'

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ED 110 214 '

DOCUMENT RESUMP,t

RC 608'656 1 '

l/

TITLE Western Kansas Mi ant Health Pfbjedt: 10th AnnulProgress. Report, 1 73. , 7i

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INSTI UT Kansas State Dept.\of,Realth, Tdpeka.PUB DI 73 /NOTE )\. 74p.

.. . I_2

EDRS 'PRICE ,MF-$0.76 HC-$3.32 ,PLUS POSTAGE. ,.

DESCRIPTORS' *Annual Reports;,,ClinicS; Ray CaNAServices; Dental is

*--,. Healti; *Health Services; *Human"Servides; MedicalServides; Mexican Americans; 4grant,Education;

k *Migrant Health Services; Migrant Housing; *Outreach." r Programs; 'Statistical Data i_

IDENtIFIERS *Kansas-

.

ABSTRICT ,

.. Basic services provided by the Western Kansas MigrantHealth Project for migrant families include: (1 remedial schooltandmigrant education programs; (2)r health educat n; (3) housing and .

sanitation; (4) nursing_services; (5) medic and dental services;.(6) hospital services; and A7) 'sup'plement food programs. Among the

.---

-" Project's services during 1973 were: outpatient services for 716.., __ patients.trieated at clinics, 92f ,office calls inc physicians' offices,

i38 e ergenp 'r om-seryices, 346 lab services,' and 82 x -rays; family'plann ng s for A0 women; and vision, hearing, and deltalScree g

,

fd -children attending summer migrants education prdgrams.This T annual progress report.reviews the Project's aqtiviiies

,,

i

'from'D ember )972 through November'1973. The Project-0S sic,-

-. services are bii fly summarized. Statistical data on the%migrantpopulation and m dical, dental, hospittal, nursti.ng, and healtheducation'setvi es ate included in the apPendides.,(NQ)

11.

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* 'Documents adquired..by:ERIC include many informal Anpubliihed v t*-materials,not aVailabN.; from other sources. ERIC makes every effort *.

_ _ * to, obtain the best' dopy available, nevertheless, items of marginal*.'.:Te'producibility-are often encountered and this, affects the quality*.of the and lardcoPy,reproductions ERIC makes avAlable '"""

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* via thp ERIC:Document* responsible for the

. '*:sOplied by..EDRS ar*******************

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roduction'Seryice (EDRS), EDRS is not -* *Ality the original document. Reproductions * ",

the'b4st at cA be made from the original,. *"*******4************************************ic

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PENr"41...

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w: tern kangas mhealth; project

U.S DEPARTMENT OF HEALTH,EDUCATION &WELFARENATIONAL INSTITUTE OF

EDUCATIONTHIS DOCUMENT HAS BEEN REPRO-DUCED EXACTLY AS RECEIVED FROMTHE PERSON OR ORGANIZATION ORIGINATING IT POINTS OF VIEW OR OPINIONSSTATED DO NOT NECESSARILY REPRESENT OFFICIAL NATIONAL INSTITUTE OFEDUCATIOWPOSITION OR POLICY

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IANNoUALi.P.ROGROSS REPORT

Western KaiVsKpsas

ligrantealta-Projectjpartme t of Health

1973

PROJECT STAFF

Project DirectorHealth ,Educators

Public Health Nurses

too,,Judy Shedd0'Tievfeve" Musquiz*vary gchlecht

. ' 4

NI"krinia,r,,,Garcia,Connie Hernandez., R.N.t'ctloriene-Whisnant, R.N.

da Agu -il4rOrtiz

Program Workers t../

Typist

/Office Assistants

--..,ASSISTING AREA HEALTH PERSONNEL

&)----unty lic Health Nurses.4

ts

School Nurses,

STATE HEALTH; DEPARTMENT CONSULTANTS

-

STATE

*Resigned, retired'or began leave

i.

PROJECT DIRECTOR1.. ,

Nev

,Olivia GonialesGeraldine Medina

.

Apoilina, Day. Gray County

Beth Coekr& , R.N., Stanton Countyd2laire Fawcett, Kearny Countyfrene- Hoy R.N., Finney County

.Dorothy Klepper, R.N., Sherman CountyJeri Menzie,. R.N. , Grant County ,

r

Kathy Lane., R.N., Leoti Public Schools:'Lupe Lopez, R.N., Garden City

Title f Program/

aessie King, R.N. "'1,

Virgi4a Lockh MPH

Jame Mankin, D .S., MPHHel tin .

Shii167;- pj

iDorothy W

A I

N.;'MPHlEvalyn S. Gen el, MD', pfrectorDivision of Maternal & Child Health

ya

'

of- absence during project year.

00(M. tt.

O

N

MIGRANT HEALTH JPROJECT POLICY BOARD

. - .

sus-iedesma, Garden Cityn Reyna 1.. ..,Goodland

( --,,

4 I,

'Is 1

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_Maria Gutierrez

Board Members:

.,02` Ulysses

4.

Ruben Calderon Garden CityOliver DeLeon LeotiJuan Ledesma KanoradoJosie Torres ;

0 Leoti

Antonia ----Trejo 'Johnson4% t

4 .

' Carmen dasteneda Leoti

Pedrb Bela Rosa 1Kanorado

Margarito Espino'sa .p.. .. *Goodland

Jimmy Guerra DeerfieldJanie Hernandez Leoti

JosdtRios UlyssesPedro Sandoval 'Garden City

Consultant Members

t

Ma el Linder . LeotiIt is Palmer`, D.D Ulysses

4s,

0 i 04

071.

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TABLE OF CONTENTS

Page No.

SuMMary1

i

II. "Remedial Schools and Migrant Education rograms 7

III. Health Education,10

I

IV. -Dousing and Sanitation.... 13,

V. Nursing Services "-1-4 15

*4 .

Vf.ft" Mglical and Dental Services j 22

,,_,,,1W4pital Services30

f

vIfq,1,

Migrant' Health Policy Board'

IL Supplemental Food Program. 37

r... "Community Action and Suppor

XI. Statistical Tables 1 4

PopUlatioll Totals ;tith ArMedical.DentarandHospit 1NursingServicesHealth,Education Service

.

43

psv

45

45

ices 62

66

,67

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I. SUMMARY

c

1973 was a Year filled wi s and SUStme s for Most of thecountry. During the past, g wr ers)hav shoWn a flair forprophecy with,such tunes as If We ejt Thro gh December, -- We

, ,May Never Pass This W y Again, -- an \GoodbYk, ellow,Brick, Road. Head- '..;line scream with gr ,predictions of the near future. Promises of

, pol'itticians and comets both fizzle, consumers screaril'about the highcostof,heating, diesel fuel and-gasoline/but all' but trample 'each

i.'

other to lei wtrat,e er they can. Consumer advoc tes say there is noenergy crisis. Oi company executives say t re is. The Arabs smile"*Jot.' :Prices of just about everything/co tinue to escalate at a,frighten,ing rate. Shortages .of baling/wi , canning jars, plastic

,

toys ant paper pr ducts are tact. Then s media carries stormyactount4tof soari g numbers of unemployed. The energy crisis touchesus alit But whp, as paused in the panic of now to consider the plight

tiof the' grant,4-

agricultural workerphos.travels from state to state to ,

p t, w edthin, hoe, pidk, and harvest our nation'slfood Supply. Andwho will feel the vise of the energy crisis tighten ,6ore painfully'thanthose who must take to the road just to survive?

,Each year several thOusand migrants travel to western Kansas seekingwhatever eMOOyment they can find. Most remain for at least several ;//'week's to.hoe and thin sugar beeti. Some find work rogueing milo,picking melons and vegetables, hauling grain and beets;'w'di.king in ,

feed lots and miscellaneous jobs. Some stay only briefly, many'remainseveral months., Others attempt to,settle in this area When permanentjobs and housing are availaple. This usually means a numberlOf meagerweeks at, best, as many farmworkers are'paid by.the hour and not a setamount per month. This arrangem t results in inflated incomes-in thesummer and depressed or nonexis pt incomes in the Winter:. For largefamilies it is very difficult o have money for the folloWing winter.This, is especially true ,ey have many bills retaining from thewinter before. Most' the migrants coming into Kansas come from Texas..ik few come from Colorado, New Mexico, Florida mold other states. A fewsettled-out migrants from Texas now living in Kansas travel to northernstates'such a Michigan to work in vegetable and fruit crops. Almostall of the migrants coming tospeaking. Most are bilingual

sas are Mexican-American and S anish-Some speak only'Spanish.. _

it1973 witnessed ex nded u Mechanical thinners in sugarbeets inwestern Kaisas. Additionally beet acreage was reduced somewhat in thesouthwest counties, althdrigh acreage increased in the northwest counties.It should be noted that ,a controversy still wages concerning the use ofmectanical"thinners. 4e-emergent herbicides must be used if the necessity'for hand labor is tg'be by=pagsed. The,combined,cost of the herbicidescoupled.with the rental or purchase cost of thinners equals or exceeds

the`- the cost of hand labor. .Some of the first thinners' used,in the areawere purchased bylthe Gaxden City Company. 'These were in turn_rentedto'grower$ at err minimal rates. This move by the Garden City -Company*,

! came about, shortly after" all migeant ho ng owned by the :crimpany was. -

/

A

A

burned down: Both events occurred following --"summer of heatedcharges leveled at growers some of which dealt with ,deplorablehousing. Manny Fierro, a Chicanp orgaqizer of some fame in Kansas,was one of the spokesmen In the controversy. OnfortunatelY theGarden City Compan' whic owns much of the farming land in Finneyand Kediny cqun -et reac ed by by- passing the need for hand laber

---140:ther than upg ng housing conditions. Ironically the criticismdirected-toward migrant housing conditions never singled out theGarden City'tompany housing nor even housingein Finney.or,Kearnycounties.

J

f4 4

The reaucea-acreage of sugarbeets in some areas it largely a resultJ 'I, of the 15W disaster, k;:hen heavy fall rains interrupted the beet

harvest for a number of weeks. The wet ground also caused the sugarto be'ldeched,from the begs." As a result the sugar content was solow that the sugar companies refused to accept most of the harvest.

. ,Many beets were never dWbut left in the ground. Growers.in the area.lost more than six million dollars. A suit is still pending againstAmerican Crystal Sugar Company for breach of contract. 'Other negativefactorsih the beet situation are increased transportation costs andthe high cats incurred in irrigation. During the year efforts ofgrowers to pui- chase both American Crystal and Great Western SugarCompanies wee in the wind. Apparently the plans to purchase Great,Western were abandoned. However, Colo-Kan Sugar, Inc. has leased thefacilities Of AMerican Crystal in Rocky Ford, Colorado'where alyheetsin the southwest area are processed. The lease is for a five Yea;;-

.period with an option to buy. It is probable that beet acreage in,thearea will be increased in 1974. ,

A number of growers in the area have abandoned raising sugarbeets andhaye diverted their land to other-crops. In Haskell, County, for example,.

few growers are now growing alfalfa instead of beets.' With dramatic).increases in the market prices of,wheat, and leSer but neverthelesssubstantial increases in prices-for milo and corn, the beet businessis a lot, less lucrative Ehsn it once wasp. At the time of the 19'73wheat harvest wheat Sold for $2.40'pep bushel as opposed to about.$1.30 before the Russian graiydeil. Since wheat harvest per bushelprices have fluctuated fromaround '$4.00 to more than '$5.00. Whilehigher grain prides are goad news foritain farmers,,they are bad news,for the cattlemen. The price freeze, IFDA,bans on certain feedadditives and-eicalated feed costs have all,served td,:oause the

. cattleman to lose his shirt. B;TTatetalli r.ftedes weie losing

more than $100 per head on cattle goingto the-market. ..BefOre.thei

meat price'freeze cattlemen were making a profit for the First timein history. What the irate urban tiousewil doesn't realize is tha fluctuationf a Penny of two per pound on the hoof capinak orbreak'cattle producers.- The only way he has ever been ab torealize even marginal, profits Is to deal in voldme. \y ortunatelythefarmer)fia's no 9ontrol'over the middlemen and retailers,'

,During the:1973 sessions of the Kansas Legislature severalbillso..E,

2'

)

z

The Project has administered the USDA sponsored Supplemental,FoodProgram, for more than four years. This program, is intended doprovideligh protein foods to p natal and postpartum mothers-1naddition to children less than ix years of age.' During the pastyear nerfSi. 31 tons, of food wer distributed to persons in tencounties."-The average number o persons recei,Ving commodities was104.58 per month. Eligibility or this program is determined bynutritional need.as Verified by a.physician or registered nurse.The only requirement Is that pe sons receiving food items be eli-gible for other services of the Project,,i.e. be agriculturalmigrants or seasonal farmworke s. 'The only cost tothe Project has

.

been shipping and storage cost_ plus staff time. Much staff timeis consumed in boxing items, r cord keeping, preparing reports,'transporting food'items to oth r communities, to' say nothing ofunloading a semi when a shipment arrives. The Project-will re-teive only one more shipment for the program. This is a result ofthe fact that no commodities will be'available after early 1974.;All Kansas counties will have food stamp programs by June 30, 104..MostiTounties have already made the transition from comthoditypfo-

.grams to food stamp programs.; It also seems:likely that the re ar,..',1upplemental Food Program is destined for termination Ationally,..'.f,

.441.1 alternate program the Women, Infants anal Children Program, (W COhas been.funded for this fiscal year on -a limited basis. WIC wi Iprovide fuhds for milk, infant formula, juice, cereal, cheese andeggs to children under five Years'of age. Programs can purchaseitems locally and distribute:of provide vouchers or cash to recip-ients.` The Project has applied, for WIC funds for a `voucher system.It should

obe noted that the number of items and allotments are less

.

than-the regular SOPlemental Food Program. Also five year oldswill not be Recently evapOrated milk has been eliminated64:6 the program now administer for children 13 thonths sixears-. Children, titue and over receive one four-pound 'box ofinstant dry milk #pr month. Children Q-12 months of,age receive30 cans of evapOrated milk 0 r montk. Children in between receive

na milk.at

The remainder ofithi Summarprovided during: the askyea

Outpatient servi provide. 926' fice calls physici

b.services an 82 X-r ys: Total cost for 3208 outpatient'servites was $14,998. Average cost per service.was $6.97., Clinicsare hgid during,the peak seasons of June and July. These OrokrideregulAr out-patient'services for families 11 the evening and physical

"-assessements for children, attending Title I migrant education programsand day care centers. During the remainder of the yearland between'clinics, patients Are referred to physicians' offices cd,a-fee-for-.treatment basis. The ,number of clinics was fewer thaiih 1973 dueto.e:general shortage of physicians in the area: Iowever, 367 add-iflonal outpatient services were provided as compared to the'previous,year. °

:will dea th a review.of services

included 716 patients treated at clinicS,ns' offices, 138 emergency room services,

4

0009.

.

The Project has administered the USDA sponsored SuPplemental,FoodProgram for more than four years. This programjs intended tQprovide.bigh protein foods to p natal and postpartum mothers-1naddition tochildren less than ix years of age.-' During the pastyear near 0, 31 ktons, of food wer distributed to persons in ten ,.

counties. -''The average number o persons receiving commodities was164.58 per month. Eligibility or this program is determined bynutritional need,as Verified by a.,_physicien or egistered nurse.The only requirement Is that pe sons reCeiving:food items be en-

' gible for other services of the Project,,i.e. be agriculturalmigrants or seasonal farmworke s. 'The only cost to'the Project hasbeen-shipping and storage cost plus staff time. Much staff timeis consumed in boxing items, r cord keeping, preparing reports,

'transporting food'items to oth r communities, to say nothing ofunloading a semi when a shipment arrives. The Project'will re-delve only one more shipment for the program. This is a result ofthe fact that no commodities will bd'available after early 1974.'Jkll Kansas counties will have food stamp programs by June 30, 19)4.

. Most4nunties have already made the transition from comModitypfo-,..gfams to food stamp programs.; It also seems;likely that the re ar'gupplemental Food Program is destined for termination hationally..'i.,''An alternate program the Women, Infantsand Children Program, (W COhas been-funded for this fiscal year on-a limited basis.., WIC willprovide fuhds for milk, infant formula, juice, ,cereal, cheese andeggs to children under fiVe Years'of age. Programs can purchaseitems locally and distribute or' provide vouchers or cash to recip-ients. The Project has applied, for WIC funds for a iroucher system.It should be noted that the number of items and allotments are less

. . 0than-the regular SiAlemental Food Program. Also five year oldswill not be:eligiliae. Recently evaporated milk has een eliminatedfrom the program ife now administenfor children 13 Months sixFears; Child46,0r2e and over receive one four-,pound lox of .

instant dry milk* month, Children Q-12 months of,age receive30 cans of evepbrated milk 6 r month'. Children in between receive

na milk.

e remainder ofXthi summer -will deal 'th a review.of services

provided durinvthe as,t yea,e;

f .

Outpatient servi provide included 716 patients treated at clinicS,.926' o fice calls physici ns' 'offices, 138 emergenCy room services,

b services an 82 X-r ys. Total cost for 2208 outpatientserves was $14,998. Aver ge cost per service .was $6.97., Clinicsare held during, the peak seasons of June and July. These protride

. regulr out-petient'services for families in the evening and physical"'assessements for children, attending Title I migrant education programsand day care centers.. During the remainder of the yearland between'clinics, patients Are referred to physicians' offiCes ofi-,a'fee-for-,tfeatmeht basis. The,number of clinics was fewer than Lin 1973 due

4,

to-a, general shortage of physicians in the area: Lowever, 367 add-\

itional outpatient services were provided as compared to theprevioust, r,year. -- , <,

i

A 4

0 a 9.

4

a

Chi dren attending summer mIgrant,education programs were alsosqeene tor vision, hearing and dental problems as well as urineabnormal ties and hemoglobin deficiencies. Less than 10% of thechildren had low hemoglobins. Follow-up was provided wheneverpossible. ImMunizations were provided when needed and possible.

.

'A total of 634 children were screened, for dental problems. Of :the 412 requiring- treatment 367 were completed befoee leaving. Anadditional 20 children were.partially-completed and 25 "gotaway"before treatmenfcduld be initiated. El.'exten adults were treated onan emergency basis. In total the Project paid for 1178 fillings,75'extractions'and 5T Crowns .Three-Partials, 12 space maintainersand eight corrective%appIiances were also provided. As a result ofneeds-rd the action taken 473 more fillings were provided than inthe-prA-Vious year. There was a decrease of450% in necessary extractionscoTOared to a year .\,

The following preveneatWeldental services were also provided:0tophylaxis 197, fissure Sealant 50, cavitron 31, and fluorideeeatnint 126. To.tai cost fOr the dental program was $14,088 orativerage cost per patient of $33.83.

.Ptsgect was without inpatient4y4771973. During the past year4O-r86 lkient ePisodes. Other av

héneet possIbie. "Total cost to5,020.14. ''Total number of h

.n4Tber-of days per patient was,4.3episode was /90.93. 7_111e averageco.Whave' teased b ore than

funds-from.pecember 1972\till latethe Project assisted with payingenues of payment gere utilizedthe Project for inpatient servicesospital days was 168.5. Average

The average cose-Per patientCost per day was $67.88. Per day50% in the past four years.

. .. .

pl4hling services Were provided for 50 women through the -,

Pr4Sect: An equal number of seasonal farm workers received service,,,t,,_ ,,

tnpugn area family planning'clinicsthe number of deliveries=.--COtitUes to decline each year.

_ ,. I

011.04g co4ditions_continue to be substandard for the most part. A.

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y!9A *using survey in rden CitY reasled at 27.3% of the housingin 'poor --s*-Infpoor or dilapidate ondition as compared to 17.7% in the same

66ndiiion_in 1960. A surVey en in Ulysses'-in 1970 revealed that!:nost;:_rOw-incomejamifies were pa ng more than 401 of their incomes

7r, for.te-tital housing,and utilities. rental hOusing bode is nowtiding in the state ,legislature. iSimilarbillS have been defeated

1, :1-ot 'killed in committee in previous years. A State housing code is,,..de$ erately needed, to upgrade rental housing for all Kansas.

..'p, .,;

i-,. .

AO th education 'fforts expanded during the 'Past year with the main.-'-'4 hrnsts in nutri onand dental education. Various Other topics

ere tackled both* by the Project and area extension staff. Consumer..'+' r,Oid legal educe on continue to be areas of need. LOw-income people

,,,I,_are, ever popula 'targets for easy payment firms with interest :fatesan.dt'miscellane s charges that often exceed the cost of the putchase.,

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The Project has-been badly understaffed for as long as it has been-Ain operation. This past year saw a number of, staff changes. AO,one point, last winter the Project functionedith less than half of

k its usual staff due to illness and resignations. Reduced speed limitsand the possibility of gas rationing loom as"frightening restrictionsfor the Project. Staff efficiency has alreadpbeen severely affectedwith reduction'of spee limits for state owned Vehicles. Attemptingto cover an. area in e ss of 16,000 square ile-S-'at 50 mph is sim-possible. 'Staff Overtime has always-been considerable deipite thefact that stiff members receive no additionaVpay or compensatorytime privileges.

Much-progress has,been accomplished in impr thethe health of themigrant over the past ten years. Early dia cists and treatment haveprevented. catastrophic illness in countless ca0s. Health education,,

t,

family planning and preventative services have served .to increase,thequality of life for many families.

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c°*,

St.e4 W

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II. REMEDIAL SCHOOL AND MIGRANT EDUCATION PROGRAMS

114

Eight Title I Migrant EducatiT,Programs servingichildren-in tencounties were, in operation this past.summer. Centers were Iodatedin garden City, Goodland, Lakin, Leoti, St. Francis, Sharon'ipprings,and Sublette. Only Johnson hdd no,Title,I Program. However, a,numberlof children fromJohnson were bussed to the program in glysses.Both the Ulysses and Sublette'prOgrams served children, from twocounties. All program except Ulysses were sponsored by local schooldistricts. The Ulysses program was sponsored by the Kansds Councilof,Agricultural Worker5 and Low-Income Families.

, .

Most,, programs operated for a.siic-week period from early June until,mid-July: ,All programs provided care and instruction from earlymorning, till. late afternoon and provided transportation. Each programadditionally provides a hot lunch and nutritious snacks. Many programsprovide breakfast as well.

0Remedial instruction for the children is integrated with relevantfield trips and extracurricular activities,. The ideology of'the

° migrant school programs is to help the Spanish-speaking child in,catching up to his proper grade level. To do this he must have afirm foundation in English and develop reading skillS. Many migrantchildren often miss school because of the travels of the family,Additionally one child may change schools a.number of times witfilnone school y ar. While all migrant children are sot Spanish-speaking,the majority re. This is a severe handicap when ent4.ing schoolwhere the Chil must sink or swim'in an English-speakintworld. The-simmer migrant edudation programs have done much to-alleviate the gaps

.

,,and soften the blows for the chili'.

The educational benefit,p.of the summ p s are obvious ddir

tionally, the children are given an option -other than going to thehot, dusty fields with theit_paren s. For the Probe a Title IPro rams also mean some very welcome assistance in prkidingscreellii hg. Thefound under onescreening and\ne

4

1)

fact that most chi 4en in a givencommunity can be6roof .five days p ;e0 is i .yable in prbyiding ',4/.

ce sary'follow-up. " , ,;,1P : , .

-4

g

Adult education programshave been provided ,for a number of yearsthrough the Garden City Community Junior College. St. Francis also .

'provides eveningadult basic education programs in conjunction with .

their summer program for children. Both programs have'as,,sisted" 4many aklults in furthering their education and gaihing neeaed skills.

-. /\ )i

'A new program to the area is the Service EmplOyment Redevelopmentprogram. SER offers on the job training anda two week job prep-aration course which includes tips on filling out applicationS,employer interviews and job tactics. SER also,prOvides assistancein career planning, welfare assistance*anctlegal aid. Enrollees in

7, ,niJ12'

rf

°

ate job Preparation course.receiveipend'af. $52-$70,pPi-kicipants in the on the .i0b,Eraining'coMponent of theare paid b 'the employer.,by SER. r

r wkek.rogram-

portion of tlw.salary is.stabsidizee

..

`A. grekt deal.of regional inbgrest ha oveeped rega4ing bilingual.o4ucation,programs. n SigAficant doc;ialentiOn indicates that a child

, learns a second Ihnguage'without trauma and in record time if he.firstok, ,

has someskillS in reading and writitg.:his own language. Ideally,, sucha program would'enable both English'and Spanish-speaking youngstersto become truly / bilingual and at ease with ach otheW.language and I"

.custOms. Presently the Garden City Public Sc ools are, consitlaingapplying for federal.funds for a'bilingual &Luca program,. Needlessto say; this proposal is not without' its opponents. ' '''

"(11

4

"DAY' C REMEDIAL CENTER ENROLLMEN

-,4

Total

.

Progrhm"..r: Location

, . ,--,-,1

CJ)

;

Codhty

4

Da

,

Care " . .RemedialI

.1.

Garden City

Ati

Finney 47 52

G2od1alld I\,

She'rman _445 125 170

't

Lakin Kearny '20 82 102

Leoti 105

St. FranCis . Cheyenne .2 27

Sharon Springs,. -

Walle 14 96

*,

110

Sublette HaskellI,

' :32 .81 113

Ulysbes Grant *' 1p7 : 107

TOTALS 12-1' '668 789

* Day Care,provided by Community Sponsored Program

Az.

9

W)14

o

414

,dr

, -

III. HEALTHEDUCATION',

.

0

It Somewhat paradOxical that often the seople.whose labor

prod s and harve-SIs the food for our ration's tables are them-

selve king in adequate nutrition. The reasons for, this areboth si pl d complex. However, 'whatever the reasons may be,surely he so. ,to the problem must lid ultimately in educe-

:(4':tion. ,p After more'than three years regular monthly nutrition and'

'cocking classes throughout the ,'its seems as though amajority of the homemakers are:awa of the basic concepts ofnutrition and are knowledgeable of w constitutes goodnutrition, The `foundation of ;the nutrit education programis the four basic food,groups.. During the t year at leastone clasy in each-area was devoted to each, of followingdietary requieents:_ Vitamin A, Vitamin B, Vit 'n C, iron,

calcium, and protein. Because ,films have proVe&-to aneffective ,media with the groups; they-were usedd4ens elY.

Ten films were shown a totallof twenty-eight times.

The most Rnjoyablle part of.the classes is', the cooking, and t

seems to be as true foeveteran cooks as for amateurs. Some

favorite &cipesifrom this year's classes include: homemadenoodles cheese eatloaf, turkey vegetxele,soup, and farinapudding. ,

/ %

Not,all the ses ions were devoted to cooking and nutrition.Other topics in luded areas such as,poison safety, dgntalhealth and hygi ne, aria the food stamp program. Theie werealso "group expe iences such as planting a garden and ashopping'tour. I-

the sessions met monthly (except for June, Jul, and`August)in Garden City, Johnson, Leoti, Ulysses, and,in either Copelandor Satanta. Within the last six months the bulk of the migrantfamilies in the Sublette area seems to have shifted from theCopeland, aredito the Satanta, area. This accounts for the chadgeof the grouptMettipg site from Copeland to Satanta. At thepresent timl0e classes are held at the Fairgrounds in GardenCity, the Unttdd Methodist Church in-Johnson, the AmericanLegion., Building (Head Start Center) in Leoti, the CommunityBuilding.in'.Ulysses, and in hOmes on a voluntary rotating basisin Satanta.

The classes in Garden City and in Ulysses are conducted through,

the Expanded Nutrition Program under the supervision of MarthaSmith of the Southwest Area Extension Office in Garden City.The nutrition aides'conduCting the classes are Jessie Schibbelhutin Ulysses and Martha Cruz and-Lucy Gomez in Garden City. Jessie

. is an old-tinier2-in the program dnd has built up very good rapport

410

r

a

with the homethaleets in the Ulysses area Martha and Lucy haveenterelthe,prOram more-recently, but they have alreadydemonstrated their Abilities and their willingness to be of

initrition aides not only conduct group meetings,but they, argo follow up with individual visits.and sessions

..34#4 the homemake4s!in their homes. In the remaining areas ofJohnson, and'..S.atanta the monthly sessions are planned and-

conducted by the Health Educators and the Program Worker. Thesestaff members also follow up the group meetings with home visitsto 'families or individuals whenever the need. arises or it seemsbeneficial to ado so. Project staff also assists wiEh'classes inUlysses and Garden City by reminding families of classes andproviding transportation when necessary.

Because of the lengthy wor ing hours for both men and women, itklas*never been feasible ave any cooking and nutrition classeswith the migrant wome du i g the summer. months2.---, However, .a

breakthroughhas. occurre . During beet harvest in the Ulyssesarda while the men ye-re; riving trucks, the women were not.workingsteadily. We seized th opportunity to inquire from the ladies? ,whether'they would be nterested in some nutrition and cooking.',sessions, Their resp nse as enthusiastic, and three sessionswere held at Drakes igrant4amp by Jessie Schibbelhut. By thistime Onlypa few migrant families remained but attendance at thesessions Was 100% of !nor IAA& residing at the camp. Thesewomen were highly motivated and very receptive. Our only regret

_was that we were not able to meet with them more times beforethe work was completed, and they,',.'had. to return to Texas-.

J,

'During June, July and August attempts were made to present basic_, health.education to .the migrants. Areas included: 6nera.health

eduationtasic nutrition education, simple consumer education,sanitation and hygiene in camp settings, Concepts of disease,communication Of'disease, and preventioni,of disease. Nine films

-4

were utilized in pies nta ions, and these were shown a total of'nineteen times. A y o these evening health education sessionsproved suceessful at,_he. Johnson migrant camp, so this past summertheY!wereheld at Drakesteamp near Ulysses and at the Strong Cabinsin Leoti in addition, to Akagi Ca near Johnson. The weekly sessiqnswere eagerly anticipAted by the residents of the,cathps, and much

° disappOintmerlf°was'e0.denced in Leoti several times when a summershower would'mean that the prothised film would have to be canceled

. since the ftlmg were shown outside. ThiS was the most convenieritcplace for the people, to gather; and it.was usually quite acceptableexcept for the showers and the mosquitoes -- of which there werelegion! .

In spite a the fact that much time and effort went into the planningand execution of the evening, health education sessions, it is feltthat there is much room for improvement. Our greatest needs seemto be additional,bilingual,staff members, and mere bilingualfilms and oher materials. It takes a lot of commitment to work

fi

\

A

rl

1 ,,'As; T '

J

an average of 'over thirteen hours arday, and often as many aseighteen hours per day. Yet, this was necessary in order tohave any health education at all for the migrants. eSecondly,in order to be maximally effective it seems imperative that the./

staff be bilingual since most of the migrant families speak,

Spanish. ',

Three members of our present staff of are bilingual. How-ever, we badly need additional staff memb4'6.---- We have beentrying Co recruit additional bilingualnurses for several monthswith no success. However, the three person hired'this past yearare all bilingual and bicultural. This past summer presented ad-ditional problems since the two=additional,summer workers we hadrecruited both had change of plans and were unavailable.

-It is very difficult to locate suitable films and other instructionamatkials in Spanish. The-office has a few good films,, and thesehave been well utilized.

Also, since last summer extensive research has b en done in thearea of locating bilingual films and other materials. Some verygood sources have been identified, and hopefullype will soonhave access to a variety of useful,educational materials.

With the assistance of additional bilingual staf and materialswe can look forward with eagerness to meet the challenge of anothermigrant peak season.

Meanwhile the monthly nutrition education tlasses continue forthose remaining in 15.anas from September through May. Althoughbasic nutrition concepts have been developed with these families,this is not an end accomplishment, but rather a foundation uponwhich further learning may take place. Specifically our aimnow is to observe food and diet patterns and through our groupsessii.ons tp motivate homemakers to work toward correctingnutitional problems.

Zenetally the most preyalent nutritional problem among Mexicanero,can migranes from'south Texas is a Vitamin A deficiency,

which! is founcrTa-...501? of the people, Also, 15% are deficient---in Vitamin D. Most of the.diets are lacking in foods from-Climilk group and the fruit and, vegetable group. 'Meat intake 1usually low to minimum. However, the consumption of bread andcereals is often twice the amount needed. The indispensabletortilla is mostly responsible -for this.

'Where do we, gofroM here? We have ,just' begun. We have learnedmuch and have effected some dietary changes, but we have4Carcelybegun to meet the challenge of dealing with specific n4tritiOnalinadequacies. This will be, the object of Our Cooking Classes'during the coming year. Hopefully we ican work together towarddeveloping food ha is that are both culturallTappealing and.

nutFitionally soun °`

it) t

IV. HOUSING AND S TATION

The housing situa on in western Kansas is a sad saga denotingshortages and def ciencieg. Each year despite much building,.shortages become more acute. Lack of available.rental housingis by no means restricted to only the low-income. However, fort e low-income family no alternatives exist. '

Mo'h migrant and seasonal farm-workers must rent their own housing-.

Very few migrhnts hre any longer provided with housing by employers.Every cpmmunity needing seasonal farth labor is a haven for someone'

! whO is willing to invest a few dollars dilapidated property.For a small investment the owner will reap,a quick profit many times-his original expenditure. Rental units available to'seasonal, workersand low- income residents are almost totally substandard. Lack of.insulationofaulty plumbing, gaping spaces !around windows and doors,inadequate heating, sloping floors, saggy ceilings, torn screening,and missing window panes only begin the liit. Worse yet are the units.that have no indoor plumbing and not even a space heater for warmth.,Those who have ,grumbled about turning their thermostats down a few"degrees ought to have the experience of, trying to keep warm in.awin pr storm with, only a gas range, for heat. Because of the 4verela M. bonging, nits designed, only for summer living have beenoccwied until December each year. Anybne for a'cold shower outside

.'.in'acDeceipber blizzard?

- Few communities,have local housing codes that protect the consumerto any degree. Those that do aren't enforced effectively. Effortsto establish a state housing Code have thus`, far only met with defeat.

A nuMber of VISTA Volunteers have been in the area since March, 1973. :

Many of tie VISTAS haVe devoted much of their efforts to housingproblems.' Plans for the kutdre include the possibility of ,selfthelp, Farmers Home Administration financed homes in Grant and .t

Finney counties. Contractor-built nnk homes are also a possibility r4n the Garden City area A housing coalition has been foruj d i :,, j

k.Garden City that is directing its efforts toward low-incomeproblems, A proposal will he submitted to the city of Garden Civy:in the near futured The proposal seeks to,assist.families with :I'

down payments for purchasing homes. A second objective will be to

assist low-income home owners, especially the elderly, with neededrepairs. Both types of loans will be Made at minimal interest ratesPayment' schedules will be set up so that the family's total expendituresfor housing will 'not exceed 25% of thgir income. The coalition also!hOpes to upgrade the local houSing code., ' 4

.t. ,./1

Another project of interest is a 100 unit HUDhousing project to beconstructed in Garden City this'year. Units will-be both for the

v: ' I

.1

1, I

, 13 .

,t0 0 1.8 f

4

K

yr

a4A

1a

i

o :t

eld4iy and 1(3W-income. See 'ties in the areahaVe applications Tending for

A housing .coalition ha'A als beian)formed ih and area,to deal with problqms of that rck0.

Progress is not totally lacking in le housing situation. Dee it°housing costs money, hoJever. Neither ocal,go rnmentinor housingowners have beenlwilling to make the c mmitment'in essary to insurethat all renters have adequate housing. Row fiille ri8rities 1become when money is involved.

1*

,

'':

t ,

i

1

t.

O ,

a

4

413

V NURS IN6"-SE ICES 1- tt

SOUTHWEST

It was a coHealth Serybut'the,stthe chantleads o

Virginia. R. Garcia, R.N.

,

1 snowy day in March when ',came to work here at Migrant'Business was a.little.slow, XI later found out),

as busy working with the people. I remember hearingthe experienced staff members "Wait until June', which

wonder what will happen 'in June'.

ng was in the air, ancl Spent the Text months learning

erigrant workers would live and work, not at all sure I. .

ber where on these great Kansas plains they lived.a country road, tasted the dirt, felt the heat of the sun.,d many'a farm house only to.realize I was lost -- again. --111

1 the key people in the area: the nurses, physicians, and

,'1 athnirfistrators. I was hoping I could remember their namest time we( met.

ce

Soonwherecoo

aa

too thedcey families in the.community Who were once migrantsad settlePd down in these cities and.town;§. Such contacts a5e

invaluable'in keeping us informed as to who has just arrived or whohas moved on to workelsewhere.'

The end of May. arrived and the horlie contacts began.. To me they were-all new faces, and mine to them.' It was an experience to set-the

, 'happy faces when some of the families returned 6 see' that Jady and, I

IMary were still here., k. , ,

,.

0. .

A special,lhanks is due to the physicians who.

took care-of,the migr n

population as they arrived and moved on, and took time out of a:',. busy day'to do physicals at migrant schools. To those who held

evening clinics many more thanks are due fot taking the-time from,other commitments to make another migrant season a'Success4-

N

Counties

4. I

Finney - KearnyGrant

- James Greenwood, .M.D.Grant - KearnyHatkellStantonWallaceWichita

ti Sheiman.f

Physicians ,

Frank Eichhorn, M.D.M. A. Brewer, M.D.

'Don Tillotson,. M.D.

Carl Pratte DA.Ronald Daily,JU.John-Chung, M,D.

' Willard Werner,' M.D.

(Assistant, Sister toAnn)Kefineth D. Austin, M.D.

The

dp:

ay care centers and migrant, schools of the atea conducted' classeson h4alih and hygiene habits.

15

W)2C

01

1

o

In each schoot we co nducted the following screening procedures-If Aadings were not normal, the children were referreetp,aphysician.1

;

. .

- , ,,_.t ,:,, ` \ _ , -.

'4

i:Hearing,'Scteentng.i

, -1; Per &Idiom ters,in which electrically produced sounds are, r"\Aconveyed b res to a receiver applied to the sOlectts 4. t,

. ,.'t.'',

te, ear. nsityand pitch of be altered and in-,''1 r

.

dials.,

61; ii,

Vision Scr i n, =.. '

. The ss c within which. an object can be seen while the eye-remain fixes an some dile point using Sneljen scale 20feet equival '

r

Urinalysis

Using Re pent 'Strips -- test for Ph, protein, glucose,keotonea,and blood in urine.

\X''Hemoglobin .

Test done with use of hemoglobin meter which determines amountof hemoglobin in the blood.

410

,..Physicals i -,

1. , -

Examinatidn of ears, nose and'throat. Listening to lungsX- and heart0ounds -- palpation of'abdomen, etc. (done by

, .physicians,..

NA

''

_'`qinmunizati.cins i

DPT, -D.T., 'polio, T.B:, measles and rubella

'I .. vaccine available if needed, referrals made and received..

1

'

'Migrant Schools/Day tare Centers\

Nurses..,"

I.,Grant County ...'. e .1 GerrilMenzie, R.N.

,.. Finney .-Ltkpe,,Lopez,'R.N.-'

,1ichita ..-.. KI,Way Lane, R.p.,Kearny Claire (Tee) Fawdett, R.N.Stanton .- ., , Beth Cockreh -;-.R.N.

'A. thanks is due also to Ir ne Hoyt, R.N. (now retired Finney Countynue)'for her heip,,and to Label commUnit9jw rker in Leoti,for all her help. Mab 'el is known as somewEat RACLE WORKERP.16,

0

o

..,

)/

Family Planning

to FaMily Planningand Child Health,

. Planning Serycounseling, esuppl,ies :of he

family planning,services,.

to tamily planning

4

a

Services were'ptovided,:priMatily through referralClinics RpqnSored.,by the Division ai.:Maternal

Kansas St4te. Department of Health. FamilyCes prOvidedAy Migrant Health included individualamination IlY a physician Vkcluding pap smears, and

haite and follow up. .:P. total of'50 women received'

.through Ole Project and were'regerred.

for furthereivice. , 7

of ,,

0

Health p4ObleMS most prevalent 'during the Raseyeir:were: upperrespiratory infections, skin infections, hyperteision, sinusitii4,

e

and anemic (especially infthe children). et- .

, ,

. i,.

20,

i With every passing year sae see improvem gin tilude toward .

4 rhealth by the.migrant worker and its cgilling community. ;One'

big problem we still-falce is the crod erhousing conditicsins-wqichcontribute to problems of spreading pedfCulotis,'impetigq, andupper respiratory infections. Childhood diseases seen ire the areas ,this past year were:' mumps .and chickenpaX.' 4,. r

/1 N -

. . .----, * -,s.

Monthly immunization, clinics are held in LeOti and Satanta. ImmUni7-

zations are given by the health nurse in counties where. local

health department is available.4

4'i

,t,

l', Another area that still needs much work isithf importance of diet ,L,,

1.especialfy for the children. This past year there. were 40 childrenwith a low hemopbin who Mere referred for trptment and follow -up

..T

care. ;1' ( ,,

,.. .4 ,4.,,

, tki .

Continuing eduat p4gr are made a/41able throughout.the,year: '

e1 i

for public heallth urses in e state.4 inlect nursei'attended, '',,; ,. ,..

:Avorkshops inso r to be train -d to db.phy!Epical assessments on chit=

Wren ages 6-6. kOlier meeting: dealt WithiCurrent trenda-in'immuni-. .

.

!Zations and new procedures. roject staff also attended semi4rs 1on adolescent behavior,_chil abuse, and the teenage parent. pc. 0So ends the tenth. year .oviding,health services to the migrant

.

'population by the Pr. ect. Many long, hot daySsand 'long hours:Ofwork' are now a part .f the past. , . o

h

N f \NORTHWEST REPORT F. Floriene Whisnant,

Because of .the impact of mechanization in the northwest count es;there 1re somewhat, fewer jobs available,than in the past yed s.All labo4er needed for the sugarbeets had been contracted priorita,the begirining of the season. Families not contracted who arrivedlooking for work in, the beets were not hired. Some found other.-,'

seasonal work either on their own or through the

. 17

I) 2 2! 0

Opportunity Center. -'4 'number of families could not find jobsand went elsewhere seeking work., Same returned home more broke,than when they.came. - ,

Heavy spring. rains caused reseed,ing bf the beets. As a result..,the hOeirigAnd thinning of the beets started three weeks laterthan usual. This caused many hardships. Some families weretold to return tab their bases until work began:

As in 'the past housing was a problem.' Many' of.the older homesthad been torn dOWn and replacedsby modular or-.mobile homes.

Mot had been rented by perinanent people. Theolder homes that'were left standing were smalf and in poor Ondition, but therent was high. One of the motel type,unillwas charging *25.10a week for a one bod unit and $50.00 a wedt,for a two .bed unit.

'These were very small. It was difficult-tp'visualize where a .

'family of ten or twelve could sleepjbut they did somehow.

I.

Many home visits were made in thethree,connties. Many of thepeople came,to theoffice seeking aid: 'medical, commodities,'

:0, jobs, housing, and aid in filling Out forms. .We worked closely

with the three summer migrant schools doing TB gin testing,shearing and vision screening and physicals. Dr.Beynon of s'

, '-'doodlan4-did the dental checks- 'in-,Sharon Springs and Goodland.Dr. Beynodand.Dr. Hirachd44' the needed dental work. The children.

' 4kom Wallace county were blis.5.1d to Goodland. Dr. Haberbosph, St.Francis, did Ale dental 'checks and needed work on children InCheyenne County. Physicals were done in Aaron Springs by Dr.

, John i. Chung and his ssistants,joien Chung, R.N. and NorvaDeines. Our office did the TB skin4tests,'hearing and visionscreening. In St. FrancisDr. Luciille Stephenson, assisted byJehn Miller, R.N.,

Dorothy'-Klepper; R.N.,Again we-did the TB skin

:"%t4sts. In Goodland Dorothy'-Klepper; 11.:N., Sherman County' ,

theme,

Community HealthNurse, Dolores'Manzo, and Charles-Bray of thesC'h-R1 asSisted-theProject staff with Rhysical assessments ofthe .1.dren in the Program: ThisDr. K. . AuStin, Shefman County Health

done by,permission fromOfficer. Any illness

that was found was 4e,ferred, to a local physician. A number ofskin disorder's were found 41, all s4hools: eczema, dermatitisand impetigo. One skin disorder could not be identified;by ,

local physicians bit responded to treatment with antibiotics.

'One -day to oay during a visit tne of the school's, a ,teacher4

eacher c1hme in-' with a- small child, stating that the .child had fallen several')

times during their daily ,walk and appeared to be' staring off into.,space. The thought of4silepsy ran through our minds. EriTndaand I took the child home P.O. talked to the mother. ,During the, "'conversation we found, thatt,the;boy had been .diagnosed a yearfagO.as epileptic anti"p14e4 *medication. The medicine had been ut4dand the prescriftioebad 4lot been refilled. Since the preacription,was out of state We asked the -mother if it would be all right if the

4'

18

0024;1'

,were to en to alocal physician. This was done and a prescriptionobtaine We explained to the mother the importance of his takingthe med cation. Two days later we made a&ther visit to see if themother as doing as we had asked, only to arid that they had movedon.

This n.1 be.my last Year'with Migrant Health, as I am resigningtoOendmore time with my family.` I have enjoyed my work verymud --{h, I have learned.a lot from the people I have worked with-.Thde are times that r feel as if I gained more than:I gave.

LAVSIN GRANT SCHOOL SUMMARY Tee Fawcett, R.N.

Home nations were started on May 29, 1973. Mr. Frank Tamez, homecoor nator, accompanied me on all visits. A total of 34 families'were isited. In checking with these families, most of them,had theirchildren'simmunization cards and schbol records. Most of the homeswere crowded,. but appeared we-ll'kept.

Scho tarted on June 4 With an enrollment-of 65 children. Manycame 04,1ater d to and ourenrollment became as high as 101 children.Children were give health kits containing soap, washcloth, comb anda toothbrush.klit, od hygiene was encouraged daily with daily showersand Oampooing. Den al check was done on June 7 by Dr. Jon Wheat!of c-

Lakinelansas. All c ildren needing dental care were treated in viis:offi .Fifty'-seven rcent of all students checked were found ,to be.free caries"; .

-

done,

. .

Height and weight were o onAll'enroilees. Mast of the children . ,

Ai--'.-.7

'' were found/to be-within normal rangefor0their age group.

Visi testing using a Suellen chartwas done, and it was found,thattwe children were in'need of correction. The school purchasedthe glasses for the children. ' .

,

H.t.-e-

4

earing ng test using °a Maico Audiometer rlevealed-that no hearing problems.,

were evident. . , ,.

.

HemagAbin and urinalysis tests 4ere also done on all enrollees. Approxi-4

-.9 -Ati, .I. t

mate y 2% were found tohaye' hemoglobins below 12 grams,,and these students'were a.Ceao-ntiematinic therapy:

Den efDe4elopment Screening Tests Were performed on childrenin the fourand ive.year levels. Some of these sailed on the language and finemo or

____areas. This I feel was due to the uneasinness of the children in-

-----c ,.

a w4setting; This was especially trite of the younger'ch ren.

19

"n(I ) 24

0

C

Name of

.Town

O

'1973 NdSING SERVICES SUMMARY

-County

Hearing

Snellen

Lmmuniza

Physicals

TB

UA

Hgb

:-.

Screening

Vision

'tions

Screening

Screening

Screening

Screening

( 0w

4-1

°C$

+0

O0

P'

PP

,--I

PO

1cd

'yl

044

-44.

J44

c4)

Eo-I

g

( 0

w $.4

44-4

rtj

'Ts

$.1

$.1

" k

,r

4.)

4-1

z,4-

4

E-1

c40 E-1

Garden City

--,

Finney

48

048

5i-.7-

...

48

0.29

048

0_.--.48

.

8

Lakin'

'Kearny

.67

0.,68

1*-

12

30"

86

20

083

0x0 95

19

o

,

.

Leoti

Wichita

.

19

0

1

20

._

_

2.

16a-

0-

71

10

85

v90

5

Johnson-,

i

1

'7-

/

Stanton -

A13

-- 0

60'

113

.:,,

013

":

''

0

Goodland/

,She

an

93

109

54

0-

0109

0120

0 '.

109

109

0

Ulysses

,

Grant

40

66'

10

,.. 37

069

20

0 ."

'53

'

054

.4

0

Sublette

Haskell

'56

.

047

2'

40

0'74

-1

.

0-

0

_ \84

0.

88/0

14

.

8

Sharon Springs

.

..

55

0,.47

.

50:-.

074

73

,74'

74

St. Francis

1_

.

Oheyenne

427

0 ' it

,,27

1.0 ,- 0

27

027.

2.

27

0:

27

438

438 42

315

571

)7

209'

'5

576

0598' 40

...,., . Immunizations.given were as follows1....:.,..

t.Measles and gubellayaccifieDiptheria fld.Tetanus

D.P.T. ;

P6lio l' .

%

sze

6 . 6%3 '3% N.

7 '9 9%

,15. 15%.

,

It was found that,m0t 9f.the,childrergreceied"ill,their immuniz-ations and,were not in),need, of the vaccines. \ .

.<!.- , . ,

,.

During the school 'tern various injuries were treated. \Complete.physic4 assessments were also donvon all the students. SeAral

. ,. .

were re erred or minor illnOsess-and treated at the clinics.z1,7. -%--*.< e

In' conclusion, I feel that our migrant prograM was-MostAccessfU/.Each year the children appear to be in better health andthe liarenisare more cognizant of their health, problems. .

.41:v g

My aide, Jane Perez, was most valuable and .tier efforts' are" atryappreciated.

i

C-

ei

\

, 8.

41.

4!VI. MEDICAL AND DENTAL SERVICES

0Utpatienp medical services include cli services, office calls inphysicians' office-s, emergency room treatment, X-rays, lab work and--otherancillary services on an outpatient basis. The project employsTic Physicians, Put.reirOurseasicians on a flee goi service orhourly basis. ThirteeNfamily clinics were held-during.ehe peakseason of June, and July.in Johnson, Garden Cfty and Satinta. Nine

pother clinics provided physical assessments for chtldren attending:Title I Migrant Educaklon,Programs and commnnity day care programs.In total 716 persons received services through both types of clinics.This number is almost identical tthat of those receiving servicesat

through clinics a year ago although there were fewer clinics thisyehr.

6 There were no Clinics he ld-*-Ulysses this summer. PhYsiciani in,that community felt that tfieir patient 'road was too oveiwhelmingto allow them to staff: an evening cLinic. Usually, they #e seeing

.,

.-- the last, patients of the day after,7:00 p.m. With clinics, beginning; P

:IP at'8:00 p.m. and the usual run df.sUirimer farm accidents automobile .?,.1 0..

9 . accidents and other emergencies, they felt that they could not handlei an additional clinic. De. Brewer suggested that as an-I-alternative

0,-they would see patients without appointmentsduring reulae.office

,

.hours and of course see any emergency in the hospital emergencyAroom after hours. This arrangement seemed tt; work out Satisfactorily.

4 althOugh fewer patienleewere seen than in previous yea9-_The con-`,

. .tifigent of Ulysses physicians has ,been extremely helpful and 66-A operative over,the.yelrs. We the extremely

. -grateful4,

for.their,,......

support. . ',1'- ...4. .

, . ,'-,

I;/

A1 -7i

All physicians in the irea were especially hard"pressedthis.yeae.Western Kansas suffers fram,a *ironic lack of physicians.'ftowaver, -

at thistswritingbdth Lakin and Leoti havebeen without `any resident %. practicing physician for several months. This places theburdell.

for tho'se communities on physiCians.in adjacent towns. ,In!pardyn

e City five family physicians have left orimetired:in thepast.tw. years. While the number of specialists in the same ,time period lies

,c increased .by fbura on.lytyo.,new general. practitioners' Have. theledicaI,cdmmUnity. -Physicians in Goodiand and Sharbn Springs

are no less overxorked. For-44s reason no evening clinics *reO held in thenor-thWeitlis. Patients were seen during-regular

,,,,,,_office hours; ,

,

4 4\ , , , -

.

..

4 *..., .

.

fit-In addition o the 716 persons receiving servicekclinics 1492..

other outpatient services were proVid14;lhe breakdOwn of these ''-

-was as follows:4 ."

, rt

. ,

. ''''' Office cant - . 926.k Emergency' room 138

Lab work '... A46X -rays 82'

Total cost fot 2/08 outpatient services was $14,998. This represents 'au average.cost of $6.97 pbr outpatient service. ' 3_A----

22.-

02e't

A .

^e.

1,

Fewer ,patients thquired'referrals"to eye wear. specialists thanin previous years. Two patients_Aquited, olrow-up for pterygiae.One 'of these later had surgery paid-Mr13y private insurance. Twochildren were referred' to an ophthalmologic ,one.for post surgery

-follow-up and the other for,ptosis. One yo g.f.adnii"wasreferredto an ear specialist and1 later had SurRery,for-4.punctured eardrum.

. _ .

Dental surveys i were condUcted in early June bi-area dentistat'each er-the Title I 111arant_Programiand commarilty day care celiterS.1 .1

A tal of 506 childr wereexamined in the initial surveys. Atadditional 128 children -Who arrived after the initital surveys hadbeen completed were screw ea in local dentists' Offices. Of the

, 506 screened in the-firs 'survey 377 required-rib-treatment: The, I incidence of dental deca was much higher than -4s usually the:case

-n-approximately _60% o the children require no treatment.. Sinceof our familie co e from areas of Texas where the fluoride '

pntent of the water is high, the percentage of childten requiringrestorative or corrective, work is usually lower than the nationalaverage. Additionally, the fact-,that the Project has providedcomprehensive dental services for the last six years has,resultedin Minimal rrequired treatment for children returning to the area.However, this summer many4families new,to the area arrived bringingwith them a bonanza of dental problems. 1

,The purpose of the delictal survey of course is to determine the' number of children requiring treatment and

wthedental caries ex-

perience of the-children of seasonal.farm workers. A survey- is

essential to initiate treatment and establish priorities fortreatment.

Dental ,providers for the program were:

Lakin, SubletteJohnson, Dlysses .

Garden City, StIblette

Dr. Jon WheatDr. Lewis PalmerDr. Charles Purma-

Gbodland,'Sharon Springs

.,c . St., Francis_

.

Dr. Dennis ParsonsDr. MiChael Harris,Dr. J. L. BeynonDr. N. R. HirsChDr: F. N. Haberbosch

During the pa t year 387 childrenyeceived_restorative dentalserviCts'through the project. This represents an'lhorease of-

=147-dhi treated as compared to a year ago. Of eh@ 412child needing treatment 367 had their work completed beforeleaving. An 'Additional go were partially completed beforeleaving the area. Unfortunately 25 childrat "got away" befOretreatment could be initiated. Eleven adults were treated on anemergency basis requiAng nine extractions. In total the projectpaid for 1178 fillings, 75 extractions rand 57 crowns. Threepartials, 12 space maintainers and eight, corrective applianceswere also provided. As a result of the needs and action taken473 more fillings were provided than 'in the previous year. /

' 23

!/ 0028

st

,

41

Dental Caries Experience - Children of Migrant Workers

Western Kansas

June 6 to July 24, 1973

City Age Humber ofChildrenExamined.

Children RequiringNo Dental Treatment

, .

Dental Caries Experience

Decidtious Permanent

Number .- Percent d e f\ def 0 ft F DM'

=

.tak?in, -

-:-..-.

'3-.5 15I

7 47% 0.67 0.13 0.60 2.80 0.07 0.00 0.00 0.07

13..

.

48 20 '42% 1.23 0.08 1.02 2.33 0.21- 0.02 0.75 0.98

Leotc.

-..._ _

'\6-13 ---- 7 12'> 14% 1.87 0.32 1.63 *3.82 2.07 ipv."01 0.97 3.05

Garden ,

city

3-5 0 :00% 3.25 0.63 0.88 4.76 - - -

2.746,13 h, 1 \., 04% 2.04 0:74 . 0.87 3.65P

'2.35 0.04 0.35

,-

SaintFrancis

3-5 1 1" 100% 0.90 0.00 0.00 0.00 -

6-13 17 9 , 53% 0.12 0.71 0.12 0.95 0.71 0.00 0.7.1 1,.42

Johnson 4,..,""----....1 2(:),

3.00 0.00 0.00 3.0.0 - - - . -

', 6713

c.,

1J3, ,I7

28.k. 0.39 0.00

0..07:'.0.21

0.56 0.95

1.14

1.61

-

0.00 0.77 2.38.

Sharon

Springs

3-5 -14t

50% .- 0.86

6-134, II, 24 60% 0.52 0.05 '0.32 0.89 6:55 0.00. 0.05 0.60

Ulysses -

3-5 11 5 45% 1.63 0.00 rbo--:.1

1 63.

6-13 37,

13 35% - 2,00\ 0.27' 1.45. 3.72 .1.37 0.00 0.81 2:18

'Sublette

3-.,..f 1-26_ 35% 1.58,,h 1

0.09 .0.50,, 2,08 0.62 0.00 4.15 0'.77-

6-13 43 16 , 4' 37% 0.92 .0.09. .0.44 1.45 0.84 0.07r 0.37 1.28

Goodland, 3--.5 - 35 24. 69% 0.71 \chil '',0:06 0..88. --N) '.--. .

0..0( 0.17 1.0g6-13 78 45% 0;82 0.:08 0.32 1.22 0.88

TOTALS 3-13 506 189 . 37% 1.23 0.19- 0.73 2.15: 0.95 0.01 0.43 1.39

'

24.

002

"

4

OF CHILDREN'S DEN SERVICES

ts0

0

0 0z

00

0u.

Garden City,

44 . 44 - 41 3 - . 43 . 1 87.'

Goodland 113 54, 40 ^- 14 74..07%

4.

Johnson 34 34

,

0 70.587.

Lakin.

96 ,t 60 60

IIM1007.:

,.,

90.1,67.Leott4.1' 87 61

.14.,-

55.

St:' _Franci.4._ 19 , 9 9 IlL3007°

'92, .Sharon-Sprinis . ' 67 26 24 .

Sublette 99 67 65 i 2' - . 97,.011,

Ulysses. 75 , ,57 . 2 85.96%

TOTAL 63'4,/: :412,, 367

25

1 3

't

25

4

I.

e

. Each year we 'see a steady decrease in the number of requiredextractions. This year was no exception with 74 fewer essentialextractions. This was a reduction of 50% from a year ago.

In addition to-resterative services the number of preventiveservices proVided was as follows:

.

Prophylaxis 197Fissure Sealant 50Cavitron .' 31Fluoride Treatment 126 4

Total cost fothe dental program was $14,088 or an average cost perpatient'of $31783.

1 ,, fi e

Severe eriodontal ffroblems including bohe loss were discovered intwo youthful patients laeOqn the year. .Both patients were referred

,to Conrad Rock in Hutchinson. The young woman re's'

t . qpired periodontal surgery. This made necessary five trips to Hutch-' ,--, inson. The young boy_wiil'have similarfsurgery in January. Costs

' '.4,-,-.--- for the latter will be assumed by Medicaid. -,.. .

, t c

As is usually ple case the Project provided much of the transportusually

tation.feethe children from the Title I and day care centers to.._

the'dentists' offices. --Project staff transported all'of the childrenfrom the. Garden City, Snblette, Ulyssesrand Johnson programs. lin

4 Leoti,' Sharon'Sp_riugp,.-Goodland And St. Francis dle programs provided .

7 the transportation:7-Makin.is fortunate in,having'a dentist across.

the dtreet f4om the 'SiICIC:j A Illimb'drapatenta also-assisted with ,..-

transportationt,ElY is-a.cOnsiderable amount of staff time . \spentp-44.,,er.stusErig7ffildren, but in informing parents of their \

....,,_',,,..- ,

childWilltndaf needs. it is.vital that pareuts. be kept informed-\ $

,(4g thitir o dreh's 4elitailoroblems, what should be done and why. 8'''

Because, of gt'a0., ef fo-rts Tv), keeF the lines of communication open .

between the 'dentist and t parent's, very few misunderstandings1, Cour. Even more ,important, the parent who refuses to allow.his

r,- -,. 4(1 to receive dental4 -serv-ice is becoming rare indeed.

_ ,f'' ',

4 tAl educatibn e0brtseof4the Stafrand dental providers continue:611 't-, ,,

,-- . .

Z:1 The .itaff.bwCincliided some dental education attempts with the monthlynutrition cla-ases. HoweVer, ideally some follow -up should be providedin the h6me.::.Becaus'of-.thejack of. staff, we Ave only been able

,

to ptoviae lAmited follow :11F, An additional problem is that the frel- ,

ferred:brusang,inethod has changed in the lastfew years. Most....

cschorols still stress the old method of brushing.

w . )$4 . r

$

' Johnson has nevar applies for Tit -le Ilifunds. This year a number.v ..,

of children were bussed from JohniOnkci the -Ulysses ptogram. How-r., _ever, sdie'children aid Tint attend eitier the Ulysses Program or .

,

the day care program in Jghnson. This Created diff,iculties in ,-).

screening 8h CoupIed',with the 'fact that many 'famglies Stayed...,

..,: r .

0 (.-4

-,.1f ,7i- '''' . . , . ,

. , ,coi ''..1. . .

i...

,---..-4-,,, ,,

,.,, (7

})tf

,,

,, -ri,'116 '

.

-;".. P, ,. 0 :,

si-fr

\

4

in'the Johnson area pnly btiehy,.completion of needed dental worksdffere . ,17

Another aspect of our program is providing needed medUation for, the,patient., At clinics this is done by the physician from Office sUpplfbs.Most patients are proVide4 with a slip to present to the *figgist withtheir prescription: pe drugstore then bills the Project.fdr themedication. During the past year the Project provided 848 prescriptionsat a cost o $5,056. ,

r.

_a

5 4 4-

1

SUMMARY OF RESTORATIVE -AND CORRECTIVE WORK COMPLETED ON CIIILDREN

PERMANENT

PRIMARY

Number

'Treated

-Amal

Adaptic

Ext.

Crowns

Amal

Adai tic

Ext.

Crowns

,

Garden City

44

78

1

.

70.

6

..

Goodland

*

.

0111

'-

3104

39

Johnson

34

0, 28

..

21

2'

Z

,.

.60

'

16

,.

....,

2.

69

218

13

r:in

):

f,..

...

,56

132

12

158

31

3.

20

anon Springs,

24

',.f

'74-

128

..

6i

6'

-

't

1777

(

St..Fnandis

9.

16

.

2

Sublet-te

67

,65

\

357

.3

38

Ulysses

.75

.97.

61

71 -

18

GRAND -TOTALS

,409

617

21

6

KEY:

Amal

= Silver alloy filling

Adaptic

= ,Whitd-resin filling

tiExt.

= ExtTactiOn

480

60

=:60

54

""...

3n3.

"(0

p

I

A

s.

:. irREVENTIVE. DENTAL SERVICES SUMMARY

!1',

Y

n=

. -

- 3. 1.... :.1;,...-'", le

.Brophy Fissure

Sealant

..

FluorideTreatment

4.

Cavitron SmoothingGrooves

1

Le 50 33 , 1 , ;

Subl tte 24 45:

Lakin 7 16 46'

Garden City 37 31

Johnson 20 1 7

Ulysses 59 1 2 7

/24 ,12

..1

,'GRAND TOTALS 197 50 126 - 31 19 .

,o

":/4e.c;:f

29 - r

0034

...

Ce'

VII HOSPITAL SERVICEv

iI

1'Hos ital services have been offered by the!Project since July; 1967 ,(

when the Department of Health, Education, and Welfare made additionalfund available for this purpose. No Other single service'has presented'the oject such,a constant pibblem injundiag,and continuity of service.Yet n other service can be aa,financially_catasttophic to the family .

as me ding hospital expenses unaided.''.;,A-

The Pr ject has agreements with_26 area hospitals at the present time.Howe:7e,, 79 of 86 Patient episodes were handled,,by the following areahospita s: Bob Wilson Memorial Hospital, .111yases; Greeley Courkty

Hospita, Tribune; aearny Cohnty-Hospital,i Lakin; Northwest Kansas0. 4.,§

Medical 'Center, Goodlandio-,ana i. Catherine Hospital, garden City.. -.

'isr ,,

When funds are availab e thl,Project pays 1007 Of'physician fees and61% of.bospitai charges Percentages are determitied by federalformulas. -'We*,,saY "when unds are available" because the Project hasbeen plagued'by insu fic ent funds for hospital Services for the pastfive years.'.Frozen fede al funds for this, category as well as spiraling

- ,hospital costs have bee prime-factors in lapses of service. Mostyears'we have fortunate' been able-to procure other federal funds-to 't

continue the programs. °Weyer, in both 1970 and 1973 there were longlapses in Hospital servi e because ofitfhe unavailability,of federalp!' :-

funds. This past year hospital fuard's Fre.exhausted in early December.Because of the realities in Washingto4.including the veto of the HEWbill and the operation of'HEWon a,clontinuing resolution, no additional

,grants were forthcoming. However, fiVe slays beforethe end_of the b

fiscal,year we received word from Topekat at an-$8,000.00 surplusin maternal andchild health funds existed- n a county-health depart- .

ment,and the funds could be diverted.`.tot-6ur pthgram. 'Migrant hospital'- bills for whiCh*no other source a'-'paYminti'Could be located wereprocessed. Needle?gior-say, the s'i4* aldrsome scrambling in order toprocess bills for 35 patients infikte dayS*

Y.i= 1.-.:%

During the interim when the Project- was,:vitnout_ftgids fOr hodpitalserlAce,. other sources of payMent weret*ilized with great fervor'

C Medicaid paid a number of migrant hoapiialfbills; These included anumber of expensive_episodes. However,Ita,fact remains that propertyrestrictions and income guidelines are to confining to make Medicaid -.

'a valid, resource for most of our low - income families: This is especiallytrue for-the small family with a meager income, An additional problemis that mapy Kansas counties have interpreted a latp 1972 revisionin, the Panic. Assistance Manual as meanint_migrantOare ineligible:"

s+ Although the Supreme Court ruled five yeais ago that state. residencyrequirements for welfare -assistance were kfnconstitutional, many stateshavefound ways to get around this ruling,

S d .,

. .-

The Project assisted' three. families in making, appeals. These famil.les _

had been'deniechnedical assitanc: ay;14 applications we'i re edied

, ,

an, In

u. .-,""-.1-r

30

qj 35;t 1,`

.1

t

J

,

et

, '' 'because ANthe fact the families had resided' in Kansas only a few

,-,,,,

0 months, and the other-because they were making on a truck ,

,,which exceeded property value restr,ictiobS. Howev?r, the equity in ..,

.-.,= '--,-

the truck was minimal and the truck was used as a tool nedesary to

J their livelihood. Considerable delay ensues before appeals areheard. Two of the families had left the state and could not appearsfor their appeals. The third family 'signed a release after what

they felt was great harassment from a county welfare department.

At this writing the Kansas welfare system is in the process.4'becoMingtotally state operated. This writer has barely begun. to absorb they

,

reamstof materials dealing with these changes. However,rofftcialson the state level feel that the change will create improved qualityof social services as well as more efficient handling of applicationsand paperwork. It is our hope that the new system will result ,infair treatment for all citizens of the state.

6.0

r

Since. the last Project Report (December 1, 1973) the Project assistedwith payment for 86 hospital episodes. Total cost to the Project was$25,020.11. Total number of days hospitalized was 368.5., The average '

number of days per patient was 4.3. The average cost per 'day wasp67.88. The average Bost per:Patient episode was $290.93.

The following comparison indicates rising costs in hospital, care inour area.

9 1969 1970 1971.11.,.

No. of Patients 113 11 141

No. .of Hospital Days 65 499 578Cost per Day $42.78 $49.45 $52.35Cos per-Episode $2i3.93' $210.29 $220.91Ave ge Days/Patient 5.0 4.25 4.1

$24,174 $24,604 $301259Tota Cost

e

Bee

andadd

le ical order. This left six unpaid bills. A number of deliveries °

Mexican nationals sans visas also could not be paid because oP.

program rules and regulations. Additionally Medicaid paid for twelveother migrant hospital episodes. These included'two C-sectians, twotubal ligations, and two cases requiring.gallbladder surgery. .Thelatter figure compares favorably with Health Maintainance Organizationfigures and is well below average for major carriers such as BlueCross: Blue Shield.

1972 1973

119 86

, 465 368.5'

$63.94 $6740$249.88 $290.93

3.9 4.3$29,736 .$25,020

total number of patients served this past year may be misleading:use of insufficient funds. not all patients qualifying for servicesnot having any other avenue of assistance could be helped. Whentional funds were received, unpaid bills were procesSed.tn ehrono-

31,

()036

1.

f 1 -,...

:,

,:

We f el that th progress has been made in providing preventative -4...4K1 "MIXi.'. Early d agnosis and treatment coupled with changing attitudes

have -been inst ental in reducing_the uuTber of days required Per'.1-

-patient. .

As usual, expenses for deliveries'and newborn acdoult0 Or thelion's share o hospital episodes_:- 48 of 86 episoa4ii. However, interms of ,dolls s, expenses for 14 patents requiring.treat'ent forconditions of t e digestive system weren't far b &hind.

-For the ProjectO.t indeed seemed.like the year of the $allb adderand the C-section. In a'tion to the episodes already men onedpaid for by Medibai e Pr jectas4sted with payLent for our .

other episodes i vbut poAtponed)ligations.

had had two r more C-sections.I

, .1 .

,

Because o the abundance of surgical patients our average hospitalstay per tatient in ceased from 3.9 a year ago to 4.3. It shouldbe'noted at at this point in the present fiscal year, our hcispital

- program is nbette financial shape than it hap been in yearg._,Recently,_$ 66 not pent last year was returned to our budget for

. hospital se es. 1'e of the- ironies of federal budgets is thatfrozen categories ca remain depleted even when surpluses exist rn --L,.. ;.

:11_ other within the sane budget. Since the hospital..,

'.. category is no longer frozen, it would appear that other transfer'sy .,-1.11 be poieible if funds are depleted. The'ldea of a $300 /\- 4maximum once considered by HEW has apparently been discarded.

\

i. .

l

We anticipate a year with the best possible harmony.between inp tientand outpatient services resulting in improved continuity of care forthe patient.

.1

. \

ving gallbladder surgery (a fifth was scheduled,fouroCaesarean Sections involving three tubalthe patients electing to have tubal ligations

,ti

a

0

32

Of.)3't

.

fc

.\ Diagnosl&

r---

4-

HOSPITACSERVICiS SUMMARY

No. of Patient

No. of Days

'Physician Fees

Ho'spital Costs

Total

-(61%)

Episodes

Deliveries

,-

.

24.

i

' 108

i m $5, \09.00.

,

$4,675.43

$9,984.43

%bp=

''''

4..

..24

90

5.00

.k

1,207.35

1,342.35

Conditions of the

Digestive Systeni

.r

14

-.A

-105

.. -

.

2,912.40

...--N

5,642.50

..

8,554.90

..

Gyn Gonditiorks and

Complications of:

Pregnancy

.-,

"

8

.

-15.5

It

.

2'1.3.50

..

888.05

-xt

;°

7:

10.61.5.5,

Respiratory

Infections`-

1

,

.

.

24

_309.64

., 1,035.50

..'11

1,345.14

..,

Injuries

r2

.

)

41,

-163.00

...

494.22

Other

..

An

,-,.1

NN

_8

22

753.00

/1.22

1,3S4..52

'''''

-2,137.52

TOTALS

t1/4

;86

368.

5$9,855.54

$15,

164.

57

1

r "9 ®'

VIII. THE '`PROJECT POLICY BOARD

In 1970 the Prdject Adviscri Board was first established. Federalvideline's, Pew at that time, called for the creation of such aboard with 'the Project appointing consumer and consultant members.This board metal: once per month for about a year and a half. Morerecent guidelines gave all migrant health projects a mandate toestablish a policy making board. Later Projects were givenspecifics for-fher-size, composition, and other requirements ofthe Board.

Elections-to elect mfrs to the Project Policy Board began inAugust, 1972./ Members wereected in -four basic areas: GardenCify, Goodland, LeOli and Uly-il-es. Efforts were made to havepersons from.suvounding towns and counties present at theelec.tion§ 'held- in the above communities. The Project PolicyBoard first met as a group in December, 1972 after gettingsnowed out in November. Getting people together for an electionis extremely difficult since many people work very late. Manyfarmworkers work seven days a week which poses additional problems.

The functions of the board are defined in the most recent draft.' °of federal guidelines prepared' in May, v I97Y as follows and are

similar to preVious drafts.%,.

Functions of the Board:

a) The oard shalt have the authority to establish, amend, and'revise gePeTal policy to include, but not be limited to,the

.1fQ1.10Wing:_,

(1) Establishing personnel polities which include recruitment,selection and d4missal, qualifications, salary andbenefils, and grievance procedures.

(2) 'Seleet ng and eliminating health care services._

.,.

(3) Creating criteria At service eligibility and developing i '

fee schfdules as appropriate.-.,.

i. 1. ---C'

i s.,(4) Establls*ag hours and laeaton of services. , -I

.-

. .,:,

. q,(5)FY

Setting:prioties fOr allocation of project funds among,,,- ,, - serviced. -,.

P

. (6) Est fishing- methods of evaluatirig the project.

,,'b) Ip,addition'the board thou

# .r

""-. 1"."..`

4(1)' Adopt articles of incorporatio by-laws, and admlnis- ,miktrative policies; and

f

t:

(2) Create committees and describe their!activities.

The board,- in establishing the abo#e-mentioned policies; y'shall not: .

(1) EstablAish any policy which is inconsistent with thMigrant Health Act orthe regulations set forth inPart 1 of this-document or which -prevents the ful ill-men of obligations imposed under the grant. ,

(2),- Involve itself in the piringband firing of any'p rsonnel.except theroject director, who shall be hired r fired'only with the approval of the board. If a project has airector prior to the creation of a policy boar , hehould be designated "acting director" or "knt rim director"Or no longer than 96 days,'duriiig which time he.boardiflould formally vote to approve or disapprove is appoint- ,

ent. If a project has no'director, the y boardshould be actively involved in' the entire pr ess ofrecruiting, interviewing, and selecting cand dates forthe frOsition: --

Select ons of these guidelines dealing with persOnn policiesand hiring and firing of the project director raise certainconf Acts between the functions of the Project Pol' y Boardand the Kansas State Bohrd of Health The speqifi point ofco flict was?that personnel policies including salaries andan al raises were already determined by the stat civil servicsyst in February, 1973 the Project Board vote' to accept thstate p sonnel system 'into their by -laws; thus iminating anyfurther onflict. -

,

Numerous ifficulties have been encountjd in filing boardvacancies'caused by members10ewang/the st r otherwise beingun le toiserve: S veral special eleati ha e been necessaryto ill cancies.an to elect'alternr ly electionswer again -held in the all. i

. .

, .

1

Since the Project area encompasses such area,rea, additionaldifficulties ate.alw4ys 'present in-getti e-groUptcigether.

-FOr'''Sgireral months meetings were rotated between thimiEUr majorreas. In the spring!the.Board voted to establish 1M., the

central location, as its regular meeting plac . Me*Xingsar ',held on -the first Sunday of the moniih,at 3:00 p.m. . Cent-ial

Time (The Project area is divided by the Mountain and centralS-7,---- Time zones.). 8 dbodlond and Garden City are nearly 150 miles

r apart. On more than one o casion Goodland has had, a blizqardwhen it's fine in Garden Ci . (

, .

-Much of the past ye as been spent familiarik g the board with.Project guidelines, functions of the Board, and ics og,parlia- :tmedtary procedure. Two days of board training w r provided by

1

fl

O

4. ' t

r- America Research Associates.in May'. 14egent1Tthe Board.is in the process of writing its by-laws and establishinva

',consumer grievance committee. A Project evaluation coMittee .

will also be established, in the 'near future. r.

. -

One very knotty problem dealt with by the boardconcerned providingservices to illegal aliens. ,Many Mexican natiOniala come.l.ntothe

. ,area Fit out visas or working permits. Mady are °sent back to Mexicoby i gration officials only to return again, within afew days orweeks. The situationis akin to robbing Peter.to pay.PatIn The

called "wetback!' take s'many job's that,would-otherwise beavailable to the migrant. .Often heForks for less-thinthe-

--;midant. ,Hefis an employer's dream,, Because he-Idoesnit wantto attract dttOtton he rarefy compleps about Anything. Theiilegal alien"problem.ismnplicatedby'thefact that most oft..nrbers.families are comprised of citizen and'nonqi-tizen'sana'pagers

.

The Boarcrreached the following decisions regarding routine sery es: .'

0 assistance be given to domestic families and nonfidomestic familieswhere one br both '"are citizens and/or have visallowithem to work in the U.S. It was also decided that,routine se., cesbe provided to children born in the U.S. regardless of the s atuso6thei parents. PersOns having an illegal alien stAus show beproved with.medical and dental services 1 on an-ern:erg. c5; basis

,whtn no other avenue of'payment exists'. .Th* ard alsovvoc ed to. .

....

provide screening services to all' children enlio141:41t 'atit I MigrantPrograms; It is the responsibility of such progfams.to'dermineelie.bility)sr enrollees. /...... e...?-.

Despite many difficulties the Boardhas gtown considerably withinthe past year. We took forward to a yea0: of continued, growth and '

increased consumer involvement.

40

,

J

F

7

,

.,.-..._

IX. SUPPLEMENTAL FOOD PROGRAM

/ .

Despite -Various ever preient difficultie%and problems, the:.Supplemental,Food:Program has been able to survive throughOUt

another,iyear, Due-to bureaucratic and political manipulationas 411 las national-shortagese at.times,one' or more items Were

43unav:a5Tablifor distribution Also, an unexpected change oflo ion of the Project Office in,.carden City meant the, temporary 4

1 an adequate storage area. Consequently, during this time, 'we ere able to keep enough commodities on fiaid to meet ,emergencydit ations, but we were not able to continue routine distributionto eligible families.

- 1

1

Nev rtheless, distribution of the available items continue&much_,,..'the same coign-previous years. Three shipments totaling 67,157

you ds of OupplemneAl foods were received and"stored at theProject Offices in GoOdland and Garden City. Distribution to :. .

-° 'Y %, thOamilles-,in Goodland', Sharon Springs, St. FranCis, and theen ire notthwest area is made through the GOodlantPdffice. '-'

';'4Garden C4ty,-,,Holcomb, Dee-ffield, Lakin, Johnson, rysses, .°

4.taj-Sublette,lopeland, Lebti, Scott' City, Lakinv,and all

letuthwest area are served.throu, the Garden City office.(. u#0lam4.14es in tfhe northWest counties pick up their commodities.at

.

',.

tie Migrant Office in Goodland. If they are not able to,ao this, the commodities are delivered to the,families by the '

staff.' .Families.'living in Garden City,Holcomb, and Deerfield41. =pick up theit commodities at the Garden City office. Commodities

are transported from Garden City and distributed to eligible -Nfamilies at= the monthly cooking and nutrition classes in Ulysses,

-,- Johnson, ,leoti; andgSatanta. When eligible families are unable:to attend the,coOking classes or when commodities are needed inan emergency situation, these-.are delivered to the families by

.!rmrthe staff. COmmodities for families in the Lakin area are'qtrane-ported to Laki13,44.411'distribution is made hy the county health

,,nurse through ter qiffiCe.',-,.

Tlitoughout the year much of the routine work involved in prep-.aration of the monthly issue and receipt tormsrand in the adtual .,,-.

physical preparation Of allotments wasl*done'by a-senior Neighbor-'hood Youth Corps worker. Assistance in these very time consumingroutine procedures enabled the Health Educator to concentrateat lean' 50% more of her time in personal .contacts, with families:and'in'heeltkeducation. Complete family histories as. well as, 1%, \

active and -inactiVe,card files are maintained on all commodity. .recipients., A10, each familyJs regularly provided with an

identificatitn card.,and,an'adthorilhtion form'wich enables,. themto.designate'sdmeOne else to pick uk their:. allotment for,-

,

them if they are unable to do4so A running inventory indicates, exactlywhat andlrOw many food items areon hand, and monthlyreports are completed for the USDA office in/Dallas and the

.

...

0

t -

DiVision OfFood Programs in Topeka..

.Approximately'61,500 pounds or almost.3k.tons ofsupplementilf4foodwere distributed to an average of 164:58`infants; preschool4ittlildren,

.

and prenatal and postpartum mothers durini-the past jeer: Withouta doubt the/most important food item %s the mill Yet, st rting inJanuary 1974 Only infants, up to thirteen, months 1)% el gihle toreceive the evaporated milk_ due to a shortage of this tem. childrenages threerto five and prenate-and postpartum mothers will continueto.reoeive.a four pound box of Instant, nonfat dry milk each month;and this 0, a ve minimal allatmen'E. However,-worse than this isthe fate oftodd ers and;preschoolers ages fourteen months to,threeyears ',/h0 Will receive nO.,supplemintal milk whatsoever during thiscritical TcOiod of thalrgrowt4 and development. This 4.S but another'in 4 keoga.list of examples that United States Food Programs aredederMined.l.mq'rely our nation's agricultural poliCY and budgetaryconstraints 'than Abe actual mainifest heed's offthe, millions ofAmericans affected by hunger and malnutrition increasfing ih sever- ityfrom year to year.

.

This is one of the steps leading to the,phasing out ofmental Food Program sometime during the,coming,year. Already allthe Kansas counties having a dolabed foods program ,hrough thelocarWelfare offices have converted to the food stamp P't4ram.-1)The Migrant Hpalth Service will receive final commodity ship-ment in early which will enable digfiribUti6ii of->supplemental "foe(' items to continue for possibly nine additional months. Theworst part about the discontinuance of thiz,program iathat thereis no suitable replacement for it. Supposedly it hi?ts been replacedby the ,Women, Infante,land Children Program, a "Phase II" variety octhe regular Supplemental Food Program. However.; WfC.prOvides fewerAemsand smaller ilottment and will serve children only to age five rather

. --than age six. Furthermore, funds'havebeen furnished for WIC onlyto June 30. Further funding will be available- if ihtial data cansubstantiate the validity of the program. However, at tigs.writingfew notice of 'grant awards for this protriM have been made and no'programs are'in operation. S,

:An applicatiOn 'to participate in the WIC Program has been subMitted.Hopefully,, we Will be able to implement this program when the regular

iSupplementaa Food Program is terminated.0

.

.

---

Perhaps one of the greatest benefits of theL'SupplementalFood.iProgram has been not merely the dstribution Of food,, as importantet this has been in supplementingdietary requirements particularlyof protein and iron; but the existence and- operation oil this peOgram.has provided easy access to the area of nutritioreedqtation. Hope-fully'the providing of the suppleMental food -items has not been -

merely a band-aid approach to the problems of huWter,and malnutzftion.through systematiIplanned efforts basia,concepti of nutrition havebeen, presented both on an indiVidual basis and in,grodp'settings.This Will continue with or without the Supplemental Food -Pogram,and possibly be the greatest, accomplishment of the piiigtam.

38

:4 0

1

c

16

MONTHLY ALLOTMENTS OF SUPPItEMENTAL FOODS

11

Infants Infants Children Women Prenatal. and,

0-6 months `7- 12- .months ,1 -5 years Postpartum

P. Evaporated Milk 30 304

2. Instant Milk 0 (1-2 Years) 1

1 (375-Years)

It,

3. Faring 3o st

3

4. Corn Syrup .-3 3

5. :)Juice 1 2 3v 36. VegefOle 7

7. Meat 1

'8.7' Egg Mix

'

'h.

2 4'Rz

-at" t-

9. Peanut Butter 1 (Eyemoths )5W.".

1 (Every 2

months) '

7.1

_

0.

The exp= sion of the FpodStamp Program to all Kansas counties isifitended be an improvement'over the previous county commodityprograms. owever, the. Food Stamp Program does not meet the needs

.of the majo ty of our familiet or of any poor families. Ourrecordeover the past. ear indicate that of families receiving the supple-mental food co" odities the verage participation in the food stampprogram was 20% The highes participation in any single.month was53%, and,d4rint ee months the participation was 0%. .The chiefreason for lank of rticipatibn is the ever increating cost of the.stamps. Effective J uary 1,.197,4. monthly stamp.allotments will beincreased 18% to 2270 n most families. However, many familieswill find the ",increase allotments' all but wiped_out by -the

increased prices of the amps. The increase in cost willbe feltmost by large.families. fact,' some households of ten or morepersons (Mott of our famill are large families.) will actually

f'.lose money because the incre e in cost will be greater than theincrease in- the value of, the s ps.

.

The increased Cbst,of the food s ps will force many of the workingpoor families to witfidraw from the rogram. Many others will be ableto purchase only a portion of the ii. thly stamp allotment becausethey will not be able to afford the f l monthly allotment. Familiesnot participating in the program will too discouraged even toapply. Actuallyzwhat is happening is th. USDA is forcing the poorto pay increasingly larger percentages of eir meager incomes forthe:same amounts of food. As a result,ther is less money availablefor othenincreasIngly Costly necessities.

7

rt

.

40

004E

S ,

COMMODITY DISTRIBUTION

Individuals Served

December.

1972 .

0

Finney Sherman Total

217 232

January 1973 213 24 237

February 1973 236 17 253. -A

March,t,--

x,

1973 235 31 266

April 1973 212 .234

May ' 1973. 205 35 240

June

July

1973

1973

40

29'

64

37

104

66

August . 1973 41 18 '59

--7--71September 1973° c 6 23 -29

October 1973 103 28 131

November 1973 101 . 17 124

1644 531 1975

ComModities distributed Decetber 1972 through November 1973 were approgimately61,500 pounds or almost 31 tons of food.

Average number Of recipients.per.monthLWas 16C58 persons, including infants,.preschool children, and prenatal and postpartum mothers.

.

17

IMF

41

0046

I

_ t..

a'

lte

'COOKING SES

'becember. 1972 5

-January 1973

February 1973 6

March 1973 5

April 1973. , 5

May 1978 4. P

.

June 1973 0 le

July 1973 0

August 1973 0

September 1973 3

October 1973 3

November 1973 . 4 8

. Totals 43

Classes

I

..%AstAttehdat

40'. - .-I,-( 44

f

42

-, S--':::,17v0

0

0%

,.-, 23

2e. .

50'_0,

343

Average' cooking ciassttendance was 7.9 individuals(not including the moniths of June, July, d August):.

Js

42

1

0

I

LW

X. COMMUNITY ACTION AND SUPPORT

4

Migrant day Care.programs were held in only two areas this year. Fewercenters than in past years may be due to the difficulty of acquiringfUnds and local support as well as the fact that by now the novelty o,,having these programs has worn off. Only those direCtly and personalyinIolved in such a program are aware.of the long hours of plain hardwork which go into the successful operatim of a migrant day care pro-gram.

SOme concerned, individuals in Scott, City began.early in the sprin to

flan and arrange .for a summer day care program to be held in tha area.

However, they .were to overcode local' obstacles, and the ogram. .

never becamaL,a reality. ', ;,./

. -, JohnSon's Concerned Citizens of Stanton County again sVonsO d" their

-------'w---day-caTe center. It lasted'approximately one month. Due ,53 a.complete., .. , ,

t

EurnOver in the migrant population of Johnson this year there Vas a,

much smaller number of infadts and children needing carp,.-- Actually inearly June when'the,,center was due to open, thereCwerionlY eight childrenup to two years of age, no children ages two to four years, and onlyseven children ages five to ten years.- However, there wereabout twiceas many teenagers as usual.

The Grant County Day Care Center again sponsor both ,a migrant nurseryand a migrant day care program. Barbara Pal er is the Director of theGrant County Day.Care Center. Additional mmer directors were Virginia ,

Boepple for the nursery and David Nine foe the day care center. Averagedaily attendancewas 7 for the nursery nd 16 for the day care center.The day care center served a total of" 9 children from the ages of two

- to six years'old. The nursery cared or childrenlfrom two weeks up tothree years of age.' Both programs we e open an average of twelve hours.per day. r ' z

\ ' D'aPite many problems, not the leastt" - planning to provide Migrant day, car

-season., V- k

4 il1

oo

3

ich is funding, Ulysses isduring the coming migrant

The Project receives a gre deal of.support Tom many organizationsand individuals within the community. CountleSs donations of- usedclothin&, household it ,"bedding, baby bundles, and quilts are

.:receivegthroughout e year. Several church groups and organizationssponsor annual pr ects to provide Christmas baskets, clothes, andtoys to needy families in the area. SAveral pharmaceutical companieshave supplied the Project with many eddcationai materials and suppliesincluding egular and soy infant formula. Area Rotary and Lion's Clubshave pur ased glasses far a number oflow-inoomechildren. Mostcommun es halie made meeting place's a kitchen facilities availdble'to the Project free of charge for nut itional classes and other educa--tiona ierleavors. Area extension offite staff have been extremely

assisting with nutrition classes and supplying audio - visual

r't.

11;

. 4

I

. ,

.,.f 4

,1

rA

.1. ,

43

0048.

aides and other materials. Extension office staff have also sponsoredsewing classes, budgeting sessions, and "workshops" for making allsorts of household items out of things Usually thrown away.

A need still, exists for more assistance with social security problems,obtaining birth certificates, driver's licenses, help with tax returns,workman's _compensation problems, and filling out applications:of allsorts. Project staff assists with many of these problems, but musttake time from other endeavors to do so. For the.staff our most pre-

.,

ciouscommodity.--is time. There is never enough to go around.

The Kansas Council of Agricultural Workers. and Low-Income Families hasbeen:ofconsiderable benefit to area families: However) with thestrangulation of O.E.O. the migrant up-grading and adult. educationcomponents of the program have been phased out due to-lack of funds.Headstart'progtams operated by KCAW-L3Fprovided opportunities for low-income youngsters in four communities. A. legal -aide program,alsosponsored by the Council provided services for migrants and.lbw-income

. families during the summer. This program was set up with,the assistanceof locaf attorneys and the Kansas University Law School.

The remainder of this section will deal with another Councilliendeavor:the VISTA Project. -,

.1

DE RERUM VISTA COUNCILII Glen GavinVISTA _Supervisor

,11-4 Kansas Coiincil of Agricultural Workers and Low-Income Families; Inc.,205 W. Chestnut in Garden City, became sponsor in 1973 of a VISTA projectfor western Kansas. (This project it successor to one sponsored byMigrant Health several years back.) The chief concern. of the VISTAworkers'here has been housing: improvement of substandard housing;construction of new housing; formation of_interest groups. to lobby forbetter housing conditions for lc:der-income families and persons; de-

r

velopment of alternative housing delivery systems; referral and coun-seling services. great served by the KCAW/VISTA project are GardenCity,: Ulysses, Liberal, Leoti and Goodland.

VISTA istiew to Liberal: David Baldwin and Marge Cowan began theirtrail=litazing effort there in March, 1973. During,thetr 'tenure theyhave organized the "Concerned Citizens Coalition," a grass-roots grail',and'have secured a fair degree of cooperation from thei "power structure"as well: The housing redevelopment program proposal, drifted by theVISTA team (with some technical assistance provided by the state), out-_lines a community-sponsored housing delivery system which will furnishbdtter housing for 100 moderate and low-income families. Redevel9p-ment will occur in the northeast neighborhood, a clearly defined '

poverty sector-marked by the conimunity;s greatest concentration ofsubstandard housing. The salient features of the piopOsal\are'anindustry-sponsored loan guarantee fund,,A1 cityadministered land grant.,syStem and low -cost construction methods (possiblys,involving a-manpower

s.

44

,ti , I /

'

.,,

training-program). The Liberal VISTAs' main auxiliary Rroject As the-_ ,Big Brother-Big Sister program, which they have been instrumentaf in

,

organizing and directing; they .have also worked a good deal in the,D :area of civil rights. The VISTA office is located at 41264.1Wash4ngton

(telephone: 624-5432). e-:

p- 1--

14 ., 4 II

*Ulysses is Kansas' pioneer VISTA--organized, FmHa-financed self-helphousing project. (Five homes were constructed there by participating,families during'Migrant Health )/s sponsorship of VISTA.) .Tom Myers ' 1

4 has been working to organize a new self-help.projectAn Ulysses --- '

pre- construction meetings add .fund-raising activities'are part of memberfamilies' agenda, as they proceed along the course which, it is, hoped,will lead to a second set Of dwellings,built cooperatively by partici- i'pating families themselves. The Farmers' Home Administration enableseligible families to--o ktain low- interst loans for building, and land, .",'"

costs, and it supplies the-services of-a construction supervisor Aincebuilding.actually begins. The! VISTA office is located in the Grantcounty courthouse (telephone: 356-4854). o

0

. _ .

Garden City VISTAs Laurie Eager and Leslie Hawkins are trying to get aself-help projeCt off the ground for Garden City-Holcomb. ,They,have .

been counseling` families fdr several months, and,have-been scouting _tabout for land in Holcomb (FmHA-offers direct services.to towns of delmore than 10,000 inh,gbitants:). They have, additionally, helped-the i,

local school systeein the-designing-of bilingual education plans, and!! .the junior college on adult educ4tidn. Thtyrare collaborating with ex-VISTA Lanell_Hays, Father RichKolege and others from-the community(including a hefty contingent "from migrant Health) on_the,"Garden'City. ..

Coalition for Better Housing," an interest group whose aims are parallelto those of theLiberal coalition.. 'The VISTA office is at 205 W. Chestnut(telephone:,275-41-23).

li , I,

.

T.

Pam Collins and Kerry Harms, in Goodland, are attempting ,0 form a ,°_,.

-

, self-help group there --- soler without much succeas,cae0 to the' ''.

Goodland target population's high incidence of transience and general, volatility, they explain. The Goodland teem perseverf Supplemental,,;

projects include: "Meals-on-Wheels" and A recyc-liticenterth ofwhich they helped inaugurate, referral, counseling and tutorlyg services.The Goodland VISTA office is in the municipal building airlephlq:,899-5760

The KCAW/VISTA.projeCt is slated to continueat least thzoligh 1115;., 'Volunteer replacements are scheduled to:Arriveat tiegular fhterivals°

.,

_ (theoretically, anyhow). For example, VISTIeshould be returillg,to thethe Leoti fold .soon. T1lough most Volunteer (who serve at subsistencewages, normally for ane\year)come from other parts of the country4(inour experience, MOItly from the east,

a

and-west coast regions.),Ploaallyfrecruited-Volunteer"candidates are invited to apply from rgeeardes.See your local VISTA wdrkerfor further information, or write-t.the'

-Tice in Gaiden:Gity. .

: ',t- - ..', 1

-

44B

1--**"

1,4

DEPARTMENT OFHEATH. EDUCATION. AND WELFARE

HEALTH *gin VICES AND MENT AC .HEALTH ADMINISTRATIONA

ANNUAL PROGRESS REPORT - MIGRANT-,HEALTH PROJECT

DATE 141:0

April 1,1 1974

PART I - GENERAL PROJECT INFORMATION

PERIOD COVERED BY THIS REPORTFROM THIROUGH

December 1972 November 30,, 1973

1. CT TITLE-,,-

,Western Kansas MigrAnt Health Projec

3. GRANTEE ORG 1412 ATION Name 16 address)

Kansas State Department of Health535 Kansas'AvenueTopeka, Kansas 66603

2. GRANT NUMBER (Ilse number Shown on the lastGrant Award Notice)

07"11".0000 18.- 104 S-4120-C-0'4. PROJECT DIRECTOR _

.

Evelyn S. Gendel, M.D.

0

.6o

00SUMMARY OF POPULATION AND HOUSING DATA FOR TOTALTROJECT AREA

15.4 POPULATION DATA - MIGRANTS (Workers and dependents)-*. NUMBER OP MIGRANTS BY MONTH b. NUMBER OF MIGRANTS DURING PEAK MONTH

MONTH

.141.

FEB.

MAR.

APRILMAY

JULY

AtG.SEPT.

OCT.

NOV.DEC.

TOTAL INMIGRANTS OUTMIGRANTS

640648656741

318544354763 .

3885

22221780

- 1084

812

640619

656731

31854424/.

4763388521961745

1076

. N.A.-29

N.A.

10

N.A.

11

N.A.°N.A.

26

358

N.A.

C. AVERAGE STAY OF MIGRANTS IN PROJECT AREA

OUT.414GRAN TS

NO. OF WEEKS FROM (tio, THROUGH (MO.)

w.114`14 February. June

1N.MIGEL ANT6: 12 May I - August

11/ OUTMIGRANTSeTOTAL

TOTAL MALE FEMALE

32 14 ,18

UNDER I YEAR

1 - 4 YEARS

II. 14 YEARS I:1

IS. 44 YEARS45 - 64 YEARS)44OLDEROS AND OLDER .

.2

7

8

-15

1

3

3

7

1

45

(2) IN-MIGRANTS:

TOTALUNDER 1 YEAR'

1 4 4 ' Anc

s is YEARS,t5 - 44 YEARS

45 .14 YEARS

"011 AND OLDER

546680,

437.'

1150-

3582202

15

;59934

208526

1739

85

7

2867.49

229624,

18431

117(

/11. --1

d. (I) INDICATE SOURCES OF INFORMATION AND/OR BASIS OF ESTIMATES FOR So.

Project records, migradt schoOl enrollment, employment lists.

(2) DESCRIBE BRIEFLY HOW PROPORTIONS FOR SEX AND AGE FOR Sb WERE DERIVED.

Current filesof the ProjeCt plus past experience.-NOTE: Peak propulation does not ocpured at the sametime in each county. Peak monthtotal does not include all migrants. Tptal estimated population was 6107

6..HOUSI`NG ACCOMMODATIONS0. CAMPS , c b. OTHER HOUSING ACCOMMODATIONS

MAXIMUM CAPACITY NUMBER OCCUPANCY (PEAK) LOCATION (Spicily): NUMBER OCCUPANCY (PEAK)

LESS THAN 10 PERSONS.

1 .P1

51

58:

181

.

.

Rural, 267

389

...

l

2145

303110. 2S PERSONS "U ban

25 . 50 PERSONS

-- II1 -100 PERSONS- --,.t

MORE THAN 100 PERSONS,.

,' ,.<4; ' TOTAL*, TOTAL.*290 h~,..

.

656' 5176

* NOTE: The combined occupancy totals for and- "6" should *qua/ cppeasimatefy-tho total peak migrant population for the year. 5

o7- MAP. OF PROJECT AREA - Append mop showing location of camps, roods; clinics, and offietplocasftnPottant to ptoject.

.4-117,

Pms-4207 (PAGE ItREV. (-69

Fenn approved:13.4.1 Bureau 'No. 68.11,100S

i.

4

POPULATION AND HOUSING DATA

FOR Finney COUNTY.* 07-H-0000.48=10-0 CS-H2O -C -0

,INSTRUCTIONS Projects involving more than one county will complete o continuotion sheet (poge 1 ____) (or each county and summarize,

oil the county dote for totol project area on poge 1. FArojects coverinponly one county will report popOotion and housing. on poge 1. I. °r

\, ) lOPUL T1011 DATA - MIGRANTS (WoMerk and dependents)6. NUMBER OF MIGRANTS BY MONTH b. NUMBER OF MIGRANTS DURING WEAK MONTHMONTH TOTAL INMIGR AN TS OUTMIGR ANTS

111 OU TMIGRAN Ts:

TOTAL

UNDER. 1 YEAR

1 4 YEARS

5 14 YEARS

15 - 44 YEARS

45 - S4 YEARS

SS AND OLDER

TOTAL MALE FEMALE

AN.

FEB.

tAR.PRIL

MAY

JUNE

JULY

AUG.

SEPT.

OCT.

NOV.DEC.

72

, 72.

'72

81,260'

321

270200108

92

80-64

72

72

72

tl260

321

`270200

108

92

80

64

-N.A.N.A.

N.A.

N.A.

N.A.

N.A..N.A.N.A.

N.A.

N.A.

-N.A.

N.A.

N.A.

N.A.

N.A.N.A.._

1119

V.A.M.A.N.A.

N.A.

N.A.

N.A.

N.A.N.A.

N.A.

N.A.N.A.

N.A.

N.A.

N.A.

N.A.

01NMIGRAN TS:

TOTAL °

UNDER I YEtRI 4 YEARS

5 14 YEAR"11

15 44 YEARS

45 - 44 YEARS

S5 AND OLDER

321

4

2383

4189-

1

.149

1

12

38

917

*0

172 ,

3

11

45.9814

1

TOTALSg. AVERAGE STAY

7 "

OUT-MIGRANTS

OF MIGRANTS IN COUNTY

NO. OF WEEKS FROM IMO.) THROUGH (.10.1

'N.A. N.A. N.A.

IN-MIGRANTS 12 May August

6.' HOUSING ACCOMMODATIONSe: CAMPS b. DRIER HOUSING ACCOMMODATIONS

MAXIMUM CAP AcFTY NUMBER OCCUPANCY (Peak) LOCATION (Specar) NUMBER OCCUPANCY (Peak)

LESS THAN 70 PERSONS

/6 25 PERSONS

24 - 90 PERSONS

S1 100 PERSONS

MORE THAN 100 PERSONS * (,,

TOTAL*

N.A.. .

CScattered Rerar -12

50,

-,-

o

..

' 42'1';

.279

, .

''5

!!Urban"_

. ..

,. ..!

,_ _ . TOTAL*62 '321.

..io

*NOTE. The combined occupancy totals for **o" geld "W' should equal cpptoeitnIttelythelotal peak migrant' pop tattoo for the year.

REMARKS

4

PHA-4202 (P GEREV): 1.69

46

4.

1

(CONTINUATION PAGE FOR PART I)

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POPULATION AND HOUSING DATA

FOR Grant ' COUNTY.

1

ANTAUMSCR

07-1i-Q00018-10:70 CS-H2O-C-0

INSTRUCTIONS. Protecp involving more than owe county will ,Mom' etp a continuation sheet (page 1 _) for each county and summarizeallthe county dot° Jor total project 0100 on Rage 1. Projects covering only one col will report population and housingon pogo 1.

I)Q_____

15

5. POPULATION CIATi - MIGRANTS (11Orkets am /dependents).

o: NUMBER OF MIGRANTS UY MONTA,_- ' ' o

.L4.

S. NUMBER OF MIGRANTS DURING PEAK MONTH

2 Li911 Tt4 TOTAL INMIGRANT5 OU TMIGil AN TS

(11 OUT.MIGRANTS:

TOTAL '

UNDER 1.YEAR

1. YEARS

14 YEARS

15 44 YEARS

45. 64 YEAIRS

65 AND OLDERC

ToiAt. FEMALE

'JAN.FEU,

MAR.

APRat

MAY'

JUNE

JULY

AUG.

-SEPT.

OC'T.

Nov.

DFC.

203

03228,270

601 3,756 --"

607'5,70 --549.4

580y 421

9 3

,203

203

1225

1270°601

756'

607

570.

549

580

421941

N.A.N.A.N.A.N.A.N.A.N.A.N.A.N.A.N.A."N.A.N.A.N A

N.A.

'N.A.'.N.A,.N.A..

N.A.',N.A.

N.A.'N.A.N.A.N'. A.N.A.

N.A.°

N.A.

N.A.

N.A.

N.A.N.A.. .

N.A.

121 INMIGRA TSTOTAL

UNDER YEAR

1- 4 YEARS

5; 14 YEARS -

15 44 YEARS

45- 64 YEARS

65 AND OLDER

756

8

'56 ,

117

528

45

2

368

23,

56

26521-

o,

4.0

388'

33

61

263

24

2-

TOTALSC. AVERAGE STAY'OF

OU TMI GR AN TS

MIGRANTS IN COUNTY

NO. OF WEEKS FROM (MOO THROUGH IMO./

N.A. N.A. N.A.

INMIGRAN TS16 May Sept.

6. ,HOUSING ACCOMMOOATIONS("AMPCJ

,

I b. OTHER HOUSING ACCOMMODATIONS

MAXIMBM CAPACITY 1 ,NUMBER OCCUPANCY (Peak/ 1.0a AVON f.SpeCo(y) NUMBER OCCUPANCY (Peek)

t.css THAN 10 PERS04; '''

10 25 PERSONS ,

26 50 PERSONS

51. 100 PERSONS

MORE THAN 100 PERSONSLt:-I TOTAL*

;,

.

4

-

.

L--

.

/ ,

-

c"';':

58

Rural 15

104

......,,,,.....

.

-75

623 .. , ...

-.--

$

"Urban"

is-1. , 58 TOTAL*

.

119 - 698 ',.

.

*NOTE: The combined ocauponcy tarots or d fr Ish5uld equal approximately the total peok migront population for the yew..

REMARKS

48

t

PHS42Q2.7 IMAGEREV, 1.69 (CONTINUATION PAGE FOR PART 7.

CA

4

cn

o,

.3 5 0

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R 3

5W

".

POPULATION AND HOUSING DATA

FoR Gray-Haskell COUNTY.

GRANT NUMBER

07-11-000018-10-0 C3-HZO=C-0

/ INSTRUCTIONS: projects involving more that; on. county will complete a continuation shut (page 1 :f_ ) for Foch county and s-

ummorall the county,doto for totol project °roe on page 1. Projects covering only one county will report population and housingon pogo 1.

S..POpuLATiON DATA MIGRANTS (Woikets and dependents)wassr.ly OF MIGRANTS -BY MONTH b. NUMBER Or MIGRANTS DURING PEAK:MONT

, MONTH TOTAL -N IN-$41 GR AN 1/Si

*JAN.

FES.MAR:

APRIL

526167,

52.-5261.67

.-mAy 250 250Jum 420 420JULY 390 390AUG. 150 150'SEPT. 140 140OC T. 96NOV.

)9665 65

DEC. 65 65TOTALS

r

c. AVERAGE,STAY OF MIGRANTS IN COUNTY

OUT-A1 GRANTS,

.;

OU T141 GR AN TS f, TOTAL,

/II/ OUT.MIGRAN.TS: `4

N.A.N.AtN.A.,

N.A.N.A.

-N.A., N.A.

N.A.

N.A.N.A.N.A.N.A.LA.N.A.

NO. OF WEEKS FROM 11.40.1 THROUGH IMO./

N.g. N.A. N.A.

INMI GRANTS

6. HOUSIND ACCOMMODATIONSa, CAMPS/

-12 May August

TOTAL

UNDER I YEAR

1. 4,YEARS

S 14 YEARS

15 - 44 YEARS.

45. 54 YEARS

SD ANC: OLDER.

N.A

{BALE FEMALE

It/ INMIGRANTS:TOTAL

UNDER 1 YEAR

I 4,yEARS'

5 12 YEARS

15' 44 YEAR

45 54 YEARS

SS ANcroLocit

4208 (-

65120206

21

1.A.N.A..,N:A.N.A.N.A.N.A.

20.5,

57-

100 .Ll

N.A.N.A.N.A.N.AN.A.N.A.

2156

3063

106'10

0

b, OTHERNDUSINO ACCOMMODATIONS.. ,

$.4 A Y,I$AuM CAP As1 Ty l 'NUMBER OCCUPANCY (Perak) LOCATION (Specify) NUP413A4OCZOPANY (Peak)eit)

L CU 'TN AN $0 PERSONS

10 ,,25 PERSONS

2$ 00 PERSONS & ,.-

at 100 PERSONS'

MORE ImS4,1 in PERSONSa ' TO T AI.*

/

. .

1 31

Rtiral- .I ., 2613

..

i

2719

;IP

0Urban"'!

4 -

f 14

5].TOTAL* S

e 139' / 369,

*NQTE. Theme mbined occupancy totals for o" aid "kr should *god( apply:rink/40y this total peak migrant population (or)he year.1hossaks

s -

4.

4

Ii

50

1171t42027FTPAGE IPr y. I69

e

p.(CONTINUATION PAGE FOR PAAT

EI(kAS-0

O

7'275

9

O

3 3 1 3 3 3 .FINNEY A A A . .'A , COUNTYet cc m

? - fIIIIIIIIIIIIIIEIIIII:ll : I

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./c

[

51

COUNTY .!I "7

cg

7'295

7'30

O t.si O

:+r

HAS LL COUNTYKANSAS

--POPULATION AND HOUSING DATA

FOR Kearny COUNTY..

GRANT NUMBER

07-H-000018-10-0 CS7H20-C-0

. \INSTRUCTION'S. Protects involving more than one county will complete a continuqtion sheet (page 1 ____) for each county and summarize

all the county data for total protect area on page 1. Protects coveting only one county will report population and housing..,i'

on page 1. ,) . - - c-- --;

..

S. POPULATION DATA - MIGRANTS (Rockets and dependents)a. NUMBER OF MIGRANTS BY MEPITH b. NUMBER OF MIGRANTS DURING PEAK MONTH

'' MON T H lv TOTAL INMIGRAN TS OUTMIGR AN TS

111 OU TMMICAN T S:

^ TOT AL

UNDER I. YEAR

6 YEARS

5 14 YEARS

121-- 44 YEARS

45 114 YEARS- ,

115 AND OLDER

TOT AL MALE FEM AL E

JAN.

FED

MAR.

APRILMAY

JUNE

JULY

AUG.

SEPT.

ad T.

NO Y.

DEC.

62. 62

6265

480,516450

W98737369

"62626265:

480516450350

98737369

N.A. -

N.A.N.A.14,A.N.A.

.4.N.A.

N.A.NX".N.A.N.A.

/N.A.

N.A.N.A.N

N.A.N.A.

N.A.

N.A.N.A."N.A.N.A.

N.A.

N.A.

N.A.'N.A.N.A.N.A.N.A.N.A.

12) 1NMIGRAN TS:

TOT AL

UNDER 1 YC AR

) 4 YEARS

5 14 YEARS

15 44 YEARS'

45 - 64 YEARS

63AHO OLDER

5169

48120301

371

2364

2255

14015

9

280.5

2-6

65161

22

TOTALSc. AVERAGE STAY

OUTMI GRANTS

OF MIGRANTS IN COUNTY

NO. OF IgEtK3 FROM IMO.) THROUGH IMO.)

N.A. N.A.

1,44.410 R AN1/5 12 May August

.1

6: HOUSING ACCOMMODATIONSz I (111.1CR 11011311,1(1`ACCOMMCIOATIOH3

, MAXIMUM CAPACITY NUMBER OCCUPANCY (Peak)A

LO c A vloetive.calt/ NUMBER 'OCCUPANCY (Pen:J

,

LESS THAN ,t) PERSONS

10 - 25 PERSONS

20 Kt PERSONS ,51 100 PERSONS

MORE THAN 100 PERSONS--

,- TOT AL*(4

-.

-

,.

.

.

Rural -.;25

.18.270-246

'.

.

"Urbtn"

1 . TOTALS43

*NOTE*NOTE The combined occupancyoncytotalifor "a** and "W. should equal cpprorarnately th total peak migrant population (or the year,,/REMARKS

1

iirTS74/52.7-1PAGREV. 1.69

A

52

dATION PAGE Fa T'

i-jr5

maimsmasor -Num 114 Mill Wassimmorra slum simaurr monnwilam

ommumis RN Igi12" . 1111g1i1MMITA.1mimmioua

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_1111111111 WAIN! 1111131111111N: miracnWEIVAVOLVI momommi -

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111U1XNFAL 11111111111 NUMMI 'MINNIE

11111.1111MIRE111111 .

MIL 11111111111111111111111111 OI II b. IMI 1111.1101.1111111 MEND 11111111kiEWMARR 1111111111111.

ki

POPULATION AND HOUSING DATASherman - Cheyenne

1973 OR Wallace COUNTY.

A

GRANT NUmIDER,

07-H-000018-10-0 CS -H2

0

INSTRUCTIONS. raises, involve 11101 than one County will complet.o continuation sheet (page 1 for each county and summarizeII the county dgta 'sol protect oivis on page 1. Protects covering only one county will report populopon and housing

o page 1.

C 5. POPULATION DATA MIGR0. NUMBER OF MIGRANTS BY M

S (WorkerTH

d dependents)b. _NUMBER OF 10 GRANTS DURING PEAK MONTH

24024TH TOTAL sw.AwanalTs Ot! GRANTS

111 OUT-MI 014AM 112

TOTAL

UNDER I YEAR

I 4 YEARS

S IS YEARS

111 44

412- 64 YEARS

66 AND OLDER

TOTAL MALE FEMALE

JAN.FED.

HAILAPRIL

MAY

JUNE

AMY

AUG.

SEPT.

OCT.

NOV.

6rc

173152

130

128

1470

1930243d21321083

785

34127LL

a23

130'118

1470

1919

243021321057

752

335,

274

,

29

11

26

7T-- 35

8

32

2

7-8

15

r,

14

1

3

3

7

181

-458

IS) 114.1A ANTS:

TO T

UNDER YEAR

4 YEAR

$ 1, 14YEARS

13 e 44 YEAR.4*- 64 YEARS

OS AND OLOER

241,g

46148

4651733

31

1140

21 .

72

204

'835

5

3

.

1290

25

76

261

898Z64

60 TAL S

c. AVERAGE STAY

e

0015-24201204 TS

OF MIGRANTS IN COUNTY

NO. OF WEEKS FROM 040.1 Tmaot,C14 MO./

.\43.-- 14. February June

1.4WGRANTS . IMay August

S. HOUSING ACC mOOATIONS16. (\THEP 1401151Na ACCOUL:00ATIOI

.

Alum C41.491Ty NUMBER OCCUPANCY (F0416) LOCATION (SPec112)OYTI'

.....

-

,

CupANCY1P6-A-1

1362

1068

4

.'

- 2-

LESS THAN 0 PERSONS

10 -55 PERSONS .

2 - 20 PERSONS.St - 1016 PERSONA

MORE THAN 100 PERSONS..-,_w

TOTALS

.N.A.

fp

.

.

-sr.k., -

Urban

- TOTAL313 24

*more The ct3,-02.ned.c.012.cy tote): (or "o' and should 49I,01 cpproxietatety the wirer peak migrant population for the year.

REMARKSt r

a

4t.

PM5420277PAGE 1 r

1'1

54

C

2

a

REV, . tcoNTIRUATION PAGE, FOR PART I)

ii(g3 ,)

tinierit h,

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.

POPULATION AND HOUSING DATA

FOR Stanton COUNTY.

GRANT NUMUER

07 -H-000018-10 -0 cs-H2o-6-0

INSTRUCTIONS Projects involvtrig more than one county will complete o continuation sheet (page 1 (or froth county and summarizeoil the county 'doto for,tota protect ores on poge 1. Protects covering only one county will report population and housingalt poge 1.

S. POPUL ATION. DA T A MIGRANTS (Workers and dependents)o. NUMBER OF MIGRANTS BY MONTH b. NUMBER OF MIGRANTS DURING PEAK MONTHMON TN TOTAL IN-MIGRANTS - OUT.4IGRAN TS

JAN.

FED.

MAR.

APRIL

MAYJUNE.

JULYAUG.

SEPT.

OCT.

NOV.DEC.TOTALS

69

69

73

76

200507,

406193

123

139

54*54

69

6973

76 _

200507

406*193

123

139

5454

e. AVERAGE STAY OF MIGRANTS IN COUNTY

OUT-MIGRANTS

IN-1.11 GRAN TS

NO. OF WEEKS FROM

N.A./

J.2 June

N.A. 111 ou T.141 GRAN tS:

N.A. TOTAL

N.A. UNDER I YEAR

N.A. -a, 1 4 YEARS

N.A. 5..14 YEARS

N.A. 111% 44 YEARS.

N.A. 45 - 54 YEARS

N.A. SS AND DI. DER'

N.A.N.A. It) IN-MIGRANTS:

N.A. TOTALN.A. UNDER 1 YEAR

1.4 TEARS

YEARSTHROUGH WO.) 15 - 44 YEARS

41- 64 YEARSN.A. SS AND 01-0EA

SePteMber

TOTAL. 1.4AL ER FEMALE

N.A. a N.A. N.A..

507

2.

5098546

31

0

253

2

17

4417i-

'19

1254

0

13

54.

175

12

0

6. HOUSING ACCOMMODATIONSc. CAMRS. r Et, OTHER HOUSING ACCOMMODATIONS

mArimo...t CAPACITY NUMBER OCCUPANCY (Peeks LOCATION (Spicily) NUMBER

LESS TNAN, a PERSONS

$0 - 25 PERSONS

26 -.00 PERSONS

11 - 100 PERSONS

MORE THAN 1,00 PERSONS

TOTAL*

1. 181

1 131

Rural"Urban"

TOTAL*

9

22

OCCuPAttr.*: (Peak)

547-272

31 326

*ROTE: The combined occuponcy totels for '.42" and should *quo, q:proalmato ly the total peek migrant population for the year.

R Cm/RKS

t.

.0

41{fl

57,

15-1741- 420PriPAGE IRFV. 4.°.'-

iCONTINCIATION PAGE FOR PART IT

t4

rat .003

,

4

I HAMILTON.

: s :' Al ihm.... WHINE

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x

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1;30

C'

VENSUNTY

4

POPULATION AND HOUSING DATAWichita

FOR Greta ly & RrntgOUNTi.,

GRANT NUMBER

)7-H-000018-10-0 CS-H20-C-0

INSTRUCTIONS: Projects involving more than one county will complete o continuation sheet (page 1 _) for each county and summartzeall the county dote for total project oreo on Page 1. Projects covering only one county will report population and housingon page 1.

, S. POPULATION OATA - MIGRANTS tWorkera snitilependents)a. NUMBER OF MIGRANTS BY MONTH CA . NUMBER OF MIGRANTS DURING PEAK MONTH

MONTH TOTAL I INmiGRAN TS OUT.MIGRANTI

t OUTMIGRANTSi..

TOTAL

UNDER. 1 YEAR

.1/41 - 4 YEARS

5 14 YEARS

115 4 44 YEARS

45 - 64 YEARS,

65 AND OLDER

TOTAL HALE FENACE

J AN.

FEB.

MAR.

APRIL

MAY

JUNE

JULY

-'AUG.

$PT.be T.

DEC.

103

120

124'

481516

483218119

96

97

78

78

103120.

124

481516483218119

9697

N.A.N.A.N.A.N.A.

N.A.

N.A.N.A. -

N.A.

N.A. -

N.A.

N.A.

4

N.A. N.

0

(2) IN- MIGRANTS:

TOTAL-

UNDER 1 YEAR

1. 4 *EARS5 14 YEARS

15 44 YEARS

45 - 64 YEARS

.65 AND OLDER

5-16

3

67147

27916

.4

2481

27

72

137

7

4

268)2

4075,

142

9

0

TOTALSc. AVERAGE STAY

OUT-MIGRANTS

OF MIGRANTS IN COUNTY

NO. OFWEEKS FROM IMO.) THRCU OH IMO./

N.A. N.A. . 'N.

IN-MIGRANTS,14 May August

6. HOUSING ACCOmmOOKTIONSa. CAMPS

t-s

b. OTHER HOUSING ACCOMMODATIONS

mAXIMUM CAPACITY NUMBER 1:)-C. cuPsucr (Peak)' LOCATION (Specify) NUMBER OCCUPANCY (Peak).

LESS THAN D PERSONS

10 -,21 PERSONS.

26 - 50 PERSONS

51,- 100 PERSONS

MORE THAN 100 ,-PERSONS_ z

TOTAL*

_

. , '

Rural '11

38

.

71

-.. 445

.

"Urban"

.:

.

TO L "' --A' ...-:

9- %ii 516.

*NOTE. The coMbined occupancy totals for o" and "6'. should equalqtptoximetely the total peek migrant populattiti for the year.

. .

t

59

r

PHS42::)2-7 IPAGE 1REV.1-67 (CONTINUATION PAGE FOR PART I)

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`-p1/4L31

-PART-11 -J4EDICAL.; DENTAL, AND HQSPITAL SERVICES.ARP-a-A&

1. mIGRANT.5 RECEIVING MEDICAL SERVICES. ,TOTAL MIGRANTS RECEIVING MEDICA.L. SERVICES ATFAMILY HEALTH CLINICi, PHYSIeNtNS OFFICES.HOSPITAL EMERGENCY ROOMS, ETC.

GRANT HUNKER07-11-000018-10-0 CS-E20-C-00 ATEsubmiTTEG

April 11 11474

2: MIGRANTS RECEIVING 6ENTAL,SERVICES

ITEM TOTALIS AND

UNDER IS OLDER

AGENUMBER OF PATIENTS

TOTAL MALE FEMALENUMBER o. NO. MIGRANTS EXAMINEDTOTAL.

OF VISITS..., (I) NO. DECAYED. MISSING.FILLED TEETH

(2) AVERAGE DMF PEtt PERSONTOTAL

UNDER YEAR

I 4 YEARS

S IA YEARS

IS 4 YEARS45 64 YEARS

IS AND OLDER

1121

175

460158

223

120

35

519

59

210

7395-

60

22

62116

250

85128

60

13

1471

216

500

170416127

43b. OF TOTAL MIGRANTS RECEIVING MEDICAL SERVICES HOW MANY

WERE:(1) SERVED IN FAMILY HEALTH

SERVICE CLINIC)(2) SERVED IN PHYSICIANS' OFFICE.

ON FEE FORSERVICEARRANGEMEN) IINCLUDE REFERRALS)

716

1492

3, MIGRANT PATIENTS HOSPITALIZED(Rekord/eaa of artengement for payment):

No. of Patients (exclude nbom)No.4-1 Hospital (lays

80

_ 368.5

b. INDIVIDUALS REQUIRINGSERVICESTOTAL

It) CASES COMPLETED

(2) CASES PARTIALLYCOMPLETED

IV CASES NOT STARTED

' 645 634 11See Section VII

1.39 139

412 11°

c SERVICES PROVIDED - TOTAL

(I) PREVENTIVE

(2).CORR EC TI V ETGT AL

(a) Extraction

(b) Other

d. PATIENT VISITS TOTAL

Dental Hygienist'.

367

36

367

25

'20

0

11

0

423 423

75 66

1258 1256 2

314 304Hrs. 10. Hrs.

2d Hrs.20Hrs..,

9.

4. IMMUNIZATIONS PROVIDED(Most Preventive Services)

TYPE

COMPLETED IMMUNIZATIONS BY AGE .-IN

COMEILETE5tHIc.

BOOSTERSeREvACCINATIONS.TOTAL

UNDER1 YEAR-- I 4. 1 5 - 14

15 ANDOLDER

TOTAL ALL TYPES -

SMA\L PDX

*634 198 222 . 87 11 40 76

3

141

122

120

174

9

54

5

6

52

52

1.52

29

2

11

_.

65

42

42

49

- .11.

5

-6

:,

9

9

20

42

1

'6

3

3

4

1

12

4

14

----,,,_

_..

1

.

5

s -1

40

.

25

..

\

0

DIPHTHERIAT

PERTUSSIS

TETANUS

POLIO

TYPHOID

MEASLES

OTHER (Specl(Y)MRDT

TBREMARKS '

* Includes. Immunizations from all /areas

0Pat

1

PHS4202.7 (PAGE 2)REV. 1.69

62

1

e 1, .

P ART. 1 tCont.nued) - S. MEDItAL CONDITIONS TREATED BY PHYSICIANS IN F-AmLi,500,041NW ,Lk -.

CLINICS. HOSPITAL OUTPATIENT DEPARTMENTS, AND PHYSICIANS'07-H-000018-10-0 CS- H2O -C -0'OFFICES. ..

2

CLASS CODEICD 6tH DIAGNOSIS OR CONDITION TOTAL "IRST

VISITS VISITS.I REVISITS

I.XVII:

IV.

-

o

01-010

011

012

013

0140IS016

017

019

02-020

029.

TOTAL ALL CONDITIONS

INFECTIVE AND PARASITIC DISEASES TOTALTUBERCULOSIS

523' 290o

6-

233

GONORRHEA ANO OTHER VENEREAL DISEASESINTESTINAL PARASITESOIARRHEAL DISEASE (In(ectous utiknown °clams):

Children undea1 year of ageAll °diet

"CHILOH000 DISEASES" mumps. measles; chickenpoxFUNGUS INFECTIONS OF SKIN (DeNnetophytoses)OTHER IN1FECTIVE DISEASES (G)To example):Animal biteg

NEOPLASMS TOTALMALIGNANT NEOPLASMS (ipre'examp)oa):

4

2

4

2

ASMC

NEOPLASMS of uncertain notate

03-- /ENDOCR114 NekJTRITIONAL. ANO METABOLIC DISEASES TOTAL030. OISEASES OF THYROID GLAND031

032

033

034

039

04-

594°

049

050

0SJ

0S2

"053

0S9

OIABETES MELLITUSOISEASES of Other Endocrine GlandsNUTRITIONAL DEFICIENCYOBESITYOTHER CONDITIONS llbladder

-

DISEASES OF BLOOD AND BLOOD 7. -MING ORGANS' TOTALIRON DEFICIENCY ANEMIAOTHER CONDITIONS pistaxis

1

309

15

2: 3

1

10 20

8

45

1

2

232

38

1

13-

6

7

M ENTAL O'SORDEPS T 4TAL'PSYCHOSES

NECROSES and P social or

ALCOHOLISMr

MENTAL RE? no,TioNOTHER CON ITION§

e /f43

2

9',

36.

4

7

5.

Nertrous Condition

06! DISEASES 0 THE/NERVOUS SYSTEM AND SENSE ORGANS TOTAL

060 PERIPHERAL NEURITIS'061 EPILEPSY062' CONJUNCVIVITIS'and °the: Eye Inle,ctions06) REFRACTIVE ERRORS of \llama064 OTITIS MEDIA069,Th OTHER CONDITIONS

2 -4-- 2

7

38 11'

4'67 7

13

.43

8

PH 4202 7 (PAGE 3!REV.1-69

63.

111

\rPART lit- 5. (Continued)

let) MI}CLASS CODC DIAGNOSIS OR CONDITION

VII.

IX.

XI.

XII

07-

07Q

071

.072

073

074

07S

079

08-

080

081

oar"

083

084

08S

086

087

088

089

09-

090

091

092

09?

094

099

10-

100

101

102

103

104

10S

109

o It

otsgisgs OF THE CIRCULATORY SYSTEM' TOTALRHEUmAtTIC FEV R

.ARTERIOSCLE TIC and Degenerative Heart Drseas,CEREUROVASOULAF,1 DISEASE (Simko) /

1OTHER DISEASES of the Hears

HYPERTENSION

VARICOSE VEINS

OTHER CONDITIONS

DISEASCS OF THE Res113ATORY SYSVEM TOTALACUTE NASOPHARYNGITIS (Common Cold)ACUTE PHAIViNGITISTONSILLITIS'BRONCHITIS

I

GO.IGN7.14,0MUER

07,41-000018-10-0 CS-H20-C-0

TOW-' VISITS

.13

1

3

2

-5

2

162!.

FIRST' ,

.1.6)

1

9

3,2f

.89

2

73

TRACHEITIS'LARYNGITIS.INFLUENZAPNEUMONIA

AST 1A, HAY FEVERCUR IC LUNG DISEAOTHE CONDITIONS

empbysema)Upper respiratory infection

DISEASES OF HE DIG STIVE SYSTEM: TOTALCARIES and Other Denial Problems

56

4713

4

36

6

6.

2

37

29

5

4

fr- 9

4

25

4

PEPTIC ULCERAPPENDICITISHtkiIA

*v.eCHOLECYSTIC DISEASE

,

OTHER CONDITIONS HepatitisFistula

DISEASES OFwTHE GENITOURINARY SYSTEM: TOTALURINARY TRACT INFECTION (Pyelonephnus. Cysritis)DISEASES OF PROSTATE GLAND (excluting Carcinoma)OTHER DISE&SES of Male General OrgansDISORDERS of SrensrruarionMENOPAUSALOTHER DISEASES of Female Genita l OrgansOTHER CONDITIONS Hematuria

3

12

5

3

3

20

,23

12

3

4

2-

2

354

11

2

3

14,

17

11

11- COMPLICATIONS OF PREGNANCY,'CHILOBIRTH. ANO THE PUERPERIUM:TOTAL '

11,0 "INFECTIONS or Genitourinary Traci during PregnancyTOXEMIAS of Pregnancy

112 SPONTANEOUS ABORTION113 REFERRED FOR DELIVERY114 COMPLICATIONS, of the Puerperium119 *OTHER CONDITIONS Premature

12- DISEASES OF THE SKIN ANO SUBCUTANEOUS TISSUE: TOTAL

120 SOFT TISSUE ABSCESS OR CELLULITI?n

121 . :IMPETIGO OR OTHER PYODERMA122 -SEEIORRHEIC DERMA.TITIS_123 ECtEMA, CONTACT 0S,RMATITIS, OR NEURODERMATITIS

124 ACNE . -I. .S

129, OTHER CONDITIONS ' Warts

1

Allergies .".

. /

7

5

6

'*2

83

3

25

6

73

2

2

4~1,

(frt'7l

* P115-420?-7 IPAGERE V, I69 '64'

5

4

4

/5

16.2/2

11

8

1

4

2

2

3

1

58

1

57

4

2

3

1.

1

2 .

7 \ .

'PA pl's6.-& (Continued), .

Gwo,NT HumoCH

\S (

ICDCLASS

MNCODE -5.,, DI AGNdSIS OR CONDITIONiik TOTAL

VISITSFIRST ,

VISITS

iv-11 52170s:

XIII.

,...-.--"--_

XIV.

XV.

XVI.

-/.

Xv::.

.

. J

"f>

-sao13 1'

112

139

14-

440

149

IS-

150,

151

159

16-

160

5161

162

163

169

i, .

17-

170

171

172

'173

174i179

D1SEAS OF -THE muSCUL'OsKELETAL SYSTEM AND15, 7\CONNE VE TISSUE' TOTAL '

RHEU ATOM ARTHRITIS 9

2

2

1. 1

0

2

221.

1

0

7

. .

\#110 tillsr 143 gpa3r. \

ARicHRITIS, Unspecified0 R CONDITIONS Bone Growth /4-11\e,\

Thoracic fusion-' j

CONGENITAL ANOMALIES' TOTALCONGENITAL ANOMALIES,,,of cireutatory system

' .

1

OTHER ,CONDITIONSr ,

/ ./CERTAIN CAUSES OF PERINATAL MORBIDITY ANDMORTALITY TOTAL

BIRTH INJURY

26 16

'''f ''-10

IMMATURITYOTHER CONDITIONS

. .

SYMPTOMS AND ILL-DEFINED CONDITIONS* TOTALSyMNOMS OF SENILITY

5

-

615

2.9

2

6\ 8

3\7

\

BACKACHE/

OTHER SYMPTOMS1EFERRABLE TO LIMBS AND JOINTS,

',HEADACHE' OCHER CONDITIONS StomachaChe ..

-,\ /ACC:D=111'f,', °^.I °0'114 L$, p,..10 vioLEK10E- TOTAL _,....1

LACER/I:TIONS. ABRASIONS. sind Other-Soft Tissue Injuries2

8 .

7

'

2

7

.

6

,O

BURNS,FRACTURES I

- SPRAINS. STRA 5, DISLOCATIONS ,

POISON INGESTIOOTHER CONDITION due/to Accident s, PoisrInt,,ir Violence .

I /. -1 . NUMBER OF INDIVIDUALS

'

i

2-

2--

200

201

202'

203

204

205.

206

207

206

209

210

2U212

213

219

SPECIAL CONDITIONS AND AMINATIONS WITHOUT SICKNESS' TOTAL f ' 2,916

FAMILY PLANNING SERVIC.1 98285

,

219

- 5

3

it, 58510

. 20913

.,_ . . 431438, - .1

-.2 .. - 192'

WELL CHILD CARE ' -re,PRENATAL CARE

\ POSTPARTUM CARE '\. .

T4J6LERCULOSIS. Follow -up ' tote caseMEDICAL AND SURGICAL FTERCARE o?,

GENERAL PHYSICA X AMINATI,ON \PAPANICOtl-AOU SMEARS \TUBERCULIN TESTING \

/ .SEROLOGY SCREENING ,

.VISION SCREENING .-

,.

AUDITORY 'SCREENING

SCREENING CHEST X-RAYS \ .

\GENERAL HEALTH COUNSELLING- Health Hromotion

OTHERSERVICES: \(.5r0CI)c) , immunizations 315 ,

. . . ,, I, . ,,

\ .

\\ ,16

. .....,

\ ,. . \ .

p, H S4 20 2-7 WAGE SIctru 1-AO

r

'

JA.

4

pOt

ti

4."

PART HI-NURSING SERVICt GRANTNO._07-H-000018-10-0 CS21120-C-0

TYPE OF SERVICE NUMBER

%. k..URSING CLINICS:'

o. NUmBE OF CLINICSb. NU :ER OF INDIVIDUALS SERVED TOTAL/

2. IELD NURSING:o. VISIT" TO HOUSE/IOLDSb. TOTAL HOUSEHOLDS SERVED

c. TOTAL INDIVIDUALS SERVED IN HOUSEHOLDSd. VISITS, TO SCHOOLS. DAY CARE CENTERS

'1 *. TOTAL INDIVIDUALS SERVED IN SCHOOLS AND DAY CARE CENTERS,2

i,3. CONTINUITY OF CARE: /-o. REFERRALS MACE FOR MEDICAL CARE TOTAL

:t: (I) rithin Area.1 (Total CoMpleted,1L'

A 4 (2) Out of Area --..--".

(Total Completed--,-.,-.,-. -b. REFERRALS MADE FOR 0 AL CARE: ,TOTAL ..:.),-..

(Total C ered ------____.....__.. _..-.:c. REFE 5 FOR MEDICAL OR DENTAL CARE FROM MT ..-

..,_

931 318

A

237 .>4.44'

210 F"'80033

1,120

210

600

AREA: TOTAL

(Total Completed

'lat.\ FOLLOW-UP SERVIbES FOR MIGRANTS, not originallyt) ,

0, 11 IN PHYSICIANS' OFFICES,(Fee-for-Sereicel'). -. 4. IMIGRANTS PROVIDED PRE- DISCHARGE PLANNING ANO POST-HOSPITAL

' S C; -,;.-..r.1ii 1,

.,,...,:...1GRANTS ASKEIDJ PRESENT RECORD7,,,At

Farm PMS-3652 Or Simi!{\;;; OR CLINIC: .' T AL

''',( , (I) Numbeyiesent g health recordqf . (2) Number given health record

fefetrd by Ptol'ect. 0 WERE TREATED

4. OTR ER ACTIVITIES -(P'ecifY):

Forst) I FIELD

.50.

REMARKS

/Total of offi calls includ- work and X-rays

.o 66

PHS.4202./2 (PAGE 61TWA/. 1.69

;p.

/

ePA V ,SAN1TATION SERVICES

TABLE A. SURVEY-0Y----HOUSING Ad,COsimODATIONS

Icr,A.TNubut07 -H- 000018 -10 -0 CS-1120-C-0

-.-),-- - HOUSING

,..-",..ACCO2.IMOOATIONS

-:! - .

..), TOT ;54._ -----COVERED BY PERMITS --

NUMBERL.. MAXIMUM '

43' CAPACITY' NUMBER--MAXIMUM

CAPACITY

CAMPS NA N.A. N.A.

--/""

N.A.OTHER VOCATIONS ...Z

HOUSING UNITS - Fatally:114 CAMPS

- ,.

N.A.N.A.

N.A.N.A.

N.A. ,

NAN.A.)

/ N.A.N.A.

.-

_ sl

N.A.

N.A.

N.A.

N_A-

-

N.A.

N.A.

N.A.N.A.

IN OTHER LOCATIONS....

HOUSING ,UNITS SenileCAMPS -

. Z'....Wt, (

ININ OTHER LOCATIONS.....H...e..

-

TABLE B. INSP'ECTIDN CF LIVINd AND tsORKING ENVIRCNMENT or mioRmas

...- . ....,-,

. .

NUMBER OFLOCATIONSINSPECTED'

TOT AL Z-NUMBER OF

:INSPECTIONS

NUMBER OFDEFECTS '

POUND

t NUMBER OFCORRECTIONS

MADE

LIVINGSNVIRONM T CAMPS OTHER CAMPS OTHER CAMPS OTHER CAMPS I OTHER.

- - a. WATERN.A.

The 'rdject

.

iXXXX

XXXX

xxixX ,

N.A. N.A.

.

does not.

XXXX

XXXX

=0(4

N.A.

hav'e a

-

NiN.

sanitar.'an.

.

XXXX

XAxx

XXXX

N.

.1.J , _.---

o.

N.A.

.

.e

LX::::

rxxxx

NA

..

,

b. SEWAGE

e. GARBAGE AND REFUSE

d. HOUSING..SAFETYI. FOOD HANDLING_g. INSECTS AND RODENTS

h. RECREATIONAL FACILITIES

Y, ING ENVIRONMENT:

e. MAT..b. TOILET FA CITIES.,,

c. OTHER/

o

Locailon14 CO^DS OF other loc(74,01,5 Where InsaantS work el ore housed.

PART/0-- HEALTH EDUCATION SERVICES, (By type of service, personnel involved end number of sessions.)

TYPE OF HEALTH'EDUCATION SERVICE

HEALTHEDUCATION

STAFF

NUMBER OF SESSIONS

PHYSICIANS r NURSES SANITARIANS

A. SERVICES TO MIGRANTS(1) Individual counselling(2) Group counselling

.2416 150 1521 ;A:

AIDES (otherthan Health Ed.

!..'s

410

OTHER (Spec, 6)

Dentist

310250 2 N A 6

B. SERVICES TO OTHER PROJECT

Consulraricn

(2) Direct ser ices

/

10 N.A.

.A. 1012 N.A. N.A

N.A. N.A

G. SERVICES TO GROWE

(4) ndividual counselling(2) Group unnllig_

0. SERVICES TO OTHER P.Gt.NCtESOR ORGANIZATIONS:

(1) Cune.ultation with iniiMiuNk(2) Consultation with groups(3) Mucci scrviCts

F.. HEALTH EouCATI0,4MEETINGS

N A. N.A. 15 N.A. N.A.N.A. 3 N A. N.A N.A. N. A.

423 - N.A. 50 N.A. N.A. N.A.'56/ N-A. 25 , N.A. N.A. N. A9 N.A.

58

PHS-4202.7 (PAGE 7,, Oth

52

15 1 I,

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provided fhiough adjacent Catin;ties

\

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