CLARION COUNTY PREVENTION PLAN FOR CHILDREN, YOUTH, & FAMILIES 2009 Written and Compiled by: Clarion County Prevention Plan Introduction This prevention plan has been a project under the Integrated Children‘s Service Plan of 20082009. Although there are many other populations that could easily be included in this plan, the plan will focus mainly on children, youth and families in compliance with the State objectives. Many agencies have contributed to this plan, both county and private. Although we tried to have all information as accurate and inclusive as possible, there may be some errors or programs that we may have overlooked. If there are changes or corrections, please contact us so we may be as accurate as possible. In order to make changes using prevention efforts, several steps must happen. First there must be awareness that the problem exists and that change is needed. The community/family/individual must be willing to make the change with available supports. Finally, a structure must be in place that will assist in making the changes towards more positive youth development. This plan is part of that process of identifying problem areas and possible structures that are already in place to make needed changes. A prevention plan could also clarify if prevention and/or treatment plans are achieving their intended results. The plan can also identify gaps in problem areas that either do not have prevention supports or the supports may not be making the intended progress. Please keep in mind that other factors, other than the programs, may change the resulting effectiveness demonstrated and this may not be an accurate picture. Some factors may be that the mentioned programs may not be provided on a continuous basis because of limited funding sources or the problem area is increasing at a lager rate than the effectiveness of the prevention. But something is needed as a starting place to demonstrate if any changes are being made. This plan may be useful to those working with children and families as a possible resource for services. Problem behaviors of youth are usually addressed with prevention efforts initiated before the behaviors start or before the problems are out of control. To better understand these concerns we have divided them into four major domains that exist in the life of the child or youth; community concerns, family/education concerns, healthcare concerns, and basic needs concerns. Geography Clarion County is 602 square miles, situated in the hills of Northwest Pennsylvania with Interstate 80 bisecting the county from east to west and the Allegheny National Forest coming into the County‘s northern border. It is centrally located between Erie, Pittsburgh and State College, each about a two hour drive away. With a total population of 39,898 (2008 US Census estimate), the residents are 95% rural. 2 Table of Contents Page: Community Concerns ......................................................................... Violence ...................................................................................... Drugs and Alcohol ....................................................................... Family/Education Concerns ................................................................ Teen Pregnancy .......................................................................... Bullying ....................................................................................... Child Abuse ................................................................................. School Readiness/Drop out.......................................................... Health Care Concerns ........................................................................ Mental/Emotional Health ............................................................. Physical Health ........................................................................... Oral Health .................................................................................. Other Local Community Services/Concerns ........................................ Housing........................................................................................ Food ........................................................................................... Finances ..................................................................................... Conclusion .......................................................................................... Compiled and updated by: Clarion County’s Promise 3 4 4 7 12 13 14 15 17 19 19 21 23 25 25 26 29 30 COMMUNITY CONCERNS Are our schools and communities safe? Individuals, community groups, schools and businesses can address many types of crime and disorder problems on their own or jointly with law enforcement officials. Communities can also take action against some of the root causes of crime by addressing community risk factors and by holding community events. This section will include information on the following topics: Violence and Drug & Alcohol. Violence A first step you can take in addressing and solving crime and disorder problems in your neighborhood is to become informed about the kinds, frequencies, and locations of such incidents. Three important indicators of violent behavior—arrest records, victimization data, and hospital emergency room records—have shown significant downward trends nationally. Sexual violence refers to sexual activity where consent is not obtained or freely given. The person responsible for the violence is typically male and is usually someone known to the victim. ―Safe schools are essential to Violence in Schools: 2001-2002 learning in an orderly atmosphere. Research shows that Assaults on All Assaults Weapon higher rates of discipline probstaff & Weapons per 1,000 Incidents per lems in a school can dampen students Incidents Students 1, 000 Students student achievement.‖1 Clarion 12,281 3,163 7.0% 1.8% School Violence is higher than PA the state average in the number Clarion 78 44 8.6% 1.3% of assaults per 1000 students but lower in weapons incidents. Jefferson 19 6 3.9% 0.8% In the county comparison, Clar106 16 9.0% 1.7% ion is lower than Venango but Venango significantly higher than JefferSource: PA State of the Child, 2004 son County. Weapons incidents in schools contribute to a heightened insecurity, unsafe conditions, and a volatile learning environment. ―Attacking someone with the intent to harm‖ is measured by the ques2007 Pennsylvania Youth Survey tion, ―How many times in the past year (12 months) Attacking Someone with the Intent to Harm have you attacked someone with the idea of seri12.0% ously hurting them?‖ For 11.5% Clarion County in 2007, 11.0% students reporting they 2005 had attacked with the in10.5% tent to harm ranged from 2007 10.0% 6.8% in 6th grade to 13.9% in 10th grade. The 9.5% average of 6th, 8th, 10th, Clarion County Pennsylvania and 12th grade responses is 11.4%, which is slightly higher than the state at 10.5%. There was an increase of 1.1% from the 2005 report in 2007. Risky Behaviors 4 Sexual Violence is often overlooked, but it a very real problem. PASSAGES of Clarion County reported serving 138 clients in Clarion County in the 2008/09 fiscal year. They also provided 380 programs to school-aged children and adults throughout the county. Violence Prevention Programs PASSAGES (Prevention and Services for Sexual Assault through Guidance, Empowerment, and Support) is a non-profit service agency serving Clarion, Clearfield, and Jefferson Counties. PASSAGES offers counseling services, a 24-hour crisis hotline, medical accompaniment and legal advocacy in addition to prevention education services. PASSAGES believe that education is the first step toward the prevention of sexual assault. Sexual violence education/prevention programs are available to all area schools and community groups for every age level from pre-school to senior citizens. In addition to prevention/education programs, community wide events such as mall shows, health fairs and the annual Celebrate the Survivor event, are held each year. All programs are free of charge and are also available to design a program specifically to meet the needs of a particular audience. For more details on these programs and more, please contact PASSAGES at 814-226-7273. Several of their programs are listed below: Preschool Aged: ―Carefree Kids Puppet Show (Safe/Unsafe Touch program with ‗Chuckles & Cocoa‘)‖ ―My Body Belongs to Me‖ (Story) Elementary Aged (K-6) ―Safe & Unsafe Touch‖ ―Carefree Kids Puppet Show (Safe/Unsafe Touch program with ‗Chuckles & Cocoa‘)‖ ―Peer Sexual Harassment‖ (Gr. 5 & 6) ―Internet Safety‖ (Gr. 4-6) ―Cyberbullying‖ (Gr. 5 & 6) ―B.A.B.E.S‖ (description listed below, this program is done in conjunction with SAFE and Drug and Alcohol.) High School Programs (Gr. 7-12) ―Peer Pressure Harassment‖ (Gr. 7-12) ―Predators In Your Home‖ (Internet Safety, Gr. 7-12) ―SEXTING‖ (Gr. 7-12) ―Sexual Violence: 101‖ (Gr. 7-12) ―Date/Acquaintance Rape‖ (Gr. 9-12) ―Drug-Facilitated Sexual Assault‖ (Gr. 10-12) College/Community Programs and/or Trainings ―Date/Acquaintance Rape‖ ―Drug-Facilitated Sexual Assault‖ ―Sexual Violence: 101‖ ―Internet Predators‖ ―SEXTING‖ ―Mandated Reporting‖ ―What Do I Say Now‖ - (How to Help Protect Children from Sexual Abuse) Clarion County SAFE (Stop Abuse for Everyone) offers services to victims and their families of domestic violence. SAFE provides prevention programs that include educational programs for residents of Clarion County. They offer these programs through schools and through various outlets in 5 the community. Some of their programs are listed below: Identifying Children Exposed to Domestic Violence- this program offers the opportunity for participants to gain awareness of how the exposure to domestic violence affects a child, how that child may exhibit different behaviors in the classroom and how the school can help. Clarion County schools and a community resources such as SAFE can work together to provide awareness, prevention, and intervention for children exposed to domestic violence to insure a safer and healthier future for our families. Teen Dating Violence– One of five teen dating relationships is defined as abusive. After participating in this workshop, participants will understand the dynamics particular to teen dating violence, be able to recognize signs, how to help the victim, and discover how the school along with SAFE can work together to bring awareness and prevention of dating violence to Clarion County students. Domestic Violence in the Workplace– Domestic violence doesn‘t only occur at home, it follows a survivor wherever they may be– sometimes even to work. Twenty one percent of fulltime employees claim to be victims of domestic violence. Employers learn the dynamics of abuse, how it effects the employee as well as the workplace, how they can help, and information on how to develop a domestic violence within the workplace protocol. Healthy Choices– Violence Free Healthy Choices is a prevention curriculum for 3rd and 4th graders. The program offers alternatives for handling interpersonal conflict and how to get help for family violence. The primary prevention goals are to encourage students to talk about these issues and to teach all upper elementary school students resolution skills that will prevent them from using violence to solve problems. Topics of the lessons are family diversity, development of a support network for fearful and unsafe situations, types of abuse and how to appropriately deal with ―secrets‖, self-esteem, peer pressure, emotions and our reactions, assertive problem solving and rules for fighting fair. This is an eight week program. BABES– The BABES program addresses issues such as coping skills, peer pressure, refusal skills, sexual abuse and violence. The curriculum is presented in a non-threatening way through the use of puppets. BABES is an eight week curriculum for kindergarten through 2nd graders with each program lasting 30 minutes. This program is a collaborative effort with Clarion County Drug & Alcohol, PASSAGES & SAFE. B.E.S.T. Relationships– The B.E.S.T. program is presented to 8th graders. The purpose of this program is to increase students‘ awareness of how self-esteem, equality, communication, and boundary setting skills are necessary to maintain a healthy relationship. Presentations involve large and small group discussions, worksheets and handouts. The Quiet Storm Project– This is a program that is designed for high school and university students. The basis of the presentation is the Quiet Storm video. The video portrays the true story of the evolution of an abusive relationship from the initial meeting of the Annie and Alex until the relationship ends in violence. Discussion and informational handouts aid in the understanding of teen dating violence. At the end of the presentation students will understand the dynamics of an abusive dating relationship, the danger signals of possible abuse, that abuse is not acceptable, and the help is available for them. D.V. 101– Domestic Violence 101 is a program that offers adult participants the opportunity to gain an awareness of the prevalence of domestic violence in our society, the dynamics of abuse, the cycle of violence, the effects and consequences of abuse, and how SAFE can help. 6 Bullying– is a two day program for 8th graders. A survey is conducted to determine if students have either been a victim or a witness to bullying in their school. Bullying behaviors and the long term consequences for the bully and the victim are defined as well as the role of the bystander. Discussion follows as to how the victim, the bystander and the school can all work together to stop bullying behaviors. Students are encouraged to sign a pledge that they will stand together against bullying in their school. Free To Be Me– is a prevention and education group presentation for children ages 6 thru 12. This program creates a fun environment to facilitate learning. Children will learn the importance of healthy self-esteem, learn how to identify feelings and learn how to develop a personal safety plan. Teen Dating Violence for Parents– After participating in this program, parents will be able to define and understand the dynamics of teen dating violence, recognize the signs of an abusive relationships in their teen age child, and learn how to help them. Drugs & Alcohol Prevention programs for substance abuse should address all forms of drug abuse, alone or in combination, including the underage use of legal drugs (e.g., tobacco or alcohol); the use of illegal drugs (e.g., marijuana or heroin); and the inappropriate use of legally obtained substances (e.g., inhalants), prescription medications, or over-the-counter drugs. Alcohol is the drug of choice among youth. Many young people are experiencing the consequences of drinking too much, at too early an age. As a result, underage drinking is a leading public health problem in this country. The Pennsylvania Youth Survey (PAYS) is used for supportive data on drugs, alcohol, and other problem behaviors among youth in Clarion County, the state, and nationally and displayed in this section of the prevention plan. This survey is given to students in 6th, 8th, 10th, and 12th graders every two years in schools who choose to participate. This survey has been conducted in various school districts since 2001. In 2005 and 2007 a county reported was put together through the PAYS research company, Westat. This survey is once again being conducts in 2009 in various school districts in the county. All school district data is kept confidentially; however, the county aggregate report is used extensively for grant writing and publications such as these. Drug use on the PAYS is broken down into the ―past 30 day use‖ and ―lifetime use.‖ Lifetime use best expresses ―experimental‖ usage while the past 30 day usage expresses what youth report doing on a regular basis. These figures are compared against the 2005 county report, state, and national averages for those years when valid. The onset of drinking and smoking habits of Clarion County Youth are a concern as these are ―gateway drugs‖ leading to other more harmful and dangerous drugs. Studies have shown that the younger the student starts using gateway drugs, the higher the risk of regular use as they get older of these substances or harder drugs. Also, the underage ―use‖ of alcohol and smoking could indicate rebelliousness thus leading to juvenile crimes and delinquency. Clarion County’s Average Age of Onset of ATOD Use and Other Antisocial Behaviors 6th 8th 10th 12th Overall 10.4 11.7 12.9 13.8 12.7 Drinking Alcohol Regularly 10.5 12.4 14 15.5 14.4 Smoking Cigarettes 10.5 11.6 12.3 13.1 12.3 Smoking Marijuana 11 12.1 13.5 14.5 13.8 DUI (Alcohol) .7 4.6 6.6 24.3 8.5 DUI (Marijuana) .3 1.8 4.7 18.6 5.9 Trying Alcohol Source: 2007 Pennsylvania Youth Survey 7 These are the results from the 2007 Pennsylvania Youth Survey with Clarion County. In comparison to the 2005 results, there isn‘t much different in the onset use of ATODs; however, the over all percentage of students who reported driving under the influence of alcohol in 2005 was 9.1%, while in 2007, this number dropped half a percent. The biggest drop was in the 12th graders going from 32.3% in 2005 to 24.3%. DUI with marijuana also dropped nearly 1%, with the biggest drop in 10th grade from 9.3% in 2005 to 4.7% in 2007. While there are some improvements, the problem remains that over 10% of 6th graders are trying alcohol, drinking it regularly, and smoking cigarettes and marijuana. Abusing drugs at an earlier age increases the risks associated with the drugs. Alcohol Use in Clarion County has gone down slightly from 2005 to 2007 according to the Pennsylvania youth survey. However, in the 2007 comparison, Clarion County 30 day usage is still higher than the state and national averages. If younger students begin using alcohol at a younger age, they are more likely to become alcoholic which leads to a multitude of problem behaviors. Drug Use in Clarion County has varied across the board. In the first graph you will see the comparison of cigarettes, smokeless tobacco, marijuana, inhalants, and other illicit drugs. Although some drug use gown from the 2005 to 2007, it is still higher than the state in most areas (except marijuana). The same can be said of the other drugs compared in the other graph: cocaine, crack cocaine, heroin, hallucinogens, methamphetamines, ecstasy and steroids. The state is only higher in one area, hallucinogens. Although Clarion is a small, rural county, there is a drug problem that needs to be addressed. Prescription Drug Abuse is the largest growing drug trends across the county. Prescription drugs are easy to get and they are free from parents, grandparents, or friend‘s medicine cabinets. As dubbed by the media, ―pharm parties‖ do exist, although they may not be called this by the youth. The Clarion County Sheriff‘s office has testified that such parties have been identified. Specific instances such as, an adult paying a babysitter in prescription drugs, have occurred in Clarion County. Because of these growing trends, it is important to note this abuse in the county and the state. The 8 three graphs represented are the 2007 comparisons of the county averages and the state. Also compared is the ―past 30 day use‖ (regular use), ―past 12-month use‖ (possible regular use), and ―lifetime use‖ (more experimental use). In the Pennsylvania Youth Survey, students are asked how many times they had taken these types of prescriptions without their doctor‘s permission or without the doctor telling them that they need to take the prescriptions. 2007 Prescription Sedative Use 2007 Prescription Amphetamine Use 8.0% 10.0% 8.0% 6.0% 4.0% 2.0% 0.0% 6.0% Clarion County 4.0% 2.0% State 0.0% Past 30-Day Past 12-Mo Lifetime Use Use Use Clarion County State Past 30 Day Past 12-Mo Lifetime Use Use Use Amphetamines are drugs prescribed by the doctor to help people lose weight or give energy. These include: diet pills and pep pills, also called: uppers, ups, speed, bennies, and dexies. (This does not include over-the-counter pills such as Dexatrim ® or No-Doz ®.) Sedatives are drugs prescribed by the doctor to help people relax or sleep. They are sometimes called downers or downs, and include prescriptions such as: Phenobarbital, Tuinal, Nembutal, and Seconal. Lastly, tranquilizers are usually prescribed to calm people down, quiet their nerves, or relax their muscles. These include: Librium, Valium, and Xanax. In all areas, Clarion‘s averages were higher than the state in the 2007 Pennsylvania Youth Survey. Amphetamines are the highest abused prescriptions in Clarion County in all areas. Numbers did not change much from the 2005 PAYS. 2007 Presciption Tranquilizer Use 6.0% 5.0% 4.0% 3.0% 2.0% 1.0% 0.0% Clarion County State Past 30-Day Use Past 12-Mo Lifetime Use Use It is important to not only prevent the students from abusing prescriptions through proper education, but also to help adults in their lives remove the temptation by proper disposal of prescription drugs. Elderly adults are also at risk for violence when it is known that they have valuable prescriptions for abuse or re-sale. Education about proper disposal is not only safe for the environment, but it also deters youth who may steal the prescriptions, thus protecting those who have the prescriptions. Since not all prescriptions can be flushed, teaching other methods of disposal is important since not all pharmacies have a disposal program. Many individuals are not aware of the drug abuse problems in the county and often refuse to acknowledge that these problems exist. Drug and alcohol abuse information has to be presented to parents and other community members (not just children and teens) so that they are well informed and able to help aid in the prevention of drug abuse among children and teens. Prevention is proven 9 to be more effective and cost efficient than help after drug abuse has take hold of an individual. Because of the young age of drug ―experimentation‖ prevention needs to start at an early age. Clarion County Drug and Alcohol, Clarion County‘s Promise and many other agencies in Clarion County offer drug prevention programs both individually and together as teams. Some programs are on-going while some programs depend on the financial state of the organization. These programs are generally offered to all youth, while some also target parents and other adults. Prevention must reach all domains in a child‘s life: home, school, individual, and community. Reaching all of these domains will greatly increase the protective factors in a child‘s life while decreasing the risk factors. Risk Factors Related to 2007 Risk Factors Drug and Alcohol Use The Pennsylvania Youth Clarion Survey provides a list of PA County Risk & Protective Factors based on the answers of Laws & Norms Favorable to Drug Use 54 47 specific questions. Risk 45 42 factors are conditions that Perceived Availability of Drugs increase the likelihood of Parental Attitude Favorable Toward ATOD Use 53 46 a young person becoming 47 41 involved in drug use, de- Friends’ Use of Drugs linquency, school dropout Favorite Attitude ATOD Use 41 37 and/or violence. Research 42 43 shows that teens who Low Perceived Risks of Drug Use have a greater number of Source: 2007 Pennsylvania Youth Survey risk factors present in their lives are more prone towards drug use and delinquency. Risk factors are judged with the median being 50, Risk Factors should be below 50. The Risk Factors specifically related to drug and alcohol use are listed below in a table from the 2007 PAYS comparing the county average to the state average. Laws & Norms favorable to drug use comes from student‘s perceptions of the rules and regulations concerning alcohol, tobacco and other drug use that exist in their neighborhoods. 1 As reported in the Pennsylvania Youth Survey, ―when laws and community standards are favorable toward drug use, violence and/or other crime, or even when they are just unclear, young people are more likely to engage in negative behaviors‖ (Bracht and Kingsbury, 1990). Scoring comes from asking questions such as, ―How wrong would most adults in your neighborhood think it was for kids your age to drink alcohol?‖ and ―If a kid smoked marijuana in your neighborhood, would he or she be caught by police?‖ The acceptance of alcohol within the community at public events can cause confusing among teens who may be getting the ―just so no‖ message at school and home. ―These conflicting and ambiguous messages are problematic in that they do not have the positive impact on preventing alcohol and other drug use that a clear, consistent, community-level, anti-drug message can have.‖ (2007 PAYS County Report) The Perceived availability of drugs is determined by asking students questions such as, ―If you wanted to get some marijuana, how easy would it be for you to get some?‖ This set of questions are designed to asses students‘ feelings about how easily they can get alcohol, tobacco and other drugs. Parental influence is vitally important when it comes to preventing drug abuse among youth. Parents are the first defense that teens have when combating the temptation for drug abuse. Parental atti- 10 tudes favorable toward ATOD use is determined by asking such questions as, ―How wrong do your parents feel it would be for you to smoke marijuana?‖ Peer influence is also important, Friends’ use of drugs is determined by asking questions such as, ―In the past year, how many of your best friends have used marijuana?‖ Teens who have friends who are into using drugs are much more likely to become involved in that behavior as well. Favorable attitudes toward ATOD use are formed from influences outside of themselves such as parents & family, school, friends, and community influences. This risk factor is determined by asking students question such as, ―How wrong do you think it is for someone your age to drink beer, wine or hard liquor (for example, vodka, whiskey or gin) regularly?‖ A high score in this area indicates that students do not see much wrong Lastly, in addition to all other risk factors listed, when teens do not feel that taking drugs is harmful, this perception can also lead to drug ―experimentation‖ which can then lead to regular use. Low perceived risks of drug use is determined by asking questions such as, ―How much do you think people risk harming themselves if they try marijuana once or twice?‖ A high score in this area can indicate that students are not aware of, or do not comprehend, the possible harm resulting from drug use. Drug and Alcohol Prevention Programs Drug and Alcohol of Clarion County provide several prevention services to Clarion County residents of all ages. Drug and Alcohol Administration specialize in providing educational and information programs and publications about: alcohol and other drugs, alternatives to substance abuse, early identification and referral of substance abusers. Student Assistant Program (SAP): is a service designed to help school personnel identify issues, including alcohol, drugs, mental health, and behavioral concerns which could pose as a barrier to a student‘s learning and school success. The SAP team‘s primary goal is to help students overcome these barriers in order for them to achieve, remain in school and graduate. ATOD education– Drug and Alcohol can go into schools or the community and present programs that do not fit into a curriculum. They have many lessons that cover topics such as: refusal skills, peer pressure, dangers of smoking, etc. Parenting programs- Parenting programs are designed for parents to become aware of what is going on the county and how they can help keep children drug free. Too Good For Drugs- Curriculum for students in grades K-3. Based on the simple motto that kids are too good for drugs. Each grade level builds on the previous year so schools can have the program every year if they wanted. Five components for all grade levels include: goal setting, decision making, bonding with others, identifying and managing emotions, and communicating effectively. It is ten lessons, lasting 30-45 minutes. Tobacco education programs- Tobacco education programs are presented to students in high school who are looking to ―kick‖ their smoking habit. There are lessons with each student getting a handout and information to help them make an informed decision about quitting. This program runs for 45 minute each and has 8 lessons. Other– Drug and Alcohol also have other programs such as: Project Northland, which is a 6 th grade program about alcohol; Class Action, which is for graded 9-12 and discussed the consequences of alcohol use; Not on Tobacco which is a tobacco cessation program; Project Drug Free; for students 11 in grades K-3 and 4-6. Drug Free Workplace presentations are available to workplaces that have policies in place. Reality Tour ® -Clarion County‘s Promise also provides drug and alcohol prevention programs for the county. Currently, the Reality Tour® is being offered to Clarion County through a grant from the PA Attorney General. The Reality Tour is a drug prevention program created by Candle, Inc. in 2003. This is a consequence-driven program that takes parents and their teens through the life and death of a teen on heroin through a series of dramatic events. Included are real life talks from law enforcement officers, drug and alcohol personal, and former addicts. This program is designed for parents and their teens in grades five and up. Because this program is as much for the parents as it is for the teens, teens cannot attend alone. This program helps encourage conversations between parents and their teens about drugs and drug abuse and to let teens see the real-life affects that drugs can have on any person‘s life. The program is offered once a month at a set location in Clarion County and is open to all teens attending with an adult and to adults with or without children. Reconnecting Youth (RY) is offered by Clarion County‘s Promise and it aids in preventing students in grades 9-12 from dropping out of school. ―RY is a proven, award-winning program that helps highrisk youth achieve in school and decrease drug use, anger, depression, and suicidal behavior.‖ This program uses small group skills training to enhance personal competencies and social support resources. By addressing these problems, youth may be more inclined to be successful in school by graduating and advancing beyond. The Clarion University Health Science Center has numerous both in-house and out-reach drug and alcohol prevention programs for different ages and grades. All their programs are free for participating schools. The in-house programs are offered as interactive programs for participants and they must provide their own transportation. However, the out reach programs are available to all school districts at their request. The programs listed below are described in detail on their website as www.clarionhsec.com. “Substance Safety” and “Drug Free Me” Drug Prevention Theater Programs (Grades K-2 is an in-house program) “Straight Talk” and “The Toxic Truth” Drug Prevention Theater Programs (Grades 9-12 is an in-house program) “Voice Your Choice” and “Dangerous Drugs” Drug Prevention Theater Programs (Grades 6-8 as an in-house program) “All About Drugs” and “Refuse to Use” Drug Prevention Theater Programs (Grades 3-5 as an in-house program) “Drug Free Power” Drug Prevention Outreach Program (Done in the school for grades K-2) “Walk Straight” Drug Prevention Outreach Program (Done in the school for grades 9-12) “Addicted to Oxygen” Drug Prevention Outreach Program (Done in the school for grades 3-5) “Breath Deep” Drug Prevention Outreach Program (Done in the school for grades 6-12) FAMILY HEALTH/EDUCATION CONCERNS Prevention is necessary at all levels in the child‘s domains but the most important are the family and school. All children need to be physically and emotionally safe wherever they are — from the actual places of families, schools, neighborhoods and communities to the virtual places of media. They also need a healthy balance between structured, supervised activities and unstructured time. This sections will include information on the following topics: Teen Pregnancy, Bullying, Child Abuse, and School Dropout/School Readiness. 12 It‘s important for children to be safe. But safe places alone are not enough. It is equally important for children‘s development that these places engage them actively and constructively. It‘s also important that children develop ongoing, secure relationships with parents as well as formal and informal relationships with teachers, mentors, coaches, youth volunteers and neighbors. Concerns usually arise whenever there is an absence of caring adults and safe places in the lives of growing children. Teen Pregnancy The consequences of teen pregnancy are often grave. For children born of teens, chances of low birth weight and prematurely are high. So are instances of parental abuse, poor health, neglect and poverty. The majority of teenage mothers also face a bleak future. Often forced to drop out of school, these young women face a life of diminished expectations without additional support. Teen-age pregnancy rates are a Percent of Total Births to Mothers Under 18 major factor in the education of our Source: PA DOH Bureau of Health Statistics children because teen mothers have difficulties completing their 4.5% education and usually do not further 4.0% their education beyond high school. 3.5% PA This leads to difficulties in procuring 3.0% Clarion jobs, earning money, and support- 2.5% 2.0% ing their children. Clarion County‘s Jefferso n rate of teens giving birth has re- 1.5% 1.0% mained below the state, with the exception of 2003. Teen births 0.5% 1999 2000 2001 2002 2003 2004 2005 2006 seem to be trending down and remained the same between 2005 and 2006. Compared to adjoining counties, we are currently lower than Venango and higher than Jefferson who had zero teen births in 2006. In actual numbers, Clarion County births to teens mothers from 2003 to 2006 are as follows: 53, 46, 47, and 43 in 2006. 1 The numbers appear to be dropping slowly in the last couple of years. Teen Pregnancy Prevention Programs Adagio Health of Clarion County works to help prevention teen pregnancy through a variety of programs. Their programs include awareness, parent and community education, peer education, professional training, and supportive health programs. CAPP (Center for Adolescent Pregnancy Prevention) focuses on postponing first intercourse and, when sexual activity begins, using contraception. This program includes those topics listed above, as well as, a multi-media awareness campaign and public policy development. Adagio Health also provides a multitude of educational resources. More information on their services, programs, and education can be learned about from contacting the Clarion Office at 814-2267500 or email at [email protected]. AAA Pregnancy Center of Clarion County offers many services of support and prevention to teens and other women who need help with an unplanned pregnancy. AAA Life Services exists to minister to the grace of Jesus Christ by upholding the sanctity of all human life. This means that they also offer educational information to prevent abortions and they offer information concerning all the options for an unplanned pregnancy. All services are free and confidential and offered to anyone in Clarion County. “Abstinence and Character Education” aims to reduce the number of teen pregnancies in the 13 county. ―Because sexual behavior has such significant medical, interpersonal and societal consequences, a risk-avoidance abstinence approach to sexual education with an emphasis on character education is needed. The program is an additional supplement to what is currently being taught; it is not intended to replace current curriculum.‖ They have programs available for pre-teen, young teen, and teen. These programs can be offered through all day events, weekend retreats, or over multiple sessions. AAA Life Services also stress the importance of parental involvement in their children‘s lives as they are the first defense against negative sexual behavior. Peer Counseling and Consultations is to prevent abortions by offering other sound choices and information on those choices. They include adoption referrals, and referrals for limited ultra sounds, also preventing low birth rates and other developmental problems in the womb by referring them to get the proper pre-natal care. Bullying Young people say that bullying is one of the biggest problems they face. In fact, 52 percent of students report seeing bullying at least once a week. This negatively affects the victims and the bullies as well as the kids who witness bullying and the school environment as a whole. Some parents don‘t think bullying is a big deal. They think it‘s a rite of passage to adulthood, that it‘s just kids being kids. But for kids, bullying is one of the biggest problems they face. In fact, every day 160,000 kids miss school because they‘re scared of bullying. Attacking Someone With Intent to Harm (2007 PAYS) 14.0% 12.0% 10.0% 8.0% Clarion County 6.0% State 4.0% 2.0% 0.0% 6th 8th 10th 12th Parental attitudes to antisocial behavior also come into play when looking at bullying behaviors among teens. This risk factor from the Pennsylvania Youth Survey is determined by asking questions such as, ―How wrong do your parents feel it would be for you to pick a fight with someone?‖ If parents do not feel that this is wrong, teens may be more likely to engage in this type of behavior. The higher this score is means the more favorable parents are to certain anti-social behaviors. Attacking with the Intent to Harm indicates bullying in school. This is determined by asking students, ―How many times in the past year (12 months) have you attacked someone with the idea of seriously hurting them?‖ According to the Pennsylvania Youth Survey 11.4% of students in grades 6, 8, 10, & 12 indicated that they had attacked another student with the intent to harm them in 2007, this is up from 10.3% in 2005. The county is higher than the state in 2007 which was 10.5%, down from 11.7% in 2005. Parental Attitudes Favorable Toward Anitsocial Behavior 60 40 Clarion 20 PA 0 6th 14 8th 10th 12th Bullying Prevention Programs Most bullying prevention programs are focused within the schools and vary from each school district. Each of seven school districts may use different programs depending on the problems within their schools. These programs also may change with available funding or which programs seem to be working in a particular school or community. Through the Student Assistant Program (SAP) with Mental Health, resources are provided to schools in Clarion County as requested. Mental Health also provides information on assembly programs and speakers. DVD programs with worksheet handouts such as, ―Sticks and Stones; Let‘s Talk about Teasing‖, ―No More Teasing‖, ―The Power Trip; Bullying in School‖, ―The Assignment– Girls, Cliques, and Cruelty‖, ―Bully No More‖, and ―Boys on Bullying‖ are available to schools. The SAP at each school is a vehicle to help identify students who may be struggling with bullying, either as the victim or the perpetrator. The SAP team helps set up supports, referrals and recommendations on an individual basis. When the liaison provides a mental health screening, if bullying is an issue, I offer individual educational meetings with that student to help with coping skills. Sometimes they utilized the videos, or a game called, ―Block the Bullying Cycle‖, or written materials. Books on bullying are also available for a student or parent to borrow. In addition, if emotional issues are identifies, then a recommendation is made for counseling. Resources for counseling options are provided to the parents, the decision to seek treatment is voluntary. Mental health is an active participant in community health fairs and the public relations events, at which they provide information to individuals and families through speaking and brochures on the subject of bullying and the SAP program. Mental Health also encourages schools to utilize a bullying program through SAFE and programs available through Clarion University‘s Health Science Education Center. "What is Bullying All About?" A program provided by SAFE, is a two day program for middle school students. A survey is conducted to see if students have either been a victim or a witness to bullying in their school. Bullying behaviors and the long term consequences for the bully and the victim are defined. The role of the bystander is also examined. Discussion follows as to how all participants can respond to the bully and how all involved including the school can work together to stop bullying. Students are encouraged to sign a pledge that they will stand together against bullying in their school. Clarion University Science Education Center also currently provides two bullying programs through in-school assemblies available at request by school districts in Clarion County: “Take a Stand, Lend a Hand” Life Skills Assembly Program (Grades K-5) “Delete Cyberbullying. Don’t Write it. Don’t Forward It.” Cyberbullying Prevention (Gr. 6-12) You can read more about these programs on their website: www.clarionhsec.com or by calling them at 814-227-1901. Child Abuse Child maltreatment is a complex problem with a multitude of causes, therefore, an approach to prevention must respond to a range of needs. A comprehensive strategy encompasses a variety of community-based programs to prevent child abuse. Reflective of the phases of the family life cycle, this approach provides parents and children with the education and support necessary for healthy family functioning. Based on what is known or believed to enhance an individual's ability to function within the family unit, several program areas contributing to the strategy can be identified. Beginning with the prenatal period, these programs offer a continuum of educational, supportive and therapeutic services for parents and children enduring throughout the school years, responding to the needs of all family members. 15 According to the Kids Count Data Center, Clarion County Substantiated Cases of abuse and neglect are higher in 2008 than they have been in the past two years. In addition, children aged 5-8 are receiving the brunt of this abuse in 2008. Overall, children in the 5-8 and 12-14 have been abused most often in the past six years. Kids Count Data Center According to the Pennsylvania Child Stat data, from 2007 to 2008, child abuse has gone up in Clarion County, surrounding counties and the state. Currently we do not have enough years to create a trend in this area, but these numbers are consistent with our other sources. Child abuse can stem from many different factors including economic factors, feeling alone and not prepared for children, not knowing resources in the county that are available free for parents, or other behavioral, mental, or physical health problems of family members, parents, or the children. Child Abuse Prevention Programs Clarion County‘s Promise provides different programs to families that help to prevention child abuse. These programs are free of charge and offered to all residents of Clarion County regardless of economic status. These programs are offered consistently, but sometimes varies depending on demand or what funding is available for such programs. These programs include: Parenting Programs– Clarion County‘s Promise has Certified Parents Educators who provide many different programs to parents for children of various ages. These programs can help parents work through problems, learn how to express their anger positively, and prevent child abuse. These programs can be referred or recommended depending on the individual situations. All programs are free and available for residents in Clarion County, the following are examples of what programs are available: I am Your Child (newborn), Denver Screening (birth to two years), Ages & Stages (birth to five years), Brigance Screening (birth to first grade), Incredible Years (three to seven years), Early Childhood (five to nine years), STEP (nine to 14 years), STEP Teen (14-20 years), PAT for Teen Parents, Parents Who Care (teens of all ages), Families in Action for Teens (grades seven to 12), Value Packed Parenting Workshop through Dr. Leman (Christian-based for all ages), and a multitude of Family Management Resources are also available for free. Happiest Baby Program– This program is offered to parents of a newborns up to four months old and is free to all residents of Clarion County. Certified Parent Educations provide the ―Happiest Baby‖ program to those who wish to participate. Parents of newborns will learn step-by-step how to help babies sleep longer and how to soothe even the fussiest infant in minutes. Baby Basket Program– The baby basket program provides valuable information for new parents to 16 help connect them with the various programs offered in Clarion County. This information can aid in the prevention of abuse to children by supporting parents when they need help. These baskets are offered free of charge to individuals in Clarion County who recently gave birth. Baskets contain a hand made blankets and other items for baby and mother. School Readiness/School Drop Out Research has shown that a large amount of learning occurs before the child even starts school, mostly before the age of three. Parent and families are usually the primary teachers at this age and it is important to monitor the child‘s development for possible delays. If delays are detected, it is easier to start to address the problems before the child starts school. Having a child ready to start school at the appropriate age is one of the best indicators that the child will succeed in school. Teens and young adults who have dropped out of high school may become disconnected with-in the community. As adults, many, if not most, of these disconnected young people will experience sporadic employment, work in low-wage jobs, live in poverty and rely periodically on public welfare, food stamps and Medicaid throughout their lives. Comparing the School drop out rates, Clarion County‘s rates have been lower than the state average over the past eight years. Clarion County‘s rates are also lower than the surrounding counties. However, in the last few years these rates have increased slightly. Public School Drop Out Rates 2000-01 2001-02 2002-03 2003-04 2004-05 2005-06 2006-07 2007-08 Average PA 2.4 2.2 2.1 1.9 1.9 1.9 1.6 1.7 2.0 Clarion 1.7 1.7 1.9 1.5 1.4 1.6 1.2 1.3 1.5 Jefferson 1.3 1.7 1.7 1.7 2.1 1.6 1.5 2.3 1.7 Venango 3.0 2.6 2.9 2.2 2.2 2.0 2 1.6 2.3 Source: Pennsylvania Department of Education The Drop out rates for Clarion County School Districts are indicators of problems associated with the child‘s education. ―Students often drop out of school because they have lost interest in school or can‘t keep up. Symptoms of malaise (dissatisfaction) could have been averted with better attention to early education and education policies. Studies show that high school dropouts have greater difficulty getting jobs, earn less money and have difficulty supporting their own children. They are also likelier to be disengaged from their children‘s education.‖ 1 Although the drop out rates for School Drop out rates for Clarion County School Districts 199899 199900 200001 200102 200203 200304 200405 200506 200607 200708 AC Valley .9 .9 1.9 1.6 2.6 1.3 1.2 1.6 1.4 0 Clarion 1.5 1.3 .7 1.8 1.1 1.5 1.5 1.3 .4 .9 CL 2.0 1.2 2.2 1.4 1.2 .8 .8 .8 1.1 1.9 Keystone 1.5 1.2 1.8 2.1 .7 1.4 .9 1.2 1.4 .7 North Clarion 1.6 .5 1.3 .8 .8 1.4 1.7 1.1 .8 .3 Redbank 1.6 2.0 2.1 2.2 3.5 1.9 .9 1.6 1.1 .7 Union 2.3 3.5 2.0 1.5 3.1 2.5 3.4 3.5 1.9 4.7 Source: PA Department of Education 17 Clarion County Schools varies between the years, nearly all are below the state averages. The schools seem to be providing the necessary education practices; however, the statistics among individual districts needs continued tracking.1 School Readiness Programs/School Dropout Prevention Programs Parents as Teachers (PAT) program— Clarion County‘s Promise and the AC Valley Family Center provide certified parent educations to families in Clarion County, free of charge regardless of income levels. This program is usually done in the home by the parent educators on a regularly scheduled basis (twice to four times a month). PAT is mainly for families with children from birth to school-age; however, Clarion County‘s Promise also provides additional programs for older children. STEP: Clarion County‘s Promise‘s parent educators also provide this program. Parents who participate in a STEP group have the opportunity to learn non-violent approaches to child rearing. In turn, these approaches show children non-violent ways to interact with others. The goal of STEP is to help parents raise courageous, peaceful adults. Reconnecting Youth (RY) is offered by Clarion County‘s Promise and it aids in preventing students in grades 9-12 from dropping out of school. ―RY is a proven, award-winning program that helps highrisk youth achieve in school and decrease drug use, anger, depression, and suicidal behavior.‖ This program uses small group skills training to enhance personal competencies and social support resources. By addressing these problems, youth may be more inclined to be successful in school by graduating and advancing beyond. Clarion County‘s Promise also offers screenings to help aid in school readiness: Denver (Birth to 2-years), Brigance (birth to 1st grade), Ages & Stages (Birth to 5-years old) Jefferson-Clarion Head Start offers Head Start, Pre-K Counts, & Even Start to residents in Clarion and Jefferson Counties. Some programs are contingent upon family economic situations, these include the following: Head Start covers the following areas of a child‘s life: education, transitioning to Kindergarten, health and nutrition, parent involvement, family services, and aids children with disabilities. The education program is ―designed to meet each child‘s individual needs by providing a variety of developmentally appropriate learning activities and experiences. These help to develop the whole child socially, emotionally, physically and intellectually.‖ Along with that, Head Start strives to help children transition to ―the big school.‖ Their goal for this area is, ―to provide children and their parents with the information and resources they need to successfully prepare for entrance into Kindergarten and the public school system.‖ These education-specific parts of the program along with the other areas (written out in detail in other areas of this prevention plan) help students and families prepare for school and give them a good foundation to help keep them in school until they graduate. Even Start is a free educational program that works with the family and provides: adult education, early childhood education, parenting ideas, and parent-child activities. ―Even Start helps families by providing support to parents so that they can be their child‘s first and best teacher, helping parents with GED preparation or improving math and reading skills, and encouraging family time through Family Fun Nights. These services are provided through Home Visits, Classes for Adults, and Child Time. Even Start is for parents who need their GED or help with reading or math skills and who have a child seven years old or younger. Pennsylvania Pre-K Counts provides high quality pre-kindergarten services to 11,000 3 & 4 year olds to help prepare them to learn and succeed in school and in life. Pre-K Counts is high quality 18 education for 3 and 4 year olds in PA and is free to families with a focus on children at risk of academic failure. Pre-K Counts take the form of full or half-day pre-K classes in schools, Head Start, Keystone STARS children care programs with a STAR 2 rating or higher, or nursery schools. There are more than 140 grantees (lead agencies) with more than 300 early learning programs participating in PA and administered by the Office of Development and Early Learning, Pennsylvania Departments of Education and Public Welfare. Clarion County Pre K Counts classrooms are located in AC Valley, Clarion, Strattranville, Knox, New Bethlehem, Rimersburg and Sligo. North Clarion school district also offers a Pre Kindergarten program. Individual school districts also provide programs for students to prevent them from dropping out or to help struggling students. These programs will vary by school district. HEALTH CARE CONCERNS Healthy environments are essential to the well-being of children and their families. Without the fundamentals of good nutrition and access to health care providers we can't hope to prevent child abuse/ neglect or raise healthy, productive citizens. This section will go over some health care concerns in Clarion County including data taken from the Department of Health‘s County Profiles in addition to other Clarion County healthcare studies. Like adults, children and adolescents can have mental health disorders that interfere with the way they think, feel, and act. Mental health influences the ways individuals look at them selves, their lives and others in their lives. Like physical health, mental health is important at every stage of life for healthy development. Mental/Emotional Health Even though most American children and youth experience normal, healthy development, approximately 6-9 million children have serious emotional disturbances. Research shows that one in five children and adolescents, age 9-17, experience symptoms of mental health problems that cause some level of impairment in a given year. However fewer that 20% of those needing mental health services receive them. Depression or symptoms of depression are also important to look at in school children. The Pennsylvania Youth Survey asks specific questions to students that can determine how many youth are experiencing symptoms of depressions. These questions and percentage of students who feel these questions are listed in a table below: Percentage of Youth Reporting Symptoms of Depression in Clarion County 2007 PAYS 6th 8th 10th 12th Overall 30.7% 33.8% 39.2% 34% 34.5% Sometimes I think that life is not worth it 17.6 25.7 30.7 27.9 25.6 At time I think I am no good at all 28.9 33.5 37.2 35.5 33.9 All in all, I am inclined to think that I am a failure 11.6 19.3 18.3 11.4 15.5 In the Past year, felt depressed or sad most days 19 Suicide rates in Clarion County are lower than the state; however the numbers have gone up over the years. The suicide rate for Clarion County over the years 2003-2005 is 9, while Pennsylvania is 11.2.2 (2. www.healthstatus2010.com) However, over the years these numbers have varied according to the Pennsylvania Department of health, including a sharp incline in 2006. Actual Number of Suicides in Clarion County. 10 8 6 4 Number 2 0 2002 2003 2004 2005 2006 Symptoms of Depressions According to the Pennsylvania Youth Survey, students in grades 6, 8, 10, & 12 all reported symptoms of depression with 10th graders reporting the highest percentages in three of the four areas. When compared to state, Clarion County students are reporting higher percentages that the state in both 2005 and 2007. In addition, these percentages have risen from the 2005 to the 2007 report for Clarion County students. If this trend continues this could lead to more and more problems in the youth of Clarion County. Clarion County Mental Health reported that, on average, more than 20% of the population suffers from a diagnosable mental illness in any given year. In Clarion County, Mental Health has served about 3% of the population each year. Considering that 1-2% also receive private care, that leaves approximately 15% of the population in Clarion County who may have diagnosable mental illness are not seeking professional treatment each year. According to Clarion County Mental Health, major depression is the most common serious or persistent mental illness, but it is also the most treatable. About 38% of the Clarion County population seeking treatment through Mental Health at any given time are diagnosed with major depression. These statistics from Mental Health coincide with statistics given through the 2007 and 2005 Pennsylvania Youth Survey where approximately 30% of students surveyed in grades 6th, 8th, 10th, & 12th graders reported several symptoms of depression. The Clarion Psychiatric Health centers offers free assessments to residents, along with a weekly parent support group for parents who have teens have gone through the center. 20 Physical Health All children need and deserve healthy bodies, healthy minds and healthful habits. These result from regular health check-ups and needed treatment, good nutrition and exercise, healthy skills and knowledge, from pre-natal to adult. With increased attention on such issues as upsurges in childhood obesity and juvenile diabetes, Americans have a raised awareness of the importance of a healthy start as a critical developmental resource in a child‘s life. Nevertheless, we are falling far short of keeping this Promise. Nine million young people today remain without health insurance. Babies born in the U.S. are less likely to survive until their first birthday than those in 27 other industrialized nations. Childhood cavities is a silent epidemic sweeping the nation that interferes with education, socialization as well as healthy development. Lack of Early Prenatal Care (Percentage) 2002 2003 2004 2005 2006 PA 15.4 18.1 18.7 18.9 19.2 Clarion 13.8 14.8 15 18.4 20.6 Jefferson 15.8 19.9 22.1 21.9 27.2 Venango 20.4 15.8 20.2 17.8 24 Source: PA Dept. of Health Prenatal Care Between the years 2002 and 2006 the percentage of mothers NOT receiving pre-natal care has gone down. In addition Clarion County‘s numbers are lower than that state and surrounding counties, Jefferson & Venango. This a positive trend that Clarion County is seeing that could be a result of prevention programs, classes offered, and parent‘s be- ing educated on the importance of pre-natal care. Low Birth Rate Low Birth Rate (percentage) In addition to more mother‘s re- 12.0% ceiving pre-natal care, the percent- 10.0% age of babies being born at a low 8.0% birth rate has also gone down be6.0% tween these years. Low birthrate is 4.0% considered to be less than 5lbs, 2.0% 3 8oz. Once again Clarion‘s per0.0% centage is less than the state and 2002 2003 2004 2005 surrounding counties. This is also a positive trend that could be a rePA Clarion Jefferson Venango sult of prevention and educational programs provided to families and mothers in the county.3 Children Receiving Aid Through TANF (Percentage) 2004 2005 2006 2007 2008 2009 6% 6.4% 6.2% 5.4% 4.7% 5.1% Clarion 3.6% 3.8% 3.4% 2.5% 2.2% 2.4% Jefferson 2.1% 2.2% 2.6% 2.2% 1.7% 2.1% Venango 6.4% 6.5% 6.2% 4.8% 4.1% 4.4% PA Source: PA Dept. of Health 21 2006 Temporary Assistance to Needy Families (TANF) is a welfare program providing cash payments for needy children under age 18. Clarion County is consistently lower than the state percentage; however these numbers may be misleading. We have found that for in- come-based services there is a stigma against those receiving services. Therefore, in order to reach the targeted at-risk population, services need to have NO income based guidelines. This will lead to healthier child development. Percentage of Students Enrolled in Free or Reduced Lunch Programs School Lunch eligibility is an im2001 2002 2003 2004 2005 2006 2007 portant factor for students in Clarion PA 32% 32.1% 33.1% 33.7% 34.8% 35.1% County. This data Clarion 36% 34% 34.1% 36% 35.5% 35.8% reflects the percentages of student Jefferson 38% 35% 37.1% 36.8% 38.2% 38.2% families that are beVenango 36% 36% 38.9% 38.8% 42.8% 43.2% low poverty levels. According to the Source: PA Department of Education PDE website, ―Numerous scientific studies have suggested a strong link between child nutrition and learning in school.‖4 Clarion County is higher than the state average, but this is decreasing as the state percentages show to be increasing between 2001 and 2006. This could be a reflection of the county‘s unemployment rate becoming lower than the state average. However, the median income for the county is still $4000 below the state medium income because of the lack of a quality job market. Being in a rural area, the cost of living is not as high as urban areas thus leaving more income for the basic costs of living and providing for children. CHIP– Children Ages Enrolled in the Children‘s Health Insur- CHIP is Pennsylvania‘s program to provide health insurance Program by Age (Actual Number) ance to all uninsured children Age 2004 2005 2006 2007 2008 2009 and teens who are not eligiGroup ble for or enrolled in Medical 0-4 yrs 76 85 90 108 110 107 Assistance. With CHIP there is income limit, so any child 5-11 yrs 284 267 286 306 300 286 is eligible for this insurance 12-18 yrs 294 307 307 329 391 406 program. This chart displays the actually number of chilTotals 654 659 683 743 801 799 dren who are enrolled and receiving health coverage Source: Annie E. Casey KIDS COUNT Data through this program. Medical Assistance (MA) is also reMedical Assistance- Number of Children of all Ages ferred to as Medicaid and it provides Enrolled in Medical Assistance, Clarion County payment for health care services on behalf of eligible low-income individu3,100 als with limited income and high medical expenses. MA available to preg3,000 nant women and children of low in2,900 come. Between 2004 and 2009, these Total numbers have gone both up and 2,800 down. From 2008 to 2009 there was a significant increase most likely due to 2,700 the economy problems and parents 2004 2005 2006 2007 2008 2009 Source: Annie E. Casey KIDS COUNT Data being laid off from their jobs this year. 22 Estimated Percent of Children Ages 017 Who Are Under 100% of Poverty (SAIPE) 25.0% 20.0% 15.0% 10.0% 5.0% 0.0% PA Clarion 2007 2006 2005 2004 2003 2002 2001 Jefferson 2000 The Estimated percent of children ages 0-17 who are under 100% of poverty (SAIPE) demonstrates possible increases in risk factors that may lead to increased problem behaviors. If appropriate protective factors are in place this may alleviate the increased risk factors. Venango Oral Health The Surgeon General‘s recent report states that oral health is essential to the general health and well-being of all Americans. Although oral health extends beyond dental health, the report clearly stresses the importance of the two leading types of dental disease: tooth decay (dental caries) and periodontal disease. Dental care can be either preventive or restorative. Preventive care, such as tooth cleaning and dental sealants, is aimed at avoiding dental problems. Restorative care repairs problems such as those caused by tooth decay and periodontal disease. But in order to have either addressed, appropriate healthcare providers are necessary. Dental care, although important is often over Other looked when planning prevention and assistance Totals: 209 57 395 programs for both adults and children. According to a dental survey completed by 660 Clarion County residents, 121 reported that they did not have dental care. Although 568 reported that they did have dental care, a little over half of them stated that they would receive more regular dental care if local dentists would accept MA or CHIP dental assistance. Although children can receive low cost or free dental care, most adults do not qualify. Insurance Type MA CHIP Clarion County has the federal designation Dental Health Professional Shortage Area in addition to Mental Health Professional Shortage Area with tracts of the county being PrimaryHealth Professional Shortage Areas and medically underserved Areas and medically underserved areas. The Clarion County Dental Task Forces was established in August of 2008 as part of the county‘s SHIP (State Health Improvement Plan) partner, Clarion County Family Net of which Clarion County‘s Promise is the lead agency. The group consists mainly of human service providers who also have a health component with their services. The Task Force also includes dental hygienists, the county health nurse, a school nurse, a dentist and a local healthcare provider. The group developed a logic model as a base plan toward relieving some of the major issues with the lack of adequate oral healthcare for Clarion County residents. 23 Clarion County currently has eleven dentists practicing general dentistry, two of them only being part time. Only one part time dentist in the county currently accepts Medical Assistance. Normal patient load for a fulltime dentist is 1100 to a maximum of 1400. With the population at nearly 40,000, this leaves a huge gap of people not having access to oral healthcare. Average Annual Rate of Death Other Health Concerns in Clarion County (2007 Population) According to the Clarion County and State Health Profiles, two areas of causes of death were higher Campylobacteriosis Giardiasis in Clarion County than the state: campylobacterio20.7 19.8 sis and giardiasis. Both are fairly common, but both Clarion are higher than the state rates as seen in the table State 10.5 6.6 provided. Campylobacteriosis is an infectious disease caused by bacteria and can spread to the blood stream and causes a serious life-threatening infection, which then will lead to death. Although this disease usually occurs in single, sporadic cases, it can also occur in outbreaks. It often comes from unpasteurized milk or contaminated water, but also come from raw chicken. Most people who get this disease can recover without treatment; however, in more severe cases antibiotics can be used.5 Giardiasis is also a disease caused by a microscopic parasite. This can be found on surfaces, or food or water contaminated by feces from infected humans or animals. It is often found in contaminated water and can be spread by unsanitary hand washing practices, water from poorly maintain wells, lakes or streams with water-dwelling animals (beavers) or cattle wondering in the source, swallowing water from public water recreational areas such as pools, eating uncooked contaminated food, having contact with someone who is infected, or traveling to countries where it is common. Giardiasis can be treated by prescription drugs and helped by drinking a lot of fluids while being infected. Practicing good hygiene, including properly washing hands, being wary of contaminated water sources, and making sure that food is thoroughly cooked along with all utensils that have been used with uncooked foods can all help to prevent this infection.5 (Center for Disease Control and Prevention) In addition to those rates, there are several risk factors noted on the Health Profiles, among those risk factors the following are higher than the state average for the 2007 population: being in ―Fair/Poor Health‖, Obesity, Overweight, having No Health Insurance, Diabetic, Smoker, and Heavy Drinking. These percentages are based off of the 2007 Clarion County population. *Those who are classified as being ―Overweight‖ also includes those who are ―Obese.‖ Risk Factors for Good Health, County Profile (PA Department of Health) Fair/Poor Health Obese Overweight No Health Insurance Diabetes Smoker Heavy Drinking Clarion 19% 28% 65% 13% 9% 23% 7% State 14% 25% 62% 12% 8% 22% 5% 24 ** Heavy drinking is defined as having an average of greater than 2 drinks per day for men and greater than 1 drink per day for women. ***Data are based on 2005-2007 annual sample surveys of Pennsylvania adults with a 95% confidence interval. Health Care Preventative “Medicine” Local hospitals and other health care agencies provide many different preventative programs and educational classes offered to Clarion County residents. Below is a brief (not comprehensive) list of hospital & other groups available in the county. There are many agencies in the county who have individual programs or who assist the below groups with prevention/education programs. Adagio Health- www.adagiohealth.org > ―Education & Prevention‖ Brookville Hospital- www.brookvillehospital.org Butler Health System– www.butlerhealthsystem.org > ―Classes & Events‖ Clarion Hospital– www.clarionhospital.org > ―Community‖ DuBois Regional Medical Center– www.drmc.com Keeling Health Center– www.clarion.edu/1154/ (Clarion University students only) Armstrong County Memorial Hospital– www.acmh.org State Health Center Applewood Center, Suite D 162 S. 2nd Street Clarion, PA 16214 Phone: (814)226-2170 Fax: (814)226-1726 UPMC– www.upmc.com- ―Community Benefits‖ OTHER LOCAL COMMUNITY SERVICES/CONCERNS Without the basic needs for survival, individuals often turn to other measures to meet these needs. These other means may not always be within the legal guidelines or through morally appropriate measures. If community agencies exist to meet these needs, then inappropriate behaviors are not necessary. Housing Homelessness isn‘t always perceived as an issue in Clarion County, but it does exist. In addition to homelessness, assistance is needed in buying homes, avoiding foreclosures, and rental assistance. With the increased economic pressures of unemployment due to plant shutdowns or job layoffs, or reduction of income or other physical abilities due to aging; meeting the needs for housing can become a major issue. In addition to being affordable, housing must also be a safe place in which to live. Area Agency on Aging (226-4640) Services covering a wide range of needs are available allowing elderly individuals to remain in their communities and homes. These services include health care; personal care, providing assistance with bathing, dressing, eating, grooming, toileting, etc.; health support services such as housekeeping, shopping assistance, laundry and mending; respite care (caregiver relief); transportation and other routine household chores as necessary to maintain a consumer‘s health, safety and ability to remain in the home; home delivered meals prepared at a central location and delivered to a 25 person‘s home. Clarion Co. Adult Services (226-4643) Assists with mentally challenged group housing among other services. Clarion Co. Housing Authority (226-8910) Assists with low income housing with by rental subsidies, providing housing, or assisting with home ownership through loan assistance for qualified persons or other means such as tax credits or home repair. Community Action Inc’s Rent/Utility Weatherization Assistance (226-4785, 800-9977661) Community Action also assists with other services which are listed in the next section. SAFE (814-226-8481) provides help for individuals and families in need of shelter resulting from possible abuse situations Food Being hungry deters development of the child in the expecting mother, makes it harder for children to learn in school, slows down their physical development, worsens health issues of the elderly and those with chronic illness, saps the strength of the working poor and perpetuates the cycle of poverty. Food Banks/Pantries in Clarion County as of 11/09 Clarion Zion Baptist Church –Surplus Food 114 Zion Rd., Clarion, PA Open: 2nd Monday of each month Sign up: 9:00 a.m. to 11:00 a.m. *Registration is required* Distribution: 11:30 a.m. to 12:30 p.m. ***Consumers are eligible once a month and must be at or below 150% of FPIG. Zion Baptist Church –Jesus Pantry 114 Zion Rd., Clarion, PA Open: 2nd Monday of each month Sign up: 9:00 a.m. to 11:00 a.m. *Registration is required* Distribution: 11:30 a.m. to 12:30 p.m --Zion also offers a clothing closet which opens at 10:00 a.m. on the 2 nd Monday of each month. Community Action, Inc. – Donated Food 30A S Sheridan Rd., Clarion, PA Open: Monday – Friday 8:30 a.m. – 4:30 p.m. Must be at or below 200% of FPIG Clarion County residents only. First United Methodist Church - The Love Cupboard 26 Call: Vivian at (814) 226-6660 for eligibility requirements 600 Wood St., Clarion, PA Open: Monday – Friday 9:00 a.m. – 12:00 p.m and 1:00 p.m. – 3:00 p.m. Emergency help only, please call ahead. Eligible once a month. First Baptist Church Main St & 7th Ave., Clarion, PA Open: 1st and 3rd Tuesday of each month 9:00 a.m. – 11:00 a.m. No pre-registration is required. Consumers can not receive food at both First United Methodist Church and First Baptist Church within the same 30 day period. New Bethlehem Redbank Valley Church Association Food Pantry – Surplus Food 300 Broad St., New Bethlehem, PA Open: 3rd Tuesday of each month 1:30 p.m. – 4:00 p.m. ***Consumers are eligible once a month and must be at or below 150% of FPIG. Redbank Valley Church Association Food Pantry – RVCA Food 300 Broad St., New Bethlehem, PA Open: 3rd Tuesday of each month 1:30 p.m. - 4 p.m. Consumers are eligible once a month and must be at or below 150% of FPIG and a resident located within the Redbank Valley School District. Fryburg St. Michael Church – Surplus Food 18766 Route 208, Fryburg, PA Open: 4th Tuesday of each month 9:30 a.m. -11:30 a.m. Held at the school located across from the Church ***Consumers are eligible once a month and must be at or below 150% of FPIG St. Michael Church – Parish Food 18766 Route 208, Fryburg, PA Open: 4th Tuesday of each month 9:30 a.m. -11:30 a.m. Held at the school located across from the Church. Must be at or below 150% of FPIG. Open to residents of Clarion County only. Please be sure to have ID. Consumers can contact Bernice at (814) 354-2523 with questions. Sligo Sligo Borough Building 2nd floor, 448 Colerain St., Sligo, PA 27 Sponsored by the Sligo Nazarene Church and Southern Clarion County Development Corporation. Open: Thursdays 9:00 a.m. – 1:00 p.m. Call 745-3940 for further information. Strattanville Angel Food Ministries $30/box Strattanville United Methodist Church Call: (814) 764-3332 for registration and distribution information. Consumers are no longer required to purchase a regular unit in order to be eligible for the specials. Rimersburg Rimersburg United Methodist Church - Share & Care Food Bank Eligible to residents of Union School District with an emergency need. Thanksgiving, Christmas & Easter Baskets Contact: Sherri Campbell 473-8380 Tionesta Tionesta Presbyterian Church - Food Bank For West Forest area residents (must show proof of residency) Emergency food and supplies Eligible 1-2 times per year (Jan. – Dec.) Must be referred by a local pastor or DPW Contact: Jo-Ann 755-3691 (office) or 755-3437 (home) Knox Knox Kupboard Eligible to Keystone School District residents only. *Pre-registration is preferred at (814) 797-1167* Other Food Related Resources Area Agency on Aging (814-226-5640) offers Meals on Wheels Adult Services (814-226-4643) assists with the special needs populations. Angel Food Ministries: Strattanville (814) 764-3332 Emlenton (724) 813-8959 or (724) 992-9835 Clarion County Board of Assistance (226-1700 or 800-648-3381) Second Harvest Food Bank (800-604-9186) WIC Program (226-8130 or 800-942-9467) Great Food For All- Faith based non denominational food distributions. Must pay in advance for boxes of food. See website for locations (www.greatfoodforall.com ) Finances 28 Not all people have the means for independent living either on their own or for their family. This may occur if there is a disability or major illness of some kind with a family member, because of incidences of alcohol or substance abuse of the income provider or domestic violence issues in the household, or if another caregiver is raising a child. Temporary financial assistance is sometimes needed just to make ends meet such as paying utility bills. Many agencies provide budgeting information for families on an as-need basis and other preventative and informational resources to their clients. In addition, the following agencies have the resources and ability to help families in financial need: PA Department of Welfare County residents can receive money and/or employment training if they do not earn enough money to support themselves or their family or if they cannot work because of a disability. They can also apply for food stamps or medical assistance (also known as Medicaid) and other benefits at the same time that you apply for Cash Assistance. Medical Assistance is for those who do not make enough money to pay medical bills, are pregnant, meeting certain requirements and/or have high medical expenses. For those who do not have enough money to buy food, they can receive a Pennsylvania EBT ACCESS Card. This card works like a bank debit card and allows food purchases to be made at grocery stores and supermarkets. The Pennsylvania Low Income Home Energy Assistance Program (LIHEAP) can help pay home heating bills or if you are in an emergency situation and are in jeopardy of losing your heat. People with children who are working or in an education program, may be eligible to receive financial assistance to help with child care while they are at work or school. Citizens may also be eligible to receive assistance with other services such as employment training and assistance, long-term care, free or reduced price school meals for your child, help with prescription medications, care and support for people with disabilities or care and education for children with special needs. If there are questions about any benefits programs, they can call the County Assistance Office at or make a free phone call to the DPW HelpLine at 1-800-692-7462 (1-800-451-5886 TDD number for individuals with hearing impairments). Community Action Activities & Services • Adult Education, Literacy and Distance Learning • Allegheny Power Low Income Usage Reduction Project • Case Management • Child Care Information Services • Community Services Block Grant • Comprehensive Self-Sufficiency • Connect With Me • Crossroads’ Domestic Violence Prevention Project 29 • Early Care and Education Project • Emergency Food & Shelter Program • First Energy Corporation’s (Penelec) Customer Assistance Program and Warm Weatherization • Homeless Assistance Program • Medical Assistance Transportation Program • New Choices-New Options Project • Parent Education and Family Support Alliance • Rental Housing Project • Senior Corps-Retired & Senior Volunteer Program • State Food Purchase Program • Supported Engagement & Work Ready • T.E.A.M. Youth Project • Transitional Housing Project • Volunteer Income Tax Assistance (VITA) • Weatherization Assistance Program WIC Program (226-8130 or 800-942-9467) Women, Infants & Children is a federally funded program that provides healthy supplemental foods and nutrition services for pregnant women, postpartum and breastfeeding women, and infants and children under age five. The goal of the WIC program is to decrease the risk of poor birth outcomes and to improve the health of the participants during critical stages of growth and development. In addition there are a variety of programs available such as the ―Angel Tree‖ program, ―Pennies from Heaven‖ and many other local school, church and organizations such as the Salvation Army, Red Cross, and United Way, that assists families in need at the holidays as well as in crisis situations. CONCLUSION Having prevention programs does not preclude the necessity of having intervention programs. However, with prevention, the amount of intense interventions is decreased; yielding better child, family and community development. This is not only a better way to handle adverse situations but more cost effective in the long term. . 30 Numbered Sources 1. Pa State of the Child, pages 13, 17 & 18 2. www.healthstatus2010.com, page 20 3. March of Dimes, page 21 4. Pennsylvania Department of Education www.education.state.pa.us, page 22 5. Center for Disease Control and Prevention, page 24 31 32
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