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Health and human service needs in coal impact areas in Eastern Montana : a report to the Montana Coal Board (Volume 1982) online

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HEALTH and HUMAN SERVICE NEEDS



in COAL IMPACT AREAS



in EASTERN MONTANA



1982



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MONgNA STATE c/8RARr





MONTANA STATE LIBRARY



3 0864 1001 8651 2



HEALTH and HUMAN SERVICE NEEDS
in COAL IMPACT AREAS
in EASTERN MONTANA



A Report to the Montana Coal Board



Prepared by

Health Development Associates

Missoula. Montana



1982



Digitized by the Internet Archive

in 2010 with funding from

IVIontana State Library



http://www.archive.org/details/healthhumanservi1982mont



TABLE OF CONTENTS

SECTION TITLE , PAGE

INTRODUCTION i.

I. CURRENT HEALTH AND HUMAN SERVICE NEEDS

Overview of the Impact Process 1.

Summary Statement of Need 4,

Specific County Needs

Rosebud County 7.

Big Horn County 14.

Treasure County 19.

Powder River County 22.

Custer County 26.

Wibaux County 31.

McCone County 34.

Dawson County 37.

II. FUTURE HEALTH AND HUMAN SERVICE NEEDS

Introduction to Future Health and

Human Service Needs 39.

Energy Company Development Plans 40.

Introduction to Decision Making Models 44.

Key questions in reviewing

health and human service
proposals 45.

Four variables that help determine
the level of community
health and human service
needs resulting from coal
development 47 .

Crosspact 49.

Impact timeline with examples of
proposals which might be
funded 51 .

III. DATA METHODOLOGY

Data Methodology 53.



IV. APPENDICES

Appendix A: County Statistical Profiles 58.

Appendix B: Bibliography of Primary and

Secondary Data Sources 138.

Appendix C: Project Contact List 144.

Appendix D: Annotated Bibliography of

Research Literature 151.



INTRODUCTION



Coal has played a significant role in American history from the development
of a vast rail transportation system, to the formation of giant industrial
enterprises, to a considerable rise in the importance of unionism under John
L. Lewis. The industry has been characterized by periods of tremendous growtn
and national importance and equally dramatic bust periods. Often the factors
behind the boom or bust were completely outside the control of the industry.

The boom ana bust cycles of the coal industry not only affect corporate
protits, they affect individual workers and families. Mining is a skilled
job, and work opportunities are limited. As one mine closes and another
opens, the' coal miner picks up and moves with the work. When the industry is
down and workers are laid off, families may be split up while one or the other
spouse goes oif to seek temporary employment.

The OPEC oil embargo in 1973, and President Ford's call for an "Energy
Independence" movement in 1976, made previously unprofitable coal deposits in
the intermountain west good investments for the capital rich energy companies
and the enterprising speculator. By the mid-1 970 's social science researchers
were beginning uo talk about a new variation of the boom and bust coal theme.
In 19Y4, ElDean Kohrs, of the University of Wyoming, coined the phrase
"Gillette Syndrome" to characterize the social and cultural trauma that
accompanied large scale energy development projects in small, rural, western
communities.

As the research papers illustrated, energy development was not without its
problems. The general public was presented with polar views of the
development. "60 Minutes" portrayed a depressing picture of boom towns built
overnight and every day growing farther out of control, while the energy
companies were painting a picture of energy development as a patriotic duty.
As witn most highly publicized issues, the truth lay somewhere in the middle.
There are undeniable oenefits from energy development: new jobs; cheaper
energy supplies; and less vulnerability to foreign political instability.
There are also costs: social disruption and dislocation of rural conmunities;
personal and family disintegration; and, sometimes, damage to a fragile
environment. The question is how can the benefits of development be
transposed into an improved quality of life for all those affected.

In March of 1982, the Montana Coai Board decided to study human service
needs in Rosebud, Big Horn, Treasure, Powder River, Custer, Wibaux and McCone
Counties. They issued a Request for Proposals to perform the following tasks:

1) Collect existing data on human service needs;

2) Analyze the existing data;

3) Assess the current human service needs; and,

4) Project future human service needs.

On May 27, Health Development Associates, Inc. (HDA) was awarded the
contract to perform this work.

HDA's staff includes professionals from a variety of health related



disciplines, each with significant work experience in the delivery of health
and human service programs in rural areas. Our general methodology for
addressing community problems is based on four major premises. First, the
community must identify the problem areas which need to be corrected, and the
resources it has available to solve the problems. This includes looking at
available need data, reviewing what has been done elsewhere, and most
importantly wnat the community sees as its priorities. iSecond, a consensus
plan must be developed to provide guidelines for community decision making
related to the desired action. This requires a structured planning process
which includes representation from all elements of the community. Third,
technical support must be available to the community during the plan
implementation period. Local institutions, agencies and individuals
responsible for carrying out the action plan need a readily accessible,
professional, resource to assist in locating and evaluating options and
alternatives. Finally, the planning and implementation process must improve
the problem solving skills of community residents. Once the technical
assistance is withdrawn, the community must be capable of meeting the
challenge alone.

This approach to community problem solving puts primary emphasis on the
community's view oi its problems. It is our experience that while service
data may indicate gaps in the formal services being provided, and research may
suggest certain types of remedies, different communities perceive their
problems differently, and consequently choose to organize their formal and
informal resources differently to meet the perceived need. A community will
act according to the severity of the perceived need, or the perceived
consequences of not acting on a particular problem. Our methodology for this
project reflects this experience.

Starting in early June, HDA began to contact federal, state and local
government oificials with regard to the availability of data related to human
service needs, and projected coal development activity, in the seven counties.
In addition, project team members began a search of existing literature on
impacts from energy development. These activities continued throughout the
duration of the contract period.

In mid- June, work started on a process for collecting input from community
residents on human service needs. This component eventually included the
development oi a list of representative community members to personally
interview, an open-ended questionaire, a group discussion format, and a group
process approach to synthesizing the community input. HDA spent a total of 39
staff days in the designated counties gathering and processing input from
community residents.

Determining future human service needs involved contacting a variety of
public and private organizations to ascertain realistic demand and development
projections, analyzing data on existing needs and services currently being
provided, and then applying our professional judgment to this data. As a part
of this process, an interview schedule was developed and those companies who
had indicated an intent to develop coal resources in the state within the next
ten years were contacted about their current estimates of development activity
and their position on company responsibility for impact mitigation.

This report is divided into four sections. The first section presents the



XI



major findings of the study. It also includes descriptions of the health and
human service needs of each county as reported by residents, community
concerns over possible future coal development, and summaries of the
statistical data compilea on each county.

Section two deals with future health and human service needs in the
designated counties. Current planning of those companies who have submitted
ten year development plans to the Department of Natural Resources is outlined.
This section also presents several decision making tools for reviewing health
and human service proposals.

In the third section, the methodological approach taken by the contractor
is explained in more detail. This section contains a description of the data
collection proceaures and a critique of the data sources.

The Appendices include annotated bibliographies on the data sources used
and the impact research literature considered most relevant. Data sources
reviewed (but not used) are also presented. Lists of all persons contacted
during the contract are presented. Finally, there is a statistical profile
for each of the counties of the health and human service needs and the
services currently being provided.



Ill



Section 1: Current Health and Human Service Needs




OVERVIEW OF THE IhlPACT PRXESS



There is no uniform description of impact for Montana's coal development
counties. Each county is quite individual with respect to the level of impact
it has received and how it has responded. There are, however, certain
characterizations than can be used to gain an understanding of the health and
human service needs created by coal development in Montana.

All seven counties which are a part of this study have been affected in
some manner by coal development in Eastern Montana. The impact process begins
when a community is targeted for development. It then continues through the
boom period and the bust, with the entire cycle often repeating itself.
Eastern Montana counties presently range in scope of impact from McCone
County, whicti is targeted for future development, to Rosebud County, which has
undergone rapid growth and urbanization ("boom town growth"). We have found
that the degree to which coal development impacts a community and creates
unmet health and human service needs is dependent on four variables: 1) the
magnitude and composition of population growth, 2) the proximity of the
development to the community, 3) the flexibility of the local governmental and
service delivery institutions in responding to the impact and 4) the
flexibility or the community in adapting to the stresses of its changing
expectations and way of life.

Perhaps one of the most significant findings of our study is that there are
many levels of impact that result from coal development. While existing
literature deals almost exclusively with boom town growth and impact, we found
in Eastern Montana a broader range of impact and resultant need.

As a result of coal development, or even the serious prospect of coal
development, the traditional rural agricultural identity of a community
changes. The community becomes more urban in nature with increased
formalization or bureaucratization of local institutions, a breakdown in the
informal decision making processes and increased fragmentation. Residents
from each county reported that they feel a loss of control over the future of
their community. The energy companies, the federal government, the state
government and even OPEC now have far more control over the future than the
residents themselves do. The place which people knew as home and where they
have had a sense of security and stability has changed. This change excites
some residents because of the anticipated or realized opportunities. Others
are frightenea because their home has become a different place.

With impact comes the need of each community to plan in an organized manner
their response to the changes. It is important that throughout the entire
impact process the community anticipates needs, including health and human
service needs which traditionally have not received significant attention in
planning efforts, and develops a response that suits that particular
community. We heard from a number of town and county officials that they
wanted growth. However, they wanted that growth to be phased, moderate in
pace and predictable. In other words, planned. All seven counties have
increased their planning efforts as a direct result of coal or, in some cases,
oil development. At least some segment of residents in each county is aware of
the need for ongoing planning and has begun developing the necessary skills
and planning structure. Local residents repeatedly told us that it is



important for the planning process to include broad community involvement. We
find from our experience that organized community based planning will help a
community maintain control over its future. We also find it is essential in
responding effectively to health and human service needs.

People in each community stressed their concerns about the uncertainty of
the future. This uncertainty has in some cases inhibited the development of an
ongoing community planning process. In several communities residents voiced
concern over the lack of complete information on the status of coal
development projects and frustration in investing community energy and
resources into setting up a planning process for managing development that may
never come. To reduce that uncertainty as much as possible and to plan for the
future many community residents feel it is important for all organizations and
agencies involved in the development or mitigation process (coal companies,
state and federal agencies, Coal Board) to worK closely together with one
another and with the community. This often includes neighboring communities
and even states. Some communities felt they only had limited infoniiation about
the role of the Coal Board and other state agencies involved in impact
designation and mitigation. Other communities mentioned a satisfactory
working relationship with coal campanies and the Coal Board. We find a strong
rationale for some form of partnership through which good information about
the status of coal development projects and the experience of other impacted
communities, as well as technical and financial assistance, is readily
available and accessible to communities planning for impact.

Prior to impact each of the seven counties had similar health and human
service needs — similar to each other and similar to other rural agricultural
communities in the West. There were shortages in medical services, problems
with alcohol and drug abuse, mental health, family violence and crime and a
lack of recreation facilities. These were, however, all problems that the
counties were addressing through their existing institutions and service
delivery systems.

Early in the impact process, as in McCone County, these needs become
accentuated and local resources strained. Agencies, provider groups and
informal service deliverers in rural Montana communities are usually small
organizations offering generalized traditional services to a stable client
population. Often they are provided through a satellite office on a part-time
basis. As new and different types of people move into the community, existing
proDlems are further accentuated and new ones develop. It becomes more and
more difficult, if not impossible, for existing resources to cope. They are
required to expand and change. Housing shortages, crimes against property,
public medical and social services for the indigent, multi-problem families,
newcomer expectations for services they have had available elsewhere and
health and human service personnel drain due to competition from high paying
energy jobs become new problems. Experience with the impact of coal
development on nealth and human services in Rosebud and Big Horn Counties
demonstrates this basic progression. Experience in Rosebud also appears to
bear out studies that have shown that in boom town situations certain problems
rise many times greater than the population increase. These are alcohol and
drug abuse, mental illness, family violence and crimes against property.

Two additional problems which have traditionally existed in the seven
counties but have become greater because of coal impact, are problems with



coordinating services and staff turnover. People in each county expressed
these problems as major. In order to make the best use of available resources
and respond effectively to the health and human service needs caused by coal
development, these two problems must be resolved. Three suggestions that we
routinely heard in the counties as solutions to these needs are: service
providers participating in an organized planning process, training local
people to respond to the problems caused by impact, and working with other
counties in a regional approach.

Before presenting the statement of need we wish to re-emphasize that the
needs and the necessary responses to those needs are unique for each
community. The appropriate response to meeting the primary medical service
need in one community may be totally inappropriate in another. The four
variables that we listed above can be useful in defining the unique
characteristics and appropriate responses.



SUMMARY STATEMENT OF NEED



Coal development has clearly created health and human service needs in
several eastern Montana canmunities. In presenting them, we find it useful to
describe both these needs which are generally characteristic of Montana's
impact counties and those which are specific to an individual county.

In working with this information it is essential that three issues be kept
in mind. First, the needs presented here existed at a specific time and
place. They are dynamic and they change. In order to compensate for that
inevitable change we have included several analytical and decision making
tools in the section on Future Needs. Second, our county specific information
is not intended to be all inclusive. The scope of this project did not
provide for such comprehensiveness. We feel confident that all needs which
are listed are genuine needs. On the other hand, if something is not listed
it does not mean that it is not a need. Third, we have used the following as
our working definition ot impact:

Impact is the process of change and the change itself
which occurs in a community as a result of coal devel-
opment. Impact is cyclical in nature beginning when a
community is targeted for development. It continues
through a boom period to the bust, with the cycle
often repeating itself. In many cases, impact from coal
development in the West cannot be separated from the
impact of other resource development because they occur
in the same areas, draw on a common labor pool, and
create a common set of community stresses and resultant
service demands. Finally, impact occurs within a re-
gional context where events in one community or state
directly affect other communities or states within the
intermountain west.



GENERAL NEEDS (Not listed in priority order)

While these needs are presented separately, they are interrelated. A
program aadressing one need will often affect other of the needs as well.
These needs generally apply to a community at any stage of impact, and only
slight adjustments are needed to describe specific community situations.

1 . Establi^nnient-. of a co mmunity planning p rocess - Each impacted community
should establish an organized and directed planning process in which all
segments of the community engage in dialogue and decision making
concerning their future. This process is broader than traditional land use
planning which often includes only representatives of particular
interests, rarely considers social impacts, and produces a document which
may or m.ay not be understood and supported by community residents. All
parts 01 the community must be represented in the community impact
planning process, those that will benefit as well as those who may lose
out from development, and the anticipated changes in the community and the
resultant health and human service needs are an essential part of the



discussion. Sucn a process is critical in responding to impact, and the
strength of local public leadership is a key determinant in its success.
The planning process will develop a sense of control, by helping to get
appropriate decisions made and increase the levels of coordination,
cooperation and integration within the community as a whole and within
individual segments such as the health and human service system. Perhaps
the most essential point is that the p,3.annin g process is more important
than the production ot a "Plan Document."

2. Establ ishment of _a^_partner.sh.ip. between, th.e porrimu nity, the companies, the
State and the C oal Board - This partnership should be established in order
to improve the availability and accessibility of information and
assistance related to coal development and the mitigation of its impact.
Partnership could take the form of regular formal or informal meetings
between all interested parties, creation of task forces on a development
project or community basis, compilation and distribution on a timely
schedule of written reports that present information on current status of
development projects and impact mitigation plans. These activities should
be integrated into the county planning process.

3. ^gv.^iQpijient o f flexib ility/adapta.bi3.ity in lo cal institutions - Each
impacted community snould develop the capability in their local
institutions to respond effectively and efficiently to the changing
demands created by coal development. This can be done by increasing
appropriate training for both government oificials and service providers,
participation in the community wide planning process, changing local
organizational structures, incorporating representatives of newcomer
populations when possible and planning for regional delivery systems where
appropriate.

^» Devej-opment of com munity integration - Communities where disintegration is
high have greater levels of health and human service problems and often
find it difficult to maintain a community planning process. There is
considerable evidence that when an organized and structured approach is
used to involve residents, botn old and new, in community activities such
as church, clubs, recreation, government and services, the level of
integration increases. Special outreach efforts, e.g., welcome wagons,
community directories, newcomer and oldtimer impact teams, have proven
effective in other impact areas. Employment of local residents in energy
development related jobs can also promote community integration. Through
the integration process, a sense of community develops which encourages
residents to take more control in responding in general to future
challenges and specifically to the needs brought on by coal development.

5 . Tra ining local p eople to perform the new jobs created by. co al development-
Local residents should be trained for the new jobs created directly and
indirectly by coal development in their community. This allows for local
people to maintain a sense of involvement with the future of their
community. Residents who originally provided health and human services
through informal networks such as churches and service groups can be
excellent candidates for jobs that are set up to provide these services on
a more formal basis. If local people are trained to provide health and
human services, the serious problem of social service staff turnover and
its costs are greatly reduced.



6. Jncre ase in social work and mental he alth services - With change comes an
increase in stress, dislocation and other personal and group problems
which require professional assistance. Social service case studies have
shown that it is not only newcomers who require this help. Long-time
residents dramatically increase their use of social work and mental health
services.

7. Incr ease in rec reation facilities and activities - Inappropriate or
dysfunctional behaviors increase in a community with coal development,
e.g., alcohol and drug abuse and family violence. Research evidence
demonstrates that a structured recreation program which reaches all
segments of the population can serve as an effective alternative to such
inappropriate behaviors.

8. IncrjeAS.e... ;q ^preven tion servi ces - In approaching any of the needs created
by coal impact it is important to attempt responding to them with timely,


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