LCHS Community Assessment 2012 2013

2012-2013 Community Assessment

Submitted to:

Suzanne Miller, PhD
Director

On behalf of:

Head Start of Lincoln County, Oregon
(A Program of Community Services Consortium)

Provided by:

Joann Zimmer, MPAE

Community Assessment 2012-2013

TABLE OF CONTENTS
1.0 Summary .........................................................................................................................1
1.1 Executive ......................................................................................................................... 1
1.2 Data ................................................................................................................................. 2
1.2.1 Basic Needs Services ........................................................................................... 2
1.2.2 Employment ........................................................................................................ 2
1.2.3 Housing ............................................................................................................... 2
1.2.4 Childcare ............................................................................................................. 3
1.2.5 Transportation ..................................................................................................... 3
1.2.6 Health ................................................................................................................. 3
1.2.7 Education ............................................................................................................ 3
2.0 Community Assessment .................................................................................................4
2.1 Purpose and Scope of Project ........................................................................................... 4
2.2 Methodology.................................................................................................................... 4
3.0 Head Start .......................................................................................................................5
3.1 What is Head Start? ......................................................................................................... 5
3.1.1 Major Components .............................................................................................. 5
3.2 Grantee Description ......................................................................................................... 6
3.2.1 Lincoln County Need........................................................................................... 8
4.0 Geographic Area.............................................................................................................9
4.1 Oregon Poverty Overview ................................................................................................ 9
4.1.1 Basic Family Budget ........................................................................................... 9
4.1.2 Living Wage...................................................................................................... 10
4.2 Lincoln County .............................................................................................................. 10
4.2.1. Population ......................................................................................................... 10
4.2.1.1 Race and Ethnicity .............................................................................. 11
4.2.2 Poverty .............................................................................................................. 12
4.2.3 Food .................................................................................................................. 13
4.2.4 Employment ...................................................................................................... 14
4.2.5 Children with Disabilities .................................................................................. 15
4.2.6 Housing ............................................................................................................. 17
4.2.7 Health Care ....................................................................................................... 18
4.2.7.1 Medical ............................................................................................... 20
4.2.7.2 Mental Health...................................................................................... 23
4.2.7.3. Dental Care ......................................................................................... 24
4.2.8 Child Care ......................................................................................................... 25
4.2.8.1 Child Care Assistance.......................................................................... 25
4.2.8.2 Child Development Programs (in addition to CSCHS) ......................... 26
4.2.9 Domestic Violence ............................................................................................ 26

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4.2.10 Transportation ................................................................................................... 27
4.2.10.1 Local Options ...................................................................................... 27
4.2.10.2 Regional Options ................................................................................. 27
5.0 Conclusions and Recommendations............................................................................. 29
5.1 Discoveries .................................................................................................................... 29
5.2 Suggestions .................................................................................................................... 29
Appendix A .............................................................................................................................. 30
Successes and Partnerships ....................................................................................................... 30
Successes .................................................................................................................................. 30
Partnerships .............................................................................................................................. 31
Appendix B .............................................................................................................................. 32
Working Paper – Suggested Gaps/Needs in Child Development Programs in Lincoln County as
expressed by the Early Childhood Special Education Workgroup Notes .................................... 32
Appendix C .............................................................................................................................. 35
Suggestions for Improving Affordable Housing Availability in Lincoln County ........................ 35
Appendix D .............................................................................................................................. 36
Parent Survey and Comments.................................................................................................... 36
Parent Survey............................................................................................................................ 36
Parent Comments ...................................................................................................................... 38
Appendix E .............................................................................................................................. 39
Provider Interviews ................................................................................................................... 39
Input into what works, where improvement could be made ........................................................ 39
Positive ..................................................................................................................................... 39
Needs Improvement .................................................................................................................. 39
Appendix F .............................................................................................................................. 40
SWOT Analysis ........................................................................................................................ 40
Appendix G ............................................................................................................................. 41
Supported Affordable Housing in Lincoln County ..................................................................... 41
Appendix H ............................................................................................................................. 42
Glossary of Acronyms .............................................................................................................. 42
Information Citations ............................................................................................................. 43

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List of Figures
Figure 4-1. Basic Family Budget – 2010 vs. FPL ................................................................................. 9
Figure 4-2. Uninsurance Rate by Race ............................................................................................... 12
Figure 4-3. Child Care Funding ......................................................................................................... 25

List of Tables
Table 3-1. Early Head Start and Head Start Enrollment 2010 .............................................................. 5
Table 3-2. CSCHS 2012-2013 School Year Current Comprehensive Statistics .................................... 7
Table 4-1. Lincoln County Poverty Information, 2010 ...................................................................... 11
Table 4-2. Population Changes 2000 to 2010 .................................................................................... 11
Table 4-3. Historical Median Household Income by Race – Lincoln County ..................................... 11
Table 4-4. Poverty by Age, Hispanic Origin, Race: 2011 Census – National ..................................... 12
Table 4-5. Household Poverty Rate by Family Type, 2006 - 2010..................................................... 12
Table 4-6. Change in Poverty Rate 2000 – 2010 Lincoln County ...................................................... 13
Table 4-7. Change in Childhood (0-17) Poverty Rate in Lincoln County 2000 - 2010 ....................... 13
Table 4-8. 2012 Lincoln County Hunger Facts.................................................................................. 14
Table 4-9. 2012 Lincoln County Youth Hunger Facts ....................................................................... 14
Table 4-10. Employment Data ............................................................................................................ 15
Table 4-11. Oregon Children with Disabilities – 2011 ........................................................................ 15
Table 4-12. EI/ESCE Report Card – 2010-2011 School Year .............................................................. 16
Table 4-13. Rental Costs in Lincoln County School District ............................................................... 17
Table 4-14. Housing Units without Plumbing, 2006 – 2010 ................................................................ 18
Table 4-15A. HRSA-Generated Data for HPSA .................................................................................... 18
Table 4-15B. HRSA-Generated Data for MUA/P .................................................................................. 19
Table 4-16. Pediatric and Family Medical Providers Accepting Medicaid ........................................... 21
Table 4-17. Institutional Medicare and Medicaid Providers, Second Quarter, 2011 ............................. 21
Table 4-18. Medical Information for CSCHS Enrolled Children 2011-2012 School Year .................... 22
Table 4-19. Medical Information for CSCHS Enrolled Children 2011-2012 School Year .................... 22
Table 4-20. Mental Health Information for CSCHS Children 2011-2012 ............................................ 24
Table 4-21. OHP Dental Providers in Lincoln County ........................................................................ 24

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Community Assessment 2012-2013

1.0 SUMMARY
1.1 Executive
In alignment with the previous two years‟ brief Community Services Consortium‟s Head Start (CSCHS)
Community Assessment (CA) updates, there have been no significant demographic differences in Lincoln
County‟s basic data aside from the increase in poverty levels and continuing un-/under-employment
levels. While these on-going statistics can be somewhat attributed to the continuing recession, the
County‟s service-based, lower-wage industry, and a lack of affordable housing, continue to be
problematic barriers to raising the standard of living and thus lowering poverty and unemployment levels.
There are, however, developments in play since the 2010 triennial assessment that are encouraging:
Oregon‟s federally supported pilot for health care reform (including Healthy Kids and potential for
influx of medical providers)
Coordinated Care Organizations (CCO), medical care homes, expanded Medicaid services/client base
Restructure of the Commissions on Children and Families into Early Learning Hubs (negative and/or
positive effects on the Head Start program has yet to be realized)
After a highly competitive process, Lincoln County secured relocation of the west coast‟s National
Oceanographic and Atmospheric Administration (NOAA) Marine Operations Center-Pacific on the
south shore of Yaquina Bay in Newport; this renowned research organization is expected to provide a
$20 million dollar per-year boost to the local economy.
In review of overall performance and perception of the CSCHS, it is noted that improvement of services
to its children and families coupled with its reputation as a model of partnership in early childhood
learning has increased significantly when compared to the 2010-2011 CA. Interviews and collaborative
meetings with community partners reflects the positive appreciation as do the increase in CLASS scores
and creation of solid infrastructure, including comprehensive policies and procedures and an ongoing
monitoring tool. Staff pursuit of higher education and attainment of degrees and certifications continues,
and notably all program staff have developed educational plans.
Additionally, parent satisfaction remains high both with program and ancillary services, and staff have
high morale and demonstrate sustainable commitment to excellence as evidenced by discussion with the
CSCHS Director and various administrative and program staff. CSC itself is a continuing source of
program and family support through internal and partnered community-based referrals. It is also
important to note that eight of twenty-five CSCHS staff members began as Head Start parents and should
be lauded both for importance to programmatic success and in reflecting positive and sustainable changes
this systemic program can engender to those in isolation and poverty.
The CSCHS Health Services Advisory Committee (HSAC) has proved itself as a vital component of the
resources in the Program‟s collaborative toolbox. The meetings occur quarterly and are substantive, and
the cross-section of involved disciplines reveals a strong community basis of support for the health and
well-being of the children and families engaged in CSCHS. The outcome measures and statistics reported
monthly depict a well-monitored and developed system of assisting children and families in accessing
needed physical and dental health services. This aspect of the program is one of the strongest in spite of
difficulties operating a thriving program in a Health Professional Shortage Area (HPSA) as defined by the
Department of Health and Human Services‟ Health Resources and Services Administration (HRSA).
The monthly Eligibility, Recruitment, Selection, Enrollment and Attendance (ERSEA) reports I reviewed
show the Newport program site to contain the largest waitlist of the three CSCHS sites. While Toledo
historically has been considered as suffering the highest levels of poverty in the County, it is Newport that
now counts the highest level of poverty. The Newport site, according to the CSCHS Director, is showing
increasing need for service expansion; Lincoln City continues to have the highest enrollment. Lastly,
South County (Waldport and Yachats) continues to show great interest in containing its own Head Start

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site, and CSCHS has shared conversation with community members, electeds, and partners to talk about
the need and resources (human and capital) that would be required for such expansion. Currently there are
no sustainable expansion funds available.
Finally, and perhaps most importantly, community information outlined in this report was of no surprise
to the CSCHS Director, and she continues to be responsive in addressing any specific concerns expressed
to her from program families and/or community at large. With a variety of changes anticipated at the State
level, funding and/or broad organizational governance, there continues to be considerable opportunity
through forums and other public meetings in Lincoln County and elsewhere for partnership-building and
other collaborative efforts. The next years will be of critical significance to CSCHS‟ longevity and
structure (as well as other Oregon Head Start programs), and annual CA updates will track changes as
they manifest.
1.2 Data
Based on information obtained through written survey; provider, Director, staff interviews; and available
statistical, historical and experiential data; the following areas have been identified as priority needs for
low-income residents with pre-kindergarten children in Lincoln County, Oregon:
1.2.1 Basic Needs Services
Basic needs services continue to be a priority. Respondents reported concerns about food, shelter, utility,
and transportation. The level of these needs demonstrates the continued importance of mobilizing both
public and private entities to ensure that sufficient affordable housing, basic needs, and other community-
based resources are available. Additionally, helping families to address basic needs is critical for
stabilization and prevention of episodic and/or long-term chronic homelessness. CSCHS staff, through
case management and advocacy, works directly with families to address any specific needs and concerns
as they arise and provide referrals as appropriate.
1.2.2 Employment
Lincoln County residents continue to report employment and economic self-sufficiency as a significant
need. These reports are not surprising given the surge in the unemployment rate which reached 13% in
Oregon generally and 9.5% in Lincoln County specifically in 2011 (was 8.5% in November 2012).
The economic stability needs of unemployed and underemployed Lincoln County residents can be
strengthened by helping link individuals to the many supports in the community including basic needs,
information about accessing state/other benefits, employment and training, and financial education
supports. Life Skills education, including budgeting and household management assistance, are also
important steps that should be taken to enhance work toward self-sufficiency.
1.2.3 Housing
The Department of Housing and Urban Development (HUD) estimates that housing costs should reflect
30% of a family‟s income1. With affordable housing at a premium in Lincoln County, the ability of
families to afford a home is slipping further out of reach. The significant numbers of individuals reporting
a concern with housing issues clearly underscores the need for a concentrated effort to alleviate the strain
on families caused by the high cost of decent, safe housing2. The surge in unemployment and continuing
high foreclosure rates has placed additional strain on low-income individuals and families, which also
contributes to an increased risk in homelessness.
Workforce housing (including affordable housing for lower-income households) is increasingly in
demand and unavailable as any remaining available housing and land are being purchased and developed

1
www.hud.gov.
2
See Table 4-13 for cost of housing in Lincoln County.

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as vacation homes. This housing type rents in off-seasons for greater amounts which, effectively, remove
any decent affordable housing from the market; what is left in affordability isn‟t always decent or safe.
1.2.4 Childcare
Affordable child care remains a significant need in Lincoln County, and greater numbers of working low-
income families indicate need for financial assistance with child care. Additionally, there is need for safe,
affordable, and flexible day care to aid a family‟s employment searches. Although employment-related
day care (ERDC) is available to low-income families through Oregon Department of Human Services, the
legislatively approved caseload and funding opportunities don‟t adequately meet the need.
1.2.5 Transportation
Transportation continues to be an issue especially for lower-income residents. While the greater
percentage of CSCHS families report ownership of a running vehicle which can travel at least 50 miles,
cost of gas and car repairs often bar use. CSCHS makes every effort to assist families with identified
transportation issues in connecting with other agencies and/or transportation services which might assist.
CSCHS families are encouraged to build carpool and other transportation-sharing options as well.
Ultimately, the need for reliable, flexible, and affordable public transportation presents as a contributing
barrier to economic self-sufficiency and an improved quality of life.
1.2.6 Health
As previously written, the entirety of Lincoln County is considered a Health Professional Shortage Area
(HPSA) and additionally lists parts of the county as Medically Underserved Areas/Populations (MUA/P).
This designation very much supports the reality that shortages exist in all aspects of health care in Lincoln
County, whether the need is in physical, mental, or dental health services. Most importantly, this medical
professional shortage is doubly concerning for children and families who are participants of Oregon‟s
Medicaid program, Oregon Health Plan (OHP), as there are even fewer of the existing medical
professionals who accept this insurance option. Pediatric specialists who accept OHP are few, and in the
case of mental health professionals and dentists, there are none listed directly in Lincoln County in the
OHP provider network.
While there are regional transportation options available – free to obtain medical services in adjoining
counties through OHP – the reality is that a greater provider network locally is a severe need and deserves
– along with housing – greater community focus.
1.2.7 Education
With the fourth-lowest high school graduation rate as a state3 (National is 78%, Oregon is 66%, Lincoln
County is 65%), there clearly remains a solid need to address educational challenges. Survey respondents
report the need for enhanced education programs including improved literacy education, English as a
Second Language (ESL) support, and GED preparation, which clearly demonstrates the need to continue
to develop and maintain comprehensive educational supports for children and adults alike. Through
improved educational outreach and programming, high school drop-out rates can be reduced and the
ability of residents to maintain longer-term economic self-sufficiency increased.

3
Ed.gov; “Regulatory Adjusted Cohort Graduation Rate, All Students: 2010-11”.

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2.0 COMMUNITY ASSESSMENT
2.1 Purpose and Scope of Project
The purpose of this report is to present the results of a Community Assessment (CA) for CSCHS. A CA is
the collection and analysis of information on the needs and characteristics of Head Start (HS) eligible
children and families in a grantee‟s service area. Further, it identifies issues and trends that impact
families with young children and programs and community resources available to meet the family needs.
A completed CA is used to guide program planning and evaluation decisions.
Every three years the National Head Start Program, through its Federal funder, Department of Health and
Human Services (HHS), requires all Head Start programs to conduct a full or extensive CA, and 2013 is
CSCHS‟s full report year (updates will be completed in each of the two years following the full CA).
There are six content areas that must be included in a CA (labeled A1-A6):
1. A1: The estimated number, geographic location, and racial/ethnic composition of Head Start children
2. A2: Other child development programs that serve Head Start eligible children and the approximate
number served
3. A3: The estimated number of children four years old or younger with disabilities and services
provided to these children
4. A4: Data regarding the education, health, nutrition and social service needs of Head Start eligible
children and their families
5. A5: The education, health, nutrition and social service needs of Head Start eligible children and their
families as defined by families of Head Start families and by community institutions that serve young
children
6. A6: Community resources that could be used to address the needs of Head Start eligible children and
their families.
To most accurately and contextually present the requisite information, this report is organized into the
following sections:
 Summary  Geographic Area
 Community Assessment  Conclusions and Suggestions
 Head Start  Appendixes
2.2 Methodology
Information contained in this report was obtained from a variety of sources including written documents,
personal interviews, and the writer‟s own knowledge and understanding. Chief among the research
reports and tools accessed to determine specific demographics were: U.S. Census Bureau 2010 data and
American Community Survey; Children First for Oregon; Children‟s Defense Fund; Oregon Head Start‟s
Program Information Report (PIR) summarized for Oregon HS programs/grantees; CSCHS internal
documents (e.g., 2011 PIR, newsletters, budget, and Governing Board presentation materials); and
information obtained through website review of various Lincoln County service providers and studies
(e.g., Healthy Start, WIC, etc., 10-Year Plan to End Homelessness, Commission on Children and
Families‟ Assessment, etc.).
An informational survey was also designed by this writer and subsequently completed by 56% of the
current CSCHS parents of children participating at all three classroom sites. Further, person-to-person
interviews were conducted and/or phone conversations were held with staff members from Lincoln
Commission on Children and Families; Olalla Center; Lincoln County Commissioners; Lincoln County
Health Department; Linn, Benton and Lincoln Education Service District; and Lincoln County school
district.

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3.0 HEAD START
3.1 What is Head Start?
Head Start is a national program which provides comprehensive developmental services for America's
low-income, pre-school-aged children (three to five years) and social services and supports for their
families. Approximately 1,400 community-based non-profit organizations and school systems nationally
develop unique and innovative programs to meet specific needs.
Head Start began in 1965 in the Office of Economic Opportunity and is now administered by the
Administration for Children and Families. In FY2012, $7,9 billion4 was available for Head Start services
nationally and awarded to local public or private non-profit agencies; 20% of the total cost of a Head Start
program must be contributed by the community. Head Start programs operate in all 50 states, the District
of Columbia, Puerto Rico, and the U.S. territories.
3.1.1 Major Components
Head Start provides diverse services to meet the goals of the following four components:
Education – Head Start's educational program is designed to meet the needs of each child, the
community served, and its ethnic and cultural characteristics. Every child receives a variety of learning
experiences to foster school readiness by enhancing intellectual, social, and emotional growth.
Health – Head Start emphasizes the importance of early identification of health problems. Every child
is involved in a comprehensive health program which includes immunizations, medical, dental, mental
health, and nutritional services.
Parent Involvement – An essential part of Head Start is the involvement of parents, as they are their
children‟s primary teachers and advocates. Parent engagement includes parent education, program
planning, and operating activities. Many parents serve as members of policy councils and committees
and have a collaborative voice in administrative and managerial decisions. Participation in classes and
workshops on child development and staff visits to the home encourages parents to learn about the
needs of their children and educational activities that can take place at home as well as information-
sharing with the teacher about their child‟s development.
Social Services – Specific services are geared to each family after needs are determined and could
include community outreach; referrals; family need assessments; recruitment and enrollment of
children; and emergency assistance and/or crisis intervention.
Only 3% percent of eligible children are able to secure spots in Head Start due to limited funding (see
Table 3-1 for enrollment information about Head Start Preschool)5.

Table 3-1. Early Head Start and Head Start Enrollment 2010

4
http://www.acf.hhs.gov/programs/ohs/news/fy-2012-head-start-funding-increase-0 (HHS Administration for Children &
Families); funding level represents an increase of approximately $409 million over the FY 2011 appropriation level.
5 National Women’s Law Center. 2011. “Head Start: Supporting Success for Children and Families”;
http://www.nwlc.org/sites/default/files/pdfs/head_start_fact_sheet_2011.pdf.

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The annual cost of center-based pre-school for a four-year old is more than the annual in-state tuition at a
public four-year college in 26 states and the District of Columbia 6, and 30% of children in poverty score
very low on early reading skills when compared to only 7% percent of children from moderate- or high-
income families 7. Without high-quality early childhood intervention, an at-risk child is:
25% more likely to drop out of school
40% more likely to become a teen parent
50% more likely to be placed in special education
60% more likely never to attend college
70% more likely to be arrested for a violent crime 8.
3.2 Grantee Description
Head Start is one of the nation‟s first child development programs to implement a two-generation
approach, working with both children and their low-income parents as primary teachers of their own
children. Teachers are also „advocates‟ for the children and their families. In 2012-2013, CSCHS will
provide federal- and state-funded preschool services to 160 Lincoln County children and their families
through classroom sites in Toledo, Newport, and Lincoln City, though the actual numbers served may
vary depending upon funding changes.
CSC began serving Head Start children and families of Lincoln County in August 1996. The program
currently provides services to 160 three and four year old children from 155 families. The 160 children
are funded as follows: 102 are federal Head Start funded and 58 are Oregon Pre-Kindergarten funded.
Children receive center-based services where they are offered 3.5 hours of classroom service four days a
week and four teacher conferences throughout the year, two of which are home visits. Center-based
classes are held in the cities of Lincoln City, Newport, and Toledo. The most recently opened location is
Newport in May 2009. For program year 2011-2012, CSCHS‟s total budget was $1,436,585 and included
17.83 full-time equivalent staff.
CSCHS supports and understands that:
Low-income children who are hungry, have never been to the doctor, who have few or no books at home,
who are more likely to view violence have different needs than their middle- or upper-income peers and
can benefit from the program. Eligible children benefit from intensive, targeted, community-based
services resulting in greater school and life success because of Head Start (see Table 3-2).
Research indicates 9 that Head Start generates long-term improvements in important outcomes such as
schooling attainment, earnings, and crime reduction.
CSCHS‟s programming foundation is based on parent and service provider partnerships and, with the
assistance of on-going and new community connections, meets its measureable outcomes through:
Supporting at-risk Lincoln County families in achieving successes and self-sufficiency with dignity
Providing experiences for enrolled pre-school children to grow socially, emotionally, physically, and
mentally
Providing every parent with opportunities to participate in program shared-decision-making
Connecting families to necessary community services and other opportunities geared toward
stabilization.
6“
Double Jeopardy: How Third-Grade Reading Skills and Poverty Influence High School Graduation”; The Annie E, Casey
Foundation; Hernandez, Donald J.; April 2011.
7
Brookings Institution. 2012. “Starting School at a Disadvantage: The School Readiness of Poor Children.”
http://www.brookings.edu/~/media/research/files/papers/2012/3/19%20school%20disadvantage%20isaacs/0319_school_disad
vantage_isaacs.pdf.
8
Center for American Progress. 2012. “Increasing the Effectiveness and Efficiency of Existing Public Investments in Early
Childhood Education: Recommendations to Boost Program Outcomes and Efficiency.”
http://www.americanprogress.org/issues/2012/06/pdf/earlychildhood.pdf.
9
“Longer-Term Effects of Head Start” (NEBR Working Paper No. 8054); Eliana Garces, Duncan Thomas, and Janet
Currie; 2001.

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Table 3-2. CSCHS 2012-2013 School Year Current Comprehensive Statistics
Health

Oct Nov Dec
Statistics 2012 2012 2012
# of enrolled children with up-to-date/all possible immunizations to date 137 142 142
# of enrolled children on schedule of preventative/primary health care
(up-to-date physical exam) 105 120 123

# of enrolled children with ongoing source of continuous, accessible health care
152 156 155
(Medical Home)
# of enrolled children completing professional dental exams 89 102 108
# of enrolled children with continuous, accessible dental care provided by a dentist
(dental home) 151 152 151

CSCHS promotes child school-readiness and family self-sufficiency through comprehensive and
intensive services including early childhood education, health and social services, nutritious meals, and
parent partnership and involvement. Through 11 primary domains of learning10 (aligned with the Head
Start Child Development and Early Learning Framework which is in the process of being adopted by the
Oregon Department of Education as the early learning standards for children ages 3-5) and an overall
structure for school-readiness, children‟s progress is measured, adjusted, and reviewed with outcome
measurement tools including Galileo Pre-K Online assessment and Classroom Assessment Scoring
System (CLASS).
Children are expected to make a 50-point gain in skills (from first assessment to final rating) over the
school year for each of the learning domains. CSCHS Developmental Level (DL) scores exceeded
expected gains in each domain; average point gain was 131 as evidenced by the following Table 3-3.

CSCHS Developmental Level (DL) scores
Beginning of Point Gain Percentage
Developmental Domain Year End of Year 50 Expected Increase
Approaches to Learning 467 609 142 30%
Creative Arts 495 661 166 34%
Early Math 463 587 124 27%
English Language Acquisition 473 555 82 17%
Language 430 574 144 33%
Literacy 444 579 135 30%
Logic and Reasoning 508 630 122 24%
Nature and Science 438 586 148 34%
Physical Development & Health 449 576 127 28%
Social and Emotional Development 428 558 130 30%
Social Studies 477 597 120 25%

10
Physical Development & Health, Social & Emotional Development , Approaches to Learning , Language Development,
Literacy knowledge & Skills, Mathematics knowledge & Skills, Science knowledge & Skills, Creative Arts Expression, Logic
& Reasoning, Social Studies knowledge & Skills, English Language Development (for dual-language learners).

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3.2.1 Lincoln County Need
CSCHS is a vital program that supports the enrolled children, families, and connected communities
within Lincoln County. In the 17 years the Program has been housed within CSCHS, the numbers served
per year has increased from 97 to 160 through award of competitive grants both federal and state (see
Table 3-4). In 2011, the Program counted 86 eligible children/families on the waiting list (see Table 3-5).
The unfortunate truth is that:
 Preschool children are the most likely age group to live in poverty
 Oregon is consistently included in national statistics as posting some of the highest unemployment and
food insecurity rates
 Lincoln County has one of Oregon‟s highest domestic violence rates per capita and the second highest
county child abuse rate (nearly twice the state‟s average)
 Pre-school children need to have a safe space in which to learn developmentally appropriate
educational and social-emotional skills and receive support to ensure school readiness

Enrollment, Attendance, and Meal & Snack Report
Month Enrollment Attendance Breakfast/Snack Lunch Total Meals
September 2012 160 91.22% 1,410 1,417 2,827
October 2012 160 87.08% 2,379 2,418 4,797
November 2012 160 82.57% 2,152 2,164 4,316
December 2012 160 86.69% 1,446 1,468 2,914
Totals 86.89% 7,387 7,467 14,854

Wait List Monthly Count
Poverty Income 130% Income Over Income Total Applications
Site T N LC T N LC T N LC T N LC Total Program
As of 10/25/2012 8 12 4 0 3 2 5 14 4 13 29 10 52
As of 11/5/2012 7 14 8 1 3 2 5 14 4 14 31 13 58
As of 12/5/2012 7 14 9 1 4 2 5 14 4 13 32 15 60
As of 1/4/2013 8 14 3 1 4 2 5 1 5 14 32 10 56

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4.0 GEOGRAPHIC AREA
4.1 Oregon Poverty Overview
The Federal Poverty Line (FPL) is based on a 1955 household survey and, though updated annually,
relies on out-of-date assumptions. It fails to address the impact of today‟s high housing, health, and child
care costs or even work-related expenses. The resulting “official” poverty rates seriously underestimate
the “real” poverty:
FPL for a family of four = $23,050 (2012)
Full time job at Oregon minimum wage = $18,304 (2012)
Full time job at Federal minimum wage = $15,080 (2012)
Basic Family Budget for a family of four in Oregon for 2012 = $50,304 (see graph below)
Though Oregon‟s minimum wage increased January 1, 2013, four-person households with two full-time
workers earning minimum wage (combined $37,232) is still less than 200% of the FPL. While many
Oregonians did get the „boost‟ to help make ends meet, two incomes is a comfort few households have.
74% of households surveyed in a 2012 Oregon Food Bank project reported incomes below 100% of FPL.
4.1.1 Basic Family Budget
Using the Economic Policy Institute‟s (EPI) “basic family budget” calculator as a model, the family
budget illustrated above was fine-tuned using more localized sources for some of the figures. EPI‟s study
was published in 2007 and adjusted for 2012 inflation using the Consumer Price Index calculator (see
Figure 4-1). The calculations by EPI, a non-profit, non-partisan think tank, also include such essentials as
housing, food, child care, and health insurance. For a typical Oregon family, a basic family budget ranges
from 197% to 231% of the Federal poverty line11. More than 1.4 million Oregonians, about one-third, try
to survive with incomes below 200% of the FPL ($46,100 for a family of four)12.

Figure 4-1. Basic Family Budget – 2010 vs. FPL

11
Economic Policy Institute, Basic Family Budget Calculator,
http://www.epi.org/budget_form.cfm?CFID=3447799&CFTOKEN=41949049.
12
U.S. Census, American Community Survey 2011;
http://factfinder2.census.gov/faces/tableservices/jsf/pages/productview.xhtml? pid=ACS_11_1YR_S1701&prodType=table.

9

4.1.2 Living Wage
A living wage is one that allows families to meet their basic needs without resorting to public assistance
and one which provides some ability to deal with emergencies and plan ahead.
In 2010, the living wage for a single adult in Oregon was $15.20/ hour. Of all job openings in Oregon in
2010, 52% paid less than 15.20/hour; for job openings that pay at least $15.20 per hour, there are at least
14 seekers on average13
4.2 Lincoln County
Lincoln County is primarily rural, and Newport serves as
the County seat. It has a total area of 1,194 square miles
about the size of Rhode Island. In terms of boundaries,
the county is bordered by the Pacific Ocean to the west,
Tillamook County to the north, Polk County to the
northeast, Benton County to the southeast, and Lane
County to the south. Lincoln County has seven unique
incorporated communities: Depoe Bay, Lincoln City,
Newport, Siletz, Toledo, Waldport, and Yachats.
The county's economy is based on services, tourism, trade, commercial fishing, food processing, paper
processing, and wood and lumber products. The economy is also supported by a large and increasing
number of retirees.
According to the 2010 US Census, Lincoln County families experience higher levels of poverty at 11.6%
as compared to the statewide rate of 11.0%.
Children are also greatly impacted by the recent poverty trends, counting approximately 39% of all
children in Oregon living in families with low incomes who cannot meet their basic needs for food and
shelter. According to Patricia Post‟s report14, some economists estimate that persistent childhood poverty
costs the United States roughly $500 billion a year by way of lost productivity, school drop-outs, crime,
and the growing numbers enrolled in nutrition and public assistance programs. Solving poverty is beyond
the scope of this needs assessment, but it can point the way to a variety of near-term and longer-term
approaches to mitigate its most serious impacts. Every forward step taken as a co-productive community
will bring multiple benefits.
According to Jeffery Bartash of MarketWatch.com, even those traditionally living above the poverty level
saw their earning power decline, with 2011 median income falling 2.9% from 2009, the second sharpest
decline on record. Some estimates indicate that more than 55 million people in the United States will need
assistance to meet their basic needs in the coming years.
The State of Oregon is 13th in the nation in economic recovery and, as we know, economic upheavals
have a disproportionately negative impact on lower-income families as they enter the unemployment
lines, see a reduction in work hours and wages, and fight rising interest rates on credit debt, all of which
have the greatest impact on those who can afford it the least.
4.2.1. Population
2010 poverty estimates show a total of 7,734 persons living below the poverty rate in Lincoln County
with more than one in ten (17%) of all families living below the poverty line (FPL)15 (see Table 4-1).

13
2010 Job Gap Study http://nwfco.org/wp-content/uploads/2010/12/2010-1209_2010-Job-Gap.pdf.
14
“Hard to Reach: Rural Homelessness and Health Care,” http://www.nhchc.org/wp-
content/uploads/2012/02/October2001HealingHands.pdf.
15
U.S. Census Bureau, Small Area Income and Poverty Estimates (SAIPE), 2010.

10

Table 4-1. Lincoln County Poverty Information, 2010

All Ages Age 0-17 Age 5-17
Number Poverty Number of Poverty Number of Poverty
Geographic Area of Persons Rate Persons Rate Persons Rate
Lincoln County, Oregon 7,734 17.0 2,325 30.1 1,538 28.3
Oregon 596,649 15.8 184,511 21.7 119,412 19.5
United States 46,215,956 15.3 15,749,129 21.6 10,484,513 19.8

Table 4-2 shows overall population changes in the United States, Oregon, and Lincoln County from 2000
to the 2010 census.

Table 4-2. Population Changes 2000 to 2010

Census 2000 Census 2010 %
Geographic Area Population Population Population Change Change
Lincoln County 44,479 46,034 1,555 3.50
Oregon 3,421,437 3,831,074 409,637 11.97
United States 281,424,602 312,471,327 31,046,725 11.03

4.2.1.1 Race and Ethnicity
Currently, the Hispanic16 population in Oregon is counted at 12%, while in Lincoln County this
population group is counted at 8.1%, an increase of 0.9% over the 7.2% listed in the 2010 community
needs assessment report. The top needs identified for the Hispanic population via the CSHS Parent
Survey (see Appendix D) are employment, health care, legal assistance, ESL training, transportation (way
to obtain legal licenses), and affordable housing.
Table 4-3 shows median income of Lincoln County‟s Hispanic population, Table 4-4 shows childhood
poverty, and Figure 4-2 shows the lack of health insurance in Oregon by race. See the section on Health
Care (page 18) for information on Oregon‟s health care reform, coordinated care organizations and the
Healthy Kids initiative, all of which intends to increase the numbers of children covered by health
insurance regardless of race.
CSCHS continues to respond to the needs of Spanish-speaking families by increasing interpreter hours,
making available bi-lingual forms, and hiring bi-lingual staff and engaging parent volunteers.

Table 4-3. Historical Median Household Income by Race – Lincoln County17

Lincoln County Oregon 10-Year U.S. 10-Year
Race
2006-2010 2005-2009 2000 Average Average
Hispanic 30,097 36,167 33,500 35,294 38,718
White 40,189 38,315 32,956 47,177 51,407

16
For purposes of U.S. Census and American Community Survey data collection, the ethnic group Hispanic also includes any
number of Latino populations.
17
American Community Survey 2000-2010

11

Table 4-4. Poverty by Age, Hispanic Origin, Race: 2011 Census – National18
(Numbers in thousands)

Hispanic Origin and Race20
Non-Hispanic
Age and
Total Hispanic Total White alone All other races
Poverty
Status19 Number Percent Number Percent Number Percent Number Percent Number Percent
Under 18 74,494 100.0 17,435 100.0 57,059 100.0 40,494 100.0 16,565 100.0
years
Below 16,401 22.0 6,110 35.0 10,291 18.0 5,002 12.4 5,289 31.9
poverty
At/above 58,093 78.0 11,325 65.0 46,768 82.0 35,492 87.6 11,276 68.1
poverty

Figure 4-2. Uninsurance Rate by Race
Oregon Health Plan 20111
4.2.2 Poverty
Table 4-5 shows percentage of Lincoln County households in poverty by household type. In 2010, it is
estimated that 11.67% of all households were living in poverty within the County compared to the
national average of 10.08%. Of the households in poverty, female headed households represented 40.66%
of all households in poverty compared to 8.15% and 51.20% of households headed by males and married
couples, respectively.

Table 4-5. Household Poverty Rate by Family Type, 2006 - 2010

Geographic Area All Types Married Couples Male Householder Female Householder
Lincoln County 11.67 7.30 21.33 34.70
Oregon 9.60 4.81 16.49 30.27
United States 10.08 4.90 14.58 28.86

18
U.S. Census, American Community Survey 2011;
http://factfinder2.census.gov/faces/tableservices/jsf/pages/productview.xhtml? pid=ACS_11_1YR_S1701&prodType=table.
19
Poverty statistics exclude unrelated individuals under 15.
20
Hispanic refers to people whose origin is Mexican, Puerto Rican, Cuban, Spanish-speaking Central or South American
countries, or other Hispanic/Latino, regardless of race.

12

Poverty rate change in Lincoln County 2000 to 2010 is shown in Table 4-6. According to the U.S.
Census, the poverty rate for the County increased by 3.1%.

Table 4-6. Change in Poverty Rate 2000 – 2010 Lincoln County

Change in Poverty
Geographic Persons in Poverty Rate Persons in Poverty Rate
Area Poverty 2000 2000 Poverty 2010 Rate 2010 2000 – 2010
Lincoln County 6,070 13.9 7,734 17.0 3.1
Oregon 361,280 10.6 596,649 15.8 5.2
United States 31,581,086 11.3 46,215,956 15.3 4.0

The poverty rate change for all children in Lincoln County from 2000 to 2010 is shown in Table 4-7. In
this case, the childhood poverty rate for the County increased by 7.5% compared to an Oregon increase of
6.6% and a national increase of 5.4%.

Table 4-7. Change in Childhood (0-17) Poverty Rate in Lincoln County 2000 - 2010

Geographic Children in Poverty Rate Children in Poverty Rate Change in Poverty
Area Poverty 2000 2000 Poverty 2010 2010 Rate 2000 – 2010
Lincoln County 2,064 22.6 2,325 30.1 7.5
Oregon 127,544 15.1 184,511 21.7 6.6
United States 11,587,118 16.2 15,749,129 21.6 5.4

4.2.3 Food
According to 2012 Oregon Food Bank report21, Oregon has higher-than-national-average rates for hunger
and food insecurity (currently 17.5% in Lincoln County). More than half (61%) of Lincoln County
students (k-12) qualify for free or reduced lunch, and more than 400 students in the school district are
considered homeless (defined as living with relatives or friends, awaiting foster care, or living in an
emergency shelter, motel, campground, car or park).
Oregon Food Bank VOICES 2009 reported that families are making food choices based on cost or quality
when knowing that choosing healthy foods may mean not having enough food to last the month. On a
state level, roughly one in six Oregonians receive food stamps (see Table 4-8). This number is the highest
in the history of the state program and well above the national average. The average food stamp benefit is
$176 a month or $1.96/meal, less than the $2.50/child Head Start is reimbursed. Food stamps are tied to
match inflation, but in 2008 the drastic spike in prices kept the annual increase from keeping pace with
prices. Sixty-seven percent (67%) of food stamp recipients report that benefits last less than two weeks.
Access to food is difficult in pockets through the County. Residents in Eddyville, for example, must drive
more than 25 miles leaving those without transportation or mobility vulnerable22. Rural grocery stores
have become more or less convenience stores, offering little in the way of fresh produce or really
nutritious food. This is alarming considering many rural residents depend on these stores.

21
“Profiles of Hunger and Poverty in Oregon, 2012 Hunger Factors Assessment”; Oregon Food Bank.
22
A person is considered „food insecure‟ if she/he lives more than 10 miles or more from a grocery store.

13

Each month, too many Lincoln County residents rely on emergency food assistance as a necessity to
make ends meet. Children are particularly vulnerable with before- and after-school program cuts, as these
opportunities are often their most consistent source of food. Programs – such as the Backpack for Kids
program23 – rely on a precarious structure of volunteers and community donations. The East County
Backpack program serves 56 students in Toledo and Siletz with 30 to 40 more kids in need but no funding
for them to participate. Fortunately Lincoln City and Newport sites have backpack programs for their high
need families and it is anticipated that Toledo will also have one in 2013 (see Table 4-9 for youth hunger
facts).
Poverty and low wages are the underlying causes for food insecurity in the region. High
underemployment and unemployment can be blamed to a degree, but living costs for basic monthly
expenses including high rent, child care costs, and gas (currently hovering near $3.80/gallon) make even
those who work full-time at minimum wage food insecure.

Table 4-8. 2012 Lincoln County Hunger Facts

Food Insecurity 17.5%
SNAP Users 18.9%
SNAP $ into the County $13 Million
SNAP Participation Rate 71%
Food Boxes 13,580
Minimum Wage Hours for a 1 Bdrm Apartment 56 hours/week
Cost per Meal $2,84
County Health Outcomes 27th

Table 4-9. 2012 Lincoln County Youth Hunger Facts

Free/Reduced-Meal Eligibility 67.4%
Free/Reduced-Meal Participation Rate 62.6%
Summer Meals (served 2010) 15.144
Backpack Programs 3
Homeless Students 471
Childhood Obesity 28.9%

4.2.4 Employment
Labor force, employment, and unemployment data for Lincoln County is provided in Table 4-10. In
November 2011, the non-adjusted unemployment rate was 9.5%. October 2012 saw the rate drop to 8.6%,
and November 2012‟s rate was lower again at 8.8%. Nearly one third (29%) of the Lincoln County work
force is employed in the leisure and hospitality industry, the most common employment for non-skilled
labor in the county. The average hourly wage for this industry is minimum wage, $8.80/hour 24, or roughly
$18,304 annually25 if the employee works full time.

23
See collaborative partner successes in Appendix A.
24
Oregon minimum wage rose to $8.95/hour January 1, 2013.
25
Oregon employment Department Covered Employment and Wages, Q3 2012.

14

Table 4-10. Employment Data

According to WorkSource Oregon‟s Labor Force and Unemployment estimates26 – November 2012 – the
county labor force consisted of 22,342 people. Employment levels tend to fluctuate throughout the year
due to dependence on seasonal employment activities like tourism, food processing, and fishing, and the
underemployment level includes the unemployed and also people who work part time but would like to
work full time. Rather than hiring new employees when the economy improves, companies probably will
move these employees to full time, meaning an unchanged jobless rate. Therefore, unfortunately, there is
a direct correlation between unemployment and poverty; as unemployment increases so does poverty. All
this serves as important context information when examining HS eligible children and families in Lincoln
County.
It is evident that economic hardship exists in all areas of the County and that job losses continue through
all industries. However, it is interesting to note that health care and government job losses are new trends,
with 11.8% and 2.3% labor decreases, respectively. Additionally, the population is slow to grow with the
baby-boom generation aging into retirement and the Latino population is the 2nd highest impoverished
population group. Ultimately, the CSCHS wait list demographics is an indicator of where services are
needed and confirms current service locations are appropriately placed throughout the County.
4.2.5 Children with Disabilities
Partnership with Early Childhood Special Education (ECSE) is a very successful collaboration in Lincoln
County (see Appendix E for Provider Interviews). By December of 2012, 20 CSCHS children, or 13% of
total enrollment, had been identified with special needs and appropriately referred to ECSE for further
evaluation and services. The partnership is important as it serves a vulnerable and high-need population,
and addresses the necessity of preparing these children for mainstream school readiness. According to
Oregon Department of Human Services 27, 108 children in Lincoln County received on-going case
management services in 2011.
Table 4-11 shows numbers of Oregon children with disabilities divided by urban and rural locations.

Table 4-11. Oregon Children with Disabilities – 2011

The Oregon Department of Education contracts with nine Education Service Districts (ESDs) across the
state to provide early intervention/early childhood special education (EI/ECSE) services in 33 local
programs. This system includes Part C early intervention (EI) for children birth to age three and Part B

26
Oregon Labor Market Information System; http://www.qualityinfo.org/olmisj/DoQuery?itemid=00004804.
27
DHS Developmental Disabilities Data Book – 2011.

15

early childhood special education (ECSE) for children age three to kindergarten age, which is age five in
Oregon. Children who are age five by September 1 are eligible for public school with special education
services provided by the local school district.
In Lincoln County, the Linn-Benton-Lincoln ESD in Albany administers this opportunity, and the Lincoln
County School district provides an in-house administrator who reviews referred children against these
disability eligibility criteria and disorders: communications; autism spectrum; hearing, visual, orthopedic
and other impairments; specific learning disability; emotional disturbance; intellectual disability;
deafness; blindness; traumatic brain injury; early intervention. Table 4-12 demonstrates the effectiveness
of specific EI/ECSE measures in preparing children for school-readiness in Lincoln County28. The full
Report Card and additional measures can be accessed via the web link in Footnote 34.
Table 4-12. EI/ESCE Report Card – 2010-2011 School Year
Improved Outcomes in Positive State
Program
Social-Emotional Skills Target
Infants and toddlers who entered or exited early intervention below age 92.3% 80.9%
expectations and substantially increased their rate of growth by
age 3 or when they exited the program
Infants and toddlers who were functioning within age expectations by age 3 or 71.4% 59.1%
when they exited the program
Preschool children who entered the preschool program below age expectations 86.4% 74.3%
and substantially increased their rate of growth by
Preschool children who were functioning within age expectations by age 6 or 26.9% 32.5%
Improved Acquisition and Use of State
Program
Knowledge and Skills Target
Infants and toddlers who were functioning within age expectations by age 3 or <5.0% 7.3%
Improved Use of Appropriate State
Program
Behaviors to Meet Needs Target
Infants and toddlers who were functioning within age expectations by age 3 or 7.1% 18.1%

28
Oregon Department of Education; http://www.ode.state.or.us/data/reportcard/sped/SPEDpdfs/12/12-SpEdReportCard-Conf-
EC21.pdf.

16

4.2.6 Housing
The combination of high demand, a limited base of buildable land, and low wages have worked in concert
to create a workforce housing crisis in Lincoln County beyond the continuing and growing need for clean,
safe, and affordable low-income housing. Even the burst of the housing bubble that helped precipitate the
recession did not reverse the fact that in a span of two decades, housing prices grew twice as fast as
wages29 (see Table 4-13). The fair market rent of a 2 bedroom unit in Lincoln County is $659/month 30,
and the estimated average hourly wage for a Lincoln County renter is $8.80. The affordable rent, typically
no more than 30% of gross monthly income31 would be $441. This means that the average renter in
Lincoln County would need to work ten hours a day, seven days a week to afford the fair market value of
a 2-bedroom unit 32. A list of supported affordable housing in Lincoln County is available in Appendix G.
The Lincoln County Workforce Housing Needs Assessment completed in 2011 found that rental rates in
the county are high. Much of the rental units available, both apartments and homes, are older, often not in
good repair (See Table 4-14), and lack many of the amenities renters require. Lacking affordable housing
brings unintended consequences such as difficulty in attracting and retaining qualified workers, and many
workers are often forced to commute long distances (into Benton County, for example) from their homes
as they find themselves (doctors, teachers, service workers in leisure and hospitality employment) priced
out of the rental market. Many workers even double-bunk with friends and/or family or „rough‟ sleep in
campers and cars just to maintain even part-time employment.

Table 4-13. Rental Costs in Lincoln County School District 33

Monthly Rental Lincoln County School District % Oregon U.S.
Occupied Units Paying Rent 6,408 100% 519,755 35,969,315
$199 or Less 229 3.57% 1.89% 2.25%
$200 to $299 348 5.43% 2.35% 3.41%
$300 to $499 849 13.25% 8.10% 9.80%
$500 to $699 1,866 29.12% 23.34% 19.41%
$700 to $999 1,974 30.81% 37.56% 29.88%
$1,000 to $1,499 927 14.47% 20.25% 23.51%
$1,500 to $1,999 144 2.25% 4.52% 7.56%
$2,000 or More 71 1.11% 2.00% 4.16%
Median $692 - $795 $841

Additionally, the practice by property owners and funders alike34 to require individuals to have no felony
convictions may exclude the majority of individuals in early recovery and those whose life history
includes criminal activity. For some CSCHS families, this may create another barrier to housing that is
insurmountable especially given limited affordable housing options and employment suitable for ex-
offenders.

29
Lincoln County Workforce Housing Needs Assessment 2011.
30
HUD Data Sets, http://www.huduser.org/portal/datasets/fmr.html.
31 The U.S. Census Bureau considers a family to be cost-burdened if it is paying more than 30 percent of its gross income for
housing and severely cost burdened if it is paying more than 50 percent of its gross income for housing. In Lincoln County,
more than half (56.8 percent) of all households are paying 30 percent or more of their monthly income for housing.
32
National Low Income Housing Coalition – Out of Reach 2012.
33
USA.com Lincoln County Oregon School District; based on 2006-2010 data.
34
http://www.rurdev.usda.gov/SupportDocuments/3560-2chapter06.pdf.

17

The number and percentage of occupied housing units without plumbing in Lincoln County are shown in
Table 4-14. U.S. Census data shows 128 housing units were without plumbing in 2000 while a decreased
74 housing units without plumbing were reported in 2010. While lack of plumbing is a tremendous issue,
it is not uncommon to find lower-income housing rife with holes in floors, roofs, and walls; heating
systems that don‟t work (rental and owner-occupied), electrical issues that are dangerous for children, etc.
Unfortunately, these types of units are often the only ones available for a population with low-income,
bad credit, and any number of other personal issues. Additionally, housing inspections which are required
of rental assistance programs and Section 8 housing vouchers will „fail‟ such housing in disrepair and
thus effectively „remove‟ additional available housing from the low-income renter.

Table 4-14. Housing Units without Plumbing, 2006 – 2010

Geographic Occupied Housing Percent Occupied Housing Percent
Area Housing Units without Housing Units without
Units, 2000 without Plumbing, Units, 2006- without Plumbing,
Plumbing, 2000 2010 Plumbing, 2006-2010
2000 2006-2010
Lincoln 19,296 128 0.48 20,652 74 0.36
County,
Oregon
Report Area 19,296 128 0.66 20,652 74 0.36
Oregon 1,333,723 7,025 0.48 1,499,267 9,729 0.65
United States 106,741,426 736,626 0.69 114,235,996 602,324 0.53

4.2.7 Health Care
According to the Department of Health and Human Services‟ Health Resources and Services
Administration (HRSA), the entirety of Lincoln County is considered a Health Professional Shortage
Area (HPSA) and additional lists parts of the county as Medically Underserved Areas/Populations
(MUA/P).
HPSAs are designated by HRSA as having shortages of primary medical care, dental, and/or mental
health providers and may be geographic (a county or service area), demographic (low-income population)
or institutional (comprehensive health center, federally qualified health center or other public facility).
MUA/Ps are areas or populations designated by HRSA as having too few primary care providers, high
infant mortality, high poverty and/or high elderly population. Tables 4-15A and 4-15B provide HRSA
data specific to Lincoln County.

Table 4-15A. HRSA-Generated Data for HPSA35

Criteria:
State: Oregon
County: Lincoln County Discipline: Primary Medical Care, Dental, Mental Health
ID: All Metro: All
Status: Designated
Date of Last Update: All Dates
Type: All

35
Of particular interest are the columns marked „FTE‟ and „# Short.‟ People attempting to be served in the County are well aware
of the shortages in providers.

18

HPSA Score (lower limit): 0
Results: 21 records found.
(Satellite sites of Comprehensive Health Centers automatically assume the HPSA score of the affiliated grantee. They are not listed
separately.)
HPSA Name ID Type FTE # Short Score
041 - Lincoln County
Lincoln 741041 Single County 1 1 18
Lincoln County Health and Human Services 141999412M Comprehensive Health Center 0 2
Coastal Health Practitioners 141999412Q Rural Health Clinic 0 16
Lincoln City Medical Center 141999412R Rural Health Clinic 0 16
Native American Tribal
Siletz Community Health Clinic 141999413R 0 13
Population
Delake/Depoe Bay 141999413X Geographical Area 5 1 8
Depoe Bay CCD Minor Civil Division
Lincoln City CCD Minor Civil Division
Low Income - North Dunes/Siuslaw 141999419S Population Group 0 2 15
C.T. 9517.00 Census Tract
Lincoln County Health and Human Services 6419994173 Comprehensive Health Center 11
Low Income - Lincoln County 6419994174 Population Group 1 4 18
Lincoln Single County
Siletz Community Health Clinic 64199941A4 12
Population
Bayshore Family Medicine 64199941AF Rural Health Clinic 0 6
Lincoln City Medical Center 64199941AH Rural Health Clinic 0 23
Coastal Health Practitioners 64199941AI Rural Health Clinic 0 23
Lincoln County Health and Human Services 7419994149 Comprehensive Health Center 12
Siletz Community Health Clinic 7419994158 13
Population
Lincoln City Medical Center 741999416D Rural Health Clinic 0 22
Coastal Health Practitioners 741999416E Rural Health Clinic 0 22

Table 4-15B. HRSA-Generated Data for MUA/P

Criteria:
State: Oregon
County: Lincoln County
ID #: All
Results: 8 records found.
Name ID# Type Score Designation Date Update Date
Lincoln County
Yachats Service Area 07080 MUA 49.80 2001/09/13
CT 9517.00
Low Inc - North Lincoln 07327 MUP 61.40 2003/04/11
MCD (90884) Depoe Bay CCD
MCD (?) Unknown
Low Inc - Toledo 07378 MUP 60.80 2003/10/16
MCD (91020) Eddyville CCD
MCD (93230) Toledo CCD

In Lincoln County, three of Samaritan Health Services' hospitals are officially designated as rural
facilities, and they partnered with the Federal Office of Rural Health to form special collaborations to
address the particular needs of rural residents. The partnership, known as a Community Health
Improvement Partnership (CHIP), has been active in Lincoln County (Samaritan North Lincoln and
Samaritan Pacific Communities hospitals) since 2002.

19

In Lincoln County, the identified CHIP priorities are:
 Children's health
 School-based health clinics
 Chronic disease management
 Affordable health insurance
 Healthy communities promotion
 Access/referral to health services.
At one time, the four school-based health clinics in Lincoln County had lost state funding and were in
danger of closing their doors. By using data from the original health care gap assessment, the CHIP
partners were able to leverage initial CHIP seed money for bridge funding and other grants and all four
centers continue to operate. Additionally, the Lincoln County CHIP sponsors a children's health fair that
provides free immunizations and was selected to be one of Oregon's pilot-site counties for the Healthy
Community initiative and is working with the Kellogg Foundation to look at school-based clinics.
Additional Lincoln County projects include:
 Working with high school media departments to produce theater-related activities encouraging self-
esteem and good decision-making among local teens.
 Working with the Parish Nurse Program to set up classes to help parents initiate parent-teen talks. This
was a result of hearing parents express a need for tools to help them talk to their children about sex and
other teen behavioral concerns.
 Working with Medical Teams International to provide needed dental services.
4.2.7.1 Medical
When it comes to covering kids with health insurance, Oregon is a step ahead of national health care
reform36. Healthy Kids provides health coverage to all uninsured Oregon children, and no family earns
too much to qualify37. Healthy Kids covers all necessary care: doctor visits, dental care, vision,
prescription medicines, mental and behavioral health care, and more, with no hidden deductibles or high
co-pays. Even kids with current health conditions can enroll, and national healthcare reform protects the
Healthy Kids program for years to come.
CSCHS reports that 96% of enrolled children are covered by OHP, Oregon‟s traditional Medicaid
program. Healthy Kids is an alternate insurance coverage available to Oregon children. Table 4-16 shows
the OHP-accepting pediatricians and family medicine doctors in Lincoln County.
For children covered through private insurance, national health reform is making important
improvements:
 Health care reform eliminated pre-existing coverage exclusions for children. Pre-existing-condition
clauses had been a barrier to health care coverage for children. This meant that children with serious
medical problems couldn‟t get the health coverage they needed.
 Children‟s dental and vision needs will be covered beginning in 2014. Healthy Kids covers dental and
vision care but many private plans don‟t. National reform requires coverage of not only basic pediatric
services under all new health plans, but also dental and vision needs.
 The insurance exchange, a key component of national health reform, will provide a central
marketplace for health insurance, which puts families in charge of their child‟s health care and
provides options. The exchange will provide one-stop shopping for individuals and small businesses to
compare rates, benefits and quality among plans. The exchange will also administer the new federal
health insurance tax credits for those who qualify and make it easier to enroll in health insurance.

36
at www.oregonhealthykids.gov.
37
A family of four earning as much as $66,000 a year qualifies for subsidized, low-cost coverage.

20

Oregon‟s insurance exchange will complement the Healthy Kids program by providing more health
insurance choices to families without job-based coverage and providing tax credits to those who can‟t
afford it. This program ensures that children have access to affordable child-only health insurance
policies, regardless of whether their parents change jobs, leave a job, move, or get sick. Health care
reform will improve the quality of care children receive.

Table 4-16. Pediatric and Family Medical Providers Accepting Medicaid

Pediatric and Family Medicine Providers Lincoln County
Sean Rash Stephen Burns Linell Wood David Bice Robert Kay
Pediatric Physician Pediatric Physician Pediatric Physician Family Medicine Family Medicine
Coastal Pediatric Coastal Pediatric Coastal Pediatric Associates Newport Lincoln City
Associates Associates Newport Accepts OHP and new Accepts OHP and
Newport Newport Does not accept OHP but patients new patients
Accepts OHP and new Accepts OHP and new takes new patients
patients patients
Bayshore Family Jennifer Wrazen D. Orton Jerry Flamming TBA
Medicine Pediatric Physician Family and Emergency Family Medicine Family Medicine
Lincoln City Samaritan Waldport Medicine Depoe Bay Depoe Bay
Accepts OHP Clinic Lincoln City Accepts OHP and new Accepts OHP and
Waldport Accepts OHP and new patients new patients
Accepts OHP and new patients
patients
Marlene Nelson, Meg Lincoln City Medical Samaritan Waldport Clinic Samaritan Toledo John Leher
Portwood Center Waldport Clinic Family Medical
Coastal Health Lincoln City Toledo Clinic
Practitioners Accepts OHP Newport
Lincoln City
Theresa Curran, PA
Samaritan Coastal Clinic
Lincoln City

Table 4-17 shows the total institutional Medicare and Medicaid providers, including hospitals, nursing
facilities, federally qualified health centers, rural health clinics and community mental health centers
currently available in Lincoln County38.

Table 4-17. Institutional Medicare and Medicaid Providers, Second Quarter, 2011

Community
Total Federally Rural Mental
Geographic Institutional Nursing Qualified Health Health Health
Area Providers Hospitals Facilities Centers Clinics Centers
Lincoln County 21 2 2 8 4 0
Oregon 672 68 138 104 64 12
United States 75,166 7,195 15,714 4,923 3,899 633

38
U.S. Department of Health and Human Services, Centers for Medicare and Medicaid Services, Provider of Services File,
Second Quarter, 2011.

21

Table 4-18 shows 2011-2012 CSCHS data for enrolled children with respect to health insurance and
medical home.
Table 4-18. Medical Information for CSCHS Enrolled Children 2011-2012 School Year

Table 4-19 shows 2011-2012 CSCHS data for enrolled children with respect to medical services
provided.
Table 4-19. Medical Information for CSCHS Enrolled Children 2011-2012 School Year

22

4.2.7.2 Mental Health
According to available data39, currently practicing in Lincoln County there are counted six counselors,
seven clinical social workers/therapists, 1 marriage/family therapist, 1 substance abuse counselor, and 1
certified and registered psychologist, all of which list children as an aspect of their practice. It is unclear,
however, how many (if any) of those professionals accept OHP 40. When the search is expanded to include
neighboring county opportunities, the number of available mental health professionals greatly increases.
The American Mental Health Alliance regularly updates and makes available to practitioners and libraries
printed directories of therapists throughout of the Portland area and Oregon 41.
Locally, low- and no-cost mental health services can be accessed through Lincoln Community Health
Center (locations in Newport, Lincoln City, and South Beach), which is supported through Lincoln
County Health and Human Services Department, Federal HRSA grant, Oregon Department of Human
Services, Lincoln County, and funds through donation, foundations, and patient fees. Additionally, there
is a toll-free telephone number available for mental health emergencies, and the Children‟s Advocacy
Center in Newport is also listed as available for working with child mental health concerns.
In 2011, the last period for which data is available, only 7% of children statewide receive needed mental
health services, with the last two quarters of that year seeing a 10% drop in that 7% served. Conversely,
enrollment in OHP increased overall by 4% in the same timeframe. It would be positive to think that
fewer children need mental health services, but in areas such as Lincoln County, the downturn in mental
health service provision is more likely due to lack of available local providers.
Currently, for Lincoln County residents on OHP, the primary mental health provider is Accountable
Behavior Health Alliance (ABHA) which is located in Benton County, Corvallis specifically. Though
there are contracted ABHA providers who specialize in children, none are located in Lincoln County, so
families must travel substantial distance (40 miles or greater) for this vital service. Table 4-20 shows
2011-2012 CSCHS data for enrolled children.

39
American Mental Health Alliance, Psychology Today.
40
http://www.oregon.gov/oha/amh/child-mh-soc-in-plan-grp/docs/brs-provider-list-county.pdf - no providers listed in Lincoln
County who serve children and accept OHP.
41
http://or.americanmentalhealth.com/freeprintdirectory.trust?cart=13597328832166374.

23

Table 4-20. Mental Health Information for CSCHS Children 2011-2012

4.2.7.3. Dental Care
Dental care for OHP participants in Lincoln County is limited similarly as medical and mental health
provision and also contains no local pediatric specialists. Though potential transportation options are
available deliver patients to professional offices outside the local area, scheduling and timing continue to
present difficulties for low-income families. Table 4-21 shows the dental provider options available to
OHP recipients and, contained within that group, are four local options: two in Lincoln City, one in
Newport, and one in Toledo (again, none of whom serve young children).

Table 4-21. OHP Dental Providers in Lincoln County

24

4.2.8 Child Care
Lack of child care in Lincoln County especially
for working parents continues to be a significant
need, and for every 100 children who need
childcare, there are approximately only 19 slots
available with licensed facilities. Of course there
are opportunities for child care in unlicensed
private and family homes, but these facilities are
not eligible for State subsidy if any is available.
According to OSU‟s Childcare Research
Project, childcare costs about $35 a day per
child, and public subsidies for childcare have
been significantly reduced in recent years.
Figure 4-3 shows who pays for childcare in
Oregon.
4.2.8.1 Child Care Assistance
The Employment Related Day Care program
(ERDC) helps eligible low-income working
families pay for child care which assists lower-
income parent obtain and maintain employment Figure 4-3. Child Care Funding
as their children are cared-for in stable child
care arrangements. ERDC helps approximately 20,000 Oregon families every year pay for child care for
approximately 35,000 children each year and works with providers and other childcare partners across the
state to help families find and keep good childcare, improve the availability of quality childcare in
Oregon, and to develop resources for parents and childcare providers.
If a parent qualifies for assistance, DHS will pay a portion of their child care bill, the amount of which is
based on the family‟s income, type of child care, and how many hours of child care are needed. Most
parents are required to pay part of the cost, and DHS pays its portion to the family‟s child care provider
directly. Providers must apply and pass a background check to participate.
The number of families served is based on the program‟s budget, and the program budget and caseload
maximums are set by the Oregon State Legislature. The caseload maximums started July 1, 2011:
 July 2011 through December 2011: 9,000 cases;
 January 2012 through December 2012: 9,500 cases; and,
 January 2013 through June 2013: 10,000.
When the caseload maximum is reached, a reservation list will be created. As there are openings, families
on the waiting list will be randomly selected and invited to apply – within 30 days – for the subsidy.
Additional, non-subsidized childcare resources might be available through the Oregon Child
Care Resource and Referral Network42 and/or the Family Care Connection which is operated through the
Oregon State University Extension Service43.

42
http://www.oregonchildcare.org.
43
http://extension.oregonstate.edu/lincoln/family_care .

25

4.2.8.2 Child Development Programs (in addition to CSCHS)
Newport Montessori - Preschool
1428 Northeast Yaquina Heights Drive, Newport, OR
(541) 265-3572

Mouse Factory Co-Op - Preschool
227 Northeast 12th Street, Newport, OR
(541) 265-5527

Nye Beach Montessori School - Preschool
144 Southwest Coast Street, Newport, OR
(541) 265-3027

ABC Preschool Kindergarten
208 Northwest 6th Street, Newport, OR
(541) 265-2654

4.2.9 Domestic Violence
The annual survey conducted by the National Network to End Domestic Violence (NNEDV) provides
insight into domestic violence services in the United States. On September 15, 2011 – one 24-hour period
– domestic violence victim advocates served more than 67,000 victims and answered more than 22,000
emergency hotline calls. This annual snapshot shows that shelters and programs continue to find a way to
help almost the same number of victims in one day as in past years – a staggering 67,399 adults and
children. However across the United States there were 1,040 more unmet requests than in September
2011.
In Oregon44, though 1,692 victims were served that day, there were also 423 unmet requests for services;
70% were people looking for emergency shelter and transitional housing. Across the nation, the unmet
requests are 16% of the number of people served. In Oregon, the unmet requests total 25% of the number
of people served. Programs reported they were unable to provide services for many reasons:
 42% not enough funding for needed programs and services
 40% not enough staff
 38% not enough specialized services
 31% no available beds or funding for hotels
 9% limited funding for translators, bilingual staff, or accessible equipment
My Sisters‟ Place (MSP) in Lincoln County is a private non-profit program, incorporated in 1980, which
provides supportive services to victims of domestic violence, sexual assault, and dating abuse. Services
include crisis intervention, emergency shelter, 24-hour crisis line, safety planning, advocacy, court
information and support, agency referral, education and outreach activities.

44
http://nnedv.org/docs/Census/DVCounts2011/DVCounts11_StateSummary_OR.pdf.

26

LCHS Community Assessment 2012 2013

LCHS Community Assessment 2012 2013

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