THE CULTURE OF BUREAUCRACY: Dumping $2.6 Million on Bakersfield
Aron, Michael
THE CULTURE OF BUREAUCRACY: Dumping $2.6 Million on Bakersfield by Michael Aron Like the coming of the railroad, the arrival of big federal money in a small, out-of-the-way California...
...As soon as the medical society clinic shut down for the “winter,” KCLM occupied the trailers and began treating its first farm-worker patients...
...We like to think of ourselves as ‘bureaucratic guerrillas’ fighting for what we believe in...
...Cavanaugh’s, too, was an artful performance (which may help explain why he is now on the White House staff...
...It wasn’t until July that Kern County’s health establishment got wind of the news-and when they did, all hell broke loose...
...they had been led to believe, they said, that the center would be located in a black neighborhood and that campesinos from all over the county would be encouraged to use it ana think of it as their own...
...In the meantime, forces were still at work trying to get the grant canceled...
...Pineda, meanwhile, found an old grocery store in Weedpatch, leased it, and gradually moved the project into it over the next three months...
...There are bullet holes in the plate glass window...
...they put the KCHC chairman on notice that his assumption of the project directorship constitutes a flagrant conflict of interest...
...Regional HEW officials fly down from San Francisco in the hope of restoring order...
...says black community promises reprisals if any harm comes to KCHC chairman...
...90 per cent of the children have serious dental problems...
...The demonstrations last until midnight without serious incident...
...in this clinic, you’re opening it to an electronic implement coming out of a wall console...
...February 18: A provider member of the KCHC board calls the executive secretary of the medical society at midnight and, on behalf of KCHC, pleads for help...
...Mathias called Cavanaugh to ask if this were sufficiently “irregular” to warrant cancellation of the contract...
...HEW says it is committed to seeing the campesinos take over on schedule, and it is hard to imagine what KCHC could possibly gain by holding out...
...Bent in the Fields April 15, the date HEW said it would terminate the project funding to KCHC, came and went, with no word from San Francisco...
...It represents a conscious grab at respectability and tacitly acknowledges its new position in the battle configuration...
...KCLM agreed, and Robert Isman, D.D.S., assumed his duties in August...
...HEW and KCHC signed the compromise that afternoon...
...Three months went by with no progress made toward filling the project director’s job and mounting hostility towards Isman from the establishment...
...KCLM was still the delegate agency administering the project, but it no longer could be said to represent the true “consumers...
...James Cavanaugh, deputy assistant secretary for health, announced a “full review” of the conditions surrounding the awarding of the grant, intimating that the contract would be canceled “if irregularities are detected...
...Congressman Robert Mathias sent an angry telegram to HEW Secretary Elliot Richardson questioning how the department could possibly sanction such behavior on the part of its regional office...
...Pineda continued the search for a clinic site and also began to think about recruitinga medical staff...
...Senator Walter Mondale’s Migratory Labor subcommittee drafted the legislation, authorizing an $1 1-million appropriation for migrant programs in fiscal 1970, and it was Mondale, personally, who pressed for insertion of an amendment providing that “persons broadly representative of all elements of the population to be served [bel given an opportunity to participate in the implementation of such programs...
...With the end of the fiscal year only six weeks away, anxious rural health officials turned their attention to a black group, the Kern County Liberation Movement (KCLM...
...The clinic is partitioned all right, but partitioned into a large reception room, two intake offices, five examining rooms, a treatment room, a laboratory, a records library, staff offices, and a lounge...
...The next moment, conciliatory: “Naturally we welcome the cooperation and support of any agencies interested in meeting the common goal of comprehensive health care for the entire community...
...There was reason to think that one of their advisors on the clinic staff had intercepted the letter for reasons she believed to be in their best interests...
...application states, “basic to this proposal is removal of the existing clinic...
...One moment they were militant: “The low income community of Kern County wants to see a migrant health center that will meet their needs and they want to see it not after a two- or three-year planning study...
...In San Francisco, meanwhile, regional HEW was kept busy trying to explain its actions to HEW officials in Washington...
...But it could just as well have been one of the other 130 migrant health programs, or any federal effort where the bureaucrat is mandated both to spend money fast and also to insure that local people control their own destinies...
...Three were in rural California counties, the fourth in the state of Washington...
...They’re learning that an unhealthy body produces nothing,” one official said, adding as an afterthought, “They’ve certainly learned it the hard way...
...The medical society seems to think that because doctors can save lives on a surgical table, their expertise necessarily embraces all facets of medicine, including how it should be delivered to people whom the doctors barely understand, can’t talk to, and don’t especially like-and the medical society fights to preserve the integrity of that idea...
...On July 15, Cavanaugh flew from ”Washington to the regional office in San Francisco...
...The official reasons are not worth going into-basically they questioned Pineda’s competence...
...For the crowd in San Francisco, the project has been, and continues to be, “an interesting social experiment” (an assistant regional director’s words), originally conceived to meet a singular need, but taking on added dimensions as it unfolds...
...Mathias asked...
...Is this what the Administration means by ‘creative federalism...
...A fifth provision went unstated, but was well understood nonetheless: in return for its great efforts and considerable sacrifice, KCHC would become HEW’S “umbrella agency” for all future projects in the county...
...In December, the medical society applied to HEW for $325,645, ostensibly to expand its existing clinic program, in effect proposing itself as an alternative to KCLM...
...An interesting bit of correspondence circulated around Bakersfield at this time, copies of an exchange between HEW Secretary Richardson and Senators Walter Mondale and Adlai Stevenson 111, past and present chairmen of the Migratory Labor subcommittee...
...Ask the campesinos whom they thank for all this, and you get a surprising-no, not surprisinganswer...
...On December 14, KCLM voted to fire Pineda...
...now they were faced with possible loss of control over it and forfeiture of their status as a bona fide government delegate agency...
...We were going to get funding into that area no matter who it upset, and not by the traditional route of currying favor with conservative county medical societies...
...One shudders at the thought of KCLMs and medical societies and campesino-equivalents plotting and maneuvering against each other and intramurally in every community where federal grants have been won...
...I would say we’ve basically been more interested in using the clinic as an instrument of longrange social change than in meeting the short-run health needs of the target community,” one HEW official admitted, fully aware that this is the kind of statement bureaucrats get roasted for every day...
...Pineda had found a young doctor from Los Angeles to become clinic physician ($25,000), had lured an aging South American from a hospital in the Bronx to become medical director ($27,500), and the three of them had talked the medical society into renting its trailers to KCLM until a permanent location could be found ($1,600, which has never been paid...
...Vincent Garza, a Mexican-American public health officer stationed at headquarters, was dispatched to replace Isman as interim project director for 90 days...
...A Mathias press release the next day called HEW’S action “inexcusable” and fixed the blame on “middle-level I bureaucrats [who] ignored the letter of the law” (a reference to their failure to consult the congressionally mandated regional planning bodies...
...But there was a time problem: the legislation had been passed relatively late in the fiscal year, giving HEW only a few months in which to spend the money or else forfeit it back to Treasury...
...Quietly, Mathias also asked the Government Accounting Office for a full investigation of the activities of the local anti-poverty umbrella agency, the Kern County Economic Opportunities Corporation...
...The equipment is brand new, ultramodern, and clean...
...maybe 20 per cent are Mexican nationals who came north to follow the softfruit season (legally or illegally) and managed to linger longer...
...Their general health is not good...
...I request that you immediately investigate this matter and withdraw the grant...
...Buttonwillow’s one physician raised a stink, but that is another story...
...The entire roster of local health agencies-the county medical society, the dental society, Kern General Hospital, the county health department, the board of supervisors, the state health department, the California Medical Association...
...Someone else was delegated to go look for them...
...Owen Hatley, to Dr...
...Dude Ranch Junket Most of the farm workers of Kern County are Mexican-Americans...
...Regional HEW proposed that a young dental school graduate from San Francisco become interim project director until a permanent director could be found...
...To date $400,000 has been spent on the project, a mere fraction of the $13 billion HEW spends every year on health programs...
...The meeting proceeded without them...
...To get things done, you go do them and fight the political battles after-especially in this Administration...
...On February 15: KCHC, citing election “irregularities,” rejects the legitimacy of the CDLC board and refuses to transfer control of the project...
...Somehow the term “migrant health center” leads you to expect a depressing storefront, partitioned in half, and dimly lit, with maybe a purple curtain separating the waiting room from the examining room, and a wizened old doctor inside waiting to grab you in his palsied, age-blotched hands...
...Garza returned to Bakersfield on a Monday morning to find himself being blasted on the front page of the Californian for his “$2,500 dude ranch junket” financed by “the taxpayers...
...As you will see, it evolves into a struggle pitting poor people of one race against poor people of another...
...When Cavanaugh said he didn’t think so, Mathias asked if the contract could possibly be renegotiated under the new guidelines just promulgated...
...Born six months earlier in the waning hours of a poor people’s workshop and designated a consumers’ auxiliary of the local anti-poverty agency, KCLM was little more than a collection of lowincome citizens...
...The regional director, the black project officer, and the Chicano Public Health Service officer from Los Angeles arrived in Bakersfield the morning of the 10th...
...In what is reported to have been a rather stormy session, Cavanaugh and regional officials rewrote the guidelines on community health grants so as to insure consultation with all appropriate state and local agencies...
...Congressman Barry Goldwater, Jr...
...He seemed genuinely pained by “this unfortunate misunderstanding...
...The story was written by the son of the county health superintendent, which says something about small cities...
...A bitter pill...
...In the evening the five campesinos met with their supporters in the basement of the Lutheran Church in Lamont...
...February 26: CDLC writes to Secretary Richardson-letter begins, “Honorable Sire...
...In this case, the money comes from the Department of Health, Education, and Welfare, for one of its 131 migrant health programs, and the town that has to fight over the grant is Bakersfield...
...The executive secretary calls his 30-year-old assistant, Riley McWilliams, at 2:30 a.m...
...obesity, hypertension, and diabetes are so prevalent that local health authorities believe these conditions to be hereditary in Mexicans...
...KCLM thought they ought to be looking in the Lakeview district, where blacks live...
...The poor people, black and brown, want better medical care than they are accustomed to receiving, but they also want ‘power and respectability and anything else that might foster the illusion that they are swimming into the mainstream, and if a government health project is the only game in town, they’ll jump at the chance to play it, and they’ll play it as fiercely and seriously as they imagine it to be played elsewhere, and so what if the brothers and sisters have to wait a little longer for something they have never had anyway...
...Can blacks and browns work together...
...The government, through all this, has been like a ship captain steering the project towards shores the crew can’t see yet...
...And when they tell you they’re putting X million dollars into programs for poor people, remember: professionals, clericals, and private businesses get the money...
...Thus, it took 15 months of sparring and jockeying before a single patient was seen...
...and the five campesinos had yet to show...
...And once opened, the clinic had to shorten its hours anytime HEW felt it necessary to suspend funds in order to reprimand this faction or that...
...Controlling your own destiny, in these days of decentralization and revenue sharing, really means that the locals can help decide how to divvy up federal money among themselves...
...Garcia, the South American medical director, took his state boards again in June, and the delay in reporting his grade leads to speculation that it is being deliberately held up in channels for political reasons...
...HEW wants the clinic to become self-sufficient, so patient billings will begin in the near future...
...On the contrary, now there was something tangible to fight over...
...As its first official act, KCLM had applied to HEW for a $70,000 planning grant to assay the health needs of Bakersfield’s black ghetto...
...They get skin diseases from working in fields sprayed with pesticides...
...Chicanos in the Wings But don’t get the idea that just because the clinic opened, the infighting ceased...
...Hmm...
...You know it’s not...
...federal funding...
...Assemblyman Stacey branded it “a sham and a fraud” and joined the ranks of the countless politicians who at one time or another have accused HEW of “strong-arm tactics.’’ With the board restructured, everyone expected funding to resume, but HEW suddenly attached new conditions to the lifting of the suspension...
...Of course, there was also the medical society’s migrant clinic in trailers in Lamont, but it operated only during “the season” (May to September...
...Although project funds were technically suspended, regional HEW began sending “emergency” funds to KCLM to keep it on’its feet...
...KCHC’s black chairman appoints himself “acting project director...
...A good time was presumably had by all, and the regional director soothed ruffled feathers by promising that no matter what happened in the future, KCLM’s efforts would not go unrewarded...
...representing a neighboring district) to Secretary Richardson: . . . this group [KCLM] has absolutely no experience that would even remotely qualify them for a grant of this magnitude...
...but there’s too much conspiracy theory there, or at least not enough money involved to make it credible...
...When it was over, an elaborate compromise had been drawn up: 1) the CDLC board would be absorbed into the KCHC board...
...One also can’t help but wonder whether the campesinos really are capable of running the project...
...Mondale wrote back: “I was shocked to learn that there is still substantial doubt as to your Department’s implementation of an amendment which became effective in March of 1970...
...It was regional HEW that flooded Bakersfield with copies of the exchange...
...Senator Kennedy, of course...
...THE CULTURE OF BUREAUCRACY: Dumping $2.6 Million on Bakersfield by Michael Aron Like the coming of the railroad, the arrival of big federal money in a small, out-of-the-way California town causes a certain amount of uproar, especially when it is dumped in a bundle by an agency that has to get rid of it quick...
...That’s just the way it happens...
...February 17: The clinic has been splattered with paint during the night...
...This is not insignificant...
...A radical Lutheran minister acted as their unofficial spokesman...
...Garza explained that these were migrant funds and that it had been HEW’S intention all along to put a health center someplace where the campesinos would have easy access to it...
...You walk into the clinic in Weedpatch, however, and your first thought is “hmmm...
...Bakersfield is a consequence of the whole idea of community particiMichael Aron is a writer living in California...
...Three weeks later, the regional director sent letters to KCHC and CDLC proposing a joint luncheon meeting on May 10 at the posh (for Bakersfield) Casa Royale motel...
...In late May, 1970, an official from the Rural Health Office of the Community Health Service of the Health Services and Mental Health Administration (HSMHA) of the Public Health Service of the regional office of HEW flew to Bakersfield to help KCLM prepare a formal application...
...Three weeks later, Garza left Bakersfield and the Public Health Service and went to Yale on a fellowship...
...To this day, people talk about Isman as if his eight months in Bakersfield had been profitably spent dealing hashish on the side...
...It used to be that when someone got sick, he worked it off or waited it out-unless he got real sick, in which case his family piled him into a car and drove the 20 miles to Kern General Hospital where they would wait for hours in the emergency room hoping that the next intake nurse spoke Spanish...
...The clinic in Weedpatch is a shock when you first see it...
...Second, the clinic’s South American medical director failed his state medical board examination, meaning he was without a license to practice in California...
...He had no experience, either dental or administrative...
...Informed of the dismissal, regional HEW immediately ordered him reinstated, saying that KCLM no longer had legal authority to make such a decision (because it no longer represented At its next regular meeting, on December 22, KCLM voted to change its name to the Kern County Health Committee (KCHC...
...Mathias’ local aide called the restructuring “a token effort to appease the community...
...If Weedpatch Had Movies That should be the end of the story...
...Then in April, 1971, HEW decided to step in and temporarily take over the project itself...
...Now that the clinic had opened in Weedpatch, the consumers were campesinos...
...There are no Machiavellian plots here, no designs by the establishment to divide and conquer...
...He showed up for meetings with bankers and lawyers wearing cut-off jeans and thongs...
...and the congressionally mandated regional planning bodies, Comprehensive Health Planning and Regional Medical Programs-vented their spleen because none had been consulted prior to the awarding of the grant...
...The real problem with this project, and, one suspects, with others as well, has been the ease with which political considerations were able to obscure the stated objective, namely, comprehensive health care for farm workers -combined with the fact that HEW would seem to have subordinated the stated objective to an unstated, or at least secondary one, namely, MexicanAmerican community organiz.ation...
...Richardson’s letter to the subcommittee requested “clarification of congressional intent” regarding the consumer-participation amendment to the Migrant Health Act...
...The argument is sometimes advanced that the medical society joined only to sabotage the project, because free health care for the poor takes money out of the pockets of local physicians and the county hospital...
...4) on or before January 1, 1973, KCHC would transfer administrative control of the project to CDLC, retaining for itself only the role of fiscal intermediary...
...The staff numbers about 25...
...Kern County...
...February 29: KCHC chairman reports alleged threats to his person...
...a project officer asked rhetorically...
...While Mathias was busy reverse pork-barreling in Washington, physicians and politicians in Bakersfield were writing letters to anyone they could think of who might be able to reverse the decision...
...2) four providers mutually agreed upon by KCHC and CDLC would join the five campesinos, together to constitute a separate board-within-a-board...
...It was not a victory, it was not a defeat,” said CDLC chairman, Natividad Arreolo, weary perhaps in the knowledge that he was due out in the fields again at 4 a.m...
...KCLM either had to demonstrate broad-based community support, or hire a permanent project director...
...City officials, whose own budgets only added up to something like $12 million, simply could not understand why HEW would select such a character to supervise a $2.6-million project...
...Reputable, experienced consulting firms are available, in contrast to false-front organizations [KCLM] created to obtain desired answers to fuzzy-minded hypotheses conjured up by some social planners...
...To the campesinos and their families, the clinic is a godsend...
...Two-thirds of the clinic staff send individual letters to HEW declaring their allegiance to CDLC...
...We want direct medical services now...
...Considering the group’s relative inexperience, it was an artful performance...
...CDLC...
...KCLM felt suddenly betrayed...
...Frankly we are tired of being studied...
...Half of the demonstrators move down the highway to the KCHC administrative office in Lamont...
...but folks in Bakersfield took a different view of the outing...
...For the next three weeks, the Bakers field health establishment would virtually convulse in an effort to get the grant canceled...
...But this had not been KCLM’s understanding at all...
...HEW’S plan was to find a Chicano community group in each area to become its delegate agency for daytoday administration of a project, in the same way that local anti-poverty groups became delegate agencies of the Office of Economic Opportunity...
...These things are usually much worse in urban areas...
...Oh, it’s not so bad there...
...The CDLC board had been invited to come at 1 p.m., but the hour passed 2 p.m...
...KCLM responded enthusiastically : certainly they would accept a grantwho wouldn’t...
...The community of 20,000 is still without a dentist because of an essentially political decision...
...That the consumers still outnumbered the providers 25 to 10 irked some people, however...
...The young one...
...To complement this action, regional HEW abruptly canceled the dental component of the project, thus insuring Isman’s complete removal from the scene...
...The suspension, Cavanaugh told a press conference, would be lifted only when the board, then made up entirely of consumers,” added professional health-care “providers” to its membership...
...State Assemblyman William Ketchum to HEW Undersecretary John Veneman, his former colleague in the California legislature: I object to the “cart before the horse” manner in which this has been handled and request that you immediately stop funding . . . . [HEWS] “better to spend now than undertake planning” philosophy is a classic symptom of the whole OEO syndrome...
...Federal Funding In September, 15 months after the awarding of the grant, a makeshift clinic was finally opened in Lamont...
...therefore, project funds would be suspended indefinitely and funding to KCHC would terminate on April 15, 1972...
...KCLM because it meant immediate resumption of funding...
...Garza was replaced in July, 1971, by Charles Pineda, a Mexican-American native of Kern County, the son of a fruit picker and holder of a master’s degree in social work...
...The board then incorporated itself as Clinica De Los Campesinos, Inc...
...March 10: CDLC submits application to HEW to take over administration of project...
...The actual reason was that Pineda had been attempting to serve two masters at once, KCLM and the campesinos, and his allegiance to the former seemed to be flagging...
...What adjustments can we make to keep the community from blowing apart...
...February 23: Telegram to KCHC from regional HEW states: actions of KCHC in direct contradiction to agreements...
...Before any of this money could be spent, however, it would be necessary to hire a project director, preferably one who could court the favor of the health establishment and orchestrate a restructuring of the board...
...but treatment will still be “free” (sort of) for the 90 per cent who belong to the union’s “Robert F. Kennedy Farm Workers’ Medical Plan” (for which a small premium is deducted from their paychecks...
...In February, the roof caves in...
...It was they who should be doing the communityparticipating...
...It took much persuasion and several trips to Bakersfield by regional HEW officials, but in November the KCLM board was restructured to include 10 professional health providers representing various agencies in the county, including the medical society, which put its migrant clinic director on the board but instructed him not to vote...
...March 17: Twelve clinic staff draft joint letter to HEW threatening to resign if CDLC not made delegate agency ; claim Riley McWilliams culturally unfit to be project director...
...Cavanaugh said he doubted it...
...and orders him to report to KCHC the next day to become interim project director...
...four of the five men who had been appointed by Pineda in October won election to the board...
...Are illiterate campesinos capable of selfadministration...
...and yet, that is probably what happens, and is happening, all over tht country at this moment...
...Acting on their own authority, but with behind-the-scenes encouragement from regional HEW, Pineda and several clinic staff members appointed five reasonably intelligent, but nonEnglish-speaking, campesinos to a “campesino board,” a kind of shadow cabinet that would wait in the wings ready to take over at the earliest signal from HEW...
...the actual season is eight to 10 months), and then only three nights a week from 6 p. m. to 10 p. m. At regional HEW the clinic is still referred to as a “band-aid station” The first thing on Garza’s agenda when he arrived in Bakersfield was to find a suitable location for a health center...
...The question remains as to whether KCHC will cede its little fiefdom to the campesinos by January 1, as agreed...
...Creative Fumbling For five days the flap over the award commanded headlines in the Bakersfield Californian (in sky-blue ink, no less...
...On July 27, KCLM held a press conference to refute the “numerous unfounded charges leveled against us in recent days...
...the poor get services...
...it was fine, as well, with the clinic staff, half of whom were Mexican, and others who had to have been sympathetic to the plight of farm workers in the first place in order to have accepted a job in a town as Godforsaken as Weedpatch...
...They said they had not been notified of the meeting...
...Final contracts were signed in June, three weeks before the end of the fiscal year...
...Heated debate lasted past midnight, but the campesinos finally decided to sign the compromise...
...One was Bakersfield, Kern County, California...
...On February 14, 24 hours before KCHC was supposed to transfer authority to CDLC, the KCHC board notifies Pineda of his dismissal in a memo listing eight specific grievances, one claiming he hired the South American medical director without consulting the board and another charging him with “loading” the clinic staff with Mexican-Americans...
...The grant had called for expenditures of $39 1,000 in the first year-$248,000 for staff salaries and the rest for clinic facilities and supplies...
...Culturallv Unfit Two things of consequence happened in January...
...That they were nonEnglish-speaking meant that they had to rely on people like Pineda to tell them what was going on...
...And the whites on the clinic staff and the others lurking in the background all the time probably wouldn’t be so eager to stir up the waters if only Weedpatch had a movie theater...
...In the months since, there have been controversial hirings and firings, protest resignations, accusations of petty theft, and at least one false rumor of a sexual nature deliberately planted to discredit a potential project director...
...For several days he, an architect, and Mathias’ local aide drove around the Lamont-Arvin-Weedpatch area looking for a site-and immediately a conflict arose...
...He urged the Bakersfield health establishment to play an “activist” role on the consumer-provider board, and assured his good friends that “this sort of thing will not happen again...
...Stevenson wrote: “I am extremely concerned that Migratory Health Program relations and guidelines provide the basis for ‘meaningful’ farm-worker participation, rather than a degree of ‘tokenism.’ This, of course, requires a policy-making function for the farmworker participants rather than merely an advisory role...
...He found them in their customary positions for that hour, bent over in the fields in 95-degree heat...
...To sweeten it, perhaps, Garza organized a weekend outing for KCLM board members at a ranchretreat 80 miles north of Bakersfield and invited the HEW regional director to come along and to bring some of his staff...
...that application was still in the pipeline when regional HEW asked KCLM if it would accept $2.6 million to immediately establish a health center...
...KCLM, on the other hand, was naturally upset: first, they had “lost” the clinic itself...
...It heals them, soothes them, educates them, trains them, employs a few of them-all free of charge, for the time being...
...pation in federal projects, but in this instance, the town only began participating after the money was pumped in-for very obvious reasons and with some very disruptive results...
...The black chairman of KCHC wades into the angry mob and fires the two staff members on the spot...
...Of course, we knew what we were doing all along...
...the paper also editorialized against the grant (“More Fumbling and Bumbling”) and even ran a two-part feature on the medical society’s “wonderful clinic...
...On February 16: 200 Chicano demonstrators mass in front of the clinic, Pineda and two clinic staff members among them, carrying picket signs and threatening to “shut it down” (in Spanish...
...First, elections for a new campesino board were held in Lamont-Arvin-Weedpatch...
...This was in October...
...All this was done very quietly, without fanfare...
...February 24: Local aide sends confidential memo to Mathias in Washington warning of black-brown racial conflict that could engulf the county...
...At last count, the clinic had given treatment to 6,000 patients from 1,200 families, and thanks to the imperatives of bureaucracy, each one now has a detailed record of his medical history, probably for the first time in his life...
...Someone suggested that they might have gotten lost, since surely they had never been to the Casa Royale before...
...they suffer high incidences of venereal disease, eye defects, heart trouble, and nervous disorders...
...Compounding the problem was the fact that Bakersfield seemed to have no Chicano community groups-20,000 Chicanos, but no groups...
...He also sent a letter to the medical society announcing an award of $67,000 to continue their clinic-on-wheels, providing they move it to Buttonwillow, in the southwest part of the county...
...By July 29, it was compromise time...
...After fighting off the encroachments of the health establishment for almost a year, they now learned that HEW wanted to put the health center in a part of the county where less than one per cent of the population js black...
...The fifth would have won, too, had he chosen to run...
...ends with veiled threat to close clinic down as “last resort...
...Bakersfield’s two Republican state assemblymen called press conferences to denounce the award...
...February 28: Medical society applies to HEW for $155,891 grant to expand its own clinic...
...From this point on, the struggle ceases to be one pitting organized medicine and its friends against poor people...
...3) the miniboard would serve in a “policyrecommending’’ capacity and receive the benefit of “whatever training and experience is available...
...Since this was the time the Nixon Administration was striving to decentralize the “vast” federal bureaucracy, it fell to the regional offices of HEW to implement the legislation...
...Our story begins in Washington, D. C. in March, 1970, with the passage by Congress of the Migrant Health Act...
...Vernon Wilsbn, an HEW official in When an independent, unbiased consulting firm, experienced in developing health delivery systems, presents a program for Kern County, then and only then will I support any sponsoring agency in any of these endeavors...
...On July 14, Dr...
...This was fine with project director Pineda, a Chicano whose father was still out in the fields...
...As of September 1, the young medical society executive was still project director, a fact from which few but the medical society derive any comfort, and yet he is there...
...Let me quote from some of these letters: Kern General Hospital Administrator Dr...
...several KCLM board members chose to resign rather than swallow it...
...application actually written by four clinic staff members...
...Cavanaugh and Mathias flew to Bakersfield together to announce that HEW was suspending project funds for 90 days pending a “restructuring” of the KCLM board of directors...
...informs that Riley McWilliams made project director without HEW approval...
...In Washington, meanwhile, Mathias’ staff had done some checking and discovered that the Kern County Liberation Movement was not registered with OEO as an official delegate arm of the local anti-poverty agency...
...For years, these people have lived in shacks and camps or slept unsheltered on the banks of irrigation canals...
...How can you call yourself a liberation movement when you’re fighting to preserve a vested interest...
...And for a reason...
...Both sides in Bakersfield welcomed the two moves-the health establishment because Garza was a professional like themselves...
...Privately, he told Mathias that HEW would consider canceling the grant if KCLM should fail in any way to execute its provisions...
...At noon they joined the KCHC board for lunch...
...An assistant regional director recalls: “Washington was not terribly happy with us, and that’s the understatement of the year...
...In Washington, Mathias continued to warn HEW that the project was “doomed to failure” unless local agencies were brought into the fold and given more say in board policy...
...When you open your mouth to say “aaahh...
...And when the man from HEW left town that night, KCLM was still the beneficiary of the potential $2.6 million...
...The medical society had a special reason for bitterness: it had been operating its own federallyfunded migrant clinic for years in two old trailers outside of town, and HEW was cutting the budget on that program at the same time it was handing $2.6 million to a bunch of poor people with no experience whatsoever in the administration or delivery of health care...
...Through the fall months Isman worked hard to win the cooperation of local health agencies, but two things were working against him : his longish hair and what they call in Bakersfield “ultraliberal leanings...
...Region IX, headquartered in San Francisco, and responsible for seven Western states (it has since lost Oregon and Washington), proposed four areas with heavy migrant “home-base” populations as possible locations for health projects...
...surmises that United Farm Workers are involved in demonstrations...
Vol. 4 • October 1972 • No. 8
