Research brief

Assisting Community-Based Rural Independent Living Programs

By Margaret A. Nosek, PhD; Carol A. Howland, BA; Earl Walden, DEd

The ILRU Research and Training Center on Independent Living at The Institute for Rehabilitation and Research and the Department of Physical Medicine and Rehabilitation, Baylor College of Medicine, Houston, TX 77030

Sponsor: National Institute on Disability and Rehabilitation Research, Washington, DC 20202

Purpose

Under a 3-year grant from NIDRR, ILRU identified community-based programs that are engaged in the delivery of independent living and supportive services to persons with disabilities who live in rural areas. Criteria were established for exemplary operational practices, and programs were selected that best meet these criteria. Materials were solicited from exemplary programs for inclusion in ILRU's Resource Materials Directory. Six programs (two in isolated rural communities, two in moderately rural communities, and two in urban settings that do outreach to rural communities) were selected as demonstration sites for receiving intensive supportive services by ILRU over the duration of the project. The outcome of these efforts were assessed using a comprehensive approach to evaluation. The final goal is to make rural-focused technical assistance services and supportive materials available to all rural independent living programs.

Progress

An advisory committee has been established, composed of persons representing the Association of Programs in Rural Independent Living (APRIL), the National Council on Independent Living (NCIL), the Council of State Administrators of Vocational Rehabilitation (CSAVR), researchers and practitioners in rural rehabilitation service delivery, and the Research and Training Center on Rural Rehabilitation Services. A Delphi questionnaire was prepared and sent out to independent living programs requesting the staff to list the five most pressing problems confronting providers of independent living services to rural areas. Next, a composite listing of these problems was sent to these programs, asking that they rank order the top 10 problems.

Five exemplary rural service providers were identified, and two emerging rural independent living centers were selected as demonstration sites for technical assistance and materials. Five monographs were written about the most problematic areas for rural centers; they are currently in production. Cluster analysis was completed and three distinct profiles of rural independent living centers identified. An article is currently in progress.

Results

A questionnaire sent to independent living programs in 1991 identified 300 programs that offer services to people with disabilities residing in rural areas. These programs received a second questionnaire covering center location, service delivery, and staff and board with and without disabilities, and budget; 123 centers responded. Analysis of the Delphi survey revealed the top five problems faced by rural ILCs to be attitudes, transportation, housing, funding, and accessibility. Cluster analysis is based on five criteria: 1) total annual budget in proportion to the number of consumers served, 2) percentage of staff time spent providing services in the consumer's home rather than at the center, 3) number of miles traveled to deliver in-home services in proportion to the number of staff traveling annually, 4) number of miles traveled to deliver in-home services in proportion to the number of consumers served annually, and 5) number of information and referral requests received during the past fiscal year. Of the 123 respondents, 100 met the criteria to fit into one of three profiles: 1) Prototype profile, representing the typical center providing services to rural areas, with the smallest budget to spend per consumer and the highest percentage of consumers with mobility impairments served (n=77); 2) Outreach profile, with the highest rate of travel to deliver in-home services and the highest percentage of elderly consumers (n=13); and 3) Peak expenditure profile, the most atypical, with few in-home services and the highest average budget per number of consumers served (n=10). Overall differences between profiles were highly significant at p<0.00001.

© ILRU Research and Training Center on Independent Living

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