A list of the current use of Migrant Health Act funds in Washington follows: Migrant Health Act funds in Washington; total in 1968 Washington State migrant health project (MG-145): Statewide project providing consultant services in medical and dental care, nursing, sanitation, nutrition, and social work to local projects; coordination of services to migrants within the State; and stimulation of services in areas with large migrant populations. In addition, nursing care was provided in Yakima County and sanitation services were provided in Okanogan County. Whatcom County migrant health project (MG-132): Medical, dental, nursing care, and sanitation services___ Skagit County migrant health project (MG-144): Medical, dental, Puyallup-Stuck Valley migrant health project (MG-19R): Medical I Not incl inuded total. Sincerely, $160, 453 41, 957 23, 788 54, 384 40, 324 1 24, 695 BERNARD Bucove, STATE OF WISCONSIN, DEPARTMENT OF HEALTH AND SOCIAL SERVICES, Hon. HARRISON WILLIAMS, Chairman, Migrant Health Subcommittee, DEAR SENATOR WILLIAMS: As Wisconsin's State Health Officer and Administrator of the Division of Health, Department of Health and Social Services, I would like to go on record in support of bill S. 2688 relating to the extension of the Migratory Health Act. The migrant worker is a prototype group which is under-educated with respect to health, insulated by language from the culture which surrounds him, unable to afford major expenses, and kept by his tradition and work from the beneficial habits of hygiene and nutrition. If the health of this group is to be improved during the agricultural and food-processing season in Wisconsin then a continuation of the Migrant Health Act is necessary. During the past four years migrant grants have enabled local communities to expand health services for the migrants in Wisconsin. Even though these projects are making progress in the health status and personal health practices of the migrant workers and their families, the number they reach is pitifully small. Reports received from the projects show an increase in the utilization of medical and dental services over the past years. During the 1967 fiscal year 1,909 migrants made 3,403 medical and dental visits to the family health clinics. This represents only 7.7 percent of the migrant population receiving medical and dental services. This means that approximately 93 percent of the migrant population did not or could not obtain the necessary health services needed. The enclosed report of the utilization of the Wisconsin Migrant Health Services will substantiate the need for an extension of, and an increase in, funds for the Migrant Health Act. Sincerely, E. H. JORRIS, M.D., A BRIEF REPORT OF WISCONSIN'S MIGRANT HEALTH PROGRAM, 1967 There are six areas of concentration of migrants in the State of Wisconsin, covering 30 counties. There were approximately 12,000 migratory workers employed during the seasonal agricultural and food-processing activities in Wisconsin during 1967. The total estimated migratory population during the peak season was 24,767. ESTIMATED POPULATION, 1967 There are five formal Migrant Health Projects in the State of Wisconsin. Three (3) are supported by local, state and federal funds; and two (2) are voluntary programs supported locally. The three health projects which are assisted by federal funds are those in Endeavor, operated by the Catholic Diocese of Madison; in Beaver Dam, operated by St. Joseph's Hospital; and in Wautoma, operated by the Waushara County Committee for Economic Opportunity. These programs were awarded a total sum of $60,845 by the Public Health Service for the fiscal year July 1, 1967-June 30, 1968. The federal funds authorized under the Migrant Health Act were used to continue and expand the medical and dental care programs, nursing services, inhospital care, sanitation services, and health education for migrant agricultural workers and their families in the project areas. The migrant allotment by project and compared with past fiscal years is as follows: The two voluntary health projects are: the Oconto program, operated by voluntary groups from Oconto and Oconto Falls; and the Door County program, operated by voluntary groups and sponsored by the Catholic Apostolate of the Green Bay Diocese. The counties served by UMOS received no formal health services. The migrant projects in Wisconsin were awarded $13,200 (which was included in the total $60,845 grant) for hospitalization. Of this sum, $9,600 was allocated for in-hospital care and $3,600 for physician in-hospital services. During the fiscal year July 1, 1966-June 30, 1967 the health care services (medical and dental), and for the first time in-patient hospitalization, was made available to 24,767 migrant people. Of the total migrant population (24,767) only 1,538 received medical services. Approximately six percent received some type of medical services and 23,229 migrants (94% of pop.) did not receive any medical care. Dental care was given to only 371 migrants, 1.7 percent of the total population. Eighty-four percent (84.0%) of those who received dental care were children under 19 years of age. Ninety-eight percent (98.0%) of the total migrant population did not receive any dental care. One-hundred seven (107) migrants were in-hospital patients at a cost of $22,611.13, and only $13,200.00 was allocated by the migrant hospital health grant. Even though part of the costs were paid for by County Welfare and Title XIX programs, there was still $12,150.54 of outstanding hospital bills. The in-hospital portion of the Migrant Health Grants is inadequate as it only pays 58 percent of what balance is remaining after other state and local funds are exhausted. For a complete picture of the utilization of the health services by the migrants offered by the five health projects, see Attachments #1, #II, and #III. ATTACHMENT I NUMBER MIGRANTS VISITING FAMILY HEALTH SERVICE CLINICS, 1967, WISCONSIN NUMBER AND PERCENT OF MIGRANTS RECEIVING HEALTH SERVICES, WISCONSIN 1 84 percent of those receiving dental care were children ages 2 to 19. Note.-23,229 migrants did not receive any medical services-94 percent of population; 24,396 migrants did not receive any dental services-98 percent of population. ATTACHMENT III UTILIZATION OF IN-HOSPITAL AND PHYSICIAN IN-HOSPITAL CARE, WISCONSIN Senator WILLIAMS. Thank you very much, gentlemen. Mr. GONZALEZ. Thank you. Subsequent to the conclusion of the hearings, the following letter was received from Dr. Radebaugh: THE UNIVERSITY OF ROCHESTER SENATE SUBCOMMITTEE ON MIGRATORY LABOR, GENTLEMEN: My testimony to the Senate Subcommittee on Migratory Labor on December 7, 1967 has aroused considerable controversy in Wayne County. The Curtice-Burns Company and the Wayne County physicians are justifiably upset. In reference to the testimony concerning J. C. Gonzales, this was obtained shortly after forty men had left the Curtice-Burns Company in Bergen, N. Y. in Genesee County. This man, as the others, was upset and presented this check as evidence. Further information from the Curtice-Burns Company indicates that this man may have received another check for the same period. I understand that the Senate Subcommittee on Migratory Labor is in communication with the Curtice-Burns Company to clarify this matter. In reference to the patient, Mr. John Cowart, who had difficulty in obtaining medical care in Wayne County, there is a need for me to correct some of my statements. Mr. Reginald Carter, who works for Basic Education for Adult Migrants, BEAM, was called to try to help Mr. Cowart obtain medical care. Mr. Carter informed me that he transported Mr. Cowart to three hospital emergency rooms, before he was able to find help. Two of these hospital emergency rooms have no record of seeing Mr. Cowart; the third referred him to the office of Drs. Reed and Davis. Dr. Davis, in Newark, New York, did, according to Mr. Carter, see Mr. Cowart, a fact unknown to me at the time of testimony. On the following day, Dr. Davis called the Veteran's Administration Hospital in Syracuse, New York to arrange for Mr. Cowart's admission. Mr. Carter has been called upon to transport a number of seasonal workers for medical care; this patient is an example of some of the difficulties. However, it in no way absolves me from trying to obtain all of the facts before using material to illustrate a need. I met with a number of Wayne County physicians and Dr. Davis, and was made aware of other details in relation to Mr. Cowart. I apologized to Dr. Davis for not realizing his interest and efforts on behalf of this patient. This testimony to the Senate Subcommittee on Migratory Labor was used to illustrate a need for further medical efforts on behalf of the seasonal farm worker. It is not an attempt to reflect upon any one physician or group of physicians; for all of us as a profession, have a responsibility. Whether we are in a medical school setting or a practicing physician who extends major efforts in trying to provide care for the seasonal worker, we need to cooperate in making medical care more accessible to the seasonal worker. To accomplish this end more support is clearly needed to solve the serious problems presented to all responsible for health care. Sincerely yours, JOHN RADEBAUGH, M.D. (Whereupon, at 1:24 p.m., the subcommittee adjourned subject to the call of the Chair.) О 2476 63 |