Impact of the New York State Budget on Rural Communities
•
0 likes•496 views
Presentation of highlighting the impact of the New York State Budget on rural communities.
Recommended
Recommended
More Related Content
What's hot
What's hot (20)
Similar to Impact of the New York State Budget on Rural Communities
Similar to Impact of the New York State Budget on Rural Communities (20)
Recently uploaded
Recently uploaded (20)
Impact of the New York State Budget on Rural Communities
- 1. Impact of the New York State Budget on Rural Communities New York State Association for Rural Health 2018 Annual Conference Greek Peak Resort Cortland, New York Casey Harrison, Certified Nurse Midwife, Doctor of Nursing Practice
- 2. About me
- 3. Session Agenda • Background • Problem Statement • Approach • Methods • Initial Results • Status • Discussion
- 4. Objectives Participants will be able to identify, and understand the purpose of, key New York State health-related funding streams within selected rural communities. Participants will be able to understand and identify the discrete categories of direct, indirect and multiplied economic impact of outside funding by looking at selected health and social entities. Participants will be able to identify and discuss the economic impact of cuts in funding on rural infrastructure and communities, through review of data collected by analytical software applied to New York State 2016-2017 fiscal year to 2017-2018 fiscal year budget reductions.
- 5. Background In 2017, NYSARH administered a member survey regarding the impact of NYS DOH funding cuts Key findings included: • The most common funding cut experienced by respondents was at or about 20% of total expected allocation from NYS DOH • More than 1/3 of respondents who experienced cuts stated that the cuts resulted in a reduction in workforce • Nearly 70% of respondents who experienced cuts stated that the cuts resulted in a reduction in community outreach and engagement
- 6. Background Nearly half of respondents indicated that the funding cuts significantly compromised the ability to recruit and retain healthcare professionals in their communities Nearly 1/3 of respondents who experienced cuts stated that the cuts resulted in a significant decrease in the ability to leverage other funding All respondents who experienced cuts stated that the cuts resulted in a reduction in programming, particularly program areas related to outreach, education and health promotion 65% of respondents who experienced cuts stated that the cuts resulted in a reduction in worker training, professional development, and/or continuing education
- 7. Background Survey findings were presented and discussed at the Rural Health Network Meeting during the NYSARH 2017 Annual Conference one year ago Discussion surrounded the fact that each and every year is a struggle to remain whole in the NYS DOH budget, let alone get reinstated to previous levels As a collective of RHNs and other public health-related programs, this has been, and continues to be, the most serious problem to address
- 8. Problem Statement • Approximately 31 public health-related programs, which rely on NYS DOH funding to survive and serve rural communities, have experienced funding cuts and remain under further funding cuts on an annual basis. Ancillary Statement – Efforts to influence lawmakers and NYS DOH to not make funding cuts to these programs – and to reinstate funding that has already been cut – have been only marginally effective
- 9. Advance the New York State Prevention Agenda, Women’s Agenda, Delivery System Reform Incentive Payment Program (DSRIP), and Health Across All Policies and Ages 31 NYS Public Health Programs Cuts & Consolidation Reduction in Programs and Rural Economy Increase in Social Determinants of Health Compromise of NYS Agenda Priorities
- 10. Approach • Inform and educate decision-makers that NYS DOH funding to 31 public health programs has a direct and significant impact not just on the health of people in rural communities, but on the economic health of those communities – and that fact increases the devastating effects of social determinants of health which makes for a sicker population • Credible evidence must provided decision- makers regarding the multiplied economic impact of funding cuts on rural communities
- 11. RuralPrep Microgrant • Community based approach with small “seed grant” funding to generate locally implemented projects in underserved communities, resulting in big impacts • RuralPrep provides multiple $4000 awards to students in health professions aiming to provide research that is collaborative and community engaged • Application included a Project title, background, research question, methods, expected products, timeline, and mentor • This funding was used to purchase a 1 yr subscription to IMPLAN software
- 12. Research Question The question this investigation seeks to answer is: What is the economic impact of state-based rural health funding cuts in rural regions; where impact is operationally defined by a standardized multiplier formula, rural regions defined as counties and legislative districts, and state-based rural health funding cuts defined by reductions in funding from one year to the next in discrete rural funding areas.
- 13. Project Background Rural Americans face unique challenges when it comes to addressing the needs of local and regional public health infrastructure, as they are generally older and sicker than their urban counterparts There are higher rates of poverty to include children living in poverty, disparities in healthcare equity and access, lower education rates and secondary schooling, greater risks for on-the-job injuries, and higher rates of uninsured Access to quality health services was identified by Rural Healthy People 2020, Healthy People’s companion document, as the single most important rural health priority for the decade
- 14. Background Continued The health and social sector provides a foundation for the health and well-being of rural communities. Rural residents are more likely to derive their income from the healthcare industry both directly and indirectly, and health and wellness of rural communities lies heavily on the Health and Social sector As such, cuts to the primary source(s) of funding to rural health programs/services increase the negative impact of the social determinants of health and are devastating to the health of the rural residents, and the communities within which they live and work.
- 15. IMPLAN Software •Maria from IMPLAN will join us on skype to give you a nice introduction to what IMPLAN is and how it works
- 16. Methods Results will be segregated by county and State legislative districts and analyzed using the IMPLAN system to identify the economic multipliers related to the funding cuts and the resulting economic impact to the county/legislative district utilizing the input-output model for analysis which will calculate direct, indirect, and induced effects of the funding loss within the rural communities. Collaboration with Area Health Education Centers and Rural Health Networks to determine the exact amount of state funding cuts made to each of these entities between the 2016-2017 New York state fiscal year and the 2017-2018 New York State fiscal year.
- 17. Focus Areas Senate District 45 • Clinton • Essex • Franklin • St. Lawrence • Washington Senate District 51 • Cayuga • Chenango • Delaware • Herkimer • Ostego • Schoharie
- 18. Definitions • Direct Effects • Funding cuts • Indirect Effects • Business to business activity i.e. suppliers, daycare, catering • Induced effects • Home sales and rent, gas, groceries • Employment • Full or part time • Labor Income • Employee wage and benefits • Value Added • Output minus input • Output • Total production
- 20. District 51 Combined Impact Type Employment Labor Income ($) Value Added ($) Output ($) Direct Effect -4.45 -164,893 -72,652.20 -237,545 Indirect Effect -0.22 -6388.19 -12,944.50 -26,087.10 Induced Effect -0.67 -23,599.20 -49,379.70 -84,555 Total Effect -5.34 -194,880 -134,976 -348,187 Multipliers 1.20 1.18 1.86 1.47
- 21. District 45 Combined Impact Type Employment Labor Income ($) Value Added ($) Output ($) Direct Effect -4.74 -16,9877 -85,084.90 -254,962 Indirect Effect -0.28 -8,385.52 -15,113.50 -32,327 Induced Effect -0.76 -27,759.70 -54,663.5 -94,461.60 Total Effect -5.78 -206,022 -154,862 -381,751 Multipliers 1.22 1.21 1.82 1.50
- 22. District 51 Output Direct Effect Indirect Effect Induced Effect Total Effect Multipliers -237,545 -26,087.10 -84,555 -348,187 1.47 District 45 Output Direct Effect Indirect Effect Induced Effect Total Effect Multipliers -254,962 -32,327 -94,461.60 -381,751 1.50
- 23. District 51 Value Added Direct Effect Indirect Effect Induced Effect Total Effect Multipliers -72,652.20 -12,944.50 -49,379.70 -134,976 1.86 District 45 Value Added Direct Effect Indirect Effect Induced Effect Total Effect Multipliers -85,084.90 -15,113.50 -54,663.50 -154,862 1.82
- 24. District 51 Labor Income Direct Effect Indirect Effect Induced Effect Total Effect Multipliers -164,893 -6,388.19 -23,599.20 -194,880 1.18 District 45 Labor Income Direct Effect Indirect Effect Induced Effect Total Effect Multipliers -169,877 -8,385.52 -27,759.70 -206,022 1.21
- 25. District 51 Employment Direct Effect Indirect Effect Induced Effect Total Effect Multipliers -4.45 -0.22 -0.67 -5.34 1.20 District 45 Employment Direct Effect Indirect Effect Induced Effect Total Effect Multipliers -4.74 -0.28 -0.76 -5.78 1.22
- 26. Top 5 Sectors Impacted District 51 • Owner-occupied dwellings • Real estate • Hospitals • Monetary authorities and depos... • Insurance carriers • Wholesale trade • Restaurants • Wired telecommunications • Office of Physicians • Retail District 45 • Owner occupied dwellings • Real estates • Hospitals • Monetary authorities and depos • Wholesale trade • Restaurants • Other local government enterprises • Office of physicians • Retail • Financial institutions
- 27. Status Preliminary results show detrimental impact on rural communities from funding loss in just a piece of the healthcare sector as a whole When we lose funding everyone is impacted in the community IMPLAN is a successful method for analyzing the detrimental impact loss of funding in the health sector has on the rural infrastructure. The numbers used today are part of a small discrete cohort of these big cuts. Utilizing IMPLAN to reflect ALL of the cuts would only amplify these results
- 28. What Next? • More precision in data per senate district • Expert use of IMPLAN software and analysis on a larger scale • Passing the torch – it is up to you to carry this on. Detailed numbers and analysis can make a dramatic real time case for detrimental impact on rural infrastructure with funding loss to health and social sector • Stakeholder involvement – result dissemination
- 29. Discussion
- 30. Contact Information Casey Harrison, CNM, DNP 11224 Beauclaire Blvd. Fredericksburg, VA 22408 caseyharrison222@gmail.com
Editor's Notes
- For anyone who was not at my first session I just wanted to take a moment to introduce myself. I am Casey Harrison. I am a certified nurse midwife and Dr of nursing practice. I am a recent graduate form Stony Brook university in Long island. I am from the border of Allegany and Steuben county, and I did my training at a facility in Cattaraugus county. Here is a picture of my wonderful not so little family right before we hiked a mountain in NH. EXCLAIMER** I do not recommend hiking 3,500 foot mountains with 5 children! But we did make it to the top. I was raised in the rural foothills of NY state. . Growing up in rural NY, and training as a midwife there, it is beautiful. The sense of family, of community, of comfort, is unlike anywhere else. I have recently moved to VA to join a lovely practice in Fredericksburg, and have intentions of advocating for rural health in VA as well.
- Top here are the NYS DOH priorities, programs and initiatives There are 31 funded either directly or indirectly as part of the mission to achieve the DOH agenda The results of the cuts worsen the SDOH therefore compromise the objectives set out by the DOH.
- For this project we chose to look at the rural counties located within two primarily rural senate districts within NY state. District 45 and 51. the counties were considered rural if they were defined so by the U.S. Census Bureau as being mostly/all rural. The results for this project were based on two discrete area’s that lost NYS DOH funding. For the purposes of IMPLAN these area’s are part of a “sector”. The sectors are determined by their NAICS codes. The North American Industry Classification System (NAICS) is the standard used by Federal statistical agencies in classifying business establishments for the purpose of collecting, analyzing, and publishing statistical data related to the U.S. business economy. The NAICS codes used to for our example were 624190 Other Individual and Family Services 611699 All Other Miscellaneous Schools and Instruction NAICS codes are self reported, and I just want to make it clear, that the two codes I have selected to represent a “general picture” of the effects of funding cuts on our social and healthcare system are not by any means all inclusive, but they were selected with care and consideration of the discrete area’s we are focusing on.
- Direct: The actual dollar amounts of funding cuts. Applying these initial changes to the multipliers in an IMPLAN model will then display how the region will respond, economically to these initial changes. Indirect: The impact of local industries buying goods and services from other local industries. Induced: attributed to households spending earnings Employment: A job can be either full-time or part-time. Labor Income: All forms of employment income, including Employee Compensation (wages and benefits) and Proprietor Income. Value Added: The difference between an industry's or an establishment's total output and the cost of its intermediate inputs. It equals gross output (sales or receipts and other operating income, plus inventory change) minus intermediate inputs (consumption of goods and services purchased from other industries or imported). Output Output represents the value of industry production.
- Direct effect – the direct impact of the sector being cut – whether it is loss of jobs, depletion of resources, programs being cut, normal purchases not being made Indirect – the ripple of that to the suppliers, food services, gas, paper production plants, gravel products, … Inducted – local retail and services not being purchased by persons effected from the cuts in the direct sector as well at the suppliers that are affected
- I noted earlier from the survey that NYSARH sent out The most common funding cut experienced by respondents was at or about 20% of total expected allocation from NYS DOH. These preliminary results were obtained using direct reported amounts of funding cuts to the two sectors representing RHNs and AHECs in rural NY within the aggregate senate districts. What this chart depicts is the impact summary of those cuts that were reported. I just want everyone to understand, this is but a small piece of the pie, as we were only able to focus on a limited area and limited sectors for this session. The 2017-2018 funding cut was much a much larger amount in total. Here you wills the definitions labeled that we just defined The direct effect output is the number we are working with to determine all other losses. The 237,545 is the direct amount of cuts in this district associated with the 20% loss in funding to the two sectors we focused on. The multipliers are the bases of how the O-O analysis works. IMPLAN estimates potential impact of economic changes. The multipler is basically the rate of change. It describes how for a given change in a particular industry a resultant change will occur in the overall local economy. Multipliers are determined by dividing the total effect by the direct effect.
- Here we have both districts total output impact based on the direct loss of funding The output multiplier describes the total economy output lost (or gained in a positive example) as a result of one dollar lost in the target industry. So for district 51, for every dollar lost to RHN and AHECs, 47 cents of activity is lost in the local economy. For district 45 for every dollar lost, 50 cents of activity is lost in the local economy So you will see ** describe $$ loss
- The value added multiplier describes the total dollars of value added in the economy as a result of one dollar of value added in the target industries. So for every dollar that the defined sectors have lost related to funding cuts, after satisfiying all of their expenditures or needs, 86 cents of value added is lost in the local economy for district 51, and 82 cents in district 45
- Labor income multipliers show the dollars lost to labor income in the economy based on one dollar lost in target industries. For every dollar lost to income in District 51, 18 cents is lost in other income in the local economy, and 21 cents is lost in income in the local economy in district 45
- Employment multipliers show total jobs lost based on 1 job in the selected industry. So based on our funding cuts, Disrict 51 lost approximately 4.45 jobs directly. With a multiplier of 1.20, that means for every 1 job, .20 of a job was lost, so the loss of 4 jobs actually created a loss of 5 jobs total within the community. The same can be seen for district 45, for every 5 jobs lost directly related to the industry cuts, 1 extra job is taken from the community.