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Rural Disability and Rehabilitation

Research Progress Report #27


Characteristics of the Montana Direct Service Labor Market

October, 2004


RTC: Rural researchers have documented the cost to Montana developmental disability service providers of replacing, hiring and training direct service staff (Research Progress Report #17, 2002; Research Progress Report #25, 2004). Our research also found a correlation between direct service staff turnover and increased incidence/costs of consumer injuries (Seekins, Traci & Szalda-Petree, 1999). These findings suggest that reducing turnover may improve consumers’ well-being and save money. This report documents the next step in our economic assessment of direct service staff turnover. The goal is improved health and well-being for adult Montanans who have intellectual and developmental disabilities and who live in supported environments.


In June, 2002, RTC: Rural researchers sent the Cost of Turnover to Service Corporations and Organizations Survey to 33 Montana community and institutional service providers. Executive Directors and/or Human Resource Directors completed the survey, which had been pilot-tested and developed with provider input (Research Progress Report #17, 2002). Thirteen community service providers and one state intermediate care facility (ICF-MR) returned surveys (42% response rate). This report is based on the data provided by those 14 providers and compares local employment and wage levels for those service sectors that compete with providers for direct service staff.


Initial findings include:

1. Urban counties have larger labor markets and labor pools than rural counties;

2. Urban health and social services jobs pay higher wages than similar rural jobs;

3. Urban counties have lower unemployment rates than rural counties;

4. Health care sector jobs compete for direct service staff by generally paying higher wages than social service sector jobs.

Characteristics of Respondents’ Labor Markets:

These data are for the counties in which respondents are located. Although Montana is mostly rural, the urban-rural geographic distribution of the fourteen providers is representative of the whole state. Five providers are located in four urban counties with populations of 55,000 or more and large labor markets. Two providers share the same urban county. These urban counties are regional trade and service centers serving western, northern, central and eastern Montana market areas of multiple surrounding counties. Nine providers are located in eight rural counties with smaller populations and a geographic orientation toward the urban trade centers. Two of the respondents share the same rural county.  These rural counties represent every part of the state. Table 1 compares urban and
rural unemployment rates, total numbers of jobs, and numbers of health and social services jobs in each provider’s county.

Description of Table 1: Urban-Rural County Labor Market Characteristics (2001).

2001 County Employment Levels

Unemployment Rate

Total # Jobs # Health Sector Jobs # Social Service Jobs
    Rural Counties n = 8
3.2% 1,272 256 62
4.4% 1,315 153 56
2.6% 3,356 413 46
3.0% 4,755 564 216
4.5% 9,698 865 193
11.4% 4,091 56 31
4.6% 5,219 456 89
3.5% 2,561 357 109

    Urban Counties n = 4

3.8% 49,151 5,597 1,796
3.8% 49,151 5,597 1,796
4.4% 32,568 3,811 1,303
3.5% 28,828 2,050 1,340
3.8% 66,420 6,950 2,289

Source: Survey Data and Montana Department of Labor and Industry


Total regional employment is a measure of the number of workers available in a local labor market. Urban service providers operate in large labor markets with thousands of workers. Rural service providers operate in much smaller labor markets. Social service sector jobs are those that provide services to individuals and families, and to individuals in residential settings; these jobs are most similar to those of developmental disabilities direct service staff. The health sector is also a direct service employee labor pool. With retraining, many health care skills and job duties are transferable to direct service support of persons with developmental disabilities. However, health sector jobs and wages may also recruit direct service staff away from developmental disabilities service providers.

The local unemployment rate indicates a county’s demand for labor. An urban county typically has lower unemployment rates because urban economies have more jobs available. A high unemployment rate means sluggish demand for labor; job seekers will have difficulty finding work. Workers wanting to find or to change jobs will have a tough time in the rural county with an 11.4 percent unemployment rate.

Table 2 compares county-wide average wages, county health sector wages, and wages paid by each responding provider. It includes each provider’s direct services staff turnover rate.

Description of Table 2: Urban-Rural County/Health Sector/Provider Wage Comparison; Providers’ Direct Services Staff (DSS) Turnover Rates for 3-Month Period (2001)

County Average Wage Rates Provider Wage/DSS Turnover Rates
All Jobs Health Sector Jobs Entry Level Wage Range Total Turnover

Rural Counties n = 8

Rural Providers (n = 9)
$8.80 $8.20 $6.00-11.40 10%
$9.30 $8.11 $6.05-6.75 11%
$10.25 $11.58 $7.83-14.27 6%
$10.80 $14.52 $8.00-10.00 0%
$11.02 $11.50 $7.80-8.30 11%
$11.83 $11.23 $7.00-10.00 0%
$9.85 $12.94 $8.10-8.85 8%
$10.80 $14.52 $7.10-7.61 2%
$10.28 $13.09 $6.00-11.60 0%

Urban Counties n = 4

Urban Providers
(n = 5)

$12.59 $16.67


$12.59 $16.67 $8.00-8.19 8%
$11.64 $15.05 $6.50-9.09 18%
$13.54 $14.86 $6.95-12.32 13%
$13.41 $19.28 $7.18-7.90 15%
Source: Survey Data and Montana Department of Labor and Industry; Note: * not reported


The urban counties have higher employment levels and wages; urban service providers must compete both for workers and with local wages. Urban workers with direct service skills and experience can command higher wages in the health service sector if it is hiring. Entry-level wages paid by the urban service providers are significantly lower than the prevailing wages of other sectors, especially the health sector. In one urban county, the difference between the service provider’s range of direct service entry-level wages and health sector wages is more than $3/hr. In another urban county, it’s almost $11/hr.

Urban service providers face tough challenges in hiring and retaining direct service staff. In the three-month period prior to completing the survey, urban providers reported higher average turnover rates for all full-time/part-time/substitute or relief direct service staff than rural providers. The highest three-month turnover rate was 40 percent. Extrapolating this rate to a 12-month period means that this provider would replace its entire direct service staff in just over eight months.

Rural providers operated in counties with fewer total and health sector jobs. Rural wage levels were also lower so there was less difference between direct service entry-level wages and other local wages. This smaller wage differential means less pressure for the rural service providers, although they still must maintain staffing levels and deal with staff turnover. Rural turnover rates per three-month period were lower (range of 0-11%) than urban rates. If the 11 percent turnover persisted for one year, that provider would replace one-third of its direct service staff, a significant challenge in a rural county with a small pool of qualified workers.


These data demonstrate that there are complex reasons for direct service staff turnover and availability. Whether a direct service employee stays with a provider depends on the current economic environment, the size of the local labor pool, the number of local employers and competing jobs, and the local unemployment rate . Each of these should be considered when structuring the direct service job environment.

Next Steps:

We will analyze turnover rates related to provider/employee characteristics: entry-level wages, adequacy of management/supervision, benefit packages, disability levels of consumers, work experience, education and skill levels. We have entered detailed data from 243 full-time, part-time and relief direct service employees employed by six of the fourteen providers into a comprehensive database and will measure their job and personal characteristics as determinants of turnover.

Resources and References:

Bainbridge, D. & Brod, R. (2004). Montana Providers of Adult Developmental Disabilities Living Services: Direct Service Staff Demographics, Job Characteristics and Job Satisfaction. Rural Rehabilitation Research Progress Report #26. Missoula: The University of Montana Rural Institute.

Seekins, T., Traci, M.A., & Szalda-Petree, A. (1999). Preventing and managing secondary conditions experienced by people with disabilities: Roles for personal assistance providers. Journal of Health and Human Services Administration, 22, 259-269.

Seninger, S. & Bainbridge, D. (2004). Montana Providers of Adult Developmental Disabilities Living Services: Urban/Rural Characteristics, Direct Service Staff Turnover Rates and Replacement Costs. Rural Rehabilitation Research Progress Report #25. Missoula: The University of Montana Rural Institute.

Seninger, S. & Traci, M. (2002). Rural Disability and Rehabilitation Research Progress Report #17: Analysis of Direct Care Staff Turnover: Preliminary Results and Observations. Missoula: The University of Montana Rural Institute.

Traci, M., Szalda-Petree, A., & Seninger, S. (1999). Turnover of personal assistants and the incidence of injury among adults with developmental disabilities: Rural disability and rehabilitation research progress report #3.Missoula: Montana University Affiliated Rural Institute on Disabilities

For more information, contact:

Meg Traci, Director  matraci@ruralinstitute.umt.edu
Montana Disability and Health Program
The University of Montana Rural Institute
52 Corbin Hall, Missoula, MT 59812-7056
888-268-2743 toll-free;
406-243-5467 Voice;
406-243-4200 TTY
406-243-2349 (fax)

Opinions expressed are those of the authors, and not necessarily those of the funding agencies.
This report is available in Braille, large print and text formats on request.