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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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II III IV V VI VII



I. C.oppupl.ty., .is. targeted for coal development

-develop community planning process (This applies for all the subsequent

stages)

-provide training for political officials and service providers in

responding to impact

-begin orgainizational development of servJce delivery organizations

II. Permitting pr ocess begins

-conduct feasibility studies for meeting anticipated needs which have

been determined by community planning process

-implement increased training including training for local people to fill

new jobs

-develop plans tor regional service delivery systems where appropriate

-develop partnership planning process

HI. Permit is approved and cont ract for coal si gned .(assu mes 8-12 months
.before constr uction begins)

-conduct preparation work for capital projects

-construct capital projects

-develop drug and alcohol prevention program for school curriculum

-strengthen SRS, public health, mental health programs

-develop recreation facilities

-develop primary and referral medical care

IV, Construction begins

-increase law enforcement capabilities

-increase counseling and family violence programs

-expand family planning and well child clinic services

-develop community integration programs

-develop outreach and referral services

-strengthen emergency services



51



V. Mine operati ons begin

-provide ongoing support for services that require subsidy
-assist with developing employee assistance programs
-plan for diversification of local economy
-provide services for senior citizens

VI . Ki pe op erations curtaile d an d layoffs occur

-provide job counseling and retraining
-strengthen community planning process
-strengthen mental health and SRS services

VII. Min^ o perations end

-set up job clearinghouse

-assess future development

-start planning process over again



52



Section 3: Data Methodology




DATA METHODOLOGY



The methodology used in this project directly reflects the contractor's
experience with health and human service delivery in rural areas.
Specifically, the methodology emphasizes the input of community residents and
local service providers in the defining of needs. We have found that
statistics are most appropriately used as background inform.ation to provide an
overviev/ of the area being studied. Statistics can also be important in the
design of specific service programs, however, the consideration of specific
program development was beyond the scope of this study.

The specific steps taken by the contractor to gather data on the health and
human service needs in the seven designated counties is outlined in detail
below. In addition, the statistical data sources are critiqued and their
limitations explained.

DATA COLLECTION PROCEDURES

1. Project planning - The planning phase of the project included a review of
the literature on coal development in Montana, and selected energy
development sites in other states. The project was divided into sections
according to the specifications of the contract with staff members
assigned responsibility for each section. Timelines were established for
each section.

2. Pre-data collection activities - Staff members contacted individuals who
had worked or were working with energy im.pacted communities to develop an
overvievj of health and human service problems and successful mitigation
techniques. (A complete list of persons contacted by this study is
included in the Appendices.)

3. Statistica l data collection - In late May, personal letters were sent to
department heads in State Government advising them of the project and
requesting assistance in gathering relevant information. A follow-up
telephone call was made within ten days to determine the appropriate
contact persons in each agency or organization. These persons were
contacted and data sources identified. In addition, these contact persons
were asked to specify other individuals at the federal, state or local
level who might have information or data sources pertinent to this study.
These new contacts were made, information requested, and again, the new
contacts were asked to identify other persons who should be contacted.
This process was continued until all referral contacts had been made.
Persons contacted included service providers, government agency personnel,
elected government officials, private industry representatives, and
private citizens.

The second phase of the data collection process involved reviewing the
data sources collected. Telephone contact was made with selected study
authors and state data system personnel to ask specific questions about
data interpretation, reliability and validity. Telephone contact was made
with community residents and local government personnel to verify the
interpretations received from state personnel, and to obtain a local



53



perspective on the importance of the data.

Cataloging and critiqueing the data and data sources was the final stage
in the data collection. Decisions were made to use only select primary
data sources on the basis of validity, reliability, and appropriateness.
(A complete bibliography of primary and secondary data sources is listed
in the Appendices.)

NOTE: There is a great deal of health and human service data in
existence. State and local people were extremely cooperative in making it
available. In many cases, the information desired was not available, but
had to actually be compiled.

^. Site visits - Five HDA staff members participated in the community visits.
In advance of the community visit the staff member prepared by reviewing
the county profile information Phoet, developed as a part of the
statistical data collection activity, and selected literature on boom
towns. A semi-structured set of questions was developed for use in each
county.

A series of individual and group meetings were scheduled in each of the
seven designated counties. The names of people to contact were secured by
starting with the known service providers and officials, and then asking
each of those individuals who else we should talk with. We specifically
sought out individuals who were formal or informal community leaders and
those known in the community for their involvement or concern over
development issues. The meetings included a wide range of community
residents: county and town officials, social service providers,
pro-deveiopment organizations, environmental organizations, church
leaders, school personnel and law enforcement personnel. These contacts
enabled us to hear first hand what the community members' personal
experience with energy development was. We asked them for both their
professional opinions and personal perceptions of the issues. As a
general rule, we continued the interviewing process until we heard similar
information repeated, at which time we felt we had a clear understanding
of community perspectives.

Each targeted county was visited for a minimum of two days, with a maximum
of four days. The counties with minimal impact were visited by one staff
member, the others by a team of two or more. At the completion of the
county visits, the HDA staff members met in Billings for a two day
debriefing session. This meeting enabled us to compile the information we
had gathered and summarize the various counties' experiences with impact
on health and human services.

5. Synthes is and analysis - Once the data was collected from the statistical
sources and the site visits, a series of meetings was held by project team
members to develop a composite of general and specific needs. After this
condensed list was prepared, the project team focused on the design of a
final report which would present the significant findings of this study
and also be a useful document for the review of future health and human
service proposals.



54



CRITIQUE OF DATA SOURCES

Two kinds of data are presented in this study: need data and service data.
Need is defined as the requirement of a population for a certain service based
on the incidence of a particular problem in that population. This project
used as references on health and human service needs a paper entitled "Health
Care Problems in Rural Energy Boom Towns" (Milburn, I98O) which exhaustively
catalogued health problems in energy impacted communities, and definitions
offered by different Montana service providers.

Service data is information collected by service providers relative to the
provision of a specific service. Very simply it is who is receiving what,
where, and in what manner. Service data is obtainable in two ways:
1) statewide reporting systems and 2) local provider data.

Ideally, need and service data could be combined to answer several
important questions including 1) what has been the effect over time of coal
development? 2) how do different geographic areas compare with one another?
3) what are the current unmet needs? and ^) what should be the human service
funding priorities based on the impacts of coal development and level of unmet
need?

In reality, because of a number of limitations of the data, these questions
can be answered only in the most general terms or not at all. The rest of
this section will explain why this is the case, citing generic problems and
some specific examples. A more detailed list of cautions in interpretation
for thirteen of the primary data sources used in the preparation of county
profile sheets is included in the Appendix.

LIMITS IN INTERPRETING DATA
Need Data

1. For nearly all health and human services, the definition of need is crude
at best. As an example, the State Comprehensive Plan for Drug and Alcohol
uses a figure for need of 10^ of the population. No attempt is made to
differentiate or refine this definition based on a number of factors (age,
sex, per capita alcohol consumption) which might indicate differences
between areas within the state.

2. Most statewide reporting systems concentrate on service data. Very often
this does not accurately reflect the true needs of a population. In
health and human services, utilization will increase if accessibility and
availability of services improves. Again, using alcohol as an exam.ple, it
would be wrong to assume a need for additional alcohol counseling services
does not exist based solely on clients per 1000 population.



1 . A number of state wide reporting systems were not in use during the period
of coal impact. Thus we cannot get an accurate picture of what happened
during the entire period. For example, the drug and alcohol system was
only started in 1978, as was the judicial information system.



55



2. There can be inherent "bugs" in the data systems which limit their
usefulness. For example, the Crime Index Control Report is being changed
this year because it has not been sensitive to the types of crimes found
in rural areas.

3. Local providers who send data into statewide systems caution against
placing too much reliance on these systems. They are seen as
"insensitive", or as not reflecting accurately what happens at the local
level. This can occur for a number of reasons. For example, total mental
health services may be underrepresented because state legislation provides
reimbursement to mental health centers for only certain types of services.
A substantive number of client contacts may not be reportable. Also,
local providers may interpret service definitions in a different manner.
Finally, when funding is tied to certain types of need or services,
clients may be reported in a fundable category instead of the category in
which they actually belong.

^. Much of the state data is collected on a regional or area basis. It is
extremely difficult to compare different geographic areas when dealing
with health and human service needs. For example, the area that includes
Billings has a good number of service providers, and appears to have a
much better over-all health status than may be the case. The communities
outside the Billings area may not be provided for.

5. Most state data systems are designed to provide service data, and are not
necessarily an accurate reflection of needs.

LOCAL PROVIDER DATA

1. There is no attempt at standardization, which makes it very difficult to
compare one geographic area with another.

2. When only local provider data is kept, the same system is rarely used for
more than a few years at a time. This makes evaluations over time, even
for the same program, difficult or impossible.

ALL SERVICE DATA

1. Service data becomes out of date very rapidly, often before it's
published. A listing of county health providers, for example, was found
to have one-third of its listings out of date a few months after its
publication.

2. All service data, no matter how good the system, can fluctuate widely in
response to a number of factors. Most important among them are the
availability of funding and the changes in personnel. The latter is
particularly significant in rural areas where the loss of a single person
may mean the reduction of several types of services. This can also be
true for the addition of services. For example, the Forsyth-based Drug
and Alcohol Program has added a number of new services including
parenting, communication, assertiveness, and domestic violence counseling



56



with the addition of one skilled individual.

3. Designing good service data systems— ones which are reliable, useful and
not expensive or time consuming is a difficult art. The technology of
design has changed greatly in the last ten years, presenting particular
problems for analyzing change over time.



57



Section 4: Appendices





1 1





A ft


•>'


1 A


l»*


ft A.


P



APPENDIX A: County Statistical Profiles



APPENDIX B: Bibliography of Primary and Secondary
Data Sources



APPENDIX C: Project Contact List



APPENDIX D: Annotated Bibliography of Research
Literature



COUNTi BIG HORN



CENSUS DATA



TOTAL POPULATION
CHILDREN UNDER 5
CHILDREN UNDER Itt
WOMEN 15-^^5
FERTILITY RATE
MINORITY PUPULATION
BLACK

SPAIUSH SURNAME
Af'lERICAN iMDiAN
PERSONS 62+




DATA SOURCE

1980 U.S. CENSUS

1981 MATERNAL CHILD HEALTH STUDY, DEPT. OF HEALTH AND ENVIR0NI1ENTAL SCIENCE
1970 CENSUS



NOTES

1. POt'ULATION CHANGE IN 7 COUNTY AREA 1970-1980: 14.35S

2. BIG HORN COUNTY SURROUNDS THE CROW INDIAN RESERVATION. THE NATIVE AMERICAN
POPULATION InCkEASEU FROM 3BX OF THE COUNTY POPULATION IN 19Y0 TO 46^ IN 1980.



58



COUNTY BIG HORN

ALCOHOL AND DRUGS
NEED; ■



COUNTY ! STATE AVE ! 7 COUNTY AVE! RANK



A. PER CAPITA ALCOHOL CONSUMPTION

. 1972



$^6.58



1Q76



36..86_



Jia.21



$nA.03



.19.81.



m^33.



57.53.



3^Q_



63>86



B. ALCOHOL PROGRAM ADMISSION RA.TES/1000



C. HIGHWAY PATROL DUI SUMMONS



D. ALCOHOL RELATED MOTOR VEHICLE ACCIDENTS (1978-81)

jmiAi<-_J_jA]

ACCIDENTS

INJURIES

FATALITIES

E. UNEMPLOYMENT RATE (1979-81)



1978


11.9


7.3


8.1


2


1979


2ii.6


8.0


8.6


1


1980


12,9


6.5


7.0


2


1981


6.4


6.3


5.'*


2





TOTAL


RATE/ 1000


STATE AVG./IOOO


RANK


1979


90


8.1


2.77


1


1980


S7


5.1


1.45


1


.1981


45


4,1


1.7


z



TOTAL ! RATE/ 1000 1


7 CO. AVE,


RANK


. 181 ! 16.3 !


10.5


1


87 ! 7.8 1


5.1


1


20 ! 1.8 1


_.8._... ..


1


COUNTY 1 STATE AVE 1


7 COUNTY AVE


: IRANK


..6..8 , 1 . 5.98 1


4.98


! 1



DEPT. OF INSTITUTIONS, MONTANA COMPREHENSIVE PLAN FOR ALCOHOL AND DRUG
ABUSE PREVENTION, TREATMENT A!ID REHABILITATION; DEPT. OF REVENUE: MONTANA
VITAL SSTATISTICS; DEPT OF JUSTICE, HIGHWAY SAFETY DIVISION; CENSUS DATA;
DEPT. OF ADMINISTRATION,
SERV ICE DATA

A. PROVIDERS

OUTPATIENT: BIG HORN COUNTY HEALTH DEPARTMENT -FAMILY COUNSELOR AND
ALCOHOL AND DRUG THERAPIST

INPATIENT: DEPENDS ON ABILITY OF CLIENT TO PAY, AND CLIENT PREFERENCE.
RIMROCK, (BILLINGS), GALEN, GLASGOW, HILLTOP (HAVRE)

B. ACTIVITY REPORTS:

# OF FIRST ADMISSIONS TO ALCOHOL PROGRAMS DURING 1981 124

NOTES :

1. ALCOHOL/DRUG COUNSELOR NOT AVAILABLE DURING RILL YEAR IN I98I.

2. THE FIRST ADMISSIONS TOTAL FOR 1981 IS AN ESTIMATE BASED ON THE CLIENT
CONTACTS DURING THE THREE MONTH PERIOD FROM JUNE THROUGH AUGUST OF 1982.

3. AFTERCARE AND CONCERNED PERSONS GROUPS HAVE BEEN STARTED, AND MEETINGS ARE
BEING HELD IN THREE TOWNS IN THE COUNTY.



59



COUNTY ^jG HORN



CRIMINAL JUSTICE



HEED:

A. 1980 CRIME INDEX REPORT



CRIMES AGAINST PERSONS
CRIMES AGAINST PROPERIT
TOTAL CRIMES



CRIME HATE per 100,000



SWKH.



-2^j22^



_3mL,I.



STATE AVERAGE



_ai5^7






J^DDMl AVE! RANK



jmA.



J3L\t^.



.3607...1



1



C. PROBATION AND PAROLE CASELOADS

_JQBL-Cim^AP-l-iy£PAgE/MO.

1 97 8 8 06 J ^^.

1 97 9 86Q [__Zi..ii_

1980 1030 ! 85. 8

1981 1069 ! 89.1



-35A



J7.Q1



46.88



D. DISTRICT COURT CASELOAD (1978-81)



k YEAR 4 YR



RATE/



AVE/ CO 7 CO.



CRIMINAL CASES
DOMESTIC RELATIONS
JUVENILE PROBATION
ADOPTION
TOTAL CASES



TOTAL


AVE.


1,000


HQjiiOXiJ.


AVE


RANK


176


i|4


3. 96


3.58 !


_A,58„ .


4


380


95


i_£*36 ,


9.93 !


8^9


5




11.7


1.06


^_UJ__1


K23


5


2"^


6.25


.56


.88 1


_^.82__j


3


1228


1-3PI 1


.ZL.^...


34.2 I


_34-^_-j


. ,2..



DATA S OURCES

DEPT. OF JUSTICE: CRIME INDEX REPORT; DISTRICT COURT CASELOAD STATISTICS;
DEPT. OF JUSTICE: OFFENSE AND ACTIVITY REPORT (STARTING 7/1/82);
DEPT. OF INSTITUTIONS: PAROLE AND PROBATION CASELOAD STATISTICS.

SERVICE DATA

A. PROVIDERS:

COUNl'Y SHERIFF: WALT RIDER

DISTRICT COURT # 13; JUDGES-'//M. SPEARE; ROBT. WILSON; CHAS. LUEDKE

COUNTY ATTORNEY: JAMES SEY.<OrJv

JUVENlLh PROBATION OFFICER/S: MS. ANN BULLIS

NOTES

1. CRIMES AGAINST PERSONS ARE Tl^IICE THE STATE AVERAGE.

2. SEX CRIMES ARE 2.5 TIMES THE STATE AVERAGE.

3. CRIME INDEX REPORT DOES NOT INCLUDE THE CROW INDIAN RESERVATION.



60



COUNTY BIG HORN



MENTAL HEALTH SERVICES



NEEP;



A. 1981 PER CAPITA ALCOHOL CONSUMPTION $44.99!

B. 1981 HIGHWAY PATROL DUI SUMMONS/ 1 000_

C. AVERAGE ALCOHOL ADMISSION

RATES/ 1,000 (1978-81)

D. POPULATION CHANGE 1970-80

E. UNEMPLOYMENT RATE 1979-80

F. 1981 JUVENILt PROBATION CASES

RATE/ 1000

G. CRIME INDEX REPORT

CRIMES AGAINST PERSONS

CRIMES AGAINST PROPERTY

TOTAL CRIMES
H. DOMESTIC VIOLENCE REPORTS/ 1000
I. 1981 CHILD ABUSE AND NEGLECT

REFERRALS/ 1000
J. DOMESTIC RELATIONS CASES (1978-810
K. WARM SPRINGS ADMISSION RATE/ 1000

(1978-81;
L. PERCENT BELOW POVERTY 1977



M. SOCIAL WORKER/ POPULATION RATIO
J. MENTAL HEALTH WORKER/POP RATIO
FAMILY COUNSEL.OR
PSYCHIATRIC SOCIAL WORKER
CLINICAL PSYCHOLOGIST



CPU ^r^ !


ST AVE


1 7 CO AVE !


PANK


: $44.99!


$57.53


! $63.68 1


2


)0 4.4 1


1.7


1 3.7 !


6


n.q !


7.0


! 7.25 !


6


10.^ !


13.2


! 14.3 !


?


6.8 !


5.98


1 4.98 1


7


10.8 !


NA


! 9.9 !


3


425.51


_215_,7


! 198.1 1


7


2602.,3J_4462_,7


I 2346.2 !


5


^780.71


7199.9


! '607.1 !


5


3.4 1


.33


1 1.04 1


7


.10.8 !


NA


! 6.3 !


1


8.56 I


10.8


1 8.9 !


5


_A2„L


.73


1 .50 1


6


25 1


15.3


! 17.85 !


2


COUNTY


1

1


REC. STANDARD




1/5500 !


1/6000




1/5500 1


1/5000







1
1


M3Q00







1

1


1/20.000





_SEEIIC£_DAIAl



A. UNITS OF SERVICE PROVIDED

B. ADMISSIONS TO CENTER

C. ADMISSION RATE/ 1,000

E. CLIENT DATA: NOT AVAILABLE

F. WARM SPRINGS ADMISSIONS I98I



NOT AVAILABLE
18.6 7 CO RATE18.12



7 CO RANK 1



DATA SOURCES:

CENSUS; COMPREHENSIVE STATE ALCOHOL/DRUG PLAN; CRIME INDEX REPORT;
DEPT OF INSTITUTIONS, JUVENILE PROBATION REPORTS; SRS, DOMESTIC VIOLENCE
REPORTING SYSTEM; SRS, CHILD PROTECTION SPECIALISTS RECORDS; BIG HORN COUNTY
HEALTH DEPARTMENT.

NOTES:

1. CRIME INDEX DOES NOT INCLUDE THE CROW INDIAN RESERVATION.

2. BIG HORN COUNTY MENTAL HEALTH SERVICES ARE PROVIDED BY THE COUNn HEALTH
DEPARTMENT. THEY DO NOT USE THE STANDARDIZED REPORTING SYSTEM OFTHE REGIONAL
MENTAL HEALTH CENTERS.

3. CHILD ABUSE AND NEGLECT RANKING DOES NOT INCLUDE ROSEBUD OR TREASURE
COUNTIES.



61



COUNTY BIG HORN



DOMESTI C VIOLENCE
(SPOUSE ABUSE, CHILD ABUSE AND NEGLECT, FAMILY DISTURBANCES)



NEED

A. ALCOHOL ADMISSION RATE/ 1,000

(1978-81)

B. UNEMPLOYMENT RATE (1979-81)

C. MENTAL HEALTH ADMISSIONS 1981



COUfTTY ! STATE AVE ! 7 COUNTY AVE! RANK



11.9



6.8



18.6



JLXL



3.M.



7.25



A58.



NA



18.12



D. TOTAL MARRIAGES/ RATE/ 1000
E. MARITAL TERMINATIONS/ RATE
PER 1000



1972


197S 11979 !1979 STATE AVE


77/ 7.9


70/ 6. ill 82/ 7.M! 10.4


76/ 7.8


6V 5,81 61/ 5,51 6,5



F. DISTRICT COURT DOMESTIC

RELATIONS CASES (1978-81)



4 YR AVERAGE 1 RATE/ 10001 7 CO AVE 1 RANK



_380



-__8,56.



_8^



D ATA SOURCES

SRS

SRS CHILD CARE SERVICES

COUNTY WELFAkE SOCIAL WORKER CASELOAD REPORTS

CRIME INDEX, DEPT. OF JUSTICE

MONTANA VITAL STATISTICS, DEPT. OF HEALTH & ENVIR. SCIENCES

EASTERN MONTANA SPOUSE ABUSE PROGRAM.



SERVICE DATA

A. REPORTED CASES OF SPOUSE ABUSE SEPT. I98I - APRIL I982 262

B. SPOUSE ABUSE CASES/ 1000/MO ^.4 COUNTY RANK

C. CHILD ABUSE/NEGLECT REFERRALS I98I 120
C. FOSTER CARE PLACEMENTS 10
NOTES



1 . CHILD ABUSE AND NEGLECT REFERRALS WERE ESTIMATED BY THE COUNTY WELFARE
DIRECTOR AT APPROXIMATELY 10 PER MONTH. THERE IS NO STATISTICAL REPORTING TO
ACCURATELY TRACK ALL REFERRALS.



62



COUNTY BIG HORN



EMERGENCY MEDICAL SERVICES



ne; ed;



1978-81 MOTOR VEHICLE ACCIDENTS
INJURY ACCIDENTS
FATAL ACCIDENTS

1977-79 STROKE FATALITIES
1977-79 HEART DISEASE DEATHS
1977-79 ACCIDENTAL DEATHS



TOTAL !


RATE/
1,000


STATE
AVE !


7 CO

AVERAGE


RANK


862 1


19.4


28. ^>9 1


18.1


5


280 !


6.^


8.52 !


6.1


6


^2 !


.72


.^4 I


.49


^


15 !


69.0


7^.9 I


85.3


2


81 !


249.0


^03.8 1


29^.5


2


n^ 1


132,0


74.1 1


94,1


6



SERVICE DATA:



A. //OF TRIPS/ YEAR
% EMERGENCY



COUNTY


! RATE/ 1000


! 7 CO AVE


R/^K


1800


1 162.2


! 78.28


1


m


1

1


I 53.3


3



B. MAJOR REASON FOR TRIP:

C. PERSONNEL:

// OF CERTIFIED EMT'S: 8 INCLUDING 1 PART-TIME RN & 1 PART-TIME LPN

// OF CERTIFIED FIRST RESPONDERS:

# OF ADVANCED FIRST AID:

ADMINISTRATIVE PERSONNEL: FULL-TIME DIRECTOR WITH ADMINISTRATIVE SUPPORT.

D. QUICK RESPONSE UNITS:



E. HOSPITALS USED: BILLINGS 60%

SHERIDAN 405&



PATA SOUPCE?:

COUNTY AMBULA.NCE SERVICE TRIP REPORTS

DEPT. OF JUSTICE, HIGHV/AY TRAFFIC SAFETY, MOTOR VEHICLE ACCIDENT SUMMARY
REPORT
MONTANA VITAL STATISTICS, DHES, BUREAU OF RECORDS AND STATISTICS

NOTES:

1. BIG HORN COUNTY AMBULANCE PRIVATELY OWNED. CONTRACTS WITH COUNTY AND COUNTY
PROVIDES BUILDING AND FUEL.

2. BIG HORN COUNTY FIREMEN NOT EMT TRAINED.

3. EQUIPMENT: (2) TYPE 2 VANS— 1980, 1982

(1) TYPE 1 4WD MODULAR WITH ADVANCED LIFE SUPPORT SYSTEM~1980

(1) TYPE 4 4WD SUBURBAN - ! 978

HELICOPTER SERVICE AVAILABLE TO BILLINGS.

4. AMBULANCE COMMUNICATES WITH HOSPITAL WHICH CONTACTS PHYSICIAN.



63



COUNTY BIG HORN



fRTMARY HEALTH SERVICES



NEED:

A. HEALTH STATUS INDICATOR RANKING: 54

B. DHHS MEDICALLY UNDERSERVED DESIGNATIONS: PRIORITY LEVEL 1



C.

D.
E.
F.
G.

H.

I.
J.
K.



INFANT MORTALITY RATE (1976-81 )_. 1.9., 9,



COUNTY ! STATE AV|:_



J6JL



INFANT DEATHS (1977-80) /1000 L6j8.

LOW BIRTH WT (1977-80/1000
PERCENT BELOW POVERTY (1977)
ADC RECIPIENTS, MONTHLY I98I

PER 100,000
MEDICAID RECIPIENTS, MONTHLY

1981/ 100,000
WOMEN 15-45/1000

% POPUUTION > 62 YEARS OF AGE

GENERAL FERTILITY RATE _129-^



16,6.



JS-u2.



_COUNIY_
K. PHYSiCIA!^ POPUUTION RATIO 1/1000



J3^



_58.3-



J5^



J-^



_24.5__



20 .0_



90.0



.7. CO AVE



.XLS.



J3.8_



JUL



JLL^



.kA.



A3lJ,



JSLIL



_12.2



iL8J.



RANK



1



•'n'i]'F_AXF_J RECQMME NDED STANDARD
1j/J 50 i IZESfiS



SERVICE DATA:



A.
B.
C.
D.



E.



LICENSED PHYSICIANS 5

ACTIVE LICENSED NURSES: RN'SJii LPN'S 18 PHN'SJ

DENTAL PRACTICES: FULL-TINE _2_ PART TIME_1 SPLITS-
HOSPITALS: BIG HORN COUNTY MEMORIAL, 16 BEDS

INPATIENT ADMISSIONS ^^4

EMERGENCY ROOM VISITS 1 t707

% OCCUPANCY ^q.5%

SURGICAL PROCEDURES INP/OUTPT 122/0
NURSING HOMES: BIG HORN COUOTY MEMORIAL HOSPITAL ;( NEW NURSING HOME DUE TO
OPEN OCTOBER 1, 1982)

tf OF BED DAYS 11 .691

% OCCUPANCY 9^.9

EXPENSE/ PT DAY $8.26

ADMISSIONS ^n



F. LIVE BIRTHS (1979)

G. INDUCED ABORTIONS (I98I)



^QMI11^MLIJ.W013MI^-MLjJLSD-ML



.250.



2Z^



JJ^



JO^


1 2 3 4 6 8 9 10 11 12

Online LibraryMontana. Coal BoardHealth and human service needs in coal impact areas in Eastern Montana : a report to the Montana Coal Board (Volume 1982) → online text (page 6 of 12)