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Annual Review FY 2019

2019 Annual Review CoverNote from the executive director

The Rural Institute for Inclusive Communities fosters research partnerships, provides education and training, and offers services that improve the quality of life for people with disabilities, their families and those who partner with them. This past year provided our team of 70 staff and students abundant opportunities to demonstrate our commitment to this mission.

We value our relationships with advocates, families, funders, researchers, policy-makers, and local, state and national agencies as we address policy challenges, learn better ways of doing things, and improve disability-related services. These relationships take us across Montana and into rural and urban communities across the U.S. and beyond.

We are successful when we harness the strength of community to meet shared challenges and address emerging and ongoing needs. In the year ahead, we will advance our commitment to support children, youth and adults with disabilities to fully participate in their communities. We appreciate your continued partnership and look forward to more opportunities for learning and growth.


Martin E. Blair, PhD
Executive Director


FY 2019 budget = $4,463,013
25% Education
45% Research
30% Service

28 published articles and reports


Local Partnerships Lead to International Exchange

In late 2018, the Rural Institute, Summit Independent Living, and the University of Montana Mansfield Center hosted Ms. Nguyen Thi Van for a three-week visit. Ms. Nguyen was recognized by the British Broadcasting Corporation as one of 100 inspiring and influential women in 2019. She is the director of the Will to Live Center which provides vocational training to people who are disabled, and Imagtor, a company that creates real estate marketing materials.

In May 2019, Bronwyn Troutman, Community Living Specialist at Summit Independent Living and Anna-Margaret Goldman, MonTECH director, visited Vietnam to expand the partnership between the Rural Institute, Summit Independent Living, the Will to Live Center, and Imagtor.

Ms. Troutman led workshops that featured content from the Rural Institute’s Healthy Community Living and Working well with a Disability programs. Dr. Goldman shared information on assistive technology.



63 students mentored across 14 disciplines
2019 63 students
2018 54 students
2017 42 students

5,777 people trained in Montana and across the country


Expanding Understanding of participation

Participating in the community requires effort, and everyone has different amounts of energy they can spend before needing to rest. For many people with disabilities, this means making tough choices about how to spend their available energy.

The Effort Capacity and Choice project explored ways to conserve a person’s energy and reduce the effort required to perform certain self-care activities. One intervention paired participants with a licensed physical therapist to assess physical needs. Participants were provided bathing equipment and trained on its use. The other intervention provided guided physical activity in an accessible gym.

Both interventions led to positive results: participants reported increased energy and more choices and opportunities to participate. Findings from this study are currently being prepared for publication.


Investigating Place-Based Solutions for Rural Community Participation

In 2018, the Rural Institute received a five-year, $4.3 million grant to support its Research and Training Center on Disability in Rural Communities (RTC:Rural). The award continues 30 years of RTC:Rural research and training to improve the lives of rural people with disabilities.

“The opportunity to build on our past work and continue to conduct applied research with our stakeholders from the disability community is a great honor,” said RTC:Rural Director Dr. Catherine Ipsen.

RTC:Rural research addresses barriers identified by rural people with disabilities in the areas of health, community living, and employment. These barriers are often related to the limited resources available in rural environments.


RESEARCH

Montana Pediatric Medical Passport (MP2)
Builds an app for healthcare information and decision making

Montana Access to Pediatric Psychiatry Network (MAPPNet)
Evaluates impact of statewide pediatric telehealth program

Effort Capacity and Choice
Investigates the link between energy exertion and quality of life

School Climate Transformation: MBI in High Need Areas
Evaluates effectiveness of PBIS in high-need schools

Achieving Success by Promoting Readiness for Education and Employment
Evaluates impact of independent living and employment supports on families

Partnering with Women with Disabilities to Develop a Health Information Website
Creates an online health information resource for women

Texas Model Spinal Cord Injury (SCI) Systems
Evaluates ways to improve the health of people with SCI

Pain, Depression, & Resilience & their Prediction of Life Satisfaction in people with SCI
Identifies the impact of Spinal Cord Injury on life satisfaction

Rocky Mountain Region ADA Research
Researches ADA legal issues

Home Usability Project
Promotes community participation of adults with disabilities

Out and About
Evaluates community intervention to promote health and wellness

Expanding the Availability and Quality of Rural Data
Rural analyses of existing large data sets

Exploring Rural Disability Onset
Understands how disability evolves             

Rural Access to Health Insurance and Health Care
Answers questions about health care and quality of life

Rural Resource Analysis
Maps community resources and networks

Building Networks to Expand Living Well Delivery
Scales up Living Well to rural hospitals

Personal Assistance Services in Rural America
Explores and addresses rural PAS outcomes

Rural Transportation Options
Explores accessible transportation in rural communities

Rural Self-Employment
Develops and evaluates online tools for state and tribal Vocational Rehabilitation


SERVICE AND EDUCATION

MonTECH: Montana’s Assistive Technology Program
Technology to support independence across the lifespan

Wheels Across Montana
Provides adaptive trikes in rural communities

Montana Family to Family Health Information Center
Provides family-focused healthcare information

Montana Disability and Health Program
Promotes health-related policy and practice initiatives

Children’s Special Health Services: Montana Transition Resources
Transition-to-adulthood health resources for youth, families and providers

Working Well with a Disability
Peer-led health and wellness training and support

Healthy Community Living
Independent living workshops focused on health and community living skills

Montana Healthy Communities
Accessible community health training

Montana Autism Center
Developmental resources for families and providers

Diversity Fellowship Program
Graduate fellowship for culturally-diverse students

UR-LEND
Leadership education in family-centered healthcare

UM OUTREACH
Trains speech language pathologists in rural and tribal communities

Movin’ On in Montana
College experience for high school students with disabilities             

National Disability Navigator Resource Collaborative
Promotes accurate ACA Marketplace information

All of Us Outreach in Montana
Recruits participants for national health outcomes research

Deaf-Blind Project
Resources and assistance to local school systems

NCDB: Transition Outcomes for Youth with Deaf-Blindness
Training to improve transition outcomes for youth


Partnering with families

In 2019, the Rural Institute opened the Montana Family to Family Health Information Center (F2F- HIC), furthering the Institute’s mission to partner with people to improve services, supports and outcomes for people with disabilities and their families.

The family-led F2F-HIC improves access to evidence-based health information so parents and families of children and youth with complex health needs and medical providers can make informed choices.

The F2F-HIC also:

  • Provides family-to-family and peer-to-peer support
  • Offers family training to help negotiate the healthcare system
  • Trains healthcare professionals to understand needs of children with special health care needs


Creating healthy Communities

Reaching People with Disabilities through Healthy Communities is a national initiative to design communities that support people with disabilities. The Rural Institute’s Meg Ann Traci, Project Director for the Montana Disability and Health Program, served as an expert advisor on Montana’s task force. Community members with disabilities, public health representatives, city planners, and people from independent living were included in the diverse task force.

In Butte, group efforts led to an inclusive swimming pool and playground. In Helena, inclusive planning resulted in the Active Living Wayfinding System, a navigation tool that incorporates accessible route design and signage for parks, trails, and streets. Now, both cities have features planned by community members of all abilities that enables everyone to participate in healthy community experiences.


Supporting emerging leaders

The Rural Institute’s Diversity Fellowship Program supported two American Indian graduate students: Salena Beaumont Hill, a PhD student in Counselor Education and a member of the Crow Tribe and a Blackfeet tribal descendant, and Helen Russette, a PhD student in Public Health and a member of the Chippewa Cree Tribe.

Ms. Hill and Ms. Russette developed and taught The Intersectionality of Disability, American Indians and Rurality, an online course for graduate and undergraduate students at the University of Montana. The course explored the cultural aspects of being American Indian and how culture relates with the realities of rurality and disability.

“The opportunity to develop and teach an interdisciplinary course focused on American Indian culture, health policies, and accessibility issues was a very rewarding experience,” shared Hill. “I appreciated the opportunity to both teach and learn from the extraordinary students enrolled in the class.”

Annual Report FY 2018

Rural Institute Cover AR FY2018DRIVING CHANGE CHANGING LIVES

Annual Report FY2018

Beginning with the first $200,000 grant in 1978, Rural Institute staff have raised over $175 million to meet the needs of people with disabilities. Dozens of education, research and service initiatives have come and gone over our 40-year history, but they have a common theme: Partnership.

Thoughtful reflection on the lessons we have learned with our partners and the good we have done over four decades demonstrates we are at our best when working side-by-side with those who benefit from our efforts. We appreciate and value people with disabilities, their families, the service providers and personal assistants who assist them, and policy makers who work closely with us. It is through our shared expertise that we achieve our most important successes—the improved quality of life and life satisfaction of people with disabilities and their families. Year 41 starts now and we look forward to working with you in the years to come!

Marty Blair


RESEARCH - Exploring Rural Disability

The Research and Training Center on Disability in Rural Communities (RTC:Rural) helps people with disabilities participate in their rural communities. RTC:Rural conducts research and provides training and technical assistance in the areas of health, employment, and independent living. We collaborate with individuals with disabilities, family members, and service providers to uncover personal and environmental factors that influence disability and quality of life. Together, we identify research priorities, understand findings, and develop best practices for applying research in rural communities.

Recent Research and Development activities at RTC:Rural:

  • Geography of Rural Disability analyses lay the groundwork for examining demographics of people with disabilities living in rural areas. This work has led to the creation of the Step-by-Step Guide to Accessing Disability Data that explains how to get disability data and make maps to show the data.
  • Employment research explores solutions to barriers people with disabilities face in achieving and maintaining employment. We created the Vocational Rehabilitation Self-Employment Guide, a web-based tool for individuals and VR counselors to assess self-employment readiness and develop a business plan.
  • Health and Wellness activities aim to address unique rural health challenges by developing and testing health promotion delivery models to serve people with disabilities in rural areas. Through RTC:Rural’s training and technical assistance activities, service providers share their experiences and receive support to implement the Living and Working Well with a Disability Programs.
  • Rural Community Living research focuses on how the accessibility of rural environments affects community participation and quality of life. This research led to the creation of resources available through the Rural Disability Resource Library and includes the Toolkit for Operating a Rural Transportation Voucher Program, developed with the Association of Programs for Rural Independent Living (APRIL).

A sample of upcoming Research and Development activities include the:

  • Geography of Rural Disability project which continues to study the relationships between the presence of community resources and disability rates in rural communities across the U.S.
  • Rural Self-Employment project, a collaboration with American Indian VR service providers, to adapt the VR Self-Employment Guide website for people with disabilities residing on rural American Indian Reservations.
  • Rural Community Living research initiative to explore rural-urban differences in personal assistance services (PAS) and develop an adapted PAS training for providers working in rural communities.

EDUCATION - Building the future

Utah Regional Leadership and Education in Neurodevelopmental Disabilities (UR-LEND)

The Rural Institute partners with the Utah Center for Persons with Disabilities and the University of Utah School of Medicine to train Montana graduate students to become leaders in providing family-centered care for children with special healthcare needs. Trainees from different disciplines attend weekly seminars on topics such as epidemiology of developmental disabilities, special education law, working with refugee families and financing healthcare, among many others. Family perspective is the thread that weaves through every lecture and community-based training experience. Trainees complete the program with an improved ability to collaborate with other healthcare professionals outside their discipline, an increased ability to recognize and address the complexity of disability, and a deeper understanding of the value of family input while providing evidence-based care.


SERVICE - Helping people achieve independence and self-support

MonTECH provides technology, support, and services that improve the quality of life for Montanans with disabilities. By loaning assistive technology and adaptive equipment, MonTECH helps people increase their independence. For example, screen reader software and screen magnifiers allow Montanans with low vision read books or watch sporting events. A grandfather who is hard of hearing used a Contego listening device to join conversations at his family reunion. MonTECH’s free device-loan program enabled Olivia, an 11-year-old with dyslexia and dysgraphia, explore how an iPad could help her ‘ear read,’ learn, and show others what she knows. With her new iPad, she is successful and less anxious at school.

MonTECH loans assistive technology and adaptive equipment to any Montanan with a disability. Last year, over 800 devices were borrowed by Montanans looking for tools to help them live more independently. MonTECH saved device borrowers $230,055 through open-ended loans and device reuse. In partnership with Rural Dynamics, Inc., MonTECH offered 15 financial loans to Montanans who could not otherwise afford assistive technology equipment.


A Year in Review

$6,498,767 Rural Institute FY2018 Annual Budget

18 Funding proposals submitted

37 Programs & Projects

  •  13 Community Service and Training
  •  24 Research and Evaluation

58 Trainees representing 13 disciplines

41 Seats on local, state and national committees, councils and boards

16 Reports and Monographs

115 Training activities that served 7,075 participants

42 Conference presentations and posters

10 Peer-reviewed articles submitted to scholarly journals for publication


Visit us:

Rural Institute - ruralinstitute.umt.edu

RTC:Rural - rtc.ruralinstitute.umt.edu

MonTECH - montech.ruralinstitute.umt.edu

Disability Counts - rtc.ruralinstitute.umt.edu/geography

Telecom Toolbox - telecomtoolbox.ri.umt.edu

Healthy Community Living - healthycommunityliving.com


RESEARCH

Healthy Community Living - Independent living skills and multimedia health promotion program

SAFETY Project - Self-advocacy training to prevent interpersonal violence

Concerns Report Method: A Family-Centered Approach to Quality Services - Family and provider input on children’s health services

Effort Capacity and Choice: Investigating a Dynamic Model of Participation - Investigates link between personal exertion and impact on choices

School Climate Transformation: MBI in High Need Areas - Evaluation of PBIS in high-need schools

Partnering with Women with Disabilities to Develop a Health Information Website - Creating an online information resource on women’s health

Texas Model Spinal Cord Injury (SCI) Systems - Evaluating ways to improve the health of people with SCI

Pain, Depression, and Resilience and their Prediction of Life Satisfaction in people with SCI - Identifies impact on life satisfaction

Achieving Success by Promoting Readiness for Education and Employment (ASPIRE) - Evaluation of comprehensive independent living and employment supports

Rocky Mountain Region ADA Research - Partnership to research ADA policy issues

All of Us - Collection of health data to improve outcomes

Home Usability Project - Promoting community participation of adults with disabilities

Out and About - Intervention to promote wellness, goal-setting and self-advocacy skills

RTC: Rural RESEARCH

Monitoring and Managing Community Accessibility

Ecological Decision Support for Health Promotion

Geography & Rural Disability

The Ecology of Rural Community Participation

Resilience in Rural Community Participation

Person - Environment Fit in Rural Communities

Measuring Opportunities in Rural Events

Rural Contracted Services

The Use of Social Media for Employment

Rural Self Employment Opportunities

Funded for 2018-2023

Building Networks to Expand Living Well Delivery

Personal Assistance Services (PAS) in Rural America

Rural Transportation Options

Rural Self-Employment

Expanding the Availability and Quality of Rural Data

Rural Resource Analysis

Rural Communication Strategies


SERVICE / EDUCATION

Living Well / Working Well with a Disability - Peer-led health and wellness training and support

Healthy Communities for People with Disabilities - Supporting accessible community health initiatives

Montana Disability and Health Program - Policy and practice initiatives to promote health and wellbeing

Inclusive Healthy Communities - Promoting community health initiatives

MonTECH: Montana’s Assistive Technology Program -Technology for independence across the lifespan

Wheels Across Montana - Free access to adaptive trikes

Children’s Special Health Services: Montana Transition Resources - Transition-to-adulthood resources for youth, families and providers

National Disability Navigator Resource Collaborative (NDNRC) - Resources to ensure accurate ACA Marketplace information

Montana Early Diagnosis - Developmental milestone resources for families and providers

Deaf-Blind Project - Assistance to school systems

Pre-Employment Transition Services Technical Assistance Center - Training and assistance to schools and employment providers

UR-LEND - Leadership education in family-centered healthcare services

Movin’ On in Montana - College experience for high school students with disabilities

UM OUTREACH - Training speech language pathologists in rural and tribal communities


Spotlight on RIIC projects:

Addressing Abuse Against People with Intellectual Disabilities

The Rural Institute is a national leader on research and training to prevent abuse of people with disabilities. Recently, Rural Institute researchers and colleagues partnered with people with intellectual disabilities and staff from 13 Centers for Independent Living across the U.S. to create The Safety Class, an eight week safety awareness program for people with intellectual disabilities. Initial feedback shows that the program is an effective way to teach safety skills and awareness. Participants stated:

“I liked learning about how to be independent, the types of abuse, how to be assertive.”

“[I liked] listening, hearing about abuse and how to talk about relationships. If you have something to say about abuse, tell someone.”

“[I] Learned about boundaries, being assertive, saying no in a difficult situation, telling someone I trust my story so they can help me.”

The Safety Class is the first known violence prevention group program designed for people with disabilities that has undergone a rigorous evaluation by 170 people with intellectual disabilities. National partners are working with us to make this program available across the U.S.

Healthy Community Living (HCL)

RTC:Rural brought together Centers for Independent Living (CIL) staff and consumers, the Association of Programs for Rural Independent Living (APRIL), and researchers to create Healthy Community Living (HCL). HCL is an inclusive health, wellbeing and independent living skills program. HCL includes two workshops (Community Living Skills and Living Well in the Community) designed to accommodate the diverse learning styles and needs of participants. Both workshops are delivered via multi-media websites that feature images and videos created and collected by project partners. HCL was created and piloted with more than 20 staff members at 12 CILs across the U.S.; the full program launch is expected in 2019.


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Update on Medicaid spending bills

Important bills that have passed House and Senate and now are being transmitted to Governor’s office

HB 334  AN ACT DIRECTING THAT MEDICAID APPROPRIATIONS BE USED ONLY FOR MEDICAID EXPENDITURES;
AND PROVIDING AN EFFECTIVE DATE.

Listen to hearing on HB 334 at the following link
http://montanalegislature.granicus.com/MediaPlayer.php?clip_id=21766&meta_id=189708
•    Read Bill
http://leg.mt.gov/bills/2017/billpdf/HB0638.pdf
•    Follow Bill
•    http://laws.leg.mt.gov/legprd/LAW0203W$BSRV.ActionQuery?P_SESS=20171&P_BLTP_BILL_TYP_CD=HB&P_BILL_NO=638&P_BILL_DFT_NO=&P_CHPT_NO=&Z_ACTION=Find&P_ENTY_ID_SEQ2=&P_SBJT_SBJ_CD=&P_ENTY_ID_SEQ=
•    Let Governor Steve Bullock know Money appropriate by Legislature for individuals with Disabilities is important to be spent on service for people with Disabilities.
https://governor.mt.gov/Home/Contact/shareopinion

SB 208 AN ACT ESTABLISHING REQUIREMENTS FOR THE USE OF MONEY APPROPRIATED FOR MEDICAID
HOME AND COMMUNITY-BASED WAIVER SLOTS; PROVIDING DIRECTION TO THE DEPARTMENT OF
PUBLIC HEALTH AND HUMAN SERVICES ON THE 0208 WAIVER FOR INDIVIDUALS WITH
DEVELOPMENTAL DISABILITIES; AND PROVIDING AN EFFECTIVE DATE.

Listen to hearing on SB 208 at the following link
http://montanalegislature.granicus.com/MediaPlayer.php?clip_id=22368&meta_id=202025
•    Read Bill 208
http://leg.mt.gov/bills/2017/billpdf/SB0208.pdf
•    Follow Bill
http://laws.leg.mt.gov/legprd/LAW0203W$BSRV.ActionQuery?P_SESS=20171&P_BLTP_BILL_TYP_CD=SB&P_BILL_NO=208&P_BILL_DFT_NO=&P_CHPT_NO=&Z_ACTION=Find&P_ENTY_ID_SEQ2=&P_SBJT_SBJ_CD=&P_ENTY_ID_SEQ=
•    Let Governor Steve Bullock know Money appropriate by Legislature for individuals with Disabilities is important to be spent on services for people with Disabilities.
https://governor.mt.gov/Home/Contact/shareopinion

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