It’s more than money: policy options to secure medical specialist workforce for regional centres

2017 ◽  
Vol 41 (6) ◽  
pp. 698 ◽  
Author(s):  
Jennifer May ◽  
Judi Walker ◽  
Mathew McGrail ◽  
Fran Rolley
Keyword(s):  
Rural Communities ◽  
Local Governments ◽  
Medical Training ◽  
Critical Mass ◽  
Models Of Care ◽  
Hub And Spoke ◽  
Recruitment And Retention ◽  
Modifiable Factors ◽  
State And Local

Objectives Regional centres and their rural hinterlands support significant populations of non-metropolitan Australians. Despite their importance in the settlement hierarchy and the key medical services provided from these centres, little research has focused on their issues of workforce supply and long-term service requirements. In addition, they are a critical component of the recent growth of ‘regional’ hub-and-spoke specialist models of service delivery. Methods The present study interviewed 62 resident specialists in four regional centres, seeking to explore recruitment and retention factors important to their location decision making. The findings were used to develop a framework of possible evidence-informed policies. Results This article identifies key professional, social and locational factors, several of which are modifiable and amenable to policy redesign, including work variety, workplace culture, sense of community and spousal employment; these factors that can be targeted through initiatives in selection, training and incentives. Conclusions Commonwealth, state and local governments in collaboration with communities and specialist colleges can work synergistically, with a multiplicity of interdigitating strategies, to ensure a positive approach to the maintenance of a critical mass of long-term rural specialists. What is known about the topic? Rural origin increases likelihood of long-term retention to rural locations, with rural clinical school training associated with increased rural intent. Recruitment and retention policy has been directed at general practitioners in rural communities, with little focus on regional centres or medical specialists. What does this study add? Rural origin is associated with regional centre recruitment. Professional, social and locational factors are all moderately important in both recruitment and retention. Specialist medical training for regional centres ideally requires both generalist and subspecialist skills sets. Workforce policy needs to address modifiable factors with four groups, namely commonwealth and state governments, specialist medical colleges and local communities, all needing to align their activities for achievement of long-term medical workforce outcomes. What are the implications for practitioners? Modifiable factors affecting recruitment and retention must be addressed to support specialist models of care in regional centres. Modifiable factors relate to maintenance of a critical mass of practitioners, training a fit-for-purpose workforce and coordinated effort between stakeholders. Although remuneration is important, the decision to stay relates primarily to non-financial factors.

Corrigendum to: It’s more than money: policy options to secure medical specialist workforce for regional centres

2017 ◽  
Vol 41 (6) ◽  
pp. 717
Author(s):  
Jennifer May ◽  
Judi Walker ◽  
Mathew McGrail ◽  
Fran Rolley
Keyword(s):  
Rural Communities ◽  
Local Governments ◽  
Medical Training ◽  
Critical Mass ◽  
Models Of Care ◽  
Hub And Spoke ◽  
Recruitment And Retention ◽  
Modifiable Factors ◽  
State And Local

Objectives Regional centres and their rural hinterlands support significant populations of non-metropolitan Australians. Despite their importance in the settlement hierarchy and the key medical services provided from these centres, little research has focused on their issues of workforce supply and long-term service requirements. In addition, they are a critical component of the recent growth of ‘regional’ hub-and-spoke specialist models of service delivery.Methods The present study interviewed 62 resident specialists in four regional centres, seeking to explore recruitment and retention factors important to their location decision making. The findings were used to develop a framework of possible evidence-informed policies.Results This article identifies key professional, social and locational factors, several of which are modifiable and amenable to policy redesign, including work variety, workplace culture, sense of community and spousal employment; these factors that can be targeted through initiatives in selection, training and incentives.Conclusions Commonwealth, state and local governments in collaboration with communities and specialist colleges can work synergistically, with a multiplicity of interdigitating strategies, to ensure a positive approach to the maintenance of a critical mass of long-term rural specialists.What is known about the topic? Rural origin increases likelihood of long-term retention to rural locations, with rural clinical school training associated with increased rural intent. Recruitment and retention policy has been directed at general practitioners in rural communities, with little focus on regional centres or medical specialists.What does this study add? Rural origin is associated with regional centre recruitment. Professional, social and locational factors are all moderately important in both recruitment and retention. Specialist medical training for regional centres ideally requires both generalist and subspecialist skills sets. Workforce policy needs to address modifiable factors with four groups, namely commonwealth and state governments, specialist medical colleges and local communities, all needing to align their activities for achievement of long-term medical workforce outcomes.What are the implications for practitioners? Modifiable factors affecting recruitment and retention must be addressed to support specialist models of care in regional centres. Modifiable factors relate to maintenance of a critical mass of practitioners, training a fit-for-purpose workforce and coordinated effort between stakeholders. Although remuneration is important, the decision to stay relates primarily to non-financial factors.

scholarly journals A Tale of Two Countries: An International Perspective on Non-Traditional Special Education

2021 ◽  
pp. 875687052098229
Author(s):  
Elif Tekin-Iftar ◽  
Bree A. Jimenez ◽  
Hatice Deniz Degirmenci
Keyword(s):  
Special Education ◽  
Rural Communities ◽  
Students With Disabilities ◽  
Local Governments ◽  
International Perspective ◽  
School Closure ◽  
Global Perspective ◽  
Medical Needs ◽  
Global Pandemic ◽  
State And Local

A global perspective of education, special education, rural communities, and non-traditional instruction is provided for two countries. Both Turkey and Australia have responded to the COVID-19 global pandemic in similar yet, different ways. Through the tale of two countries navigating the rapid response to school closure for students with disabilities, we all can gain understanding from examining strategies used by national, state, and local governments; school systems; and support agencies. From these strategies, we can determine effective and efficient models moving forward that support all students (e.g., students with mental health and medical needs) through non-traditional education during natural disasters, pandemics, or unexpected events

scholarly journals Where are they working? A case study of twenty Cuban-trained South African doctors

2019 ◽  
Vol 11 (1) ◽  
Author(s):  
Munirah Motala ◽  
Jacqueline Van Wyk
Keyword(s):  
Rural Communities ◽  
South African ◽  
Rural Areas ◽  
Career Choices ◽  
Medical Training ◽  
Sampling Strategy ◽  
Structured Interviews ◽  
Primary Care Level

Background: The year 2017 marked the 21st anniversary of the South African Cuban Medical Collaboration (SACMC) programme that offers disadvantaged South African (SA) students an opportunity for medical training in Cuba. Graduates are expected to return to practice at a primary care level in rural communities; however, little is known about the professional trajectories and career choices of graduates from the programme.Aim: This study explored the reasons why students enrolled in the programme, their professional and career choices as graduates and their career intentions.Setting: The study setting was the whole of SA although participants were primarily drawn from KwaZulu-Natal.Methods: An exploratory, qualitative case study used a purposive sampling strategy to gather data through semi-structured interviews from participants.Results: Graduates (N = 20) of the SACMC programme were all practicing in local SA settings. Participants preferred the SACMC programme as it offered them a full scholarship for medical training. Nineteen doctors had fulfilled their obligation to work in rural areas. Thirteen doctors are engaged in primary healthcare practice, either as private practice generalists or as public service medical officers. Three doctors had completed specialty training: one doctor was training towards specialisation, one doctor was employed at national government and two doctors were employed as medical managers. At the time of the study, 11 doctors were practicing in rural locations and 19 had indicated a long-term intention to work and live within South Africa.Conclusion: The participants of this study who graduated from the SACMC programme are fulfilling their obligations in rural communities. They all intend to contribute to the SA medical workforce in the long-term.

scholarly journals Using Place-Based Jobs Policies to Help Distressed Communities

2020 ◽  
Vol 34 (3) ◽  
pp. 99-127
Author(s):  
Timothy J. Bartik
Keyword(s):  
Labor Markets ◽  
Local Governments ◽  
Public Services ◽  
Job Training ◽  
Cost Effective ◽  
Local Labor Markets ◽  
Equity And Efficiency ◽  
Employment Rates ◽  
State And Local

Place-based jobs policies seek to create jobs in particular local labor markets. Such policies include business incentives provided by state and local governments, which cost almost $50 billion annually. The most persuasive rationale for these policies is that they can advance equity and efficiency by increasing long-term employment rates in distressed local labor markets. However, current incentives are not targeted at distressed areas. Furthermore, incentives have high costs per job created. Lower costs can be achieved by public services to business, such as manufacturing extension, customized job training, and infrastructure. Reforms to place-based jobs policies should focus on greater targeting of distressed areas and using more cost-effective policies. Such reforms could be achieved by state and local governments acting in their residents’ interests or could be encouraged by federal interventions to cap incentives and provide aid to distressed areas.

scholarly journals Tax Incentives: An Effective Development Strategy for Rural Communities?

2002 ◽  
Vol 34 (2) ◽  
pp. 319-325 ◽  
Author(s):  
Daniel V. Rainey ◽  
Kevin T. McNamara
Keyword(s):  
Rural Communities ◽  
Development Strategy ◽  
Rural Areas ◽  
Local Governments ◽  
Tax Incentives ◽  
Economic Opportunity ◽  
Capital Investments ◽  
Local Economies ◽  
State And Local ◽  
Effective Development

As national and local economies become more globalized, many rural areas are going to find it more difficult to compete for private capital investments. A traditional tool, modifications to tax policy, of state and local governments will not be as effective (for many communities it has never been effective) in the future. These communities will need to seek other avenues of growth. However, for many rural communities even alternative avenues will not lead to enhanced economic opportunity.

Using National Financial Incentives to Build Local Resiliency: The U.S. Disaster Mitigation Act

2010 ◽  
Vol 5 (2) ◽  
pp. 164-171
Author(s):  
Kenneth C. Topping ◽  
Keyword(s):  
Financial Incentives ◽  
Local Governments ◽  
Hazard Mitigation ◽  
Disaster Mitigation ◽  
Federal Grants ◽  
Local Resilience ◽  
State And Local ◽  
The U.S

The U.S. Congress passed the Disaster Mitigation Act of 2000 (DMA 2000) which requires adoption of multihazard mitigation plans as a precondition of local government eligibility for federal pre-disaster and postdisaster hazard mitigation grants. Its underlying purpose was to encourage local governments to systematically plan for reducing risks and future disaster losses before requesting federal grants to execute hazard mitigation projects. This paper examines the DMA 2000 legislation, its purposes, and the responses to it by state and local governments. Among other things the paper: 1) describes DMA 2000 statutory requirements, 2) assesses overall participation by region, 3) uses the State of California as a case study to examines hazard mitigation plan compliance issues, and 4) explores long-term implications of this broad national effort to use financial incentives to increase local resilience. By early 2009, 18,783 locally adopted hazard mitigation plans had been approved by FEMA. Although community resilience outcomes cannot be truly assessed without further research, the magnitude of this response implies substantial long-term local capacity building benefits within the U.S. This experience should also be the subject of comparative research regarding parallel efforts elsewhere.

scholarly journals Financial sustainability as a factor of forming fiscal space of local budgets

2021 ◽  
pp. 4-16
Author(s):  
Taisiya H. Bondaruk ◽  
Igor S. Bondaruk ◽  
Maksym V. Dubyna
Keyword(s):  
European Commission ◽  
Local Governments ◽  
Financial Stability ◽  
Practical Significance ◽  
Financial Sustainability ◽  
Local Authorities ◽  
Fiscal Space ◽  
State And Local ◽  
Theoretical Foundations

The purpose of the research is to deepen the theoretical foundations of financial stability as a factor in shaping the fiscal space of local budgets and substantiate the methodological tools for assessing the financial stability of local budgets of Ukraine in the medium and long term. Methods. The following research methods were used in analysing the problem: induction, deduction, system approach, statistical analysis, logical generalization, graphical method. Results. Fiscal extension gives the opportunities to local authorities to obtain and use extra budget resources for achieving the goal taking into account the restrictions caused by the necessity to maintain the financial sustainability in mid- and long-term periods. A methodological toolkit for assessing the financial sustainability of local budgets in mid- and long-term periods is proposed. The complex of arguments for the appropriate applying of the estimation of financial sustainability of local budgets in the national practice using the methodology of the European Commission in the mid-term period is given. It is substantiated that the development of strategic directions for ensuring the long-term financial sustainability of local budgets in Ukraine should take place with the use of foresight. It is substantiated that the fiscal space provides opportunities for local governments to obtain and use extra budgetary resources to achieve a certain goal, taking into account the constraints due to the need to maintain financial stability in the medium- and long-term periods.  Methodical tools for assessing the financial stability of local budgets in the medium- and long-term periods are proposed.  A set of arguments on the expediency of applying the methodology of the European Commission in the medium-term period in the native practice of calculating the financial stability of local budgets is presented.  It is substantiated that the development of strategic directions to ensure long-term financial stability of local budgets of Ukraine should take place using foresight. Practical meaning. The practical significance of the obtained results is in the possibility of using methodological tools to assess the effectiveness of local budget sustainability management by state and local authorities in developing and making management decisions to regulate the level of financial stability of local budgets. Prospects for further research. The formation of theoretical foundations of financial stability as a factor in the formation of the fiscal space of local budgets and substantiation of methodological tools for their assessment in the medium and long term periods confirms the need for further scientific substantiation of strategic directions of long-term financial stability of local budgets in Ukraine under the condition of decentralization.

Long-Term Care Planning, Preparedness, and Response Among Rural Long-Term Care Providers

2020 ◽  
pp. 1-4
Author(s):  
Tiffany A. Radcliff ◽  
Jennifer A. Horney ◽  
Aram Dobalian ◽  
Blanca O. Macareno ◽  
Umar Y. Kabir ◽  
...  
Keyword(s):  
Rural Communities ◽  
Rural Areas ◽  
Long Term Care ◽  
Local Level ◽  
Federal State ◽  
Care Providers ◽  
Term Care ◽  
State And Local ◽  
Communication And Coordination

Abstract Objective: Rural Long-term Care (LTC) providers face unique challenges when planning, preparing for, and responding to disasters. We sought to better understand challenges and identify best practices for LTC in rural areas. Methods: Case studies including key informant interviews and site visits were conducted with LTC staff and emergency planning, preparedness, and response partners in three rural communities. Themes were identified across sites using inductive coding. Results: Communication across disaster phases continues to be a challenge for LTC providers in rural communities for all disaster types. Communication challenges limit LTC providers’ ability to address patient needs during emergencies and limit the resilience of providers and patients to future disasters. Limited coordination among local leadership and LTC providers prevents dissemination of information, resources, and services, and slows response and recovery time. Including LTC providers as stakeholders in planning and exercises may improve communication and coordination. Conclusion: More than two decades into efforts to increase preparedness of health care systems to all hazards, rural LTC facilities still face challenges related to communication and coordination. Agencies at the federal, state, and local level should include input from rural LTC stakeholders to address gaps in communication and coordination and increase their disaster resilience.

scholarly journals METHODS FOR IMPROVING THE EFFECTIVENESS OF THE FINANCIAL MANAGEMENT OF LOCAL GOVERNMENT UNITS IN POLAND

2016 ◽  
Vol 10 (1) ◽  
pp. 177-185 ◽  
Author(s):  
Anna Świrska
Keyword(s):  
Local Government ◽  
Financial Management ◽  
Local Governments ◽  
Public Financial Management ◽  
Public Resources ◽  
Survey Results ◽  
State And Local ◽  
The Individual ◽  
Performance Budget

The issue of public sector management, especially management of public finance, identifies as extremely important in both theoretical and practical areas. Within the context of social and economic change, its meaning becomes crucial to the smooth and efficient functioning of public institutions including local government units. The search for optimal solutions in the sphere of local governments’ financial management and the implementation of new tools causes an increase in the efficiency of financial management at local and central levels, an increase in the rational use of public resources’ management, a transparency of expenditures, and above all, an improvement in the efficiency of public tasks that the state and local governments carry out for their citizens. The aim of this paper is to present three tools that have been introduced in recent years with the aim to increase the efficiency of public financial management. They are the performance budget, the individual debt index, and the long-term financial forecast of the LGU. Also, selected survey results are presented that show the opinion of local authorities on the implementation and usefulness of the tools mentioned.

Access Indiana

2010 ◽  
pp. 190-210
Author(s):  
J. Ramon Gil-Garcia ◽  
Francisco R. Hernandez-Tella
Keyword(s):  
Local Governments ◽  
Developing Nations ◽  
Public Private Partnerships ◽  
Key Factors ◽  
Public Agencies ◽  
Structured Interviews ◽  
Private Partnership ◽  
State And Local ◽  
High Degree

Indiana was one of the first states to build a state website. Its IT functions had strong legislative underpinnings and its central IT agency exercises a relatively high degree of authority over agency-based IT functions. In addition, Indiana’s website, AccessIndiana, was the product of a long-term public-private partnership. Based on the analysis of official and public documents and some in-depth semi-structured interviews with key factors such as the general manager of Indiana Interactive and the former state CIO, this case describes the recent history and success of AccessIndiana from about 1995 to 2005. This was the period in which Access Indiana was considered one of the most successful public-private partnerships managing a state Website. After a brief period of uncertainty, in July of 2006, the state of Indiana signed a new long-term contract with Indiana Interactive to develop and maintain its official portal. AccessIndiana offers important lessons to public agencies, particularly for state and local governments and developing nations.

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