West Virginia Statewide Needs Assessment For Home Visitation Programs (2010)

WEST VIRGINIA HOME VISITATION PROGRAM STATEWIDE NEEDS ASSESSMENT HRSA AWARD # 1 X02MC19425-01-00
September 20, 2010
West Virginia Department of Health & Human Resources Bureau for Public Health Office of Maternal, Child & Family Health 350 Capitol Street, Room 427 Charleston, West Virginia 25301 (304) 558-5388
Table of Contents Introduction ..................................................................................................................................... 6 HOME VISITATION ................................................................................................................. 6 Section One: Statewide Data Report............................................................................................... 8 Section Two: Identify the unit selected as community ............................................................. 11 Definition of Community .............................................................................................................. 11 At-Risk Community .................................................................................................................. 11 Maternal and Child Health ............................................................................................................ 11 Premature Births ........................................................................................................................ 12 Low Birth Weight...................................................................................................................... 14 Infant Mortality ......................................................................................................................... 16 Poverty ...................................................................................................................................... 18 Crime ......................................................................................................................................... 21 Domestic Violence .................................................................................................................... 26 Rates of high school dropouts ................................................................................................... 28 Substance Abuse.28 Unemployment .......................................................................................................................... 45 Child maltreatment........................................................................................................................ 46 Section Three: Data Reports for each at risk Community ............................................................ 56 Boone County............................................................................................................................ 56 Cabell County ............................................................................................................................ 59 Clay County............................................................................................................................... 62 Fayette County .......................................................................................................................... 65 Gilmer County ........................................................................................................................... 68 Kanawha County ....................................................................................................................... 71 Lincoln County .......................................................................................................................... 74 Logan County ............................................................................................................................ 77 McDowell County ..................................................................................................................... 80 Mason County ........................................................................................................................... 83 Mercer County........................................................................................................................... 86
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WVDHHR/BPH/OMCFH/HRSAAward#1X02MC194250100
Mineral County ......................................................................................................................... 89 Mingo County ........................................................................................................................... 92 Nicholas County ........................................................................................................................ 95 Raleigh County .......................................................................................................................... 98 Ritchie County......................................................................................................................... 101 Summers County ..................................................................................................................... 104 Upshur County ........................................................................................................................ 107 Wayne County ......................................................................................................................... 110 Wetzel County ......................................................................................................................... 113 Wood County .......................................................................................................................... 116 Wyoming County .................................................................................................................... 119 Section Four: Quality and Capacity of Existing Programs/Initiatives for Early Childhood Home Visitation in Each of the Communities Identified as Being At Risk .......................................... 122 Existing Programs ................................................................................................................... 122 Name of the Program Partners In Community Outreach ................................................ 123 Home Visiting Model or Approach In Use ......................................................................... 123 Specific Services Provided ................................................................................................. 123 Intended Recipient of the Service ....................................................................................... 123 Targeted Goals/Outcomes of the Intervention .................................................................... 123 Demographic Characteristics of Individuals or Families Served ....................................... 123 Number of Individuals or Families Served ......................................................................... 123 Geographic Area Served ..................................................................................................... 123 Name of the Program Healthy Families America ............................................................ 124 Home Visiting Model or Approach In Use ......................................................................... 124 Specific Services Provided ................................................................................................. 124 Intended Recipient of the Service ....................................................................................... 124 Targeted Goals/Outcomes of the Intervention .................................................................... 124 Demographic Characteristics of Individuals or Families Served ....................................... 124 Number of Individuals or Families Served ......................................................................... 125 Geographic Area Served ..................................................................................................... 125
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The Name of the Program Maternal Infant Health Outreach Worker ............................ 126 Home Visiting Model or Approach In Use ......................................................................... 126 Specific Services Provided ................................................................................................. 126 Intended Recipient of the Service ....................................................................................... 126 Targeted Goals/Outcomes of the Intervention .................................................................... 126 Demographic Characteristics of Individuals or Families Served ....................................... 126 Number of Individuals or Families Served ......................................................................... 127 Geographic Area Served ..................................................................................................... 127 Name of the Program Parents As Teachers ..................................................................... 128 Home Visiting Model or Approach In Use ......................................................................... 128 Specific Services Provided ................................................................................................. 128 Intended Recipient of the Service ....................................................................................... 128 Targeted Goals/Outcomes of the Intervention .................................................................... 128 Demographic Characteristics of Individuals or Families Served ....................................... 128 Number of Individuals or Families Served ......................................................................... 128 Geographic Area Served ..................................................................................................... 129 Name of the Program Head Start/Early Head Start ........................................................ 130 Home Visiting Model or Approach In Use ......................................................................... 130 Specific Services Provided ................................................................................................. 130 Intended Recipient of the Service ....................................................................................... 130 Targeted Goals/Outcomes of the Intervention .................................................................... 130 Demographic Characteristics of Individuals or Families Served ....................................... 131 Number of Individuals or Families Served ......................................................................... 131 Geographic Area Served ..................................................................................................... 131 Name of the Program Right From The Start Program .................................................... 133 Home Visiting Model or Approach In Use ......................................................................... 133 Specific Services Provided ................................................................................................. 133 Targeted Goals/Outcomes of the Intervention .................................................................... 133 Demographic Characteristics of Individuals or Families Served ....................................... 133 Number of Individuals or Families Served ......................................................................... 133
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Geographic Area Served ..................................................................................................... 134 Name of the Program Healthy Start/Helping Appalachian Parents & Infants ............... 135 Home Visiting Model or Approach In Use ......................................................................... 135 Specific Services Provided ................................................................................................. 135 Intended Recipient of the Service ....................................................................................... 135 Targeted Goals/Outcomes of the Intervention .................................................................... 135 Demographic Characteristics of Individuals or Families Served ....................................... 135 Number of Individuals or Families Served ......................................................................... 136 Geographic Area Served ..................................................................................................... 136 Section Five: Narrative Description of the States Capacity for Providing Substance Abuse Treatment and Counseling Services to Individuals/Families in Need of These Services Who Reside in Communities Identified as Being At Risk in Terms of Substance Abuse .................. 137 Section Six: Narrative Summary of Needs Assessment Results, Including a Discussion of How the State Will Address Unmet Needs.......................................................................................... 138 SOURCE & METHODOLOGY................................................................................................. 140 Descriptions of Study Counties ............................................................................................... 144 Appendix A County Economic Levels ................................................................................ 148 Appendix B Letters of Support151 Appendix C WV Bureau for Behavioral Health & Health Facilities..156 Appendix D Home Visitation Model Profiles..159
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Introduction HOMEVISITATION
As designated by the WV DHHR on behalf of Governor Joe Manchin III, the Office of Maternal, Child and Family Health (OMCFH) has the assignment of the lead agency to coordinate, develop and implement the West Virginia Home Visitation Program. The primary focus of this Program will be to increase the infrastructure within our state to expand home visitation services to clients residing in highest at risk counties determined by the results of this comprehensive Statewide Needs Assessment. The home visitation models/programs currently providing services within West Virginia include: Right From he Start Program (the States Medicaid perinatal case management home visitation program; Partners in Community Outreach (Healthy Families America; Maternal Infant Health Outreach Workers; and Parents as Teachers), Early Head Start, and Healthy Start/Helping Appalachian Parents and Infants (HAPI) Project. High quality home visiting programs are an effective service delivery method to support healthy development in early years, ensuring that children succeed in school and beyond. . . infants and toddlers who participate in high quality home visiting programs are shown to have increased cognitive development, greater likelihood to enroll in preschool programs, increased school readiness at kindergarten entry, higher IQs and language scores at age six, higher grade point averages and math and reading achievement test scores at age nine, and higher graduation rates from high school. This determination has been documented in numerous research studies (Biluka 2005; VanLandgehem 2002, Hagan, Shaw and Duncan 2008; Zero to Three 2008). The most extensive research based evaluation was completed by the CDCs Task Force on Community Prevention Services which determined Early childhood home visitation has been used to address a wide range of public health goals for both visited children and their parents, including not only violence reduction, but also other health outcomes such as educational achievement, problem-solving skills and greater access to resources (Bilukha 2005, 11). The Task Force viewed it as essential that these visits must begin at least within the childs first two years of life but preferably prior to birth. A successful home visitation program consists of a two generational approach of addressing problems and introducing interventions of mutual benefit to parents and children consisting of: Training of parent(s) on prenatal and infant care Training on parenting skills Developmental interaction with infants and toddlers Family planning assistance Development of problem-solving and life skills
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Education and work opportunities Linkage with community services The Task Force also identified the barriers to the effectiveness of home visitation found in the literature as being: Difficulties in retention of participants resulting from moving and lack of incentives to remain in the visitation program Turnover of program staff due to low salaries, travel, burnout and physical danger Use of under-qualified staff which is a point underscored by the NCSL which found that programs delivered by professionals (nurses and social workers) were much more effective than those delivered by paraprofessionals or volunteers (William-Mbengue 2004). The National Governors Associations Center for Best Practices found early home visitations were effective in reducing the costs to state governments due to better foster care placements, reduced use of hospitalization and emergency room visits and unintended pregnancies (Cornell 2002). Their report stressed the importance of integrating home visiting with other early childhood programs and the need to improve the quality of the programs. Both of these suggestions were supported by Zero to Three (2008). There has been considerable attention focused on home visitation in West Virginia (Heasley 2007). West Virginia Senate Bill 4242 was implemented and established in 1990. Under those provisions, WVDHHR, Bureau for Public Health, OMCFH (the WV Title V Agency) was assigned responsibility for administering the prenatal care services and coordination for low income women and their infants through the establishment of the Right From the Start Program. In 2005, the West Virginia Legislature passed a resolution to study the need to expand In-Home Family Education. Partners in Community Outreach, a coalition of home visitation programs in the State (Healthy Families, American Maternal Infant Health Outreach workers and Parents as Teachers), was formed to promote the establishment of a statewide system of In-Home Family Education to provide high quality and voluntary home visiting services. For purposes of conducting this comprehensive statewide Needs Assessment, OMCFH completed a contractual agreement with Marshall University Center for Business and Economic Research (CBER) to provide an objective analysis of West Virginia communities at risk of poor maternal, infant and child outcomes as well as various factors influencing those critical outcomes. The West Virginia Home Visitation Program involved multiple varied stakeholders to ensure a collective inventory of the required needs assessments (Title V MCH Block Grant needs assessment; community strategic planning/needs assessments conducted in accordance with the Head Start Act; Inventory of unmet needs and prevention focused programs to prevent child abuse and neglect under CAPTA), as well as multiple other available state/community resources that reflected the quality and capacity of West Virginia home visitation services.
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SectionOne:StatewideDataReport
West Virginia SAMHSA SubState Treatment Planning Data Reports
Indicator
Title V
CAPTA
Head Start
Other
Comments
Premature birth -Percent: # live births before 37 weeks/total # live births Low-birth-weight infants -Percent: # resident live births less than 2500 grams/# resident live births Infant mortality (includes death due to neglect) -# infant deaths ages 0-1/1,000 live births Poverty -# residents below 100% FPL/total # residents -# residents <18 below 100% FPL/total # residents <18 -#residents ages 5-17 below 100% FPL/total # residents age 5-17 Crime - # reported crimes/1000 residents - # crime arrests ages 0-19/100,000 juveniles age 0-19 ----47,529/pop 2,244/pop 18.0% 22.0% ----17.4%2 23.9%2 20.6%2 7.4 ---7.721 9.5% ---9.55%1 11.9% ---11.84%
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Indicator
Title V
CAPTA
Head Start
Other
Comments
Domestic violence -As determined by each State in conjunction with the State agencies administering the FVPSA School Drop-out Rates -Percent high school drop-outs grades 9-12 -Other school drop-out rates as per State/local calculation method Substance abuse -Prevalence rate: Binge alcohol use in past month -Prevalence rate: Marijuana use in past month -Prevalence rate: Nonmedical use of prescription drugs in past month - Prevalence rate: Use of illicit drugs, excluding Marijuana, in past month Unemployment -Percent: # unemployed and seeking work/total workforce 10.5% Child maltreatment -Rate of reported of substantiated maltreatment (substantiated/indicated/alt response victim) -Rate of reported substantiated maltreatment by type Child fatalities 7,109 victims 387,184 (child pop) in 2007 -13.7 per 1,000 1.29 per 100,000 --10.3% -----
17.0 2.8 2.8 ---
19.66 5.38 ---5.46 4.32
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--
--
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Indicator
Title V
CAPTA
Head Start
Other
Comments
Other indicators of at risk prenatal, maternal, newborn, or child healthAs available

1
2
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--
--
--
--
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West Virginia Department of Vital Statistics (2008) US Census
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SectionTwo:Identifytheunitselectedascommunity DefinitionofCommunity
For the comprehensive statewide Needs Assessment for home visitation services, a community is defined on a county level due to a combination of functional and logistical constraints. The absence of large, urban, metropolitan centers and municipalities in the State have historically reduced both the ability and incentive to collect data at levels disaggregated below that of the county. In several cases, data disaggregation below the state level has been limited by data provision by various sources into multi-county regions. For both the sake of consistency across data variables and simplicity in collection and aggregation activities, the county was chosen as the appropriate level of examination.
AtRiskCommunity
An at-risk community is defined as a community (county) for which indicators, in comparison to the statewide metric for a given variable or concept, demonstrates the potential level of greater risk than the State as a whole. The distinction is based upon a comparison of community specific and statewide average data. At-risk communities, by this functional definition, exhibit measures determined to be "worse off" than either the State average or the median distribution of observed levels of performance across the State's 55 counties. The counties identified as at-risk in West Virginia are:
Boone Cabell Clay Fayette Gilmer Kanawha Lincoln Logan Mason McDowell Mercer Mineral Mingo Nicholas Raleigh Ritchie Summers Upshur Wayne Wetzel Wood Wyoming
MaternalandChildHealth
Maternal smoking, alcohol and substance abuse are major issues impeding early child development. One major study indicated that the cost benefit return on smoking cessation programs was $3 to $1. Unfortunately, West Virginia has the highest level in the nation of women who smoke while pregnant. Smoking while pregnant is a major cause of premature birth and LBW babies. It is also the greatest cause of perinatal death. The evidence shows that public
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education programs are not particularly effective, and the best delivery system is in-home visitation. Alcohol and substance abuse follow closely behind smoking as a cause of unfortunate birth outcomes. At least 4 percent of pregnant women use illicit drugs and 30 percent consume alcohol, often combined with smoking. In the words of the American College of Obstetrics and Gynecology this is the single largest preventable cause of developmental compromise of infants in the U.S.
PrematureBirths
Research confirms increased risks of morbidity and mortality among late-preterm infants. While infants born from 34 to 36 weeks gestation can be the size and weight of some full-term infants, a report published by the American Academy of Pediatrics notes that they are less physiologically and metabolically mature than infants born at 37+ weeks of gestation and at higher risk of developing medical complications during and after birth. Cerebral palsy is three times more likely among these infants than among full-term infants. Respiratory problems are more common in late-preterm infants, as are feeding problems, jaundice, and re-hospitalization during the neonatal period. For 2004-2008, Table 1 shows a state average rate of 12.2 percent of births were preterm (less than 37 weeks gestation). The lowest overall rate of 7.0 percent is shown in Grant County with the highest rate of 18.0 percent in Wayne County.
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Table1PrematureBirthsinWestVirginia Preterm<37weeks(20042008)
County Wayne Pleasants Cabell Mason Lincoln Putnam Kanawha Mercer McDowell Clay Tyler Nicholas Mingo Ritchie Boone Jackson Wetzel Wood Logan Mineral Wyoming West Virginia Wirt Fayette Gilmer Raleigh Brooke Roane Births 2,282 350 5,988 1,564 1,409 3,179 11,798 3,702 1,476 675 455 1,518 1,853 545 1,629 1,653 949 4,992 2,160 1,544 1,300 106,185 282 2,902 358 4,629 1,115 834 Preterm (< 37 Weeks) 409 59 960 240 212 469 1,687 528 209 95 64 212 249 74 214 219 125 653 278 195 164 12,914 34 347 43 554 128 93 Percent Preterm 18.0% 16.9% 16.1% 15.4% 15.1% 14.8% 14.3% 14.3% 14.2% 14.1% 14.1% 14.0% 13.7% 13.6% 13.2% 13.2% 13.2% 13.1% 12.9% 12.7% 12.6% 12.2% 12.1% 12.0% 12.0% 12.0% 11.5% 11.2% Rank 1 2 3 4 5 6 7 8 9 11 10 12 13 14 17 15 16 18 19 20 21 22 24 23 25 26 27 County Ohio Pendleton Monroe Monongalia Morgan Braxton Marshall Harrison Lewis Berkeley Calhoun Webster Summers Randolph Barbour Greenbrier Marion Taylor Upshur Tucker Preston Doddridge Jefferson Hancock Pocahontas Hardy Hampshire Grant Births 2,429 368 686 4,564 811 769 1,663 4,190 998 6,871 393 520 570 1,657 883 1,937 3,125 777 1,374 322 1,680 354 3,370 1,634 452 796 1,224 627 Preterm (< 37 Weeks) 268 41 73 477 84 80 172 431 103 696 40 53 56 162 86 188 303 74 130 30 154 32 301 138 38 59 87 44 Percent Preterm 11.1% 11.1% 10.7% 10.5% 10.5% 10.4% 10.4% 10.3% 10.3% 10.2% 10.2% 10.2% 9.9% 9.8% 9.7% 9.7% 9.7% 9.5% 9.5% 9.3% 9.2% 9.0% 9.0% 8.5% 8.4% 7.4% 7.1% 7.0% Rank 29 28 30 32 31 33 34 36 35 38 39 37 40 41 43 42 44 45 46 47 48 49 50 51 52 53 54 55
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Figure1WVPretermBirthsByCounty,20042008
Hancock Brooke
WestVirginiaTotal:12.2%
Ohio
PercentageofPretermBirthsbyCounty WestVirginiaResidentBirths,20042008
Lowest:GrantCounty(7.0%)
Marshall Monongalia Marion
Wetzel Pleas ants Tyler Dodd ridge
Morgan Preston Mineral Hampshire Tucker Grant Hardy
Berkeley Jeff erson
Highest:Wayne County(18.0%)
Harrison
Taylor Barbour
Wood Wirt Jackson
Ritchie
Cal houn Roane
Gilmer
Lewis Upshur Randolph Pendleton Webster
Mason
Braxton
>=14.1% 12.2% 14.0% 10.1% 12.1%
Putnam Cabell Kanawha Wayne Lincoln Boone Mingo Logan
Clay Nicholas
Pocahontas
<=10.0%
Fayette Greenbrier Raleigh
Lessthan37weeksgestation. Percentagecalculatedasoftotalbirthsexcluding unknowngestation. WestVirginiaBureauforPublicHealth HealthStatisticsCenter,2010
Wyoming
Sum mers Mercer
Monroe
McDowell
LowBirthWeight
Low birth weight (LBW) has been determined to be the principal cause of infant mortality and a leading cause of childhood illness. Women who receive prenatal care in the first trimester were four times more likely to have positive infant health outcomes as those who did not (Lowry and Beikirch 1998). This result was confirmed in a study of undocumented immigrants which found women without prenatal care were four times more likely to deliver a low birth weight baby and seven times more likely to deliver a premature infant (Lu 2000). Table 2 displays the state average rate of 9.5 percent of babies in West Virginia born with low birth weight from 2004-2008. The lowest overall rate of 5.9 percent is shown in Grant County with the highest rate of 13.8 percent occurring in Wayne County.
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Table2LowBirthWeightinWestVirginia(2008)
County Wayne Mercer McDowell Logan Mason Mingo Cabell Wyoming Pocahontas Pleasants Lincoln Nicholas Wetzel Kanawha Mineral Fayette Summers Boone Doddridge Raleigh Tyler Wood Gilmer West Virginia Clay Brooke Marion Greenbrier Births 2,282 3,702 1,476 2,160 1,564 1,853 5,988 1,300 452 350 1,409 1,518 949 11,798 1,544 2,902 570 1,629 354 4,629 455 4,992 358 106,185 675 1,115 3,125 1,937 Low BW 312 475 189 268 182 211 692 141 48 37 145 156 97 1,196 156 291 57 162 35 454 44 483 34 10,097 63 103 284 174 Percent LBW 13.8% 12.8% 12.8% 12.4% 11.7% 11.6% 11.6% 10.9% 10.6% 10.6% 10.3% 10.3% 10.2% 10.2% 10.1% 10.0% 10.0% 10.0% 9.9% 9.8% 9.7% 9.7% 9.5% 9.5% 9.3% 9.3% 9.1% 9.0% Rank 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 County Randolph Ohio Harrison Lewis Marshall Putnam Tucker Webster Calhoun Preston Jackson Monroe Upshur Barbour Ritchie Pendleton Monongalia Wirt Braxton Morgan Berkeley Hancock Jefferson Taylor Hardy Hampshire Roane Grant Births 1,657 2,429 4,190 998 1,663 3,179 322 520 393 1,680 1,653 686 1,374 883 545 368 4,564 282 769 811 6,871 1,634 3,370 777 796 1,224 834 627 Low BW 149 216 372 88 147 277 28 45 34 143 139 57 110 70 43 29 357 22 59 61 515 121 239 54 55 84 57 37 Percent LBW 9.0% 8.9% 8.9% 8.8% 8.8% 8.7% 8.7% 8.7% 8.7% 8.5% 8.4% 8.3% 8.0% 7.9% 7.9% 7.9% 7.8% 7.8% 7.7% 7.5% 7.5% 7.4% 7.1% 6.9% 6.9% 6.9% 6.9% 5.9% Rank 28 29 30 31 32 33 34 35 36 37 38 39 40 41 42 43 44 45 46 47 48 49 50 51 52 53 54 55
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Figure2WVLowBirthWeightbyCounty,20042008
Hancock Brooke
WestVirginiaTotal:9.5%
Ohio
PercentageofLowBirthweightbyCounty WestVirginiaResidentBirths,20042008
Lowest:GrantCounty(5.9%)
Marshall Monongalia Marion
Morgan Preston Mineral Hampshire Tucker Grant Hardy
Berkeley Jeff erson
Highest:Wayne County(13.8%)
Harrison
Taylor Barbour
Wood Wirt Jackson
Ritchie
Cal houn Roane
Gilmer
Lewis Upshur Randolph Pendleton Webster
Mason
Braxton
>=10.3% 9.5% 10.2% 8.3% 9.4%
Clay Nicholas
Pocahontas
<=8.2%
Lessthan2,500grams. Percentagecalculatedasoftotalbirthsexcluding unknownbirthweight. WestVirginiaBureauforPublicHealth HealthStatisticsCenter,2010
Wyoming
Sum mers Mercer
Monroe
McDowell
InfantMortality
Infant mortality is the result of a complex set of biological and social factors, and infant deaths have long been viewed as an important indicator of a populations health. While the rest of the Nation has shown an almost steady decline in the rate of infant mortality since 1994, West Virginias rate has remained slightly above the national average for each of the last 10 years. Because of the relatively low numbers of births in West Virginia, it is best to look at infant mortality rates in five-year averages as shown in Table 3. West Virginias five-year average infant mortality rate was 7.6 (per 1,000 live births). Table 3 ranks the infant mortality rate by county in West Virginia from the highest of 15.5 in Pocahontas County to lowest rate of 1.2 in Roane County. For 2008, 12 counties reported no cases of infant mortality.
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Table3InfantMortalityinWestVirginia(20042008)
County Pocahontas Ritchie McDowell Gilmer Mingo Summers Cabell Boone Wood Wayne Randolph Mason Raleigh Tyler Nicholas Berkeley Mineral Ohio Hampshire Lewis Upshur Jackson Braxton Preston Calhoun WV Total Clay Wetzel Births 452 545 1,476 358 1,853 570 5,988 1,629 4,992 2,282 1,657 1,564 4,629 455 1,518 6,871 1,544 2,429 1,224 998 1,374 1,653 769 1,680 393 106,185 675 949 Infant Deaths 7 7 18 4 20 6 63 17 47 21 15 14 41 4 13 58 13 20 10 8 11 13 6 13 3 810 5 7 Rate 15.5 12.8 12.2 11.2 10.8 10.5 10.5 10.4 9.4 9.2 9.1 9.0 8.9 8.8 8.6 8.4 8.4 8.2 8.2 8.0 8.0 7.9 7.8 7.7 7.6 7.6 7.4 7.4 Rank 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 County Hancock Brooke Lincoln Marion Mercer Kanawha Barbour Harrison Marshall Putnam Logan Taylor Hardy Tucker Morgan Wyoming Fayette Webster Pleasants Monongalia Jefferson Greenbrier Wirt Grant Monroe Doddridge Pendleton Roane Births 1,634 1,115 1,409 3,125 3,702 11,798 883 4,190 1,663 3,179 2,160 777 796 322 811 1,300 2,902 520 350 4,564 3,370 1,937 282 627 686 354 368 834 Infant Deaths 12 8 10 22 26 81 6 28 11 21 14 5 5 2 5 8 17 3 2 25 18 9 1 2 2 1 1 1 Rate 7.3 7.2 7.1 7.0 7.0 6.9 6.8 6.7 6.6 6.6 6.5 6.4 6.3 6.2 6.2 6.2 5.9 5.8 5.7 5.5 5.3 4.6 3.5 3.2 2.9 2.8 2.7 1.2 Rank 28 29 30 31 32 33 34 35 36 37 38 39 40 41 42 43 44 45 46 47 48 49 50 51 52 53 54 55
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Figure3WVInfantMortalityByCounty,20042008
Hancock Brooke
WestVirginiaTotal:7.6
Ohio
InfantMortalitybyCounty WestVirginiaResidents,20042008
Marshall Monongalia Marion Preston Harrison Taylor Barbour Gilmer Lewis Upshur Braxton Webster Nicholas Randolph Pendleton Mineral Hampshire Tucker Grant Hardy Morgan Berkeley Jeff erson
Lowest:Roane County(1.2)
Wood Wirt Jackson
Ritchie
Cal houn Roane
Mason
>=8.9 7.6 8.8 6.3 7.5
Clay
Pocahontas
<=6.2
Highest:PocahontasCounty(15.5)
Wyoming
Sum mers Mercer
Rateiscalculatedper1,000livebirths.
Monroe
McDowell
WestVirginiaBureauforPublicHealth HealthStatisticsCenter,2010
Poverty
Nearly 14 million children in the United States 19 percent of all children live in families with incomes below the federal poverty level $22,050 a year for a family of four. Research shows that, on average, families need an income of about twice that level just to cover basic expenses. Using this standard, 41% of children live in low-income families. There is a large disparity in the number of residents living below the poverty level in West Virginia. The poverty rate in West Virginia in 2008 was 17.4 percent with the lowest levels occurring in Putnam County (9 percent) and the highest in McDowell County (32.8 percent). Most of these children have parents who work, but low wages and unstable employment leave their families struggling to make ends meet. Poverty can impede childrens ability to learn and contribute to social, emotional, and behavioral problems. Poverty also can contribute to poor health and mental health. Risks are greatest for children who experience poverty when they are young and/or experience deep and persistent poverty. Research is clear that poverty is the single greatest threat to childrens well-being. But effective public policies to make work pay for low-income parents and to provide high-quality early care
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and learning experiences for their children can make a difference. Investments in the most vulnerable children are also critical.1 Table 4 represents the poverty rates by for all age groups in West Virginia as of 2008. The highest poverty rate for all ages is in McDowell County with 32.8 percent of the population living under poverty. Table4PovertyinWestVirginia(2008) AllAges
County All Ages, Under Poverty All Ages, Poverty Rate Rank County All Ages, Under Poverty All Ages, Poverty Rate Rank
McDowell Webster Summers Clay Mingo Lincoln Gilmer Logan Wyoming Mercer Roane Barbour Boone Calhoun Doddridge Braxton Upshur Cabell Fayette Raleigh Wirt Lewis Marion Mason Nicholas Harrison Randolph Greenbrier
7,327 2,593 2,898 2,463 6,452 5,417 1,554 8,064 5,223 13,283 3,243 3,224 5,282 1,527 1,502 2,982 4,645 18,725 8,922 14,837 1,090 3,222 10,336 4,583 4,672 12,128 4,700 5,952
32.8% 27.9% 25.4% 24.7% 24.6% 24.4% 24.3% 23.1% 22.3% 22.0% 21.6% 21.3% 21.3% 21.3% 21.3% 21.1% 20.8% 20.6% 20.2% 19.6% 19.1% 19.0% 18.8% 18.1% 18.1% 17.9% 17.7% 17.6%
1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28
Wayne Wetzel West Virginia Taylor Ritchie Monroe Marshall Pocahontas Preston Tyler Monongalia Wood Tucker Grant Jackson Kanawha Ohio Hampshire Hancock Pendleton Hardy Mineral Pleasants Morgan Brooke Berkeley Jefferson Putnam
7,200 2,840 308,064 2,678 1,742 2,313 5,397 1,371 4,949 1,453 13,178 13,678 1,070 1,881 4,388 29,656 6,570 3,299 4,316 1,035 1,865 3,617 909 1,944 2,674 11,253 4,963 4,975
17.6% 17.6% 17.4% 17.2% 17.1% 17.0% 16.9% 16.8% 16.6% 16.6% 16.3% 16.2% 15.9% 15.8% 15.8% 15.8% 15.7% 14.9% 14.6% 14.0% 13.9% 13.8% 13.2% 12.1% 11.8% 11.2% 9.9% 9.0%
29 30 31 32 33 34 35 36 37 38 39 40 41 42 43 44 45 46 47 48 49 50 51 52 53 54 55
Table 5 shows that for children under 18, McDowell County again has the highest poverty rate of 46.3 percent while Jefferson County shows the lowest rate of 11.1 percent.
National Center for Children in Poverty http://www.nccp.org/
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Table5PovertyinWestVirginia(2008) Foragesunder18
County McDowell Webster Clay Summers Lincoln Mingo Calhoun Barbour Logan Wyoming Doddridge Roane Wirt Fayette Braxton Gilmer Upshur Mercer Raleigh Boone Lewis Nicholas Wetzel Cabell Mason Harrison Taylor Pocahontas Under 18, Under Poverty 2,150 776 788 738 1,624 2,002 445 1,010 2,349 1,480 444 934 353 2,944 858 338 1,421 3,728 4,462 1,522 961 1,390 918 4,976 1,379 3,821 804 400 Under 18, Poverty Rate 46.3% 42.3% 35.4% 35.1% 33.7% 33.7% 32.8% 31.9% 31.6% 31.6% 31.4% 31.3% 30.9% 30.6% 30.2% 29.1% 29.1% 28.9% 28.0% 27.5% 27.1% 26.7% 26.5% 25.9% 25.7% 25.5% 25.4% 25.2% Rank 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28 County Randolph Tyler Marion Ritchie Tucker Preston Marshall Wayne Wood West Virginia Greenbrier Kanawha Hampshire Monroe Grant Jackson Hancock Ohio Mineral Pendleton Hardy Brooke Pleasants Morgan Monongalia Berkeley Putnam Jefferson Under 18, Under Poverty 1,437 421 2,745 519 306 1,501 1,576 2,105 4,369 90,634 1,681 9,487 1,145 614 540 1,359 1,259 1,824 1,184 283 557 781 244 578 2,393 3,825 1,490 1,395 Under 18, Poverty Rate 25.0% 24.9% 24.8% 24.6% 24.6% 24.5% 24.4% 24.2% 24.0% 23.9% 23.8% 23.5% 22.9% 22.7% 22.6% 22.6% 21.2% 21.1% 20.4% 19.4% 19.0% 18.1% 17.0% 16.7% 15.2% 14.9% 11.8% 11.1% Rank 29 30 31 32 33 34 35 36 37 38 39 40 41 42 43 44 45 46 47 48 49 50 51 52 53 54 55
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Table 6 demonstrates, for children ages 5-17, McDowell County with the highest poverty rate of 42.8 percent while Jefferson County shows the lowest rate of 9.3 percent. Table6PovertyinWestVirginia(2008) Forages517
County McDowell Webster Clay Summers Calhoun Barbour Lincoln Mingo Wyoming Roane Fayette Logan Gilmer Braxton Doddridge Wirt Raleigh Mercer Upshur Nicholas Lewis Wetzel Mason Boone Cabell Randolph Tyler Taylor Age 5-17, Under Poverty 1,401 518 493 478 289 664 999 1,213 988 609 1,884 1,490 225 565 276 226 2,871 2,298 871 908 611 590 901 930 3,070 929 284 526 Age 5-17, Poverty Rate 42.8% 38.1% 31.0% 30.8% 29.3% 29.1% 29.1% 28.7% 28.6% 28.4% 27.9% 27.9% 27.6% 26.7% 26.1% 26.1% 25.2% 24.8% 24.8% 24.3% 23.7% 23.7% 23.4% 23.3% 22.9% 22.6% 22.4% 22.3% Rank 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28 County Pocahontas Marion Ritchie Preston Tucker Harrison Wayne WV Total Marshall Greenbrier Hampshire Jackson Kanawha Grant Wood Monroe Ohio Hancock Mineral Hardy Brooke Pendleton Morgan Monongalia Pleasants Berkeley Putnam Jefferson Age 5-17, Under Poverty 259 1,740 335 940 200 2,271 1,325 56,158 995 1,044 750 881 5,579 337 2,520 376 1,129 768 746 340 502 168 355 1,435 146 2,148 926 836 Age 5-17, Poverty Rate 22.0% 21.9% 21.7% 21.4% 21.3% 21.2% 20.6% 20.6% 20.4% 20.3% 20.1% 20.0% 19.5% 19.3% 19.0% 18.4% 18.1% 17.8% 17.4% 15.8% 15.5% 15.4% 13.5% 13.1% 13.1% 11.7% 10.1% 9.3% Rank 29 30 31 32 33 34 35 36 37 38 39 40 41 42 43 44 45 46 47 48 49 50 51 52 53 54 55
Crime
National Incident-Based Reporting System (NIBRS) and its state equivalent, West Virginia Incident-Based Reporting (WV-IBR), were developed to provide more and better information about crime. Essential to the maintenance of uniform and consistent data is the utilization of standard definitions. Criminal incidents in NIBRS are classified as crimes against persons, crimes against property and crimes against society.1 Incidents can involve more than one offense, victim or offender. For counting purposes, one offense is counted for each victim of crimes against persons (assault offenses, homicide offenses, kidnapping/abduction, and sex offenses, forcible and non-forcible).
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Regardless of the number of victims, one offense is counted for each distinct incident of crimes against property (bribery, burglary/breaking and entering, counterfeiting/forgery, destruction/damage/vandalism of property, embezzlement, extortion/blackmail, fraud offenses, larceny/theft offenses, motor vehicle theft, robbery, stolen property offenses) and crimes against society (drug/narcotic offenses, gambling offenses, pornography/obscene material, prostitution offenses and weapon law violations). Violent crimes are murder, forcible sex offenses, assault offenses, kidnapping/abduction and robbery. Robbery is a violent crime against property as it involves force or threat of force but its objective is to obtain money or property.2 Table7NumberofCriminalIncidents,Offenses,PersonsVictimizedandOffenders KnowntoLawEnforcement
2007 County Barbour Berkeley Boone Braxton Brooke Cabell Calhoun Clay Doddridge Fayette Gilmer Grant Greenbrier Hampshire Hancock Hardy Harrison Jackson Jefferson Kanawha Lewis Lincoln Logan Marion Marshall Population Coverage 15,747 100,513 24,312 12,416 20,173 96,934 7,118 10,022 7,429 37,454 6,904 8,926 32,340 22,697 34,196 13,462 63,976 28,370 51,455 185,576 17,082 22,147 35,577 53,700 33,189 Incidents 398 6,157 1,156 385 373 10,000 211 260 114 1,546 197 238 749 843 965 399 4,027 427 2,525 16,292 410 758 2,988 1,764 1,509 Offenses 547 8,472 1,367 680 446 12,168 250 286 116 1,972 292 302 886 1,503 1,078 707 5,528 508 2,875 24,706 534 916 4,073 2,423 2,049 Victims 424 5,422 1,018 384 350 8,601 217 208 82 1,551 200 188 648 1,086 778 586 3,776 400 2,068 16,621 334 646 2,655 1,720 1,539 Offenders 385 5,894 1,123 571 446 6,482 177 204 103 1,237 284 302 715 1,354 1,073 704 4,099 402 2,525 18,408 399 663 4,068 2,410 1,708
Crime in West Virginia 2008
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2007 Population County Incidents Coverage Mason 24,775 1,159 McDowell 19,583 495 Mercer 59,165 4,385 Mineral 26,092 1,098 Mingo 25,285 961 Monongalia 84,762 4,485 Monroe 13,321 406 Morgan 15,757 371 Nicholas 23,962 1,470 Ohio 41,802 2,934 Pendleton 7,575 91 Pleasants 7,213 110 Pocahontas 7,423 383 Preston 25,906 403 Putnam 53,923 2,889 Raleigh 78,721 6,547 Randolph 28,362 1,161 Ritchie 10,619 425 Roane 15,525 571 Summers 13,357 445 Taylor 16,254 146 Tucker 5,393 170 Tyler 10,696 32 Upshur 23,611 761 Wayne 36,258 1,592 Webster 9,444 247 Wetzel 16,226 217 Wirt 5,965 195 Wood 85,995 5,511 Wyoming 21,642 725 West Virginia 1,756,327 95,076 * 2007 Crime in West Virginia - 36th Edition
Offenses 1,357 536 6,312 1,793 1,232 6,743 503 478 2,084 4,541 158 126 514 528 3,558 9,387 1,410 513 682 517 159 203 32 957 1,911 321 246 287 7,111 780 129,663
Victims 996 397 4,501 1,339 930 4,919 414 369 1,527 3,531 133 96 327 400 2,617 7,207 931 348 417 411 111 140 21 630 1,448 222 195 250 5,019 562 91,910
Offenders 1,141 508 5,381 1,761 965 4,479 412 478 1,745 4,311 121 114 496 509 3,105 8,986 934 418 489 457 106 114 23 740 1,158 268 183 274 5,032 378 100,822
The following is a direct excerpt from the U.S Department of Justice Federal Bureau of Investigation Criminal Justice Information Services Division and should be considered when reviewing the following crime data: Each year when Crime in the United States is published, some entities use reported figures to compile rankings of cities and counties. These rough rankings provide no insight into the numerous variables that mold crime in a particular town, city, county,
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state, or region. Consequently, they lead to simplistic and/or incomplete analyses that often create misleading perceptions adversely affecting communities and their residents. Valid assessments are possible only with careful study and analysis of the range of unique conditions affecting each local law enforcement jurisdiction. The data user is, therefore, cautioned against comparing statistical data of individual reporting units from cities, metropolitan areas, states, or colleges or universities solely on the basis of their population coverage or student enrollment. It is incumbent upon all data users to become as well educated as possible about how to understand and quantify the nature and extent of crime in the United States and in any of the nearly 18,000 jurisdictions represented by law enforcement contributors to the Uniform Crime Reporting (UCR) Program. Valid assessments are possible only with careful study and analysis of the various unique conditions affecting each local law enforcement jurisdiction. Some factors that are known to affect the volume and type of crime occurring from place to place are: Population density and degree of urbanization. Variations in composition of the population, particularly youth concentration. Stability of the population with respect to residents mobility, commuting patterns, and transient factors. Modes of transportation and highway system. Economic conditions, including median income, poverty level, and job availability. Cultural factors and educational, recreational, and religious characteristics. Family conditions with respect to divorce and family cohesiveness. Climate. Effective strength of law enforcement agencies. Administrative and investigative emphases of law enforcement. Policies of other components of the criminal justice system (i.e., prosecutorial, judicial, correctional, and probational). Citizens attitudes toward crime. Crime reporting practices of the citizenry. Due to this advisory and the large number of non-reporting agencies in the State, the data in Table 8 has not been ranked by county. Table8RateofCriminalIncidentsandOffensesKnowntoLawEnforcement(2007)
County Barbour Berkeley Boone Braxton Incidents Rate per 10,000 252.7 612.6 475.5 310.1 Offenses Rate per 10,000 347.4 842.9 562.3 547.7
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County Brooke Cabell Calhoun Clay Doddridge Fayette Gilmer Grant Greenbrier Hampshire Hancock Hardy Harrison Jackson Jefferson Kanawha Lewis Lincoln Logan Marion Marshall Mason McDowell Mercer Mineral Mingo Monongalia Monroe Morgan Nicholas Ohio Pendleton Pleasants Pocahontas Preston Putnam Raleigh Randolph
Incidents Rate per 10,000 184.9 1,031.6 296.4 259.4 153.5 412.8 285.3 266.6 231.6 371.4 282.2 296.4 629.5 150.5 490.7 877.9 240.0 342.3 839.9 328.5 454.7 467.8 252.8 741.1 420.8 380.1 529.1 304.8 235.5 613.5 701.9 120.1 152.5 516.0 155.6 535.8 831.7 409.4
Offenses Rate per 10,000 221.1 1,255.3 351.2 285.4 156.1 526.5 422.9 338.3 274.0 662.2 315.2 525.2 864.1 179.1 558.7 1,331.3 312.6 413.6 1,144.8 451.2 617.4 547.7 273.7 1,066.8 687.2 487.2 795.5 377.6 303.4 869.7 1,086.3 208.6 174.7 692.4 203.8 659.8 1,192.4 497.1
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County Ritchie Roane Summers Taylor Tucker Tyler Upshur Wayne Webster Wetzel Wirt Wood Wyoming
Incidents Rate per 10,000 400.2 367.8 333.2 89.8 315.2 29.9 322.3 439.1 261.5 133.7 326.9 640.9 335.0
Offenses Rate per 10,000 483.1 439.3 387.1 97.8 376.4 29.9 405.3 527.1 339.9 151.6 481.1 826.9 360.4
DomesticViolence
West Virginias Coalition Against Domestic Violence reported in 2008 that licensed domestic violence programs in West Virginia provided services to over 600 women, children and men. As based upon a West Virginia Uniform Crime Report by the West Virginia State Police for 2006, arrests in domestic violence incidents accounted for 62 percent of the total arrests for crimes against the person and over 1/3 of our homicides are related to domestic violence. In May 2010, West Virginia received an award of nearly $1 million to STOP Violence Against Women Grant Program to fund 24 projects statewide. The purpose of these funds is to establish or enhance teams whose core members include victim service providers, law enforcement, and prosecution to improve the criminal justice systems response to violence against women. Additionally, statewide projects are funded to provide training and educational opportunities for all victim service providers, law enforcement, prosecution and court personnel across the state. Table9DomesticViolenceinWestVirginia
Intimate Partner Raleigh Kanawha Boone Mercer Logan Wood Ohio Nicholas Putnam Number 772 1,943 209 485 220 544 270 140 295 Rate 9.8 10 8.1 7.9 6.1 6.2 6 5.3 5.4 Non-Intimate Partner Number 359 742 109 192 139 269 148 79 150 Rate 4.5 3.8 4.2 3.1 3.8 3.1 3.3 3 2.8 Total Rate per 1,000 14.3 13.9 12.4 11 9.9 9.3 9.3 8.3 8.2
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Intimate Partner Pocahontas Lincoln Hardy Cabell WV McDowell Wayne Harrison Hampshire Ritchie Barbour Wirt Lewis Upshur Mason Marion Mingo Monongalia Marshall Tucker Randolph Berkeley Jackson Brooke Mineral Jefferson Roane Monroe Clay Tyler Webster Braxton Greenbrier Summers Fayette Pendleton Morgan Preston Calhoun Gilmer Grant Doddridge Taylor Wetzel Pleasants Wyoming Hancock Number 51 111 63 481 8,626 117 192 282 85 33 65 19 59 73 97 209 89 283 116 20 85 297 74 64 83 134 38 36 20 21 21 31 69 27 80 14 32 48 13 9 17 10 20 20 7 20 13 Rate 5.8 5 4.7 5.1 4.7 4.8 4.6 4.1 3.9 3.1 4.1 3.2 3.4 3.1 3.8 3.7 3.3 3.4 3.4 2.9 3 3.2 2.6 2.6 3.1 2.7 2.5 2.7 1.9 2.2 2.1 2.1 2 2 1.7 1.8 2 1.6 1.8 1.3 1.5 1.3 1.2 1.2 0.9 0.8 0.4
Non-Intimate Partner Number 22 58 35 190 3,995 51 93 162 59 26 23 12 32 50 36 77 43 119 46 12 45 120 43 37 25 62 20 16 17 12 12 19 40 14 62 8 13 33 5 7 7 6 13 12 5 6 3 Rate 2.5 2.6 2.6 2 2.2 2.1 2.2 2.4 2.7 2.5 1.5 2 1.9 2.1 1.4 1.4 1.6 1.4 1.3 1.7 1.6 1.3 1.5 1.5 0.9 1.3 1.3 1.2 1.6 1.3 1.2 1.3 1.1 1 1.3 1 0.8 1.1 0.7 1 0.6 0.8 0.8 0.7 0.7 0.2 0.1
Total Rate per 1,000 8.2 7.6 7.4 7.1 6.9 6.9 6.8 6.5 6.5 5.6 5.6 5.3 5.3 5.2 5.2 5.1 4.9 4.8 4.7 4.6 4.6 4.5 4.1 4.1 4 4 3.8 3.8 3.6 3.5 3.4 3.4 3.1 3 3 2.8 2.8 2.7 2.4 2.3 2.1 2.1 2 1.9 1.6 1.1 0.5
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Ratesofhighschooldropouts
High school dropouts suffer from reduced earnings and many lost opportunities during those critical years of development. These rates play a role in both the social and economic costs to a state. Although there may not be a single reason why students dropout of school, indicators have shown trouble transitioning to high school, lack of basic skills and lack of active engagement between parents, students and educational staff can all play a role in the rates. Table10DropoutRates
2nd Month 7-12 2nd Month County Rate County 7-12 Dropouts Rate 7-12 Enroll Dropouts 7-12 Enroll 898 43 4.8% 5,051 143 2.8% Monroe Harrison 740 31 4.2% 914 26 2.8% Webster Clay 1,834 77 4.2% 7,442 212 2.8% Nicholas Berkeley 3,118 132 4.2% 2,952 80 2.7% Fayette Logan 1,967 72 3.7% 493 13 2.6% Mingo Calhoun 2,324 85 3.7% 484 12 2.5% Greenbrier Pendleton 12,271 437 3.6% 4,660 117 2.5% Kanawha Monongalia 1,037 37 3.6% 717 17 2.4% Hardy Ritchie 3,406 120 3.5% 2,229 53 2.4% Wayne Jackson 1,748 61 3.5% 2,299 53 2.3% Upshur Marshall 1,588 56 3.5% 3,690 84 2.3% McDowell Jefferson 1,257 44 3.5% 1,163 26 2.2% Lewis Barbour 5,266 185 3.5% 537 11 2.0% Cabell Pocahontas 3,990 134 3.4% 5,962 113 1.9% Mercer Wood 1,956 67 3.4% 482 9 1.9% Boone Wirt 1,725 57 3.3% 1,330 25 1.9% Wyoming Wetzel 3,660 119 3.3% 1,078 21 1.9% Marion Roane 1,425 45 3.2% 1,220 22 1.8% Lincoln Morgan 1,991 62 3.1% 532 9 1.7% Randolph Tucker 5,196 163 3.1% 667 11 1.6% Raleigh Tyler 1,862 58 3.1% 1,019 16 1.6% Mason Taylor 869 27 3.1% 1,708 26 1.5% Grant Hampshire 698 21 3.0% 4,137 57 1.4% Summers Putnam 1,033 31 3.0% 1,977 28 1.4% Braxton Hancock 2,034 60 2.9% 429 4 0.9% Preston Gilmer 2,473 72 2.9% 2,024 15 0.7% Ohio Mineral 582 17 2.9% 632 3 0.5% Doddridge Pleasants 124,388 3,527 2.8% 1,612 8 0.5% Brooke WV Total *Note-West Virginia Department of Education bases dropout rate calculations on combined grades of 7 through 12.
SubstanceAbuse
The National Survey on Drug Use and Health (NSDUH) obtains information on nine different categories of illicit drug use: marijuana, cocaine, heroin, hallucinogens, inhalants, and nonmedical use of prescription-type pain relievers, tranquilizers, stimulants, and sedatives. In these categories, hashish is included with marijuana, and crack is considered a form of cocaine. Nonmedical use of prescription-type pain relievers, tranquilizers, stimulants, or sedatives is defined as use of at least one of these medications without a prescription belonging to the
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respondent or use that occurred simply for the experience or feeling the drug caused. Estimates of illicit drug use reflect any of the nine categories listed above. Estimates are presented for illicit drugs, marijuana, perceptions of risk of marijuana use, incidence of marijuana use, illicit drugs other than marijuana, cocaine, and pain relievers. In 2007-2008, the rate of past month alcohol use among persons aged 12 to 20 (underage use of alcohol) ranged from a low of 13.6 percent in Utah to a high of 38.3 percent in Vermont. Utah (11.7 percent) also had the lowest rate for past month underage binge use of alcohol, and North Dakota (28.0 percent) had the highest rate for this measure. There was a decrease at the national level in underage alcohol use from 28.1 percent in 2006-2007 to 27.2 percent in 2007-2008; similarly, there was a decrease at the national level for underage binge alcohol use from 18.8 percent in 2006-2007 to 18.0 percent in 2007-2008. Twelve states showed decreases in underage binge alcohol use: Arizona, Arkansas, Idaho, Kansas, Kentucky, Missouri, Nebraska, New Jersey, Pennsylvania, Washington, West Virginia, and Wisconsin.3 The substate regions defined in Table 11 were provided by the West Virginia Department of Health and Human Resources, Behavioral Health & Health Facilities, and are defined in terms of the State's 55 counties. Due to sample size constraints, certain regions were combined to form substate regions along with three aggregate planning areas (Northern, South Central, and Southern). The substate region definitions include nonadjacent counties being combined to form the Southern I and III region.
Table 11 WEST VIRGINIA Substate Regions (defined in terms of counties)
Eastern Highland Barbour Berkeley Grant Greenbrier Hampshire Hardy Jefferson Mineral Morgan Nicholas Pendleton Pocahontas Randolph Tucker Upshur Webster
Northern Northern A Northern C and B and D Northern A Northern C Brooke Marion Hancock Monongalia Preston Northern B Taylor Marshall Northern D Ohio Wetzel Braxton Doddridge Gilmer Harrison Lewis
South Central South South South Central I Central II Central III Calhoun Cabell Boone Jackson Lincoln Clay Pleasants Mason Kanawha Ritchie Wayne Putnam Roane Tyler Wirt Wood
Southern Southern I Southern II and III Southern I McDowell Fayette Mercer Monroe Wyoming Raleigh Summers Southern III Logan Mingo
SOURCE: State Estimates of Substance Use from the 20072008 National Surveys on Drug Use and Health
US Department of Health and Human Services (2010).
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WEST VIRGINIA Illicit Drug Use in Past Month and Illicit Drug Use Other Than Marijuana in Past Month in West Virginia among Persons Aged 12 or Older, by Substate Region: Percentages, Annual Averages Based on 2006, 2007, and 2008 NSDUHs
Illicit Drug Use in Past Month State/Substate Region Estimate West Virginia Eastern Highland Northern Northern A and B Northern C and D South Central South Central I South Central II South Central III Southern Southern I and III Southern II 7.72 7.23 8.72 7.44 9.35 7.76 6.97 9.06 7.39 6.87 6.68 7.25 95% Prediction Interval (6.71-8.87) (5.76-9.03) (7.12-10.65) (5.41-10.15) (7.39-11.76) (6.43-9.32) (5.19-9.30) (6.82-11.94) (5.66-9.59) (5.40-8.69) (4.93-8.99) (5.31-9.82) Illicit Drug Use Other Than Marijuana in Past Month 95% Prediction Estimate Interval 4.32 (3.53-5.28) 4.00 2.98-5.33) 4.90 (3.79-6.33) 4.49 (3.15-6.34) 5.11 (3.79-6.86) 4.31 (3.37-5.49) 4.02 (2.85-5.64) 5.03 (3.60-6.99) 4.02 (2.90-5.54) 3.95 (2.94-5.28) 3.95 (2.80-5.55) 3.95 (2.75-5.65)
SOURCE: SAMHSA, Office of Applied Studies, National Survey on Drug Use and Health, 2006, 2007, and 2008.
Table 12 Marijuana Use in Past Month, Average Annual Rate of First Use of Marijuana, and Perceptions of Great Risk of Smoking Marijuana Once a Month in West Virginia among Persons Aged 12 or Older, by Substate Region
Marijuana Use in Past Month State/Substate Region Estimate West Virginia Eastern Highland Northern Northern A and B Northern C and D South Central South Central I South Central II South Central III Southern Southern I and III Southern II
1
Average Annual Rate of First Use of Marijuana1 Estimate 1.25 1.24 1.57 1.27 1.73 1.19 1.04 1.16 1.32 0.95 0.98 0.90 95% Prediction Interval (1.10 -1.42) (1.01 -1.52) (1.29 -1.90) (0.95 -1.68) (1.36 -2.18) (1.00 -1.42) (0.79 -1.37) (0.87 -1.54) (1.04 -1.66) (0.77 -1.18) (0.75 -1.28) (0.68 -1.20)
5.38 5.25 6.48 5.04 7.19 5.07 4.59 5.74 4.91 4.58 4.59 4.57
95% Prediction Interval (4.57 -6.32) (4.03 -6.82) (5.13 -8.16) (3.53 -7.16) (5.50 -9.36) (4.06 -6.30) (3.26 -6.43) (4.11 -7.97) (3.61 -6.66) (3.45 -6.06) (3.23 -6.48) (3.19 -6.52)
Perceptions of Great Risk of Smoking Marijuana Once a Month 95% Estimate Prediction Interval 44.38 (41.65 -47.13) 45.14 (40.89 -49.47) 42.53 (38.48 -46.69) 45.21 (38.94 -51.63) 41.22 (36.48 -46.12) 44.50 (40.75 -48.32) 45.77 (40.13 -51.53) 47.94 (41.96 -53.98) 41.50 (36.41 -46.79) 45.76 (41.04 -50.56) 45.68 (39.64 -51.85) 45.92 (39.90 -52.06)
Average annual marijuana initiation rate = 100*{[X1 (0.5 * X1 + X2)] 2}, where X1 is the number of marijuana initiates in the past 24 months and X2 is the number of persons who never used marijuana. Both of the computation components, X1 and X2, are based on a survey-weighted hierarchical Bayes estimation approach. Note that the age group is based on a respondent's age at the time of the interview, not his or her age at first use. The prediction intervals for Average Annual Rate of First Use of Marijuana use a simultaneous solution for First Use of Marijuana and Never Used Marijuana outcomes, which had age groupspecific random effects that were allowed to be correlated across the two outcomes. The associated Markov Chain Monte Carlo chains were used to calculate the posterior variance. SOURCE: SAMHSA, Office of Applied Studies, National Survey on Drug Use and Health, 2006, 2007, and 2008.
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Table 13 Marijuana Use in Past Year, Cocaine Use in Past Year, and Nonmedical Use of Pain Relievers in Past Year in West Virginia among Persons Aged 12 or Older, by Substate Region
State/Substate Region West Virginia Eastern Highland Northern Northern A and B Northern C and D South Central South Central I South Central II South Central III Southern Southern I and III Southern II Marijuana Use in Past Year Estimate 95% Prediction Interval 9.22 (8.13 -10.44) 9.04 (7.37 -11.05) 11.42 (9.51 -13.66) 8.73 (6.53 -11.59) 12.74 (10.36 -15.57) 8.38 (7.05 -9.94) 7.17 (5.36 -9.54) 9.13 (6.96 -11.89) 8.63 (6.72 -11.03) 7.98 (6.34 -10.01) 7.88 (5.92 -10.43) 8.19 (6.12 -10.87) Cocaine Use in Past Year Estimate 95% Prediction Interval 2.56 (2.02 -3.23) 2.49 (1.80 -3.45) 3.22 (2.40 -4.31) 2.79 (1.84 -4.21) 3.43 (2.47 -4.75) 2.31 (1.72 -3.09) 2.12 (1.42 -3.15) 2.53 (1.71 -3.72) 2.28 (1.55 -3.34) 2.19 (1.58 -3.03) 2.19 (1.48 -3.23) 2.18 (1.46 -3.24) Nonmedical Use of Pain Relievers in Past Year Estimate 95% Prediction Interval 5.46 (4.65 -6.40) 5.15 (4.04 -6.55) 6.10 (4.93 -7.54) 5.40 (4.04 -7.18) 6.45 (5.03 -8.24) 5.50 (4.49 -6.71) 5.06 (3.79 -6.72) 6.31 (4.78 -8.29) 5.23 (4.02 -6.79) 4.87 (3.80 -6.21) 4.83 (3.59 -6.47) 4.95 (3.69 -6.60)
NOTE: For Substate Region definitions see Section D of the report on Substate Estimates from the 2006-2008 National Surveys on Drug Use and Health. NOTE: Estimates are based on a survey-weighted hierarchical Bayes estimation approach, and the 95 percent prediction (credible) intervals are generated by Markov Chain Monte Carlo techniques. SOURCE: SAMHSA, Office of Applied Studies, National Survey on Drug Use and Health, 2006, 2007, and 2008
Table 14 Alcohol Use in Past Month, Binge Alcohol Use in Past Month, and Perceptions of Great Risk of Having Five or More Drinks of an Alcoholic Beverage Once or Twice a Week in West Virginia among Persons Aged 12 or Older, by Substate Region
Alcohol Use in Past Month Estimate 95% Prediction Interval 38.39 (35.66 -41.19) 37.08 (32.55 -41.84) 42.59 (38.11 -47.19) 42.75 (35.75 -50.07) 42.51 (37.53 -47.64) 39.10 (35.36 -42.96) 35.41 (29.77 -41.49) 38.24 (32.17 -44.71) 41.88 (36.25 -47.73) 32.72 (28.24 -37.53) 33.60 (28.02 -39.68) 30.97 (25.03 -37.60) Binge Alcohol Use in Past Month1 Estimate 95% Prediction Interval 19.66 (17.84 -21.61) 18.77 (16.14 -21.71) 23.30 (20.51 -26.34) 22.01 (18.18 -26.39) 23.93 (20.75 -27.43) 18.97 (16.64 -21.55) 19.09 (15.71 -22.98) 19.34 (15.86 -23.39) 18.66 (15.65 -22.11) 16.98 (14.30 -20.04) 17.00 (13.81 -20.76) 16.93 (13.76 -20.66) Perceptions of Great Risk of Having Five or More Drinks of an Alcoholic Beverage Once or Twice a Week Estimate 95% Prediction Interval 42.12 (39.55 -44.73) 41.61 (37.88 -45.45) 42.23 (38.52 -46.03) 41.41 (36.28 -46.72) 42.63 (38.29 -47.10) 42.14 (38.96 -45.39) 42.40 (37.86 -47.08) 42.71 (38.08 -47.47) 41.61 (37.35 -46.01) 42.55 (38.92 -46.27) 41.93 (37.44 -46.56) 43.79 (38.94 -48.75)
State/Substate Region
West Virginia Eastern Highland Northern Northern A and B Northern C and D South Central South Central I South Central II South Central III Southern Southern I and III Southern II
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Table 15 Alcohol Use in Past Month and Binge Alcohol Use in Past Month in West Virginia
State/Substate Region West Virginia Eastern Highland Northern Northern A and B Northern C and D South Central South Central I South Central II South Central III Southern Southern I and III Southern II Alcohol Use in Past Month among Persons Aged 12 to 20 Estimate 95% Prediction Interval 25.19 (23.02 -27.49) 23.32 (20.04 -26.96) 29.50 (25.88 -33.40) 25.95 (21.45 -31.03) 31.00 (26.54 -35.85) 24.93 (22.08 -28.02) 23.53 (19.49 -28.12) 27.44 (22.68 -32.78) 24.03 (20.21 -28.31) 20.94 (17.69 -24.60) 21.02 (16.94 -25.77) 20.78 (16.76 -25.46) Binge Alcohol Use in Past Month among Persons Aged 12 to 201 Estimate 95% Prediction Interval 17.85 (15.95 -19.92) 15.86 (12.95 -19.28) 23.02 (19.56 -26.89) 20.21 (15.86 -25.39) 24.21 (19.90 -29.11) 17.04 (14.62 -19.77) 17.13 (13.52 -21.47) 18.54 (14.36 -23.60) 15.91 (12.78 -19.65) 13.47 (10.88 -16.55) 13.03 (9.83 -17.07) 14.33 (11.07 -18.34)
Table 16 Cigarette Use in Past Month, Tobacco Product Use in Past Month, and Perceptions of Great Risk of Smoking One or More Packs of Cigarettes Per Day in West Virginia among Persons Aged 12 or Older
Cigarette Use in Past Month Estimate 95% Prediction Interval 30.36 (28.05 -32.77) 30.62 (26.96 -34.53) 29.38 (26.13 -32.85) 29.78 (25.06 -34.99) 29.18 (25.50 -33.16) 30.71 (27.70 -33.89) 32.56 (28.05 -37.41) 32.79 (28.34 -37.57) 28.24 (24.32 -32.53) 30.73 (27.03 -34.70) 30.66 (26.20 -35.52) 30.87 (26.38 -35.76) Tobacco Product Use in Past Month1 Estimate 95% Prediction Interval 37.61 (35.15 -40.13) 37.37 (33.67 -41.22) 36.62 (33.09 -40.29) 35.72 (30.78 -40.97) 37.06 (32.92 -41.40) 38.01 (34.83 -41.30) 40.48 (35.72 -45.43) 39.66 (34.63 -44.91) 35.45 (31.28 -39.84) 38.51 (34.54 -42.63) 38.67 (33.82 -43.76) 38.18 (33.05 -43.58) Perceptions of Great Risk of Smoking One or More Packs of Cigarettes Per Day Estimate 95% Prediction Interval 68.22 (65.75 -70.58) 67.93 (64.33 -71.33) 68.78 (65.52 -71.87) 67.81 (63.35 -71.97) 69.26 (65.43 -72.85) 68.42 (65.33 -71.35) 66.75 (62.47 -70.76) 67.64 (63.16 -71.83) 69.93 (65.84 -73.73) 67.38 (63.64 -70.90) 67.55 (63.01 -71.79) 67.02 (62.42 -71.31)
West Virginia Eastern Highland Northern Northern A and B Northern C and D South Central South Central I South Central II South Central III Southern Southern I and III Southern II
1
Tobacco Products include cigarettes, smokeless tobacco (i.e., chewing tobacco or snuff), cigars, or pipe tobacco. SOURCE: SAMHSA, Office of Applied Studies, National Survey on Drug Use and Health, 2006, 2007, and 2008.
32
WEST VIRGINIA Table 17 Needing But Not Receiving Treatment for Alcohol Use in Past Year and Needing But Not Receiving Treatment for Illicit Drug Use in Past Year in West Virginia among Persons Aged 12 or Older, by Substate Region: Percentages, Annual Averages Based on 2006, 2007, and 2008 NSDUHs
Needing But Not Receiving Treatment for Alcohol Use in Past Year1 Estimate 95% Prediction Interval West Virginia Eastern Highland Northern Northern A and B Northern C and D South Central South Central I South Central II South Central III Southern Southern I and III Southern II 6.09 (5.21 -7.10) 5.85 (4.56 -7.49) 7.28 (6.01 -8.80) 6.69 (5.08 -8.77) 7.57 (6.06 -9.42) 5.55 (4.56 -6.73) 5.46 (4.13 -7.18) 5.96 (4.51 -7.84) 5.34 (4.10 -6.92) 5.75 (4.56 -7.23) 5.96 (4.47 -7.89) 5.34 (4.03 -7.05) Needing But Not Receiving Treatment for Illicit Drug Use in Past Year2 Estimate 95% Prediction Interval 2.67 (2.17 -3.29) 2.47 (1.74 -3.49) 3.06 (2.26 -4.13) 2.81 (1.87 -4.20) 3.18 (2.21 -4.55) 2.56 (1.94 -3.37) 2.43 (1.61 -3.66) 2.97 (1.97 -4.44) 2.37 (1.60 -3.51) 2.62 (1.86 -3.67) 2.61 (1.71 -3.94) 2.63 (1.69 -4.08)
NOTE: Estimates are based on a survey-weighted hierarchical Bayes estimation approach, and the 95 percent prediction (credible) intervals are generated by Markov Chain Monte Carlo techniques. NOTE: For Substate Region definitions, see Section D of the report on Substate Estimates from the 2006-2008 National Surveys on Drug Use and Health.
1
Needing But Not Receiving Treatment refers to respondents classified as needing treatment for alcohol, but not receiving treatment for an alcohol problem at a specialty facility (i.e., drug and alcohol rehabilitation facilities [inpatient or outpatient], hospitals [inpatient only], or mental health centers). 2 Needing But Not Receiving Treatment refers to respondents classified as needing treatment for illicit drugs, but not receiving treatment for an illicit drug problem at a specialty facility (i.e., drug and alcohol rehabilitation facilities [inpatient or outpatient], hospitals [inpatient only], or mental health centers). Illicit Drugs include marijuana/hashish, cocaine (including crack), heroin, hallucinogens, inhalants, or prescription-type psychotherapeutics used nonmedically, these estimate are based on data from original questions excluding those on the use of over-the-counter drugs or new methamphetamine items that were added in 2005 and 2006. See Section B.4.8 in the Appendix B of the Results from the 2008 National Survey on Drug Use and Health: National Findings. SOURCE: SAMHSA, Office of Applied Studies, National Survey on Drug Use and Health, 2006, 2007, and 2008.
33
Figure 4 Illicit Drug Use in Past Month among persons Aged 12 or Older in West Virginia, by Substate Region: Percentages, Annual Averages Based on 2006, 2007, and 2008 NSDUHs
Figure 5 Illicit Drug Use Other Than Marijuana in Past Month among Persons Aged 12 or Older in West Virginia, by Substate Region: Percentages, Annual Averages Based on 2006, 2007, and 2008 NSDUHs
34
Figure 6 Marijuana Use in Past Month among Persons Aged 12 or Older in West Virginia, by Substate Region: Percentages, Annual Averages Based on 2006, 2007, and 2008 NSDUHs
35
Figure 7 Perceptions of Great Risk of Smoking Marijuana Once a Month among Persons Aged 12 or Older in West Virginia, by Substate Region: Percentages, Annual Averages Based on 2006, 2007, and 2008 NSDUHs
Figure 8 Marijuana Use in Past Year among Persons Aged 12 or Older in West Virginia, by Substate Region: Percentages, Annual Averages Based on 2006, 2007, and 2008 NSDUHs
36

Figure 9 Cocaine Use in Past Year among Persons Aged 12 or Older in West Virginia, by Substate Region: Percentages, Annual Averages Based on 2006, 2007, and 2008 NSDUHs
Figure 10 Nonmedical Use of Pain Killers in Past Year among Persons Aged 12 or Older in West Virginia, by Substate Region: Percentages, Annual Averages Based on 2006, 2007, and 2008 NSDUHs
37
Figure 11 Alcohol Use in Past Month among Persons Aged 12 or Older in West Virginia, by Substate Region: Percentages, Annual Averages Based on 2006, 2007, and 2008 NSDUHs
Figure 12 Binge Alcohol Use in Past Month among Persons Aged 12 or Older in West Virginia, by Substate Region: Percentages, Annual Averages Based on 2006, 2007, and 2008 NSDUHs
38
Figure 13 Perceptions of Great Risk of Having Five or More Drinks of an Alcoholic Beverage Once or Twice a Week among Persons Aged 12 or Older in West Virginia, by Substate Region: Percentages, Annual Averages Based on 2006, 2007, and 2008 NSDUHs SOURCE: SAMHSA, Office of Applied Studies, National Survey on Drug Use and Health, 2006, 2007, and 2008.
Figure 14 Alcohol Use in Past Month among Persons Aged 12 to 20 in West Virginia, by Substate Region: Percentages, Annual Averages Based on 2006, 2007, and 2008 NSDUHs
39
Figure 15 Binge Alcohol Use in Past Month among Persons Aged 12 to 20 in West Virginia, by Substate Region: Percentages, Annual Averages Based on 2006, 2007, and 2008 NSDUHs
Figure 16 Cigarette Use in Past Month among Persons Aged 12 or older in West Virginia, by Substate Region: Percentages, Annual Averages Based on 2006, 2007, and 2008 NSDUHs
40
Figure 17 Tobacco Product Use in Past Month among Persons Aged 12 or older in West Virginia, by Substate Region: Percentages, Annual Averages Based on 2006, 2007, and 2008 NSDUHs
Figure 18 Perceptions of Great Risk of Smoking One or More Packs of Cigarettes Per Day among Persons Aged 12 or older in West Virginia, by Substate Region: Percentages, Annual Averages Based on 2006, 2007, and 2008 NSDUHs
41
Figure 19 Alcohol Dependence in Past Year among Persons Aged 12 or older in West Virginia, by Substate Region: Percentages, Annual Averages Based on 2006, 2007, and 2008 NSDUHs
Figure 20 Illicit Drug Dependence in Past Year among Persons Aged 12 or older in West Virginia, by Substate Region: Percentages, Annual Averages Based on 2006, 2007, and 2008 NSDUHs
42
Figure 21 Alcohol Dependence or Abuse in Past Year among Persons Aged 12 or older in West Virginia, by Substate Region: Percentages, Annual Averages Based on 2006, 2007, and 2008 NSDUHs
Figure 22 Alcohol Dependence or Abuse in Past Year among Persons Aged 12 or older in West Virginia, by Substate Region: Percentages, Annual Averages Based on 2006, 2007, and 2008 NSDUHs
Source: SAMHSA, Office of Applied Studies, National Survey on Drug Use and Health, 2006, 2007, and 2008.
43
Figure 23 Dependence or Abuse of Illicit Drugs in Past Year among Persons Aged 12 or older in West Virginia, by Substate Region: Percentages, Annual Averages Based on 2006, 2007, and 2008 NSDUHs
Figure 24 Needing But Not Receiving Treatment for Alcohol Use in Past Year among Persons Aged 12 or older in West Virginia, by Substate Region: Percentages, Annual Averages Based on 2006, 2007, and 2008 NSDUHs
44
Figure 25 Needing But Not Receiving Treatment for Illicit Drug Use in Past Year among Persons Aged 12 or older in West Virginia, by Substate Region: Percentages, Annual Averages Based on 2006, 2007, and 2008 NSDUHs
Unemployment
The unemployment rate in West Virginia was 8.6 percent in July 2010, up 4.6 percentage points from December 2007, but down from its most recent peak of 9.5 percent reached in March 2010. Over 67,000 West Virginia residents were counted among the unemployed in West Virginia during July 2010. Table18
County Barbour Berkeley Boone Braxton Brooke Cabell Calhoun Clay Doddridge Fayette Gilmer 2004 6.3% 4.2% 4.9% 5.9% 7.3% 4.7% 9.1% 7.4% 4.9% 6.1% 4.7% 2005 5.9% 3.8% 4.4% 5.7% 6.9% 4.3% 8.3% 7.4% 4.6% 5.5% 4.5% 2006 5.3% 3.8% 4.3% 5.1% 6.8% 4.2% 6.7% 6.3% 4.8% 5.2% 4.3% 2007 5.0% 3.7% 4.3% 5.0% 5.4% 3.7% 6.5% 6.4% 4.5% 5.0% 3.7% 2008 4.8% 4.7% 3.8% 5.0% 5.6% 3.8% 6.7% 6.1% 4.8% 4.5% 3.7% 2009 8.9% 8.7% 8.0% 8.6% 11.4% 6.8% 13.1% 11.5% 7.9% 8.6% 6.8%
45
County 2004 2005 2006 2007 2008 2009 Grant 6.6% 6.0% 5.5% 4.8% 5.2% 10.3% Greenbrier 5.7% 5.8% 5.7% 5.6% 5.4% 9.6% Hampshire 4.6% 3.9% 3.6% 3.3% 4.2% 8.3% Hancock 7.5% 7.1% 7.0% 5.3% 5.7% 11.5% Hardy 4.0% 3.6% 3.6% 3.8% 4.5% 9.2% Harrison 5.2% 4.5% 4.3% 3.9% 3.8% 6.7% Jackson 6.2% 5.6% 4.8% 4.4% 4.9% 11.6% Jefferson 3.3% 3.1% 3.1% 2.9% 3.7% 6.7% Kanawha 4.7% 4.6% 4.0% 3.6% 3.4% 6.4% Lewis 5.2% 4.8% 4.7% 4.7% 4.1% 7.5% Lincoln 6.2% 6.1% 5.6% 5.0% 4.6% 9.9% Logan 5.5% 4.7% 4.4% 4.8% 4.1% 8.3% McDowell 9.7% 7.9% 7.0% 6.8% 5.8% 11.8% Marion 4.9% 4.3% 4.1% 3.9% 3.5% 6.0% Marshall 6.0% 5.5% 5.2% 4.8% 5.0% 9.0% Mason 7.9% 7.4% 6.4% 6.3% 6.9% 12.1% Mercer 5.6% 4.8% 4.5% 3.8% 4.0% 6.8% Mineral 5.8% 5.1% 4.6% 4.3% 4.5% 7.7% Mingo 6.6% 5.5% 5.0% 5.2% 4.2% 9.2% Monongalia 3.8% 3.5% 3.2% 2.9% 2.7% 4.5% Monroe 4.2% 4.4% 5.0% 4.3% 4.4% 7.5% Morgan 4.2% 4.4% 4.3% 4.3% 5.2% 9.0% Nicholas 5.3% 5.3% 4.9% 4.5% 4.5% 8.9% Ohio 5.0% 4.6% 4.4% 3.8% 4.1% 7.8% Pendleton 3.7% 3.6% 3.9% 3.4% 4.2% 7.7% Pleasants 6.0% 6.0% 5.1% 5.2% 5.7% 10.6% Pocahontas 6.1% 6.1% 7.1% 6.7% 7.0% 12.1% Preston 5.3% 4.6% 4.1% 3.9% 3.8% 7.2% Putnam 4.6% 4.3% 3.7% 3.4% 3.2% 6.3% Raleigh 5.2% 4.5% 4.1% 4.0% 3.9% 7.4% Randolph 5.4% 5.0% 4.7% 4.6% 5.3% 9.0% Ritchie 6.5% 5.6% 4.6% 4.7% 5.4% 9.6% Roane 7.7% 7.1% 5.8% 5.9% 6.3% 12.4% Summers 6.2% 6.0% 5.8% 5.5% 4.9% 8.1% Taylor 4.8% 4.9% 4.8% 4.5% 4.3% 7.3% Tucker 6.5% 6.0% 5.7% 5.5% 6.3% 11.7% Tyler 7.2% 6.9% 6.6% 5.7% 6.1% 10.8% Upshur 5.4% 4.6% 4.3% 4.0% 4.2% 8.6% Wayne 5.2% 5.0% 5.0% 4.3% 4.6% 8.0% Webster 5.5% 5.5% 5.3% 5.2% 5.4% 10.6% Wetzel 8.5% 9.0% 7.5% 6.3% 7.0% 12.0% Wirt 6.9% 7.1% 5.6% 5.5% 5.9% 12.2% Wood 5.4% 5.2% 4.5% 4.3% 4.6% 8.8% Wyoming 6.2% 5.1% 5.1% 5.6% 4.6% 10.3% Source: U.S. Bureau of Labor Statistics NOTE: Rates shown are a percentage of the labor force. Data refer to place of residence.
Childmaltreatment
Child abuse and neglect is another area which has not received the attention merited by the high benefits to costs ratio these programs provide. Maltreatment of children leads to a myriad of
46
other problems like poor physical health, poor emotional health, social difficulties, cognitive dysfunction, high-risk behaviors and behavioral problems both as children and adults. For very young children, neglect is the biggest single cause of maltreatment with abuse increasing as the child ages. In West Virginia, a study found that the results of poor parenting will cost the state almost $80 million by 2010 (Heasley 2007). Screening for child neglect through home visitation programs show the greatest returns for reducing the incidence of child maltreatment. Table19ChildMaltreatmentReferrals(20082009)
Child Maltreatment Referrals and Acceptance Rates 2008 2009 Accepted Percentage Received Accepted Percentage Received 378 85.33% 378 306 80.95% 262 127 86.99% 137 114 83.21% 72 82 74.55% 106 75 70.75% 84 88 87.13% 70 61 87.14% 43 486 83.65% 622 476 76.53% 353 659 72.34% 843 553 65.60% 466 839 78.48% 962 691 71.83% 551 468 75.00% 490 374 76.33% 259 871 81.78% 1,085 758 69.86% 631 712 84.66% 853 625 73.27% 543 60 72.29% 95 62 65.26% 71 101 82.11% 175 122 69.71% 113 116 84.67% 123 108 87.80% 71 264 86.56% 306 253 82.68% 182 94 92.16% 107 91 85.05% 40 1,555 80.57% 1,863 1,324 71.07% 1,095 547 74.42% 741 481 64.91% 398 1,676 72.33% 2,288 1,539 67.26% 1,198 401 68.31% 537 319 59.40% 300 3,188 77.55% 3,861 2,542 65.84% 2,179 550 79.83% 630 495 78.57% 389 632 81.44% 792 594 75.00% 433 417 90.65% 448 351 78.35% 259 702 79.50% 723 508 70.26% 400 557 69.71% 780 502 64.36% 437 193 82.13% 212 124 58.49% 167 716 70.75% 965 675 69.95% 439 152 59.61% 240 96 40.00% 126 939 59.58% 1,705 972 57.01% 1,006 224 76.71% 270 171 63.33% 136 326 68.34% 452 266 58.85% 273 225 70.31% 281 169 60.14% 128 290 54.41% 531 297 55.93% 312 2010 Accepted 150 61 44 37 208 261 297 190 356 306 40 48 48 129 31 676 272 768 163 1,221 266 274 170 238 246 72 255 57 467 93 129 80 151
Brooke Calhoun Doddridge Gilmer Hancock Harrison Marion Marshall Monongalia Ohio Pleasants Ritchie Tyler Wetzel Wirt Wood Boone Cabell Jackson Kanawha Lincoln Logan Mason Mingo Putnam Roane Wayne Barbour Berkeley Grant Hampshire Hardy Jefferson
Received 443 146 110 101 581 911 1,069 624 1,065 841 83 123 137 305 102 1,930 735 2,317 587 4,111 689 776 460 883 799 235 1,012 255 1,576 292 477 320 533
Percentage 57.25% 84.72% 52.38% 86.05% 58.92% 56.01% 53.90% 73.36% 56.42% 56.35% 56.34% 42.48% 67.61% 70.88% 77.50% 61.74% 68.34% 64.11% 54.33% 56.03% 68.38% 63.28% 65.64% 59.50% 56.29% 43.11% 58.09% 45.24% 46.42% 68.38% 47.25% 62.50% 48.40%
47
Lewis Mineral Morgan Pendleton Preston Randolph Tucker Upshur Taylor Braxton Clay Fayette Greenbrier Mercer Monroe McDowell Nicholas Pocahontas Raleigh Summers Webster Wyoming West Virginia
Received 446 530 242 132 622 580 110 494 301 371 272 1,112 625 1,365 181 891 541 131 1,906 254 199 781 36,714
Child Maltreatment Referrals and Acceptance Rates 2008 2009 Accepted Percentage Received Accepted Percentage Received 279 62.56% 437 262 59.95% 224 334 63.02% 511 264 51.66% 293 151 62.40% 283 163 57.60% 165 93 70.45% 91 59 64.84% 60 385 61.90% 472 208 44.07% 266 432 74.48% 665 399 60.00% 342 76 69.09% 108 75 69.44% 50 303 61.34% 572 310 54.20% 306 177 58.80% 227 90 39.65% 110 225 60.65% 347 222 63.98% 178 202 74.26% 319 233 73.04% 166 769 69.15% 1,091 693 63.52% 595 348 55.68% 624 423 67.79% 290 758 55.53% 1,303 738 56.64% 731 107 59.12% 206 130 63.11% 116 695 78.00% 832 625 75.12% 382 437 80.78% 550 400 72.73% 267 86 65.65% 147 109 74.15% 83 1,193 62.59% 1,826 1,155 63.25% 1,025 133 52.36% 221 138 62.44% 134 147 73.87% 210 148 70.48% 98 633 81.05% 755 577 76.42% 352 26,598 72.45% 35,468 23,515 66.30% 19,649
2010 Accepted 94 140 68 33 113 152 24 163 48 142 116 257 177 385 73 270 178 52 555 72 61 205 11,182
Percentage 41.96% 47.78% 41.21% 55.00% 42.48% 44.44% 48.00% 53.27% 43.64% 79.78% 69.88% 43.19% 61.03% 52.67% 62.93% 70.68% 66.67% 62.65% 54.15% 53.73% 62.24% 58.24% 56.91%
48
Figure26
Region Wide Percentage of Referrals Accepted
72.95% 76.00%
90.00% 80.00% 70.00% 60.00% Percentage 50.00%

27.54% 27.42%
80.50%
67.88%
66.44%
59.59%
59.78%
63.47%
66.31%
55.53%
47.72%
57.57%
40.00% 30.00% 20.00% 10.00% 0.00%
2008 (72.28%) 2009 (66.16%)

19.00%
2010 (56.72%)
State Office
Region I
Region II Region
Region III
Region IV
Table20RegionIChildMaltreatmentData
Calhoun Referrals Maltreatment has not occurred Maltreatment has occurred No Findings Unable to complete Initial Assessment Maltreatment has not occurred Maltreatment has occurred No Findings Unable to complete Initial Assessment Maltreatment has not occurred Maltreatment has occurred No Findings Unable to complete Initial Assessment Maltreatment has not occurred Maltreatment has occurred No Findings Unable to complete Initial Assessment Maltreatment has not occurred Maltreatment has occurred No Findings Unable to complete Initial Assessment 2008 63 51 23 22 43 17 11 7 415 73 154 32 417 101 93 15 470 125 144 34 2009 39 26 4 11 14 15 3 1 614 78 67 37 420 72 46 28 421 107 67 31 2010 25 29 6 36 11 2 193 48 20 146 27 11 253 53 27
Gilmer
Hancock
Harrison
Marion
49
Marshall
Monongalia
Ohio
Region I
Ritchie
Wetzel
Wirt
Wood
Brooke
Referrals Maltreatment has not occurred Maltreatment has occurred No Findings Unable to complete Initial Assessment Maltreatment has not occurred Maltreatment has occurred No Findings Unable to complete Initial Assessment Maltreatment has not occurred Maltreatment has occurred No Findings Unable to complete Initial Assessment Maltreatment has not occurred Maltreatment has occurred No Findings Unable to complete Initial Assessment Maltreatment has not occurred Maltreatment has occurred No Findings Unable to complete Initial Assessment Maltreatment has not occurred Maltreatment has occurred No Findings Unable to complete Initial Assessment Maltreatment has not occurred Maltreatment has occurred No Findings Unable to complete Initial Assessment Maltreatment has not occurred Maltreatment has occurred No Findings Unable to complete Initial Assessment Maltreatment has not occurred Maltreatment has occurred No Findings Unable to complete Initial Assessment
2008 480 120 114 44 502 135 161 49 548 73 235 41 61 14 21 133 50 37 10 65 21 19 2 66 22 14 2 953 152 236 54
2009 309 76 91 15 597 117 92 39 495 94 108 31
2010 202 43 3 292 71 15 288 48 23 1
219 62 30 12 193 69 26 8 82 21 5 1 987 172 154 62 11 2 2
77 20 5 163 41 6 32 6
537 122 51 34 2 3
Table21RegionIIChildMaltreatmentData
Boone Referrals Maltreatment has not occurred Maltreatment has occurred No Findings Unable to complete Initial Assessment 2008 437 107 68 66 2009 468 115 36 60 2010 178 67 21
50
Cabell
Jackson
Kanawha
Lincoln
Logan
Mason
Mingo
Putnam
Region II
Roane
Wayne
Referrals Maltreatment has not occurred Maltreatment has occurred No Findings Unable to complete Initial Assessment Maltreatment has not occurred Maltreatment has occurred No Findings Unable to complete Initial Assessment Maltreatment has not occurred Maltreatment has occurred No Findings Unable to complete Initial Assessment Maltreatment has not occurred Maltreatment has occurred No Findings Unable to complete Initial Assessment Maltreatment has not occurred Maltreatment has occurred No Findings Unable to complete Initial Assessment Maltreatment has not occurred Maltreatment has occurred No Findings Unable to complete Initial Assessment Maltreatment has not occurred Maltreatment has occurred No Findings Unable to complete Initial Assessment Maltreatment has not occurred Maltreatment has occurred No Findings Unable to complete Initial Assessment Maltreatment has not occurred Maltreatment has occurred No Findings Unable to complete Initial Assessment Maltreatment has not occurred Maltreatment has occurred No Findings Unable to complete Initial Assessment Maltreatment has not occurred Maltreatment has occurred No Findings Unable to complete Initial Assessment
2008 673 107 367 124 202 31 95 20 2,311 171 484 354 420 73 99 30 310 89 187 32 302 41 29 28 334 135 36 50 348 31 49 11 26 2 3 2 118 26 33 9 502 104 108 63
2009 1,005 106 208 121 234 40 36 25 1,752 96 209 372 386 76 45 35 330 110 66 34 284 45 11 32 394 108 23 51 424 24 29 15
2010 555 67 53 133 39 18 1,007 80 249 188 29 11 213 48 9 162 11 4 194 47 19 191 13 9
91 17 9 7 420 103 67 60
35 8 1 234 47 36
51
Table22RegionIIIChildMaltreatmentData
Barbour Referrals Maltreatment has not occurred Maltreatment has occurred No Findings Unable to complete Initial Assessment Maltreatment has not occurred Maltreatment has occurred No Findings Unable to complete Initial Assessment Maltreatment has not occurred Maltreatment has occurred No Findings Unable to complete Initial Assessment Maltreatment has not occurred Maltreatment has occurred No Findings Unable to complete Initial Assessment Maltreatment has not occurred Maltreatment has occurred No Findings Unable to complete Initial Assessment Maltreatment has not occurred Maltreatment has occurred No Findings Unable to complete Initial Assessment Maltreatment has not occurred Maltreatment has occurred No Findings Unable to complete Initial Assessment Maltreatment has not occurred Maltreatment has occurred No Findings Unable to complete Initial Assessment Maltreatment has not occurred Maltreatment has occurred No Findings Unable to complete Initial Assessment Maltreatment has not occurred Maltreatment has occurred No Findings Unable to complete Initial Assessment Maltreatment has not occurred Maltreatment has occurred 2008 240 37 54 28 559 101 155 81 261 85 50 16 218 33 31 18 175 37 31 2 212 39 52 17 239 55 33 22 193 47 43 14 87 6 27 12 326 70 55 12 122 13 2009 223 30 17 25 847 98 79 108 235 66 10 14 242 47 10 10 51 19 7 6 148 29 6 19 189 32 13 6 141 32 11 14 39 3 2 6 404 58 33 14 52 2010 98 21 14 429 55 84 144 45 10 89 25 5 7 4
Berkeley
Grant
Hampshire
Hardy
Jefferson
108 24 17 76 12 3 101 22 7 37 6 3 197 26 7 47 8
Lewis
Mineral
Preston
Randolph
Taylor
52
Tucker
Upshur
Morgan
Referrals No Findings Unable to complete Initial Assessment Maltreatment has not occurred Maltreatment has occurred No Findings Unable to complete Initial Assessment Maltreatment has not occurred Maltreatment has occurred No Findings Unable to complete Initial Assessment Maltreatment has not occurred Maltreatment has occurred No Findings Unable to complete Initial Assessment
2008 49 9 17 5 1 1 111 30 16 15
2009 2 3 4 1
2010 5 7 1
270 56 17 18
113 23 9 40 2 11
Table23RegionIVChildMaltreatmentData
Braxton Referrals Maltreatment has not occurred Maltreatment has occurred No Findings Unable to complete Initial Assessment Maltreatment has not occurred Maltreatment has occurred No Findings Unable to complete Initial Assessment Maltreatment has not occurred Maltreatment has occurred No Findings Unable to complete Initial Assessment Maltreatment has not occurred Maltreatment has occurred No Findings Unable to complete Initial Assessment Maltreatment has not occurred Maltreatment has occurred No Findings Unable to complete Initial Assessment Maltreatment has not occurred Maltreatment has occurred No Findings Unable to complete Initial Assessment Maltreatment has not occurred Maltreatment has occurred 2008 171 41 5 11 133 42 13 8 385 97 193 115 211 50 18 27 390 126 101 29 479 144 147 93 83 16 2009 131 34 20 7 160 51 9 16 346 109 83 98 344 73 19 21 532 99 56 28 336 117 46 61 103 33 2010 109 53 3 67 49 16 207 58 24 131 30 11 308 32 17 279 68 52 48 17
Clay
Fayette
Greenbrier
McDowell
Mercer
Monroe
53
Nicholas
Pocahontas
Raleigh
Region IV
Summers
Webster
Wyoming
Referrals No Findings Unable to complete Initial Assessment Maltreatment has not occurred Maltreatment has occurred No Findings Unable to complete Initial Assessment Maltreatment has not occurred Maltreatment has occurred No Findings Unable to complete Initial Assessment Maltreatment has not occurred Maltreatment has occurred No Findings Unable to complete Initial Assessment Maltreatment has not occurred Maltreatment has occurred No Findings Unable to complete Initial Assessment Maltreatment has not occurred Maltreatment has occurred No Findings Unable to complete Initial Assessment Maltreatment has not occurred Maltreatment has occurred No Findings Unable to complete Initial Assessment Maltreatment has not occurred Maltreatment has occurred No Findings Unable to complete Initial Assessment
2008 13 14 345 112 91 41 43 43 12 2 841 201 185 159 1 3
2009 4 10 249 105 20 40 56 29 8 856 167 93 92
2010 6 120 59 21 31 14 1 442 81 65 1 1 35 15 4 61 29 9 181 50 43
8 7 2 85 33 21 13 339 155 52 80
15 10 2 79 28 3 8 388 109 24 72
54
55
SectionThree:DataReportsforeachAtRiskCommunity
Boone County is currently at risk of becoming economically depressed. The countys unemployment rate is 4.2% compared to the state average of 4.4%. The per capita income of the county is $16,406 which is 74.99% of the average per capita income of West Virginia. The countys poverty rate is 22.0%, which is 122.91% of the state average poverty rate of 17.9%. All six of the health and well being indicators were present in this county.
BooneCounty
Indicator Title V CAPTA Head Start SAMHSA Sub-State Treatment Planning Data Reports Other Comments
Premature birth -Percent: # live births before 37 weeks/total # live births Low-birth-weight infants -Percent: # resident live births less than 2500 grams/# resident live births Infant mortality (includes death due to neglect) -# infant deaths ages 0-1/1,000 live births Poverty -# residents below 100% FPL/total # residents -# residents <18 below 100% FPL/total # residents <18 -# residents ages 5-17 below 100% FPL/total # residents ----21.3 27.5 ----11.33 ----11.61 ----14.16
56
BooneCounty
age 5-17 Crime - # reported crimes/1000 residents - # crime arrests ages 0-19/100,000 juveniles age 0-19 Domestic violence -As determined by each State in conjunction with the State agencies administering the FVPSA School Drop-out Rates -Percent high school drop-outs grades 9-12 -Other school drop-out rates as per State/local calculation method Substance abuse -Prevalence rate: Binge alcohol use in past month -Prevalence rate: Marijuana use in past month -Prevalence rate: Nonmedical use of prescription drugs in past month - Prevalence rate: Use of illicit drugs, excluding Marijuana, in past month --------
23.3
475.5
12.4
3.4
3.4
18.66 4.91 4.02 7.39
57
BooneCounty
Unemployment -Percent: # unemployed and seeking work/total workforce Child maltreatment -Rate of reported of substantiated maltreatment (substantiated/indicated/alt response victim) -Rate of reported substantiated maltreatment by type Other indicators of at risk prenatal, maternal, newborn, or child health - As available
8.0 Child Maltreatment in measured in region not counties in West Virginia
58
Cabell County is currently in a transitional status. The countys unemployment rate is 4.0% compared to the state average of 4.4%. The per capita income of the county is $22,692 which is 103.72% of the average per capita income of West Virginia. The countys poverty rate is 22.6%, which is 126.26% of the state average poverty rate of 17.9%. Despite its economic status Cabell County had all six of the health and welfare indicators present.
CabellCounty
Premature birth -Percent: # live births before 37 weeks/total # live births Low-birth-weight infants -Percent: # resident live births less than 2500 grams/# resident live births Infant mortality (includes death due to neglect) -# infant deaths ages 0-1/1,000 live births Poverty -# residents below 100% FPL/total # residents -# residents <18 below 100% FPL/total # residents <18 -# residents ages 5-17 below 100% FPL/total # residents 20.6 25.9 22.9 --10.33 ---11.14 ---15.10 ----
2008 Vital Statistics 2008 Vital Statistics
2008 Vital Statistics
US Census
59
CabellCounty
age 5-17 Crime - # reported crimes/1000 residents - # crime arrests ages 0-19/100,000 juveniles age 0-19 Domestic violence -As determined by each State in conjunction with the State agencies administering the FVPSA School Drop-out Rates -Percent high school drop-outs grades 9-12 -Other school drop-out rates as per State/local calculation method Substance abuse -Prevalence rate: Binge alcohol use in past month -Prevalence rate: Marijuana use in past month -Prevalence rate: Nonmedical use of prescription drugs in past month - Prevalence rate: Use of illicit drugs, excluding Marijuana, in past month ---7.1 ----1031.6
3.5
3.5
19.34 5.74 5.03 9.06
60
CabellCounty
61
Clay County is currently distressed and economically depressed. The countys unemployment rate is 6.4% compared to the state average of 4.4%. The per capita income of the county is $12,221 which is 55.86% of the average per capita income of West Virginia. The countys poverty rate is 27.5%, which is 153.63% of the state average poverty rate of 17.9%. Clay County had two of the health and welfare indicators with rates above the state average and two indicators above the median.
ClayCounty
Premature birth -Percent: # live births before 37 weeks/total # live births Low-birth-weight infants -Percent: # resident live births less than 2500 grams/# resident live births Infant mortality (includes death due to neglect) -# infant deaths ages 0-1/1,000 live births Poverty -# residents below 100% FPL/total # residents -# residents <18 below 100% FPL/total # residents <18 -# residents ages 5-17 below 100% FPL/total # residents age 5-17 24.7 35.4 31.0 --7.04 ---7.75 ---17.61 ----
US Census
62
ClayCounty
Crime - # reported crimes/1000 residents - # crime arrests ages 0-19/100,000 juveniles age 0-19 Domestic violence -As determined by each State in conjunction with the State agencies administering the FVPSA School Drop-out Rates -Percent high school drop-outs grades 9-12 -Other school drop-out rates as per State/local calculation method Substance abuse -Prevalence rate: Binge alcohol use in past month -Prevalence rate: Marijuana use in past month -Prevalence rate: Nonmedical use of prescription drugs in past month - Prevalence rate: Use of illicit drugs, excluding Marijuana, in past month ---3.6 ----259.4
2.8
2.8
18.66 4.91 4.02 7.39
63
ClayCounty
64
Fayette County is currently at risk of becoming economically depressed. The countys unemployment rate is 5.0% compared to the state average of 4.4%. The per capita income of the county is $15,463 which is 70.68% of the average per capita income of West Virginia. The countys poverty rate is 21.7%, which is 121.23% of the state average poverty rate of 17.9%. Having three indicators above the state average and one above the state median qualified Fayette County for the project.
FayetteCounty
US Census
65
FayetteCounty
4.2
4.2
17.00 4.59 3.95 6.68
66
FayetteCounty
67
Gilmer County is currently at risk of becoming economically depressed. The countys unemployment rate is 4.0% compared to the state average of 4.4%. The per capita income of the county is $16,822 which is 76.89% of the average per capita income of West Virginia. The countys poverty rate is 25.9%, which is 144.69% of the state average poverty rate of 17.9%. Gilmer County had two of the health and welfare indicators above the state average and two above the state median which placed it in the program group.
GilmerCounty
US Census
68
GilmerCounty
0.9
0.9
22.01 7.19 5.11 9.35
69
GilmerCounty
70
Kanawha County is currently in a transitional status. The countys unemployment rate is 3.8% compared to the state average of 4.4%. The per capita income of the county is $30,926 which is 141.35% of the average per capita income of West Virginia. The countys poverty rate is 14.4%, which is 80.45% of the state average poverty rate of 17.9%. Despite being the home of the state capital with an above average per-capita income, Kanawha County qualified on four of the indicators for health and welfare.
KanawhaCounty
US Census
71
KanawhaCounty
3.6
3.6
18.66 4.91 4.02 7.39
72
KanawhaCounty
73
Lincoln County is currently distressed and economically depressed. The countys unemployment rate is 5.2% compared to the state average of 4.4%. The per capita income of the county is $14,423 which is 65.92% of the average per capita income of West Virginia. The countys poverty rate is 27.9%, which is 155.87% of the state average poverty rate of 17.9%. Lincoln County is included as it has five of the 6 health and welfare indicators.
LincolnCounty
US Census
74
LincolnCounty
3.2
3.2
19.34 5.74 5.03 9.06
75
LincolnCounty
76
Logan County is currently at risk of becoming economically depressed. The countys unemployment rate is 4.4% compared to the state average of 4.4%. The per capita income of the county is $16,900 which is 77.24% of the average per capita income of West Virginia. The countys poverty rate is 24.1%, which is 134.64% of the state average poverty rate of 17.9%. Logan County makes the list as four of the six health and welfare indicators are present.
LoganCounty
US Census
77
LoganCounty
2.8
2.8
19.34 5.74 5.03 9.06
78
LoganCounty
79
McDowell County is currently distressed and economically depressed. The countys unemployment rate is 6.7% compared to the state average of 4.4%. The per capita income of the county is $10,199 which is 46.62% of the average per capita income of West Virginia. The countys poverty rate is 37.7%, which is 210.61% of the state average poverty rate of 17.9%. McDowell County qualifies by having four of the indicators above the state average and one additional above the state median.
McDowellCounty
US Census
80
McDowellCounty
3.5
3.5
16.93 4.57 3.95 7.25
81
McDowellCounty
82
Mason County is currently at risk of becoming economically depressed. The countys unemployment rate is 6.7% compared to the state average of 4.4%. The per capita income of the county is $16,435 which is 75.12% of the average per capita income of West Virginia. The countys poverty rate is 19.9%, which is 111.17% of the state average poverty rate of 17.9%. Five of the six health and welfare indicators are above the state average with one additional one being in excess of the state median.
MasonCounty
US Census
83
MasonCounty
3.1
3.1
19.34 5.74 5.03 9.06
84
MasonCounty
85
Mercer County is currently in a transitional status. The countys unemployment rate is 4.2% compared to the state average of 4.4%. The per capita income of the county is $18,191 which is 83.14% of the average per capita income of West Virginia. The countys poverty rate is 19.7%, which is 110.06% of the state average poverty rate of 17.9%. Four of the six health and welfare indicators were above the state average in this county.
MercerCounty
US Census
86
MercerCounty
3.4
3.4
16.93 4.57 3.95 7.25
87
MercerCounty
88
Mineral County is currently in a transitional status. The countys unemployment rate is 4.6% compared to the state average of 4.4%. The per capita income of the county is $19,279 which is 88.12% of the average per capita income of West Virginia. The countys poverty rate is 14.7%, which is 82.12% of the state average poverty rate of 17.9%. Mineral County is included by having four of the six health and welfare indicators present despite its relatively high economic status.
MineralCounty
US Census
89
MineralCounty
Crime - # reported crimes/1000 residents - # crime arrests ages 0-19/100,000 juveniles age 0-19 Domestic violence -As determined by each State in conjunction with the State agencies administering the FVPSA School Drop-out Rates -Percent high school drop-outs grades 9-12 -Other school drop-out rates as per State/local calculation method Substance abuse -Prevalence rate: Binge alcohol use in past month -Prevalence rate: Marijuana use in past month -Prevalence rate: Nonmedical use of prescription drugs in past month - Prevalence rate: Use of illicit drugs, excluding Marijuana, in past month --4.0 ---420.8
0.7
0.7
18.77 5.25 4.00 7.23
90
MineralCounty
91
Mingo County is currently distressed and economically depressed. The countys unemployment rate is 4.9% compared to the state average of 4.4%. The per capita income of the county is $15,964 which is 72.96% of the average per capita income of West Virginia. The countys poverty rate is 29.7%, which is 165.92% of the state average poverty rate of 17.9%. Four of the five health and welfare indicators in Mingo County were above the state average with one additional above the state median.
MingoCounty
Premature birth -Percent: # live births before 37 weeks/total # live births Low-birth-weight infants -Percent: # resident live births less than 2500 grams/# resident live births Infant mortality (includes death due to neglect) -# infant deaths ages 0-1/1,000 live births Poverty -# residents below 100% FPL/total # residents -# residents <18 below 100% FPL/total # residents <18 -# residents ages 5-17 below 100% FPL/total # residents 24.6 33.7 --14.37 ---12.06 ---15.00 ----
US Census
92
MingoCounty
age 5-17 Crime - # reported crimes/1000 residents - # crime arrests ages 0-19/100,000 juveniles age 0-19 Domestic violence -As determined by each State in conjunction with the State agencies administering the FVPSA School Drop-out Rates -Percent high school drop-outs grades 9-12 -Other school drop-out rates as per State/local calculation method Substance abuse -Prevalence rate: Binge alcohol use in past month -Prevalence rate: Marijuana use in past month -Prevalence rate: Nonmedical use of prescription drugs in past month - Prevalence rate: Use of illicit drugs, excluding Marijuana, in past month
28.7
--
--
--
--
380.1
--
--
--
4.9
3.7
3.7
19.34 5.74 5.03 9.06
93
MingoCounty
94
Nicholas County is currently at risk of becoming economically depressed. The countys unemployment rate is 4.7% compared to the state average of 4.4%. The per capita income of the county is $17,905 which is 81.84% of the average per capita income of West Virginia. The countys poverty rate is 19.2%, which is 107.26% of the state average poverty rate of 17.9%. All six of the indicators were found to be present in Nicholas County.
NicholasCounty
Premature birth -Percent: # live births before 37 weeks/total # live births Low-birth-weight infants -Percent: # resident live births less than 2500 grams/# resident live births Infant mortality (includes death due to neglect) -# infant deaths ages 0-1/1,000 live births Poverty -# residents below 100% FPL/total # residents 18.1 9.65 ---12.22 ---13.18 ----
95
NicholasCounty
Indicator Title V CAPTA Head Start SAMHSA Sub-State Treatment Planning Data Reports -Other Comments
-# residents <18 below 100% FPL/total # residents <18 -# residents ages 5-17 below 100% FPL/total # residents age 5-17 Crime - # reported crimes/1000 residents - # crime arrests ages 0-19/100,000 juveniles age 0-19 Domestic violence -As determined by each State in conjunction with the State agencies administering the FVPSA School Drop-out Rates -Percent high school drop-outs grades 9-12 -Other school drop-out rates as per State/local calculation method Substance abuse -Prevalence rate: Binge alcohol use in past month -Prevalence rate: Marijuana use in past month -Prevalence rate: Nonmedical use of prescription drugs
26.7 24.3
--
US Census
--
--
--
--
613.5
--
--
--
8.3
4.2
4.2
18.77 5.25
96
NicholasCounty
Indicator Title V CAPTA Head Start SAMHSA Sub-State Treatment Planning Data Reports
4.00 7.23
Other
Comments
in past month - Prevalence rate: Use of illicit drugs, excluding Marijuana, in past month Unemployment -Percent: # unemployed and seeking work/total workforce Child maltreatment -Rate of reported of substantiated maltreatment (substantiated/indicated/alt response victim) -Rate of reported substantiated maltreatment by type Other indicators of at risk prenatal, maternal, newborn, or child health - As available
97
Raleigh County is currently in a transitional status. The countys unemployment rate is 4.1% compared to the state average of 4.4%. The per capita income of the county is $21,313 which is 97.41% of the average per capita income of West Virginia. The countys poverty rate is 18.5%, which is 103.35% of the state average poverty rate of 17.9%. Raleigh County is included as all six of the indicators are present with four being above the state average and two above the state median.
RaleighCounty
Premature birth -Percent: # live births before 37 weeks/total # live births Low-birth-weight infants -Percent: # resident live births less than 2500 grams/# resident live births Infant mortality (includes death due to neglect) -# infant deaths ages 0-1/1,000 live births Poverty -# residents below 100% FPL/total # residents
10.92 ----
9.50
--
--
--
6.48
--
--
--
19.6
98
RaleighCounty
Indicator Title V CAPTA Head Start SAMHSA Sub-State Treatment Planning Data Reports -Other Comments
-# residents <18 below 100% FPL/total # residents <18 -# residents ages 5-17 below 100% FPL/total # residents age 5-17 Crime - # reported crimes/1000 residents - # crime arrests ages 0-19/100,000 juveniles age 0-19 Domestic violence -As determined by each State in conjunction with the State agencies administering the FVPSA School Drop-out Rates -Percent high school drop-outs grades 9-12 -Other school drop-out rates as per State/local calculation method Substance abuse -Prevalence rate: Binge alcohol use in past month -Prevalence rate: Marijuana use in past month -Prevalence rate: Nonmedical use of prescription drugs
28.0 25.2
--
US Census
--
--
--
--
831.7
--
--
--
14.3
3.1
3.1
17.00 4.59
99
RaleighCounty
Indicator Title V CAPTA Head Start SAMHSA Sub-State Treatment Planning Data Reports
3.95 6.68
Other
Comments
in past month - Prevalence rate: Use of illicit drugs, excluding Marijuana, in past month Unemployment -Percent: # unemployed and seeking work/total workforce Child maltreatment -Rate of reported of substantiated maltreatment (substantiated/indicated/alt response victim) -Rate of reported substantiated maltreatment by type Other indicators of at risk prenatal, maternal, newborn, or child health - As available
100
Ritchie County is currently at risk of becoming economically depressed. The countys unemployment rate is 5.0% compared to the state average of 4.4%. The per capita income of the county is $18,308 which is 83.68% of the average per capita income of West Virginia. The countys poverty rate is 19.1%, which is 106.7% of the state average poverty rate of 17.9%. Richie County is included as three of the health and welfare indices are above the state average and one above the state median.
RitchieCounty
Premature birth -Percent: # live births before 37 weeks/total # live births Low-birth-weight infants -Percent: # resident live births less than 2500 grams/# resident live births Infant mortality (includes death due to neglect) -# infant deaths ages 0-1/1,000 live births Poverty -# residents below 100% FPL/total # residents -# residents <18 below 100% FPL/total # residents <18 -# residents ages 5-17 below 100% FPL/total # residents 17.1 24.6 --0.00 ---7.96 ---9.73 ----
US Census
101
RitchieCounty
age 5-17 Crime - # reported crimes/1000 residents - # crime arrests ages 0-19/100,000 juveniles age 0-19 Domestic violence -As determined by each State in conjunction with the State agencies administering the FVPSA School Drop-out Rates -Percent high school drop-outs grades 9-12 -Other school drop-out rates as per State/local calculation method Substance abuse -Prevalence rate: Binge alcohol use in past month -Prevalence rate: Marijuana use in past month -Prevalence rate: Nonmedical use of prescription drugs in past month - Prevalence rate: Use of illicit drugs, excluding Marijuana, in past month
21.7
--
--
--
--
400.2
--
--
--
5.6
2.4
2.4
19.09 4.59 4.02 6.97
102
RitchieCounty
103
Summers County is currently distressed and economically depressed. The countys unemployment rate is 5.5% compared to the state average of 4.4%. The per capita income of the county is $11,980 which is 54.76% of the average per capita income of West Virginia. The countys poverty rate is 24.4%, which is 136.31% of the state average poverty rate of 17.9%. Four of the six indices are present in Summers County all of which are above the state average.
SummersCounty
US Census
104
SummersCounty
3.0
3.0
17.00 4.59 3.95 6.68
105
SummersCounty
106
Upshur County is currently at risk of becoming economically depressed. The countys unemployment rate is 4.2% compared to the state average of 4.4%. The per capita income of the county is $17,987 which is 82.21% of the average per capita income of West Virginia. The countys poverty rate is 20.0%, which is 111.73% of the state average poverty rate of 17.9%. With three of the health and welfare criteria being above the state average and one above the state median Upshur County will be included.
UpshurCounty
US Census
107
UpshurCounty
3.5
3.5
18.77 5.25 4.00 7.23
108
UpshurCounty
109
Wayne County is currently in a transitional status. The countys unemployment rate is 4.7% compared to the state average of 4.4%. The per capita income of the county is $18,768 which is 85.78% of the average per capita income of West Virginia. The countys poverty rate is 19.6%, which is 109.5% of the state average poverty rate of 17.9%. The income figures for Wayne County are distorted due to the presence of part of the City of Huntington and two of its suburbs being located in the far northern portion of the county. But the rest of the county is severely distressed. Five of the six indicators for health and welfare are above the state average with one more above the state median.
WayneCounty
Premature birth -Percent: # live births before 37 weeks/total # live births Low-birth-weight infants -Percent: # resident live births less than 2500 grams/# resident live births Infant mortality (includes death due to neglect) -# infant deaths ages 0-1/1,000 live births Poverty -# residents below 100% FPL/total # residents -# residents <18 below 100% FPL/total # residents <18 17.6 24.2 --8.70 ---14.35 ---19.78 ----
US Census
110
WayneCounty
-# residents ages 5-17 below 100% FPL/total # residents age 5-17 Crime - # reported crimes/1000 residents - # crime arrests ages 0-19/100,000 juveniles age 0-19 Domestic violence -As determined by each State in conjunction with the State agencies administering the FVPSA School Drop-out Rates -Percent high school drop-outs grades 9-12 -Other school drop-out rates as per State/local calculation method Substance abuse -Prevalence rate: Binge alcohol use in past month -Prevalence rate: Marijuana use in past month -Prevalence rate: Nonmedical use of prescription drugs in past month - Prevalence rate: Use of illicit drugs, excluding Marijuana, in past month
20.6
--
--
--
--
439.1
--
--
--
6.8
3.5
19.34 5.74 5.03 9.06
3.5
111
WayneCounty
112
Wetzel County is currently at risk of becoming economically depressed. The countys unemployment rate is 7.1% compared to the state average of 4.4%. The per capita income of the county is $18,909 which is 86.43% of the average per capita income of West Virginia. The countys poverty rate is 19.8%, which is 110.61% of the state average poverty rate of 17.9%. Wetzel County in included as three of the indicators are above the state average with one additional placing it above the state median.
WetzelCounty
US Census
113
WetzelCounty
1.9
1.9
23.30 5.04 4.49 7.44
114
WetzelCounty
115
Wood County is currently in a transitional status. The countys unemployment rate is 4.6% compared to the state average of 4.4%. The per capita income of the county is $22,189 which is 101.42% of the average per capita income of West Virginia. The countys poverty rate is 13.9%, which is 77.65% of the state average poverty rate of 17.9%. Four of the six health and welfare indicators were above the state average for Wood County.
WoodCounty
US Census
116
WoodCounty
1.9
1.9
19.09 4.59 4.02 6.97
117
WoodCounty
118
Wyoming County is currently distressed and economically depressed. The countys unemployment rate is 5.2% compared to the state average of 4.4%. The per capita income of the county is $15,336 which is 70.09% of the average per capita income of West Virginia. The countys poverty rate is 25.1%, which is 140.22% of the state average poverty rate of 17.9%. Wyoming makes the list of project counties as four of the six health and welfare indicators are above the state average.
WyomingCounty
US Census
119
WyomingCounty
3.3
3.3
16.93 4.57 3.95 7.25
120
WyomingCounty
121
Section Four: Quality and Capacity of Existing Programs/Initiatives for Early Childhood Home Visitation in Each of the Communities Identified asBeingAtRisk ExistingPrograms
The home visitation models/programs currently providing services in the State include: Partners in Community Outreach (Healthy Families America; Maternal Infant Health Outreach Workers; and Parents as Teachers), Early Head Start, Right From The Start Program (the States Medicaid perinatal case management home visitation program) and Healthy Start/Helping Appalachian Parents & Infants (HAPI) Project. The West Virginia Birth to Three/Early Intervention Part C Program (BTT) provides a system of services and supports for children birth to age three (3) who have a delay in development or who may be at risk for delay. While many critical BTT services are provided in the home setting, this program will serve as a referral source in the continuum of services for at-risk infants but will not be considered a home visiting program for purposes of this grant funding stream.
122
NameoftheProgram Partners in Community Outreach (PICO) HomeVisitingModelorApproachInUse Partners in Community Outreach (PICO) is a coalition of In-Home Family Education programs operating in West Virginia that provide support, training and quality enhancement to participating programs. The program models represented in the coalition include: Healthy Families America, the Maternal Infant Health Outreach Worker Program (MIHOW), and Parents as Teachers. Each of these program models are carried out with fidelity within the framework of their nationally recognized standards. Each individual model will be explained within their individual model explanation. SpecificServicesProvided Based upon the individual model (Healthy Families America, Maternal, Infant Health Outreach Worker Program (MIHOW) and Parents as Teachers, each program carries out home visitation services within their nationally recognized standards. These services provided will be expanded upon within their individual description. IntendedRecipientoftheService Based upon the individual model, the intended recipients range from prenatal to early childhood. TargetedGoals/OutcomesoftheIntervention The coalitions goal is to create a statewide system of inhome family education that reaches at least 20% of the families that are expecting a child or have children under age three. Inhome family educators are currently focusing on reducing low birth weights, failure to immunize, and child maltreatment. DemographicCharacteristicsofIndividualsorFamiliesServed The three models serve primarily high-risk, low income families with very young children present in the household. The specific characteristics of each model will be explained in the individual model explanation. NumberofIndividualsorFamiliesServed Partners in Community Outreach does not serve clients but provides the network to assist in building a system that assures program quality and accountability for the models within their system. GeographicAreaServed The combined efforts of the three models provided services within 17 West Virginia counties.
123
NameoftheProgram Healthy Families America (HFA) HomeVisitingModelorApproachInUse All Healthy Families America programs adhere to a series of Critical Elements. Critical Elements serve as the framework for program development and implementation. Only those programs that apply for affiliation and promise to adhere to all the elements, as determined by the HFA credentialing system, may be referred to as HFA sites. These basic elements allow for flexibility in service implementation to permit integration into a wide range of communities. The communities are encouraged to review the existing curricula and materials and select what best meets the needs of their population being served. Little Bits, Growing Great Kids, and Partners for a Healthy Baby curricula are the primary curricula used. SpecificServicesProvided Ensure families have a medical provider Share information on children's development processes Assist families in identifying their baby's needs and obtaining certain resources Support families in the home while they respond to their child's and their own needs Share ideas on caring for babies, toddlers, and young children Link families with other resources in the community for assistance with job placement, identification of child care providers, etc Assist families in following up with recommended immunization schedules Help families feel more empowered IntendedRecipientoftheService Services are targeted for overburdened families who are at-risk for child abuse and neglect and other adverse childhood experiences. The model is designed to work with families having a history of trauma, intimate partner violence, mental health and/or substance abuse. Services can begin during pregnancy and for three (3) to five (5) years after the birth of the baby. TargetedGoals/OutcomesoftheIntervention Reduced child maltreatment Increased use of prenatal care Decreased pre-term, low weight babies Improved parent-child interaction and school readiness Decreased dependency on welfare (TANF) and other social services Increased access to primary care medical services Increased immunization rates Reduction in intimate partner violence Increased breastfeeding Enhanced child development Increased knowledge of child development DemographicCharacteristicsofIndividualsorFamiliesServed Voluntarily accept services into the program and be a resident of either Cabell or Wayne County in West Virginia.
124
NumberofIndividualsorFamiliesServed Number of families served during each calendar year in the following categories Category: Prenatal Infants to Three Year Olds Three to Five Year Olds 2006 88 88 13 2007 93 93 14 2008 93 93 14 2009 88 88 13
The individual detail by County of their program is Appendix D.. GeographicAreaServed Services are provided within Cabell and Wayne counties in West Virginia. Figure27HealthyFamiliesAmericaServiceArea
Ha nc oc k
B rook e
Oh io
Healthy Families America C ounties S erved C Y 2009
M a rs ha ll
W e ze l t
M o nonga lia M orga n M a ion r
T yl r e Ple a s a nts T a lo r y Dod dridge Wo od R itc hie H a rris on B a rbour
P re s ton M ine ra l H a m ps hire G ra nt H a rdy Le w is
B e rk e le y J e ffe rs on
Tuc k e r
Wirt Ca lhoun M a s on J a c k s on G ilm e r
Ups hu r
R a ndolph Roa ne B ra x ton P utna m We bs te r C a be ll Ka na w ha Cla y
Pe ndle to n
N ic hola s Wa y ne Linc oln
Po c a onta s h
Boone Fa y e tte G re e nbrie r M ingo L oga n Ra le igh Wy om ing Sum m e r s M onr oe
M c D owe ll
M e rc e r
125
TheNameoftheProgram Maternal Infant Health Outreach Workers (MIHOW) HomeVisitingModelorApproachInUse Home visits are based upon four (4) comprehensive Home Visit Guides from pregnancy through third year of life developed by the Center for Health Sciences at Vanderbilt Universitys Medical School. SpecificServicesProvided Prenatal information including healthy pregnancy information and preparation for labor and delivery Health and child development education Support for healthy lifestyles Positive parenting assistance Nonjudgmental listening Advocacy with health and social service systems Parenting groups IntendedRecipientoftheService Services are provided to any pregnant woman who voluntarily chooses to participate with no cost to the client. Clients enter the program prenatally and continue with home visiting services through the childs third year of life. Caregivers and children birth to kindergarten can participate in Parent/Child Play groups or Family Group Activities without participating in the Home Visit Program. TargetedGoals/OutcomesoftheIntervention Enroll in prenatal care by the second trimester of pregnancy Access benefits and services helpful during pregnancy and early childhood years Provide a safe environment for their infant(measured by Infant Safety Survey) Understand the need for support and assistance during pregnancy and parents Work to develop social connections Initiate breastfeeding at birth Feed their babies within a normal range to promote optimal growth without overfeeding Create a medical home for their children and follow routine health practices such as well baby exams and immunizations Read regularly to their children Feel more confident in their ability to solve problems Express confidence in self and satisfaction with parenting DemographicCharacteristicsofIndividualsorFamiliesServed Services are available to any pregnant woman and child through their third year of life in the Fayette, Raleigh and Nicholas counties within the southern part of the state.
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NumberofIndividualsorFamiliesServed Number of families served during each calendar year in the following categories:
Category: Prenatal Infants to Three Year Olds Three to Five Year Olds 2006 103 163 25 (Group Services) 2007 95 162 25 (Group Services) 2008 116 163 25 (Group Services) 2009 99 176 25 (Group Services)
The individual detail by County of their program is Appendix D. GeographicAreaServed Fayette County (including neighboring communities in Greenbrier, Raleigh and Nicholas counties) and Ohio County. Figure28MaternalInfantHealthOutreachWorkersServiceArea
Ha nc oc k
B rook e
Maternal I nfant Health Ou treach Work ers (MIHOW) Cou nties Served C Y 2009
Oh io
M a rs ha ll
W e ze l t
M ononga lia M orga n M a rion
Ty r le Ple a s a nts Ta y lor Dod dridge Wood R i c hie t Ba rbo ur H a rris on
Pre s ton M ine ra l
Be rk e le y J e ffe rs on H a m ps hire Gr a nt
T uc k e r H a rdy
Wirt Ca lhoun Mas n o Jacks n o G ilm e r
L e wis
Up s ur h
Ra nd olph R oa ne B ra x ton
P e ndle ton
Put na m Ca be ll K a na w ha Cla y
We bs te r
N ic hola s Wa y ne L inc oln
P oc a honta s
B oone
Fa y e tte G re e nbr ie r
M ingo Loga n Ra le igh Wy om ing Sum m e r s M onr oe
M c Dow e ll
M e rc e r
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NameoftheProgram Parents as Teachers (PAT) HomeVisitingModelorApproachInUse The West Virginia PAT program utilizes the four part intervention model and accompanying curriculum known as Born to Learn. The curriculum was developed through the National Center based in St. Louis teaming with Washington University Neuroscience Program. SpecificServicesProvided Conduct information on stages of development Provide tips on home safety Methods of effective discipline Development of constructive play activities Offer monthly group meetings, weekly play groups Provide periodic monitoring and formal screenings of overall development, language, hearing and vision IntendedRecipientoftheService Voluntary to any and all families prenatal through age 5. TargetedGoals/OutcomesoftheIntervention Improvements in prenatal, maternal and newborn health, including improved pregnancy outcomes Improvements in child health and development, including the prevention of child injuries and maltreatment and improvements in cognitive, language, social-emotional and physical development indicators Improvements in parenting skills Improvements in school readiness and child academic achievement Reduction in crime or domestic violence among participants Improvements in family economic self-sufficiency Improvements in the coordination of referrals for, and the provision of, other community resources and supports for eligible families consistent with State child welfare agency training DemographicCharacteristicsofIndividualsorFamiliesServed Parents as Teachers serve all pregnant women regardless of income. The program is free and voluntary to any expectant family. The program serves any client from prenatal through age 5. NumberofIndividualsorFamiliesServed Number of families served during each calendar year in the following categories
Category: Prenatal Infants to Three Year Olds Three to Five Year Olds 2006 * * * 2007 * * * 2008 * * * 2009 * * *
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The individual detail by County of their program is Appendix D. The Parents as Teachers Program is continuing to collect the remaining county data reports and will submit with the Updated State Plan. GeographicAreaServed Services are provided in Brooke, Hancock, Clay, Kanawha, Marshall, Monongalia, Monroe, Preston, Taylor, Greenbrier, Pocahontas, Summers, Mercer, Tucker, Wetzel and Tyler counties. Figure29ParentsasTeachersServiceArea
Hancock
Brooke
Parents as Teachers (PAT) Counties Served CY 2009
Ohio
Marshall
Wetzel Tyler Pleasants Doddridge Ritchie
Monongalia Marion Morgan Preston Mineral Taylor Harrison Barbour Tucker Grant Hardy Hampshire Berkeley Jefferson
Wood
Wirt Cal- Gilmer houn Mason Jackson Roane
Lewis
Upshur
Randolph Braxton
Pendleton
Putnam Cabell Kanawha Clay Nicholas Wayne Lincoln Boone
Webster
Pocahontas
Fayette Greenbrier
Mingo Logan Wyoming Raleigh Summers Monroe
McDowell
Mercer
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NameoftheProgram Head Start/Early Head Start (HS/EHS) HomeVisitingModelorApproachInUse Early Head Start evolved out of Head Start's long history of providing services to infants and toddlers through Parent Child Centers, Comprehensive Child Development Centers (CCDPs) and Migrant Head Start programs. Recent advances in the field of infant development make this an especially exciting time to have Head Start formally expand its family to include the provision of Early Head Start services. SpecificServicesProvided In 1994, the Secretary of Health and Human Services formed an Advisory Committee on Services for Families with Infants and Toddlers to design EHS. EHS evolved out of Head Start's long history of providing services to infants and toddlers through Parent and Child Centers, Comprehensive Child Development Centers (CCDPs), Migrant and Seasonal Head Start programs, and other early child development and family support efforts serving families with very young children. Recent advances in the field of infant development make EHS services so important. IntendedRecipientoftheService Early Head Start (EHS) is a federally funded community-based program for low-income families with infants and toddlers and pregnant women. TargetedGoals/OutcomesoftheIntervention The community-based Early Head Start programs are based on a foundation of nine principles: Commitment to high quality that will develop policies and practices that are founded in the knowledge, skills, and professional ethics embraced by the fields of child development, family development, and community building. Promote healthy child development and family functioning beginning before conception, and continues prenatally, upon birth, and through the early years. Development of strong positive relationships that continue over time Support of the highest level of parent involvement and partnership Welcome and fully include children with disabilities. The individual needs of each child will be evaluated and responded to in a way that builds upon individual strengths. Support the home culture and language of each family as an important aspect of early identity formation. Programs will also explore the role of culture and language in child and family development, and community values and attitudes. Ensure program services are grounded in the belief that all families can identify their own needs and strengths, set their own goals, and are capable of growth. Responsible for facilitating a smooth transition from Early Head Start into Head Start or other high quality programs and support services. Collaborate with local community agencies and service providers to maximize the resources available to families with young children in a cost-efficient and comprehensive manner.
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DemographicCharacteristicsofIndividualsorFamiliesServed Each Early Head Start program is responsible for determining its own eligibility criteria. Family income is one key factor in determining eligibility. The federal poverty guidelines are used to evaluate family income. Early Head Start programs may elect to target their services to a particular population to best meet the unique needs of families and children in their community.4 NumberofIndividualsorFamiliesServed Number of families served during each calendar year in the following categories Category: Children Families 2009 511 *
Head Start/Early Head Start programs are continuing to collect the remaining Community Needs Assessments and will submit with the Updated State Plan. GeographicAreaServed Figure 30 displays the service delivery area for the grantee organization where children and families receive comprehensive services that address family needs, health, nutrition, and early education. In West Virginia, services are provided through a variety of collaborative models and all West Virginia Head Start programs have 4 year old children that are dually enrolled in WV Pre-K. West Virginia Head Start and Early Head Start is currently comprised of 22 grantees: 17 Head Start grantees, 4 Head Start/Early Head Start grantees, 1 Early Head Start grantee, and 1 Head Start delegate program.
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Figure30HeadStart/EarlyHeadStartProgramServiceArea
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NameoftheProgram Right From The Start Program (RFTS) HomeVisitingModelorApproachInUse A comprehensive statewide home visitation and case management program using a Medical based assessment and service care plan with services provided by registered nurses and licensed social workers. RFTS has recently purchased and in the process of implementing the Partners in a Healthy Baby curriculum for both prenatal and infant clients. SpecificServicesProvided Personalized assessment to identify barriers to health care, follow-up and monitoring Depression screening Prenatal risk screening Smoking Cessation Parenting skills TargetedGoals/OutcomesoftheIntervention Improvement in overall health of pregnant women, families and infants statewide through access to early and adequate prenatal care Reduction in infant mortality, infant birth weight and preterm births Extend support services to pregnant women and infants at risk for adverse health Outcomes while maximizing scare fiscal resources through in home targeted case management provided by registered nurses and licensed social workers DemographicCharacteristicsofIndividualsorFamiliesServed Client must reside in West Virginia Client must have a positive pregnancy test and an estimated due date Income must be less than 185% of the Federal Poverty level Client must be eligible for West Virginia Medicaid Infants must be less than one year of age NumberofIndividualsorFamiliesServed Number of families served during each calendar year in the following categories Category: Prenatal Infants Up to One Year 2006 2,709 2,151 Clients served 2007 2008 2,580 3,662 2,027 3,625 2009 3,382 3,499
State profiles for each year is provided in Appendix D .
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GeographicAreaServed Services are provided statewide through eight Regional Lead Agencies with care coordination provided by a workforce of 185 designated care coordinators (registered nurses and licensed social workers) as shown in Figure 31. Figure31RightFromTheStartProgramServiceArea
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NameoftheProgram Healthy Start/Helping Appalachian Parents & Infants (HAPI) Project HomeVisitingModelorApproachInUse The WV Healthy Start/HAPI Project (Helping Appalachian Parents and Infants) is a federally funded Healthy Start grant in RFTS Region VII The purpose of this project is to work collaboratively with existing systems (most notably Right From The Start (RFTS) and the Birth Score Office) to provide comprehensive services to those women, infants and families at highest risk. Services for both programs are delivered by the same staff, and maximize the use of state and federal resources. Simultaneous enrollment in HAPI and RFTS allow the blending of resources to provide a comprehensive package of services that would otherwise be unavailable to women, infants and families. A month-by-month health education curriculum was developed by the HAPI Project team based on the infants development and moms development. SpecificServicesProvided Prenatal risk assessments for depression and substance abuse Prenatal oral health education and limited services Comprehensive postpartum/interconceptional health education curriculum Increased access to mental health and medical services Smoking cessation Assistance with transportation and childcare costs Information/education on healthy pregnancy behaviors IntendedRecipientoftheService The program provides postpartum/interconceptional services for mothers up to two (2) years following the birth of their infants. TargetedGoals/OutcomesoftheIntervention Help women have as healthy pregnancies and families as possible Reduce infant mortality, and low birth weight Improve maternal well-being during pregnancy, postpartum and interconceptional period. Increase community involvement to improve perinatal health Increase community collaboration at all levels and to increase consumer involvement and input into improving services throughout the perinatal healthcare system. DemographicCharacteristicsofIndividualsorFamiliesServed Client services are provided to Medicaid Eligible or OMCFH eligible RFTS clients. The HAPI project has developed an integrated service delivery system with the Title V/West Virginia OMCFH Right From the Start Program.
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NumberofIndividualsorFamiliesServed Number of families served during each calendar year in the following categories Category: Prenatal Infants to Two Year Olds 2006 441 375 2007 599 556 2008 575 576 2009 521 308
We are still in the process of obtaining all the HAPI individual county data by group and will submit with the Updated State Plan. GeographicAreaServed Eight (8) counties in the north central part of the State (Barbour, Harrison, Marion, Monongalia, Preston, Randolph, Taylor and Upshur Figure32HelpingAppalachianParentsandInfantsServiceArea
Hancock
Brooke
Helping Appalachian Parents and Infants (HAPI) Counties Served CY 2009
Ohio
Marshall
Wetzel Tyler Pleasants Doddridge Ritchie
Monongalia Marion Morgan Preston Mineral Taylor Harrison Barbour Tucker Grant Hardy Upshur Hampshire Berkeley Jefferson
Wood
Wirt Cal- Gilmer houn Mason Jackson Roane
Lewis
Randolph Braxton
Pendleton
Putnam Cabell Kanawha Clay Nicholas Wayne Lincoln Boone
Webster
Pocahontas
Fayette Greenbrier
Mingo Logan Wyoming Raleigh Summers Monroe
McDowell
Mercer
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SectionFive:NarrativeDescription oftheStatesCapacityfor Providing Substance Abuse Treatment and Counseling Services to Individuals/Families in Need of These Services Who Reside in CommunitiesIdentifiedasBeingAtRiskinTermsofSubstanceAbuse
There is significant increase in substance use in West Virginia among adults and children/adolescents. The Substance Abuse and Mental Health Services Administration (SAMHSA) estimates that 7.77% of the states population aged 12 or older was dependent on a drug or alcohol in 2006-07, which is slightly higher than the national average of 7.5%. Still, the arrests for drug abuse and, in particular, methamphetamine use continues to be a burden to the judicial system. According to a 2007 funding analysis report done for BHHF by the Public Consulting Group, substance abuse impacts West Virginia on a per capita basis at an annual rate of $1,143 which is comparatively greater than many other states, such as Oklahoma which is $412 and $1,112 in Alaska. According to several recent studies, most recently by the Kaiser Family Foundation, West Virginia had the highest rate of prescription drug use in the nation in 2007. The study went on to point out that the rate of prescriptions was highest in states which have more people with disabilities and who are older and West Virginia is at or near the top in both categories. The state reportedly had 17.7 annual retail prescriptions filled per capita as opposed to a national average of 11.5. In addition, recent unpublished state public health data suggests that the state has the highest rate of prescription drug overdoses in the country. As a result, it should come as no surprise that the state has seen increasingly high demand for prescription drug abuse treatment. The Division of Alcoholism and Drug Abuse of the Bureau for Behavioral Health and Health Facilities administers the statewide provision of substance abuse treatment and prevention services for adults and adolescents. The Division achieves this function primarily through contractual arrangements with the state's 13 community behavioral health centers and other agencies. The Division's other primary responsibilities as the federal government's identified single state agency for substance abuse funds are: to manage the block grant funding, identify service needs, facilitate training, and provide leadership for collaborative community efforts in the areas of both prevention and treatment.5 Residential substance abuse treatment programs are located throughout the state, and provide 24 hour care for those who meet American Society of Addiction Medicine Patient Placement Criteria for the Treatment of Substance-Related Disorders, Second Edition-Revised (ASAM PPC-2R) criteria for residential care. Residential treatment starts with clinically managed residential detoxification, and can continue for as long as 90 days. All programs refer consumers for treatment and recovery services at the completion of their residential stay. Not all programs provide clinically managed residential detoxification. All programs receive state and federal funds to treat the indigent, most accept private insurance and/or Medicaid and Medicare. All programs accept male and females except where specialized programs that are gender specific are noted. For a complete listing of programs and facilities see Appendix C.6
5 6
West Virginia Bureau for Behavioral Health & Health Facilities. http://www.wvdhhr.org/bhhf/ada.asp West Virginia Bureau for Behavioral Health & Health Facilities.http://www.wvdhhr.org/bhhf/sa_residential.asp
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SectionSix:NarrativeSummaryofWVNeedsAssessmentResults, IncludingaDiscussionofHowtheStateWillAddressUnmetNeeds
The WV Home Visitation Program plans to hold a series of meetings with expanded key stakeholders to collective review the completed Statewide Needs Assessment. The WV Home Visitation workgroup will include representatives from the following: WV Early Childhood Advisory Council, Early Childhood Health Project, Birth To Three/Early Intervention Part C, WV Department of Education-School Readiness, WVDHHR Bureau for Behavior Health and Health Facilities-Division of Alcoholism and Substance Abuse, WV Coalition Against Domestic Violence, WV DHHR Bureau for Children and Families-Division of Child and Adult Services, WV Department of Education-Office of Special Programs Extended and Early Learning, and current home visitation key stakeholders. The collaborative workgroup will address the needs of the selected at-risk counties in order to develop and implement a statewide continuum of evidenced based home visitation services for targeted clients from pregnancy to five (5) years of age. With the limited funding available, one of the primary objectives of the WV Home Visitation Program will be to expand the current infrastructure and capacity of the eligible home visitation models to address as many identified needs as possible. Through the collaborative efforts of the Home Visitation workgroup, the Program plans to strengthen and expand eligible models in the selected counties at-risk. The workgroup will develop a work plan for providing expanded services in the underserved areas based on need, capacity and community input. The WV Department of Health and Human Resources Office of Maternal, Child and Family Health intends to apply for full funding of the Home Visitation Program through submission of an Updated State Plan. The Updated State Plan will include narrative describing details how the Home Visitation Program will meet evidenced based criteria and provide services to meet specific needs of families in our identified highest at risk counties. The selection of the specific home visiting model(s) to be funded for expansion remains contingent upon HHS issuance of the third FOA. While compiling required information for the Needs Assessment, there were several gaps in data and/or information identified. Currently the Home Visitation Program does not have standardized outcome measures or documentation available across the existing home visitation models to objectively assess the States full capacity of home visitation services. A uniform web based data collection system to assure ability to report outcome measures, number of clients served per county and other required data elements will be established. The goal will be to ensure cross-model, coordinated data collection that enables quantifiable measurement of the established benchmarks, which will be the biggest challenge since the Program will be using multiple models to provide services. Each model will carry out their activities within the framework of their national or state recognized standards while providing common outcomes and key indicators of program effectiveness into the statewide collaborative data collection system. Through the combined efforts of OMCFH, the WV Home Visitation Program and Collaborative Workgroup, the capacity and commitment to provide a strong infrastructure and support exists to implement a statewide continuum of home visitation services. By combining stakeholders,
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establishing new partnerships, strengthening training capacity, providing needed technical assistance, and maintaining an integrated surveillance and reporting system, the WV Home Visitation Program will be best positioned to address the findings of the Statewide Needs Assessment in development of an Updated State Plan.
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SOURCE&METHODOLOGY
Methodology What follows is an explanation of how the counties to be included in the project were determined. Two methods were combined to ensure that all appropriate counties were considered for inclusion. Of the 55 West Virginia counties, 22 were finally selected based on a combination of the approaches. ARC Approach: The first approach determined which counties were classified as at risk or distressed by the Appalachian Regional Commission (ARC) The ARC was established by Congress to be a prime mover in the economic development of the 13 state Appalachian region states stretching from southern New York to northern Mississippi. Each year the ARC collects social, economic and demographic data for each county in the region and classifies them as distressed, at-risk of becoming distressed, transitional moving from at-risk to competitive. Competitive counties have characteristics which indicate they are ranked among the best 10-25 percent of U.S. counties in terms of the indicators. While no West Virginia counties fall in the classification of attainment, that ranking applies only to the top 10 percent of all U.S. counties based on the indicators. (Appendix A) The terms at risk and distressed were selected by the ARC in order to classify counties in the United States by economic status. Distressed counties are those that rank in the bottom 10.0% of the nations counties. These counties are the most economically depressed. At risk counties are those that rank between the bottom 10.0% through the bottom 25.0% of the nations counties. These counties are at a significant risk of becoming economically depressed areas. The indicators for classifying these counties are three-year average unemployment rate, per capita market income and poverty rate. The 2011 ARC Report is used as it contains the most recent figures. Table 24 displays the West Virginia Counties which met the distressed or at-risk criteria. Figure ? indicate the location of those counties. On Table ? those counties are highlighted indicating whether they were above or below the average for West Virginia. Incidences where a county was below the West Virginia average are indicated in red and when above the West Virginia average in green. In some cases being above the average is negative as in the case of three year average unemployment rate and poverty rate. In the cases of per-capita market income being below average indicates negative economic performance. The following summarizes the findings.
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Table24
County Economic Status, FY 2011
West Virginia County Cabell Barbour Boone Braxton Calhoun Clay Doddridge Fayette Gilmer Kanawha Lincoln Logan Mason McDowell Mercer Mineral Mingo Monroe Nicholas Pocahontas Raleigh Ritchie Roane Summers Taylor Tucker Tyler Upshur Wayne Webster Wetzel Wirt Wood Wyoming -
Three-Year Average Unemployment Rate, 20062008

4.40%
Per Capita Market Income, 2007

$21,879
Per Capita Market Income, Percent of W.V. Average, 2007

100.00%
Poverty Rate, 2000
Poverty Rate, Percent of W.V. Average, 2000

100.00%
17.90%
Transitional At-Risk At-Risk At-Risk Distressed Distressed At-Risk At-Risk At-Risk Transitional Distressed At-Risk At-Risk Distressed Transitional Transitional Distressed At-Risk At-Risk At-Risk Transitional At-Risk Distressed Distressed At-Risk At-Risk At-Risk At-Risk Transitional Distressed At-Risk Distressed Transitional Distressed
4.00% 5.10% 4.20% 5.10% 6.70% 6.40% 4.80% 5.00% 4.00% 3.80% 5.20% 4.50% 6.70% 6.70% 4.20% 4.60% 4.90% 4.60% 4.70% 7.10% 4.10% 5.00% 6.10% 5.50% 4.60% 5.90% 6.20% 4.20% 4.70% 5.40% 7.10% 5.70% 4.60% 5.20%
$22,692 $15,596 $16,406 $14,237 $12,250 $12,221 $16,250 $15,463 $16,822 $30,926 $14,423 $16,900 $16,435 $10,199 $18,191 $19,279 $15,964 $15,380 $17,905 $16,708 $21,313 $18,308 $14,434 $11,980 $16,815 $17,487 $15,851 $17,987 $18,768 $12,789 $18,909 $12,895 $22,189 $15,336
103.72% 71.28% 74.99% 65.07% 55.99% 55.86% 74.27% 70.68% 76.89% 141.35% 65.92% 77.24% 75.12% 46.62% 83.14% 88.12% 72.96% 70.30% 81.84% 76.37% 97.41% 83.68% 65.97% 54.76% 76.85% 79.93% 72.45% 82.21% 85.78% 58.45% 86.43% 58.94% 101.42% 70.09%
22.60% 22.60% 22.00% 22.00% 25.10% 27.50% 19.80% 21.70% 25.90% 14.40% 27.90% 24.10% 19.90% 37.70% 19.70% 14.70% 29.70% 16.20% 19.20% 17.10% 18.50% 19.10% 22.60% 24.40% 20.30% 18.10% 16.60% 20.00% 19.60% 31.80% 19.80% 19.60% 13.90% 25.10%
126.26% 126.26% 122.91% 122.91% 140.22% 153.63% 110.61% 121.23% 144.69% 80.45% 155.87% 134.64% 111.17% 210.61% 110.06% 82.12% 165.92% 90.50% 107.26% 95.53% 103.35% 106.70% 126.26% 136.31% 113.41% 101.12% 92.74% 111.73% 109.50% 177.65% 110.61% 109.50% 77.65% 140.22%
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Figure e33ARCEc conomicall lyAtRiska andDistres ssedCounti ies
West Vir rginia Comp parison to U.S. Averages West Virg s: ginias three year averag unemploy ge yment rate of 4.4% is lowe than the th er hree year na ational avera of 5.0%. West Virg age ginias per c capita of i below the na ational per c capita incom of $32,930. West Vir me rginia income o $21,879 is $11,051 b stands at a 17.9% pov verty rate wh is highe than the n hich er national pove rate whi is 12.4%. erty ich rginia Comp parison to Ap ppalachian R Region Aver rages:West V Virginias th hree year ave erage West Vir unemploy yment rate of 4.4% is lo o ower than the three year Appalachia average of 5.2% due t the an f to boom in the coal ind dustry over those years West Vir s. rginias per capita incom of $21,8 is me 879 below the Ap ppalachian p capita in per ncome of $2 24,360. West Virginia st tands at a 17.9% $2,481 b poverty r which is higher than the Appalachian povert rate which is 13.6%. rate s n ty h Health a Welfare Indicators Approach and e A second method use in the sel d ed lection of the counties to be include in the prog o ed gram area w to was consider the indicato for health and welfar in at-risk counties usi the items specified i the ors h re ing in eterm delive ery, low bir rate, po rth overty, dom mestic violen nce, high sc chool study request: pre est were consider red. The pre esence or ab bsence or ea of ach dropouts. All 55 We Virginia Counties w
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WVDHHR/B BPH/OMCFH/HR RSAAward#1X0 02MC1942501 00
these indicators was established. It was determined that in counties where four (4) or more of the six (6) indicators were present were to be included in the study. Table 25 presents the results and Figure II is a map of those counties. As can be noted, several of the ARC counties are not included in the list as there were not sufficient number of health and welfare indicators present to warrant inclusion. Some counties in the ARC list as classified as transitional were added as a sufficient number of indicators were present despite their economic status. In most cases this was due to the presence of a larger (by West Virginia standards) city with an impoverished hinterland surrounding the city. In reading Table II the yellow boxes indicate counties where the rate exceeded the West Virginia average (mean). The blue boxes indicate counties where the indicator was close to the mean and above the median for the State. This corrected for extreme values which had distorted the mean calculation. The result was the 22 counties indicated in Table 25. Table25
County Preterm <37 weeks LBW Infant Mortality Poverty Domestic Violence High School Dropouts Count
Cabell 16.05% 11.57% 10.521 19.20% Nicholas 14.00% 10.29% 8.564 19.20% Boone 13.16% 9.96% 10.436 22.00% Mason 15.38% 11.67% 8.951 19.90% Wayne 18.03% 13.75% 9.202 19.60% Raleigh 11.97% 9.81% 8.857 18.50% Lincoln 15.06% 10.30% 7.097 27.90% McDowell 14.17% 12.80% 12.195 37.70% Mingo 13.69% 11.60% 10.793 29.70% Fayette 11.98% 10.04% 5.858 21.70% Logan 12.90% 12.43% 6.481 24.10% Mineral 12.65% 10.12% 8.420 14.70% Summers 9.86% 10.00% 10.526 24.40% Wood 13.09% 9.69% 9.415 13.90% Wyoming 12.63% 10.85% 6.154 25.10% Kanawha 14.33% 10.16% 6.866 14.40% Mercer 14.28% 12.85% 7.023 19.70% Wetzel 13.17% 10.22% 7.376 19.80% Ritchie 13.58% 7.89% 12.844 19.10% Upshur 9.48% 8.01% 8.006 20.00% Gilmer 12.01% 9.50% 11.173 25.90% Clay 14.09% 9.33% 7.407 27.50% WV Total 12.19% 9.53% 7.628 17.90% County Median 13.37% 10.19% 8.71 19.95% County Mean 13.44% 10.58% 8.83 22.00% Highlighted Counties in Column A Represent ARC at risk or distressed
7.1 8.3 12.4 6.9 6.8 14.3 7.6 5.1 4.9 3.0 9.9 4.0 3.0 9.3 1.1 13.9 11.0 1.9 5.6 5.2 2.3 3.6 6.9 6.2 6.69
3.05 4.01 2.90 3.47 3.16 2.75 3.75 2.52 2.66 3.50 2.62 3.12 3.26 2.08 3.66 3.97 1.14 1.81 1.91 2.84 1.15 2.14 2.80 2.87 2.79
6 6 6 6 6 6 5 5 5 5 4 4 4 4 4 4 4 4 4 4 4 4 4 4.73
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Figure34AtRiskCounties
DescriptionsofStudyCounties
Boone County is currently at risk of becoming economically depressed. The countys unemployment rate is 4.2% compared to the state average of 4.4%. The per capita income of the county is $16,406 which is 74.99% of the average per capita income of West Virginia. The countys poverty rate is 22.0%, which is 122.91% of the state average poverty rate of 17.9%. All six of the health and well being indicators were present in this county. Cabell County is currently in a transitional status. The countys unemployment rate is 4.0% compared to the state average of 4.4%. The per capita income of the county is $22,692 which is 103.72% of the average per capita income of West Virginia. The countys poverty rate is 22.6%, which is 126.26% of the state average poverty rate of 17.9%. Despite its economic status Cabell County had all six of the health and welfare indicators present. Clay County is currently distressed and economically depressed. The countys unemployment rate is 6.4% compared to the state average of 4.4%. The per capita income of the county is $12,221 which is 55.86% of the average per capita income of West Virginia. The countys poverty rate is 27.5%, which is 153.63% of the state average poverty rate of 17.9%. Clay County had two of the health and welfare indicators with rates above the state average and two indicators above the median. Fayette County is currently at risk of becoming economically depressed. The countys unemployment rate is 5.0% compared to the state average of 4.4%. The per capita income of the county is $15,463 which is 70.68% of the average per capita income of West Virginia. The countys poverty rate is 21.7%, which is 121.23% of the state average poverty rate of 17.9%.
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Having three indicators above the state average and one above the state median qualified Fayette County for the project. Gilmer County is currently at risk of becoming economically depressed. The countys unemployment rate is 4.0% compared to the state average of 4.4%. The per capita income of the county is $16,822 which is 76.89% of the average per capita income of West Virginia. The countys poverty rate is 25.9%, which is 144.69% of the state average poverty rate of 17.9%. Gilmer County had two of the health and welfare indicators above the state average and two above the state median which placed it in the program group. Kanawha County is currently in a transitional status. The countys unemployment rate is 3.8% compared to the state average of 4.4%. The per capita income of the county is $30,926 which is 141.35% of the average per capita income of West Virginia. The countys poverty rate is 14.4%, which is 80.45% of the state average poverty rate of 17.9%. Despite being the home of the state capital with an above average per-capita income, Kanawha County qualified on four of the indicators for health and welfare. Lincoln County is currently distressed and economically depressed. The countys unemployment rate is 5.2% compared to the state average of 4.4%. The per capita income of the county is $14,423 which is 65.92% of the average per capita income of West Virginia. The countys poverty rate is 27.9%, which is 155.87% of the state average poverty rate of 17.9%. Lincoln County is included as it has five of the 6 health and welfare indicators. Logan County is currently at risk of becoming economically depressed. The countys unemployment rate is 4.4% compared to the state average of 4.4%. The per capita income of the county is $16,900 which is 77.24% of the average per capita income of West Virginia. The countys poverty rate is 24.1%, which is 134.64% of the state average poverty rate of 17.9%. Logan County makes the list as four of the six health and welfare indicators are present. Mason County is currently at risk of becoming economically depressed. The countys unemployment rate is 6.7% compared to the state average of 4.4%. The per capita income of the county is $16,435 which is 75.12% of the average per capita income of West Virginia. The countys poverty rate is 19.9%, which is 111.17% of the state average poverty rate of 17.9%. Five of the six health and welfare indicators are above the state average with one additional one being in excess of the state median. McDowell County is currently distressed and economically depressed. The countys unemployment rate is 6.7% compared to the state average of 4.4%. The per capita income of the county is $10,199 which is 46.62% of the average per capita income of West Virginia. The countys poverty rate is 37.7%, which is 210.61% of the state average poverty rate of 17.9%. McDowell County qualifies by having four of the indicators above the state average and one additional above the state median. Mercer County is currently in a transitional status. The countys unemployment rate is 4.2% compared to the state average of 4.4%. The per capita income of the county is $18,191 which is
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83.14% of the average per capita income of West Virginia. The countys poverty rate is 19.7%, which is 110.06% of the state average poverty rate of 17.9%. Four of the six health and welfare indicators were above the state average in this county. Mineral County is currently in a transitional status. The countys unemployment rate is 4.6% compared to the state average of 4.4%. The per capita income of the county is $19,279 which is 88.12% of the average per capita income of West Virginia. The countys poverty rate is 14.7%, which is 82.12% of the state average poverty rate of 17.9%. Mineral County is included by having four of the six health and welfare indicators present despite its relatively high economic status. Mingo County is currently distressed and economically depressed. The countys unemployment rate is 4.9% compared to the state average of 4.4%. The per capita income of the county is $15,964 which is 72.96% of the average per capita income of West Virginia. The countys poverty rate is 29.7%, which is 165.92% of the state average poverty rate of 17.9%. Four of the five health and welfare indicators in Mingo County were above the state average with one additional above the state median. Nicholas County is currently at risk of becoming economically depressed. The countys unemployment rate is 4.7% compared to the state average of 4.4%. The per capita income of the county is $17,905 which is 81.84% of the average per capita income of West Virginia. The countys poverty rate is 19.2%, which is 107.26% of the state average poverty rate of 17.9%. All six of the indicators were found to be present in Nicholas County. Raleigh County is currently in a transitional status. The countys unemployment rate is 4.1% compared to the state average of 4.4%. The per capita income of the county is $21,313 which is 97.41% of the average per capita income of West Virginia. The countys poverty rate is 18.5%, which is 103.35% of the state average poverty rate of 17.9%. Raleigh County is included as all six of the indicators are present with four being above the state average and two above the state median. Ritchie County is currently at risk of becoming economically depressed. The countys unemployment rate is 5.0% compared to the state average of 4.4%. The per capita income of the county is $18,308 which is 83.68% of the average per capita income of West Virginia. The countys poverty rate is 19.1%, which is 106.7% of the state average poverty rate of 17.9%. Richie County is included as three of the health and welfare indices are above the state average and one above the state median. Summers County is currently distressed and economically depressed. The countys unemployment rate is 5.5% compared to the state average of 4.4%. The per capita income of the county is $11,980 which is 54.76% of the average per capita income of West Virginia. The countys poverty rate is 24.4%, which is 136.31% of the state average poverty rate of 17.9%. Four of the six indices are present in Summers County all of which are above the state average.
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Upshur County is currently at risk of becoming economically depressed. The countys unemployment rate is 4.2% compared to the state average of 4.4%. The per capita income of the county is $17,987 which is 82.21% of the average per capita income of West Virginia. The countys poverty rate is 20.0%, which is 111.73% of the state average poverty rate of 17.9%. With three of the health and welfare criteria being above the state average and one above the state median Upshur County will be included. Wayne County is currently in a transitional status. The countys unemployment rate is 4.7% compared to the state average of 4.4%. The per capita income of the county is $18,768 which is 85.78% of the average per capita income of West Virginia. The countys poverty rate is 19.6%, which is 109.5% of the state average poverty rate of 17.9%. The income figures for Wayne County are distorted due to the presence of part of the City of Huntington and two of its suburbs being located in the far northern portion of the county. But the rest of the county is severely distressed. Five of the six indicators for health and welfare are above the state average with one more above the state median. Wetzel County is currently at risk of becoming economically depressed. The countys unemployment rate is 7.1% compared to the state average of 4.4%. The per capita income of the county is $18,909 which is 86.43% of the average per capita income of West Virginia. The countys poverty rate is 19.8%, which is 110.61% of the state average poverty rate of 17.9%. Wetzel County in included as three of the indicators are above the state average with one additional placing it above the state median. Wood County is currently in a transitional status. The countys unemployment rate is 4.6% compared to the state average of 4.4%. The per capita income of the county is $22,189 which is 101.42% of the average per capita income of West Virginia. The countys poverty rate is 13.9%, which is 77.65% of the state average poverty rate of 17.9%. Four of the six health and welfare indicators were above the state average for Wood County. Wyoming County is currently distressed and economically depressed. The countys unemployment rate is 5.2% compared to the state average of 4.4%. The per capita income of the county is $15,336 which is 70.09% of the average per capita income of West Virginia. The countys poverty rate is 25.1%, which is 140.22% of the state average poverty rate of 17.9%. Wyoming makes the list of project counties as four of the six health and welfare indicators are above the state average.
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AppendixA
Distressed Designation and County Economic Status Classification System, FY 2007 FY 2011 The Appalachian Regional Commission (ARC) uses an index-based county economic classification system to identify and monitor the economic status of Appalachian counties. The system involves the creation of a national index of county economic status through a comparison of each county's averages for three economic indicatorsthree-year average unemployment rate, per capita market income, and poverty ratewith national averages. The resulting values are summed and averaged to create a composite index value for each county. Each county in the nation is then ranked, based on its composite index value, with higher values indicating higher levels of distress. CountyEconomicLevels Each Appalachian county is classified into one of five economic status designations, based on its position in the national ranking. Distressed Distressed counties are the most economically depressed counties. They rank in the worst 10 percent of the nation's counties. At-Risk At-Risk counties are those at risk of becoming economically distressed. They rank between the worst 10 percent and 25 percent of the nation's counties. Transitional Transitional counties are those transitioning between strong and weak economies. They make up the largest economic status designation. Transitional counties rank between the worst 25 percent and the best 25 percent of the nation's counties. Competitive Competitive counties are those that are able to compete in the national economy but are not in the highest 10 percent of the nation's counties. Counties ranking between the best 10 percent and 25 percent of the nation's counties are classified competitive. Only two counties in West Virginia (Putnam and Jefferson) meet the criteria to be classified as Competitive under the ARC guidelines. Attainment Attainment counties are the economically strongest counties. Counties ranking in the best 10 percent of the nation's counties are classified attainment. None of the 55 counties in West Virginia meet the ARC designation of Attainment. ARC County Economic Status Designation by National Index Value Rank
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County Economic Indicators ThreeYear Average Unemployment Rate The three-year average unemployment rate is a measure of long-term structural unemployment. The unemployment rate is calculated by dividing the three-year sum of persons unemployed by the three-year sum of the civilian labor force and expressing the result as a percentage.7 Per Capita Market Income Per capita market income is calculated by dividing total personal income, less transfer payments, by population. Transfer payments include retirement and disability insurance benefit payments, medical payments, income maintenance benefit payments, unemployment insurance benefit payments, veterans benefit payments, and other such payments.8 Poverty Rate The poverty rate is computed by dividing the number of persons living below the poverty threshold by the number of persons for whom poverty status has been determined.9 Time Series
U.S. Department of Labor, Bureau of Labor Statistics, Local Area Unemployment Statistics. http://www.bls.gov/lau/home.htm U.S. Department of Commerce, Bureau of Economic Analysis, Regional Economic Information System. http://www.bea.gov/regional/reis/ U.S. Department of Commerce, Census Bureau, Census of Population and Housing 2000 Summary File 3. http://www.census.gov/hhes/www/poverty.html
9
7 8
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ARC computes new county economic levels each fiscal year based on the most current data available at the beginning of the calendar year of computation. The time series used for each economic indicator and fiscal year is listed in the table below.
Fiscal Year Three-Year Average Unemployment Rate Per Capita Market Income Poverty Rate
2011
20062008
2007
2000
(Effective Oct. 1, 2010Sept. 30, 2011)

2010
20052007
2006
2000

2009
20042006
2005
2000

2008
20032005
2004
2000

2007
20022004
2003
2000
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AppendixBLettersofSupport
151
152
153
154
155
AppendixC
West Virginia Bureau for Behavioral Health and Health Facilities
RESIDENTIAL PROGRAMS
ACT UNIT VALLEY HEALTH CARE 100 Crosswind Drive, Fairmont, WV 26554 NANCY DEMING, Program Supervisor (304) 363-2228 AMITY CENTER WESTBROOK HEALTH SERVICES 1011 Mission Drive Parkersburg, WV 26101 DEE PRINCE, Director (304) 485-1781 EASTRIDGE TREATMENT CENTER EASTRIDGE HEALTH SYSTEMS 125 West Martin Street Martinsburg, WV 25401 CAREN FORESTANDI , Director (304) 263-2037 PARCWAY PRESTERA CENTER P. O. Box 8069 Huntington, WV 25705 TAMI SMITH, Residential Director (304) 697-1790 PARCWEST PRESTERA CENTER 1420 Washington Avenue Huntington, WV 25704 TAMI SMITH, Residential Director (304) 697-1790 JOHN D. GOOD RECOVERY CENTER UNITED SUMMIT CENTER 100 Hopemont Drive, Terra Alta, WV 26764 DAVID HOOVER, Coordinator (304) 789-3142 THRESHOLD PRESTERA CENTER - EAST P. O. Box 3698 Charleston, WV 25336 KEN STEELE, Director (304) 776-0772
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FMRS (SAFE HAVEN) PUBLIC INEBRIATE SHELTER FMRS HealthSystems, Inc. Beckley, WV 25801 BILL SHORT- Male referrals (304) 256-7144 DREMA TABOR, - Female referrals 304) 256-7146 After 4 pm call the crisis stabilization unit at FMRS (304) 256-7100 and let them know you are seeking a bed for a male or female as needed at Pinehaven or the FMRS Crisis Stabilization Unit.
WOMEN'S SPECIALIZED PROGRAMS

RENAISSANCE WOMEN & CHILDREN'S PROGRAM (LONG-TERM) PRESTERA CENTER P. O. Box 8068 Huntington, WV 25705 KIM MILLER, Director of Women's Substance Abuse Services (304) 525-4673 12 Beds for women with children 8 Beds for women w/o children 12 Expansion Beds for women w/children NEW BEGINNINGS (WOMEN'S LONG-TERM RESIDENTIAL) FMRS HealthSystems, Inc. (PINEHAVEN) 202 Columbia Street, Fairmont WV 26554 NANCY DEMING, Supervisor (304) 363-2500 9 Beds (Women's Transitional Facility)
TRANSITIONAL LIVING FACILITIES

SERENITY FELLOWSHIP HOME 200 COLUMBIA STREET FAIRMONT, WV 26554 TELEPHONE: (304) 367-1185 FAX: 363-0263 JESSE LAWSON, SUPERVISOR MALES SOUTHERN WEST VIRGINIA FELLOWSHIP HOME, INC. POST OFFICE BOX 500 BECKLEY, WV 25802 TELEPHONE:(304) 253-1441 RONNIE DALE CAMPBELL & LEE COOK MALES & FEMALES BRAXTON COUNTY FELLOWSHIP HOME 72 SOUTH STONEWALL STREET
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SUTTON, WV 26601 TELEPHONE: (304) 765-2616 PAUL MOSS, PRESIDENT MALES & FEMALES KANAWHA VALLEY FELLOWSHIP HOME 1107 VIRGINIA STREET, EAST CHARLESTON, WV 25301 TELEPHONE: (304) 342-8051 FAX: 342-8053 DEBBIE MASINTER, DIRECTOR MALES MERCER COUNTY FELLOWSHIP HOME, INC. 421 SCOTT STREET, POST OFFICE BOX 4211, BLUEFIELD, WV 24701 TELEPHONE: (304) 327-9876 FAX: 327-6234 SALLY REILAND, DIRECTOR MALES MID-OHIO VALLEY FELLOWSHIP HOME, INC. 1030 GEORGE STREET PARKERSBURG, WV 26101 TELEPHONE: (304) 485-3341 FAX: 485-3396 BOB WEAVER, DIRECTOR MALES & FEMALES WITH OR WITHOUT CHILDREN ACCEPTED RAINBOW HOUSE, INC. POST OFFICE BOX 114 GYPSY, WV 26361 TELEPHONE: (304) 592-3592 FRED BYERS, MANAGER MALES LAURELWOOD PRESTERA CENTER 432 SIXTH AVENUE HUNTINGTON, WV 25705 TELEPHONE: (304) 525-5250 CONTACT: SHARON KNITTS MALES & FEMALES
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AppendixDHomeVisitationModelProfiles
159
Affordable Care Act Maternal, Infant and Early Childhood Home Visiting Program West Virginia Needs Assessment Name of Program: __Cabell-Wayne Healthy Families America__ In-Home Family Educator - Education Level and Years of Experience: Current direct service staff: #1: _Angela Blackburn High School diploma plus some college 9 years of experience #2: _Ellen Carroll-Cundiff Associate Degree 4 years of experience_ #3: _Lizbeth Lockhart High School diploma 5 years of experience_ #4: _Carolyn Vanhoose GED 9 years of experience #5: _Brenda Marcum Associate Degree 4 years of experience_ #6: _Shannon Marcum High School diploma plus some college 3 years of experience_ #7: _Bethany Casteel Bachelors degree 2 years of experience_ Direct Service Staff within past 5 years: #8: _Cornealia Palmer -_High School diploma plus some college 12 years of experience_ #9: _Rhonda Childers -_High School diploma plus some college 9 years of experience_ #10: Jeanette Kinkead High School diploma plus some college - 5 years of experience_ #11: Chad Messer Associate Degree - 6 years of experience Number of families served during each calendar year in the following categories (separated by county): County Cabell Category: Prenatal Infants to Three Year Olds Three to Five Year Olds County Wayne 2005 77 77 12 2006 53 53 8 2007 56 56 8 2008 56 56 8 2009 60 60 7 2010 73 73 12
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Category: Prenatal Infants to Three Year Olds Three to Five Year Olds
2005 52 52 8
2006 35 35 5
2007 37 37 6
2008 37 37 6
2009 28 28 6
2010 37 37 10
Number of home visits during each calendar year in the following categories (separated by county): County: Cabell Category: Prenatal Infants to Three Year Olds Three to Five Year Olds 2005 23 1462 257 2006 40 1337 236 2007 62 1808 319 2008 54 1473 259 2009 60 552 97 2010 73 619 109
County: Wayne Category: Prenatal Infants to Three Year Olds Three to Five Year Olds 2005 16 974 172 2006 28 891 157 2007 42 1205 213 2008 36 1322 233 2009 28 369 65 2010 65 413 73
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Healthy Families America:

(1) Specific services provided by this model:

Ensure families have a medical provider Share information on children's development processes Assist families in identifying their baby's needs and obtaining certain resources Support families in the home while they respond to their child's and their own needs Share ideas on caring for babies, toddlers, and young children Link families with other resources in the community for assistance with job placement, identification of child care providers, etc Assist families in following up with recommended immunization schedules Help families feel more empowered
(2) Targeted Goals/Outcomes of this model: Reduced child maltreatment Increased use of prenatal care Decreased pre-term, low weight babies Improved parent-child interaction and school readiness Decreased dependency on welfare (TANF) and other social services Increased access to primary care medical services Increased immunization rates Reduction in intimate partner violence Increased breastfeeding Enhanced child development Increased knowledge of child development
(3) Description of the program model standards and/or quality indicators on the qualifications and training of home visitors:
Qualifications of home visitors (from the HFA standards): Screening and selection of direct service staff and volunteers and interns (performing the same function) include consideration of personal characteristics, including but not limited to: Are experienced in working with or providing services to children and families; An ability to establish trusting relationships; Acceptance of individual differences; Experience and willingness to work with the culturally diverse populations that are present among the programs target population; and Knowledge of infant and child development.
Training of HFA staff (from the HFA standards):
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Staff receive orientation (separate from intensive role specific training) prior to direct work with families to familiarize them with the functions of the program. Staff are oriented to: their roles as they relate to the programs goals, services, policies and operating procedures (including forms, evaluation tools and data collection), and philosophy of home visiting/family support prior to direct work with families or supervision of staff. the programs relationship with other community resources prior to direct work with families. child abuse and neglect indicators and reporting requirements prior to direct work with families. issues of confidentiality prior to direct work with families. issues related to boundaries prior to direct work with families.
Staff receive intensive role specific training within six months of date of hire specific to their role within the home visitation program to help them understand the essential components of their role within the program. All staff conducting assessments received intensive role specific assessment training, by a certified trainer who has been trained to train others (a 4 day training), within six months of date of hire to understand the essential components of his/her role as an assessment worker. Home visitors have received intensive role specific home visitor training, by a certified trainer who has been trained to train others (a 4 day training), within six months of date of hire to understand the essential components of his/her role as a home visitor. Staff receive training on a variety of topics necessary for effectively working with families and children within six-months of hire. Topics include: Infant Care (sleeping; feeding/breastfeeding; physical care of the baby; and crying and comforting the baby) Child Health and Safety (home safety; Shaken baby syndrome; SIDS; seeking medical care; well-child visits/immunizations; seeking appropriate child care; car seat safety; and failure to thrive) Maternal and Family Health (family Planning; nutrition: pre-natal/post-natal healthcare; and pre-natal/Post-Partum Depression) Infant and Child Development (language and literacy development; physical and emotional development; identifying developmental delays; and brain development) Role of Culture in Parenting [working with diverse cultures/populations (age, religion, gender, sexuality, ethnicity, poverty, dads, teens, gangs, disabled populations); culture of poverty; and values clarification]
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Supporting the Parent-Child Relationship (supporting attachment; positive parenting strategies; discipline; parent-child interactions; observing parent-child interactions; and strategies for working with difficult relationships)
Staff (assessment workers, home visitors and supervisors) received training on a variety of topics necessary for effectively working with families and children within twelve-months of hire. Topics include: Child Abuse and Neglect (etiology of child abuse and neglect; and working with survivors of abuse) Family Violence (indicators of family violence; dynamics of domestic violence; intervention protocols; strategies for working with families with family violence issues; referral resource for domestic violence; effects on children; and gangs)
Substance Abuse (etiology of substance abuse; culture of drug use; strategies for working with families with substance abuse issues; smoking cessation; alcohol use/abuse; Fetal alcohol syndrome; street drugs; and referral resources for substance abuse.
Staff Related Issues (stress and time management; burnout prevention; personal safety of staff; ethics; crisis intervention; and emergency protocols)
Family Issues (life skills management; engaging fathers; multi-generational families; teen parents; relationships; and HIV and AIDS)
Mental Health (promotion of positive mental health; behavioral signs of mental health issues; depression; strategies for working with families with mental health issues; and referral resources for mental health)
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Affordable Care Act Maternal, Infant and Early Childhood Home Visiting Program West Virginia Needs Assessment Name of Program: __New River Health Association MIHOW Program In-Home Family Educator - Education Level and Years of Experience: #1: _Kathy Bracken #2: _Jennifer Chittum #3: _Brenda McClung BS/WVU_______ 19 years experience___ ______________ _____________
High School Diploma__3 years experience_________________ BSW/Concord High School Diploma 3 years experience_________________ 13 years experience_____________ 20 years experience
#4: _Charlene Red Newkirk #5: _Sue Slater
Associate Child Development/William Rainey Harper High School Diploma BA/Berea
#6: _Rhonda Walker #7: _Kathie Kiser
13 years experience__________________ 8 years experience______________
#8: __________________________________________________________________________ #9: __________________________________________________________________________ #10: _________________________________________________________________________ Number of families served during each calendar year in the following categories (separated by county): County _Fayette_________________________________ Category: Prenatal Infants to Three Year Olds Three to Five Year Olds 2005 65 65 25 (Group services) 2006 60 60 25 (Group services) 2007 70 70 25 (Group services) 2008 70 70 25 (Group services 2009 55 55 2010 Through August) 50 50
25 25 (Group (Group services) services)
County ___________________ 2005 Category: Prenatal Infants to Three Year Olds
2006
2007
2008
2009
2010
165
Three to Five Year Olds
Number of home visits during each calendar year in the following categories (separated by county): County: __Fayette________________________________ Category: Prenatal Infants to Three Year Olds Three to Five Year Olds 2005 260 401 2006 178 362 2007 322 653 2008 284 577 2009 223 444 2010 (Through August) 119 243
County: __________________________________ Category: Prenatal Infants to Three Year Olds Three to Five Year Olds 2005 2006 2007 2008 2009 2010
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Affordable Care Act Maternal, Infant and Early Childhood Home Visiting Program West Virginia Needs Assessment Name of Program: ___Ohio County MIHOW________________________________________ In-Home Family Educator - Education Level and Years of Experience: #1: _Stephanie Barnett AS in Business CDA Creditial -Certified Lactation Counselor and currently enrolled in West Virginia Northern Community College Bachelor of Social Work 2+2 program. 6 years of experience.___________________________________________________ #2: _Michelle Romanek - AS in Elementary Education working toward Regents Degree from West Liberty State University. 3 years of experience ___________________________________ #3: __________________________________________________________________________ #4: __________________________________________________________________________ #5: __________________________________________________________________________ #6: __________________________________________________________________________ #7: __________________________________________________________________________ #8: __________________________________________________________________________ #9: __________________________________________________________________________ #10: _________________________________________________________________________ Number of families served during each calendar year in the following categories (separated by county): County _______Ohio County___________________________ Category: Prenatal Infants to Three Year Olds Three to Five Year Olds 2005 19 35 0 2006 14 36 0 2007 17 38 0 2008 21 29 0 2009 18 27 0 2010 14 27 0
167
Number of home visits during each calendar year in the following categories (separated by county): County: ____Ohio County______________________________ Category: Prenatal Infants to Three Year Olds Three to Five Year Olds 2005 228 420 0 2006 168 436 0 2007 204 456 0 2008 252 348 0 2009 216 324 0 2010 168 324 0
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Affordable Care Act Maternal, Infant and Early Childhood Home Visiting Program West Virginia Needs Assessment Name of Program: _____ABLE Families____________________________________________ In-Home Family Educator - Education Level and Years of Experience: #1: _Jenta Cheung,_some college, 3 years____________________________________________ #2: __Rosemary Dillon, high school graduate, 8 years__________________________________ #3: __Gail Muncy, some college, 3 years_____________________________________________ #4: ___Emma Sue Pack high school graduate, 12 years________________________________ #5: ___Marlene Spaulding, high school graduate, 5 years_______________________________ #6: ___Christy Stroud, high school graduate, 2 years__________________________________ #7: ___Kim Sturgell high school graduate 3 years______________________________________ #8: ___Oneida Toppins, Associates Degree, 2 years___________________________________ #9: __________________________________________________________________________ #10: _________________________________________________________________________ Number of families served during each calendar year in the following categories (separated by county): County _______Lincoln___________________________ Category: Prenatal Infants to Three Year Olds Three to Five Year Olds County _________Mingo_________________________ Category: Prenatal Infants to Three Year Olds 2005 19 63 2006 21 66 2007 23 73 2008 20 60 2009 22 86 2010 11 73 2005 2006 2007 2008 5 4 2009 4 8 2010 3 11
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Number of home visits during each calendar year in the following categories (separated by county): County: _Lincoln_________________________________ Category: Prenatal Infants to Three Year Olds Three to Five Year Olds 2005 2006 2007 2008 52 50 2009 43 93 2010 22 88
County: ___Mingo_______________________________ Category: Prenatal Infants to Three Year Olds Three to Five Year Olds 2005 212 701 2006 235 730 2007 257 806 2008 230 690 2009 253 989 2010 85 547
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Affordable Care Act Maternal, Infant and Early Childhood Home Visiting Program West Virginia Needs Assessment Name of Program: ___East End Family Resource Center Parents As Teachers_______________ In-Home Family Educator - Education Level and Years of Experience: #1: ___Patience Deweese, 3 years of college, 2 months PAT experience__________________ #2: ___** Please see notation at bottom of page._____________________________________ #3: __________________________________________________________________________ #4: __________________________________________________________________________ #5: __________________________________________________________________________ #6: __________________________________________________________________________ #7: __________________________________________________________________________ #8: __________________________________________________________________________ #9: __________________________________________________________________________ #10: _________________________________________________________________________ Number of families served during each calendar year in the following categories (separated by county): County ____Kanawha_______________________ Category: Prenatal Infants to Three Year Olds Three to Five Year Olds County __________________________________ Category: Prenatal Infants to Three Year Olds 2005 2006 2007 2008 2009 2010 2005 2006 2007 2008 2009 2010 3
171
Number of home visits during each calendar year in the following categories (separated by county): County: _____Kanawha_____________________________ Category: Prenatal Infants to Three Year Olds Three to Five Year Olds 2005 2006 2007 2008 2009 2010 1
**Other families that are being served through this program by Roseline Jackson are included with the numbers from the Upper Kanawha Valley PAT due to the funds that pay for the Parent Educator.
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Affordable Care Act Maternal, Infant and Early Childhood Home Visiting Program West Virginia Needs Assessment Name of Program: _______Tucker Co. PAT Program_________________________________ In-Home Family Educator - Education Level and Years of Experience: #1: Angela Davis 4 Yr Bachelor of Science degree Family Consumer Science/2 yrs PAT; 15 yr Child-related exp #2: Jessica Wamsley 2 yrs College; current FT WVU student majoring in Elem and Special Ed with minor in Child Development/7 mo PAT; 9 yr Child-related exp #3: __________________________________________________________________________ #4: __________________________________________________________________________ #5: __________________________________________________________________________ #6: __________________________________________________________________________ #7: __________________________________________________________________________ #8: __________________________________________________________________________ #9: __________________________________________________________________________ #10: _________________________________________________________________________ Number of families served during each calendar year in the following categories (separated by county): County ___Tucker county_______________________________ Category: Prenatal Infants to Three Year Olds Three to Five Year Olds County __________________________________ Category: Prenatal 2005 2006 2007 2008 2009 2010 2005 2006 2007 2008 2 2009 2 3 2010 1 7 4
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Infants to Three Year Olds Three to Five Year Olds
Number of home visits during each calendar year in the following categories (separated by county): County: ______Tucker county____________________________ Category: Prenatal Infants to Three Year Olds Three to Five Year Olds 2005 2006 2007 2008 2 2009 4 3 2010 1 9 12
174
Affordable Care Act Maternal, Infant and Early Childhood Home Visiting Program West Virginia Needs Assessment Name of Program: Upper Kanawha Valley Starting Points/Parents as Teachers___________ In-Home Family Educator - Education Level and Years of Experience: #1: Diane Hughes certified as a Parent Educator with the Parents as Teachers National Center in September 1995 and is currently serving families as of 9/13/10. High School Graduate, Completed ACDS Apprenticeship Child Development Specialist Program at Ben Franklin. Worked as a volunteer at Sharon Dawes Elementary tutoring children from Kindergarten through 6th grade on a daily basis from 1982 1995. #2: Jennifer Parsons became a certified Parent Educator in May of 2007 and is currently serving families as of 9/13/10. She is a high school graduate with a Regence Degree in English and served as an AmeriCorps Member in 2006 tutoring children in Kindergarten through 6th grade. Jennifer has also completed the ACDS-Apprenticeship for Child Development Specialists program._ #3: Heather Miller was certified as a Parent Educator in November of 2007 and is currently working with families as of 9/13/10. She is a high school graduate and has volunteered in the community working with young children in church settings since 2004. She is also a parent with a child that completed the PAT curriculum and volunteered at the center during play groups, group meetings and community events. Heather also completed the ACDS Apprenticeship for Child Development Specialists program._______________________________________ #4: Roseline Jackson was certified in Parents as Teachers in November 1999. She is a high school graduate. She has been involved in an after school program for 3 yrs and has been involved in community work through her church for 30 yrs. Roseline started with the UKV Starting Points and Parents as Teachers in 2008 and is currently serving families as of 9/13/10. #5: Angie Haney was certified as a Parent Educator in July 2010 and is currently serving families as of 9/13/10. Angie has worked with young children in the child care setting for several years and has volunteered in the community working with children and families through her church and with children at the elementary school. Angie was a parent enrolled with Parents as Teachers from 1998 and her youngest child just completed the PAT program in 2009. She volunteered during play groups, group meetings and community events and served as a parent representative on the advisory board. Angie is currently enrolled in the second semester of the ACDS Apprenticeship for Child Development Specialists program.
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Number of families served during each calendar year in the following categories (separated by county): County Kanawha_ Category: Prenatal Infants to Three Year Olds Three to Five Year Olds County N/A__________ Category: Prenatal Infants to Three Year Olds Three to Five Year Olds 2005 2 28 10 2006 1 9 14 2007 4 27 18 2008 8 20 21 2009 3 30 32 2010 2 23 26
2005 x x x
2006 x x x
2007 x x x
2008 x x x
2009 x x x
2010 x x x
Number of home visits during each calendar year in the following categories (separated by county): County: Kanawha_ Note: (In 2005, 32 families received between 1 and 5 home visits. In 2006, 16 families received between 1 and 5 visits. In 2007, 4 families received between 1 and 5 home visits, 39 families received between 6 and 9 home visits and 2 families received between 10 and 12 home visits. In 2008, 22 families received between 1 and 5 home visits, 12 families received between 6 and 9 home visits, 2 families received between 10 and 12 home visits and 4 families received between 13 and 19 home visits. In 2009, 30 families received between 1 and 5 home visits, 22 families received between 6 and 9 home visits, 5 families received between 10 and 12 home visits and 1 family received more than 20 home visits). Category: Prenatal Infants to Three Year Olds Three to Five Year Olds 2005 2006 2007 2008 2009 2010 *See note *See note *See note *See note *See note 4 *See note *See note *See note *See note *See note 38 *See note *See note *See note *See note *See note 32
County: N/A__________________________________ Category: Prenatal 2005 x 2006 x 2007 x 2008 x 2009 x 2010 x
176
Infants to Three Year Olds Three to Five Year Olds
x x
x x
x x
x x
x x
x x
177
RIGHT FROM THE START Profile CY 2009 (01/01/2009 to 12/31/2009)

Referrals: 27,890 Prenatal Risk Screening Instrument (PRSI) ............................................................................. 5,665 Prenatal Alternate Entry ........................................................................................................... 8,276 Infant Alternate Entry ............................................................................................................ 13,949 Prenatal Risk Screening (PRSI) Indicators: Access to Prenatal Care: - 1st Trimester............................................. 4,083 - 2nd Trimester ............................................... 768 - 3rd Trimester ............................................... 172 - Unknown ................................................... 642 Top 10 Risk Factors (in order of occurrence): - Partner Smokes - Client Smokes - Partner Drinks - Lack of Transportation - Victim of Domestic Abuse -
(72%) (14%) (3%) (11%)
Inadequate Food Inadequate Clothes Inadequate Shelter Use of Recreation Drugs Client Drinks (1%) (34%) (57%) (8%)
Client Education Levels: - Less than 8th Grade ....................................... 60 - 8th-12th Grade .......................................... 1,919 - Degree/Diploma ...................................... 3,244 - Unknown .................................................... 442
RFTS Care Coordination: Client Enrollment: (Care Paid by Title XIX and Title V/OMCFH) .........................................7,201 Care Coordination - Client Contacts
Client Category Prenatal Infant Enhanced Services Only Total Unduplicated Clients 3,382 3,499 320 7,201 Home Visits 8,587 14,674 NA 23,261 Other Contacts* 12,540 15,548 NA 28,088 Total Contacts 21,127 30,222 N/A 51,349 Average Contacts/Client 6.25 8.64
Other contacts includes office, clinic, phone, and other miscellaneous locations Levels of Care Coordination for Women Enrolled in RFTS Minimal Care ............................................................................ 339 (15%) Moderate Care .......................................................................... 526 (24%) Intensive Care ........................................................................ 1,345 (61%) Tobacco Screening: ............................................................................................................... 2,189 Self-Reported Nonsmokers ................................................................................ 809 (37%)
178
Self-Reported Smokers ....................................................................... 899

No Change After Learning of Pregnancy........ 196 (22%) Cut Down ........................................................ 686 (76%) Increased/Started ............................................... 17 (2%) Self-Reported Women that Quit ................................... ..................... 481 Quit Before Becoming Pregnant ..................... 181 (38%) Quit After Becoming Pregnant ....................... 300 (62%)
(41%)
(22%)
Smoker Profile:
Average Age ..................................................................................... ... 23.35 years Average Weeks Pregnant ..................................................................... 19.79 weeks
Tobacco Follow-up: ............................................................................................................... 2,711

Unduplicated Clients Receiving Follow-up ................................................ 1,773 (81% of women screened) Smoke the same ................................................................................ 276 (15%) Quit ................................................................................................... 273 (15%) Cut Down ......................................................................................... 337 (19%) Increased/Started ............................................................................... 168 (10%) Unknown ........................................................................................... 719 (41%)
Edinburg Depression Screening: 5,233

# of Prenatal Depression Screenings Completed ................................................................................... 3,653 Scores: 0 to 7 .................................................................................................... 66% 8 to 11 .................................................................................................. 19% 12 ....................................................................................................... 15% # of Post Partum Depression Screenings Completed ............................................................................. 1,580 Scores: 0 to 7 .................................................................................................... 71% 8 to 11 .................................................................................................. 15% 12 ....................................................................................................... 15%
Outcome Measures: 3,101

Prenatal: 1,593 Maternal Complications ........................................................................................................................... 15% Breastfeeding at Hospital Discharge ........................................................................................................ 35% Breastfeeding at Case Closure ................................................................................................................. 13% Using Birth Control After Delivery ......................................................................................................... 58% Average Gestation ....................................................................................................................... 38.21 weeks Average Infant Birth Weight .......................................................................................................7.07 pounds Infant: 1,508 Use of Infant Safety Seat ......................................................................................................................... 89% Assigned Primary Care Provider.............................................................................................................. 76% Well Child Appointments Current ........................................................................................................... 71% Immunizations Current73%
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West Virginia Statewide Needs Assessment For Home Visitation Programs (2010)

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WEST VIRGINIA HOME VISITATION PROGRAM STATEWIDE NEEDS ASSESSMENT HRSA AWARD # 1 X02MC19425-01-00

September 20, 2010

West Virginia SAMHSA SubState Treatment Planning Data Reports

17.0 2.8 2.8 ---

19.66 5.38 ---5.46 4.32

West Virginia SAMHSA SubState Treatment Planning Data Reports

Other indicators of at risk prenatal, maternal, newborn, or child healthAs available

West Virginia Department of Vital Statistics (2008) US Census

Marshall Monongalia Marion

Wetzel Pleas ants Tyler Dodd ridge

Morgan Preston Mineral Hampshire Tucker Grant Hardy

Berkeley Jeff erson

Wood Wirt Jackson

Cal houn Roane

Lewis Upshur Randolph Pendleton Webster

>=14.1% 12.2% 14.0% 10.1% 12.1%

Putnam Cabell Kanawha Wayne Lincoln Boone Mingo Logan

Fayette Greenbrier Raleigh

Lessthan37weeksgestation. Percentagecalculatedasoftotalbirthsexcluding unknowngestation. WestVirginiaBureauforPublicHealth HealthStatisticsCenter,2010

Sum mers Mercer

Marshall Monongalia Marion

Wetzel Pleas ants Tyler Dodd ridge

Morgan Preston Mineral Hampshire Tucker Grant Hardy

Berkeley Jeff erson

Wood Wirt Jackson

Cal houn Roane

Lewis Upshur Randolph Pendleton Webster

>=10.3% 9.5% 10.2% 8.3% 9.4%

Putnam Cabell Kanawha Wayne Lincoln Boone Mingo Logan

Fayette Greenbrier Raleigh

Lessthan2,500grams. Percentagecalculatedasoftotalbirthsexcluding unknownbirthweight. WestVirginiaBureauforPublicHealth HealthStatisticsCenter,2010

Sum mers Mercer

Wetzel Pleas ants Tyler Dodd ridge

Wood Wirt Jackson

Cal houn Roane

>=8.9 7.6 8.8 6.3 7.5

Putnam Cabell Kanawha Wayne Lincoln Boone Mingo Logan

Fayette Greenbrier Raleigh

Sum mers Mercer

National Center for Children in Poverty http://www.nccp.org/

Crime in West Virginia 2008

Table 11 WEST VIRGINIA Substate Regions (defined in terms of counties)

US Department of Health and Human Services (2010).

90.00% 80.00% 70.00% 60.00% Percentage 50.00%

40.00% 30.00% 20.00% 10.00% 0.00%

2008 (72.28%) 2009 (66.16%)

2009 309 76 91 15 597 117 92 39 495 94 108 31

2010 202 43 3 292 71 15 288 48 23 1

219 62 30 12 193 69 26 8 82 21 5 1 987 172 154 62 11 2 2

108 24 17 76 12 3 101 22 7 37 6 3 197 26 7 47 8

2008 13 14 345 112 91 41 43 43 12 2 841 201 185 159 1 3

2009 4 10 249 105 20 40 56 29 8 856 167 93 92

2010 6 120 59 21 31 14 1 442 81 65 1 1 35 15 4 61 29 9 181 50 43

18.66 4.91 4.02 7.39

8.0 Child Maltreatment in measured in region not counties in West Virginia

2008 Vital Statistics 2008 Vital Statistics

2008 Vital Statistics

19.34 5.74 5.03 9.06

6.8 Child Maltreatment in measured in region not counties in West Virginia

2008 Vital Statistics 2008 Vital Statistics

2008 Vital Statistics

18.66 4.91 4.02 7.39

6.1 Child Maltreatment in measured in region not counties in West Virginia