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REGION I — EAST DESERTCOACHELLA VALLEY

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REGION I — EAST DESERTCOACHELLA VALLEY Powered By Docstoc
					           REGION I — EAST DESERT/COACHELLA VALLEY
                                                                                        to keep up with local events and promote outreach
Region Snapshot:                                                                        efforts. In part because of the area’s isolation, there is a
                                                                                        strong desire among health and service agencies to col-
Region I is comprised of the cities of Indio and Coachella,                             laborate and cooperate for the mutual good. Hidden
as well as the unincorporated areas of Mecca, Thermal,                                  Harvest, Martha’s Village & Kitchen, Fight Cancer Now,
Oasis, Thousand Palms and Salton Sea. The region’s                                      and the Desert Empowerment Zone are just some of the
economy is primarily agricultural; it is the fifth largest                              local agencies banding together to serve the needs of the
agricultural production area in the United States. This                                 area’s residents. The Coachella Valley Housing Coalition
mainly rural region offers its residents few medical, den-                              is working to develop affordable housing complexes that
tal, mental health or social service resources. One hurdle                              include health clinics and childcare for the residence.
to service access for the residents is geographical isola-                              Participants in the key informant interview process were
tion, i.e. Eagle Mountain. Another is the summer temper-                                aware of the challenges facing their region, and have
ature which presents additional challenges to service                                   voiced their willingness to work for improvements in the
providers. The lack of an effective media presence in the                               lives of the region’s residents.
east valley area makes it virtually impossible for residents


Demographics
   Population
                                                              1990                          2000                          Numeric                        Percent
      Area                                                  Population                    Population                      Change                         Change

      East Desert                                               88,934                       114,196                        25,262                        28.4%
      County of Riverside                                  1,170,413                      1,545,387                       374,974                         32.0%
      State of California                                29,760,021                     33,871,648                     4,111,627                          13.8%
   Source: U.S. Census Bureau, Census 2000
   Note: For the purpose of the United Way Needs Assessment, the East Desert/Coachella Valley is defined as including the following zip codes: 92201,92202,92203,
   92236, 92254, 92274, and 92276.

   Population by Age
                                                              East Desert/Coachella Valley                                   County of Riverside
      Age Group                                               Number             Percent                                  Number            Percent

      Under 18                                                40,834                          35.8%                       468,691                         30.3%
      18-44                                                   46,143                          40.4%                       588,784                         38.1%
      45-64                                                   17,222                          15.1%                       291,948                         18.9%
      65+                                                      9,997                          8.8%                        195,964                         12.7%


Population by                                                                                                   African American
                                                                                             White
                                                                                             20,752                   1,504
Race/Ethnicity                                         Other/Multi-Race
                                                             916
                                                                                                                   1%                             Hispanic
                                      Asian/Pacific Islander                                                                                       89,344
                                                                 1%                             18%
                                             1,149          1%
                                             Native American                                                                             78%
                                                   531 1%




                                                                                   12
              REGION I — EAST DESERT/COACHELLA VALLEY
                          HEALTH STATISTICS
A. Mortality Statistics, 2000                                                                   Deaths Due to Unitentional
                                                                                                Injury*
(Rate per 100,000 population)
                                                                                                   Cause                    Number          Rate
                                       East Desert/ Riverside California            National       Motor Vehicle               9             9.2
                                     Coachella Valley County                         Goal          Poisoning                  13            12.5
                                                                                                   Falls                      4              4.6
  1.       Heart Disease                     187.7                270.0   201.510    166.0         Fire                       0             0.0
  2.       Cancer                            178.1                183.9   179.8      159.9         Drowning                    4             3.3
  3.       Diabetes                           33.1                 17.9    20.8        N/E         Gunshot                     0             0.0
  4.       Stroke                             60.7                 58.6    63.3       48.0
  5.       COPD                               44.3                 53.7    43.1       60.0      Deaths Due to Cancer*
  6.       Unintentional Injuries             36.1                 33.8    27.4       17.5         Type                     Number          Rate
  7.       Pneumonia/Influenza                24.8                 25.6    28.4        N/E 11      Lung                       40            51.1
  8.       Liver Disease                      16.0                 13.7     3.6        N/E         Female Breast              13            31.5
  9.       Suicide                            10.3                 11.5     9.5        5.0         Colorectal                 12            15.5
 10.       Homicide                           13.5                  5.4     6.1        3.0         Prostate                   4             13.3
 11.       AIDS                               10.0                  5.7     4.3        0.7         Stomach                    4              5.9
                                                                                                   Uterine/Cervix             4             9.6
  10
      California mortality data uses a 2 year average 1999-2000
  11
      For adults age 60 and older                                                               *Rates computed for fewer than 20 events are unreli-
                                                                                                able and should be interpreted with caution.




B. Morbidity Statistics, 2000                                                                   Births By Age of Mother:
                                                                                                  Age Group            Number           Percent
Reported cases of Selected Communicable Diseases                                                     <18                  186            6.9%
(Rates per 100,000 population)
                                                                                                    18-19                 338           12.6%
                                       East Desert/ Riverside California            National
                                     Coachella Valley County                         Goal           20-34               1,925           71.6%
                                                                                                     35+                  241            9.0%
      1.   Hepatitis C                        93.7                112.7   118.3        1.0         All ages             2,690           100%
      2.   Chalmydia                         238.2                195.9   281.6       N/A12
      3.   Gonorrhea                          19.3                 27.9    63.8       19.0      1st Trimester Entry into
      4.   Hepatitis A                        11.4                 13.7     8.8        4.5      Prenatal Care:
 12
  N/A Prevalence data is not available in California                                                                     1,960          72.9%


C. Natality Statistics, 2000                                                                    Live Birth Rate per 1,000:
                                                                                                   Population                             23.6
                                       East Desert/ Riverside California            National       Females age 15-19                     107.9
                                     Coachella Valley County                         Goal
                                                                                                Infant Mortality Rate:
      Low birth weight infants                6.9%                 6.3%    6.2%       5.0%         (Rate per 1,000 live births)
      Late or no prenatal care               27.1%                19.9%   16.9%      10.0%         East Desert/
       (After 1st trimester)                                                                       Coachella Valley                         6.7
      Birth to adolescents                     6.9%                4.6%    3.7%        N/E         Riverside County                         5.9
      (Under age 18)                                                                               California                               5.8
      Birth to 35+ mothers                     9.0%               12.5%   16.1%        N/E         National Goal                            4.5


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             REGION I — EAST DESERT/COACHELLA VALLEY

Public Aid
 Region                             Medi-Cal Percentage Food Stamps Percentage CaLWORKs Percentage Population
                                    Persons13 of Population Persons of Population Persons of Population

 East Desert/
 Coachella Valley                     24,662                22%                   8,174                  7%                5,523                  5%        114,196
 West Desert/
 Coachella Valley                     20,377                10%                   6,037                   3%               4,593                   2%       205,214
 Corona/Norco                         13,718                  8%                  2,993                   2%               2,727                   2%       179,641
 Hemet/San Jacinto                    26,289                13%                   8,938                   4%               7,317                   4%       201,342
 Jurupa                               12,899                16%                   4,642                   6%               3,876                   5%        82,968
 Moreno Valley                        23,551                16%                   8,767                   6%               7,930                   6%       143,089
 Other/Out of County                                                                 223                                      370
 Palo Verde                             3,941               16%                   1,583                   6%               1,144                   5%        25,095
 Pass Area                              9,559               18%                   3,369                   6%               2,952                   5%        54,039
 Perris Valley                        14,321                20%                   6,045                   8%               4,939                   7%        71,831
 City of Riverside                    37,740                13%                 13,806                    5%              11,524                   4%       284,809
 Temecula/Murrieta                      4,420                 3%                     791                  1%                  721                  1%       129,308
 Tri-Communities                        8,058               11%                   2,531                   3%               2,103                   3%        75,550
 County-Wide Total                  199,535                 13%                 67,899                   4%              55,719                   4%       1,567,082

October 2001 *These Numbers include every person eligible for Medi-Cal in the state, regardless of which agency authorized Medi-Cal



                                                                   CPS14                      Out of Home                  In-Home Support                  APS16
                                                                  Referrals                   Placements                       Services15                  Referrals

 East Desert/Coachella Valley                                          174                          170                              905                      23
 West Desert/Coachella Valley                                          247                          226                            1,148                     109
 Corona/Norco                                                          200                          219                              616                      18
 Hemet/San Jacinto                                                     279                          375                            1,134                     104
 Jurupa                                                                145                          270                              460                      23
 Moreno Valley                                                         227                          673                              734                      28
 Other/Out of County                                                   108                          931                               36                      54
 Palo Verde                                                             37                           28                              340                       7
 Pass Area                                                              84                          194                              570                      25
 Perris Valley                                                         132                          298                              526                      16
 City of Riverside                                                     388                          522                            1,588                      83
 Temecula/Murrieta                                                     110                          124                              257                      12
 Tri-Communities                                                       101                          104                              408                      30
 County-Wide                                                         2,232                        4,134                            8,722                     532

 13
   Medi-Cal person’s data reflects caseload numbers for the month of April 2001, all other data reflects caseload numbers for the month of October 2001.
 14
   Child Protective Services
 15
   IHSS-Disabled & Elderly Adult
 16
   Adult Protective Services


                                                                                      14
              REGION I — EAST DESERT/COACHELLA VALLEY

Demographics and Health Statistics— Children Age 5 and Under
Population
                                                             1990                            2000                     Numeric                        Percent
      Area                                                 Population                      Population                 Change                         Change

      East Desert                                            10,780                          14,141                      3,361                        31.2%
      County of Riverside                                   124,231                         148,643                     24,412                        19.7%
      State of California                                 2,842,506                       3,018,386                    175,880                         6.2%
Source: U.S. Census Bureau, Census 2000
Note: For the purpose of the United Way Needs Assessment, the East Desert/Coachella Valley is defined as including the following zip codes: 92201,92202,92203,92236,
92254, 92274, and 92276.


Population by                                                                                                Other/Multi-Race
                                                                                                                   127
Race/Ethnicity                                                                        Asian/Pacific Islander
                                                                                               71 1%
                                                                                                                        White
                                                                                                                                                    African American
                                                                                                                        1,048
— Children Age 5                                                            Native American
                                                                                   61
                                                                                                               1%
                                                                                                                                                   1%
                                                                                                                                                           131

and Under                                                               Hispanic
                                                                                     <1%                             7%

                                                                         12,703             90%


Source: U.S. Census Bureau, Census 2000



Public Aid - Age 0-5
CalWORKs and Food Stamps Recipients Age 0-517

      CalWORKs                  Category 09 Food Stamps18                             Category 30 Food Stamps19                       All Food Stamps

      1,778                                        727                                                   1,535                                 2,262
 17
   Data includes all children who were five years of age or less on at least one day during the month.
 18
   Category 09 Food Stamps cases include families who do not also receive CalWORKs
 19
   Category 30 Food Stamps cases include families who also receive CalWORKs.



 Mortality Statistics — Children Age 5 & Under
 (Rate per 100,000 population)
                                               East Desert/                 Riverside             California        Deaths Due to Unitentional
                                             Coachella Valley                County                                 Injury*
       1.    Perinatal Conditions                      49.5                       50.5                   45.1          Cause                      Number           Rate
       2.    Congenital Anomalies                      56.6                       29.6                   27.1          Motor Vehicle                0              0.0
       3.    Unitentional Injuries                     14.1                       14.1                    1.0          Poisoning                    0              0.0
       4.    Pneumonia/Influenza                        0.0                        3.4                    1.5          Falls                        0              0.0
       5.    Cancer                                     7.1                        4.0                    2.8          Fire                         0              0.0
                                                                                                                       Drowning                     1              7.1
       6.    Heart Disease                              0.0                        3.4                    2.5
                                                                                                                       Gunshot                      0              0.0
       7.    Homicide                                   0.0                        2.7                    2.3
       8.    COPD                                       0.0                        1.3                    0.6       *Rates computed for fewer than 20 events are unreli-
                                                                                                                    able and should be interpreted with caution.

                                                                                         15
         REGION I — EAST DESERT/COACHELLA VALLEY

Interview Results
What do you believe are the major healthcare system                  doctors, dentists, mental health professionals, and case
strengths in your community?                                         managers.
                                                                          Although, participants identified their local mental
    • Number of hospitals                                            health services as a vital part of the health delivery sys-
    • County public health clinic                                    tem in their region, they also recognized the need for an
    • Mental health                                                  expansion of counseling services to address issues iden-
    • Mobile health van                                              tified with the adolescent population, families, anger man-
    Participants recognized the benefit of having three              agement, and marriage counseling. Residents of Eagle
large hospitals located within the Coachella Valley. The             Mountain represent an extreme example of geographic
local public health clinic and county mental health, both            isolation and transportation deficit and demonstrate the
located in Indio, provide an invaluable service to a large           need for expanded mental health service to be delivered
portion of the community. The Santa Rosa del Valle                   to the community.
mobile health van brings affordable and available medical                 Participants were concerned that the dental needs of
care to neighborhoods.                                               children and adults, lower socio-economic groups and
                                                                     the “working poor” were unmet due to the lack of avail-
What do you believe are the major issues with the                    able low-cost dental services. This is a direct result of
healthcare system in your community?                                 the lack of dental providers in the area, as well a lack of
                                                                     providers who will accept Medi-Cal or provide sliding fee
    • Transportation                                                 payment schedules.
    • Need additional free clinics                                        Residents of all ages and ethnicity's travel to Mexico
    • Lack of health insurance                                       on a regular basis for doctor, dentist and diagnostic
    • Lack of mental health services                                 appointments, as well as, pharmaceuticals.
    • Lack of bi-lingual staff
    • Cost of health insurance                                       What do you believe are the major social service
    • Distance to RCRMC                                              strengths in your community?
    • Need for low-cost dental clinics
    • Adolescent mental health services                                  • Collaboration and Communication
     Transportation was identified as an issue by all three               In large part, the area’s isolation has brought about a
of the methods employed in the assessment process.                   strong and powerful spirit of cooperation and collabora-
The needs for improved “transportation” meant different              tion. The Diocese of San Bernardino has brought people
things to different people and included additional bus               together in order to look for local solutions to local prob-
routes (a wider system), additional runs on each bus                 lems. Agencies, such as the Desert Empowerment Zone
route (a more convenient system), and lower fares (a                 provide a home for several different independent organi-
more affordable system). Participants expressed the hope             zations under one roof, making it convenient for individu-
that expansion of the system will include bus routes that            als who need assistance. Other agencies, such as Hidden
take residents to the places where medical and social                Harvest, go the people to deliver their services.
services are available. The region’s public transportation
system was consistently listed as a barrier to individuals           What do you believe are the major issues with the
receiving the services they needed.                                  social service system in your community?
     The failures of the public transportation system in the
region led participants to suggest that one solution would               • Lack of affordable/available childcare
be to increase the number of free to sliding fee scale clin-             • Transportation
ics and locate them throughout the region. In effect, to                 • Lack of domestic violence services and shelters
bring the service facility to the user, rather than requiring            • Lack of affordable housing
the user to go to the service facility. Several references               • Lack of services for the homeless
were made to the hope and possibility of opening satellite               • Lack of outreach
services of Riverside County Regional Medical Center.                    The need for affordable and available childcare is as
Participants identified the need and expense of health               strong in this region as in all others. Before school and
insurance as daily challenges for their families.                    after school activities are minimal at best. Licensed pre-
Participants identified the need for additional bi-lingual           school facilities that assist children with developmental

                                                                16
         REGION I — EAST DESERT/COACHELLA VALLEY

Interview Results — continued
learning and kindergarten preparation are sought after              cies to take advantage of available opportunities, i.e.
service. Head Start maintains a consistent waiting list for         summer food program monies that have gone unused
their program.                                                      because no agency was willing to undertake the task of
     This region has an overall deficiency of social servic-        feeding children when school was not in session. Key
es. Special need was noted for local domestic violence              informants also expressed frustration with the number of
shelters with counseling services, and additional services          people who come to “assess the region,” and leave with-
for the homeless. Substandard housing is a true issue in            out making any identifiable difference in the quantity or
this region, people struggle on a daily basis to find and           quality of available services.
keep affordable housing. Often, what passes for housing                  A climate of fear exists in the area among the
in the area would be unacceptable in a more urban set-              Hispanic residents concerned with issues of citizenship
ting. Participants noted some families in the region must           and culture. This has resulted in a lack of trust towards
live in a “house” that has no water, no utilities, no sewer         organizations and agencies active in the region. Those
system, and, in this temperature extreme environment, no            engaged in outreach efforts need to understand and plan
cooling system.                                                     for a certain level of individual reluctance by those who
                                                                    need, but fear, the services that are being offered.
Are there any population groups (for example: by age,
sex, or ethnicity) or geographic areas that have espe-              Are there any groups that have more than enough
cially serious issues?                                              resources to address their issues?

     • Eastern Coachella Valley                                         • No
     • Migrant farm workers
     • Undocumented workers                                         Do you feel that there are any issues you would like to see
     • Homeless population                                          addressed in education, environment, arts and culture?
     Participants discussed in great detail the need to
increase services for migrant farm workers, both docu-                  • Literacy
mented and undocumented, and their families. It was                     • Need drug intervention
suggested that if farmers would only think of the migrant               • Lack of bi-lingual staff
farm worker as an asset, rather than a liability, services              The lack of drug prevention and intervention pro-
might become more available to the people most in need.             grams is of major concern to participants. There is a
This region has a growing challenge with their homeless             tremendous lack of available and affordable substance
population. Although Martha’s Village and Kitchen in Indio          abuse treatment programs.
is a “state of the art” facility providing shelter, food,
healthcare and childcare, it cannot take care of a home-            Looking at the resource system as a whole, what do
less population that continues to grow.                             you feel are its strengths and weaknesses?

Are there system issues — such as lack of communi-                      • Transportation (W)20
cation among group — or policies that limit the effec-
tiveness of certain resources?

     • Lack of communication/collaboration
     • Funding processes
     • Lack of trust
     Although this region has developed outstanding
avenues for inter-agency discussion, participants noted
that deficiencies still exist in communication and collabo-
ration efforts. Participants discussed in detail their frus-
tration with funding organization guidelines and mandates
that were viewed as presenting roadblocks rather than
opportunities. Likewise, they expressed frustration at a
perceived lack of willingness on the part of service agen-              20
                                                                         Weakness


                                                               17
       REGION I — EAST DESERT/COACHELLA VALLEY

Community Asset Survey Results
The following were designated by at least 50% of Region I community asset survey respon-
dents, as major issues:
     Healthcare Issues                                    Educational Issues
        • Drug Abuse                                         • Available money for higher education
        • Alcohol Abuse                                      • Language barrier
        • HIV/AIDS                                           • Overcrowded schools
                                                             • Ability to read and write
     Healthcare Access                                       • Parent/community involvement
        • Affordable healthcare                              • School safety
        • Affordable health insurance                        • Quality education
        • Affordable substance abuse programs                • Technical/vocational schools
        • Mental health care
        • Culturally sensitive health care                Environmental Issues
                                                              • None

     Social Issues                                        Housing Issues
        • Domestic violence                                  • Overcrowded housing
        • Teen pregnancy                                     • Substandard housing
        • Homelessness
        • Child abuse                                     Housing Access
        • Hunger                                             • Shortage of affordable housing
        • Grandparents raising grandchildren                 • Shortage of family housing
        • Elderly abuse and neglect                          • Shortage of available housing
                                                             • Special needs housing
     Social Service Access
        • Affordable quality childcare                    Quality of life issues
        • After school care                                  • Gangs
        • Crisis support services                            • Crime
        • Affordable legal assistance                        • Youth violence
        • Food bank programs                                 • Adequate recreational activities
                                                             • Neighborhood deterioration
                                                             • Adequate law enforcement
     Economic Issues
        • Poverty                                         Transportation
        • Unemployment/underemployment                        • Public transportation
        • Lack of employer supported benefits                 • Poor road conditions


Emerging Issues
Issues that scored slightly below 50%, while not priorities at this time, were seen as emerging
issues, which may rise to the priority category in future needs assessments. The following list
represents issues that ranked from 45 to 49 percent within the moderate or major categories:

        •   Chronic illness not due to environment           •   Urgent care facilities
        •   Dental                                           •   Personal debt
        •   Family planning                                  •   Absentee landlords
        •   Mental health                                    •   Shortage of senior housing
        •   Nutrition                                        •   Adequate cultural activities


                                                     18
       REGION I — EAST DESERT/COACHELLA VALLEY

Community Forum Results
Region I hosted one community forum at the Head Start parent/staff meeting located at Desert
Sands Elementary School. The following are issues identified and voted on by the group in
order of priority:
     Healthcare System Issues                                       • Lack of dentist who will work with low-
        • Families or children who cannot access                      income families
          healthcare due to social security status, i.e.,           • Long wait at doctors offices
          illegal status                                            • Transportation
        • Emergency rooms tell people to come back
          in 3 or 4 hours                                        Social Service Issues
        • IEHP assigns doctors, patients have no flexi-             • Lack of free immigration services in area
          bility in decisions                                       • Lack of funding for a bus, van for trans-
        • Distance to specialty hospitals, physicians                 portation of parents
          and services                                              • Food banks criteria needs to be more flexible
        • No Spanish speaking staff at doctor's                     • Need additional services for the entire family
          offices, no translation available                           for substance abuse issues
        • Low quality medicine                                      • Lack of services, food and clothing
        • Not treated with respect at local hospital                • Transportation




Priority Community Needs
Regardless of the method used in obtaining the information for this report, common issues
of concern were expressed throughout the interview, asset survey, and community forum
processes. Participants identified, often with passion, the following unmet needs of the
Region I area. These are listed in priority order:

        •   Affordable healthcare                                   •   Transportation
        •   Affordable health insurance                             •   Mental health services
        •   Drug Abuse                                              •   Affordable dental services
        •   Domestic Violence                                       •   Affordable quality childcare




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