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July/August 2010

Inside This Issue:

Research Examines Direct Care Worker Training Needs for Aging and MR/DD Systems
Direct care workers (DCWs) are the front-line caregivers in the aging and mental retardation/developmental disabilities systems. The training DCWs receive affects the quality of life for the people they serve. Increasingly, they are caring for persons with mental disabilities and cognitive, developmental and physical impairments who are outliving their parental caregivers.

Research sponsored by the Center for Rural Pennsylvania indicates that Pennsylvania policies on DCW training do not yet reflect best practices and that Pennsylvania policies governing DCW training for aging and mental retardation/developmental disabilities services are inconsistent across provider facility types, even though the populations and needs are often similar.

Research background
In 2008, Dr. J. Beth Mabry, M. Elizabeth Kemeny and Ashley Chateau of Indiana University of Pennsylvania and Loni Yatsko of the University of Akron conducted research to examine how Pennsylvania DCWs in the aging and mental retardation/developmental disabilities (MR/DD) provider systems are trained to meet the needs of the growing population of individuals with developmental disabilities who are aging, and how training needs and challenges may be different in rural areas.

To conduct the study, the researchers compared Pennsylvania regulations for DCW training with publicly available DCW training regulations of other states and with evidence-based best practices.

They also surveyed licensed Pennsylvania aging and MR/DD service providers to gather data on current training practices, challenges, and needs, and to identify issues specific to rural service providers.

The researchers then conducted a content analysis of currently used materials for DCW training that were provided or reported by service provider organizations to compare current practices in Pennsylvania’s rural and non-rural areas with best practices.

Research findings
The research found that Pennsylvania policies governing DCW training for aging and MR/DD services are inconsistent across provider facility types, even though the populations and their needs are often similar. Provider facilities include group and community homes, “family living,” vocational training facilities, personal care homes, assisted living facilities, nursing homes, intermediate care facilities, domiciliary care homes and adult day care/older adult daily living centers.

The research also found that Pennsylvania requirements for DCW training are comparable to those of other states in content, frequency and duration.

The researchers noted that Pennsylvania policies on DCW training do not yet reflect best practices, and that Pennsylvania regulations for DCW training are not specific enough in indicating the depth or methods of delivery of training.

Current training practices reported in the service providers survey indicated that most service providers offer some form of annual DCW training.

In contrast with best practices, DCW training in Pennsylvania is delivered primarily in lecture-based classes or passive video watching. Further, fewer than half of the service providers surveyed evaluated the effectiveness of DCW training in terms of client/resident or organizational outcomes, and more than one in 10 did not evaluate training effectiveness at all. The researchers noted that survey respondents seemed to be more concerned with complying with regulations than delivering quality training.

The research found few major differences in current training practices among providers in rural and urban counties.

The research also found that the challenges and needs in DCW training were remarkably similar for all service providers, whether or not they were located in rural areas.

According to the survey respondents, the major challenges in delivering training were a lack of resources, including time, funding, scheduling flexibility, and access to quality affordable materials (See table below). Common learning needs for DCWs were: understanding client diagnoses and their implications for care, responding positively to difficult behaviors, and improving communication skills.

Addressing training needs
To better prepare DCWs to care for clients who are aging with developmental disabilities, the researchers offered several policy considerations that endorse the development of a comprehensive, standardized, integrated approach to both initial and ongoing DCW training. They suggested: making DCW training requirements uniform across provider types and consistent with best practices in content and delivery methods; creating a standardized “universal DCW certification” program that would provide a flexible workforce capable of serving a variety of populations and needs; establishing regional “best practices training teams” of professionals, who are thoroughly trained in best practices content, philosophies, and skills, and who may serve all licensed providers of aging and MR/DD services; and establishing “train the trainer” curricula for instructors in the “universal DCW certification” program and members of regional best practices training teams.

Report available
For a copy of the research report, Direct Care Worker Training for Aging Clients with Developmental Disabilities, call or email the Center for Rural Pennsylvania at (717) 787-9555 or info@rural.palegislature.us or visit www.rural.palegislature.us.
 

Top Challenges in Training DCWs by Provider Type and Rural Location

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Chairman's Message
This month the Center for Rural Pennsylvania released reports that focus on the results of two different research projects. The first report, featured on Page 1, talks about training issues for direct care workers in the mental retardation/developmental disabilities systems. The second report, featured on Page 4, addresses emergency management and preparedness in Pennsylvania.

The diversity of our work reflects the diversity of rural Pennsylvania and the challenges and opportunities facing its 3.4 million rural residents.

When the Center was created by Act 16 of 1987, it was mandated to administer grants to conduct research on matters related to rural conditions. That mandate has allowed the Center to look at a broad range of issues including direct care worker training, emergency preparedness, health conditions of rural residents, community banks, unemployment and underemployment, agritourism, school district enrollment and building capacity, small business owners, mobile homes, and so much more.

In June, the Center’s Board of Directors approved a number of Letters of Intent as part of the 2011 Research Grant Program. The researchers who submitted the approved letters are now working to develop their full proposals, which will be reviewed and voted on at the Center’s board meeting in November. The 2011 proposals again focus on a wide range of topics including tourism, microfinancing, Marcellus Shale drilling, Pennsylvania’s wine industry, and rural county prison systems.

Research, however, is not the only requirement the Center fulfills to develop a true understanding of rural Pennsylvania and its residents.

A second mandate requires the Center to develop and maintain a database of knowledge and information about rural conditions and needs. Samples of how the Center has been meeting this mandate can be found on Page 5, which includes data about oil and gas drilling permits issued in Pennsylvania, Page 6, which looks at foreign language courses offered in secondary schools, and Page 7, which looks at state and national data on driving under the influence.

If you’re a regular reader of Rural Perspectives, I’m sure you’re familiar with the long list of data articles that have looked at everything from illegal dumpsites to marriage and divorce rates, and from the number of restaurants operating to the number of motorcycles registered in rural Pennsylvania.

The Center's research findings and data analyses are shared not only with the General Assembly, but also with a much larger audience including state and federal agencies, grant writers, community leaders, educators, entrepreneurs, and nonprofit organizations.

The Center will continue its work of providing research results and data analyses that inform policy, help with the development of regulations, and offer solid information for the benefit of rural Pennsylvania.

As a final note, on behalf of the board and staff, I offer our thanks to Dr. Keith Miller, former board member and president of Lock Haven University, for his commitment and service to the Center for Rural Pennsylvania. Dr. Miller is now president of Virginia State University and we wish him and his family all the best. 

Senator John Gordner

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Emergency Preparedness in Pennsylvania
Research Highlights Policies, Budgets, Practitioner Concerns

In 2008, researchers from California University of Pennsylvania conducted a study to assess emergency preparedness in Pennsylvania, particularly to determine if differences exist between Pennsylvania’s rural and urban counties.

The research, conducted by Drs. Thomas R. Mueller and Jamie D. Mitchem and sponsored by the Center for Rural Pennsylvania, included an analysis of Pennsylvania emergency preparedness policies and budgets, an online survey of county and regional emergency preparedness practitioners, and interviews with state emergency preparedness officials.

Research results
The results of the online survey indicated that the majority of survey respondents found funding to be inadequate for their responsibilities. These respondents said costs have increased while funding has not, and insufficient funding and staff are limiting their capabilities.

The research also found that the level of participation in grant programs among respondents was fairly low, but the application success rate was quite high. Most respondents who applied for grants were seeking homeland security grants for equipment and training/exercises from the federal and state governments.

The budgetary analyses indicated that state funding for the Pennsylvania Emergency Management Agency (PEMA) has decreased since 2005 back to the level at which it was in 1998. PEMA funding varied and fluctuated according to recent disasters.

The research also found some key differences between rural and urban county respondents in Pennsylvania as follows:

• Rural counties have smaller staffs, which limit what they can do.
• A few rural counties did not have an Emergency Operations Plan, an Emergency Operations Center, or an Emergency Communications Plan, which all counties should have as recommended in the National Fire Protection Association (NFPA) 1600 standards to accommodate National Incident Management System (NIMS) compliance. All urban counties had met these standards.
• Rural counties were less likely to have distributed emergency guides to the public, and were less likely to have conducted a public education/awareness campaign during the past year. This could result in lower emergency preparedness levels among the public in rural counties.
• Rural counties were more likely to indicate they did not have enough equipment and were below average on preparedness compared with the rest of the state. They also lacked reverse 911 capabilities at a higher rate than urban counties.
• Rural counties were being particularly hard hit by staff and budget reductions, and some were finding it difficult to complete their basic duties with the limited resources that were available.

Among all survey respondents, most had attended training and felt that there were sufficient training opportunities available to them. However, many respondents did not have the time or funds to complete the training.

In Pennsylvania, most county emergency preparedness officials reported having mutual aid agreements, except for a few rural counties.

Almost half of the survey respondents indicated that emergency coordination in Pennsylvania was not smooth and effective. Frequent policy changes, lack of staff, and lack of cooperation between agencies and the various levels of government also were identified as problems.

Even with the challenges discussed, more than half of the respondents agreed that emergency preparedness is improving with time in Pennsylvania.

Conclusions
Based on the research results, the researchers suggest the following to strengthen emergency preparedness in Pennsylvania: implement education and staffing requirements for emergency preparedness positions; increase funding for PEMA at a defined percentage of the state budget to make it more stable; and develop a state grant program specifically for emergency preparedness practitioners in Pennsylvania’s rural counties.

The researchers also suggest that PEMA develops online training opportunities for emergency management personnel to make training more convenient. They also suggest that the state mandate mutual aid agreements and Hazard Mitigation Plans from each county and allocate state funds and emergency preparedness responsibilities to county emergency preparedness officials to oversee their entire county.

For a copy of the research results, Survey of Emergency Management and Preparedness Agencies in Pennsylvania’s Rural Counties, call or email the Center for Rural Pennsylvania at (717) 787-9555 or info@rural.palegislature.us or visit www.rural.palegislature.us.

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A Look at Oil and Gas Drilling Permits Issued in Pennsylvania
Drilling in the Marcellus Shale is big news. However, it is not the only energy drilling going on in Pennsylvania.

According to permit data from the Pennsylvania Department of Environmental Protection (DEP), 2,847 active well permits were issued from January 1, 2010 to May 31, 2010. Of those permits, 1,173, or 41 percent, were for Marcellus Shale gas drilling and 1,674 were issued for other types of drilling.

The table below provides a more detailed look at permit data for 2010, including information on the types of permits issued, the average drill depth for the wells, the number of operators that applied for a permit, the number of permits issued by municipality, and permits issued for drilling in rural and urban municipalities.

Pennsylvania Drilling Permit Data, 2009, and January to May 2010

Drill Permits Issued by DEP, January to May 2010

Data source: DEP Bureau of Oil and Gas, 2009 and 2010. Note: On map, dots are approximate representations of drill permit locations.

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Foreign Language Courses Offered by Pennsylvania School Districts
Learning a second language can offer many benefits to today’s students. It can help expand their understanding of the world in which they live, help to counter stereotypes and increase their future hiring potential.

An analysis of Pennsylvania Department of Education data by the Center for Rural Pennsylvania indicates that rural secondary students do not have as many opportunities as urban secondary students to learn a foreign language while they are in school.

During the 2006-2007 school year, rural secondary schools (7th to 12th grades) had fewer types of foreign language courses and fewer advanced-level language courses compared to urban secondary schools. In addition, the percentage of rural students taking a foreign language class was significantly below the urban rate.

Findings
Enrollment in language courses
During the 2006-2007 school year, 85,465 rural secondary students, or 34 percent of all rural secondary students, were enrolled in a foreign language course.

Among urban school districts, 249,984 secondary students, or 42 percent of all urban secondary students, were enrolled in a foreign language course.

Among rural school districts, foreign language course enrollment varied. During the 2006-2007 school year, 39 percent of rural school districts had language course enrollment below 30 percent; 46 percent had enrollment levels between 30 and 39 percent; and 15 percent had enrollment levels at 40 percent or higher.

Among urban school districts, course enrollment also varied, but was opposite that of rural districts: 15 percent of urban districts had enrollment levels below 30 percent; 33 percent had enrollment levels between 30 and 39 percent; and 52 percent had enrollment levels above 40 percent.

Types of language courses offered
During the 2006-2007 school year, rural school districts offered about two types of language courses, on average. Urban districts offered about three different courses, on average.

Both rural and urban school districts most frequently offered courses in Spanish, French and German.

As a percentage, districts that had one or two different language courses had fewer minority students (non-white and/or Hispanic) than districts that offered three or more courses (4 percent and 9 percent, respectively).

Financially, districts that had one or two different language courses received more in state revenues ($5,823 per student) than districts that had three or more language courses ($4,657 per student).

Districts with one or two different language courses had lower percentages of students scoring “advanced” on the reading portion of the PSSA test (29 percent) than students in districts that had three or more courses (32 percent). There was, however, no statistically significant difference between the two types of districts on the math proportion of the PSSA.

Also, districts with one or two different language courses had a lower percentage of adults (25 years old and older) in the district with a bachelor’s degree (13 percent) and lower average housing values ($91,100) than districts with three or more courses (16 percent and $111,300, respectively).

Fact sheet available
For the complete fact sheet, Foreign Language Course Offerings in Pennsylvania School Districts, call or email the Center at (717) 787-9555 or info@rural.palegislature.us or visit www.rural.palegislature.us.

How the Analysis Was Completed
The Center for Rural Pennsylvania compared foreign language student enrollment, types of language courses, and course levels among rural and urban school districts. The analysis focused on secondary students in grades 7 through 12 during the 2006-2007 school year. 

The Center used the Pennsylvania Department of Education’s Office of World Language data on enrollment, course types, and course levels. However, the Center was unable to determine how these courses were delivered—whether by classroom teacher or through distance learning technology.  The analysis did not include sign language courses, cultural awareness courses, or introductory level courses.

The Center defined rural school districts as those with a population density below the statewide average of 274 people per square mile.  School districts at or above the statewide average were defined as urban.  In this analysis, there were 242 rural districts and 256 urban districts.  Three districts – Saint Clair Area, Midland Borough, and Bryn Athyn – were not included in the analysis because they did not have secondary students.

Because 2006-2007 data for the Interboro School District and the Mid Valley School District were missing, the Center substituted data from the 2005-2006 school year.

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Just the Facts: Driving Under the Influence
According to the Pennsylvania State Police Uniform Crime Report, about 15,330 people were arrested for driving under the influence (DUI) in rural Pennsylvania in 2009. That’s about 29 percent of all DUIs in Pennsylvania that year.

Clinton County had the highest rate of DUIs in 2009, with approximately 731 people arrested per 100,000 population. Columbia County had the lowest rate, with about 261 people arrested per 100,000 population. The statewide rate in 2009 was about 417 per 100,000 population.

Nationwide, there were approximately 1.5 million DUIs in 2008, or about 487 DUIs per 100,000 population. According to the Centers for Disease Control and Prevention (CDC), this number is estimated to be less than 1 percent of all persons who drove under the influence.

Wyoming had the highest number of DUIs in the nation, with about 1,356 per 100,000 population in 2008. Delaware had the lowest, with about 25 per 100,000 population. Pennsylvania ranked 30th among all states for DUIs per 100,000 population with about 53,000 total DUIs in 2008. 

Since 1990, the number of DUI arrests in Pennsylvania has increased by about 21 percent overall and by about 22 percent in rural counties. From the available data, it is impossible to tell whether this is because of improved enforcement or changes in drivers’ behaviors.

Driving under the influence may lead to automobile crashes, which can result in fatalities. A high number of DUIs per 100,000 population shares a statistically significant relationship with the number of alcohol-related crash fatalities. According to the CDC, approximately 32 people die each day in an alcohol-related crash in the U.S., a number that accounts for about 32 percent of all motor vehicle crash fatalities.

Data from the National Highway Traffic Safety Administration show that about six people per 100,000 died in the U.S. in 2009 in an alcohol-related crash. Wyoming had the highest rate of alcohol-related fatalities at about 14 per 100,000 population. Utah had the lowest, with about two per 100,000 population. In 2009, Pennsylvania ranked 33rd among all states for alcohol-related crashes, with about five fatalities per 100,000 population.

Pennsylvania’s rural counties have a significantly higher number of these fatalities per 100,000 population than urban counties. From 1990 to 2008, rural Pennsylvania had an average of about nine alcohol-related fatalities per 100,000 population, while urban Pennsylvania had approximately four.

However, urban counties had a higher number of these fatalities per 1,000 road miles, with urban areas having an average of eight fatalities per 1,000 road miles and rural Pennsylvania having an average of about seven.

Fortunately, the overall number of these fatalities has been decreasing in the state, with a decline of about 15 percent in rural areas and 20 percent in urban areas from 1990 to 2008.

 

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