefits of special services available through Federal funding. Project applications are being submitted from two other counties for the coming summer. If funded, these will provide services for an additional 8% of the migrant workers.

It is our feeling that continued extension and expansion of the Federal Migrant Health Act is essential to the provision of health services for migrant workers and their families in Maryland.

Yours truly,

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Lansing, Mich., December 20, 1967.

Chairman, Migrant Health Subcommittee, U.S. Senate,
New Senate Office Building, Washington, D.C.

DEAR SENATOR WILLIAMS: The Michigan Department of Public Health has been concerned and involved with the extension and improvement of health services to our migratory farm workers.

As you may know, Michigan ranks third among the states in the utilization of migratory workers. We estimate that 80,000 workers are required to harvest Michigan's crops valued in 1964 to be $175,000,000. These interstate migratory workers are housed in approximately 3,000 camps in 54 counties in Michigan's lower peninsula.

Our department has taken the leadership in promoting a healthful environment, family medical clinic and hospital care programs at the state and local level, effectively utilizing the funds made possible by the Migrant Health Act of 1962, as amended in 1965.

In the event that the Migrant Health Act is terminated, Michigan will lose medical and hospital care now available to approximately 45,000 migrants or 56%

of the estimated total number of our migratory workers (80,000) and sanitation services to all 80,000 migratory workers.

Over the last four years there has been an increase of health care services for 2,500 migrants at a cost of $9,000 to services for 45,000 migrants at a cost of $471,043 in 1967 (not including local contributions of $298,887). Sanitation services during this same period increased from no Federally supported program to a statewide program supported by $176,789 of Migrant Health funds.

In 12 counties, 14 clinic site locations are providing family medical services and 20 participating hospitals are providing needed hospital care. In the various programs over 80 full-time and part-time individuals are providing the services with the cooperation of 54 participating local physicians.

We are currently assisting four local health departments in the preparation of proposed medical and hospital project applications, which would make available migrant health services to an additional 15,000 migrants and dependents with a proposed budget of approximately $100,000.

It is estimated on the basis of current expenditures, that it would cost an additional $240,000 to extend this same range of health services to migrants living and working in the other 38 counties utilizing the services of migrants,

In order to continue the current program of essential health services for migrant agricultural workers and to provide for their extension to all migrants in the state, it is urged that the Migrant Health Act be continued and that additional funds be appropriated.


R. GERALD RICE, M.D., Acting Director.


DEPARTMENT OF HEALTH, Minneapolis, December 20, 1967.


Chairman, Migrant Health Subcommittee,

New Senate Office Building, Washington, D.C.

DEAR SENATOR WILLIAMS: Through the Association of State and Territorial Health Officers we have received a copy of the invitation to submit a written statement to your committee on migratory labor. Attached is a brief account of the Migrant Health Project, Minnesota Department of Health. The statewide program was started in 1963; May 1, 1968 to April 30, 1969 will be the fifth consecutive year of this health service. Since 1966, when Migrants, Inc., an Office of Economic Opportunity funded organization, was formed, the Minnesota Migrant Health Project has cooperated with that program.

We trust that this written statement can be included in the record to support proposed legislation to extend the Migrant Health Act and to authorize funds. We are also enclosing a copy of the project Annual Progress Report, 1967-1968. Respectfully,

Secretary and Executive Officer.


Project Title: Migrant Labor Environmental

Health and Nursing Service and Health Education Project (MG67)

A. There are approximately 10,000 migrant workers and dependent family members who come to Minnesota to work in sugar beet and vegetable crops each year. The crop season is from March to November. While in the state, families are housed in approximately 770 camps, most of which consist of temporary facilities.

Staff members are employed by the health project to supplement local nursing and sanitation services. These include nurses, health aides and sanitation inspectors.

The following is a brief summary of the 1967 program (as prepared for Migrants, Inc., Meeting Nov. 11, 1967):

1. Twelve nurses reached 500 families and made 2,000 nursing visits. The number of visits has never been stressed as a goal in itself. More important is the degree to which the nurses can do intensive family visiting.

2. Health Education Services through Counseling. Greatest numbers were in areas of diet or nutrition for children and adults, personal hygiene, dental, immu

nization. "What to do" "How to do it" and "Why to do it" were focal points in teaching families. "Taking time to care" is considered essential.

3. Environmental Sanitation-Plans include addition of an inspector next year.

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4. Employed twelve staff nurses, eight nurses aides, three inspectors. Anticipate same number of nurses and aides and four inspectors.

5. Number of school children screened: Dental 806; vision 904; hearing 887. Referrals were sent to home base for:

Dental, 170 need immediate care; 364 need care within 6 months.
Vision, 100 (61 need retest).

Hearing, 106 (91 need retest).

6. 1316 community contacts were made with 675 different individuals.

7. 4058 Personal Health Cards were issued in 1967.

8. Three clinics operated for 20 sessions serving 259 patients; 59% females, 41% males; 38 referrals were processed for prescriptions, chest X-rays, dental care, laboratory, etc.

B. Summary of requested amount and use of Federal migrant health grant for project year May 1, 1968, to April 30, 1969:

1. Personnel: Staff includes coordinator, 11⁄2 clerks, 13 nurses, 9 health aides, 4 sanitation inspectors..

2. Supplies-

3. Travel-statewide transportation, meals, maintenance for 27 staff members....

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$56, 095

1, 515


510 2,900

600 1,000


3, 850

25, 160

17, 290

2, 050

128, 837

C. If the above budget request is filled, unmet needs of migrant families can be taken care of in a reasonably realistic manner.


Jefferson City Mo., December 28, 1967

Chairman, Committee on Labor and Public Welfare, Subcommittee on Migratory
Labor, Senate Office Building, Washington, D.C.

DEAR SENATOR WILLIAMS: I am pleased to accept your invitation to submit a written statement in support of Senate bill 2688, which you introduced in the Senate on November 21, 1967. You will find my statement enclosed, and I hope that it will be of some small help to you in securing favorable action on your bill. I am also enclosing a copy of "The First Year of MAMOS", a booklet we have prepared describing the goals and activities of our program, which is funded under Title III-B of the Economic Opportunity Act. Inside the front cover of this booklet, you will find a brochure which graphically illustrates the needs that we have discovered among migrant workers for health and medical services. This "HELP" appeal was sent to churches and interested individuals throughout Missouri, and more than $900 has been donated to date. The proceeds of our Family Health Services Fund are used to provide emergency medical and health services for members of migrant and seasonal farm families. Needless to say, with this small fund we cannot begin to meet the needs that exist, but it has helped to make life easier for nearly 30 migrant and seasonal farm families.

The imperative of providing health services for migrants was underscored in dramatic fashion last month, when tubercular skin tests were administered to 77 individuals enrolled in our program of adult basic education and preemployment training. Out of the 77 tests administered 34 individuals—nearly one-half of those tested-developed positive reactions!

For those of us who work with MAMOS in attempting to provide migrants with "a way out", the need for health services is not something we affirm merely from humanitarian instinct. It is a definite, visible, concrete need with which we work each day. It may be easy to ignore statistics on migrant health, but it is impossible to ignore the man in your classroom who cannot learn because he is too sick to learn *** it is impossible to ignore the man who has worked and studied to obtain a permanent job, only to learn that he cannot qualify for the job because of health reasons.

Migrants are not typically weaker folk. Their health problems are caused in large measure by the long hours and harsh conditions of their work, and by the fact that health and medical services are generally inaccessible to them.

You can be certain that I wish you and the senators sponsoring your bill every success. America has ignored the migrant farm worker long enough!

Most sincerely,

MICHAEL D. GARRETT, State Director.


One of the most glaring needs exhibited by the rural poor is the need for health services of all kinds. The President's National Advisory Commission on Rural Poverty recently reported a startlingly high incidence of disease and premature death among the rural poor. Infant mortality, for example, is far higher among the rural poor than among the least privileged group in ubran areas. Rural residents, regardless of income, are more likely to have disabling chronic health conditions than their urban counterparts. Rural people have a higher rate of injuries than urban residents and rural farm residents have the highest rate of injuries cause by work-related accidents. Despite these factors, medical care and health services are conspicuously absent from rural America.

The lack of health services in rural America is most keenly felt by the Nation's one million migratory farm workers. Typically, these migratory farm laborers work under harsh and unhealthy conditions. They are exposed to heat, cold, wind, dust, chemicals and mechanical hazards. Their crowded living quarters frequently lack sanitary toilet facilities and water that is safe and accessible for drinking and washing. In 1964, the migrants' mortality from tuberculosis and other infectious diseases was 21⁄2 times the national rate, and their mortality from influenza and pneumonia was more than twice the national rate. The accident mortality rate for migrants in 1964 was nearly three times the national rate.

These statistics present more than interesting information about a faceless mass of humanity. These statistics reflect the deplorable condition of one million men, women and children who travel annually to work the harvests in more than 700 United States counties. This condition is aggravated by the migrant's inability to help himself. (1) Characteristically, the migrant is a member of an economic or social minority group. Chiefly, he belongs to Negro, Spanish-speaking, Indian and low income "Anglo" minorities. (2) The migrant is poor. In 1965, his annual income from all sources averaged $1,400. (3) The migrant lacks upward job mobility. The average migrant adult has only a fifth grade education. and many function at a far lower educational level. While the migrant necessarily acquires a degree of agricultural skill, he has little experience or skill in other work. (4) The migrant is usually ineligible for public assistance. Because his work requires extensive travel, the migrant is a non-resident in most of the areas where he does his seasonal work and cannot qualify for medical or health assistance from local public hospitals or welfare departments.

The plight of America's migrants is not going to improve automatically. Over the future of the migrant farmworker there hangs the threatening cloud of increasing automation and technology. From 1950 to 1965, new machines and methodology increased U.S. farm output by 45 percent-and reduced farm employment by 45 percent. During the next 15 years, the need for farm labor will decline by another 45 percent. In 1951, only 1 percent of Missouri's cotton was picked by machine. Today, 95 percent of this cotton is machine-picked. A single two-row mechanical picker replaces 70 workers in the harvesting of cotton. Something affirmative must be done to aid the migrant.

The adoption of Senate Bill 2688, which would extend and expand the Migrant Health Act, will not meet all the needs exhibited by America's migratory farm

workers. However, the adoption of this legislation is an imperative first step in meeting these needs.

Minimal health services should be readily available to all Americans, regardless of race, income, place of residence or type of occupation. Because the Migrant Health Act has begun to make these services available for the first time to migrant farmworkers, and because the legislation introduced by Senator Harrison A Williams, Jr. would expand and extend this essential program, I would urge that the Migrant Health Act be renewed in 1968 as proposed in Senate Eill 2688. MICHAEL D. GARRETT, State Director, Missouri Associated Migrant Opportunity Services, Inc. (MAMOS).

Bridgeton, N.J., January 4, 1968.

Chairman, Subcommittee on Migratory Labor,
U.S. Senate, Washington, D.C.

DEAR SENATOR WILLIAMS: My letter is to urge you to do everything in your power to extend the Migrant Health Act for five years and to include as many more farm workers as possible. The agriculture workers whether migrant or local comprise a large percentage of the impoverished people of our county. Poor health can be the cause of the improverishment as well as lack of education and skill. Seasonal transient workers coming to our area to supply labor to one of our major industries, agriculture, call for additional services to supplement the local year around health services. The latter are not adequate as yet to meet the preventive and diagnostic medical needs of the local population.

Prior to receiving project funds to provide health services for the migrant worker, unpaid bills for hospital and other medical services had to be absorbed into the charges for services to the regular users of the services. These conditions added another stigma to the migrant's acceptance in the community,

The agricultural worker has benefited greatly from Federal funds supporting the health services in our County. It would be most tragic if planned programs for extended health services would have to be curtailed because of lack of these funds. Respectfully yours,

WILLIAM P. DOHERTY, V.M.D. Director, Migrant Health Project, Cumberland County.

SEWELL, N.J., December 29, 1967.

Re bill S. 2688

Committee on Labor and Public Welfare,
Subcommittee on Migratory Labor,

U.S. Senate, Washington, D.C.

DEAR SENATOR WILLIAMS: The need to provide and increase Migrant Health Service is readily recognizable. In the 1967 Migrant season in Salem County, migrant farm workers were provided with over 1500 migrant health service visits. All needing services were not reached as desired, due to budget limitation.

The current concept of health, "The state of mental, physical and social well being and not merely the absences of disease" should be applicable to the migrant population as in other groups. The statistical records of health services to the migrants indicate that the need is there.

To provide this group with the health services to obtain "the best quality health", there is a need to continue, as well as, to increase the financial assistance for the Migrant Health Services.

Respectfully yours,


Director for New Jersey State Department of Health Services for Salem

County-Migrant Season, 1967.

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