Panhandle Regional Prevention Coalition

Panhandle Regional Prevention Coalition

Assessment and Strategic Plan 2009

I. Assessment

A. Define the Community

Geographic Area

The Panhandle of Nebraska consists of the 11 (Banner, Box Butte, Cheyenne, Dawes, Deuel, Garden, Kimball, Morrill, Scotts Bluff, Sheridan, and Sioux) rural and frontier counties in the far west one-third of the state. The 14,810 square mile area is bordered by equally remote areas of South Dakota (north), Wyoming (west) and Colorado (south).

Demographic Characteristics

There are 87,562 persons living in the region, down 2,848 individuals from the last report of 2005. Over one third of the population (37,917) resides in Scotts Bluff County.

Racial and ethnic minorities make up 16.2 % of the Panhandle residents. Overall, Hispanic Americans account for 12.16% of the area population. In Scotts Bluff County Hispanic Americans account for 25.2% of the population. The Panhandle has the largest population of Native Americans in Nebraska (2.7 % of the Panhandle). The predominantly Lakota people residing in four Panhandle counties (Box Butte 3.26%, Dawes 4.02%, Scotts Bluff 2.35% and Sheridan 10.99%) are not federally recognized within Nebraska.

It is unknown what percentage of the Hispanic population is Spanish-speaking only. The Native American population is primarily English-speaking.

The arrest rate for all crime in the area (56.4 arrest/1,000 population) was somewhat higher than the overall rate for Nebraska (54.2), but the arrest rate for juveniles (46.7) was much higher the statewide rate of 33.3.

Socio Economic

Panhandle residents are poorer than those living in other parts of Nebraska and the nation. Forty-one percent of area children live in poverty in single-parent homes; 58% of those in poverty in the region live in families with two parents. Nearly 14% of Panhandle residents have incomes at/or below the federally defined poverty level. One of the 11 counties has one of the nation’s 10 lowest per capita personal incomes.

The proportion of residents living in poverty was generally higher for racial/ethnic minority groups than for whites.

There are no current statistics which demonstrate the impact of the economic recession on the region. Free and Reduced Lunch rates are generally recognized as an indicator of poverty. However, in many communities in the Panhandle families will not complete forms for FRL due to perceived lack of community confidentiality and privacy. As a result, there is not only the inability to accurately assess the impact of the recession on children, but school districts are financially impacted by reductions in funding. In at least one community this factor is threatening funding for an after school program.

Education

In the public school system, the Panhandle has 473 students in 15 preschools, 7,497 students in 37 K-6 schools, 2,211 students in 23 grade 7-8 schools and 4,680 students in 21 high schools for a total of 14,861 students. In addition, there are 480 students in private schools in the Panhandle and 327 students who are home-schooled.

The Pine Ridge Job Corps, a no-cost education and vocational training program administered by the U.S. Department of Labor that helps young people ages 16 through 24 get a better job, make more money, and take control of their lives, is also located in the Panhandle, near Chadron. Their enrollment includes 224 students, all of whom are residents at the center. They offer vocational training in union construction trades (carpentry, bricklaying and painting) and non-union trades such as business, warehouse and maintenance.

The Panhandle also has one state college and one community college. Chadron State College served 2,287 undergraduate students in the 2007-08 term, an increase from both previous years. Enrollment for the current school year has also increased. There were 439 grad students enrolled at CSC in 2007-08.

Western Nebraska Community College has campuses in Scottsbluff, Alliance and Sidney. With 4,083 students enrolled in the fall of 2008, the college offers more than 80 degree and certificate plans.

Overall, 16.6% of area residents age 25 and older have less than a high school education, compared to 13.4% statewide. The proportion of area residents in this age group that had not completed high school was higher among Hispanic Americans (51.9%), African Americans (31.4%) and Native Americans (30.4%) than it was among whites (14.9%).

Major Historical Events and Forces

The history of settlement of this western area shaped and still impacts the community culture toward alcohol especially:

·  Alcohol as a reward for a man’s day of work.

·  The entitlement of personal domain. “It is my land and I can drink where I want when I want.”

·  Don’t interfere in others’ business and they won’t interfere in yours.

As the area was developed by railroads, oil, and highway construction, a “hard working, hard drinking wide open west where anything goes” theme was promulgated. Many communities that have work crews come in from other areas still deal with this perception and the ensuing alcohol misuse and fights.

Leadership and decisions were in the hands of the prominent few. Elected leaders and law enforcement were accountable to this group and expectations of preferential treatment were not uncommon. For many individuals this theme carries through to today not only in regard to alcohol related issues, but to a myriad of local issues. It is part of the community power structures on which individuals rely and by which some elect their local leadership. In other towns some citizens expect preferential treatment from elected and appointed positions of leadership in communities.

Historically, the role of law enforcement relative to alcohol-related occurrences was varied. The one thing it was not was an actual “enforcement” of the law role. There are many stories of local officers coming across youth out partying and pulling up a seat and joining them, or pouring out the beer and disbanding. Those too drunk to drive expected officers to take them home. In one community meeting people noted that as recently as the 1950’s alcohol disturbances were handled by “slipping the cop a bill.” At the large majority of community meetings, and in law enforcement interviews, people noted that this attitude remains a challenge. People truly do not believe enforcement of alcohol laws is the responsibility of local police and state patrol.

The final major historical factor in the region is the history of the wars between the Native American people and the army and the ensuing placement of the Sioux people on reservations, which were also referred to as prisoner of war camps, during the assessment process. For the Lakota people of the region it was at this point in their history that law enforcement and jails were introduced as a means of control, and the deaths of Lakota people in jail began. Recent research is showing that such trauma (of war and attempts at cultural assimilation) becomes generational trauma and impacts subsequent generations who were not directly involved.

The arrival of the U.S. Army also led to changes in the Panhandle communities. The town of Crawford, near Ft. Robinson, was initially the site of brothels and drinking establishments for the military.

During this time alcohol was introduced to the Lakota people. As Native Americans engaged in alcohol use, and misuse, stereotypical attitudes about Indians and alcohol were developed and continue today.

The Native American community points out another serious historical note about alcohol use in their community. Enforcement of alcohol laws for Native American use was never on those providing the alcohol, but toward those who imbibed. Further, throughout their community history there are numerous incidents of Native American people being taken to jail (alcohol and other offenses) where death occurred in the jail. These deaths have not always been investigated to the satisfaction of the Native American community. Historically there are many incidents where people still question the cause of death.

During the community meetings young Lakota men explained how this knowledge impacts their behavior when in communication with law enforcement and authority figures. There is still a generational fear that a wrong move will result in injury or death. This includes alcohol-related offenses.

Resolution of these issues is impacted by the fact that by and large the historical conflict between cultures has not been resolved. Today the region is still impacted by prejudice, discrimination, and distrust between these two groups.

Economic

The region’s economy relies primarily on agriculture and the surrounding agri-businesses. The ag economy has been very poor in the past several years due to an extended drought. Agri-businesses employ many of the non-production people, in areas such as grain elevators, feedlots, etc. The small main street businesses in each community are much-reliant on the agri-business men and women to support their hometown stores.

Scottsbluff/Gering (Scotts Bluff County) is the largest shopping and medical center community, drawing many people from throughout the region to shop and visit doctors there. Scottsbluff has been expanding in the retail and medical fields during the past year, but has still shown recent drops in population. Only Cheyenne County, headquarters for world’s foremost outfitter, has shown an increase in population during the past five years.

The area is also well-served by two major national railroads, the Burlington-Northern Santa Fe Railway and the Union Pacific Railroad. The two railroads employ about 25% of the population in some communities, with many driving into the area to work on the railroad.

Political Factors

Political factors are covered under Major Historical Events and Forces.

Description of Prevention System

The prevention system within the Panhandle includes the following organizations:

Public Health

Panhandle Public Health District, covering ten counties (all but Scotts Bluff), and Scotts Bluff County Health Department partner on numerous prevention projects within the region. Both departments take a broad view of the role public health in prevention. Both organizations have a limited number of staff and provide few direct public health services. Instead the organizations use the CDC model for implementation of programs, policies and practices through the development of Local Public Health Systems and partnerships. This process includes the use of MAPP (Mobilizing for Action through Planning and Partnerships) process of assessment, planning, implementation, evaluation, and sustainability, similar to the SPF SIG assessment process.

PPHD is currently implementing Worksite Wellness throughout ten counties. This program includes a confidential employee survey on broad health issues including alcohol, drug and tobacco use. The program approximates Wellness Outreach at Work.

The Boards of both Public Health departments include County Commissioners, providing an effective link to government in each county.

Panhandle Partnership for Health and Human Services

Panhandle Partnership for Health and Human Services is a regional not for profit organization that has existed since 1999. Membership in PPHHS represents individuals and health and human services organizations. PPHHS does not provide direct services but rather focuses on the development of collaborative skills, capacity and opportunities within the region. This work includes the continual development and refinement of prevention and early intervention systems.

PPHHS is currently the recipient of the regional Drug Free Communities Grant. The focus and activities of this grant are part of the regional logic model and includes the regional Hero campaign. Activities are implemented locally through ten of the local prevention coalitions listed below (not including Project Extra Mile).

The Maternal Child Health Committee is a standing group within PPHHS. MCH is currently training and implementing a Screening and Brief Intervention component of the Family Reproductive Health services throughout the region.

Rural Nebraska Healthcare Network and Trauma Network

The Rural Nebraska Healthcare Network is comprised of nine hospitals and their associated Rural Health Clinics. Eight of these are within the region plus Perkins County Health Services. RNHN has a long history of development of collaborative endeavors to enhance a quality health system for the area. Current work includes a five year planning and training process toward the implementation of the sharing of health information, which includes additional partners of Region I and the Federally Qualified Health Clinic. All members of RNHN are also included in the Regional Trauma System.

RNHN also focuses, and works collaboratively, on the health role in prevention. This work includes developing and sustaining the Children’s Outreach Home Visitation Program, Fall Prevention, Emergency Preparedness, and marketing and information.

Area hospitals are also part of the Region 4 Trauma Network.

Regional West Medical Center and Chadron Community Hospital use Alcohol Screening and Brief Intervention within the Healthcare Setting in the Emergency Room.

Physicians, Physician Assistants and Nurse Practitioners

Health care providers are an essential component of the prevention system. As the region has a shortage of healthcare providers, engaging these professionals occurs at the point of implementation of strategies.

Region I Behavioral Health

While Region I is a member of PPHHS and works collaboratively with RNHN, it is also key element of the regional Prevention System. Region I not only provides technical assistance and support to the prevention system, but also braids funding within the system.

Regional Training Academy

Public Health, PPHHS, and RNHN have entered into agreement with Western Nebraska Community College to develop and operate a unique resource, the Regional Training Academy. The Training Academy is separate from the two year college system and affords the partners the opportunity to develop courses and curriculum to increase upward mobility within organizations through on the job education and training, and to enhance quality of services through standardized fields of study. These courses also focus on developing collaborative leadership skills, development of prevention systems, cultural inclusion and diversity, and enhanced alcohol and drug prevention training. Courses offered through this entity can be taken for credit and can offer those without advanced education the opportunity to earn a two year Associate Degree while employed.

Safe Communities Designation

The Panhandle is currently working toward a Safe Communities Designation. This designation includes areas related to the regional prevention coalition efforts on alcohol misuse, particularly MVA’s and the reduction of injury. Therefore, the work is interrelated in these sectors.

The Safe Communities work group includes the two public health entities, RNHN, Trauma Network, Region I and local community teams (leaders, elected officials, Chambers of Commerce, faith communities, local law enforcement, health providers, and representatives from a few of the County Prevention Coalitions).