Services For Migrant Children in the Health, Social Services, and Education Systems

Services For Migrant Children in the Health, Social Services, and Education Systems.

Nancy M. Pindus, Fran E. O'Reilly, Margaret Schulte, and Lenore Webb

The Urban Institute

March, 1993

This study was prepared for the Department of Health and Human Services under Contract No. HHS-100-92-0005, Delivery Order No.1. The Delivery Order Officer is Ms. Susan Goodman, Office of the Assistant Secretary for Planning and Evaluation.

Executive Summary

In addition to the many burdens imposed on all children of poverty, migrant children face mobility, language, and cultural barriers. Thus, the children of migrant farmworkers--generally defined as persons who cross a prescribed geographic boundary and stay away from their normal residences overnight to perform farmwork for wages--face increased challenges in obtaining educational, health, and social services. The purpose of this study is to identify the needs of migrant children, to examine how these needs are being met in selected sites, and to identify successful models of service integration that might be more widely adopted. As our population becomes more multicultural and multiethnic, programs that have been successful in serving migrant farmworkers may be instructive to other service providers and program planners who must learn how to overcome language and cultural barriers.

Project Objectives

This project, carried out from June 1992 to February 1993, aims to meet the following objectives:

• Identify six exemplary programs for migrant children that are successfully integrating two or more services;
• Identify factors that facilitate integration both at the program, local agency, and community levels and at the state and federal levels;
• Identify gaps in services at the sites studied;
• Identify barriers to successful, comprehensive service delivery for migrant children; and
• Identify research and evaluation issues for the future.

Sites Selected

Sites were selected to represent a range of factors, including geographic location, programs involved in the service integration effort, ages of the children served, and grower involvement or

support. To be selected, the site had to be successfully integrating two services (e.g., health and

education, health and social services, education and social services). The six sites selected were:

• Brockport, New York (Monroe County);
• Greeley, Colorado (Weld County);
• Stockton, California (San Joaquin County);
• Woodburn, Oregon (Marion County);
• McAllen, Texas (Hidalgo County);
• Belle Glade, Florida (Palm Beach and Hendry Counties).

Site visits were conducted by two-person teams, and included interviews with representatives of key programs serving migrants, as well as a variety of community agencies. Managers as well as service providers were interviewed during the three-day visits. Visits also included on-site observations of program operations, tours of migrant housing facilities, attendance at parent or community meetings, and informal discussions with migrant students and parents. Detailed case studies of each site are available upon request.

Operational Definition and Conceptual Framework

The term "service integration" is widely used today to describe the way services should be provided for a wide range of groups with multiple service needs, including children with disabilities, the mentally ill, at-risk youth, and the homeless. Migrant farmworker families have multiple service needs, many of which have reached a critical level. Meeting the educational, social service, and health needs of this population can be facilitated by service integration. Treating one problem while ignoring others may be ineffective. Examples range from placement of a parent in a job training program when there is no access to child care, to treating a child for a gastrointestinal disorder but not addressing the problem of contaminated drinking water in the camp where she lives (National Migrant Resource Program 1992). Each of the sites visited stressed the importance of focusing on the family unit in order to effectively address the needs of children and adults.

We view the implementation of system integration as a continuum, characterized at one end by a fragmented system that addresses specific needs of the clients without an overall assessment, moving toward coordination of services for the client, with the ultimate goal of integrated service. From the client's point of view, the ideal integrated system would be perceived as one program or system, even if the services are not all located in one place. From the service provider's standpoint, the ideal integrated system provides for an overall assessment of the client's needs and the necessary knowledge and relationships established to assure that clients receive the services they need, regardless of which community agency offers the services.

A graphic presentation of our integrated service model is presented on the following page. It shows that there are many types of services and a great number of organizations to consider in serving clients with multiple needs. The migrant family is at the center of this model, surrounded by the major programs specifically established to address the needs of migrant farmworkers and their families. In each community, there are a number of other services, providers, and community groups which assist migrants. Finally, the service integration configuration in each community is shaped by its economic, physical, political, and cultural environment. Integration is an ongoing process, and even communities that demonstrate successful service integration still strive to encompass more services in their network. This study presents three scenarios to describe ideal types of service delivery systems: services for the preschool child (centered around Migrant Head Start); services for the elementary school child (centered around Migrant Education); and services for the high school age child (centered around Migrant Education and JTPA). For each age and program, service integration for migrants must also address intra- and interstate coordination to assure continuity as families move for farm employment during the growing season and return to their homes in the winter months.

Some of the case- or service-level strategies to foster service integration observed in our study include:

• The use of case managers and migrant coordinators/advocates;
• Co-location/on-site services;
• Extended hours so that access to programs can be better coordinated;
• Transportation;
• Portable records;
• Culturally relevant programs in order to increase acceptance of a wide range of services and providers;
• Translation services, which improve access to more programs;
• Joint sponsorship of community functions such as health fairs and cultural festivals;
• Home visits which address family needs for a wide variety of services; and
• Coordinated outreach.

System or administrative strategies identified in the communities visited for this study include:

• Interagency coalitions;
• Written agreements or memoranda of understanding between agencies or providers;
• Regionalization/umbrella organizations;
• Participation on boards of other community organizations; and
• Joint fundraising activities.

Promising Models--Selected Examples

The site visits in this study were to communities identified as having exemplary programs for service integration for migrant children of all ages . Thus, by definition the site visits did not involve visits to single programs, but included interviews with many different community agencies. Across the six sites visited, a number of models of service integration were identified that could be adopted by other sites interested in improving coordinated service delivery. Selected examples are described below.

Regional Coordination/Umbrella Organizations

For Head Start children who migrate along the east coast of the United States, the process of coordination among programs is greatly facilitated by the East Coast Migrant Head Start Project (ECMHSP). ECMHSP is an umbrella organization that provides fiscal and administrative services to Head Start delegate agencies in 12 east coast states. A primary goal of the project is to promote continuity of Head Start services to migrant children and their families along the east coast of the United States. ECMHSP provides program and fiscal monitoring and training and technical assistance at the center level and promotes staff development activities on a regular basis. This umbrella organization enables sites to serve families and teach children, while the central office takes on administrative tasks such as payroll, purchasing, negotiating for space or resources, and arranging training for staff. ECMHSP also facilitates continuity as families move from one site to another through a continuity record provided to parents. Each Head Start program that is a part of ECMHSP uses the same forms to provide health and developmental records that parents can take with them when they travel. Student records are also sent to the main office of ECMHSP in Arlington, Virginia so that any other ECMHSP center can request the file if the family does not have it upon arrival. Other administrative records are also standardized across programs, as is an annual program evaluation procedure.

Community Coalitions

Some community coalitions are attempting to assess the overall needs of their communities and plan together for meeting those needs.

The Coalition of Migrant and Farmworker Services, a coalition of agencies that serve farmworkers, was started in Brockport, New York in the late 1970s. Its focus, then and now, is on coordination. Agencies in this coalition include: Brockport Migrant Education, Oak Orchard Community Health Center, Agri-Business Child Development, Foodlink (a food distribution program), the local office of the New York State Department of Labor, the Hispanic Migrant Ministry, and Rural Opportunities, Inc. This is the forum where providers can bring up gaps in services. The "Working Together Group," which is an outgrowth of this coalition, has been meeting for about three years and takes a structured, head-on, approach to resolving philosophical differences. For example, the group hired a paid facilitator to work with them to help develop trust among the various individuals and organizations represented.

The impact of these efforts in Brockport has been seen across all services. Members of the "Working Together Group" have collaborated on grant proposals, staff training, and parent education. Members of these organizations serve on the boards of directors of other organizations in the coalition. Each program indicates that it has gained an understanding of the missions and limitations of the other agencies.

Relationships with Colleges and Universities and Other Educational Institutions

Across sites there were a number of models observed in which the various programs or agencies serving migrant farmworkers and their families had developed special relationships with local colleges and universities that enabled them to either expand their programs, or somehow capitalize on the resources of the colleges and universities. A commonly observed practice in the sites visited was a well-developed relationship between the health centers serving migrant families and nearby medical schools.

A different arrangement was seen in the Brockport, New York site, where the Migrant Education Program has been located on the campus of the State University of New York (SUNY) at Brockport since 1974. That year the New York State Department of Education established centralized outreach centers throughout the state that were based at state universities or other regionally based local education agencies. The Migrant Education Program in Brockport runs both summer and year-round programs for migrants on the SUNY Brockport campus. The college campus setting for the program benefits both the Migrant Education Program and SUNY Brockport. The college provides office, resource/library, and classroom space in addition to four vans to transport students to and from the night school. The campus setting exposes migrant students to higher education and life on a college campus. The setting also facilitates the use of college students such as work/study students, student teachers, and those participating in the Literacy Corps as tutors. Benefits for the college include placements for student teachers and education administration interns, as well as a wide range of opportunities for those interested in using and practicing Spanish, studying alternative approaches to education, and learning concepts of multicultural education.

Grower Support

Very limited examples of grower support in providing and improving accessibility and integration of services were observed in the six sites visited. The most notable example occurred in Florida at the Shannon Center, a Migrant Head Start center located on the property of A. Duda and Sons (DUDA), one of the large growers in the area. This center serves 100 children, most of whom are infants and toddlers. The parents of most of the children served by the Shannon Center work for DUDA, although children of other migrant families in the community are also eligible to be served there. Families return to work for DUDA each season because of the benefits provided by this grower. As a result, 80 percent of the families at the Shannon Center return each year. Partly because of this return rate, parents are very involved in the center, helping out in the classrooms and with repairs when time is available. For example, parents raised money to build a paved path in the playground area for riding toys.

The creation of the Shannon Center was a joint effort by the DUDA employee relations manager and staff of the East Coast Migrant Head Start Project (ECMHSP). The Center offers advantages for both growers and families. Parents can drop off and pick up their children on their way to and from work, thus improving worker satisfaction and punctuality; and the site is convenient for parent meetings, since it is close to where families live. The employee relations manager indicates that this arrangement has eliminated travel and babysitting problems for workers. DUDA provides all maintenance and security for the site.

Farmworker Housing

Perhaps the most pressing problem identified by respondents in the sites visited was a lack of affordable, quality housing for migrant farmworkers and their families. A number of efforts were identified to provide housing to this population in a manner that also enabled integration of services by providing space for co-location of services with housing units. One example of such an effort has been in place in California since 1966, when the Housing Authority of the County of San Joaquin began providing housing for migrant farmworkers in response to squalid living conditions among migrant families. The Housing Authority manages, owns, or leases approximately 5,000 rental units throughout the county for migrants and other agricultural workers and low-income families. The state regulates the conditions of operation for the housing centers and negotiates with the Authority for rehabilitation and repair of the units. The housing for migrant farmworkers is subsidized by the State Office of Migrant Services, which contracts with housing centers across the state. Rental housing units in the San Joaquin Valley are provided to 288 migrant families at three state-owned centers, which are open 180 days per year--usually from May to October, depending on the growing season in a given area. Funding also comes from HUD, FHA, and rent from tenants. The Housing Authority also provides space on the premises of the migrant housing camps to various agencies that serve migrant families, including Head Start, state-funded daycare programs, Girl Scouts, and agencies providing GED or ESL classes.

Interstate Coordination

Continuity of services for migrant families is a primary concern as families move across state lines where different types of programs and services are available. The issue is particularly acute for children in the education system, where curriculum and graduation requirements vary from system to system.

Migrant education staff in the Stockton County, California area have taken a unique approach to the need for information to facilitate program continuity. Since most of their students migrate to and from Mexico, they negotiated a binational agreement with Mexico that provides written documentation (in both English and Spanish) of students' current educational status. The document provides summary information on the student's, level in school and academic information, including specific objectives by subject area. A grade point average is also provided, as is a space for teacher comments. The written document also helps students gain entrance into school in Mexico. School officials in Colorado have recently begun similar work to develop a binational accreditation project with Mexico.

The Texas Migrant Interstate Program (TMIP) has an extensive program of interstate communications for older children (in grades 7-12). TMIP sends staff to New York, Washington, Georgia, and Michigan (and sometimes Ohio and Indiana) to work with staff in other states and with students from Texas. A Program Coordination Center at Texas A & I University pays for sending staff to other states. TMIP maintains a consultant pool for this purpose that includes counselors and teachers who are willing to travel to other states. Respondents at the Brockport, New York site reported that they had worked extensively with Texas staff over the past 8 to 10 years. They have worked out an arrangement where Texas schools now accept New York's recommendations for secondary school credit transfers. They have paid for counselors from Texas to spend 6 weeks in the state to review student records, and are investigating ways to work with Texas personnel on the issue of a required standardized test for secondary students--the Texas Assessment of Academic Skills.

Promotores/Lay Educators

The promotores model, providing training to residents of the colonias who then serve as lay educators and organizers in their communities, has been implemented successfully in Hidalgo County, Texas by both Planned Parenthood and the Expanded Food and Nutrition Program. The lay educators are well-received in their communities, thus providing an effective means of educating residents. The promotores model is an example of service integration because it taps various community resources for training and program implementation, and attempts to address a wide range of needs identified by residents. Planned Parenthood's education department in Hidalgo County recruits women from the colonias and trains them in various topics related to family planning and women's health. The Expanded Nutrition Program, part of the Texas Agricultural Extension Service, has been providing training and education programs that have served the rural colonias since 1968. Headed by a home economist, the program has 20 paraprofessional teachers who provide training to residents of the colonias and other rural areas. The programs are six to eight months long and include training in basic skills, food preparation, menu planning, budgeting, and self-esteem. Additional projects using this model are being initiated by the Hidalgo County Health Care Corporation (HCHC), a migrant and community health center, and the Texas Department of Human Services' Partnership for Self Sufficiency.

"One-Stop Shopping"

One difficulty associated with service delivery to migrant families is the large number of agencies involved in the provision of services and the limited time and transportation available to migrant farmworkers to avail themselves of these services. The "one-stop-shopping" model has often been touted as one way to address these time and transportation issues. A successful version of this model was observed in the Brockport, New York site where the Oak Orchard Community Health Center uses its mobile van to provide a variety of services to families eligible for Migrant Head Start services during the summer season. Before the season begins, the health center works out a schedule of visits with the Migrant Head Start provider in the area. The van, staffed by a nurse practitioner, a nurse, and a community health worker/translator who is authorized to complete WIC certifications, comes to the Head Start center and provides physicals, health screenings, and immunizations for the children, and Medicaid enrollment and WIC certification for the families. The Head Start center's health coordinator facilitates this process by preparing the necessary forms for each child/family before the van arrives.

Federal Policy Issues

The needs of migrants cannot be adequately addressed without consideration of inter-state issues. Removal of barriers to access that result from differing definitions and eligibility requirements, and promotion of regional efforts to better serve farmworkers are appropriately addressed at the federal level.

The various definitions of migrant farmworker have created barriers to services integration. Often clients who are eligible for one service such as Migrant Education may not be eligible for other services such as Migrant Head Start or Migrant Health. The definition of migrant farmworker for most federally funded programs excludes vast amounts of agricultural employment in some states. For example, in Oregon there is a lot of seasonal fishing and nursery work available, but workers do not qualify for migrant programs when employed by these businesses. Immigration laws have resulted in a large number of undocumented workers who do not qualify for services. This stresses the available resources of the community and makes it hard to provide needed services to everyone.

Program eligibility requirements and definitions should be reviewed to identify specific gaps created by the lack of uniformity. The problem of the formerly Migrant Head Start child who is no longer eligible for Migrant Head Start but who is too young for regional Head Start, is an example. These gaps and others should be addressed primarily by mechanisms that increase flexibility. Federal officials should convey their commitment to service integration to state and local administrators, and provide a clear mandate for flexibility in order to promote service integration. This flexibility should include granting waivers and giving states more autonomy in defining "migrant" and "seasonal farmworker," so that they can better meet the needs of the workers in their communities through existing programs.

Regionalized efforts, most notably those undertaken by the East Coast Migrant Head Start Project, the Texas Migrant Council, and Texas Migrant Interstate Program, are an effective means of providing continuity for migrant children. Despite the success of these examples, efforts to promote applications of this model are limited.

The federal government should encourage such efforts throughout the country for all programs serving migrants. The federal government might also provide incentives for growers and other businesses and providers in the community to participate in such regional networks. For example, some of the factors that make the partnership between growers and service providers work so well in Belle Glade, Florida could be expanded to other communities with federal encouragement. Policymakers should provide incentives for cooperation among growers to assist in service integration for migrant families. Joint efforts might enable small growers to overcome the economic barriers posed by dependence on a few crops or a short growing season, so that they can begin to offer some of the support that the larger growers, such as those in South Florida, are able to provide.

A lack of quality housing exacerbates health and other needs of farmworkers. Many problems could be eliminated in the long range if more affordable housing and better environmental health services were made available. An opportunity for more service integration at the federal level clearly exists. The Department of Housing and Urban Development, the Department of Labor, and the Environmental Protection Agency need to be brought into the mainstream of some of the federal service integration initiatives that impact directly on migrant families. While each of these agencies has some involvement now, it tends to be for specific services, which are provided independent of other agencies.

Factors to be Considered at Federal, State, and Local Levels

Some lessons learned in this study should be considered at all levels in planning services and programs for migrant families.

• Any national or state policies or evaluations must consider issues of scale. The numbers to be served, the extent of the need, and the difficulties in coordinating a great number of programs dispersed over a wide area distinguish communities such as Hidalgo County, Texas from smaller communities that serve migrants, particularly those in northern, upstream locations where migrants travel for seasonal work.
• Serving the family unit and meeting basic needs of the family are essential components of programs serving migrant children. Parent education, housing, job training, and other "adult" services are as important to the child's success as health screening and education. A holistic approach to serving the family results in better services to all family members, including children.
• An increasing number of migrant parents have themselves been served by Migrant Head Start and Migrant Education. This is a new phenomenon that policymakers may wish to consider. Parents are aware of programs available to their children and know of the value of these programs. They do not attach a stigma to seeking help from these programs, as earlier generations may have. Current and future migrant parents can be expected to be more sophisticated, demanding, and involved consumers.
• Immigration laws and economic conditions, among other factors, impact on the demographics of the migrant population. These changes affect the skills needed by service providers, the types of services required, and the procedures needed for interstate coordination. For example, it was noted that one impact of the Immigration and Reform Act of 1986 was an increase in Hispanic families in the migrant labor stream. Many communities are seeing greater numbers of families from rural Mexico and Central America who speak dialects unfamiliar even to bilingual staff.