Poverty Study Report - League of Women Voters

Document technical information

Format pdf
Size 1,7 MB
First found мая 15, 2016

Document content analysis

Language
English
Type
not defined
Concepts
no text concepts found

Transcript

Poverty in Whitman County, Washington
A Study by the League of Women Voters of Pullman
May, 2016
Report Prepared By:
Mary Collins, Chair
Childcare
George Kennedy and Judy Meuth
Education and Job Training
Janet Kendall, Paul Spencer, Libby Walker
Elder Care
B. J. Carlson, Naomi Calkins-Golter, Muriel Jordan, Lucy Linden, Suzanne Polle
Food Security
Mary Collins, Ashley Hope, George Kennedy, Ryan Lazo, Bertie Weddell
Health Care
Ginger Harstad-Glawe, Judy Stone
Housing
Martin Beuller, Mary Collins
Law Enforcement and Legal Services
Lenna Harding, Tessa Scholl, Jane Von Frank
Transportation
Karen Kiessling, Paul Spencer
Information Distribution
Mary Collins
Susan Daniels, George Kennedy, Alice Schroeder: Editing
Katie Bittinger: Study design and data access
ii
Executive Summary
Whitman County has been described as the poorest county in Washington state with a poverty
level of 32.6% (American Fact Finder2, 2013). U.S. Census studies suggest this statistic is
distorted by the high number of Washington State University students living in Pullman relative
to the general population. Correcting for this still leaves Whitman County with a poverty level
of about 16.7 %, higher than the state average of 14.1%. Paradoxically, Whitman County has
some of the lowest unemployment figures and best schools in Washington state (Tweedy, 2015).
Additionally, it appears that Whitman County has more citizens in need than are accessing
resources available to them. This results in reduced allocations to Whitman County from state
and federal resources. It is not clear that the lower use of resources results from people choosing
not to use such services or if there are barriers to access. The greatest poverty in terms of
absolute numbers is in Pullman; however, the smaller towns throughout Whitman County have
higher relative proportions of low-income households. This is more pronounced in the northern
part of the county.
Child Care
Eligibility limits for the Washington state Working Connections Child Care subsidies exclude
many families who are above the limits but who still cannot afford child care on their own.
Working Connections eligibility procedures sometimes leave families who qualify temporarily
without subsidies, and exclude parents who are full time students (unless single) but who do not
work at least part time. As of 2016, state funding for Working Connections Child Care will fall
below the demand by families in need. Capacities in state and federal free preschool programs,
Early Childhood Education Assistance Program (ECEAP), Head Start, and Early Head Start, are
designated as sufficient by the state. However, these programs are required to maintain waiting
lists of children ready to move into any vacant slot, so there are always families waiting to get in.
Several rural towns in Whitman County do not have adequate or any licensed child care or
school district preschool capacities, causing families to travel back and forth to other towns with
greater capacities in order to provide their children with child care. This situation is particularly
difficult for families in poverty.
Education and Job Training
Whitman County follows the nation and state in having high levels of children living in poverty
as demonstrated by participation in the subsidized school meals program. Children represent
about one third of the poor in Whitman County. Schools in the county receive significant state
and federal resources to promote educational success for low-income students. Participating in
job training and seeking employment are requirements of a number of assistance programs.
Spokane Falls Community College in Pullman partners with local service providers to encourage
and assist low-income students who seek higher education.
iii
Elder Care
The elderly make up about one third of low-income individuals in Whitman County. Services
for low-income, elderly persons focus on health care and transportation, as well as housing and
food security.
Food Security
Most of the federal and state funds for food go toward programs for children. The regional
system for obtaining and distributing food to low-income households is large and complex.
Most food within this system is donated by food producers, distributors, and retailers. Food
distribution services are present in all of the towns in Whitman County and appear to constitute
important social and cultural experiences for both the volunteer providers and users of the food
pantries. Food made available by these organizations is often limited in quantity and time of
availability. Food from food pantries, as well as state and federal programs, is still not sufficient
to meet minimum needs. Promising local efforts are addressing the availability of fresh food and
promoting improved nutrition and education to enhance food self-sufficiency. Between 10% and
19% of low-income households in Whitman County report going hungry in the last year due to
lack of available nutritious food (Bittinger, 2015).
Health Care
Health care is the most complex and expensive system of services in Whitman County. Greater
access to health insurance is improving services but placing greater burden on poorly reimbursed
providers. Access to dental services is especially difficult as determined by the Health and Social
Services Needs Assessment Study in Whitman County (Bittinger, 2015), as well as this current
study. Low-income children and the elderly generally have easier access to health care support
than do non-disabled adults whose low-wage jobs often lack benefits. The long history of
difficult access to health care nationally has resulted in many low-income communities having
insufficient understanding of access to and use of the health care system.
Housing
Homelessness is not currently a major problem in Whitman County, although there is more
homelessness than apparent. Emergency funds for immediate access to shelter are modest but
appear to be adequate at this time. Of greater concern is the instability of these funds since they
are completely reliant on individual and business gifts and word-of-mouth fund raising. The
greatest housing needs are for transitional and long-term housing for low-income families and
individuals. Family Promise, which works with homeless families with children is an especially
effective effort at providing short-term (90 day) shelter as well as food, job seeking assistance,
and training in family and financial skills. Low-income, long-term housing resources are
inadequate and in Pullman struggle for adequacy in the student driven rental market. Efforts at
low-income home ownership are promising and have some unique design and funding
partnerships that facilitate construction of such housing in economically diverse neighborhoods,
thereby improving the social networks of low-income families and property values within the
community.
iv
Law Enforcement and Legal Services
First responders including police, fire, and ambulance services do important work assisting
service organizations reaching those in need. Individuals and families needing legal services
have access to public support in criminal cases and some civil cases, but lack access to resources
in most non-criminal cases. In order to assure emergency communication abilities, federal
programs provide free or low cost telephones to low-income households.
Transportation
Public transportation is widely available in Pullman only. In addition, many services and retail
opportunities are available only in Pullman or Colfax creating difficulty for those living in the
areas more distance from these towns. This is especially the case for non-health care related
travel. Pullman Transit as well as COAST transportation are exploring avenues for increasing
transportation resources in Whitman County. Thirty percent of low income, non-Pullman
households reported difficulty in accessing transportation to needed services in the past year
(Bittinger, 2015).
Information Distribution
The work of the large number of public and charitable efforts to serve low income households in
Whitman County is hampered by the lack of a centralized, easily accessible, thorough, detailed,
and up-to-date description of these services. Service providers are very good at working with
other individuals and organizations in their service area, but may lack information about topics
beyond their specialty. Multifaceted organizations such as the Community Action Center have
the best information, but even this is incomplete. In 2015 YMCA of the Palouse took over the
hosting and administration of the 0n-line Palouse Resource Guide, originally designed to provide
health and human service agency information for both residents and service providers.
Maintenance of the web site, however, has become problematic and suffers from inadequate
staffing and funding.
v
Table of Contents
Introduction and Methodology………………………………………………………………..1
Results……………………………………………………………………………………….....3
Who Are Whitman County’s Poor?......................................................................................3
What Services are Available to Those Living in Poverty?....................................................6
Cash Assistance…………………………………………………………………….………….6
Child Care…………………………………………………………………………………..….7
Context………………………………………………………………………………....7
Need for Child Care……………………………………………………………………8
Child Care Capacity…………………………………………………………………...9
Child Care Services……………………………………………………………………9
Child Care Costs……………………………………………………………………….11
Publicly Funded Free and Subsidized Child Care……………………….........12
Head Start, Early Head Start, and Early Childhood Education and
Assistance Program…………………………………………………....12
Additional Federal and State Subsidies………………………………………..14
USDA Food Subsidies…………………………………………………14
Child Care Access Means Parents in School ……………………….....14
Special Needs Support…………………………………………………14
Provider-Offered Subsidies ………………………………………..…..14
Conclusions………………………………………………………………………….....15
Education and Job Training……………………………………………………........................17
School Districts in Whitman County………………………………………………..…17
College Bound Scholarship Program……………………………………………..……18
WorkFirst……………………………………………………………………………….19
WorkSource………………………………………………………………………….….20
Boost Collaborative Washington………………………………………………....…….20
Rural Resources……………………………………………………………………..…...21
Conclusions…………………………………………………………………………..….21
Elder Care……………………………………………………………………………………......22
vi
Context………………………………………………………………………..………....22
Services for Elderly in Poverty………………………………………………..………...23
Circle of Caring Adult Day Care……………………………………………......24
Rural Resources Aging and Disability Resource Center……………..……...….24
Friends of Hospice………………………………………………………..…......25
Pullman Community Council on Aging………………………………...……….25
Conclusions………………………………………………………………………….…..26
Food Security…………………………………………………………………………….....…...27
Context…………………………………………………………………………..…...….27
Public Programs…………………………………………………………………………28
Supplemental Nutrition Program for Women, Infants, and Children (WIC)…...28
Supplemental Nutrition Assistance Program (SNAP)……………………...…...29
Free and Reduced Price School Meals……………………………………...…...30
Charitable Programs………………………………………………………………...…...33
Food Pantries in Whitman County………………………………………….......34
Community Garden and Gleaning Programs……………………………….......36
Backyard Harvest………………………………………………….........37
Pullman Community Action Center Food Bank Garden Program…......37
Palouse Fresh Food Project………………………………………..……37
Regularly Organized Food Drives………………………………………………………37
Food Quality and Access to Food in Whitman County……………………………...…37
Strengths and Weaknesses in the Food Security System in Whitman County…….…..39
Health Care………………………………………………………………………………….......40
Social and Economic Determinants of Health…………………………………….........40
Shortage Areas for Primary Medical Care in Whitman County……………………......40
Hospitals…………………………………………………………………………………41
Pullman Regional Hospital……………………………………………………...42
Whitman Hospital and Medical Center…………………………………………42
Public Health…………………………………………………………………….………44
Whitman County Health Care Providers………………………………………….........45
vii
Primary care providers……………………………………………………..…..45
Obstetrics and Gynecology……………………………………………..………47
Pediatrics…………………………………………………………………...…...47
Other Clinic Settings, 2014………………………………………..…………....48
Pullman ReadyCare…………………………………………………….48
The Palouse Free Clinic…………………………………………….......48
Planned Parenthood……………………………………………….…....48
Rural Health Clinics……………………………………………….…...49
Palouse Health Center……………………………………………....49
Physician Specialists……………………………………………….......49
Mid-Level Practitioners……………………………………………......50
Mental Health Providers…………………………………………………….....50
Palouse River Counseling……………………………………………....50
WSU Psychology Clinic………………………………………………..50
Dentists…………………………………………………………………………50
Dental Services for Children………………………………………......51
Vision Care Providers……………………………………………………….....52
Pharmacies…………………………………………………………………......53
Health Insurance…………………………………………………………….....53
Mental Health Insurance……………………………………………….54
Medicaid……………………………………………………………......54
Medicare……………………………………………………………......56
Conclusions……………………………………………………………………...…......56
Housing…………………………………………………………………………………….......58
Homelessness……………………………………………………………………..……59
Housing Resources for those living in poverty in Whitman County……………..…...60
Emergency/short-term Housing………………………………………………..………60
Alternatives to Violence of the Palouse………………………………..………61
The Community Relief Fund………………………………………………......61
Transitional Housing……………………………………………………………….......61
Crises Rental Assistance/Consolidated Homeless Grant………………..……..61
viii
Tenant Based Rental Assistance…………………………………………..……62
Family Promise of the Palouse……………………………………………........62
Long-term Housing ……………………………………………………………….........63
Section 8 Housing……………………………………………………..………..63
Community Action Center Housing……………………………………………64
Self Help………………………………………………………………………..65
Habitat for Humanity………………………………………………………......66
Strengths of Low Cost Housing Programs in Whitman County…………………........67
Recognized needs for Low Cost Housing Programs in Whitman County………..…...68
Law Enforcement and Legal Services……………………………………………………..…...69
Law Enforcement…………………………………………………………………........69
Access to Courts and Legal Services……………………………………………...…...69
Legal Problems of Low-Income Washingtonians……………………………...……...69
Reports of Whitman County Civil Legal Needs……………………………………….70
Policies Intended To Mitigate The Legal Disadvantages Of Poverty…………………71
Civil Legal Advice and Advocacy for Whitman County’s Poor………………………73
Transportation………………………………………………………………………………….76
Transportation service providers in Whitman County…………………………...........77
COAST…………………………………………………………………………………77
Special Mobility Services………………………………………………………….…...78
Pullman Transit-Fixed Route Buses and Dial-A-Ride…………………………….…...80
Other Transportation Information………………………………………………….......81
Conclusions………………………………………………………………………….....81
Information Distribution…………………………………………………………………….....82
References Cited………………………………………………………………………….........83
Appendix 1: Record of Interviews……………………………………………………………..93
Appendix 2: Childcare…………………………………………………………………………99
ix
Introduction and Methodology
According to the U.S. Census, 14.8% of citizens in the U.S. live below the federal poverty level
(DeNaves-Walt and Proctor, 2015). In the State of Washington this number is 13%. The number
in Whitman County has been reported as 33.2% (Bishaw, 2013). At the same time, Whitman
County has one of the lowest unemployment rates and some of the best educational systems in
Washington State (Tweedy, 2015). This apparent paradox inspired the League of Women Voters
of Pullman to conduct a two-year study of poverty in Whitman County. The goals of the study
were to try to understand this paradox by learning more about who are Whitman County’s poor
and to learn about resources available to those living in poverty in our county.
We did our study by reading about and interviewing representatives of organizations and
agencies in Whitman County that serve those living in poverty. Our study is a complement to the
recently completed Health and Social Services Needs in Whitman County 2015 Community
Needs Assessment that provides a systematic analysis of community members’ responses to
questions about their needs and uses of various services (Bittinger, 2016).
We looked at eight different service areas: childcare, education and job training, elder care, food
security, health care, housing, law enforcement and legal services, and transportation. In each of
these areas we attempted to describe the services available, report on the number and character of
service users, and compare the attributes of these in Whitman County with the state of
Washington and the U.S. generally.
We began our study by trying to identify organizations and agencies serving low-income people
in Whitman County. We used our collective experiences, the Internet, and various publications to
develop a list of such organizations. We then developed a set of general questions aimed at
identifying information about the types of services, the scale of operations, and the size and
demographic character of the communities being served. We also developed questions specific to
each of the study areas. After reading as much as we could about these organizations in publicly
available resources, we wrote to each explaining our goals and asking for an opportunity to
interview a representative. In most cases, we found people able and willing to work with us, but
in some instances time and other concerns led some to choose not to participate. A list of
interviews is presented in Appendix 1.
A number of organizations that provide services to low-income families and individuals, often at
significant levels, were not included in our study. These include faith-based organizations that do
a great deal of work in this area, but do not always keep detailed records of expenditures and
prefer not to publish details of their work in order to protect their own privacy and that of those
they serve. In addition, some of the programs we studied are not set up specifically to aid those
in poverty, but the nature of their work means they often help poor people. In many of these
cases, it was not possible to separate data related to those living in poverty from the more general
populations being served.
One of our goals was to obtain specific numbers related to costs and numbers of individuals and
families served. Early on we found that getting such reliable numbers is often difficult. Different
1
reporting time frames and methods meant we often found summary numbers hard to obtain or
contradictory. Therefore, all of the numerical information reported should be considered as an
indication of scale of costs and services, not as absolutes. Similarly, we tried to use the most
recent information available, but this often varies by up to several years.
2
Results
Who Are Whitman County’s Poor?
The first significant finding of our report was that the 33.2% level of poverty reported for
Whitman County is neither a clear nor correct representation of the economic status of our
citizens. The 2012 census estimates that the population of Whitman County is 46,606 (U.S.
Census, 2016). The number of students on the Pullman campus of Washington State University
in the fall of 2015 was 20,043 (WSU, 2016). Because the census treats students living apart from
their families in off-campus households the same as other households, and because most students
do not have full-time jobs, it has been recognized that in communities with high numbers of
post-secondary students relative to total population poverty figures are distorted (Bishaw, 2013).
For U.S. communities with total populations of 20,000 to 60,000 this distortion was most
pronounced in Whitman County, Washington (Bishaw, 2013:18). Bishaw considered what the
level of poverty would be if those households of students living off-campus, but not with family
members, were removed from the equation. For Whitman County this adjusted figure is 16.7%
(Bishaw, 2013:18). This changed Whitman County’s ranking from being the poorest in
Washington State to being the 18th poorest of 39 counties. For the city of Pullman the adjustment
was from a poverty rate of 44.8% to one of 20.9%.
The Community Needs Assessment Report (Bittinger 2015) found lower rates of poverty similar
to Bishaw’s study. They report that about 19% of their county wide respondents were lowincome households while Pullman respondents were about 20% low-income households. This
study considered households with monthly incomes of less than $2,000 to be low-income which
is about the same as the current Federal Poverty level for a household of 4 people.
Throughout this study we use the lower 16.7% figure in our discussions. The 16.7% essentially
excludes all WSU students, but we know anecdotally that WSU students do use some of the
available services. So in reality this number is some unknown, but greater figure.
Importantly, while 16.7% is significantly less than the 33.2% initially reported it, is still higher
than the state average of 14.1% and national average of 14.5% and still constitutes an apparent
paradox related to the quality of life in Whitman County. Furthermore, while WSU provides
some services, social service agencies in Whitman County, and particularly those in Pullman,
may also be called upon to provide services to college students.
The most complete and reliable data on the demographics of those being served are from food
providing program of the Council on Aging. It notes the size and age characteristics of
households receiving food at the food pantries it serves. Data for households receiving
Supplemental Nutrition Assistance and free or reduced prices school lunches are also
informative. These data show that seniors (individuals over 55) constitute about 35%, adults 1954 make up about 36%, and children 18 and younger make up about 30% of food pantry users.
The majority of people receiving SNAP benefits live in Pullman, but Pullman has the fewest and
significantly fewer SNAP participants relative to its total population than do other communities
3
in the county. Communities in the northern part of the county tend to have higher rates of SNAP
participation than do those in the southern part of the county. The same geographic pattern is
apparent in the data for Free and Reduced Price School Meals programs. Most of the
communities in Whitman County fall below the State averages for users of these programs.
This information is summarized in Table 1. It should be noted that the data presented are either
single day or month “snap shots” and so should be viewed as patterns rather than absolutes as
counts such as these vary day-to-day or month-to-month. A further caution is that proportional
values such as these can be affected by the small populations of many of the communities
represented.
4
Table 1: Distribution by Community of Some Services For Those Living in Poverty (DSHS
interview with Jane Roberts by Mary Collins and Karen Kiessling September 28, 2015; WSOPI
2015)
Community
Population
2010
Census
Households
Receiving Cash
Assistance on
9/28/15
Students
Receiving Free
and Reduced Price
School Meals
May 2015
Households
Receiving SNAP
Benefits on 9/28/15
Endicott
289
.6%
58.1%
12%
Farmington
146
0
N/A
6%
Garfield
597
.3%
54.5%
6%
LaCrosse
313
1%
30.6%
11%
Lamont
70
3%
N/A
17%
Malden
203
0
N/A
14%
Oakesdale
431
.2%
37.8%
6%
Rosalia
550
.3%
65.8%
10%
St. John
537
0
N/A
8%
Tekoa
778
1%
50.2%
9%
Albion
579
.5%
N/A
7%
Colfax
2805
.2%
31.1%
7%
Colton
210
0
22.6%
7%
Palouse
998
.3%
31.3%
4%
Pullman
31,359
.2%
31%
3%
Uniontown
294
0
N/A
7%
Washington
State
6,724,540
1%*
45%
15%
North part
of County
South part of
County
*Monthly average for 2011(Office of Family Assistance 2016)
5
What Services are Available to those Living in Poverty?
Cash Assistance
Cash assistance, formerly known as welfare, does not fall within any one of our study areas and
so is discussed here alone. Washington’s program for cash assistance program to low-income
families is WorkFirst. The program distributes funds in the Temporary Assistance to Needy
Families program established by congress and administered by the U. S. Department of Health
and Human Services as well as Washington State Family Appropriations.
Only families with children or children in foster care are eligible for these funds. For adults,
there is a lifetime limit of five years for receipt of these benefits. A formula that considers
income, expenses, and other factors is used to calculate the amount of assistance available.
However, the most a family of three can receive is $521 per month. Participation in the program
requires that recipients have some, or be actively preparing for and seeking, employment.
In September of 2015, there were 31,712 WorkFirst cases in the state of Washington for a per
capita ratio of .4%, and 90 in Whitman County for a per capita ratio of .2%. The distribution of
these cases is presented in Table 1.
Table 1. Temporary Assistance to Needy Families Cases September, 2015 (DSHS interview with
Jane Roberts by Mary Collins and Karen Kiessling September 28, 2015)
Community
Number of Cases
Albion
3
Colfax
7
Endicott
2
Garfield
2
LaCrosse
4
Lamont
2
Oakesdale
1
Rosalia
2
Tekoa
8
Palouse
3
Pullman
55
Other
1
Total
90
6
Child Care
Context
It has long been documented that affordable child care is key to the economic and social stability
of the vast majority of Americans, allowing adults to work and families to thrive (Glynn, 2015;
Office of Management and Budget, 2015). Equally important, children who participate in highquality child care and early childhood education, compared to those who do not, benefit in
myriad ways well into adulthood. The benefits include being more likely to be ready for school
and having fewer behavioral problems in school, succeeding in elementary and high school,
attending college and receiving a degree, consistently holding a job, delaying of parenthood,
avoiding use of public assistance, and having fewer negative interactions with the justice system.
The benefits are strongest for children who come from low-income families, children of color,
and learners of English as a second language (Benefits of High-Quality Child Care, 2012; Child
Care Quality, 2014; Golden, 2014; High-quality child care for low-income children, 2010).
It is also a given that single working parents are under the greatest pressure to find ways of
caring for their children while they work, but with the now decades-long increase in the number
of households with two working parents, the pressures have increased more generally, making
availability of affordable child care one of the primary concerns of and means to ensure the
health and viability of contemporary, middle-class American society.
If this can be seen so clearly as a primary need for the American middle class, it is only
intensified as a need for those living at or near the Federal Poverty Level (FPL). And, certainly,
this is no less true of the 16.7% of Whitman County residents living at or near the federal
poverty level. The clear increased need for affordable child care nationally and regionally,
however, is heightened and complicated further by both increased costs and a decrease in the
number of child care providers. As to costs, “Weekly nursery and preschool expenses for
children 5 and younger rose almost 50 percent between 1990 and 2011, after adjusting for
inflation, according to government data…. The soaring costs may even be keeping some parents
out of the workforce. Some 29 percent of mothers with children under 18 didn’t work outside
the home in 2012, up from 23 percent in 1999” (Child-care costs on the rise, 2015).
Simultaneously, public support for subsidizing child care and preschool is lagging. Washington
is 33rd among states for access to state preschool for low-income 4-year-olds. “About 42 percent
of Washington children with a family income below 110 percent of the federal poverty level $25,905 for a family of four – are currently served by either the state-run early childhood
education program or the federally supported Head Start program. The Washington Department
of Early Learning estimates more than 28,000 children are eligible for these programs but are not
enrolled” (Budget writer to helm Early Learning, 2015).
The realities of increasing costs are complicated when we consider that the number of providers
is decreasing. As recently as 2013, “[In Washington state], there [were] about 550 fewer
7
licensed providers than there were in December 2012, continuing a trend of decline over the past
few years. Since 2009, the state has had a net loss of almost 1,500 child care providers. The
decline has primarily been in ‘in home’ or ‘family child care’ providers, which has dropped
about 23% over the last five years” (Childcare Aware of Washington Data Report, 2013).
For Whitman County, the trend in fewer providers is the same, although capacity has increased
slightly: “In Whitman County, the number of child care providers has dropped from 39 with
capacity for 1173 children in 2008, to 29 providers with capacity for 1276 children in June of
2015 (includes licensed child care and exempt school-age programs only)” (Child Care in
Whitman County August, 2015).
Need for Child Care
In order to determine more specifically the need for child care in Whitman County, we drew first
on American Community Survey, U. S. Census data: of the 2,236 children under six in Whitman
County (4.8% of total population), 1303 (58%) are children whose parents (including two
parents and single parents—both single mother and single father—living at home) are all in the
work force (American Fact Finder2, 2013).
We assume that most working parents would need to find some kind of child care, presumably
most often from licensed facilities. We also assume that, in comparing the numbers of children
under six (1303) needing child care to the reported capacities of child care providers (1276) in
Whitman County, there is a gap of approximately 27 children under six for whom there is no
space in the child care system. The number of children needing care who cannot be
accommodated by licensed capacity in Whitman County is in reality much greater than 27, since
the number of children ages six through 12 needing care after school and during school breaks is
not accounted for in the American Fact Finder statistic above.
If we also look more specifically at the 3-4 year old preschool age group, we find the following:
of the 1020 children 3y-4y in Whitman County, 51.3%, are enrolled in nursery school or
preschool facilities; therefore 48.7%, are not enrolled in “any kind of school”, according to the
U.S Census (American FactFinder2, 2013). It appears that approximately half of the children in
this age group, for which educational programming is critically important, are not enrolled “in
any kind of school.” However, some of these children could be enrolled in facilities that do not
claim preschool curricular activities, but may still provide learning activities, since Washington
requires all licensed providers to participate in the Early Achievers Program that demands
learning activities.
Our research did not uncover statistics on children ages 0-12 years who are living in poverty in
Whitman County. US Census data report that 1,419 children under age 18 in the county are
living in under the federal poverty level (American Fact Finder 2015), but do not offer
comparable statistics for those under age 13. Therefore, we cannot know the exact needs of
families in poverty for child care and preschool.
8
Child Care Capacity
The most current figures on combined part time and full time capacities and enrollments of child
care providers, as reported by providers and agencies in 2015, are given in Table 1. These data
include counts from providers who did not participate in the study as well as those who did.
Therefore, the licensed capacity numbers are known, but the actual enrollments are estimated.
Table 1.Whitman County Licensed Child Care Centers’ and Home Care Providers’ Capacities
and Enrollments.
Enrollments1
Capacities
General
Capacity 1m—
Totals
1y
1192
70
1y—
3y
145
3y—
5y
309
6y—
12+ y
361
General
Enrollments 1mTotals
1y
1250-1299
61
1y—
3y
176
3y—
5y
514
6y—
12+ y
249
1
Enrollments include children in full time (FT) care and part time (PT) care at various times of the day, but do not
exceed licensed capacities.
Providers interviewed by the LWV reported at the time that 70 families were waiting for slots in
the licensed child care facilities in the county.
Child Care Services
Washington state licensed child care providers in Whitman County offer a range of care options
for children ages one month through 12 years. Federal and state subsidized and free child care
and/or preschool are offered in several forms throughout the county.
Most center and home providers are open approximately 10 hours a day, 7:30am to 5:30pm,
Monday through Friday. Full time and part time care are the most common categories of care for
ages 0-5 years. Some providers offer preschool for 3 to 5 years as well. A few providers are
primarily schools (public and private). Several school districts operate part time preschools –
Colton (for children with special needs only), Endicott/St.John, Garfield/Palouse, LaCrosse,
Rosalia, and Tekoa. Oakesdale School Childhood Center offers additional child care services.
Before and after school care are generally available from both centers and home care providers.
However, some providers noted that they would rather take a full time or part time child than a
child needing only a few hours a day both for reasons of income and wanting to be at full
capacity always.
Drop-in care during regular hours is available from most providers, if they have a vacant slot per
their licensed capacity, and generally if the child is already receiving care of some type from
them. After hours care is not a common offering. The WSU Children’s Center is the only child
care center that offers specific after hours care. Their Evening Care program provides
approximately 30 children care from 5:30 pm to 9:30 pm, Monday through Thursday. Several
home providers offer occasional, ad hoc after hours care for limited periods of time, most not
9
exceeding one hour beyond closing time. Almost all center and home providers have strict
policies regarding times when children must be picked up, including fees assessed for every
minute a parent is late.
Summer care for 6- to 12-year-olds, for an average of eight weeks, is available at most centers
and home providers. Some providers offer care during school breaks and holidays.
Special needs child care, depending on the age and needs of the child, is offered through school
districts or non-profit contractors. School districts in Colton, Colfax, Endicott/St.John,
Garfield/Palouse, Oakesdale, Rosalia, and Tekoa serve children with special needs in their
preschools. Community Child Care Center contracts with Pullman School District to provide
services to children with special needs through their integration into classrooms at Community
Child Care Center. The Community Child Care Center operates Head Start and the Early
Childhood Education and Assistance Program in the county. The Community Child Care Center
reported that approximately 44% of Pullman children in Head Start and Early Childhood
Education and Assistance Program receive special needs intervention services (Mary McDonald,
Community Child Care Center, interviewed by George Kennedy, March 8, 2016). Several other
providers reported that they had had or do have in their care children with special needs. These
providers do not have specific programming for the children, but do offer as much individual
attention as they can.
The non-profit Boost Collaborative provides early intervention services in Whitman County for
children with developmental disabilities, developmental delays, and other developmental
difficulties. Boost offers early intervention and education services to children birth to three years
and their families by working with the children where they are being cared for, either in child
care provider sites or in the children’s homes. The provision of services has increased
significantly in Whitman County over the last decade: “The number of families receiving early
intervention services in Whitman County has increased by 180% from 2006 and 2014. The
increase statewide during this period has been 35%” (Boost Collaborative, 2015).
Some providers offer limited transportation services. Both centers and home providers, though,
rely on parents’ use of their own cars, school district or Pullman Transit buses, and walking for
transport of children to and from their facilities. On the other hand, a few providers supply their
own transport to and from public schools and limited summer recreational activities. Community
Child Care Center offers transportation in Pullman for Head Start and Early Childhood
Education and Assistance Program enrollees whose families can demonstrate they have no other
means of transport.
Care and/or instruction in languages other than English is rare in Whitman County child care
facilities. Because staff members sometimes speak a language other than English, care in those
languages is available to children in a few centers. The languages include Spanish, Hindi,
Chinese, and occasionally other languages. Two centers instruct in other languages (Spanish,
French). Boost Collaborative engages volunteers who are native speakers in many languages
10
from WSU International Programs. The volunteers act as interpreters for interactions between
Boost and families from all over the world.
Child Care Costs
Paying for child care without assistance is a luxury many in our society cannot afford. Ironically,
child care is no luxury when all parents/guardians are or need/want to be in the workforce; child
care is a necessity for the wellbeing of the family, child, and the American economy (Fact Sheet:
Helping All Working Families with Young Children Afford Child Care 2015). In Whitman
County, the costs of child care vary significantly depending on two important factors: location
(Pullman or communities outside Pullman) and eligibility for subsidies and no-cost care. In
general, regular (not subsidized) costs for a particular category of child care in Pullman are
higher and have a wider range than in other communities (see Table 1A, Appendix 2). These
differences reflect the number and type of providers in Pullman and the decreased cost of care
for student parents at the WSU Children’s Center. Costs for full time infant care at a child care
center in Pullman range from $722 to $1,130 per month; costs for the same care in a center
outside Pullman range from $650 to $705. When we look at average costs, the fee for full time
care for a 3- to 5-year-old in a Pullman center is approximately $820; part time care is $512. In
other Whitman County communities, the average costs for the same care in a center are $545 for
full time and $333 for part time. A hypothetical family that needs full time care for an infant and
a 3-year-old, using the lowest costs and including a sibling discount, in Pullman would pay an
average of $1,791 per month; for a family outside Pullman, the average is $1,223.
It is important to understand that average costs at licensed home care providers are
approximately two-thirds the costs of centers. However, across the county the number of
children allowed by the Washington state license for home care providers is much lower than
that of centers, so fewer families can take advantage of these lower costs.
Before and after school care costs are difficult to compare because some providers do not offer
care both before and after school and charges are listed variably by providers. Extrapolating from
the various tuition scenarios, the cost for before and after school care is approximately
$400/month in Pullman and $250/month outside Pullman. Summer care for 6- to 12-year-olds
differs by type, hours, duration, and prices from one provider to the next, differences that defy
generalization of costs.
Average costs for drop-in care are similar across the county, around $6.50 per hour. After hours
care is offered by only one provider, the WSU Children’s Center, at a fee of $18 per hour.
Several center and home providers charge a fee of $5 to $10 for every minute that passes after a
child should have been picked up.
Colton, Endicott/St. John, Garfield/Palouse, LaCrosse, Rosalia, and Tekoa school districts
operate part time preschool for tuition-paying students; the average monthly cost is $121. Some
districts also subsidize this cost in some years to bring tuition lower or cover it completely.
11
School district preschools and district contractors serve children with special needs free of cost.
Boost Collaborative has been successful in garnering federal, state, and other funds to take care
of the costs for the services it provides to families.
Publicly Funded Free and Subsidized Child Care
Washington state and the federal government subsidize the cost of child care in Whitman County
in a number of ways. Head Start, Early Head Start, USDA Free and Reduced Lunch programs,
and Child Care Access Means Parents In School are federally funded. Early Childhood
Education Assistance Program, Working Connections Child Care, and some benefits to WSU
students are state funded. Special Needs care is supported by both federal and state dollars.
Currently, two state subsidy programs are not designated for or operating in Whitman County:
the Seasonal Child Care Program for agricultural working families and the Homeless Child Care
program. See Table 2A, Appendix 2 for information on providers and locations for subsidized
and free care.
Head Start, Early Head Start, and Early Childhood Education Assistance Program
As noted earlier, only about 42% of Washington children eligible for free state or federal
preschool (Early Childhood Education Assistance or Head Start) are enrolled (Budget writer to
helm Early Learning, 2015). Early Childhood Education Assistance Program, Early Head Start,
and Head Start programs are required to be at full capacity and to keep waiting lists that can be
used to fill any vacancy as soon as it occurs. If facilities’ enrollments fall below their allocated
capacities, they lose allocations. Although this requirement means there are always families
outside the programs and waiting to access them, Washington state designates Whitman County
as “saturated,” that is, having sufficient slots for government supported preschools. The state
reaches this conclusion by comparing the number of first graders in the free and reduced lunch
program to the number of children in Head Start and ECEAP. There are prescribed need factors
that determine where a child is placed on the waiting list for Head Start/ Early Childhood
Education Assistance Program including age (4 year olds are prioritized), foster status, abuse,
and additional considerations.
Head Start and Early Head Start are free to families who are at 100% to 130% of the federal
poverty level (FPL). However, Head Start in Whitman County in practice serves children who
are at or below 100% of the FPL. In order to serve children from 100%-130% of FPL, the Head
Start provider must apply for and gain pre-approval to accommodate a child from a family in that
income bracket. The Early Childhood Education Assistance Program (ECEAP) serves families
who are at or below 110% of the federal poverty level. The Working Connections Child Care
Program provides a scaled subsidy to families with incomes up to 200% of the federal poverty
level. For more information on eligibility for and nature of these programs, see descriptions and
Table 3A, Appendix 2).
12
If we consider Head Start and ECEAP in Whitman County, we find that “in the 2014-2015
school year, we estimated 156 three- and four-year old children [were] eligible for ECEAP.
These same children [were] eligible for Head Start. In addition, children between 110% and
130% of the federal poverty level [were] eligible for Head Start but over the limit for ECEAP,”
but the Washington state Department of Early Learning (DEL) does not have an estimate for that
number of additional children (Joyce Kilmer, Department of Early Learning, email
communication to Judy Meuth, Nov. 11, 2015). Total 2015 ECEAP, Early Head Start, and Head
Start capacities (number of children for whom there is a place in the programs) are shown in
Table 2. All slots in the programs are filled. ECEAP capacity is 107 slots, with 50 of those in
Pullman and the rest divided among rural towns in the county.
Table 2. Early Head Start, Head Start, and Early Childhood Education and Assistance
Program (ECEAP) Capacities/Enrollments in Whitman County
Pullman
Colfax Endicott
Garfield
Palouse
Rosalia Tekoa Total
50/50
20/20
11/11
4/4
6/6
7/7
9/9
107/107
ECEAP
Early Head
12/12
12/12
Start
54/54
54/54
Head Start
Working
Unknown/127
Connections
Sources: LWV interviews with providers; Brenda Kane, Community Child Care Center, email communication to
Judy Meuth, Dec. 21, 2015; Matt Judge, DEL, email communication to Judy Meuth, Dec. 14, 2015.
The Washington state Working Connections Child Care program provides subsidies for child
care costs. Eligibility is based on income and participation in approved activities, usually work.
The Washington Department of Early Learning does not have estimates on the number of
families who are eligible, since it cannot know how many income-eligible households meet the
work criteria. At present, statewide, Working Connections is funded for and limited to 33,000
households per month, and the current actual caseload is 29,142. “Forecasts indicate we will
reach 33,000 households by August 2016. At that time a wait list will likely go into effect, with
certain vulnerable populations (homeless families, teen parents, TANF families, etc.) exempt
from the wait list” (Matt Judge, Department of Early Learning, email communication to Judy
Meuth, Dec. 14, 2015). At present, Working Connections subsidizes child care for 127 children
in Whitman County (Table 2).
Almost all child care providers interviewed for this study accept Working Connections and/or
offer some other subsidy (see Provider Offered Subsidies section below). The child care
subsidies are increasingly important, since in Washington, “compared to 2007, the median
household income has decreased while median child care rates have increased” (Childcare
Aware, 2013). Luckily, within the state, “the vast majority of providers (85%) accept at least one
kind of subsidy or offer other forms of financial assistance, although some limit the number of
subsidized children they accept at any given time” (Childcare Aware, 2013).
13
Additional Federal and State Subsidies
USDA Food Subsidies
USDA food subsidies are available to providers who offer a meal and two snacks per child per
day. The subsidy, however, does not generally cover the provider’s cost in supplying food.
Child Care Access Means Parents in School
The Child Care Access Means Parents In School grant, available at three child care centers in
Pullman, is a federal program of the U.S. Department of Education that assists university student
parents with the cost of keeping their children enrolled in a licensed child care center.
Undergraduate and graduate students must be PELL grant eligible, enrolled in classes at a
university or community college, and have children enrolled in a licensed and accredited child
care center.
Special Needs Support
Since special needs care rates are often higher than other child care rates, a family may need
additional subsidies. If a family qualifies for Working Connections Child Care and has a child
under age 19 “who has a physical, mental, emotional, or behavioral condition requiring a higher
level of care,” the family may be eligible for state assistance in paying for care (Washington
State Department of Early Learning, 2014).
By law, a family cannot be denied the early intervention services that Boost Collaborative
provides for lack of ability to pay for them. However, funding for the services is not secure from
the state or federal government. For instance, Boost Collaborative used to have state support for
more parenting classes, but that support was cut after the state assessed needs across Washington
and decided that Whitman County did not have as great a need as some other counties. Since
Boost Collaborative is not chartered as a medical provider, it has no formal way of billing
Medicaid for the services it provides to families, 60-70% of whom are eligible for Medicaid
coverage.
In lieu of more stable funding, Boost Collaborative receives most of its funding via Whitman
County school districts, some federal funding channeled through Washington Department of
Early Learning, and other public funding from United Way and other fundraising efforts. Boost
uses university interns and other volunteers for part of its staffing. So far, Boost has been able to
patch together funding for all families to receive services free of charge (Sue Kreikemeier, Boost
Collaborative, interviewed by George Kennedy, May 4, 2015).
Provider-Offered Subsidies
The most common provider subsidy is a 10% to 20% discount in tuition for siblings of a child
already paying full tuition. Four providers will directly subsidize child care cost if a family is in
great need and does not qualify for other assistance. Three providers alter payment due dates to
14
accommodate paycheck schedules or will give leeway on due dates to families who have
demonstrated they will pay their bill. School district preschools and two additional providers
offer lower costs because they occupy rent-free space. One school district pays the on-site
preschool costs of all children who are USDA Free and Reduced-Price lunch recipients. One
provider offers a discount for automatic bank withdrawals and/or for pre-payment of tuition.
Several providers offer limited transportation, either via the providers’ vehicles or staff members
accompanying walking children.
Conclusions
Child care providers in Whitman County voiced various concerns about child care services for
low income families. The concerns deal primarily with eligibility limits, subsidy levels, program
rules, full capacities, and waiting lists. Our additional research also uncovered unmet needs that
sometimes echoed providers’ concerns. Here are the primary concerns:
The majority of providers stated that federal and state income eligibility guidelines are
unrealistic to support many families who need assistance. Many families do not qualify
for subsidized care, but cannot make ends meet if they have to pay for child care
completely out of pocket. In one case, a father receiving a Working Connections subsidy,
his moderate promotion and raise at work made his copay obligation go from $65/month
to over $1,000/month. Only the provider’s willingness to work out a financial plan with
him kept his child in child care (LWV interview communication with child care center
provider to Judy Meuth and George Kennedy, April 15, 2015). Some parents struggle to
pay for preschool and/or child care, especially where low-cost school district preschools
are full. Many parents with school-age children cannot afford after school care, so
children as young as 7 are home alone after school.
Several providers noted that the Working Connections program requires that a parent be
working (full or part time) or be actively seeking work, so student parents generally
cannot qualify. The only exception made to this rule is for single parents. This condition
discourages parents who would normally be considered more employable at a future time
from currently going to school full time, adding time to degree and perhaps greater
indebtedness. At the same time, this rule makes affordable child care more difficult or, in
some cases, impossible to secure.
Working Connections has some procedures that make things tough for poor families and
service providers. For instance, the state looks at a family’s income at 6-month intervals
to determine eligibility and copay level, resulting in a particularly difficult situation for
seasonal workers. Periods of no work or reduced hours make them eligible for Working
Connections assistance, but increased work hours during the next 6-month period may
make them ineligible, canceling the subsidy. When work hours decrease again,
reapplication takes time, and unless the child care provider allows the family’s child(ren)
to stay in the facility, they will likely have to drop out. If the child is allowed to stay, the
15
provider has to hope the state will approve the family’s reapplication so that they can pay
the provider back.
During licensing or re-accreditation periods for a child care center, military families are
unable to get subsidies to use at that center because military regulations require the
families to use only currently accredited child care facilities.
All of the interviewed home providers and child care centers in Whitman County are
willing to serve children with Working Connections subsidies, but two report that they
must review their budgets carefully to accommodate children with subsidies, since
subsidy reimbursements typically fall within only 70-75% of full tuition levels. This can
lead to setting limits on the number of children accommodated with subsidies.
In 2016, because of limited state funding, Working Connections funding will not be able
to cover all eligible families.
Since Early Childhood Education Assistance Program, Early Head Start, and Head Start
programs require full capacity in funded enrollment slots, and there is greater demand for
these slots than supply, waiting lists are inevitable.
16
Education and Job Training
As part of the League of Women Voters Poverty Study, the Education and Training
Subcommittee interviewed a number of public school district and post-secondary administrators
in Whitman County. We also talked with business and nonprofit employers in the county about
potential training and employment opportunities.
School Districts in Whitman County
Committee members interviewed administrative staff at ten school districts in Whitman County
that serve children in grades K-12. The very small Lamont and Steptoe Districts that work with
neighboring districts were not interviewed. Table 1, below, provides a summary of some of the
demographic information related to poverty (OSPI 2015). Districts range in size from 62 to more
than 2600 students. All districts but one report more than 30% of students receive free/reduced
meal.
Table 1. School Districts in Whitman County, Oct. 2014
District
Colfax
Colton
Endicott
Garfield **
LaCrosse
Oakesdale
Palouse **
Pullman
Rosalia
St. John
Tekoa
Enrollment
Free/Reduced Price
Meals
Dropout
623
166
105
111
76
107
187
2558
200
166
181
31.1%
22.6%
58.1%
54.5%
30.6%
37.8%
31.3%
31%
65.8%
33.5%
50.2%
12%
6%
N/A
0%
12%
0%
0%
10%
11%
10.0%
30.0%
Towns in district
Colfax
Colton, Uniontown
St. John (High School)
Garfield
LaCrosse
Farmington, Oakesdale
Palouse
Pullman, Albion
Malden, Rosalia
St. John, Endicott
Tekoa
**Garfield and Palouse share a high school.
One straightforward indicator of poverty in the various schools is the percentage of students who
qualify for free or reduced lunch, although not all students who would be eligible complete the
required paperwork, so the percentage may be higher than reported. The percentages range from
a high of 50% or more in Endicott, Tekoa, and Rosalia to a low of 22% in Colton. The remaining
school districts report between 30 and 48% of students who qualify for this program.
Those who do not graduate from high school are more likely to face living in poverty than those
who do (Remberger, 2013). For the 2014 class cohort at the state level, the dropout rate by the
end of the senior year was 12.3%. For Whitman County the rate was 3.8%, but this number is
17
problematic as the rates –Table 1– vary widely for the different school districts in Whitman
County (Munson, 2015).
All but one district report serving homeless children, and most staff have received training in
identifying and assisting students living in poverty. The number of homeless students reported
varied by district, with a high of 37 in Pullman in 2012-2013 and many other districts reporting
three or four (Education and Job Training Interviews, Appendix 1). Tekoa and Oakesdale share a
“student support specialist” to assist homeless students and those living in poverty, while the
nurse in Colfax serves this role. The counselor in Rosalia serves as the “homeless liaison.”
Gaining Early Awareness and Readiness for Undergraduate Programs is a U.S. Department of
Education discretionary grant opportunity. These competitive grants are made to states on a sixyear matching fund basis. Funded programs must include both an early intervention component
designed to increase college attendance and success and raise the expectations of low-income
students, as well as a scholarship component (USDA, 2015). Washington state has a Gaining
Early Awareness and Readiness for Undergraduate Programs grant that serves all 7th through
12th graders who receive free or reduced lunch. Programming includes college campus visits,
financial assistance for SAT and ACT exams, career research, and help with the senior project..
Most districts provide training for teachers and staff regarding how to identify homeless students
and those living in poverty.
The U.S. Department of Education also provides funding to support schools serving low-income
students through the Title 1 program. In 2014, Whitman County schools received $768,363 in
Title 1 grants. These funds are used to support teacher training and programs aimed at improving
the academic achievement of low-income students.
Other school related activities receive support from the Community Action Center, private
donations, Booster Clubs, and Education Foundations. These programs include helping students
gain access to healthcare resources and pay for Associated Student Body activity passes, athletic
equipment, and school supplies.
College Bound Scholarship Program
A program important to students in poverty is the College Bound Scholarship Program that was
established by the state legislature in 2007 (College Bound, 2015). The program provides
financial assistance to low-income students who want to achieve the dream of a college
education. This early promise of financial aid is intended to alleviate the financial barriers that
prevent low-income students from considering higher education as a possibility.
Students must enroll for the scholarship program between the beginning and end of their 7th and
8th grade years. Enrollment is facilitated by the middle school, and eligibility is based on family
18
income. Students participating in the Free and Reduced-Price lunch program are eligible and
students in foster care are automatically enrolled. When enrolling, students sign a pledge to
graduate from high school – General Education Development certificates do not qualify–with at
least a 2.0 grade point average and to have no felony convictions. The scholarship covers
average tuition, some fees, and a small book allowance. Students participating in the College
Bound Program must apply for federal student aid, and College Bound funds are provided only
to those costs not covered by federal student aid.
Eighty nine percent of the eligible Washington state class of 2018 enrolled in the scholarship
program. Seventy five percent of the class of 2014 who enrolled in the program graduated from
high school, compared to only 62% of low-income students in the class of 2014 who did not
enroll in the program. More than 200,000 students have enrolled in the program statewide since
its inception.
The number of enrollees for Whitman County has ranged from less than 10% to 56% of those
eligible in the past six years. Colfax and Pullman report the largest number of students applying
for the scholarships. In the majority of Whitman County’s school districts, no students, or fewer
than 10 students, applied for the College Bound Scholarships during the same period. There are
currently 90 students from Whitman County who are enrolled in colleges or universities as
College Bound Scholars (B. Ahlstrom, Assistant Director of College Bound in telephone
interview with M. Collins, Jan 22, 2016).
WorkFirst
WorkFirst is Washington State’s welfare reform program that provides financial assistance to
families receiving cash assistance (Temporary Assistance to Needy Families). Included in the
program are requirements that clients participate in education and/or work training opportunities.
Community Colleges in Washington provide some of these opportunities. WorkFirst Financial
Aid pays for tuition, books, and required fees for eligible students. (This aid is not the same as
federal financial aid programs.) Students may attend full, half, or less than half time and may
enroll in credit or non-credit classes. To be eligible for WorkFirst Aid, students must enroll in
classes that are job-related or improve employment opportunities, cannot be receiving Federal
Financial Aid, and must have a family income at or below 175% of the FPL.
Worker Retraining is WorkFirst program that is a Washington state cooperative initiative
between the Community Colleges of Spokane and the Washington State Employment Security
Department. Priority is given to dislocated workers. Services provided include employment and
training assistance, counseling, career planning, financial assistance, and job placement
assistance. In 2015, 15 students from Whitman County were enrolled in this program (Sally
Jackson, SFCC, interviewed by Libby Walker, Sept. 23, 2015).
19
Basic Food Employment and Training is also a WorkFirst proram. This is a partnership between
Spokane Falls Community College and the Department of Social and Health Services that offers
educational and workforce training opportunities to students receiving Basic Food Assistance
(food stamps).
WorkSource
WorkSource is Washington State’s employment service under the U.S. Unemployment Service.
They provide job listings, job-hunting skills and assistance, as well as skill and career assessment
and guidance. In addition to these services, the Whitman County office, located within the
Community Action Center in Pullman, provides job seekers computers, telephones, fax, and
copy machines. They also have video viewing stations where employment related training films
are available. The service prioritizes efforts for unemployment insurance claimants, veterans,
WorkFirst participants, offenders, youth, disabled individuals, Service Corps participants, and
migrant farm workers (WorkFirst, 2016).
Boost Collaborative Washington
Boost Collaborative, also known as Palouse Industries, is a community based non-profit
organization devoted to improving the lives of individuals with disabilities and their families
throughout Whitman and Latah Counties. Many of these are people or families in poverty. Boost
Collaborative provides education, training, and help finding and maintaining employment for
disabled persons, but Palouse Industries also sometimes hires non-disabled people in need of
employment (Boost, 2015).
Rural Resources
Rural Resources is a private nonprofit corporation whose goal is to assist people and
communities to develop the skills, resources, and services necessary to improve their general
welfare. Based in Colville, it works in all of eastern Washington including Whitman County.
Using funds from the U.S. Department of Labor Workforce Innovation and Opportunity Act,
they provide services to eligible adults. Intensive services available include comprehensive and
specialized assessments, job counseling, and the development of an individual training
plan. This can include the On The Job Training program, which provides a 50% reimbursement
to employers of the trainees’ wages. Individual Training Accounts Programs provide financial
assistance for people who need to complete a formal training program to become
employed. Youths 16 through 24 are encouraged to complete their educations and can receive
work experience placements. This is provided for youths with little or no work history and is
designed to teach basic skills and create positive work habits.
20
Conclusions
With notable exceptions at both the high and low ends, most of the school districts in Whitman
County have participation rates for the federal Free and Reduced Price lunch program modestly
lower than the state average of 45%. Most school districts also have lower rates for number of
students not finishing high school than the state average of about 12%. School districts
throughout the county receive substantial funding for programs aimed to increase the success of
low-income students. Some of the most successful programs are the Gear Up (Gaining Early
Awareness and Readiness for Undergraduate Programs) and College Bound scholarships.
Most of the public social service programs serving low-income individuals and families require
or encourage participation in some sort of work-seeking or work-skill training program. The
Pullman campus of Spokane Falls Community College offers low cost access to Associate of
Arts degree programs and Bachelor of Arts degree preparation courses. The school works with
the Department of Social and Human Services to offer courses through the Adult Basic
Education, Worker Retraining, and Basic Food Employment and Training programs.
21
Elder Care
Context
An historical perspective from The National Bureau of Economic Research states that elderly
poverty in the U.S. decreased dramatically during the 20th century. Between 1960 and 1995, the
official poverty rate of those 65 and above fell from 35 percent to 10 percent, and research has
documented similarly steep declines dating back to at least 1939. While poverty was once far
more prevalent among the elderly than among other age groups, today's elderly have a poverty
rate similar to that of working-age adults and much lower than that of children (NBER, 2015).
Social Security has contributed significantly to the decline in elderly poverty. Enacted in 1935,
the Social Security system experienced rapid benefit growth in the post-WWII era. In fact, there
is a strong association between the rise in Social Security expenditures per capita and the decline
in elderly poverty (NBER, 2015).
“Caregiving in the U.S. 2009,” a study by the National Alliance for Caregiving of caregivers
randomly selected for interview, found that the average care recipient’s age increased from 67 to
69, owing to an increase in the percentage of those 75 or older (from 43% to 51%) from the last
study in 2004 (NAC, 2009). Two of the professionals interviewed for the Eldercare segment of
this study noted dual trends: the age of those who need assistance by their organizations tends to
be trending to younger age clients, even as the number of older adults needing service increases
(Hollie Mooney, Circles of Caring; Annie Pillers, Friends of Hospice; both interviews by L.
Linden and K. Kiessling, December 3, 2015).
Washington state and the country as a whole have comparable percentages of the total population
65 and over, whereas Whitman County has only 10% of its population in that age range. In
Whitman County, there are about 4600 people over 65. About 6.7% of individuals over age 65
in Whitman County are living in poverty. In Pullman the rate is about 10.1% while for areas
outside of Pullman the rate is about 5.4% (Bittinger 2015).
Table 1. Numbers of Individuals over Age 65.
Location
Proportion of Population
65 Years and Older
Proportion of Population 65 and
Older Living in Poverty
U.S.
14.5%
9.4%
Washington State
14.1%
7.8%
Whitman County
10.0%
6.7%
Pullman
4.7%
5.4%
Non-Pullman
19%
10.1%
22
Services for Elders in Poverty
Many of the services available to seniors living in poverty, such as housing, food security, and
health care, are covered in other chapters of this report. This section will discuss services not
covered by other chapters. Organizations serving the needs of elders often do not consider
income as a condition for service, so our discussion often applies to all seniors, not just those
living in poverty. The Pullman Community Council on Aging kept user records for Meals on
Wheels and foot care (Nancy Backus, Pullman Community Council on Aging (PCCoA),
interviewed by Naomi Golter and Suzanne Polle, Aug. 15, 2015). Cir said they would now keep
demographic records as they recognized the value of that information from our interview
questions (Hollie Mooney, Circles of Caring, December 3, 2015 and Annie Pillers, Friends of
Hospice, December 3, 2015).
Services available to the elderly in Whitman County discussed in this chapter are summarized
below.
Table 2. Services to the Elderly in 2014.
Organization
Type of Service
Adult day care,
Circle of Caring lunch, some
therapy
Rural Resources Case
Aging and
management.
Disability
Kinship care
Resource
giver support.
Center
End of life care,
care giver
Friends of
respite, task
Hospice
assistance,
companionship.
Food, elder care,
Pullman
foot care, chore
Community
assistance, and
Council on
preparation of
Aging
services
directory
Number of Staff
Number of
Volunteers
Number of
Elders Served
9 full-time,
5 part-time
Unknown
18-20 daily
4 full-time
None
Unknown
1 full-time
20
23 individuals/50
families
1 full-time,
1 part-time
200
250
23
Circles of Caring Adult Day Health
Circles of Caring Adult Day Health is a private, non-profit 501(c) (3) agency that offers a daily
program providing a safe, nurturing atmosphere for adult and elderly clients. Its mission is to
provide community-based health and wellness enhancement for vulnerable adults and frail elders
on the Palouse. It moved to Pullman from Moscow two years ago and serves both Whitman and
some Latah County residents. Services provided are food, transportation, eldercare and
healthcare, as well as nursing and medical administration, including feeding, assistance oindaily
living, physical therapy, restorative maintenance, and music and memory programs. Lunches are
supplied by Bishop Place. Some volunteer drivers supply transportation to pick up and return
clients, but most is done by staff trained to lift and move people who are less mobile. Referrals
come from physicians, DSHS, and family inquiry.
Others who refer clients are hospital discharge planners for patients who cannot live alone, but
who can benefit from day care. Circles of Caring provides safe, stimulating day programming for
adults and elders faced with a variety of issues, and respite support and education programs for
families of adults and elders faced with end-of-life issues. They employ both full time and part
time employees.
Clients are required to have a physician’s order to participate in Circles of Caring. They cannot
demonstrate behavior that is disruptive or dangerous to others. Also, if one is formally evicted
from a rental unit, he/she is permanently disqualified from participation in the program; a second
report of illegal drugs in a rental will also cause disqualification. Depending on the payment
source, the number of hours for an individual can be limited. Circles of Caring currently serves
30 families and has 18 to 20 clients a day at a client cost of $20.00 an hour. Washington State
Medicaid pays $67.75 per day and Idaho Medicaid pays $6 per hour.
Circles of Caring staff define its greatest need as more scholarships for more clients who cannot
afford the cost of the program and for special tools such as the “wii” game that gives both
physical and mental stimulation. The staff also noted trends and patterns showing that the age of
the clients is getting younger, now ages 50 to 70, where before it was 70 to 90 years. Stroke
victims are younger. Circle of Caring has not yet filled their capacity. (Circles of Caring Adult
Day Health , Hollie Mooney, Exec. Director Interviewed by Lucille Linden and Karen Kiessling
on December 3, 2015).
Rural Resources Aging and Disability Resource Center
Rural Resources Aging and Disability Resource Center is a 501c3 agency with no religious
affiliation that began case management services from the Pullman office three years ago as a
Family Caregiver Support program. It serves all of Whitman County. The parent organization is
Aging and Long-Term Care of Eastern Washington located in Spokane and funded by DSHS as
an area agency to coordinate federal and state programs with local efforts. Funding is federal and
is granted to the state under the Older Americans Act. Four full time employees provide
24
comprehensive case management, assessments, referrals, and a Kinship Caregiver Support
Program, working with individuals and some families. They partner and collaborate with many
organizations and agencies that serve the elderly and disabled (Naomi Galkins-Golter, Roberta
Rutherford and Andree Marcus-Rader Interviewed by BJ Carlson and Muriel Jordan on May 11,
2015).
Rural Resources leaves it to home and community workers to determine financial eligibility. No
financial qualifications are required for case management, but some services may have
requirements, including Title 19, the Community Options Program, and Community First Choice
programs. These are intended to provide in-home care for the elderly using a combination of
federal and state funds. There are some service limits, such as financial (poverty) and function
requirements (specific level of care needed) for Title 19 services. There is an age limit of 60+
for “options counseling,” unless there is a disability that requires physical care, in which case
clients need to be over 18.
Friends of Hospice
Friends of Hospice is a community based non-profit 501 (c) (3) with a director and an active
board of directors of eight. The organization was founded in 1994, and the current director has
been in place since 2013. The Friends’ mission is to ease suffering at the end of life. It works to
foster the awareness of and support end-of-life care, hospice services, advance care planning, and
grief support in Whitman County. It serves without regard to patient income.
The services provided by Friends of Hospice include food-nutritional supplement, transportation
and gasoline vouchers, care giver respite, companionship, errand and homemaking tasks,
advance care planning, massage, and bereavement support. It also has the Threshold Choir,
which is a local chapter of an international group of women who sing, and Living Legacy, a
project that records the life stories for people in end-of-life situations. Services are offered in
individual’s homes, licensed homes, nursing homes, assisted living units, and independent units
and hospitals. Those interviewed noted that patients are needing care at a younger age and that
families are not living in traditional family units as much as earlier. This creates new challenges
for end of life situations (Friends of Hospice, Annie Pillers, Director Interviewed by Lucille
Linden and Suzanne Polle, on December 3, 2015).
Pullman Community Council on Aging
The Pullman Community Council on Aging is a non-profit 501(c)(3) group of citizens and
professionals working as advocates for Pullman’s senior citizens. Scott Hallett chairs the
organization founded in 1973 by community citizens. Its mission is to assist Pullman seniors
with programs that support not only daily needs, but also their ability to live as independently as
possible. The services provided include food, eldercare, preparation of a Guide to Senior
Services, the McQuarrie Foot-Care Clinics, Meals on Wheels, and Senior Chore Service.
25
In 2014, 300 copies of the Guide to Senior Services were printed and distributed throughout
Pullman and Whitman County. This lists about 60 services to seniors available in the county and
is widely distributed through libraries, agencies, banks and other places frequented by seniors.
A $200,000 donation by Agnes McQuarrie in 2010 established a foot care clinic with financial
aid to low-income users. Use of this service requires a modest co-pay that has become a
significant source of income for the organization. In 2014, 120 individuals used the foot care
clinic. In addition, 30 people were served through the Meals-On-Wheels program while 100
were assisted with the chore service (Nancy Backus, Pullman Community Council on Aging,
interviewed by N. Golter and S. Polle, August 28, 2015).
The Council serves both individuals and families and has no means test for either. Services are
limited to Pullman residents 60 and over. While there is no limit to how often services may be
received, the Council tries to ensure all who want to benefit from their programs can do so, and
therefore may limit some services to individuals who have not benefited previously.
Conclusions
Agencies and organizations interviewed function well due to the dedicated professionals and
committed volunteers who carry out the work for the population of seniors and elderly in
poverty. The inter-agency cooperation and communication is excellent; each mentioned other
agencies it contacts regularly. Boards of directors are active not only in providing direction, but
also in hands-on assistance; for instance, the Friends of Hospice board maintains two lift chairs
to lend to patients and supplies specialty nutrition supplements when needed.
General conclusions are
Providers commented that the need for personal services to stay independent continues to
grow;
Changes in traditional family units, distance, and other family demands often take
precedence over care giving;
Services to clients age 50 to 70 have increased as compared to earlier ages of 70 to 90.
Increased numbers of stroke patients at a younger age have been reported.
26
Food Security
Context
Programs that provide food to households with insufficient food differ in one important respect
from some other programs that address poverty. Providing food to those who need food
assistance is a temporary measure that does not directly help people move out of poverty in the
way that education or training programs can. Food assistance programs do, however, contribute
to the mental and physical health and development of their clients. In this way, food assistance
can contribute indirectly to helping people move out of poverty.
In 1996, the World Food Summit defined food security as “when all people, at all times, have
physical and economic access to sufficient, safe and nutritious food to meet their dietary needs
and food preferences for an active and healthy life.” The United States Department of
Agriculture (USDA) reports that in 2014, 14% of households in the United States were food
insecure. It further reports that 13.7 % of households in Washington State were food insecure
during the same period. Feeding America, the largest hunger relief organization in the United
States, reports that in 2013, 20% of Whitman County’s population suffered from food insecurity
(Feeding America, 2013). If this number is adjusted to account for households comprised of
students who live off-campus and not with their families, the number might be closer to 10%,
significantly lower than both the state and federal averages. This lower average, however, still
means that approximately 4,500 people living in Whitman County do not always have enough to
eat. In Whitman County there are both public and charitable programs that aim to provide food
to those in need. There is some overlap in that the commodity programs of the USDA (CSFP
and TEFAP) buy foods that are then distributed to state programs and are delivered to
households or as served meals by charitable organizations.
27
Public Programs
Table 1. Public Programs Addressing Food Insecurity in Whitman County, 2014. (WSDH,
2015; USDA WIC, 2015; USDA ACS, 2015; USDA SNAP, 2015; USDA NSLP, 2015; USDA
CSFP, 2015; Second Harvest, 2015).
Program
Number of Participants in
Whitman County
Services Provided
Supplemental Nutrition Program for
Women, Infants, and Children (WIC)
1,292
Item specific food vouchers
Supplemental Nutrition Assistance
Program (SNAP)
3,840
Food Vouchers
Free or Reduced School Meals
1,520
Prepared meals
Commodity Supplemental Food
Program (CSFP)
88
Food packages and
administrative funds
1,825
Food packages and
administrative funds
Emergency Food Assistance
Program (TEFAP)
Supplemental Nutrition Program for Women, Infants, and Children (WIC)
The Supplemental Nutrition Program for Women, Infants, and Children program is funded by
the U.S. Department of Agriculture through grants to the Washington State Department of
Health, which contracts for delivery with the Whitman County Health Department. With an
annual budget of about $200,000 and offices maintained in Colfax and Pullman, this is the
largest program administered by the Whitman County Health Department. Participants are
pregnant women and children under the age of 5 years. In 2014, there were 183,405 individuals
(about 3% of the total population) participating in the program in Washington state and about
1,292 (about 3% of the total population) in Whitman County. About 39% of the babies born in
Whitman County participated in the WIC program, lower than the state rate of 47% (WSDH,
2015). In August of 2015 there were about 750 enrolled in the program, about 600 lived in
Pullman and about 25 lived in Tekoa. The rest were scattered throughout the county (Whitman
County Department of Health, Troy Henderson Director, interview with Mary Collins and Karen
Kiessling Aug. 3, 2015).
Eligibility for WIC is income based. Table 2 presents the income guidelines. Women may
participate throughout their pregnancies and up to 6 weeks after birth, if not nursing, and until
the infants’ first birthday, if they do nurse. Children can participate up to their 5th birthday
(USDA WIC, 10/29/15).
28
Table 2: Supplemental Nutrition Program for Women, Infants, and Children Income
Eligibility Guidelines.
Number of people in
household*
Maximum annual income
Maximum monthly income
2
$29,471
$2456
3
$37,167
$3098
4
$44,863
$3739
5
$52,559
$4380
6
$60,255
$5022
7
$67,951
$5663
*Each unborn child counts as one member of household.
The program provides supplemental nutritious foods, nutrition education, and counseling at WIC
program clinics, and screening and referrals to other health, welfare, and social services. Each
participant receives $45 per month in food vouchers. The vouchers identify the quantities, types,
and sometimes brands of food that can be purchased at authorized vendors. Each state develops
its own list of approved foods (WSDH, 10/29/15).
Supplemental Nutrition Assistance Program (SNAP)
The Supplemental Nutritional Assistance program (SNAP) is also known as the Basic Food
program and was formerly known as Food Stamps. The program is funded by federal legislation
and some matching state funds. In addition to food vouchers, able-bodied adults are expected to
participate in job skills training and actively searching for employment.
Eligibility is income based as described in Table 3. Income is determined after a set of
deductions is applied: medical expenses not covered by insurance; legally owed child support
payments; dependent care when such care is needed for work, training, or education; and some
housing costs. Participants must be U.S. citizens or legal immigrants and residents of the state of
Washington. Disabled individuals may also qualify. Households may have up to $2,000 in
countable assets or $3,250, if at least one member of the household is over 60 or is disabled.
Some vehicle and housing assets are not treated as countable assets.
29
Table 3: Supplemental Nutrition Assistance Program Income Eligibility.
Household Size
Maximum Annual Income
Maximum Monthly Income
1
$15,301
$1275
2
$20,709
$1726
3
$26,117
$2176
4
$31,525
$2627
5
$36,933
$3078
6
$42,341
$3528
7
$47,749
$3979
8
$53,157
$4430
Generally the program requires that able-bodied adults between 18 and 50, without dependents,
can get benefits for only three months in a 36-month period if they do not work or participate in
a job training or job search program. This requirement has been suspended for Whitman County.
Children, the elderly, and disabled can have benefits for an indefinite period. Monthly allotments
are provided via an electronic transfer of funds to a type of credit card (referred to as an EBT
Card). Table 4 describes the benefits as of 2014, which are lower than prior years’ benefits.
Most students between 18 and 49 are not eligible for SNAP benefits. However, students may be
able to get SNAP benefits, if they are otherwise eligible and receive some other form of public
assistance and work at least 20 hours per week. In addition, they may also receive benefits under
these conditions: they have a dependent under 6 years of age, a child over the age of 5, but under
12, and do not have adequate child care to enable them to attend school, or they work a minimum
of 20 hours, or take part in a state or federally financed work study program.
Table 4: Supplemental Nutrition Assistance Program Benefits 2014.
Household Size
Maximum Annual Benefit
Maximum Monthly Benefit
1
$2,268
$189
2
$4,164
$347
3
$5,964
$497
4
$7,584
$632
5
$9,000
$750
6
$10,800
$900
30
SNAP benefits can be used to buy only food items intended for home consumption and seeds and
plants that produce food for home consumption. Alcohol, tobacco, hot food and food sold for onpremises consumption, and non-food items such as pet food, soaps and other household products,
paper products, medicines and vitamins, grooming items and cosmetics cannot be purchased.
According to the 2012 American Community Survey, 15% of households in Washington state
and about 9% of Whitman County households receive SNAP benefits. Table 5 presents data on
those receiving SNAP benefits in September, 2015.
Table 5: Households Receiving Supplemental Assistance Program Benefits in Whitman
County September 2015.
Community
Number of SNAP
Households
% of Total Community
Albion
41
7%
Colfax
186
7%
Colton
15
7%
Endicott
34
12%
Farmington
8
6%
Garfield
36
6%
Lacrosse
35
11%
Lamont
12
17%
Malden
26
14%
Oakesdale
37
6%
Palouse
37
4%
Pullman
748
3%
Rosalia
52
10%
St. John
41
8%
Tekoa
71
9%
Uniontown
19
7%
31
Free and Reduced Price School Meals
Washington state law requires that when federal funds are available, lunch must be served to
students in grades k-4 if twenty five percent or more of the enrolled students qualify for a free or
reduced-price lunch as defined by the National School Lunch Program (NSLP). Schools where
more than forty percent of the students qualify for free or reduced-price lunches are required also
to offer breakfast. Schools offering summer academic, enrichment, or remedial programs must
offer summer lunch programs or demonstrate an adequate alternative, if fifty percent of more of
the students qualify for free or reduced-price lunches (RCW 28A.235.160). The federal program
is also available to schools through grade 12.
The NSLP within the U.S. Department of Education provides about 62% of the funding for
school meals, snacks, and milk. State and local levies fund an additional 7%, while cash sales
provide about 31%. In addition to cash reimbursements, the federal program provides access to
foods the USDA buys, which vary according to quantities available and market prices. The
program also establishes nutritional requirements (NSLP, 11/2/15).
Households with incomes less than or equal to 130% of the federal poverty guidelines are
eligible for free meals, while those with incomes less than or equal to 185% of the federal
poverty guidelines are eligible for reduced-price lunches. In Whitman County in 2012, there
were a total of 4614 enrolled k-12 students. Of these, the daily average participation in the
breakfast program was 676, while daily average participation in lunches was 2389. Most of the
breakfast meals were free, but most of the lunches were paid (Table 6).
Table 6: School Meals in Whitman County 2010-2011, rounded figures (WSOPI 2015)
Average Daily Participation
% Free
% Reduced-Price
% Paid
Breakfast
676
60%
14%
26%
Lunch
2389
35%
9%
56%
In the state of Washington, about 45% of all k-12 students were enrolled in the Free and Reduced
Price Meals (FRPM) program in May, 2015. In Whitman County the average rate of
participation is 35% All of the school districts in Whitman County offer both breakfast and
lunch, although some are funded through their general funds, not the FRPM program (Kids
Count 2015, WSOPI 2015; telephone calls to school district offices by M. Collins 1/14/2016).
The number of students who were enrolled in the FRPM program in Whitman County in May of
2015 varied greatly across the county (Table 7). Seven school districts reported numbers lower
than the state average, while four reported numbers higher than the state average.
32
Table 7: Free and Reduced Price Meal Program Participation in Whitman County
Communities, May 2015 (WSOPI, 2015)
School
District
Students Enrolled in Free and Reduced
Price Meals Program
Proportion of all Students
Colfax
189
31.1%
Colton
40
22.6%
Endicott
61
58.1%
Garfield
60
54.5%
LaCrosse
22
30.6%
Lamont
16
48.5%
Oakesdale
42
37.8%
Palouse
52
31.3%
Pullman
831
31%
Rosalia
127
65.8%
St. John
52
33.5%
Tekoa
101
50.2%
Charitable Programs
Charitable programs include food banks, food pantries, community garden and gleaning
programs, and regularly organized food drives. Those serving Whitman County are summarized
in Tables 8 and 9. Food banks are organizations that receive foods from either public or private
sources and hold them for distribution to food pantries. Food pantries distribute food directly to
households. The primary food bank serving Whitman County is Second Harvest located in
Spokane, Washington.
Second Harvest is a private non-profit organization serving communities in 21 counties in
eastern Washington and northern Idaho. Food is collected in the following ways: 1. purchase and
donations from food drives (5%) 2. the United States Department of Agriculture (8%) 3. farmers,
ranchers, and wholesalers (27%) 4. manufacturers and distributors (23%) 5. grocery and other
retail stores (37%). Between June, 2014 and May, 2015, Second Harvest distributed 24.7 million
pounds of food through 250 food banks, meal sites, and other programs. Second Harvest
averages a distribution rate of about 500,000 pounds each week. The organization maintains two
33
distribution centers, one in Spokane and one in the Tri-Cities, which are served by over 6000
volunteers (Second Harvest, 2015).
Figure 1: Second Harvest Food Sources
Food drives
USDA
Farmers, Ranchers, and
Wholesalers
Manufacturers and
Distributors
Groceriers and Retail
Outlets
In Whitman County, Second Harvest delivers food once each month to the Council on Aging,
which then distributes the food to local food pantries. Between 2010 and 2014, Second Harvest
provided an average of 400,000 pounds of food per year to Whitman County. During the same
period, they also provided an additional almost 200,000 pounds of USDA commodities per year
to Whitman County.
In addition to Second Harvest, Northwest Harvest, another non-profit food bank located in
Seattle, Washington, with a warehouse in Spokane, provided an average of about 26,000 pounds
of food to Whitman County each year also working through the Council on Aging.
Food Pantries in Whitman County
There are two food pantries in Pullman and one in most of the county’s incorporated towns,
Table 8. There are other smaller pantries, such as at least one at WSU for which we could find no
information and who do not participate in the Council on Aging/Second Harvest systems. The
known pantries are described in Table 9. All but the food pantry at the Community Action
Center in Pullman are operated only by volunteers. The Community Action Center food pantry
has a small paid staff as well as volunteers. In the smaller communities most of the food comes
from federal commodities or commercial growers or distributors. In Pullman and Colfax, a larger
proportion of food is procured from food drives and other local sources. About 800 households
are served by these food pantries each month.
All of the food pantries are open limited hours and can provide only limited quantities of food.
Even those who described themselves as allowing, “as much as needed,” could offer only one or
34
two bags to the average household per visit. Most of the food pantries use a system where
volunteers pre-pack the grocery bags, although many are moving toward a shopping model by
which food pantry users select what they want. This system requires more space but results in
less wasted food and more adequately meets the needs of the pantry users. When asked, food
pantry personnel said they want to offer a wide variety of foods to clients, but clients tend to
prefer foods that can be prepared quickly. Nearly all of the food pantries have some refrigeration
and freezer space available, although it is not always at the distribution site.
Table 8. Charitable Food Programs Serving Whitman County
Organization
2nd Harvest
Annual
Funding
Funding Sources
Amount of Food
Distributed Annually
in Whitman County
$8,979,791
Gifts, some federal grants
600,000 lbs
NW Harvest
26,000 lbs
Council on Aging
$1,200,000*
Back Yard Harvest
$100,000
CAC Food Bank Garden
Program
Palouse Cares
$35,000
State grants
Regional grants
626,000lbs**
10,251 lbs
Gifts and local grants
1360 lbs
90% gifts, 10% local
grants
20,000 lbs.
*Includes food, transportation, and senior services.
**Includes 2nd Harvest, NW Harvest, and USDA commodities.
Each of the food pantries operates under its own organizational framework. Some are formally
defined as tax-exempt, some are under the auspices of separate service organizations, and some
lack any formal organization. Those who visited the food pantries noted that it appears that
reliable and dedicated volunteers serve at all county food pantries, and that food pantries serve as
important elements in the social character of the communities in which they are located.
35
Table 9: Food Pantries in Whitman County (Food Pantry Interviews, see Appendix 1).
Food Pantry
Households
Served
Monthly
Days of
Service per
Month
% USDA
Commodities
and 2nd
Harvest/NW
Harvest
Local food
drives and
purchased
food
Operating
Budget
Albion
31
1
75%
25%
None
Colfax
62
1
10%
90%
None
Colton/Uniontown
87
1
Unknown
Unknown
None
Endicott
48
1
Unknown
Unknown
None
Garfield
89
1
Unknown
Unknown
None
LaCrosse
43
Unknown
Unknown
Unknown
None
Malden
37
1
90%
10%
None
Oakesdale
21
1
Unknown
Unknown
None
Palouse
43
1
90%
10%
None
Pullman, CAC
176
12
6%
94%
$20,000
Pullman, Child
Welfare
50
4
0%
100%
$10,000$20,000
Rosalia
32
2
Unknown
Unknown
None
St. John
30
1
100%
0%
None
Tekoa
50
1
80%
20%
None
Community Garden and Gleaning Programs
Two significant food-producing programs work in Whitman County: Back Yard Harvest and the
Community Garden program of the Pullman Community Action Center.
Backyard Harvest
Backyard Harvest, a private, nonprofit organization headquartered in Moscow, serves several
local counties through gleaning of fruits and vegetables in local yards and orchards, as well as
from several local community garden projects. It also processes EBT cards (the SNAP food
stamp program) at local farmers markets. In 2014 Backyard Harvest had a staff of about 10 parttime employees (about 150 total hours per week), 180 volunteers, and a budget of about
$100,000 serving four counties in Washington and Idaho. They gleaned 11,541 pounds of fruit
36
and grew 1,140 pounds of produce, of which 10,251 pounds were distributed to food pantries in
Whitman County. Almost 90% of the fruit gleaned was from the WSU Tukey orchard.
Pullman Community Action Center Food Bank Garden Program
The Community Action Center Food Bank Garden program is a three-year old effort to provide
fresh fruits and vegetables and food growing and nutritional information to low-income
individuals. The organization has a single full time staff person and about 50 seasonal
volunteers; its funding comes from gifts and local grants.
It has garden plots in Pullman at the Community Action Center, Koppel Farms, St. James
Episcopal Church, Sunnyside Elementary, and Lincoln Middle School. In addition, it has
hydroponic growing facilities at the Community Action Center. In 2015 it produced about 1360
pounds of fresh fruit and vegetables over 80% of the year. In addition to growing food for
distribution at the Community Action Center Food Bank, the Garden Program conducts
workshops at Lincoln Middle School and Sunnyside Elementary in collaboration with after
school programs operated by the YMCA. These workshops include hands-on gardening and
food preparation. The Garden Program also recently began monthly cooking demonstrations
held during food bank distribution hours.
Regularly Organized Food Drives
Palouse Cares is a non-profit organization serving the Palouse region including Whitman
County. It has done multiple community, door-to-door food drives and fund raising auctions in
Pullman and Moscow in December of each of the last 10 years. In 2014, it collected 40,819
pounds of food and $34,000. These gifts were shared with service organizations as well as food
pantries in Whitman and Latah counties (Rick Minard email correspondence with Mary Collins
January 4, 2016).
Palouse Fresh Foods Project
The Palouse Fresh Foods Project is within the Center for Civic Engagement at Washington State
University. It is a collaborative effort between Americorps Avista and a consortium of
Washington institutions of Higher Education. The program provides interns to Whitman County
service organizations, delivers after school youth programs in gardening and composting, and is
hosting a series of workshops at the Pullman Koppel Farms community Gardens (WSUCCE
2016).
Food Quality and Access to Food in Whitman County
Access to affordable, good quality foods is essential to food security. The Food, Conservation,
and Energy Act of 2008 (H.R. 2419) uses the term “food desert” to designate an area in the U.S.
with “limited access to affordable and nutritious food, particularly such an area composed of
predominantly lower-income neighborhoods and communities.” Thus, the designation of an area
as a food desert considers both access to nutritious food and income.
37
According to the USDA Economic Research Service Food Access Research Atlas, areas in the
northern and northwestern parts of Whitman County (Figure 2, below) have both low incomes
and low access to food (USDA, ERS, 2014, updated 2015). This part of the county contains no
towns with populations greater than 1,000. This entire area contains only one grocery store
(Tekoa Market). Although Figure 2 does not provide information on vehicle ownership and
people in sparsely populated areas are often accustomed to driving to metropolitan areas to
obtain goods and services, “the cost and effort required to access healthful food may also
contribute to food insecurity, if a household has to spend scarce budget and time resources
traveling to a store that sells healthful food. The lack of full-service stores in some
neighborhoods may also make participation in the USDA Supplemental Nutrition Assistance
Program (SNAP) less attractive if it is more difficult to redeem benefits” (Ver Ploeg et al.,
2012:1).
Furthermore, if only one store is accessible, consumers are not able to choose between
businesses differing in price, quality, and variety of foods (Ver Ploeg et al., 2012). Low access is
defined as distance from a supermarket >10 miles in a rural area or >1 mile in an urban area
(USDA, ERS, 2014). In addition, the area of eastern Washington encompassing WSU in
Pullman is designated by the Economic Research Service as low income/low access to food
(Figure 2). This may be misleading, however, because Pullman has an excellent transportation
system that provides access to the town’s four supermarkets. In this situation, not having a car
might make food shopping less convenient, but it would not preclude access to food stores or
reduce consumer choice among stores.
Figure 2. Areas in Whitman County with low income and low access to food (USDA Food
Atlas 2016).
38
Strengths and Weaknesses in the Food Security System in Whitman County
Strengths include a citizenry that donates generously from its resources and time. There are
significant, long-standing programs in even the most remote parts of the county. These efforts
often represent a strong thread of social involvement, commitment, and caring within the
communities served. Importantly, when we visited during food distribution hours, we often
found both the servers and recipients enjoying the social engagement.
The central role of the Council on Aging in the distribution of foods from the regional food
banks and federal commodities is important in the efficient provisioning of food pantries, and its
collaboration with other food collection and production projects is important. Continuing and
increasing the centralization of food collection efforts, while maintaining community autonomy
in the distribution work, is essential.
Local efforts to provide fresh and healthy foods are also a growing strength of the food security
systems. In addition to the programs described above, the Palouse Fresh Foods Project of the
WSU Center for Civic Engagement is effectively working to connect student volunteers with
community programs and has developed an informational system to aid in the efficiency of fresh
food donations.
It might be possible to increase the long-term impact of food assistance programs by providing
information about preparation of nutritious, inexpensive, and appealing food. Some of the most
promising work is the educational efforts of the Pullman Community Action Center Gardening
Program. The workshops and demonstrations it is developing for youth and food pantry users are
informative and fun and have the potential to increase significantly the independence and
improve the nutritional status of food insecure individuals.
The greatest weakness of the existing systems is that all of the good work being done still does
not provide enough food to households to make people food secure. Among those most in need,
a household of four people, which must include children, might expect about $600 in SNAP
benefits, free school lunches and maybe breakfasts, and perhaps two bags of food from a food
pantry each month. The USDA estimates a national average cost of about $850 per month to feed
a family of four on a low-cost plan (USDA Center for Nutrition Policy and Promotion, 12/8/15).
An immediate need is to explore the possibility of summer lunch programs. School districts,
whose rate of free or reduced price lunches is at least 50%, can apply for summer lunch grants
from the US Department of Agriculture. Opportunities for summer lunch programs for school
districts where the rates for Free or Reduce Price Program participation ranges from 22.6% to
48.5% should be explored.
39
Healthcare
Social and Economic Determinants of Health
According to the Washington State Department of Health,
Social and economic conditions are major determinants of health. Income, wealth,
education, employment, neighborhood conditions and social policies interact in complex
ways to affect our biology, health-related behaviors, environmental exposures, and
availability and use of medical services. Health impacts associated with lower
socioeconomic position can begin before birth and build up throughout life. Despite
national efforts to eliminate health disparities, including those related to low socioeconomic position, by 2010, neither Washington nor the nation achieved this goal. In
fact, disparities grew for many measures of socio-economic position and health (WSDH
Social and Economic Determinants of Health, 2013).
Unmet medical care issues in Whitman County are summarized in Table 1.
Table 1: Healthcare Utilization and Access in Whitman County, 2011-2013(WSDH
Behavioral Risk Factor Surveillance System (BRFSS), 2011-2013).
Unmet Needs Risk Factors for adults at least 18 years of age
No primary care
provider
No health care visit in
past year
21%
Delayed or unmet care in
past year due to cost
42%
10%
No dental visit in
past year
39%
Lack of Prevention Screenings*
No mammogram in past
2 years (Women > 40)
No pap smear in past 3
years (Women > 18)
27%
28%
No colonoscopy in past
10 years (Adults > 50)
23%
No flu shot in past
1 year (all ages)
62%
*In 2011 the ACA required Medicare and all qualified commercial health plans to cover routine preventive services.
Shortage Areas for Primary Medical Care in Whitman County
The Washington State Department of Health and the Federal Health Resources and Services
Administration survey primary health care providers on a three-year rotational schedule. The
responses and other factors identify geographical areas and population groups that have critical
shortages of health care providers to supply primary medical, dental, or mental health care.
These are called Health Professional Shortage Areas and indicate poor access to and utilization
of basic healthcare services. Several state and federal programs use these designations to
40
determine eligibility for payment enhancements and workforce programs. The major criteria for
these designations are provider to population counts, poverty rates in towns, and travel times.
Whitman County has been assigned designated Shortage Areas for the following:
Primary Medical Care in the geographic areas of Garfield, Tekoa, Oakesdale, Rosalia
plus Rock Lake and Lacrosse; and for the population group of low-income people living
in Colfax, Palouse, Uniontown, and Pullman.
Primary Dental Care for the population group of low-income/homeless in the entire
county.
Mental Health Care for all residents in the county (WSDH HPSA, 2015).
The following map visualizes the geographic shortage areas.
Figure 3.
Hospitals
There are two hospitals in Whitman County: Pullman Regional Hospital (PRH) in Pullman and
Whitman Hospital and Medical Center (WHMC) in Colfax. Both are designated Critical Access
Hospitals by the Federal Office of Rural Health Policy for the purpose of ensuring that Medicare
41
enrollees have access to healthcare services in rural areas, especially hospital care. They receive
enhanced Medicare reimbursement (WSDH CAH, 2015).
Pullman Regional Hospital
Pullman Regional Hospital (PRH) works to “ensure a strong, robust healthcare system for the
region” (Adams, 2013, 2014). The hospital’s record-setting growth, after opening the new
facility in 2004, led to increased commitments to providing a range of services to the Pullman
community. However, decreases in reimbursements from government and private insurance
companies illustrate the need for increased community financial support. A Maintenance &
Operations levy was approved in February 2014, and the hospital’s Foundation has achieved
some success in fund raising (Adams, 2013, 2014). The difference between an average billing
and what Medicaid ($0.52 on the dollar), Medicare, or commercial insurance ($0.70/dollar) pays
PRH cannot be charged to the patient. Even if reimbursed 100% of what is “allowable” by
insurances, it would account for only 50% of the hospital’s actual costs. As a small, rural
hospital, PRH cannot benefit from bulk discounts. Instead, it must find innovative ways to deal
with inadequate reimbursements, while at the same time keeping a small volume service, such as
the Intensive Care Unit, vital (Eylar, 2015).
An average sampling of similar hospitals indicates PRH’s charges range from 102-260% lower
than the statewide average. A typical inpatient will pay $7000/day and $19,500 per admission
(Eylar, 2015). The hospital partners with CarePayment, a healthcare finance company—not a
collection agency or credit card company—that commits to helping people manage their medical
expenses by providing a financing option to pay off their balances in manageable monthly
payments, over a maximum of 25 months, with no interest. Following implementation of the
Affordable Care Act (Table 2), PRH attributes its 60% decrease in spending charity dollars to the
2014 Medicaid Expansion in Washington (Febus, 2015). The hospital authorizes charity dollars
by having the patient prove insurance denials on an application.
42
Table 2. Whitman Hospital and Medical Center and Pullman Regional Hospital: % of
Receivables by Insurance Type, Bad Debt, and Charity Costs, 2013/2014 (WA State
Auditor’s Office, WHMC, 2015; Febus, 2015).
Medicaid Medicare
Bad Debts
Private
Insurance
Charity
& Self
Pay
Whitman
2013-7%
2014-3%
201330%
2013-30%
2014-31%
2013-$ 482,171
2014-$ 616,953
2013-$ 312,228
2014-$ 70,143
2013-$ 1,514,000
(1.8% of patient
revenue)
2013-$ 1,390,000
(1.5% of patient
revenue)
2014-$ 1,656,000
2014-$ 382,000
(0.42% of patient
revenue)
201431%
Pullman
2013-6%
201415%
201332%
201435%
2013–
62%
2014–
50%
(1.8% of patient
revenue)
2015-$ 1,422,310
(1.5% of patient
revenue)
2015-$ 342,579
(0.33% of patient
revenue)
PRH has recognized an increase in poverty by identifying more patients with no place to go upon
discharge, a lack of adequate subsidized housing, and too few home health services. To address
these problems in part, PRH will occasionally use its status as a Critical Access Hospital to allow
patients otherwise ready for discharge to be kept in “swing beds” designated for either acute or
skilled nursing facility-level care. Another indicator of increased poverty is an increase in
Emergency Department visits for people who have insurance, but either don’t have a primary
care provider or one who accepts Medicaid. Before the Affordable Care Act, there was an
average of 16 visits per day; today the average is 24 visits per day (Eylar, J., PRH, interviewed
by Judy Stone and Karen Kiessling, July 16, 2015).
Part of PRH’s mission is “providing leadership for integrated health and healing activities in
order to create a self-sustaining, self-directed, inclusive model of healthcare for the region”
(Adams, 2013, 2014). The hospital board and the district’s commissioners are proactive in
establishing and maintaining community outreach programs meant to increase access and use of
health and social services needed by low-income, elderly, and people who need help
43
coordinating the many arms of healthcare services. Working toward that goal, several programs
were put in place over the past few years.
An Interagency Care Coordination group was established in 2012, with representatives from
Pullman Regional Hospital’s social work and nursing departments, skilled nursing facilities,
assisted living centers, adult family homes, Circles of Caring, Rural Resources, and Home
Health and Hospice. The group’s goals include establishing seamless interagency transitions and
holding interagency care plan meetings about patients in order to have people in the right level of
care at the right time, while balancing medical necessity, social needs, and payment abilities.
Pullman Fire and Emergency Medical Services recently joined the group to discuss providing
after-hours transportation between Pullman Regional Hospital and a residential facility for
Pullman residents who do not meet medical necessity for transport (Adams, 2013, 2014).
PRH has developed a Social Work Extenders program that mentors, as a proactive move, WSU
senior Human Development students to visit clients regularly at subsidized independent-living
sites, the Free Clinic, and Pullman Family Medicine. In 2014, the hospital contracted with the
Washington State Health Care Authority to provide a state social work-based program, called
Health Homes, for people with Medicare/Medicaid. Home visits are made to aging and disabled
persons with chronic, multi-morbid conditions (i.e. multiple diseases/health problems) who have
poor access to services for many reasons and often live in our outlying towns (Adams, 2013,
2014).
Also in 2014, the Whitman County Health Network was organized. Members include
representatives from medical practices, the Department of Public Health, both hospitals, WSU,
the Community Action Center, the Pullman and Colfax School Districts, long-term care
facilities, and mental health providers. The Network’s priorities are to reduce duplication and fill
in gaps in services; assess opportunities for appropriate regional alliances related to health
services, social services, and public secondary education services; integrate medical care with
social determinants of health; and explore the role of “medical equity” in plans and programs as
it relates to access to services (Adams, 2013, 2014).
Whitman Hospital and Medical Center
Whitman Hospital and Medical Center declined to participate in interviews. All data come from
its website and one financial report (WHMC, 2015).
Public Health
The Whitman County Department of Public Health has two offices, one in Pullman and one in
Colfax. Public Health services mandated by Washington Administrative Code include
communicable diseases, tuberculosis, and sexually transmitted disease control, prevention, and
treatment services (WAC 246, 2015). The Health Department’s current Washington State
44
Consolidated Contracts through the Washington Department of Health for 2015-2017 (WSDH
Consolidated Contracts, 2015) are for Women, Infant, and Children Nutrition, Maternal & Child
Health, and Immunizations & Child Profile, which is a record keeping and tracking system for
childhood immunizations. Over the last two years, the number of Public Health programs, most
of which were directed towards low-income people. During our interview, the director voiced
some concerns, including not enough eligible people signing up for Medicaid in small towns.
“The few people coming to the Health Department for immunes or TB tests are doing so because
of being used to the easy access rather than being low income”. The director would like to
develop educational programs for the newly insured (Henderson, T., WCDH, interviewed by
Mary Collins and Karen Kiessling, 8/3/2015).
Whitman County Health Care Providers
Primary care providers
Primary care providers are medical doctors or doctors of osteopathy who serve as an initial point
of contact for patients. They comprise practices in Family Medicine, OB/GYN, Pediatrics,
Geriatrics, and Internal Medicine. WSU doctors were not included in this study with the
exception of those affiliated with its public Mental Health Clinic in the Psychology Department.
There are 39 primary care providers who practice out of 14 sites including single and multiphysician practices, the Palouse Free Clinic, and the walk-in ReadyCare clinic, Table 3 (WSDH
PCP, 2013). This is 1 per 1,200 citizens of Whitman County. The national average of patients
seen by a primary care provider is 19 per day; in the state of Washington it is 14 per day
(Bernstein 2014; Skillman et. al., 2012), and in Whitman County it ranges from 5 to 20 per day
in our three family medicine group practices. All of these practices are accepting new patients.
The percentage of their clients using private, Medicare or Medicaid insurance, and payment
options for the uninsured are presented in Table 4.
Table 3. Primary Care Providers in Whitman County, 2015
Family Practice
Pullman
Colfax
Total
13
5
18
Internal
Medicine
8
1
9
OB/GYN Pediatrics
5
0
5
45
7
0
7
Total
33
6
39
Table 4. Family Practice/Internal Medicine Groups, 2014
Practice
Palouse Medical Pullman
Family Practice plus
Internal Medicine.
Pullman Family
Medicine- Pullman
Family Practice.
Whitman Medical
Group- Colfax, Tekoa,
St. John.
Family Practice plus
Internal Medicine.
Private
insurance
62%
64.5%
Discounts
for cash
at time of
service
Medicaid
Medicare
Uninsured
Payment
plans for
uninsured
9-10%
28-29%
<1%
90 day
20%
25.5%
(currently
no new)
10%
.9%
6 month,
1/2 at
visit.
25%
17%
58%
22-25%
2-3%
120 days
10%
Palouse Medical also owns and runs the ReadyCare walk-in clinic. Forty percent of their main
practice is over 65, leading to higher numbers of Medicare and lower numbers of Medicaid
clients. Although Pullman Family Medicine is not accepting new Medicaid clients right now, it
will review this decision in early 2016. The policy at Whitman Medical Group is to see
everyone who needs care so it works with each uninsured client to set up an individualized
payment plan that works for him/her. These three Primary Practice groups have identified many
issues related to poverty in our county:
Access and utilization issues Sometimes diagnostic testing, choices of medications, and other
treatments have to be modified to accommodate what patients’ insurance will cover: people may
self-pay instead of using their insurance when they have high deductibles and co-pays; lack of a
support system can hinder transportation to appointments—many use COAST; clients may opt
not to see the first choice referral made by their primary care provider, if they have to travel to
Spokane to do so; and it may be difficult or impossible to access mental health, addiction, dental,
nutritional, and/or home health needs locally.
Non-compliance issues These are seen in prescriptions not getting filled or refilled, patients not
coming back for follow-up visits, and a high rate of “no-shows.” Drug samples are rarely given
out because providers believe they lead to higher drug pricing.
Other, more general issues Most practices don't ask a patient’s poverty status or use the FPL to
make service decisions; they supply a hardship application only if the patient brings it up. The
46
poor are easily lost in the healthcare system, especially if multiple providers and agencies are
involved and this lack of oversight contributes to the abuse of medical facilities and services, to
learned helplessness, and to presenting for care with late-stage illnesses.
Possible solutions for some of the needs these providers see related to poverty are education in
financial planning and parenting support. Most providers feel burdened by the poverty they see,
but don’t meet to discuss possible solutions outside of their own practice. Reimbursement rates
have dropped, so providers have to see more patients to be able to cover expenses. Having
another family medicine practice might help, but not if Medicaid reimbursements don’t increase
and/or additional providers don’t accept Medicaid. Prescription relief is needed to subsidize
necessary medications for low-income patients, and funding for more caseworkers to help them
access services (Broeckel, J., Whitman Medical Group, interviewed by Stone/Collins, Nov. 3,
2015), (Hatley, S., Pullman Family Medicine, interviewed by Glawe/Daniels, June 17, 2015),
(Kwate, T. and Nunamaker, D., Palouse Medical, interviewed by Glawe/Daniels, Sept. 9, 2015).
Obstetrics and Gynecology
Moscow-Pullman OB/GYN is the sole OB/GYN practice in Whitman County, and yet it is
taking new clients and believes it accepts everyone who chooses to see either an obstetrician or
gynecologist for her care. An average wait to be seen as a new patient is three to four weeks,
depending on the provider. All five providers are committed to no caps on the number of
Medicaid patients they will see.
Medicaid accounts for 35-40% of its billings, an increase from 25% (which is typical for a
family medicine doctor) of a few years ago. Uninsured clients receive a 25% discount if they pay
at the time of their visit. Payment plans can reach 180 days, and the practice is in the process of
developing a “hardship application” for those who cannot fit into either of those services (Orr,
L., Moscow-Pullman OB/GYN, interviewed by Stone, Dec. 1, 2015).
Pediatrics
Palouse Pediatrics, the only pediatric practice in Whitman County, is owned by Pullman
Regional Hospital and was recently designated a Rural Health Clinic. It is accepting new
patients, with the usual wait time to get an appointment for either a new or established patient
being about three weeks. Palouse Pediatrics accepts Medicaid, accounting for 30% of their
billings; uninsured clients account for 5%. A 20% discount is given for paying in full at the
visit; six-month payment plans are available; and charity care can be requested (Port, K., Palouse
Pediatrics, interviewed by Stone, Dec. 1, 2015).
47
Other Clinic Settings, 2014
Pullman ReadyCare
Pullman ReadyCare, part of the Palouse Medical Corporation, offers acute and minor care for
walk-in patients seven days a week. About half of its clients are people18-29 who do not have
primary care providers.
The Palouse Free Clinic
The Palouse Free Clinic was established in April, 2014 as a non-profit with the commitment to
providing free access to primary medical care for acute and chronic conditions in under-served
populations in the Palouse area. The all-volunteer staff includes doctors, physical therapists,
mental health providers, first-year University of Washington Medical School students at the
University of Idaho and Washington State University through the WWAMI program, pre-nursing
students, administrative staff, social work interns, medical nutritionists, and pharmacists. Staff
try to connect people they see with a primary care provider and would like to have more of them
in the area. Services provided include non-invasive procedures, medical supplies when possible,
and prescription and over-the-counter medications. If they don't have needed medications on
hand, Sid’s Pharmacy will assist in providing them. The prescription of narcotics is against
Clinic policy. In 2014 they opened for 39 evenings (Tuesdays, 6-8 pm) over nine months, saw
131 new patients, and 95 follow-up visits. 72% of the clients seen were ages 22–50.
During 2014, the Palouse Free Clinic administered exit questionnaires. To the question of “If this
Free Clinic wasn’t here, where would you have gone for healthcare?”, 23% said a local provider,
emergency department, ReadyCare, or Student Health, and 18% said nowhere. In the previous
12 months, 33% had been to an emergency department, and when asked the last time they
received medical care of any kind, the answers ranged from “a couple of days” to "don't
remember" to “2005.” The average monthly household income was computed to be $1,581 with
64% being unemployed (Hall, S., Palouse Free Clinic, interviewed by Glawe/Kiessling, June 8,
2015).
Planned Parenthood
Planned Parenthood is a non-profit, 501(3)(c) with state and national affiliations. An advanced
registered nurse practitioner provides a sought-after, safe, non-judgmental setting for women's
and men's health care that includes birth control; free condoms; pregnancy testing; sexually
transmitted disease testing and treatment; HIV testing; lesbian, gay, bisexual, and transgender
services; and abortion referrals. Approximately one-third of its budget goes toward free or lowcost care; 79% of its clients have Medicaid or are Uninsured; 70% are below the FPL, and 94%
qualify for assistance. Planned Parenthood believes access to birth control and education are the
two most effective ways to get out of poverty (Name of person interviewed withheld by request,
Planned Parenthood, interviewed by Glawe/Kiessling, May 22, 2015).
48
Rural Health Clinics
Whitman County has two Rural Health Clinics, a designation given by the Centers for Medicare
and Medicaid Services to address an inadequate supply of physicians serving Medicare
beneficiaries in rural areas, and to increase the utilization of nurse practitioners and physician
assistants in these areas (a mid-level practitioner is required to be in the clinic 50% of the time).
Rural Health Clinics are paid an all-inclusive, annually contracted rate per visit, regardless of the
care given, for primary health and qualified preventive health services and are eligible for
enhanced Medicare and Medicaid reimbursement.
Washington state licenses advanced registered nurse practitioners to practice independently,
allowing the Palouse Health Center in Palouse to be owned and run by Sandra Schorzman,
ARNP. The second Rural Health Clinic, Palouse Pediatrics in Pullman, owned by Pullman
Regional Hospital, was certified in February, 2015.
Palouse Health Center
Schorzman says a few of the many poverty issues affecting health include a lack of assurance in
dealing with illness, poor coping skills, excessive use of emergency departments, and poor
nutrition. Non-compliance is also an issue, but is aided by insurance companies who notify
providers when tracking of their subscribers indicates they are not filling prescriptions or
keeping up with preventive screenings. This clinic sees about 20 patients a day, including walkins, and accepts all insurances. Like other providers, the small number of homeless clients this
practice sees is transient. Thirty one percent of the practice uses Medicaid, 19% Medicare, and
11% is uninsured. Palouse Health Center buys medications to give to patients who can't afford
to pay for them. Its sliding fee scale can go as low as 0% of a bill (Griffin, W., Palouse Health
Center, interviewed by Stone/Collins, Sept. 16, 2015).
Physician Specialists
Although many physician specialists come from Spokane on a routine monthly schedule to see
patients at Whitman Hospital and Medical Center and Pullman Regional Hospital clinics,
recruiting and retaining specialists to live and practice in Whitman County has been a challenge.
Many local specialists do not accept Medicaid, which requires referrals to Spokane physicians
(Griffin, W., Palouse Health Center, interviewed by Stone/Collins, Sept. 16, 2015). When there
are only one or two providers of a certain specialty, they have to be on-call 24/7, including
weekends, leading to an undesirable quality of life and burnout. The two Whitman County
hospitals and Gritman Hospital in Moscow now participate in two joint ventures to recruit, coown and/or subsidize specific specialties in an effort to stabilize local access to these services.
Palouse Surgeons, LLC is a joint venture of Gritman Medical Center, Pullman Regional Hospital
and Whitman Hospital and Medical Center that currently supports four general surgeons. Palouse
Specialties, P.S. is also jointly owned by the three hospitals. Currently they support urology and
ear, nose, and throat specialties. Psychiatry and behavioral health is seen as a critical gap.
49
Mid-Level Practitioners
Fifteen advanced registered nurse practitioners and physicians' assistants are employed by
physicians’ offices and provide additional access to healthcare for Whitman County citizens.
Mental Health Providers
Washington State ranks 48 out of 50 states in the need for and access to mental health care
(Mental Health America, 2015). There are 12 mental health practices in Whitman County
employing a total of 41 practitioners: Palouse Psychiatry & Behavioral Health, WSU Psychology
Clinic, Palouse Recovery Center, Palouse River Counseling, and 8 others in private practice.
The 41 providers include one psychiatrist; 21 social workers, counselors, and advanced
registered nurse practitioners; 15 psychologists; and four chemical dependency counselors.
Palouse River Counseling has the Whitman County contract as a non-profit, 501(3) (c) to
provide mental health services, including a 24 hour/365 day crisis intervention to low-income
citizens. Palouse River Counseling has 25 providers who see most patients once a week, and its
day treatment center, Harvest House, is open five days a week. They have 3 individuals who
provide chemical dependency services. Along with taking Medicaid, Palouse River Counseling
offers a sliding fee scale based on the availability of United Way funds. The agency works
closely with the Whitman County’s Community Action Center, Community Service Officer,
Department of Public Health, schools, hospitals, nursing homes, and jails (Allenger, R., Palouse
River Counseling, interviewed by Glawe, October, 2014).
The WSU Psychology Clinic has a sliding fee system for its clients, who come from a wide
geographic area (Sharpless, B., WSU Psychology Clinic interviewed by Glawe, March 15,
2015).
Dentists
There are 13 dentists in Whitman County none of whom accept Medicaid, except for the four
who participate in the Access to Baby and Child Dentistry (ABCD) program mentioned below.
Therefore, low-income persons must travel out of the county to receive dental services available
at the Clarkston or Spokane Community Health Association of Spokane (CHAS) Clinics.
Although the Community Health Association of Spokane clinics treat anyone and use sliding fee
scales, there is normally a three- month wait for an appointment.
One dental practice interviewed has a wait to get an appointment of five weeks for a new patient,
four weeks for an established patient, and an emergency visit can take up to three days. The
practice does accept uninsured patients and gives a 5% discount for paying at the time of the
visit. When discussing poverty issues, it was noted that restorative dental care becomes more
expensive and complicated over time due to the difficulty obtaining care and to avoidance of
dealing with dental problems. Local dentists do not meet to discuss ways to make dental care
50
available for people living in poverty (Dustin, R., Pullman Dental Care, email interview by
Stone, Oct. 20, 2015).
Dental Services for Children
There are two dental programs that serve children in low-income families in Whitman County.
Use of these is shown in Table 5 below. One of the programs is the SmileMobile operated by the
Washington Dental Service Foundation (WDSF SM, 2015), serving children ages 0-17 and
pregnant women having Medicaid. They also bill private dental insurance and offer a sliding fee
scale for the uninsured, which is usually $5/visit. In 2015 they increased their visits to our county
to twice a year and served a total of 172 children. The Whitman County Department of Health
coordinates the SmileMobile’s visits and advertises heavily within the Women Infants and
Children nutrition program. Letters are sent to all families through the schools and referrals come
from local dentists and Family Promise. The van sits in a donated parking lot Monday through
Friday with assessments being done on Mondays and Tuesdays and cleaning and simple
restorations carried out on Wednesday, Thursday, and Friday. Any follow-up needed is referred
to Spokane ABCD (see below) pediatric dentists. The staff says the most common dental issues
for kids living in poverty are poor brushing habits and poor nutrition (Maxwell, A. WCDH,
interviewed by Judy Stone, September 3, 2015).
The second program, Access to Baby and Child Dentistry program, is managed by the
Washington Dental Service Foundation (WDSF ABCD, 2015) and attempts to provide
comprehensive and continuous dental service for children birth through five years who are on
Medicaid. The goal is to have all children seen by their first birthday for preventive care,
screening, treatment, and education of the parents. Annual services include three fluoride
treatments, two exams, and two parent education sessions plus all necessary dental procedures,
with referrals made when necessary to ABCD pediatric specialists in Spokane. Clients enroll
from a choice of four currently participating dentists (two in Colfax, two in Pullman) who
receive enhanced reimbursement. Each dentist sets his/her own limits of about 20-25 ABCD
clients/month from their own towns.
Three of the providers also keep these children in their practices until the ages of 15-17. All
agree that prevention is vital because many parents don't realize that the health of “baby teeth” is
critical to future healthy teeth. Emphasis is placed on early brushing and preventing “bottle rot”
gum disease. The Washington 2010 Smile Survey shows the rate of untreated decay among lowincome preschoolers was cut in half over the last five years (WSSS 2011). The Whitman County
Health Department stopped managing this program in July, 2015 due to non-covered costs to the
Whitman County Department of Health. The state is currently seeking a non-profit in Whitman
County to take over management of the program. The goal of the program is to serve 55% of
those eligible. For Whitman County the rate of service in 2012 was 38.1% while in 2014 it was
51
31.7%. The decrease in use of this program is attributed to poor access to too few participating
dentists (O’Meara-Wyman, 2015).
Table 5. Use of the Dental Programs for Low income Children in Whitman County (WHCA, 2015)
Eligible 2012
Users 2012
Eligible 2014
Users 2014
Users 2015
ABCD
1,468
559
1525
483
SmileMobile
172
Vision Care Providers
Whitman County has six optometry practices, employing eight optometrists in Pullman, and one
practice with an office in Colfax as well. The effects of living in poverty, which optometrists
have noted, are delayed treatment leading to longer treatment or recurrences and learned
helplessness. Only one ophthalmologist practices in Whitman County; he travels to Colfax every
Tuesday from the Spokane Rockwood Clinic that owns the practice, plus one to two Mondays
per month for surgeries at Whitman Hospital. The clinic accepts Medicaid and Medicare, which
is 70% of the practice, because he primarily treats eye diseases of the elderly. For the uninsured,
the clinic offers sliding fees and payment plans, financial assistance through Project Access in
Spokane, and some treatments pro bono. The practice is accepting new clients but does not serve
children under 12.
Poverty-related issues cited by this practice include non-compliance with regularly filling and
using expensive glaucoma eye drops; lack of transportation limiting follow-up care; adults with
Medicaid not scheduling routine eye exams, which are covered for all ages, because Medicaid
doesn’t cover eye glasses (Haymore, J., and Van Tine, S., Rockwood Inland Eye Center,
interviewed by Stone, Aug. 31, 2015).
Summary of the Number and Ratio of all Health Care Providers to Population
Table 6. Provider to Population Ratios, 2014
Provider Type
Comment
Number of Ratio of Practitioners
Providers*
to Population
Mental Health
41
1 : 1,266
Primary Care Physicians
39
1 : 1,200
Physician Specialists
14
1 : 3,345
ratio has improved since 2012
Dentists
13
1 : 3,602
ratio has improved since 2012
Vision care
8
1 : 5,853
*Not all of these providers practice full time.
52
ratio has worsened since 2012
Pharmacies
Whitman County has eight pharmacies; five in Pullman, one each in Colfax, St. John, and Tekoa.
Some of the means pharmacists use to help their low-income clients include
giving prescriptions out in affordable increments;
using Washington state discount coupons;
referring to three Medication Cost Assistance programs in Washington that, although
they have no physical presence in Whitman County, do provide medications:
o RxAssistPatient assistance programs (rxassist.org) – Individual pharmaceutical
companies that provide free medications for low-income persons;
o Rx Outreach Assistance Program (rxoutreach.org) – A licensed mail order
pharmacy that provides affordable prescription medications for low-income
persons;
o Washington Prescription Drug Program (hca.wa.gov) - A legislated drug discount
program with free enrollment and no age or income restrictions. Helps with those
who are uninsured or have high insurance plan deductibles;
contacting the prescriber when insurance doesn't cover the drug or there is a less
expensive alternative like a generic, which often saves up to 60%;
contacting the client or provider if a prescription isn’t picked up;
referring patients to the Palouse Free Clinic, Pullman Regional Hospital Emergency
Department, Community Health Association of Spokane, Council on Aging, Senior
Centers, Department of Social and Health Services;
advising patients to go online to compare prices and calling local pharmacies on the
client’s behalf.
It is unlawful for a pharmacy to give out free samples (Emerson, C., Safeway Pharmacy,
interviewed by Glawe, Aug. 10, 2015).
Health Insurance
Although health insurance has made healthcare more affordable for people who are employed by
companies that provide it, or for those who can afford it themselves, the numbers of uninsured—
and therefore largely untreated medically—have been very high. The Affordable Care Act
(ACA), passed in 2010, seeks to make health insurance available to all Americans. Washington
State University students are required to have health insurance, although WSU stopped offering
its own student insurance in 2014. Students are now required to find their own plans using the
WA Healthplanfinder or to use their parents’ insurance. Created by the Washington Health
Benefit Exchange, the Washington Healthplanfinder is an easily accessible, online marketplace
for individuals, families, and small businesses in Washington State to compare and enroll in
good health insurance plans, sometimes with cost savings (WAHBE, 2015).
Whitman County saw a decrease in those uninsured from 16.4% in 2008 to 14.7% in 2010,
primarily due to federal health care reform allowing college students to remain covered by their
53
parents’ insurance policies until age 26. But by late 2011 the County’s uninsured rate increased
to 15.5 %: “Key factors in this increase, we believe, include stagnant incomes, continued high
unemployment, and health care costs that continue to outpace inflation” (Kreidler, 2011). The
Affordable Care Act dropped the uninsured rate to 12% by 2013 and 9% in 2014.
But an additional important point to note is that
The uninsured numbers do not include an additional category of people: those who have a health
insurance policy, but who struggle with high medical expenses nonetheless, such as high
deductibles, drug costs, and co-pays. In addition, a secondary cause amplified the problem.
Employers, facing economic pressures of their own, are increasingly moving health insurance
costs to employees. According to the federal Medical Expenditure Panel Survey, for example,
families’ share of premiums among private employers rose 13 percent in Washington State from
2008 to 2010. Their deductibles rose 40 percent and co-pays rose 15 percent (Kreidler, 2011).
The types of medical insurance and the rates of coverage in Whitman County are presented in
Table 7.
Table 7. Healthcare Insurance Coverage in Whitman County, 2014
(WSDH BRFSS, 2011-2013; ACS, 2014; HealthGrove 2016)
All ages
0-17 years
18-64 years
>65 years
Health Insurance
91%
97.1%
88.8%
99.4%
Dental Insurance
86%
Unknown
66%
Unknown
Medicare
N/A
N/A
N/A
99%
Medicaid
21.5%
6%
10%
Unknown
Mental Health Insurance
Although all health plans must include mental health coverage, most insurance companies now
restrict coverage for mental health treatment. In 2015, 3.9% of adults in the U.S. have a mental
illness and are uninsured (ACS 2014). The rates for the State of Washington and Whitman
County are not known.
Medicaid
The Department of Health and Human Services reported that beginning in January, 2014, states
like Washington that adopted new Medicaid eligibility levels so that childless adults earning up
to 138% of the federal poverty level ($15,654) would be eligible, saw a marked drop in
uninsured patient admissions (30%), reducing charity care and bad debt write-offs and increasing
Whitman County’s enrollments by 2785 (DSHS Medicaid, 2013-14).
Medicaid covered services for adults include
54
medical care, emergency care & ambulance fees;
maternity care through pregnancy, labor and delivery, and 60 days postpartum; infants
born to women receiving Medicaid are automatically covered until the child’s first
birthday; nearly four in 10 births in Whitman County and Washington State were to
women with Medicaid as their primary source of insurance during 2006 to 2010 (WCDH,
2012);
mental health, chemical/alcohol dependence services;
all dental care for >21 years (resumed in January, 2014);
vision-refraction exams every 24 months – but frames, lenses, and contacts are not
covered;
prescription meds;
transportation to and from medical appointments, when necessary;
interpreters.
And for children up to 20 years:
all necessary dental exams, prevention, screenings, treatments, and surgeries;
vision care every 24 months, including frames, lenses, and contacts (DSHS Medical
Assistance, 2014).
Medicaid Reimbursements
One of the significant challenges low-income people face in finding affordable primary care
physicians is the low reimbursement rate prospective physicians receive for their services:
“Low Medicaid reimbursement rates are frequently cited as the main reason that physicians are
reluctant to provide care for Medicaid patients” (Patterson et al., 2014). Medicaid typically pays
61% of what Medicare pays for the same outpatient physician services, and Medicare typically
pays 80% of what commercial health insurers pay (Coleman, 2015).
As a part of improving this disparity, the Affordable Care Act increased primary care providers’
payments to equal Medicare reimbursement rates in Washington for 2013 and 2014.
Approximately one-third of primary care physicians in smaller practices indicated an increased
willingness to accept new and current clients as a result of this increase (Patterson et al., 2014).
However, when the Kaiser Commission on Medicaid and the Uninsured did their Annual
Medicaid Budget Survey, which asked states about their plans to extend the primary care rate
increase beyond December 31, 2014, Washington was one of 24 states that responded it did not
plan to do so (Snyder, 2014).
Drawing on other research done by the Urban Institute in 2014, Washington state primary care
doctors saw their chances for increased rates of reimbursement beyond 2014 were less certain,
“Washington state doctors could see their reimbursement rates for primary care drop by 36
percent next year according to a new study by the Urban Institute” (Zuckerman, 2014). And
making that reduction more specific, MaryAnne Lindeblad, state Medicaid director with the WA
Health Care Authority, said. “But it amounts to a 28 percent cut in fees for primary care for
children — and a 70 percent drop in reimbursement rates for doctors who care for adults under
55
Medicaid” (Lindeblad, 2014). Lindeblad also pointed out that, “Governor Jay Inslee’s proposed
state budget includes funding to replace the Medicaid cuts, but there’s no guarantee legislators
will approve it” (Lindeblad, 2014).
Surveyed Washington providers said they will restrict access to patients with Medicaid if the
payment increase is discontinued in 2015 by doing one of the following:
not accepting new clients having Medicaid --- > 1/3 of respondents;
limiting the number of new Medicaid clients accepted --- about 1/3 of respondents;
reducing or totally stop seeing current clients having Medicaid --- about 1/5 of
respondents (Patterson et al., 2014).
Medicare
Medicare is the federal health insurance program for people 65 or older, certain younger people
with disabilities, and people with end-stage renal disease. The different parts of Medicare help
cover specific services:
Medicare Part A is hospital insurance that is automatic at age 65 with no premium. It covers
inpatient hospital stays, 100 days of post-hospital care in a skilled nursing facility, hospice care,
and some home health care;
Medicare Part B is medical insurance and requires a premium to cover outpatient care; annual
wellness exams; ambulance; durable medical equipment; mental health in and out-patient;
limited prescription drugs; screenings for cervical & vaginal, breast and colorectal cancers,
glaucoma and diabetic retinopathy; immunizations for flu, hepatitis B, and pneumonia.
It does not cover:
routine hearing exams or hearing aids;
dental procedures like cleanings, fillings, tooth extractions, or dentures;
eyeglasses or contact lenses, with the exception of one pair of corrective lenses following
cataract surgery that implants an intraocular lens.
Medicare Part D is prescription drug coverage that is added to other Medicare plans. These plans
are offered by insurance companies approved by Medicare.
Conclusions
Roadblocks to accessing adequate health care by those living in poverty in Whitman County:
No public bus service operates outside Pullman for those with no car or gas money;
Only three primary care providers have offices outside of Pullman/Colfax;
Many healthcare providers of medicine, dental and mental health care don’t accept
Medicaid;
Some people are ineligible for Medicaid or not able to pay for high deductibles and
copays on some plans;
Some face the choice between health care (e.g., diagnostic testing, treatments,
surgeries, medications, or seeing specialists in Spokane or dentists in Clarkston) and
the need to pay rent and/or buy food and clothing;
56
Medicaid covers dental for all ages, but no dentists will accept it, and although it
covers eye exams for all ages, it will not pay for glasses for adults;
Medicare doesn’t pay for the typical services needed by the elderly – routine hearing
exams or hearing aids; dental procedures like cleanings, fillings, tooth extractions, or
dentures; routine eye exams or eyeglasses;
There are fewer public health programs available to low-income citizens of Whitman
County than there were in the recent past;
Low Medicare and Medicaid reimbursement rates have led to providers not accepting
Medicaid and/or Medicare.
All healthcare providers are struggling with ongoing cuts to insurance
reimbursements and fees frozen by some insurance panels;
The state continues to recognize significant shortages to the availability of medical,
dental, and mental health care in outlying towns as well as in Pullman.
Along with a 9% uninsured rate, 21% of our residents >18 do not have a primary care
provider, 42% haven’t seen a doctor, and 39% have not seen a dentist in the past year.
Data from the Palouse Free Clinic are the clearest indicators of the needs and limited access to
health care suffered by Whitman County residents living in poverty. Depression and anxiety top
the list of presented conditions, followed by asthma, hypertension, migraines, and diabetes.
Among the highest needs clients have are dental, vision, mental health, substance abuse,
nutrition, and hearing services. The Palouse Free Clinic has identified many issues of getting
adequate health care including lack of transportation, lack of child care, inability to miss work,
embarrassment about seeking care for fear of being judged by others, not entirely trusting the
care they are receiving, limited finances, poor access to local specialty care, poor continuum of
care, and non-compliance.
Positive changes are taking place. Several agencies stand out in finding innovative means to
reach out to people living on low incomes (e.g., Pullman Regional Hospital, Palouse Free Clinic,
Palouse Health Center). There are also some progressive efforts to develop programs to fill in the
cracks that people living with both poverty and complex illnesses fall through so they can
effectively utilize the healthcare system, develop independence, and receive the coordinated care
required from multiple providers and agencies (e.g., Social Work Extenders, Health Homes,
Interagency Care Coordination, and Whitman County Health Network).
57
HOUSING
There are 19,323 housing units available for the 44,776 citizens of Whitman County. The
information in Table 1 indicates that in all but Pullman most are owner occupied. In all but
Pullman, Palouse, and Colton the vacancy rates are higher than the state average of 9.7%. The
majority of the housing in the County is owner occupied and generally mirrors the state ratios of
owner occupied housing to rental units, except in Pullman where renter occupied units are more
than twice the number of owner occupied units.
Table 1: Housing Characteristics for Whitman County based on 2010 Census (WSDOC 2015).
Community
Vacancy
Rate
Owner
Occupied
Albion
302
10%
61%
29%
Colfax
1405
12%
56%
32%
Colton
167
2%
86%
13%
Endicott
165
15%
68%
18%
Farmington
65
17%
68%
15%
Garfield
311
10%
63%
26%
LaCrosse
181
15%
65%
20%
Lamont
40
17%
63%
20%
Malden
118
24%
61%
15%
Oakesdale
196
15%
67%
17%
Palouse
474
9%
70%
42%
Pullman
11,966
8%
27%
66%
Rosalia
270
15%
63%
21%
St. John
304
14%
65%
21%
Tekoa
360
15%
59%
26%
Uniontown
149
13%
72%
15%
Rural
2850
County total
19,323
36%*
Non-Pullman
State
Median
House Value
Rentals
Number of
Dwellings
$182,300
69%*
2,928,300
9.7%
62%
*Does not include rural
58
55%*
Median
Rent
Number
Subsidized
$697
3%*
$989
5%
31%*
$250,800
38%
The median value for houses in Whitman County is $182,300. The median rent in Whitman
County is $697 per month. Although statistics could not be located, it is assumed that these
values are somewhat higher in Pullman than in the county as a whole. Statewide, the median
house value is $250,800; the median rent is $989 (ACS, 2015).
The importance of the differences in housing costs is affected by the differences in median
household incomes between Whitman County and the state as a whole. The American
Community Survey 5-year estimate for median household income in Washington state is
$59,478, while for Whitman County it is $36,257. Thus, the median household income for
Whitman County is 29% less than that for the state as a whole. As home ownership costs are
about 30% lower in Whitman County than in the state generally, and rent is 27% less, it would
seem that housing costs as a proportion of household income in Whitman County are more or
less the same as housing costs for the state as a whole. However, the rates for subsidized
housing relative to numbers of low-income renters are very different. There are 559,670 lowincome renter households reported for the state of Washington. In addition, there are 134,393
subsidized housing units available, which means that 24% of the state’s low-income renters
could be accommodated by subsidized housing. In Whitman County, however, there are 6955
reported low-income households and 439 subsidized rental units for a potential accommodation
rate of only 6%.
A report of the Washington State Department of Commerce Affordable Housing Advisory Board
in January of 2015 states that 36% of Washington households have housing costs greater than
50% of the household income. They also report that the affordable housing gap is shrinking, but
only very slowly. This is especially problematic because according to their projections,
Washington state will continue to have an economic and job growth rate higher than the national
average, but most of this growth will be in low-income, service-related jobs. According to their
projections, these factors are most pronounced in urban areas but will have a statewide impact
(WADOC, 2015).
Homelessness
Homelessness as a distinct category of need is hard to measure. In accordance with federal law,
the Washington State Department of Commerce does an annual “Point in Time” count of
homeless individuals and families. The results of work coordinated by the Community Action
Center in Whitman County for the January 29, 2015 “Point in Time” count are presented in
Table 4.
59
Table 4: Results of 2015 Point In Time Survey of Homelessness
Number of Homeless individuals*
Washington state
Whitman County
Sheltered
12,297
74
Unsheltered
7,121
0
Minors in Sheltered Households
6,098
60
Minors in Unsheltered Households
795
0
Sheltered households of minors only
120
0
Unsheltered households of minors only
59
0
2,250
0
Chronically homeless
*Does not include those staying with friends or relatives.
This information shows that statewide about half of all homeless households include children,
while in Whitman County nearly all of the homeless households include children. The
information also suggests that lack of any form of shelter or chronic homelessness is not a major
problem in Whitman County.
Housing Resources for those living in poverty in Whitman County
For the purposes of this study, housing resources were grouped into three categories:
emergency/short-term, transitional, and long-term. Emergency/short-term resources are intended
to include those that can be accessed within a single day, and are of only a few days duration.
Transitional programs may require an enrollment process and have a finite duration. Long-term
programs require an enrollment process and have an indefinite to permanent duration.
Emergency/short-term Housing
There are no homeless shelters in Whitman County. Emergency/short-term programs available to
those in Whitman County include Alternatives to Violence of the Palouse and the Community
Relief Fund. This information is summarized in Table 5 and described below.
Table 5: Emergency/short-term Housing Direct Services 2014 (ATV 2014, CAC 2015).
Emergency/Short Term
Housing
ATV of the Palouse
Community Relief Fund
Resources
Community Served in
Whitman Co.
$425,000
31 individuals sheltered
$3218
53 nights
60
Alternatives to Violence of the Palouse
Alternatives to Violence of the Palouse (ATVP) is a non-profit organization that provides
emergency shelter to men, women, and families who are escaping family and sexual violence.
Serving both Whitman and Latah counties, ATVP is funded 80% by grants and 20% by gifts.
Many, but not all, of those sheltered are living in poverty. Though shelter is available for a
maximum of 90 days, in 2014 the average stay was 27 days. About half of the people sheltered
are children; the other half, predominately women. In 2014, a total of 62 individuals were
sheltered, about half of whom were sheltered in Whitman County. Of these, about half were
children, 45% were adult females, and 5% were adult males. In addition to shelter, ATVP offers
advocacy, legal assistance, peer support groups, sexual assault and abuse therapy, and emergency
transportation, food, and clothing (Interview with Christine Wall Director of Alternatives to
Violence by Mary Collins March 5, 2015; ATV 2014). In 2014, 433 individuals in both Whitman
and Latah counties used one or more of these services.
The Community Relief Fund
The Community Relief Fund, administered by the Community Action Center, has existed for two
years and is funded by area churches, businesses, the United Way, and individuals. In addition to
issuing motel vouchers on its own, it provides housing vouchers to the Pullman Police
Department for distribution. Vouchers will fund a maximum of two nights’ lodging. In 2014 a
total of 53 nights of lodging were provided. Of these, 20% went to families, 40% to single
males, and 40% to single females (CAC 2015).
Transitional Housing
Transitional housing is intended to last for more than a few weeks, but not more than a couple of
years. In all transitional housing programs, public and private, caseworkers have considerable
involvement with clients, including regular meetings and personal contracts that establish
individual goals and measures of accountability. In addition, caseworkers are able to draw from
the multiple types of resources provided by state and federal programs to accommodate the
specific needs of individuals and households. Participants in a program administered by the
Community Action Center also work with a case manager who facilitates training and other
learning opportunities, such as job-seeking skills, parenting, and money management skills.
Providing information related to money management is a relatively new area of concern for all
programs and has come about as a result of high levels of indebtedness, including student loans
many clients carry.
Crisis Rental Assistance/Consolidated Homeless Grant
This program is funded by the state of Washington and administered by the Community Action
Center in Pullman. Funding includes document-recording fees associated with all real estate
transactions that are mandated by the Washington State 2006 Homelessness Housing and
Assistance Act. The Act directs that 66% of the fees collected in a county be returned to the
61
county, while 34% is remitted to the State Home Security Fund for homeless housing. In 2013,
the state collected $192,696 in these fees in Whitman County. Funds available for transitional
housing support include not only payments to landlords for housing, but also administrative
costs. The program is aimed at eviction prevention and provides rental assistance for up to 24
months at no cost to the recipient. Participants must have household incomes no greater than
30% of the area median income, if there are no children in the household, or no more than 50%
of the area median income if the household includes children. In 2013 193 households
representing 401 individuals were served in Whitman County (WSDOC, 2014).
Tenant Based Rental Assistance
This is a federally funded program of the U.S. Department of Housing and Urban Development
(HUD), administered by the Community Action Center in Pullman, which assists very lowincome households with rent, deposit, and utility costs for up to 24 months. Assistance levels are
established that reduce a household’s rent payment to no more than 30% of the household
income. These funds can be used alone or with other subsidies, but if other subsidies are used,
these funds are reduced to maintain the 30% of household income limit. To qualify households
must earn no more than 50% of the area median income. In 2013, 66 households, representing
140 individuals, were served by this program in Whitman County (TBRA 2013).
Family Promise of the Palouse
Family Promise of the Palouse (FPP) is an affiliate of the national organization, Family Promise.
It is a private, not for profit organization that is funded through grants and gifts and works with
11 local churches, five of which are in Pullman. The churches and their members provide
overnight shelter, meals, and companionship for families. They have a day facility in Moscow
that provides individual storage space for families’ possessions, a common activity area, and an
outdoor play area. Some transportation is provided, as well as other support services. Families
may be sheltered for up to 90 days. In 2014, FPP sheltered 17 families; of these 8 were twoparent households, 5 were single-mother, and 4 were single-father.
62
Table 6: Most Recent Year Available Data for Transitional Housing (WSDOC, 2014; LWV
interview L. Rhinehart)
Transitional
Housing
Programs
Crises Rental
Assistance/
Consolidated
Homeless
Grant
Tenant Based
Rental
Assistance
Family
Promise of
the Palouse
Types of
Resources
Source of
Funds
Up to 24
months of
rent
Document
recording
fees and State
funds
Up to 24
months of
rent &
utilities
US Dept. of
Housing and
Urban
Development
UP to 90
days of
shelter
Grants and
gifts
Resources
for
Whitman
County
$807,446
$170,000
$123,000
Latah and
Whitman
County
Income
Qualification
Participant
Costs
Community
Served in
Whitman
County
30-50% of
area median
income
None
Up to 50% of
area median
income
Up to 30%
of
household
income
140
individuals/
66
households
At or below
federal
poverty level
None
17 families
401
individuals/
193
households
Long-term Housing
Section 8 Housing
The primary program for low-income housing is the Section 8 program funded by the U.S.
Department of Housing and Urban Development (HUD) and administered by the Spokane
Housing Authority (SHA) and the Community Action Center (CAC) in Pullman. This program
provides rental assistance for as long as a recipient qualifies and follows program guidelines.
Individuals or households are approved for the process based on income and a ‘point’ system
that gives priority status for applicants with physical or mental disabilities, the elderly, children <
18, or people with a terminal illness. The program offers direct payments to landlords according
to HUD and SHA values that reflect local housing costs: a 1-bedroom voucher can be worth no
more than $600, a 2-bedroom, $725 dollars, and a 3-bedroom, $996. Furthermore, the program
limits rentals according to family size: 1-2 people can qualify for a 1-bedroom unit, 3-4 people, a
2-bedroom unit, and 5-6 people, a 3-bedroom unit. The program does not pay for security
deposits or the last month’s rent in advance. If utilities and garbage are to be paid by the
63
program, they must be included in the rent. If utilities are not included, there are utility assistance
programs available.
The Section 8 process requires that participants apply for and be granted a voucher, participate in
a 2-hour orientation, and then have 90 days to find a rental unit. Once a participant has identified
a unit and secured the landlord’s willingness to participate in the Section 8 program, the unit is
inspected to assure it meets basic health and safety standards. The participant then must sign a 1year lease and the landlord registers for direct payment. After the first year, it is possible to
move to a month-to-month rental plan. Participants are responsible for reporting changes in
income or household make-up. Failure to do so can result in termination from the program.
Short-term changes in income, such as inheritances, bonuses, gifts, etc. do not automatically
disqualify participants from the program. These must be reported, but depending on the amount
and how the funds are used, they may not affect the rental assistance. For instance, if a
participant receives a gift of a few hundred dollars and applies the money to needed car repairs
or debt retirement, a caseworker can exclude the special income from the base income
qualification.
In the area governed by the Spokane Housing Authority, there is no term limit for participation
in the Section 8 Housing program. There is, however, according to the program administrator at
the CAC, relatively frequent turn over with 10-20 participants giving up their vouchers monthly.
Reasons include such things as moving out of the area and changes in income or household
members but no systematic record of reasons for leaving the program are maintained. There is a
waiting list for vouchers with an average 6-month waiting period. Additionally, of those
approved for vouchers, about half fail to complete the process of securing a rental (Interview
with L. Corsetti, Community Action Center by M. Collins and M. Beuhler 2014).
One of the program strengths is that it requires participants to assume the responsibility of
finding a rental and staying in good standing with the landlord. The 50% failure rate for
completing or maintaining good standing in the program is the result of a number of factors
beyond the scope of this study. One factor within our area of interest, however, is that some
landlords and rental agencies choose not to participate in the program, though their reasons for
not participating are currently unclear.
Community Action Center Housing
The Community Action Center owns and operates housing for low-income and elderly
individuals. The apartments are located in Tekoa, Palouse, and Pullman. Those in Tekoa,
Palouse, and Kenwood Square in Pullman are subsidized Project-based HUD Section 8 housing.
The Palouse and Kenwood Square rentals are for low-income elderly whose income cannot
exceed between 50% and 80% of the area median income. Kenwood Square is also available to
disabled individuals over 18 years old. The Tekoa facility is for families or disabled individuals
whose income cannot exceed 50% of the area median income.
64
The Maple Street Apartments in Pullman are available to households whose incomes cannot
exceed 50% of the area median income. Tomason Place rentals are available to households
whose incomes cannot exceed between 30% and 60% of the area mean income. Tomason Place
is part of the Internal Revenue Service’s (IRS) Low-Income Housing Tax Credit Program. It
assists with the development of low-income rentals through dollar-for-dollar tax credits to
private developers for between 30% and 70% of the total project development costs. Rents are
calculated according to household income such that, for example, those with incomes at 30% of
the area median pay $303 per month for a 2-bedroom unit, while those earning 60% of the area
median income pay $720. Additional income percentile/number of bedroom rates apply. The
Bellevue Duplexes in Pullman are conventional market housing that welcomes Section 8 tenants.
Table 7: Community Action Center Rental Properties (CAC rental brochures 2015)
Location
Number of
Units
Community Served
Bellevue
Duplexes
Pullman
27
Available to anyone
Maple St. Apts.
Pullman
2
Low income
Tomason Place
Pullman
26
Low income
Palouse
11
Head of household must be at least
62 years of age and low income.
Pullman
39
Head of household must be at least
62 years of age or disabled and low
income.
Tekoa
8
Low income
Palouse Cove
Kenwood Square
Wheatland Apts.
Self Help
The Community Action Center also administers a program through their Homeowner Resource
Center, “Self Help”, that works to help families become homeowners. The program is made
possible by the US Department of Agriculture Rural Development 502 Guaranteed Mortgage
program. The homes are constructed by the Community Action Center and professional
contractors, and are then sold to qualifying families. Eight homes have been constructed to date
and four more are planned. The program requires that participant families be low-income and
first-time homeowners. They must demonstrate that they have a good credit rating and a stable
income. The CAC lends the amount of the down payment, while the remainder of the mortgage
is held by a banking firm that participates in the USDA program. Participants must contribute
100 hours of labor applied toward interior painting and landscaping. Currently house prices are
65
kept below $190,000. The interest rate on the 15- or 30-year mortgage is set by the USDAapproved lender (USDA 2015). To date 12 homes have been built by this program.
Palouse Habitat for Humanity
Palouse Habitat for Humanity (PHH), which operates under the guidelines of Habitat for
Humanity International, works to complete one new house per year in the Palouse. It has also
recently begun a program that helps with home maintenance for those living in poverty. The
organization is faith based, but does not proselytize or require any religious affiliation of its
participants. The program is funded by grants and gifts including an annual gift from Thrivent
Financial for 50% of the home construction cost. In addition, the organization operates a store
that accepts used or surplus construction materials and sells them to the general public. The costs
of the houses built to date have been between $64,000 and $107,000 in cash and as many as 6000
hours of volunteer construction and associated work.
Habitat for Humanity works with partners who have lived or worked in Whitman County for at
least a year and who demonstrate “need, ability to pay, and ability to partner” (PHH, 2015).
Habitat provides no interest loans as well as volunteer assistance for home construction.
Awardees must contribute $1000 as a down payment. They also must contribute 300 hours of
labor for a single-parent household and 500 hours for a two-parent household. Loans are
structured so that monthly payments do not exceed $500. Homeowners carry two mortgages
with Habitat for Humanity. The first is for the actual cash cost of the construction of their house.
The second is for the difference between the actual cash invested in construction and the
appraised value of the house. Of the 14 houses in Whitman County and Latah County
constructed to date, 7 are still under mortgage to the original builder/partner, one has had the
mortgage paid in full, and 6 have been sold. In addition to home construction, Habitat for
Humanity of the Palouse started a program of home maintenance in 2012. This program also
uses volunteer as well as paid professional labor as well as homeowner “sweat equity” to help
with modest home maintenance projects.
66
Following is a summary of long-tern housing resources available in Whitman County:
Table 8: Long-term Housing Resources Other Than CAC Owned Facilities.
Longterm
Housing
Program
Types of
Resources
Location
Quantity of
Resources
for Whitman
County
Income
Qualification
Participant
Costs
Fixed value
based on
family size
At or below 30% 60% of area median
income and “point”
system.
Rent in excess
of voucher
payment
standards.
12 houses
completed
First time home
buyer. Income
below or equal to
65-100% of area
median income.
300 vouchers
Section 8
Housing
vouchers
Whitman
County
Self-Help
Home
ownership
loan
assistance
Habitat
Home
for
ownership
Humanity loans and
construction
assistance
Colfax 4
Uniontown 4
Palouse 4
Albion 1
Uniontown 2
Colfax 1
Pullman 2
Palouse 2
Demonstrated good
credit and stable
income.
7 houses in
Whitman
County.
1 house
annually*
At or below 3060% of area median
income.
1.5% of
purchase price
as cash earnest
money and
closing costs.
Bank
mortgage,
Down payment
loan, 50 hours
labor per adult.
$1000 down
payment and
300-500
volunteer
hours.
*Habitat for Humanity of the Palouse serves both Whitman and Latah Counties. To date about half of the houses
they have built are in each county.
Strengths of Low Cost Housing Programs in Whitman County
Community integration
The Community Action Center housing located in Pullman is scattered across the community
with units on College Hill and Pioneer Hill as well as other areas. The Community Action Center
Self Help and Habitat for Humanity Houses are similarly spread throughout the county and
throughout the towns they are located in so that there do not appear to be pockets of low-income
housing. Dispersal of low-income housing has been recognized as a significant factor in
strengthening communities and expanding opportunities for those living in poverty to improve
their circumstances (Chetty et al., 2015). Design and construction classes at WSU taught by
Professor Bob Kircak bring students into the building and design process of the Habitat for
67
Humanity houses. This effort has led to improved architectural appeal and community
integration of their houses. Special efforts directed at home ownership have also been spread
throughout the county, with more homes being constructed outside than inside Pullman. This
also contributes toward integration of low-income housing and is an economic boon to a number
of the small towns in the county.
Interagency collaboration
All of the organizations working to provide affordable housing in Whitman County are familiar
with one another’s work and collaborate when possible. The Community Action Center takes a
lead role in working with the various federally funded programs.
Recognized needs for Low Cost Housing Programs in Whitman County
Funding stabilization
Stabilization of the relatively new Community Relief Fund, the only real resource for addressing
immediate needs of the homeless, is needed. The fund is currently supported mostly by churches,
a few businesses, and individuals. The current annual expenditures of this fund are modest, less
than $7000. It is unclear if this is adequate since numbers of individuals turned away for lack of
funding are not kept.
Physical resources
There are too few low cost one-bedroom rentals. A number of landlords are unwilling to
participate in the Section 8 housing program. It is not clear if this has grown out of bad
experiences with tenants or with the program administration. Better understanding of this
situation could help improve landlord and service provider collaboration and increased
willingness to participate in the Section 8 housing program.
Data collection/management
A weakness in the current system is that it is difficult to get information on how many
households are not being served by current housing programs. Other than the Section 8 program,
which maintains a waiting list, there are no consistent records of how many people are denied
service and the reasons for denial. The Community Action Center is implementing a new
information keeping system that will track numbers of those who do not get housing, as well as
those who do. This should help provide a better understanding of how we are meeting lowincome housing demand.
68
Law Enforcement and Legal Services
Law Enforcement
Law enforcement and other first responders, such as fire and ambulance, do not tailor their
services according to the economic status of individuals they serve. However, they are often the
initial point of contact between those living in poverty and services available to them. The
Pullman Police and Fire Departments work with the Community Action Center to make housing
and transportation vouchers available in emergency situations when the Community Action
Center is closed. Also, a Colfax Traveler’s Fund is supported by Colfax churches and private
donors and administered by Sheriff’s deputy chaplain Ron McMurray that serves the county
outside of Pullman (Interview with Whitman County Sheriff’s Office by L. Harding and K.
Barron. June, 2015).
Ambulance services for people covered by Medicare and Medicaid are paid only 30% of the
amount billed. By law, the service providers are forbidden to charge these patients the
difference. For patients who aren’t covered, a payment plan can be set up, but unpaid bills can
go into collections. Pullman bills between $800,000 and a $1 million a year for ambulance
service but collects only 70-80%. This leaves the city of Pullman having to cover the difference
between costs and receipts.
With the goal of providing emergency services to low-income households, the federal
government, through the Federal Communications Commission’s Lifeline program, in
collaboration with communications companies, offers free or very low-cost telephone phone (cell
or land line) or emergency life line services to low-income individuals. The program is funded
by Universal Services fees paid by all cell phone users. The program allows only one phone per
household, and service allowances range from 250 to 350 minutes, including some with up to
1000 free texts per month. The program is currently developing a plan for providing broadband
Internet services (fcc.gov, 2015). Individuals work with communications companies to access
the service, but we were unable to identify the number of households using this program.
Access to Courts and Legal Services
It is likely that impoverished residents of Whitman County experience a greater number of legal
problems than the general population. It is also likely that despite constitutional, statutory, and
regulatory provisions intended to assure that justice is accessible to all and administered
impartially, people living in poverty face more impediments in resolving their problems within
the legal system and in obtaining advice and assistance to assert their rights.
Legal Problems of Low-Income Washingtonians
Earlier this year, the Washington State Office of Civil Legal Aid published results of a statewide
study in which the Washington State University Social and Economic Sciences Research Center
(SESRC) surveyed a sample of 3125 households with incomes up to 200% of the federal poverty
level. Survey questions described 138 specific legal situations and asked if anyone in the
69
household had experienced them in the prior 12 months. More than 70% of those who answered
said they had faced at least one of the problems described, and among those, the average number
of problems reported was 9.3. The greatest numbers of problems reported in the statewide
survey concerned health care, employment, and consumer finance (WSUSESRC, 2015).
Most respondents reported limited confidence in the civil justice system, and 65% of those who
reported at least one legal problem did not seek legal help. Among those who had sought legal
assistance, 61% felt they had obtained some degree of resolution of their problem (WSUSESRC,
2015).
Reports of Whitman County Civil Legal Needs
Locally, respondents to the Whitman County Community Needs Assessment rated the need for
legal services as ninth of the top 10 community social service needs, and as fourth among social
service needs for their own households. Low-income and non-Pullman residents ranked the
community’s need for legal services less highly than did respondents as a whole, and lowincome and student respondents ranked their own households’ need for legal services less highly
than did respondents as a whole (Bittinger 2015).
The most detailed information available about the civil legal needs of low-income Whitman
County residents comes from records kept by the Community Action Center for cases handled by
Whitman County Legal Services from September 2, 2010 through August 6, 2014. During that
period, there were 296 requests for legal services from people who were over 65 or whose
incomes were not more than 200% of the federal poverty level. The Community Action Center
referred 289 of these cases, of which 288 involved a person under age 65, to local attorneys who
agreed to represent the parties pro bono. Records for 176 of the referred cases describe the area
of substantive law involved; these areas, and the relative proportions of callers who requested
help in them, are shown in Figure 4. These data indicate a sizeable majority of the cases involved
family law issues. Ten percent of Whitman County Legal Services clients during this period
reported having been victims of domestic violence (CAC, 2014).
70
Figure 4. Whitman County Legal Services Cases 9/2/2010-8/6/2014
Family Law
Housing
Consumer
Employment
Income Maintenance
Other
Policies Intended To Mitigate the Legal Disadvantages Of Poverty
A.
Provisions For Criminal Defendants
Probably the best-known example of a policy intended to make the legal process fairer by
reducing disparities in resources between the parties is the constitutional right of indigent
criminal defendants, announced by the United States Supreme Court in the 1963 case of Gideon
v. Wainwright, to have attorneys paid for at public expense. The Revised Code of Washington
(RCW), Section 10.101, provides that defendants are deemed to be indigent and entitled to
representation by a Public Defender if they meet any one of the following criteria:
after-tax income not more than 125% of the federal poverty level;
receipt of any of a number of public assistance benefits such as TANF, Medicaid, SSI,
food stamps or the like;
insufficient available funds to pay any amount to retain counsel.
Others who have sufficient funds to pay a portion of the cost of counsel, but not enough to pay
the full cost, can be appointed counsel if they sign a promissory note to repay the county for the
portion they are deemed able to pay.
In 2013, the most recent year for which full statistics were available, Whitman County spent
$315,000 on public defense, under 4 contracts with local attorneys. The chart below shows the
71
proportions of various classes of criminal cases assigned to Public Defenders that year (WSOPD
2015).
Figure 5. Whitman County Criminal Cases 2013
Adult Felony
Misdemeanor
Juvenile Offender
0
200
400
600
Assigned to Public Defender
800
1000
1200
1400
Cases Filed
Criminal defendants who are convicted can be required to reimburse the county for the costs of
their public defense, as well as fines, restitution to crime victims, court costs, costs of
incarceration and others. Any obligation to pay money is likely to be more onerous for a poor
person than for one with more resources. RCW 10.01.160, which authorizes courts to impose
costs, explicitly provides that a court shall not order a defendant to pay costs unless the
defendant is or will be able to pay them, and that in determining the amount and method of
payment of costs the court shall take account of the financial resources of the defendant and the
nature of the burden that payment of costs will impose. However, there are some costs that
cannot be waived, and all costs that are imposed accrue interest at the rate of 12% per annum
until they are paid.
B.
Provisions for Low-Income Parties In Civil Cases
In Lassiter v. Department of Social Services, the U.S. Supreme Court held in 1981 that the
Constitution does not provide indigent litigants in civil cases with a right to counsel paid for at
public expense. Subsequently, both federal and state cases have found a right to counsel in
certain civil proceedings such as guardianships, civil commitment, and child dependency actions,
and in Whitman County and throughout Washington, public defenders are appointed and
represent indigent clients in such cases.
72
Advocates for low-income people believe that meeting the civil legal needs of this population
will require courts to recognize or legislatures to enact a right to counsel in civil cases. In 2006
the American Bar Association adopted a resolution urging “federal, state, and territorial
governments to provide legal counsel as a matter of right at public expense to low income
persons in those categories of adversarial proceedings where basic human needs are at stake,
such as those involving shelter, sustenance, safety, health, or child custody, as determined by
each jurisdiction” (ABA, 2006), and in 2010 it developed a model statute it encourages states to
adopt to create such a right (ABA, 2010). The Northwest Justice Project, Washington’s largest
civil legal aid program, has taken an active role in advocating such a right to counsel, but has not
yet convinced either the legislature to enact, or the Washington Supreme Court to recognize,
such a policy.
Although it has not yet found that indigent civil litigants have a right to be represented by
attorneys at public expense, the Washington Supreme Court has promulgated and applied court
rules intended to remove or reduce barriers to their use of the courts. General Rule (GR) 34
requires courts to waive fees for litigants who meet any of the following criteria:
after-tax income not more than 125% of the federal poverty level;
receipt of any of a number of means-tested public assistance benefits
such as TANF, Medicaid, SSI, food stamps, etc.;
income over 125% of federal poverty level, but basic living expenses that
make him or her unable to pay the court fees sought to be waived;
other compelling reasons as found by the court;
representation by a Qualified Legal Services Provider (QLSP) that has screened
the party and found him or her eligible for services.
Recently the Supreme Court has held that GR 34 requires courts to waive all fees, and not just
initial filing fees, for eligible litigants (Jafar v. Webb, 2013).
Of the 708 civil cases filed in Whitman County Superior Court in 2013, 62 requested and 55
were granted GR 34 fee waivers. In 2014, when 692 cases were filed, fee waivers were granted
for 48 of the 55 plaintiffs who requested them and denied to 7 (Telephone conversation between
Jill Whelchel, Whitman County Clerk, and Jane Von Frank, November 2015).
Civil Legal Advice and Advocacy for Whitman County’s Poor
There are currently no civil legal aid programs headquartered in Whitman County. If lowincome county residents appear in court in civil matters, they are either representing themselves
73
or private attorneys represent them. As of September, 2015, 83 active members of the
Washington State Bar Association maintained offices in Whitman County or in Moscow, Idaho.
Of those, about half are in practices where they represent a broad range of clients in civil matters,
as opposed to working as counsel for a government entity or business or working as a legal
educator.
The nature of the attorney-client relationship, and the duty of confidentiality it imposes, make it
difficult to quantify the amount of service that private attorneys have long provided in Whitman
County and that they continue to provide to low-income clients. It is certain that many attorneys
have done much, and will do more, for clients who are in poverty. It is also evident that many
low-income people in Whitman County find it difficult or impossible to find a lawyer who will
represent them in the civil matter for which they need help, at a price they can afford. The
difficulty is not so much that private attorneys are unwilling to provide pro bono services, as it is
that not enough attorneys are willing and available to provide reduced-rate or free services in
certain substantive legal areas in which potential clients seek help. For example, although a
large majority of legal services requests to the Community Action Center between 2010 through
2015 were for help with family law or domestic relations issues, among a roster of more than 20
attorneys who were willing to provide pro bono legal services to indigent clients, only 2 or 3
accepted family law cases (Interview with Melissa Johnson, Community Action Center
coordinator for Whitman County Legal Services, by Jane Von Frank, August 2014).
For several years the Northwest Justice Project, the Community Action Center in Pullman, and
the Whitman County Bar Association coordinated in a system that attempted to match poor
Whitman County residents with private attorneys to represent them in civil matters. The
Northwest Justice Center operates a toll-free statewide telephone hotline, the Coordinated Legal
Education, Advice, and Referral hotline (CLEAR). When calls came in from Whitman County,
the Northwest Justice Center referred them to the Community Action Center. The Community
Action Center had a coordinator who talked with the caller, obtained information, kept records
and contacted a member of the Whitman County Bar Association who had expressed interest in
providing pro bono services for CAC referrals. If the attorney was interested in taking the case,
CAC gave the caller the attorney’s name, the caller contacted the attorney, and if the caller and
attorney agreed, the attorney represented the caller in the matter.
In the summer of 2015, the Community Action Center discontinued its participation in the
program. Since that time the Northwest Justice Center has not been forwarding calls that come
in from Whitman County. The Whitman County Bar Association is working with the Spokane
County Bar Association to develop a program under which the Spokane Bar Association’s legal
aid program will perform essentially the same intake and facilitator functions that the
Community Action Center performed before the summer of 2015. As of December 2015, it is
reported that the Legal Foundation of Washington has identified funds that it will make available
as a grant to the Northwest Justice Project in Spokane for a part-time coordinator who will
74
handle calls from Whitman County and refer them to the Spokane Bar Association-Whitman
County Bar Association panel of volunteer attorneys.
75
TRANSPORTATION
Whitman County has a population of 47,250 residents living on 2,600 square miles of land. It
averages 20.7 persons per square mile as compared with 101.2 per mile for the state. Whitman
County consists of 16 incorporated towns with Pullman, population 32,110, having the vast
majority of residents. The second largest town is Colfax, the county seat, with less than one
tenth the population of Pullman, at 2780.
The populations in the remaining incorporated towns have long distances to travel for food
variety, work, and numerous services. Using the distance to a supermarket as an arbitrary
measure, the scale of travel to services is illustrated in Table 1. Fixed route public transportation
services are available only inside the city limits of Pullman. People without the use of a car and
those living within Pullman who need to travel outside of the city limits have serious unmet
transportation needs.
Table 1. Distance to Nearest Supermarkets from Towns in Whitman County. (WSOFM, 2015).
Town
Population
Nearest Supermarket (Pullman, Colfax, or Spokane)
Albion
555
9 miles
Colfax
2,790
1 supermarket
Colton
420
14 miles
Endicott
296
20 miles
Farmington
150
35 miles
Garfield
595
25 miles
LaCrosse
320
29 miles
Lamont
80
45 miles
Malden
200
31 miles
Oakesdale
430
36 miles
Palouse
1,030
15 miles
Pullman
32,110
3 supermarkets
Rosalia
560
27 miles
St. John
510
24 miles
Tekoa
785
43 miles
Uniontown
335
17 miles
76
Transportation service providers in Whitman County
The transportation services available in Whitman County are summarized in Table 2 and
described below.
Table 2. Transportation Services in Whitman County
Name
Type of
One-way Fares
Number of
Service
passenger trips
COAST
Council on
Aging and Demand
Donation accepted
12,654 (2014)
Human
response
Services
Pullman
Transit
Fixed
Route
Buses
Pullman
Transit
Dial-ARide
Fixed route
$.50 regular
$.30 seniors, disabled
youth passes available
Demand
response for
seniors
(65+) and
disabled
$.40
$3.00 to Pullman
Airport
Number of Vehicles
11 vans with wheel
chair access
4 minibuses with
electronic lifts
10 volunteer drivers
1,472,626 (2012) 19 buses
18,653 (2012)
5 vans
COAST
COAST provides transportation to citizens in four Washington counties: Asotin, Garfield,
Whitman, and southern Spokane. It also serves five counties in Idaho: Clearwater, Idaho, Latah,
Lewis, and Nez Perce County. COAST services include vans and paid drivers as well as
volunteer drivers who use their own vehicles and receive mileage reimbursement and liability
insurance coverage. Rides are free to those who arrange for that ride at least one day in advance,
and if resources are available to complete the trip. This agency is under the direction of the
Council on Aging and Human Services, based in Colfax, and is funded by federal and state
grants, along with client and public donations. None of its programs is aimed specifically at
persons in poverty but all may use them. COAST asks for date of birth; it, therefore, knows the
ridership is largely elderly. COAST has handicapped accessible vans and can provide
transportation for those with disabilities.
77
COAST is currently deciding how to raise its visibility in the county and how to increase the
number of volunteer drivers it has throughout the county, particularly in both Pullman and
Colfax. Currently COAST has one volunteer in Pullman, and one in Colfax, and a significant
need for more. Volunteer drivers drive at their own convenience rather than regularly scheduled
times. COAST hopes to advertise for volunteer drivers through the churches in the county.
While COAST provides a vital service for special transportation, including non-emergency
medical transportation, it is not a service one might use to go daily to and from work.
Craig VanTine, Director of Transportation, Council on Aging and Human Services stated,
“Many people offer rides to neighbors who no longer drive. If those drivers volunteered with
COAST, they could provide that help, get their gas paid for, have liability insurance provided to
them, and drive as much or as little as they wished. We just need to get that message out to
folks” (Interview with Craig VanTine by K. Kiessing, 2015). Volunteer drivers must prove
ownership of their vehicle, insurance for it, a clean driving record, and undergo a background
check and a short orientation on record keeping for fuel reimbursement.
COAST attempted to start a vanpool route from Rosalia to Pullman. This failed because the
major employers, the City of Pullman, WSU, and Schweitzer Engineering Laboratories, have
different shift times, and it was a challenge to identify enough individuals with compatible
schedules who might use the service. COAST was able to encourage some ridesharing.
In September 2009, through a vote by the county commissioners, the Whitman County
Unincorporated Area Transit District was created specifically for the purposes of providing
vanpool services, with COAST to be the contracted operator of the system. COAST is
designated on paper as the vanpool program provider, but operating funding has been
unavailable and the effort remains dormant. (WSHSTP , 2015).
Special Mobility Services
Special Mobility Services is based in Spokane with a subsidiary service, Transportation
Solutions, in Walla Walla. They hold the “broker” contract for allocating transportation of nonemergency medical transportation in ten counties in Washington. Those counties are Adams,
Asotin, Ferry, Garfield, Grant, Lincoln, Pend Oreille, Stevens, Spokane and Whitman. Services
are restricted to those who are certified by the Department of Social and Health Services for
necessary medical transportation to appointments for treatment. Three hundred vouchers were
allocated for this fiscal year, but it is unknown how many have been used.
All clients of Transportation Solutions are Medicaid patients, so the Special Mobility Services is
affiliated with the Washington Health Care Authority. They are a 501 (c) (3) non-profit
organization, not affiliated with any religious organization, and work in Whitman County with
78
COAST in Colfax and Transportation Solutions of Walla Walla. Both Special Mobility Services
and Transportation Solutions handle disabled clients with special transportation challenges.
Approximately 8400 rides are provided each year in Whitman County. All clients are eligible
for non-emergency medical transportation services.
One challenge in providing Medicaid transportation in rural areas is that Medicaid does not pay
for “deadhead” miles, which means miles driven by the service provider without passengers to
pick-up clients. In some cases, it can easily be 90 deadhead miles to take someone from a remote
region to Spokane. However, COAST has been able to recover the cost for deadheading miles
by raising its Medicaid contract price (WSHSTP 2015).
The Special Mobility Services Director, Rusty Koontz, states that “unmet needs in Whitman
County will be identified by a Human Services Transportation Plan” (2015). Washington State
Department of Transportation worked with its partners across the state to develop to a statewide
Human Service Transportation Plan to coordinate the needs, interests, and visions of
Washington’s 14 regional transportation-planning organizations:
The plan highlights service gaps and challenges, investigates best practices from around the state
and beyond and recommends strategies to improve access to transportation throughout the state.
The emphasis is on delivering transportation service to people with special needs, those who are
unable to transport themselves due to physical or mental limitations, income or age (WSHSTP,
2015).
The major avenue for assessing unmet needs for transportation is the Regional Transit Planning
Organization, funded and regulated by the Washington State Department of Transportation for
the southeast corner of Washington serving four counties: Asotin, Garfield, Columbia, and
Whitman. The “Palouse Regional Transportation Planning Organization was formed in 1993 as a
result of the Growth Management Act to ensure local and regional coordination of transportation
plans”(RTPO, 2015). Whitman County has opted out of the Growth Management Act but
remains involved in this consortium for planning purposes. This is a voluntary association of
local governments within a county or contiguous counties. Members include cities, counties, the
state Department of Transportation, tribes, ports, transportation service providers, private
employers, and others. Planning covers all modes of transportation: water, highways, air travel,
public transit, and ports. This website lists the Wheatland Express as running a shuttle between
Washington State University and the University of Idaho campuses. That shuttle service ceased
operation at the end of 2011, which raises questions about the accuracy of the other data on this
site (RTPO, 2015).
79
Pullman Transit-Fixed Route Buses and Dial-A-Ride
The Pullman Public Transportation System is composed of a fixed route bus service and a DialA-Ride van service. The van service is restricted to seniors 65 and over and those with
disabilities. Both of the services began in March of 1979. Neither of these is directed at lowincome clients, but prices for service appear to be low enough that riders with limited income
could utilize them.
There are 33 full time drivers who are trained to drive either fixed route buses or Dial-A-Ride
vans. Three vans are on the road providing door-to-door service from 6:30 am to midnight, but
riders must make a reservation in advance. In 2014, Dial-A-Ride provided 19,366 one-way rides
inside the city limits of Pullman. In 2013, Pullman Transit provided 1,400,710 fixed route bus
rides inside the city limits. This is a heavily used and highly valued transit system, and is the
envy of many rural communities.
Pullman Transit is pursuing the possibility of expanding its service area outside the city limits.
An important step in that effort is underway. Pullman Transit has received a grant to conduct a
feasibility study to expand service to outlying areas and improve coordination with other
stakeholders as a part of the 2015 Technical Assistance Program (TAP). This is a pilot program
to provide direct technical assistance to rural transportation programs in the area of building
system capacity to respond to community needs. Pullman Transit was one of five systems
awarded a TAP grant in the entire nation (Wagner, 2015).
Robin Phillips, National Rural Transit Assistance Program’s Executive Director commented,
“The problems faced by these agencies are repeated across the country in other programs and
states. The desire is to find solutions that can be repeated in other settings to provide public
transportation to enrich the lives of families, provide social mobility and job security to all
groups in the region involved” (Phillips, 2015). This grant is promising for the Whitman County
region because it improves the possibility that the Pullman Transit System may be able to expand
beyond the city limits to serve the county. The grant specifically will fund a consulting firm who
will survey the area transit needs in Whitman County. The data gathered will be the basis for
transportation planning in the future and will be vital for grant writing to address future needs.
Connectivity is essential to a countywide system. Being able to bring persons to a central point
for transfer to services is a possibility. The study may also examine the possibility of resurrecting
the shuttle service between Washington State University and the University of Idaho campuses.
Connectivity there would be to transfer at the state line, if there were a Moscow Transit service
to do that. One problem is that Whitman County does not have any transit authority or enabling
legislation in place. Leaving the city limits puts one in the county where agreements would also
be required. Transit personnel stated that stakeholders would be involved in commenting on the
draft plan and that the League of Women Voters of Pullman would be included in this group of
80
stakeholders (Michael Wagner, Wayne Thompson and Chris Mitchell interviewed by Karen
Kiessling 21 July, 2015). This survey and draft plan appears to be the most promising possibility
for expanding services to those most needing it.
Current fees for service on Dial-A-Ride are 40 cents per one-way trip; the charge to the airport is
$3.00. Fixed route bus service costs 50 cents per ride; for those over 65 it is 30 cents. Point-topoint transfers are free. Leaving the bus for a period requires an additional payment to re-enter.
All Washington State University students, faculty, and staff ride free of charge on presentation of
a WSU identification card. All middle school and high school students who live more than one
mile from the school ride free, and the Pullman School District distributes bus pass cards to those
who meet this criterion.
Other Transportation Information
Greyhound Bus Line will provide free bus tickets to runaways voluntarily returning home and
missing or exploited children as verified by courts or police (Greyhound, 2015).
The Pullman Community Relief Fund, administered by the Community Action Center and
created by the Poverty Awareness Taskforce, provides emergency funds for gasoline and travel
needs on a one-time basis. Approximately 1/3 of its budget was spent on travel costs for persons
needing assistance. In 2014, this included 14 one-way tickets to areas beyond Whitman County,
200 Pullman bus tokens, and three fuel vouchers for a total cost of $2452.
Conclusions
For much of Whitman County, it is clear that a person without a car does not have access to large
grocery stories and vendors of other necessary household supplies.
Affordable transportation was identified as one of the top needs for residents outside of Pullman
in the Health and Social Services Needs in Whitman County 2015 Community Needs
Assessment General Report (Bittinger, 2015).
The creation of the Whitman County Unincorporated Area Transit District in 2009 was an effort
to provide vanpool services to the area. Its implementation would be a vital source of support for
those working to climb out of poverty in Whitman County.
Creating a plan, with Pullman Transit as the hub, which would look at providing transportation
for the region by utilizing the public transit services that exist in several towns, COAST, counties
that are involved, and other entities would be the greatest potential good for all stakeholders.
This is especially true for low-income persons whose critical need for transportation is now
unmet.
81
Information Distribution
Our study shows something of the size and complexity of public and charitable services available
to low-income households in Whitman County. We learned that individuals and organizations
working in these services, as well as individuals and groups with special interest in such services,
try to keep abreast of offerings by others and have good formal and informal information sharing
networks (e.g., Poverty Awareness Task Force). There is, however, a lack of an easily accessed
and up-to-date centralized directory of information about all of the resources available to lowincome households. Providers of one type of service are not often well informed about services
in other topic areas. The system is difficult to navigate for those who are seeking resources, and
for those offering services resulting in gaps in care and inefficiencies in utilization.
For many years there has been available for the Palouse region a number of hard copy directories
that were widely utilized by both individuals seeking services and service providers. For
example, Neill Public Library maintained the People Helper, and the Young Children and
Families collaborative published the widely used Palouse Resource Guide. In 2008, realizing the
need for a more easily maintained directory Project Access converted the Palouse Resource
Guide into a self-sustaining on-line resource with the support of a grant from the federal Human
Resources and Services Administration. At the conclusion of the grant, the Palouse Alliance for
Healthy Individuals, Families, and Communities was asked to locate an agency to host and
maintain the guide. In 2013, the YMCA of the Palouse agreed to take over management of the
website, although there were no resources to support on-going maintenance. The YMCA rebuilt
much of the site to improve ease of use. The original model, which the YMCA is continuing to
use, funds the work by asking entities listed on the site to pay annual subscriptions based the
amount of information on the site. The Palouse Resource Guide appears as a link on the YMCA
of the Palouse website (http://www.palouseymca.org). The searchable site is currently operative,
but the number of resources presented and the information about each is very limited. As of
January 2016, only 15 agencies or organizations are participating in the guide. The intent is to
list entities with few financial resources, such as local food pantries, at no cost, but at this time
they are not listed on the site. The work to maintain site information is done by student interns.
The technological component of this effort is in good condition, but without expanded resources
the effort is unable to be effective and may deteriorate with time (Interview by Mary Collins with
Christine Oakley, Palouse Alliance for Healthy Individuals, Families, and Communities, and
Colleen Hinman and Kayla Iverson, YMCA of the Palouse, January 26, 2016).
82
REFERENCES CITED
ABA
2006 American Bar Association, Resolution 112A (urging right to counsel in cases involving
basic human needs) (Aug. 2006).
2010 American Bar Association, Resolution 104 (Model Access Act) (Aug. 2010).
ACS
2014. American Community Survey Selected Economic Characteristics, Health Insurance
Coverage. Available at:
http://factfinder.census.gov/faces/tableservices/jsf/pages/productview.xhtml?pid=ACS_14_5YR
_DP03&src=pt. Accessed Dec. 21, 2015
2015 Available at http://www.census.gov/programs-surveys/acs/. Accessed 2/15/2016.
Adams, S.
2013, 2014. Pullman Regional Hospital 2013 and 2014 Annual Performance, Assessment, and
Improvement Reports. Available at http://www.pullmanregional.org/sites/default/files/2013PRH-Annual-PI-Report.pdf. Accessed Dec. 16, 2015
American Fact Finder
2015 Poverty Status in the Past 12 Months. Available at
http://factfinder.census.gov/faces/tableservices/jsf/pages/productview.xhtml?pid=ACS_14_5YR
_S1701&prodType=table. Accessed Dec. 19, 2015.
American Fact Finder2
2013 American FactFinder2.census.gov/faces/nav/jsf/pages/index.xhtml), U.S. Census, est.
2009-2013.
ATV
2014 Alternatives to Violence. Available at http://atvp.org/. Accessed 2/15/2016
Benefits of High-Quality Child Care Persist 30 Years Later,
2012 http://research.vtc.vt.edu/news/2012/jan/19/benefits-high-quality-child-care-persist-30years-/.
Bernstein, L.
2014. How many patients should your doctor see each day? The Washington Post. Available at
https://www.washingtonpost.com/news/to-your-health/wp/2014/05/22/how-many-patientsshould-your-doctor-see-each-day. Accessed Dec. 27, 2015.
83
Bishaw, Alemayehu
2013 U. S. CENSUS BUREAU, SOCIAL, ECONOMIC & HOUSING STATISTICS
DIVISION, POVERTY STATISTICS BRANCH. Examining the Effect of Off-Campus College
Students on Poverty Rates SEHSD 2013-17
Bittinger, Katherine
2015 Health and Social Services Needs in Whitman County 2015 Community Needs
Assessment Results – General Report. Community Action Center, Pullman.
Boost
2015 Fast Facts about Boost Collaborative Children and Family Support Services.
2015 Palouse Industries. Available at http://boostcollaborativewa.org/index.html. Acessed
2/13/2016.
Budget writer to helm Early Learning, Moscow-Pullman Daily News, Sep. 1, 2015, p. 3A.
Chetty et al.
2015 The Impacts of Neighborhoods on Intergenerational Mobility Childhood Exposure Effects
and County-Level Estimates. Available at http://www.equality-ofopportunity.org/images/nbhds_exec_summary.pdf. Accessed 2/15/2016.
Childcare Aware of Washington Data Report 2013, http://wa.childcareaware.org/aboutus/data/2013-data-folder/2013-annual-data-report.
Child-care costs on the rise, The Week, Aug. 28, 2015, p. 33.
Child Care Quality, http://www.childcareservices.org/fs/finding/child-care-quality/.
Child Care in Whitman County August 2015, http://www.childcarenet.org/about-us/data/2015data/whitman.
College Bound
2015 Available at http://www.wsac.wa.gov/college-bound Accessed 10/12/2015.
CAC
2014 Community Action Center, Reports of cases referred to Whitman County Legal Services
from September 2010 through August, 2014.
2015 Available at http://www.cacwhitman.com/. Accessed 2/15/2016.
84
CMS RHC
2015. Rural Health Fact Sheet. Available at https://www.cms.gov/Outreach-andEducation/Medicare-Learning-NetworkMLN/MLNProducts/downloads/RuralHlthClinfctsht.pdf. Accessed Dec. 17, 2015.
Coleman, K.
2015. Health Pocket. Medicaid Acceptance by Healthcare Providers Drops to 1-out-of-3.
Available at https://www.healthpocket.com/healthcare-research/infostat/medicaid-acceptancedoctors-health-care-providers-2015#.VnsCafkrLGI. Accessed Dec. 23, 2015.
Community Child Care Center
2013 Annual Report 2012-2013. Pullman, WA.
DeNaves-Walt, Carmen and Bernadette D. Proctor
2015 Current Population Reports U.S.Department of Commerce Economics and Statistics
Administration U.S. CENSUS BUREAU. Income and Poverty in the United States: 2014, U.S.
Government Printing Office, Washington, DC
DSHS Medical Assistance, 2014. Economic Security Administration, Medical Assistance
Briefing Book. Available at https://www.dshs.wa.gov/sites/default/files/ESA/briefingmanual/2014medical_assistance.pdf. Accessed Dec. 20, 2015.
DSHS Medicaid, 2013-14. Medicaid Services-Enrollment Data, Whitman County July 2013June 2014. Available at http://clientdata.rda.dshs.wa.gov/ Accessed July, 2015
Fact Sheet
2015, Helping All Working Families with Young Children Afford Child Care, Jan. 21
Available at https://www.whitehouse.gov/the-press-office/2015/01/21/fact-sheet-helping-allworking-families-young-children-afford-child-care. Accessed 2/15/2016.
Fcc.gov
2015 Available at http://www.freegovernmentcellphones.net/states/washington-governmentcell-phone-providers. Accessed 2/13/2016
Febus, S. 2015. PRH Financial Report for month ending Oct. 31, 2015. Accessed 12/02/2015.
Feeding America
2013 Available at http://www.feedingamerica.org/. Accessed 2/15/2016.
Glynn, S. J.
2015 The Importance of Preschool and Child Care for Working Mothers, Center for American
Progress. Available at
85
https://www.americanprogress.org/issues/education/report/2013/05/08/62519/the-importance-ofpreschool-and-child-care-for-working-mothers/. Accessed Dec. 16, 2015.
Golden, Olivia
2015 Celebrating Head Start at 50: How Lessons from Head Start Can Inform an Agenda for
America’s Poor Children, CLASP, http://www.clasp.org/whats-next.
Greyhound
2015. Available at www.greyhound.com Accessed December 2015.
HealthGrove
2016 http://medicare-usage.healthgrove.com/ . Accessed April 19, 2016.
HHS ACA, 2010. Key Features of the Affordable Care Act by Year. Available at
http://www.hhs.gov/healthcare/facts-and-features/key-features-of-aca-by-year/index.html.
Accessed Dec. 21, 2015.
Jafar v. Webb, 177 Wn. 2d 520, 303 P. 2d 1042 (2013).
Kids Count
2015 Kids Count Data Center. Data tables available at http://datacenter.kidscount.org
Kreidler, M 2011. Washington State Office of the Insurance Commissioner. State of the
uninsured Health coverage in Washington state. Costs, trends and projections 2008 to 2014.
Available at www.insurance.wa.gov. Accessed Dec. 23, 2015.
Lindeblad, M. 2014. As Enrollment soars, Medicaid fee cuts may threaten access in Washington
state. Seattle Times. Dec. 30, 2014. Available at http://www.seattletimes.com/seattle-news/asenrollment-soars-medicaid-fee-cuts-may-threaten-access-in-washington-state. Accessed Dec. 22,
2015.
Medicare, 2015. The Official US Government Site for Medicare. Available at
https://www.medicare.gov/what-medicare-covers/index.html. Accessed Dec. 22, 2015
MHA, 2015. Mental Health America, formerly the National Mental Health Association, Parity or
Disparity: The State of Mental Health in America. Available at
http://www.mentalhealthamerica.net/sites/default/files/Parity%20or%20Disparity%202015%20R
eport.pdf. Accessed Dec. 22, 2015.
NAC
2009 National Alliance of Caregivers Available at
http://www.caregiving.org/data/Caregiving_in_the_US_2009_full_report.pdf. Accessed Dec. 30,
2015.
86
NBER
2015 Available at http://www.nber.org/bah/summer04/w10466.html. Accessed 12/31/2015.
OFM
2016 http://www.ofm.wa.gov/trends/social/fig201.asp. Accessed 4/20/2016
Office of Family Assistance
2016 http://www.acf.hhs.gov/programs/ofa/resource/2011-recipient-tan Accessed 4/21/2016
Office of Management and Budget
2015 FACT SHEET: Middle Class Economics: The President’s Fiscal Year 2016 Budget.
Available at https://www.whitehouse.gov/blog/2015/02/02/fact-sheet-middle-class-economicspresident-s-fiscal-year-2016-budget. Accessed Dec. 16, 2015.
OSPI
2015 Office of the Superintendent of Public Instruction. Available at http://www.k12.wa.us/.
Accessed 2/13/2016.
2015 Report Card. Available at
http://reportcard.ospi.k12.wa.us/summary.aspx?groupLevel=District&schoolId=1&reportLevel=
State&year=2014-15. Accessed 11/2/15
Palouse YMCA
2015 Available at http://www.palouseymca.org/. Accessed 2/15/2016.
Patterson DG, Andrilla CHA, Skillman SM, Hanscom J. 2014. The impact of Medicaid primary
care payment increases in Washington state. Seattle, WA: WWAMI Center for Health
Workforce Studies, University of Washington. Dec., 2014. Available at
https://depts.washington.edu/fammed/chws/publications/the-impact-of-medicaid-primary-carepayment-increases-in-washington-state. Accessed Dec. 22, 2015.
PHH
2015 Palouse Habitat for Humanity Available at http://palousehabitat.org/. Accessed 2/15/2016
Phillips, Robin
2015 Press Release, National Rural Transit Assistance Program, July 2015.
PRH, 2015. Pullman Regional Hospital website. Available at http://www.pullmanregional.org.
Accessed Dec. 16, 2015.
Remberger, Russell W. PhD
2013 Poverty and High School Dropouts: The Impact of Family and Community Poverty on
High School Dropouts. Graduation and Dropout Statistics Annual Report April 2015 Assessment
and Student Information Robin G. Munson, Ph.D., Assistant Superintendent. Available at
http://www.apa.org/pi/ses/resources/indicator/2013/05/poverty-dropouts.aspx. Accessed
2/13/2016
87
RTPO
2014. Human Services Transportation Coordination Plan for the Palouse ({RTPO) Regional
Transportation Planning Organization, Final Report, November 2014, p.3 – 7. Available at
www.wsdot.wa.gov/plan. Accessed December 2015.
2015 (Palouse Regional Transportation Planning Organization 2015). Clarkston, WA 99403,
Available at http:// www.seweda.org/ . Accessed December 2015.
RWJF,
2012. 2015 County Health Rankings, Washington. Available at
http://www.countyhealthrankings.org/app/washington/2015/rankings/whitman/county/outcomes/
overall/snapshot. Accessed Dec. 20, 2015.
Second Harvest
2015 Accountability Report. Available at http://www.2-harvest.org/accountability/. Accessed
2/15/2016
Skillman, S., Fordyce, M., Yen, W., Mounty, T.
2012 Washington State Primary Care Provider Survey, 2011-2012: Summary of Findings
August 2012. University of Washington School of Medicine Department of Family Medicine.
Available at http://depts.washington.edu/uwrhrc/uploads/OFM_Report_Skillman.pdf. Accessed
Dec. 29, 2015.
Snyder, L., Paradise, J., Rudowitz, R.
2014, The ACA Primary Care Increase: State Plans for SFY 2015, Oct 28, 2014. Available at
http://kff.org/medicaid/perspective/the-aca-primary-care-increase-state-plans-for-sfy-2015.
Accessed Dec. 23, 2015.
Society for Research in Child Development
2010 "High-quality child care for low-income children: Long-term benefits." ScienceDaily. 15
September 2010. www.sciencedaily.com/releases/2010/09/100915080433.htm.
TBRA
2013 Program Guidelines. Available at
http://www.commerce.wa.gov/Programs/housing/Homeless/Pages/TenantBasedRentalAssistance
.aspx. Accessed 2/15/2016
Tweedy, Douglas
2015 Whitman County Profile. Employment Security Department Washington State. Available
at https://esd.wa.gov/labormarketinfo/county-profiles/whitman. Accessed 2/10/2016
U.S. Census
2016 Whitman County Washington Quick Facts. Available at
http://quickfacts.census.gov/qfd/states/53/53075.html. Accessed 2/10/2016.
88
USDA CNPP
2015 Center for Nutrition Policy and Promotion. Available at http://www.cnpp.usda.gov/.
Accessed 12/8/15
USDA, CSFP
2015 Commodity Supplemental Food Program. Available at
http://www.fns.usda.gov/csfp/commodity-supplemental-food-program-csfp. Accessed
2/15/2016.
USDA ERS
2015 Available at http://ers.usda.gov/. Accessed 2/15/2016.
USDA Food Atlas
2016 http://www.ers.usda.gov/data-products/food-access-research-atlas/go-to-the-atlas.aspx .
Accessed 4/18/2016.
USDA,NSLP
2015 http://www.fns.usda.gov/nslp/national-school-lunch-program-nslp. Accessed 10/29/2015
USDA, SNAP
2015 Available at http://www.fns.usda.gov/snap/supplemental-nutrition-assistance-programsnap. Accessed 2/15/2016
USDA WIC
2015 Supplemental Program for Women, Infants, and Children. Available at
http://www.fns.usda.gov/wic/women-infants-and-children-wic. Accessed 10/29/15
Ver Ploeg ,M., Breneman, V., Dutko, P. Williams, R. Snyder, S. Dicken, and Kaufman, P.
2012. Access to Affordable and Nutritious Food: Updated Estimates of Distance to
Supermarkets Using 2010 Data. Economic Research Service Report No. 143. Available at
http://www.ers.usda.gov/media/956784/err143.pdf. Accessed Dec. 10, 2015.
WAC 246-100, 2015. Public Health Mandated Services. Available at
http://apps.leg.wa.gov/wac/default.aspx?cite=246. Accessed Dec. 17, 2015.
WAHBE, 2015. Washington Health Benefit Exchange powering Washington Healthplanfinder.
Available at https://www.wahbexchange.org/ Accessed Dec. 22, 2015.
WA State Auditor’s Office
2015 WHMC Financial Statements Audit Report, Whitman Hospital and Medical
Center, for the period January 1, 2013 through December 31, 2014, Published August 27, 2015.
Accessed Nov. 12, 2015.
WSDOC
89
2014 Homelessness in Washington State Report 2014. Available at
http://www.commerce.wa.gov/Programs/housing/Homeless/Pages/default.aspx. Accessed
2/15/2016.
2015 Housing Needs Assessment Available at
http://www.commerce.wa.gov/commissions/AffordableHousingAdvisoryBoard/AffordableHousing-Needs-Study/Pages/default.aspx. Accessed 2/15/2016.
Washington State Department of Early Learning
2007 Child Care Subsidies: A Booklet for Licensed and Certified Child Care Providers.
Available at http://ccrr.wsu.edu/media/78921/22-877.pdf. Accessed 2/13/2016.
2016 Currently there is no wait list for Working Connections Available at
http://www.del.wa.gov/care/help/wait.aspx. Accessed 2/13/2016.
2016 State Child Care Assistance and Subsidy Information. Available at
http://www.del.wa.gov/publications/subsidy/ . Accessed 2/13/2016
WSDH
2011-13, BRFSS Whitman County Chronic Disease Profile, Health Risk Indicators, Preventive
Care. Available at http://www.doh.wa.gov/portals/1/Documents/Pubs/345-271ChronicDiseaseProfileWhitman.pdf Accessed July, 2015
2011 Whitman County Health Indicators: Indicator Definitions and Measurement Criteria,
2011. Available at http://www.doh.wa.gov/Portals/1/Documents/1200/LPHI-TechNotes.pdf.
Accessed Dec. 16, 2015.
2012 Maternal and Child Health Assessment Report. Available at
http://www.whitmancounty.org/pdf.aspx?pdfid=301 Accessed Sept., 2014.
2013. Primary Care Provider Survey, Health care access data, Whitman County. Available at
http://www.doh.wa.gov/Portals/1/Documents/Pubs/689059.pdf Accessed July 2015.
2013 Social and Economic Determinants of Health, updated 05/14/2013. Available at
www.doh.wa.gov/Portals/1/Documents/5500/Context-SED2013.pdf. Accessed Dec. 16, 2015.
2015 CAH Rural Health/Critical Access Hospitals. Available at
http://www.doh.wa.gov/ForPublicHealthandHealthcareProviders/RuralHealth/HealthcareFacility
Resources/CriticalAccessHospitals. Accessed July, 2015.
2015 Consolidated Contracts, 2015 – 17. Available at
http://www.doh.wa.gov/ForPublicHealthandHealthcareProviders/PublicHealthSystemResourcesa
ndServices/Funding/ConsolidatedContracts. Accessed Dec. 17, 2015.
90
2015 HPSA Rural Health/Data and Other Resources/Health Professional Shortage Areas.
Available at http://www.doh.wa.gov/hsqa/ocrh. Accessed Dec. 16, 2015.
WA Health Care Authority ABCD,
2015. ABCD Utilization in Whitman County. Available at
http://www.hca.wa.gov/medicaid/dentalproviders/pages/dental_data.aspx. Accessed Dec. 17,
2015
Washington State Department of Social and Health Services
2016 The Child Care Subsidy Programs, Available at
http://www.dshs.wa.gov/onlinecso/wccc.shtml. Accessed 2/13/2016.
WSOFM
2015. Office of Financial Management>Population Division. Available at
http://www.ofm.wa.gov> population. Accessed Dec 2015.
Washington State Office of Public Defense.
2014 Status Report on Public Defense in Washington State. April 2015, p. 47.
WDSF
2015 ABCD Access to Baby and Child Dentistry. Available at http://abcd-dental.org/.
Accessed Dec. 17, 2015.
2015 SM SmileMobile. Available at
https://www.deltadentalwa.com/guest/public/aboutus/wds-foundation/smilemobile.aspx.
Accessed Dec. 17, 2015.
WHMC
2015. Whitman Hospital and Medical Center website. Available at www.whitmanhospital.com.
Accessed Dec. 16, 2015.
WorkFirst
2016 Available at http://www.workfirst.wa.gov/ . Accessed 1/19/16.
WSHSTP
2015 Washington Statewide Human Services Transportation Plan/Transpogroup. Available at
www.wsdot.wa.gov/st. Accessed December, 2015.
Transit Development Plan 2013 – 2018 and 2012 Annual Report. City of Pullman/Pullman
Transit. Date of Public Hearing: October 15, 2013. Available at www.pullman-wa.gov/transit .
WSU
2016 Quick Facts. Available at https://wsu.edu/about/facts/. Accessed 2/10/2016.
WSUCCE
91
2016 Center for Civic Engagement. Available at http://cce.wsu.edu/programs/palouse-foodproject/. Accessed 3/8/2016.
WSUSESRC
2015 Washington State University Social & Economic Sciences Research Center. Washington
State Supreme Court Civil Legal Needs Study Update. June 2015.
Zuckerman, S., 2014. As Enrollment soars, Medicaid fee cuts may threaten access in Washington
state. Seattle Times. Dec. 30, 2014. Available at http://www.seattletimes.com/seattle-news/asenrollment-soars-medicaid-fee-cuts-may-threaten-access-in-washington-state. Accessed Dec. 22,
2015.
92
Appendix 1: Record of Interviews
LWV Poverty Study
Record of Interviews
Contact individual
Address
Interviewers
Date
Albion Food Pantry
Starr Cathey
310 F St Albion, WA
99102
Mary Collins/George
Kennedy
3/26/2015
Colfax Food Pantry
Paige Collins
S 213 Main St Colfax
WA 99111
203 S Montgomery
St., Uniontown WA
99179
George Kennedy/Bertie
Weddell
4/2/2015
Mary Colins
Mailed response
101 Banta St.,
Endicott, WA 99125
Mary Collins
Mailed response
FOOD SECURITY
Endicott Food Pantry
Debbie Niehenke
David
Gilman/Jenny
Meyer
Garfield Food Pantry
Penny Martinez
211 East Main
Garfiled, WA
Mary Collins
Telephone
6/15/2015
Malden Food Pantry
Herb Bacon
11 Ash St, Malden,
WA 99149
Mary Collins/Ryan Lazo
6/9/2015
Charlotte Snekvik
230 E Main, Palouse,
WA 99161
Mary Collins/Bertie Weddell
4/21/2015
George Kennedy
3/14/2015
Ryan Lazo/Bertie Weddell
3/24/2015
Ryan Lazo/Bertie Weddell
3/24/2015
Colton-Uniontown Food Pantry
Palouse Food Pantry
Annette Syms,
Debbie Thompson
350 Fairmont Road
Pullman, WA 99163
108 NW Stadium
Way Pullman, WA
99163
St. John Food Pantry
Joan Corder
5 West Broadway St.
John, WA 99171
Tekoa Food Pantry
Fran Sauer
419 N Washington St,
Tekoa, WA 99033
Bertie Weddell/George
Kennedy
6/8/2015
Council on Aging and Human
Services/meals on wheels
Paige Collins
210 S Main Colfax,
WA 99111
Mary Collins/Suzanne Poole
7/10/2015
SNAP (DSHS)
Jane Roberts
418 South Main
Colfax, WA 99111
Mary Collins/Karen Kiessling
9/28/2015
WIC/Whitman Cty Public Health
Troy Henderson
310 N Main Colfax,
WA 99111
Mary Collins/Karen Kiessling
8/23/2015
Backyard Harvest
Chris Cummings
PO Box 9783
Moscow, ID 83843
Mary Collins
9/25/2015
Community Gardens/CAC
Joseph Astorino
Mary Collins
1/6/2016
Ryan Lazo/Ashley
Hope
Mary Collins
9/4/2015
Mary Collins
email response
1/4/16
CAC Community Food Bank
Pullman Child Welfare
Palouse Fresh Foods Project/WSU
CCE
Palouse Cares
Jeff Tietjen
Rick Minard
HOUSING
93
Poverty Awareness Taskforce/
Community Relief Fund
CAC Crises Rental Assistance
Jeff Tietjen
Family Promise of the Palouse
Ann Smith
Lindsey
Rinehart/Katti
Carlson
Alternatives to Violence of the
Palouse
Christine Wall
350 SE Fairmont
Pullman, WA 99163
Mary Collins/Martin Beuhler
6/30/2015
350 SE Fairmont
Pullman, WA 99163
Mary Collins/Martin Beuhler
4/29/2015
PO Box 9389
Moscow, ID 83843
Mary Collins/Martin Beuhler
2/26/2015
Mary Collins
3/5/2015
Tenant Based Rental Assistance
(TBRA)
Jeff Tietjen
350 SE Fairmont
Pullman, WA 99163
Mary Collins/Martin Beuhler
6/30/2015
Temporary Housing Operating
and Rent (THOR)
Jeff Tietjen
350 SE Fairmont
Pullman, WA 99163
Mary Collins/Martin Beuhler
6/30/2015
Shannon Gaines
350 SE Fairmont
Pullman, WA 99163
Mary Collins/Martin Beuhler
4/29/2015
Ann Smith
350 SE Fairmont
Pullman, WA 99163
Mary Collins/Martin Beuhler
4/29/2015
Palouse Habitat for Humanity
Jennifer Wallace
PO Box 3054
Moscow, ID 83843
Mary Collins
6/2/2015
Section 8 Rental Opportunity
Program (ROP)
Liz Corfetti
350 SE Fairmont
Pullman, WA 99163
Mary Collins/Martin Beuhler
1/29/2015
CAC Rental properties
CAC Self Help
LEGAL SERVICES/LAW
ENFORCEMENT
207 E Main
Pullman WA
Steve Martonick
Chris Tennant
260 SE Kamiaken
Pullman, WA 99163
Lenna Harding/JaneVonFrank
2/4/2015
Hansen
PO Box 647300
Pullman WA 99164
Lenna Harding/Karen
Kiessling
3/26/2015
Whitman Cty Sheriff
Ron Rockness
411 N Mill St.
Colfax, WA 99111
Lenna Harding/Karen Baron
Pullman Fire Dept
Mike Heston
620 S. Grand
Pullman, WA 99163
Lenna Harding/Judy Stone
3/10/2015
Chapliancy Fund
Ron McMurray
Lenna Harding
email 6/13/15
Lenna Harding/Karen
Kiesling
8/14/15
Pullman Police Dept
WSU Police Dept
Fire District 12
Lester Erwin
410 SW Walnut
Pullman, WA 99163
Pullman Regional Hospital Social
Services
Katie Druffel
835 SW Bishop Blvd,
Pullman, WA 99163
Alternatives to Violence of the
Palouse
Whitman Hospital
Gene Siple
Tessa Schull
Kathleen Haley
CHILDCARE
Boost Collaborative
Sue Kreikemeier
115 NW State St.
Suite 105 Pullman,
WA 99163
Pullman Christian Child Care
Cassi Fitzgerald
345 SW Kimball
Pullman, WA 99163
94
George Kennedy/Judy Meuth
5/4/2015
George Kennedy/Judy Meuth
5/26/2015
Montessori School of Pullman
Beverley Wolff
115 NW State St
Pullman, WA 99163
George Kennedy/Judy Meuth
5/6/2015
YMCA at WSU, Franklin, and
Sunnyside
Colleen Hinman,
(asst Lisa Lopez)
5 NE Spring St.
Pullman, WA 99163
George Kennedy/Judy Meuth
4/24/2015
Community Child Care Ctr
Greyhound Way
Mary McDonald
530 Greyhound Way
Pullman, WA 99163
George Kennedy/Judy Meuth
3/11/2015
Community Child Care Ctr St James
Mary McDonald
1410 Stadium Way
Pullman, WA 99163
George Kennedy/Judy Meuth
3/11/2015
Parveens Playhouse Child Care Ctr
Prveen Kazimee
George Kennedy/Judy Meuth
6/10/2015
Sunnyside Preschool and Child Care
Ctr
April Mangiantini
425 S Grand Ave
Pullman, WA
110 SW Wawawai
Rd Pullman, WA
99163
George Kennedy/Judy Meuth
4/10/15
Rose Jackson
1425 Olympia Ave
Pullman, WA 99164
George Kennedy/Judy Meuth
6/1/2015
George Kennedy/Judy Meuth
6/4/2015
George Kennedy/Judy Meuth
5/28/2015
George Kennedy/Judy Meuth
5/13/2015
WSU Childcare
Building Blocks Childcare Center
Foot Prints Child Care Ctr
Jackie Eveland
Community
Childcare
214 S Whitman
Rosalia, WA 99170
210 W Pearl St
Oakesdale, WA
99158
Seedlings Child Care Ctr
Community
Childcare
Community
Childcare
201 W Union
Garfiled, WA 99130
George Kennedy/Judy Meuth
7/10/2015
Community Child Care Ctr
Community
Childcare
1207 N Morton
Colfax, WA 99111
George Kennedy/Judy Meuth
3/11/2015
Oakesdale School Childhood Ctr
Heather Gouge
6/15/2015
455 NW Irivng
Pullman, WA 99163
Angela Keeton
8/13/2015
Jenny's Play House
6/29/2015
Endicott School District Preschool
Tara Huntley
Garfield School District Preschool
Luanne Deerkop
St. John School District Preschool
Amy Watt
Palouse School District Preschool
Brittany Sawyer
Rosalia School District Preschool
Marita Bothman
Tekoa School District Preschool
Kayla Burtchett
Comunity Childcare
Department of Early Learning
Brenda Kane
Judy Meuth
email
12/21/2015
Matt Judge
Judy Meuth
email
12/14/2015
Mary Collins/Suzanne Polle
7/10/2015
ELDERCARE
Council on Aging and Human
Services\COAST, Sr. Nutrition
PO Box 107 Colfax,
WA 99111
95
Rural
Resources\COPES/MPC/Kinship/Info
and Assistancr/General Case
Mgt./Caregiver support
Naomi CalkinsGolter
1615 NE Eastgate
Suite G 4EA Pullman
Circles of Caring Adult Day Health
Lucy Linden and Suzanne
Polle
12/3/2015
Naomi Golter and Suzanne
Polle
8/28/15
Lucy Linden/Karen Kiessling
12/3/15
Mary Collins
email and
telephone
12/15,1/16
1615 NE Eastgate
Suite G 4EA Pullman
1615 NE Eastgate
Suite G 4EA Pullman
Melissa Johnson
Home Health
Pullman Council on Aging/Meals on
Wheels/chore service/guide to Sr.
services
5/11/15
1615 NE Eastgate
Suite G 4EA Pullman
Roberta Rutherford
Andree MarcusRader
Friends of Hospice
BJ Carlson and Muriel
Jordan
Annie Pillers
Scott Fowler/Nancy
Backes
Hollie Mooney 588
Bishop Blvd. Suite D
Pullman
PO Box 1123
Pullman, WA 99163
EDUCATION/WORK TRAINING
OPPORTUNITIES
BOOST/Palouse Industries
NE 1235 Professional
Mall Blvd Pullman,
WA
Eric Hoyle
SFCC
Sally Jackson
SFCC
Dyan Bledsoe
WA Student Achievement
Council/College Bound
Beth Ahlstrom
Rural Resources
Morgan Smith
917 Lakeridge Way
SW Olympia, WA
98502
1207 Morton St.
Colfax, WA 99111
706 Union St. Colton,
WA 99113
111 Hill Ave
LaCrosse, WA 99143
Colfax School District
Colton School District
Nathan Smith
LaCrosse School District
Oakesdale School District
PO Box 228
Oakesdale, WA
99158
600 E Alder Palouse,
WA 99161
Jake Dingman
Palouse School District
Palouse School District
Tim Coles
Pullman School District
Paul Sturm
240 SE Dexter
Pullman, WA 99163
96
Janet Kendall/Elizabeth
Walker
Paul Spencer
Elizabeth Walker
Paul Spencer
Elizabeth Walker/Paul
Spencer
2015
email
10/29/2015
telephone
10/2015
email 6/26/2015
6/23/2015
Elizabeth Walker/Paul
Spencer
6/23/2015
Elizabeth Walker/Paul
Spencer
2/10/2015
Pullman School District
Bob Maxwell
Rosalia School District
240 SE Dexter
Pullman, WA 99163
Elizabeth Walker/Paul
Spencer
2/10/2015
916 Josephine
Rosalia, WA 99170
Elizabeth Walker/Paul
Spencer
2/10/2015
Paul Spencer
email 8/19/2015
Paul Spencer/Susan Daniels
7/2/2015
St. John-Endicott School District
Tekoa School District
PO Box 869 Tekoa,
WA 99033
Connie Kliewer
Pullman HS
Joe Thornton
Pullman HS
Kelly Glaze
510 Greyhound Way
Pullman, WA 99163
Libby Walker/Paul
Spencer
Libby Walker/Paul
Spencer
2/10/2015
2/10/2015
TRANSPORTATION
Dial-A-Ride/Pullman Transit
Michael Wagner
775 NW Guy
Pullman, WA 99163
Paul Spencer/Karen Kiessling
COAST
Suzanna Seigneur
PO Box 107 Colfax,
WA 99111
Paul Spencer/Karen Kiessling
Rick Koontz
3102 E Trent Ave
Spokane, WA 99202
Paul Spencer/Karen Kiessling
Adrienne Maxwell,
Dietician
WCHD, 1250
ProMall Blvd.,
Ste 203, Pullman
Judy Stone
9/3/2015
Lori Orr, Off. Mgr.
Theresa Kwate and
Dena Nunamaker
1205 SE Pro Mall
Blvd, #102
825 SE Bishop
Blvd, Ste. 200
Judy Stone
12/1/2015
Ginger/Daniels
9/9/2015
835 SE Bishop
Blvd, Ste 140
235 E. Main,
Palouse, 99161
Ginger Glawe/Karen
Kiessling
6/8/2015
Palouse Health Center
Sharon Hall,
Executive Director
Suzanne Schorzman,
ARNP
Judy Stone/Mary Collins
9/16/2015
Palouse Pediatrics
Karly Port, Off. Mgr.
1205 SE Pro Mall
Blvd, #104
Judy Stone
21/1/2015
Theresa Kwate and
Dena Nunamaker
825 Bishop Blvd,
Ste 200
Ginger Glawe
9/9/2015
340 NE Maple
Ginger Glawe
Oct-14
1525 SE King
Drive
Ginger Glawe/Karen
Kiessling
5/22/2015
1205 SE ProMall
Blvd, Ste 202
Judy Stone
10/20/2015
6/17/2015
Special Mobility Services
5/12/2015
HEALTHCARE
ABCD Program (Access to Baby &
Child Dentistry)
Moscow-Pullman
OB/GYN
Palouse Medical
Palouse Free Clinic
Pullman Ready Care
Planned Parenthood
Ronda Allenger, MH
Dir.
Director of
Community
Outreach - name
withheld
Pullman Dental Care
Rylee Dustin,
Off.Mgr.
Palouse River Counseling
Pullman Family Medicine
Shannon Hatley, RN
915 NE Valley Rd.
Ginger Glawe/Susan
Daniels
Pullman Fire Dept., EMS
Mike Heston, Chief
620 S. Grand Ave
Stone/Harding
3/9/2015
Pullman Regional Hospital
Jeannie Eylar, CCO
and Steve Febus,
835 SE Bishop
Blvd
Judy Stone/Karen
Kiessling
7/16/2015
97
CFO
Rockwood Inland
Eye Center (ophth)
Dr. Haymore and
Stephanie Vantine
1170 W. Fairview,
Colfax, 99111
Judy Stone
8/31/2015
Rolling Hills Eyecare
Paulette Lowery
1045 N. Grand
Ave, Ste E
Judy Stone
9/28/2015
Safeway Pharmacy
Carlene Emerson,
Pharmacist
430 SE Bishop
Blvd.
Ginger Glawe
8/10/2015
Tanya Reid, OD
Adrienne Maxwell,
Dietician
1450 S. Grand Ave
WCHD, 1250
ProMall Blvd.,
Ste 203, Pullman
Ginger Glawe/Susan
Daniels
Judy Stone
8/29/2015
9/3/2015
Whitman County Department of
Public Health
Troy Henderson,
Director
310 N. Main,
Colfax, 99111
Mary Collins/Karen
Kiessling
8/3/2015
Whitman Medical Group
Jen Broeckel, Off.
Mgr.
1210 W. Fairview,
Colfax, 99111
Judy Stone/Mary Collins
11/3/2015
WSU Psychology Clinic
Brian Sharpless,
Ph.D., Dir.
Ginger Glawe
3/5/2015
Palouse Alliance
Mary Collins
1/26/2016
Kayla Iverson
YMCA
Mary Collins
1/26/2016
Colleen Hinman
YMCA
Mary Collins
1/26/2016
Shopko Optometry
SmileMobile
Others
Christine Oakley
98
Appendix 2: Childcare Information
Table 1A
Child Care Costs 2014-2015 in Whitman County, WA in dollars per month, unless otherwise noted1
Child Care Providers
2
Infant
1 m—1y
Toddler
1
1y - 3y
Child Care and/or
Preschool 3 y-5y
Before/After School;
Drop In
Evening
Summer,
School District
6y-12y
Preschool
Centers
Pullman
Range
722-1,130 FT
679-1,085 FT
640-1,000 FT
330-480 Before/After
5-9/h
460-705 PT
425-680 PT
375-655 PT
18/h Evening
20-60/d
971 FT
910 FT
820 FT
388 Before/After
6.66/h
607 PT
566 PT
512 PT
650-705 FT
505-525 FT
485-665 FT
400 PT
300 PT
275-390 PT
678 FT
515 FT
545 FT
400 PT
300 PT
333 PT
Range
575-650 FT
510-650 FT
Average
613 FT
Range
(8 centers)
Average
Outside Pullman (4
centers and 6
school district
preschools)
Range
Average
410-940
795
36/d
250-252 Before/After
5-8/h
350-465
100-150 PT
251 Before/After
6.25/h
398
510-600 FT
410 Before/After
4.50-10/h
410
580 FT
555 FT
410 Before/After
7.50/h
30/d FT
30/d FT
30/d FT
20/d PT
20/d PT
20/d PT
Home Providers
Pullman
(2 providers)
Outside Pullman (1
provider)
Average
121 PT
1
Among providers, there is not a standard categorization by age or type of care. For that reason, the numbers represented here sometimes represent collapsed
categories from particular providers or other adjustments made in an attempt to provide a coherent estimation of costs. FT = Full Time, PT = Part Time, m =
month, y = year, w = week, d = day, h = hour. Where Washington State University Children’s Center (WSUCC) categories fit into the table categories, ‘Ranges’ in
Pullman include WSU student rates at WSUCC; those rates are significantly subsidized by WSU and grant programs.
Some providers do not have stated ‘Part Time’ fees; one provider does not have stated ‘Full Time’ or ‘Part Time’ fees. These providers charge by the hour or
day. See the column headed Drop In for information on these fees. Before/After School data includes providers who offer both Before and After School care.
Some providers offer only Before or After School care and some provide neither or charge by the hour. See the column headed Drop In for information on
these fees.
2
Not all providers agreed to be interviewed and not all responded to requests for interviews. Valid contact information for three home providers listed by
ChildcareCenter.us for Whitman County could not be found. One center and six home providers were not interviewed, so no information on them is included in
this table.
Table 2A
Subsidized and No Cost Child Care in Whitman County
Providers Participating in
1
LWV Survey
Number of providers with
Number of providers with
WA State Support
Federal Support
Working
Connections
2
Program
ECEAP
8
1
3
Provider
Subsidies
3
Special
Needs (WA
& U.S.)
Early Head
3
Start
Head Start
USDA Food Subsidies
2
1
1
1
1
1
1
1
1
1
1
1
(1 meal, 2 snacks)
CCAMPIS grant available
to WSU students
Provideroffered
Subsidies
Centers, School District
3
Preschools (SDP)
Pullman
4
3
8
Total = 8 centers
Colfax
Total = 1 center
Endicott/St. John
Total = 2 SDP
100
Garfield/ Palouse
1
1
1
1
1
Total = 1 center, 2 SDP
Oakesdale
1
1
Total = 1 center/SDP
Rosalia
1
1
1
2
1
1
1
Total = 1 center, 1 SDP
Tekoa
Total = 1 SDP
Home Child Care
Pullman
2
2
2
Total = 2 providers
Tekoa
1
Total = 1 provider
1
One Pullman center declined to participate in the LWV survey; four home child care providers in Pullman and one in Colfax did not participate in the survey. As
a result, this table does not include information from those providers.
2
Additionally, an estimate of 12 children in 2015 also used DEL’s Working Connections Program subsidies for children receiving care in their own home by a
non-relative or by a relative in that person’s home.
3
All Whitman County sites with ECEAP, Early Head Start, and Head Start are administered by Community Child Care Center (CCCC), the Whitman County
contractor for these programs. Outside Pullman, CCCC contracts with school districts to provide ECEAP in their preschools. School Districts also offer preschool
services to tuition-paying children; in unusual circumstances, the districts offer some subsidies to these children.
Sources: LWV interviews with child care providers, 2015; Matt Judge, DEL, email communication to Judy Meuth, Nov. 19, 2015.
101
Table 3A
Eligibility for Free or Subsidized Child Care, Whitman County, WA
Program
Age
Income
Other Factors
Head Start
Head Start - 4 years by
Aug. 31 prioritized,
accept 3 year- olds by
Aug. 31 when space is
available.
At least 90 % of enrolled families must be at or below 130 % of
the FPL. Priority given to families at or below 100 % the FPL;
If space is available, children in the
following circumstances are accepted.
maximum 35 % can be 100 -130 % of the FPL. Up to 10% of
children can be from families who are above the income limits.
They are accepted because of
In foster care or involved with
the child welfare system.
Homeless.
Programs
Early Head Start pregnant women,
infants, and toddlers.
Early Childhood
Education and
Assistance
Program (ECEAP)
4 years by Aug. 31
prioritized, accept 3
year- olds by Aug. 31
when space is
available
Developmental factors, such as developmental delay,
disability, or other special needs, or
Environmental factors, such as family violence, chemical
dependency, child protective services involvement or
incarcerated parents
Families at or below 110 % of the FPL. Up to 10% of children can
be from families who are above the income limits. They are
accepted because of
Developmental factors, such as developmental delay,
disability, or other special needs, or
If space is available, children in the
following circumstances are accepted:
In foster care or involved with
the child welfare system.
Homeless
Environmental factors, such as family violence, chemical
dependency, child protective services involvement or
incarcerated parents
Working
Connections Child
Care (WCCC)
Infant through school
age (to age 19 if
child has special
needs)
Assistance is based on household income and family size.
See Copay Calculation Table below this table for
Families qualifying for WCCC who have a special needs
child can apply for special needs higher rate to help pay for
care.
102
Adults in family are working or are
participating in an approved work
activity and children meet
citizenship requirements
Washington State Department of Early Learning, Child Care Subsidies, A Booklet for Licensed and Certified Child Care Providers,
http://www.wsu.edu/CCRR/images/22-877.pdf
Washington State Department of Early Learning, Homeless Child Care, http://www.del.wa.gov/care/help/homeless.aspx
Washington State Department of Early Learning, State Child Care Assistance and Subsidy Information, http://www.del.wa.gov/publications/subsidy/
Washington State Department of Early Learning, Who is eligible? http://www.del.wa.gov/care/find-hs-eceap/eligible.aspx
103
Head Start, Early Head Start, ECEAP and Working Connections Child Care Program
Head Start
Head Start is a federal program of education and care for low income children and their
families; it is free to the families who are at or below 130% of the FPL. The Head Start grantee
and its subcontractors “deliver a range of services, responsive and appropriate to each child's
and each family's heritage and experience, that encompass all aspects of a child's development
and learning” (Washington Department of Early Learning, http://www.del.wa.gov/care/find-hseceap/difference.aspx).
Head Start focuses on both the education and overall wellbeing of the child and family.
Preschool education programming is aimed at building strong school readiness skills and “social
and emotional stability” (http://www.community-childcare.org/Headstart_new.html). The
Whitman County Head Start grantee, Community Child Care Center, offers Head Start in
in Pullman; it is not available outside Pullman (http://www.communitychildcare.org/Headstart_new.html).
Early Head Start
Early Head Start (EHS) is a federally funded program for low-income families with infants,
toddlers and pregnant women and provides a range of services and programs for children and
their families, who must be at or below 130% of the FPL. There is no cost to the families or
children for participation in Early Head Start.
Early Head Start provides prenatal services to pregnant women and family and child support
services to promote the healthy development of infants and toddlers and healthy, functioning
families. EHS is available only in Pullman, offered by Community Child Care Center
(http://www.community-childcare.org/Early%20Head%20Start.html).
Early Childhood Education and Assistance Program (ECEAP)
Early Childhood Education and Assistance Program is very similar in goals and services to Head
Start. However, ECEAP is funded by Washington State (Washington Department of Early
Learning, 2015). ECEAP serves families who are at or below 110% of the FPL.
The Whitman County ECEAP Grantee, Community Child Care Center, offers programs
in Pullman, Endicott, Garfield, Palouse, Rosalia, St. John, and Tekoa (http://www.communitychildcare.org/ECEAP_New.html).
Working Connections Child Care
Washington State offers subsidies through the Working Connections Child Care program for
childcare to families with incomes up to 200% of the FPL. The subsidies and co-pays are scaled
by income and number of people in the family (Washington State Department of Social and
Health Services, The Child Care Subsidy Programs, 2015).
Working Connections subsidizes care in licensed or certified child care centers and home
provider facilities and by relatives in their home or non-relatives in the child’s home
(Washington State Department of Social and Health Services, The Child Care Subsidy Programs,
http://www.dshs.wa.gov/onlinecso/wccc.shtml). Currently there is no wait list for Working
Connections (http://www.del.wa.gov/care/help/wait.aspx).
105

Similar documents

×

Report this document