Howard County Health & Human Services Needs Assessment

Conducted by

O’Neill Research LLC & Strategic Development Group, Inc. • • Full reports will be available online at the United Way website: www.unitedwayhoco.org

. Reports may be subject to revision.

Citations have not been included in the PowerPoint and may be found in the full reports.

Reports that Will be Available for Public Review 1. Executive Summary and Analysis 2. Research Phase 3. Input Phase 4. Service Provider Responses by Agency 5. Vulnerable Population Crosstab Workbook

1. Executive Summary and Analysis

• Provides summaries of the individual reports and an overall analysis of community needs.

2. Research Phase

• Stats & Demo Report • Service Provider Survey Report – the data here is aggregated so that we could generalize about service needs and stresses in the community.

3. Input Phase

• Key Informant Interviews Report • Focus Groups Report • Vulnerable Population Survey Report

4. Service Provider Responses by Agency

• This data is disaggregated so that decision makers and other interested parties can review the status of each individual agency.

5. Vulnerable Population Crosstab Workbook

• Data mining asset • Cross tabulates each demographic category with each needs and human services question • Resource for grant writing along with Demographic Report

Key Findings

Research Phase – Demographic Report The Economic Environment The population has declined since 1980: • Between 1980 and 1990 by 6.9% • Between 2000 and 2010 by 2.6% The population in Indiana grew • Between 2000 and 2010 by 6.6%

Key Findings

Research Phase – Demographic Report The Economic Environment • 9,435 workers commute in to Howard for jobs (2009) • 4,025 workers commute out to other counties for jobs (2009) • This means: the loss of millions of dollars of disposable income and potential volunteers and civic leaders.

• City efforts to revitalize the downtown and keep anchors like YMCA are a crucial part of turning these commuters into residents.

Key Findings

Research Phase – Demographic Report The Economic Environment • Howard County’s median age (40.7) is 3.7 years older than the state’s median age of 37.0. • The unemployment rate spiked at 15 percent in 2009 and has come down to 10 percent in 2011 • Median household income is declining in absolute terms and relative to the state.

Key Findings

Research Phase – Demographic Report The Economic Environment • Howard County lags the state at 19.7 percent of workers with a B.A. or higher degree. The national rate is 27.5 percent. • Good news factoid: Chrysler adds 550 jobs in 2011.

• Even though Howard County remains a manufacturing center, it must continue to diversify its economy which means developing a more educated workforce.

Key Findings

Research Phase – Demographic Report The Economic Environment • In 2000, Howard County and Indiana had exactly the same poverty rate: 8.8%. By 2010, Howard County’s poverty rate of 16% for all ages was higher than the statewide 15.3%. • The percentage of children under age 18 living in poverty jumped from 13.1% in 2000 to 24.5% in 2010.

Key Findings

Research Phase – Demographic Report Social, Family, and Health Issues • An estimated 1,058 grandparents are responsible for their grandchildren.

• 836 male and 2,682 female householders are single parents.

• The child abuse and neglect rate per 1000 children went from 12.2 in 2009 to 21.2 in 2011 nearly 7 points higher than the state rate.

Key Findings

Research Phase – Demographic Report Social, Family, and Health Issues • A minimum wage earner (earning $7.25 per hour) can afford monthly rent of no more than $377, but an efficiency apartment (with no bedrooms) in Howard County costs $551.

• 13,279 people have a disability who are non institutionalized • 20.4 percent of people with disabilities live below the poverty line.

Key Findings

Research Phase – Demographic Report Social, Family, and Health Issues • Hoosier Assurance Program (HAP) in 2008 served 1,828 people in Howard County for addictions or mental illness • Based on County Health Rankings, Howard County ranks 64 th in the state in terms of health outcomes and 56 th in health factors (out of Indiana’s 92 counties).

Key Findings

Research Phase – Demographic Report Social, Family, and Health Issues

Death Measures Includes only areas in which Howard Co exceeds U.S

Rates are age-adjusted to the year 2000 standard; per 100,000 population.

Death Measures Colon Cancer Coronary Heart Disease Homicide Lung Cancer Motor Vehicle Injuries Stroke

Howard County Rate 20.4

173.6

7.6

62.7

17.0

59.5

U.S. Rate 2005 17.5

154.0

6.1

52.6

14.6

47.0

Key Findings

Research Phase – Demographic Report Service Provider Survey • • • • 24 out of 31 organizations report an increase in the cost of doing business, 1 reports a decrease 25 out of 31 organizations report an increase in demand for services, none report a decrease 10 organizations report being unable to serve clients seeking services with numbers ranging from less than 10 to over 500 clients. Organizations cite a lack of funding and an increasing demand for services as top challenges.

Key Findings

Research Phase Service Provider Survey • Agencies providing mental health and housing services report the largest numbers of unserved clients. • All the agencies most frequently cite employment opportunities/job placement, mental health and housing services as unmet needs for their clients.

Key Findings

Input Phase Focus Groups & Key Informant Interviews • 23 key informant interviews were completed with community leaders including: CEOs in the private and public sectors, university chancellors, judges, elected officials, school superintendents, the sheriff, and agency directors.

Key Findings

Input Phase Focus Groups & Key Informant Interviews • • • The focus groups had 38 participants in the following sessions: Justice System Officials • Preschool and Primary Educators Healthcare Providers Social Safety Net Providers • Business, Labor, and Postsecondary Education Leaders • Faith-Based Service Providers

Key Findings

Input Phase Focus Groups & Key Informant Interviews • • Key Informants indicated that economic opportunity was a root issue exacerbating other human service needs.

There was broad agreement on a set of four paired issues as key human service needs: o Mental health and addictions o Family financial crisis and early childhood and child rearing issues

Key Findings

Input Phase Focus Groups & Key Informant Interviews There was also strong consensus in the focus groups that: • Mental health and addictions were major human service needs.

• Adults, youth, and children were all in need of services in these areas.

Key Findings

Input Phase Focus Groups & Key Informant Interviews • • • • Focus groups identified the following • missing elements in mental health and addictions services: An initial assessment center where police and other frontline professionals can direct people for initial contact. A 28-day treatment facility. Sending people to other parts of the state creates problems.

A shelter for intact families.

A half-way house.

A work release program.

Key Findings

Input Phase Vulnerable Populations Survey Demographics • • • • 71.6 percent of the respondents report that they are women. The age demographics are relatively representative of Howard County as whole. The population represented on this survey overwhelmingly report very low income households. Over half the respondents report that their unemployment is the result of a disability, and approximately one third report that they are simply unable to find work.

Key Findings

Input Phase Vulnerable Populations Survey Health and Human Service Needs • Finance related issues top the list for problems dealt with in the last six months with job problems at 44.7% • 26.3 % of the respondents also cited mental health as an issue their households experienced in the last six months.

Key Findings

Input Phase Vulnerable Populations Survey • Food was by far the need reported as requiring the most assistance followed by medication and transportation.

• The most identified source of help for the respondents’ biggest problems at 30.3 percent was their families and not an agency or institution.

Key Findings

Input Phase Vulnerable Populations Survey • The six top diagnoses reported as experienced by respondents over the past year are mental health or behavior affected: high blood pressure (if stress related), high cholesterol (if diet related), depression, anxiety, diabetes (if diet related), and obesity.

• 70 percent of the total respondents indicate that they never or only occasionally exercise. This is extraordinarily low by national standards.

Key Findings

Input Phase Vulnerable Populations Survey • 27.9 percent of the respondents report that they smoke cigarettes. The national rate is 19 percent. • Nearly one third of the female respondents report that they smoke cigarettes. • Respondents appear much more likely to smoke if they are less than 55 years of age and the lower their income the higher the frequency.

Key Findings

Input Phase Vulnerable Populations Survey • Taken together, this information suggests that there may be a significant life threatening behavior primarily affecting women under the age of 55 and their children in the lowest income subgroups.

Key Findings

Input Phase Vulnerable Populations Survey • Smoking and lack of exercise are significant health-risk behaviors for the vulnerable populations.

• They may be contributing to the higher rates of morbidity for Howard County in colon cancer, lung cancer, coronary heart disease, and stroke. • They may be complicated by co-occurring mental illness and other addictions.

Community Needs Profile

• • The Community Needs Profile identifies those human service issues which emerged as high concerns taking into account all of our research activities. It also discusses those issues which merit consideration although they were not as widely noted.

Community Needs Profile

Three basic needs that were consistently identified as critical and pressing across all of our research: • • • Food Housing and shelter Lack of financial resources

Community Needs Profile

Three health-related needs that were consistently identified as critical and pressing across all of our research: • Mental Health • Addictions • Health-risk behaviors

Community Needs Profile

• • • Three additional issues of importance: Disability - 13,279 residents with disabilities; over half the respondents on the vulnerable population survey report having a disability; long waiting lists for Medicaid-waivers Transportation – trolley system receives both praise and requests for extended times and routes Education and Economic Opportunity – efforts must continue to revitalize the downtown, invest infrastructure, and create a stable, educated workforce.

Community Needs Profile

• • • k-12 educators and workforce development professionals will have a key role in “rehabilitating” the low income workforce through helping them acquire higher skills. Howard County and Kokomo are moving to revitalize the downtown, to improve public transportation, and to diversify the economy through facilities like Inventrek.

All these efforts will help to develop a sustainable economy with the power to generate a range of jobs for a workforce that retains many unskilled individuals.