Title:Estimating the Economic Impact of HRSA OHRP Outreach and Network Development Grantees
Description:
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Title: Estimating the Economic Impact of HRSA OHRP Outreach and Network Development Grantees
1 Estimating the Economic Impact of HRSA OHRP Outreach and Network Development Grantees Carol J. Simon PhD September 2009 2 ORHP EIA Project Purpose
Purpose measure the economic impact of ORHP grantees in their communities
ORHP grants as Mini-Stimulus packages
How have Grantees used funds
What is the impact of that spending on job growth and economic activity
Target the 3rd and 4th year Rural Outreach and Network Development program grantees
EI Team
The Lewin Group
The University of Washington Rural Health Research Center
Mark Doescher Sue Skillman
3 Goal a tool for estimating Economic Impact (EI)
Deliverable easy-to-use formulas to measure Economic Impact
Separate versions for Outreach program and the Network Development program grantees
Formulas will be utilized by current future grantees to demonstrate the potential long term impact of programmatic investment on rural communities
Demonstrating economic impact can be a vehicle for sustaining funding and support
4 What Is An Economic Impact Analysis
Economic Impact analysis tracks the reach of program dollars
Translates project-specific impacts into community-wide effects
Jobs created
Spending that supports local businesses and taxes
Impact of new or expanded services on the well-being of the population
Bottom line every dollar invested by HRSA creates more than a dollars worth of value in the community
5 Type of economic impacts
Direct impacts are measured by the new health community services and the number of jobs that are generated by grantee activities (e.g. wages salaries and benefits paid directly to grant-supported employees)
Indirect impacts are the result of a second round of spending that occurs when the grantees purchase goods and services from local businesses
Induced impacts occur when employees of the grantees and of the firms that sell goods and services to the grantees in turn spend their earnings on local goods and services. This effect multiplies the initial program effects.
6 Framework for Economic Impact Analysis 7 Why It Is Important to Conduct EIA for ORHP Grantees
Used to demonstrate program value and argue for on-going support
Help understand the timing and extent of program impacts in the community
Build the business case to other funders and attract new financial and in-kind resources that can leverage the reach of HRSA dollars
Identify high-performing grantees and understand best practices
Benchmark grantee performance against expected norms
8 Steps in Development of the EIA Formulas Models
Select study sample
Review grantee documentation
Contact program grantees and collect information
Jobs spending to provide services infrastructure investment community impact area
Data organization
Estimate the multiplier model
Apply to grantees
Estimate the long term increase in jobs spending and economic activity in the community
9 Sample of Grantees
Study Sample Selection
Criteria used in selecting 3rd and 4th year grantees
Assured geographic representation
Assured adequate numbers of HIT Network and Outreach grantees
Assured representation of all major issue areas identified by ORHP and grantees
3rd year grantees recommended by ORHP and program staff
20 as the total (15 Outreach 4 Network Development and 1 HIT)
Selected 20 4th year grantees
13 Outreach 4 Network Development and 3 HIT
10 Characteristics of Contacted Grantees by Covered Issue Areas 11 Grantee Characteristics 12 Key Data Needs-- overview
Program and project information
Spending HRSA co-funded spending
Health care services
Educational services
IT
Infrastructure
Employment
Clinical
Administrative
Technical
Co-funding and in-kind support
Grantee Information
Program activities
Number and location of sites
Community information
Service area
Economic political and social environment
13 Key Data Needs- detail
Program and project information HRSA grant and program primary objectives funding budget/spending on staff and labor expenditures on health services expenditures on infrastructure (type) number and types of health services provided FTE staff and functions information on new services or expanded functions made possible by the grant.
Grantee Information Grantee size (FTE ) and type (e.g. health center provider organization research organization etc) number and location of sites affiliations with larger/parent/network organizations other relevant HRSA funding other funding supporting grant activities taxes paid.
Community information Name and size of community location demographic and economic descriptive information. Community and environment factors affect the size of economic impacts and multipliers (i.e. the extent to which local activity multiplies in the local economy and health sector).
Grantee contact information from the directory of grantees grantee profile annual reports and ORHP web sites.
14 Data Collection Documentation Review and Data Capturing Protocol Development
Flexibly organize data across grantees involved in a wide range of activities (e.g. health promotion disease management access to care)
Easy and informative
Feed into Excel-based database
Examine different economic impacts as well as the pathways by which the initiatives affect the community and region
Respond to grantee questions
15 Data Collection Contact Program Grantees
Develop contact strategy for phone interviews with grantees
ORHP sent introductory message
Interview protocol offer structured scripts and guidance on the conversation with grantees
Schedule and implement phone interviews
Phone calls took place between late December 2008 and April 2009
Grantees were exceptionally enthusiastic and supportive excellent collaboration in data collection (thank you!)
37 out of 40 completed good representation across geography and program type
16 Data availability Percentage of grantees able to access various types of data 17 Lessons Learned from Data Collection
Key lessons learned
Some programs evolved from what was proposed in the grantees initial grant application
Considerable variation in the way that grantees documented finances
required flexibility in identifying types of spending
Important elements success factors
Recognize variability among grantees with regard to how they count the services they deliver
Probes and examples helpful
Service area is key many grantees need assistance conceptualizing and measuring their reach
Differentiate in-community versus outside spending
Track donated and in-kind services and discounts
Identify in-kind services from partnerships
18 Observations -- 2
Network Development grantees were often fundamentally different in their staffing practices
many Networks had no direct employees only contractors or consultants.
Network Development grantees were at times challenged to define their respective service areas. Some Network grantees may cover all rural areas in the state yet have offices in just one area which could make balanced EIA formulations challenging.
some grantees that are in the process of expanding their network boundaries to neighboring states.
19 Observations Feedback
Information on spending and employment were good
Either provided in the interview or were fairly easily obtained/verified from accounting staff.
Qualitative support to the numbers was in abundance. Grantees could generally speak in terms of hard numbers and qualitative context for their service communities.
Conversely in-kind items and donated services (both estimations of value and systematic tracking) often were less frequently reported as for many grantees this was not a need and thus the resources were not put into tracking.
Some grantees did not systematically track figures on training done by staff or health and/or other services provided
Some did not maintain systematic tracking of total visits versus unduplicated visits or non-direct services provided (e.g. referrals).
Difficult to construct this information retrospectively
20 Observations -- 3
Outreach grantees that are part of a county health department could capitalize on in-kind or shared labor
labor provided by staff and executives (e.g. directors and coordinators) who were compensated in-part or in total by other funding sources leaving more HRSA dollars available for other program activities.
However with so many funding sources these grantees sometimes thought more in terms of the global project instead of individual funding sources.
Increasingly all programs noted they were relying on supplies and equipment from national vendors as many rural areas are limited in retail offerings. This puts many grantees at a disadvantage for positively impacting their areas local economy.
21 Observations -- 4
Internal Grantee Barriers
Staff turnover and internal shifting of responsibilities affected a few of the grantees and makes data collection and overall management more challenging.
Data Collection Issues that are Likely to Persist
Many grantees are short staffed and the project directors and coordinators may wear multiple hats for purposes of grant administration as well as within their parent organizations.
Many grantees only thoroughly track and report what is absolutely necessary.
Variability in program expenses from year to year will likely persist as grantees needs change and priorities shift during implementation.
Allocation of HRSA funding versus supplemental funding will continue to be a struggle as grantees continue to often pool their resources.
22 Recommendations for Future EIA Related Data Collections
It will be useful to provide clear data collection guidelines at the implementation of the grants
It may also be helpful to make technical support available for these tasks
Engage grantee personnel who have good knowledge on the EIA relevant aspects
Grantees operating programs or networks within existing organizations (e.g. a health department hospital state hospital association) appear to have the advantage of being able to capitalize on existing economies of scale.
23 EIA Formula Model Development
Application of multipliers to the collected grantee data
Summarize direct impacts of grantee initiatives on local employment spending and service provision
Apply multipliers of the selected Input-Output model to the summarized data
Calculate direct and indirect economic impacts
Develop user-friendly formulas for future grantees
Populate formula model using the EIA study results
Test model fit by comparing the predicted impact value against the actual data of the sample grantees
Apply coefficients to develop formulas for future grantees
Add user-friendly interface to model to enhance user convenience (optional)
24 Example to Demonstrate the Economic Impact Calculation
Grantee example
Hypothetical Network Development Grantee
Multipliers/Community
Missouri community
Data organization simplified calculations
Use sample simplified (disguised) data that was collected from documentation review and grantee interviews
25 Sample Data Summary Show-me State Network Grantee 26 Grantee Community Characteristics
The size and geographic reach of the grantees service area affects the multiplier larger areas gt higher multiplier
Unpaid volunteer labor and in-kind services are important to many grantees underestimating these can lead to an understatement of the impact
27 Investment multiplies as it moves thru the community
Each dollar of investment by HRSA
Creates direct program jobs services
Creates indirect (multiplied) value as the new employees spend in the community
The more the community spends locally the larger the multiplier
Can feedback to create new support for HRSA grantees
28 The multiplier measures how many times new dollars recycle in a local community
Example HRSA grantee spends 311000 in their first year
Creates 726K in local economic value
Of which 22300 in in the form of increased wages and earnings
Multipliers are specific to the industry and the size of the service area health care has an above average multiplier effect (2.33)
29 The multiplier measures how many new jobs are ultimately created from expanded economic activity
Example HRSA grantee hires 2.3 FTEs
But attracts an additional 7.0 volunteer FTE in administration
Total employment 9.3 FTE
Jobs multiplier for technology services 2.4031
For administrative services 1.102
Volunteer labor is important!
Multipliers are specific to the industry and the size of the service area health care has an above average multiplier effect
30 Grantee Activities create significant community value
Each dollar invested results in over 2 new dollars of value in this example
Health care and technology have high multiplier values
Expanding the service area increases value
Cautions
Need to be realistic about reach understand but dont overestimate impact area
Understand the functions and effort provided by volunteers co-funding and in-kind support
31 Next Steps
Calculate economic impact values for the sampled grantees
Build the multiplier model
Develop a template tool that grantees can use
Inputs
Grantee activities focus health care education network infrastructure
Jobs classification
Spending by type of spending
Geographic area served
Excel-based tool to calculate impacts
32 THANK YOU!
We are extremely grateful to the HRSA Outreach and Network Development grantees who have worked with us on this project.
we couldnt do it with out your time and effort!
The EI Team at the Lewin Group and University of Washington Rural Health Research Center
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