RTC: Rural staff often encounter questions about rural centers for independent living (CILs) that are surprisingly difficult to answer:

"How many rural CILs are there?" 
"Where are they located?" 
"Are there enough rural CILs?"

The answers depend on how you define a "CIL," and how you define a "rural" program. Our research indicates that there is a total of 336 centers for independent living scattered across the nation. Title VII of the Rehabilitation Act funds many -- but not all -- of them. Federally-funded CILs typically receive funds from several other sources as well. All 336 meet the standards for CILs. Map 1 shows the distribution of CILs by their location in metropolitan or non-metropolitan counties. 

Description.

 

 

 

 

 

 

 

 

 

 

 

 

 

We've counted eighty-eight CILs that are located in non-metropolitan counties. We know that many metropolitan CILs also provide services to non-metropolitan, rural areas. Research Triangle Institute's (RTI's) study showed, however, that a vast majority of a typical CIL's consumers live in the county where the program is located. If most consumers live in the county where their CIL program is located, outreach programs become more important. Many CILs operate "subordinate offices" (satellites, branch offices, outreach offices, and others) which extend the reach of their advocacy and services. Table 1 defines each type of subordinate office or program.

Description of Table One.

	Table 1  CIL Subordinate Offices or Programs: Four Types That Extend the Reach of Advocacy and Services
Satellite	Sometimes called "mentored centers", these meet all CIL criteria, but share a board of directors with the main CIL.
Outreach	Fiscally and administratively part of another CIL and has a staff person in the local community less than half-time.
Branch	Fiscally and administratively part of another CIL and has a staff person in the local community at least half-time.
Other	Unique or unclassifiable programs/offices, frequently in rural communities.

Map2 shows the location of the 245 subordinate offices and programs for which we have a geographic location in metropolitan or non-metropolitan areas. (We have found a total of 278 to date.)

Description of Map Two.

 

 

 

 

 

 

 

 

 

 

 

 

Are there enough CIL programs to provide advocacy and other services to all those who might find them useful -- in all areas of the United States?

One way to address this question is to look at how centers and subordinate programs/offices are distributed across three types of counties. A city CIL may target subordinate programs and offices in areas of the city with a minority population, or may cover a suburban area. Its subordinate programs/offices may also be located in non-metropolitan, rural counties surrounding the city.

Subordinate programs and offices operated by CILs in non-metropolitan counties are almost always designed to serve areas that are even more rural and remote. These may also serve minority populations (for example, a subordinate program located on tribal lands).

Table 2 shows estimates of how the 336 CILs and their subordinate programs and offices are distributed across three types of counties.  

Description of Table Two.

Table 2 Distribution of CIL and Subordinate Programs by County Type
	Metropolitan County	Non-Metropolitan County Adjacent to a Metropolitan County	Non-Metropolitan County, Non-Adjacent to a Metropolitan County
Main CIL Offices	248	33	55
Subordinate Program or Offices	111	47	87
Total Counties*	835	1003	1303
Counties per Main Centers	3.4	30.4	23.7
Counties per Subordinate Program or Office	7.5	21.3	15
Overall Ratio of Counties per CIL Site	2.3	12.5	9.2

* Note: "Total Counties" equal the national count for each county type: 835 metro + 1003 non-metro adjacent + 1303 non-metro, non-adjacent = 3141 total counties. We lack complete data for some main CILs and many subordinate offices; therefore counts of "counties covered" or "counties served" are incomplete. Our best estimates appear in our submitted manuscript (see References). Data for subordinate offices are less complete than that for main offices. A higher proportion of subordinate offices are in non-metro counties, so figures based on data received to date exaggerate the rural deficit.

Another way to determine whether there are enough CILs to serve rural areas is to examine the distribution of people receiving CIL services. As we mentioned, the RTI study found that most of a CIL's consumers live in the county where the CIL is located. Although CIL advocacy efforts can have wide-ranging effects, our research shows that rural residents with disabilities are still under-served when compared to urban consumers. If we look at the data on the total number of people who potentially might benefit from independent living services (those with severe disabilities), even urban people with disabilities appear to be under-served.

Table 3 shows our estimates of:

1. Counties in which CIL services are actually provided;
2. The number of people actually receiving services;
3. The population of people with disabilities who might benefit from services; and
4. Relevant ratios. 

Description.

Table 3   Estimates of the Population Receiving CIL Services and Those That are Under-Served
	Metro	Non-Metro Adjacent	Non-Metro, Non-Adjacent
Counties Served	672	444	780
People Receiving Services	188,893	7,511	15,783
People with Severe Disabilities	19,182,047	3,309,889	2,704,848
Ratio of People Served to People with Severe Disabilities	.010	.002	.006

In conclusion, the glass appears to be about half full. Although there are many CILs serving rural America, nearly 40% of the country still has no access to services. Neither urban nor rural areas have the capacity to meet the potential need for independent living services.

---

For more information, please contact us at:

Research & Training Center on Disability in Rural Communities
The University of Montana Rural Institute: A Center for Excellence in
Disability Education, Research and Services
52 Corbin Hall, Missoula, Montana 59812-7056
(406) 243-5467 (V/TT)   (406) 243-2349 fax     (888) 268-2743 toll-free
email the Rural Institute

This factsheet was prepared by Tom Seekins, Alexandra Enders , and Bill Innes. This publication is available in Braille, large print, and ASCII DOS text formats.

Reference and Resources

Tashjian, M. (1998). Analysis of federally supported independent living programs: Final report. Research Triangle Park, NC: Research Triangle Institute.

Seekins, T., Innes, W. & Enders, A. (1999). A geographic analysis of independent living center services: Equitable distribution between urban and rural areas. Missoula, MT: Research & Training Center on Rural Rehabilitation, University of Montana.

Seekins, T., Innes, W., Enders, A., & Hubbard, M.(1998) RURALFACTS: Estimating the cost for achieving universal access to centers for independent living. Missoula, MT: Research & Training Center on Rural Rehabilitation, University of Montana.

---

This publication is funded by a grant from the U.S. Dept. Of Education (H133B70017-01). The opinions expressed are those of the authors and do not necessarily reflect the opinions or policies of the funding agency.

---

Resources for additional information:

Independent Living Research Utilization   |  Association for Programs in Rural Independent Living

This factsheet is available in Braille, large print and ASCII DOS text formats on request.

Questions? Would you like to receive periodic updates about our research and training activities? Do you have comments or suggestions about this site? E-mail your requests, comments and suggestions to Diana Spas or call 888-268-2743 and ask for the Information Coordinator.