Distance Education Feasibility Study Mental Health Funded .

Transcription

Distance Education Feasibility StudyMental HealthFunded bySuperior Region Workforce, Education and Training CollaborativeHumboldt State University Department of Social WorkCalifornia State University, Chico School of Social WorkOctober 2009Pamela A. Brown, ProfessorTene Kremling, LCSWDepartment of Social WorkHumboldt State UniversityArcata, CA 95521Donna Jensen, LCSW, Mental Health CoordinatorMeredith Ray, MSWSchool of Social WorkCalifornia State University, ChicoChico, CA 95929

Table of ContentsIntroduction . . 6Methods and Sample . . 7FindingsCentral/Eastern RegionButte CountyStaff . . 8Employers . .11Colusa CountyStaff .12Employers . . .15Glenn CountyStaff. .15Employers . . .16Lake CountyStaff . 17Employers .19Lassen CountyStaff . .19Employers . . .22Modoc CountyStaff . . .22Employers . . 242

Nevada CountyStaff . . .25Employers . . 27Plumas CountyStaff . . .28Shasta CountyStaff . .28Employers 30TehamaStaff . . . .30Employers. . . 32Coastal RegionDel Norte CountyStaff . .33Employers. . .36Humboldt CountStaff . 37Employers . .39Mendocino CountyStaff. . . 40Employers. . . .43Trinity CountyStaff . 453

Employers . . .45Coastal Tribal Social Service ProgramsStaff . 46Employers . .49Superior Region Snapshot . . .51Staff Responses . . 52Resources . .56Community CollegesCentral/Eastern Region .57Butte-Glenn Community College . .57College of the Siskiyous . 58Feather River College . 59Lassen Community College . . .59Shasta Community College . .60Sierra Community College . . 61Coastal Region 62Current Programs . . .62Program and Curriculum Development . .63Distance education capability . . 64Summary . 65AA Curriculum .65Nursing Programs . . . .67Other Training Needs . . . .70Summary . . 704

Recommendations . . . .72Acknowledgements . 74Participants from Counties, Tribes and Community Colleges . .745

INTRODUCTIONThe service area of the Superior County Mental Health Region consists of the 16 northernmostcounties in California. The region is served by two public universities, California StateUniversity, Chico (CSUC) and Humboldt State University (HSU). Both universities offer socialwork and nursing programs. CSUC covers 12 Northeastern California counties (Butte, Colusa,Glenn, Lassen, Modoc, Plumas, Shasta, Siskiyou, Tehama, Lake, Sierra and Nevada). HSUcovers four Northwestern California counties (Del Norte, Trinity, Humboldt and Mendocino).According to the CSUC Center of Economic Development (1999), this region is unique in thatthere are no large cities, and the service area is composed predominantly of small cities andtowns with large areas of rural countryside. The “North State” area covers an area larger than thestate of Iowa (56,796 square miles) and has many rural areas where there are distinct needs. Forperspective, this geographic region, is 35% of the land mass (in square miles) of the state ofCalifornia and is larger than 26 other entire states in the United States. For purposes of this studyand future planning, the Superior Region was divided into three geographic regions to utilize as areference: the coastal region (Del Norte, Humboldt, Mendocino and Trinity counties), centralregion (Shasta, Tehama, Butte, Glenn, Colusa and Lake counties) and eastern region (Siskiyou,Modoc, Lassen, Sierra, Nevada and Plumas counties). CSUC surveyed the central and easternregions while the coastal region was surveyed by HSU.The geographic distances in the northern California coastal and eastern regions are significant,with many winding roads and a winter climate in some of the more mountainous areas can makedriving difficult, if not impossible. There is a fairly good public transportation system in thecities, but it is not adequate in the outlying, more rural parts served by the higher educationinstitutions. There are also entire counties in the Superior Region that have no public transitsystem. In the recent past, there have been some distance education efforts in the SuperiorRegion. CSU, Sacramento and CSU, Long Beach (CSULB) have both offered distance MSWprograms based out of Ukiah, Redding and Chico. These were weekend programs at whichstudents commuted to the city and spent the weekend in classes. Some years ago, CSUC offeredgeneral education courses via satellite in Crescent City; this was discontinued. Within the pastfour years, HSU offered courses in Child Development to staff in Covelo, who serve theindigenous community of the Round Valley Tribes. Between 1995 and 2004, CSULB graduatedthree cohorts of MSW students using videoconferencing as the primary course delivery. In spiteof a stated need in most of the counties represented in this study, no comprehensive distanceeducation programs currently exist.It was in response to a stated need by mental health directors in the Superior Region that a needsassessment was undertaken in 2009 to determine the need in the more remote areas for degreedstaff in mental health and the potential interest among mental health staff to pursue their AA,LVN, BSW, RN, MSW and Nurse Practitioner degrees. It is the experience of the county andtribal social service directors that “home grown” staff tend to be more satisfied with their work,in tune with local cultures, and remain in their positions longer than people who are hired fromoutside the region. This is even more significant in indigenous communities where culturalcompetence is critical to effective service delivery. It was the intention of this study to documentto what extent county and tribal social services could support their staff to pursue higher6

education, the level of interest among their staff and what configuration of a distance degreeprogram might meet their current life situations.METHODS and SAMPLESixteen counties and seven tribal social service programs were targeted for the surveys, meetingsand interviews. The counties invited to participate were Butte, Colusa, Del Norte, Glenn, Lake,Lassen, Humboldt, Mendocino, Modoc, Nevada, Shasta, Tehama and Trinity. Multiple attemptswere made to include Siskiyou, Plumas and Sierra Counties, but without success. Tribesparticipating in the study were Elk Valley Rancheria, Hoopa Tribe, Resighini Rancheria, RoundValley Tribes, Smith River Rancheria/Tolowa Nation, Trinidad Rancheria and Yurok Tribe. InTrinity County, we were directed to the Nor El Muk Band of indigenous people. They are notincluded in the survey. However, this is a very remote area and we will want to include them inany distance education offerings in the Trinity area. Bear River Band of the RohnervilleRancheria and Table Bluff Rancheria were not included in this study, but would be tribes toinclude in any educational efforts.The sample populations were different for the two surveys. In the Coastal Region survey, thesample was all current employees and volunteers in a county, community based contractedorganization (CBO’s) and tribal social service programs. This decision was based on thepotential that a staff, for example, working in public assistance or WIC, may have a desire to bea social worker; that staff person is familiar with the culture and resources within the health andhuman service system. Therefore, they too represent a “grow our own” pool of possible staff formental health.In the central/eastern region, the survey went only to staff employed in mental health branchesand CBOs. Surveys from the central/eastern region were much more successful with return ratesfrom CBOs while in the coastal region, there was a higher response rate from tribal social serviceprograms. For each county and tribal social service agency, the directors or their appointedadministrative staff participated in face-to-face or telephone interviews and/or focus groups andmeetings. Three directors submitted written surveys.Three standardized survey instruments were developed through the CSUC and HSU partnershipand were approved on each campus by the Institutional Review Boards. Survey Monkey, a webbased survey platform, enabled easy access for mental health and tribal employees, as well asconsumer and family member volunteers. County staff were informed via email sent out by thesupport staff in each agency. In some instances due to lack of technology in agencies, staff senthard copies of their survey response, which was then input to Survey Monkey. The “EmployeeInterest Survey” consisted of 15 questions about level of interest, potential for promotion orsalary increase with a degree, relevant level of degree, (i.e. AA, LVN, BSW, RN, PHN, MSW,Nurse Practitioner), preferred mode of delivery, barriers to education and so on. Commentsections followed most of the questions. The “Employer Interest Survey” included 27 questionsthat focused on the need for degreed staff in social work and nursing, the expected number ofhires in the next five years, the level of support that a student could be given, the availableresources in the agency (e.g. computers, rooms), and the desired curriculum content in AAprograms.7

The survey for county and tribal social services staff was carried out online from March throughSeptember 15, 2009. For some agencies, hard copies were delivered and returned and later putinto Survey Monkey. Follow-up was made with CBOs. The meetings with county mental healthand tribal social service directors occurred in April through August. A total of 686 staffresponded to the survey.1 Everyone did not respond to all questions, so the numbers in the tablesthat follow do not always add up to 100%.Relevant faculty and administrators at seven community colleges in the region were contactedand interviewed during spring and summer 2009. These include Butte-Glenn CommunityCollege, College of the Redwoods, College of the Siskiyous, Lassen Community College,Mendocino College, Sierra College and Shasta College. The meetings with community collegesaddressed the questions in the “Community College Survey” about existing technologicalresources, certificate and degree programs, curriculum content for an AA in Human Services,articulation agreements with four-year institutions (namely HSU and CSUC), and potentialbarriers to developing a distance education model. In addition, nursing programs at CSUC andHSU and other institutions that offer nursing education in the Superior Region were reviewed.CENTRAL/EASTERN REGIONButte CountyStaffElectronic surveys were sent to the Butte County Department of Behavioral Health (BCDBH) aswell as its contracted agencies. Ninety-one individual responses were evaluated. Sixty-tworespondents (68.1%) work for the county mental health agency, 38.4% (35) are currentlyemployed at a CBO with one respondent each stating employment at Butte Community Collegeand in private leEthnicity:LatinoCaucasianNative AmericanMulti-racialOtherAge:Under 3031-40Percent/Count22.0% (20)76.9% (70)5.5% (5)75.8% (69)1.1% (1)5.5% (5)6.6% (6)*7.7% (7)33.0% (30)1Shasta County Mental Health is not represented in this statistical snapshot. It had conducted its own needsassessment and therefore is not a part of our findings. The information for Shasta County is available on page 27.8

41-5051-60Over 60No Comment25.3% (23)19.8% (18)9.9% (9)4.4% (4)Other: Native American and Caucasian (2), Pacific Islander (1), Jamaican & Pueblo Indian (1), “Not sure whatyou’re asking” (2).Many individuals were interested in promotion to a higher job classification with 79.7% (63)respondents saying yes. Forty of those (58.8%) indicated that additional formal education wouldhelp facilitate that promotion with 20.6% (14) feeling that additional onsite job training wouldassist with a promotion. There were numerous written responses, with major themes being 1)obtaining a clinical license, 2) obtaining a Pupil Personnel Services (PPS) certification, and 3)job position availability.Barriers to Training and EducationAnswer he commuteFinances/cost of attendingGetting release from workLength of time it takes to complete the degreeLimited time available due to workProgram not availableFamily responsibilitiesLack of personal support (i.e. people makefun/stigmatize/segregate me/first time college3.5%student)Other (please specify)*14.0%answered questionskipped questionCount740141834925285734Other: “PPS not available at local university,” “Nothing, if I want something bad enough, I will find a way to do it,training and education are not barriers,” “Administrative indifference,” “Currently in MSN program,” “Doubtwhether I would have the ability to continue to manage current health issues on top of managing job AND amaster’s degree program.”9

Educational GoalAnswer OptionsHigh School Diploma/GEDAA degree in Human ServicesBachelor's degree in Social Work (BSW)Master's degree in Social Work (MSW)Licensed Vocational Nurse (LVN)Registered Nurse (RN)Bachelors of Nursing (BSN)Masters in Public Health (MPH)Nurse Practitioners License (NP)Other degree (please .7%63.8%answered questionskipped questionCount013932201375833Other: MFT/psychology (4), PPS (1), PhD (9), public administration (2), AA (3), master’s undecided, generaltraining/fellowships and others unrelated to the mental health field.Thirty-four respondents (47.2%) were either very or moderately interested in enrolling in aneducational program that was delivered via online and fac-to-face instruction while 52.8% (38)were not interested.Preferred DeliveryAnswer OptionsOnline courses on the InternetOn-site courses taught where I liveVideoAll of the aboveOther (please specify)*Percent40.0%26.0%10.0%48.0%18.0%answered questionskipped questionCount201352495041Other: “does not apply” or “NA.”Respondents expressed mixed feelings regarding distance education specific to online delivery.There were equal numbers of comments from those desiring increased accessibility via onlinedelivery and those who prefer face-to-face contact, feeling that they would need the motivationto attend a class in person to stay on track with their education.10

Preferred TimeAnswer OptionsEveningWeekdayWeekendAny of theseOther (please specify)*Percent65.5%9.1%50.9%20.0%9.1%answered questionskipped questionCount365281155536Other: “24 hr. accessibility on the Internet,” “Less likely to attend onsite classes after working all day. I now attendonline classes for my BA and this is much better for someone who works full-time Online allows much morefreedom and better time management,” “flexibility within times,” “Video or online that I could work on at my ownpace,” “streaming video with student/teacher chat room.”Most respondents, 53.8% (28), would prefer two courses per semester with 11 (21.2%) desiringone course and seven (13.5%) desiring four (full-time) courses per semester. If given time off orthe ability to flex work time, 80.3% (49) of respondents were willing to commit to ongoingemployment in mental health services for an agreed upon time. Nine respondents were not sureand three stated they probably would not commit to employment in exchange for theiremployers’ support of their education.More than 79% of respondents stated they would be able to travel to Butte Community Collegeto take courses. Given the geography of Butte County, it is somewhat reasonable to assume thatthe CSUC campus would also be accessible although it was not given as an option to thisquestion. Twenty-eight (48.3%) of respondents indicated that their county agency would beaccessible to them. Of the 53.4% (31) individuals who selected a community site as accessible,most of the comments recommended CSUC campus, BCDBH or “any Butte County site.”Other staff comments that were not uncommon themes were, “Make it flexible online would bethe best option for those of us that are stretched so thin,” “ it would be nice if the educationalsystem would create an educational degree based on those who already work full-time. Creatingassignments that would be integrated into the ‘student’ work environment practicallearning it would be a good time to implement an integration of the workforce and educationalsystems to create a necessary growth for economic fruition” and“ the three-year program at Chico State is quite ideal. My extenuating circumstance was that Ihave not completed my probationary time period with the county and my job requires numerousweekend commitments. Thank you for looking into the interest in this.”EmployersThe BCDBH director appointed the BCDBH Mental Health Services Act (MHSA) coordinatoras primary contact for this survey. An administrative representative from a CBO, Youth ForChange, was also interviewed. Although BCDBH has other contracted agencies, it was notpossible to coordinate individual meetings with each. There is some survey information that wasascertained from management at these agencies, which is included in this report. The countyMHSA coordinator confirmed there is a need for individuals throughout the educationalpathway, from AAs through master’s degrees.11

There was concern that this survey did not include those interested in obtaining a master’s degreein Marriage and Family Therapy (MFT). It was expressed that the MFT guild was equallyimportant as social work and nursing. This information was confirmed by staff in the commentsmade about the desire for an MFT degree. With the advent of the MHSA and consumerempowerment, BCDBH saw the value of having employment opportunities for individuals at theAA level and were working with the county human resources office to develop a jobclassification. The CBOs also expressed a need for education at the AA levels dependant on theprogram. The CBOs highlighted that they depend on billing and often prefer folks at a higherlevel of education to aid in the billing of mental health services. However, they do have a needfor AA folks to serve as rehabilitation case managers to support their clinical staff.The BCDBH representative indicated a need for staff at all levels, including MFTs. It wasdifficult to determine specific numbers and types of positions that would be present in five years.There is a particularly strong need to increase the number of psychiatric technicians, nurses andnurse practitioners working in the BCDBH system. CBOs expressed a projected need for MSWsand RNs. Youth For Change stated it has 10 current employees who need/desire education toobtain an MSW. It also projected having available positions for those individuals as well as oneposition for an employee with a master’s in nursing degree. Although there is an inability toguarantee promotions, there is the desire to support those staff that makes the commitment.Unknown agency projections as well as union and fair hiring practices prevent BCDBH (and allother CBOs) from making any promotional guarantees.Areas of concern include the strong need to include articulation agreements throughout theeducational pathway in order to “create a ladder/pipeline, not a dead end street.” Another barrierto be aware of is being able to assess student readiness to work at a college level, whether it’s atraditional or distance education mode of delivery. Finally, BCDBH and all CBO administratorsinte

California State University, Chico School of Social Work October 2009 Pamela A. Brown, Professor Donna Jensen, LCSW, Mental Health Coordinator Tene Kremling, LCSW Meredith Ray, MSW Department of Social Work School of Social Work Humboldt State University California State University, Chico