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Montana Providers of Services to Adults with Developmental Disabilities: Urban\/Rural Characteristics, and Direct Service Staff Turnover Rates and Replacement Costs <\/span><\/strong><\/span><\/p>\n August, 2004<\/span><\/p>\n Background<\/strong>:<\/span> 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<\/a>, 2002). Our research also found a correlation between direct service staff turnover and increased incidence\/costs of consumer injuries (Research Progress Report #3<\/a>, 1999). These findings suggest that reducing turnover may improve consumers’ well-being and save money. As part of a multi-stage effort to improve health outcomes for adult Montanans who live in supported environments and have intellectual and developmental disabilities, this report documents the next step in assessing the economics of direct service staff turnover. Although Montana is predominantly rural, the urban-rural geographic distribution of the fourteen providers is representative of the entire state. Five providers were in urban counties with populations of 55,000 or more and large labor market areas. These counties are regional trade and service centers serving market areas of multiple surrounding counties. Nine providers were in rural counties with smaller populations and a geographic orientation toward the urban trade centers. Summary descriptions for urban and rural providers are included.<\/strong><\/p>\n Results:<\/span><\/strong><\/p>\n Initial findings include:<\/p>\n 1. Urban service providers serve more consumers and employ more staff on average than rural providers.<\/p>\n 2. Urban service providers have significantly larger budgets on average than rural providers. 4. Rural service providers serve significantly higher numbers of consumers with severe disabilities than do urban providers.<\/p>\n 5. Turnover rates of direct service staff varied across service providers depending on the proportions of full-time, part-time, and relief pool employees.<\/p>\n 6. Turnover rates were lowest among full-time staff, and highest among relief staff.<\/p>\n 7. Average hiring costs associated with turnover rates were $1,085 for urban providers and $811 for rural providers.<\/p>\n 8. Training costs per direct service hire averaged slightly above $600 for both urban and rural employers.<\/strong><\/p>\n Provider Characteristics:<\/span><\/strong> An organization’s direct service staff turnover is affected by: 1. Its size; 2. The wages it pays; 3. The benefits it provides; 4. The quality of management it offers; and 5. The types of consumers it serves. Table 1 shows urban and rural data for some of these factors, including direct service staff size, annual budget, consumer disability levels, and consumer living arrangements (group home or supported living). The table provides average and median values, plus a low-high range. “Urban” and “rural” designations are determined by a provider’s county location.<\/p>\n Description of Table 1.<\/a> <\/a>Urban and Rural Provider Characteristics<\/span><\/span><\/strong><\/p>\n
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\nMethods<\/span><\/strong>:<\/span> In June, 2002, RTC: Rural researchers sent a Cost of Turnover to Service
\nCorporations and Organizations Survey to 33 Montana community and institutional
\nservice providers. We asked Executive Directors and\/or Human Resource Directors to complete the survey, which had been pilot-tested and developed with provider input (Research Progress Report #17<\/a>, 2002). Thirteen community service providers and one state intermediate care facility (ICF-MR) returned surveys (42% response rate). This report looks at urban and rural data on providers’ specific organizational and structural characteristics, including workforce size, budgets, and consumers served. It also examines urban and rural direct service staff turnover rates, job benefits, reasons for job exits, and replacement costs of staff recruitment and training.<\/span><\/p>\n
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\n<\/strong>3. Urban service providers have slightly more consumers in supported living situations and fewer in group home environments. For rural providers, this trend in residential placement is reversed.<\/p>\n