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									                                                                                                         Template I
                                                                             Grants and Other Non-Grant Funding Flowing to or Through the SORH



       Grantee and         State      Funding        Amount of    Percentage     Dollar Value Economic        Type of      Projected     Total Office Return on    Office Cost Net Return on Office Cost Net Return on       Comments on Assumptions
      Nature of the                   Agency          Grant          of the        of Grant   Multiplier    Multiplier     Economic         Cost      Investment    from Non    Investment    from State     Investment         and Program Notes
Organization Receiving              and Purpose      Received        Grant       Attributable                (County,    Return (Value Attributable ($Returned/1$      State       (Net $    Government        (Net $
        the Grant,                                                Attributable     to Office               Service Area, Attributable to to Results     Cost) =    Government Returned after Sources (e.g., Returned after
 e.g., Hospital, Clinic,                                           to Office        Actions                  or State)   Office Action                 (Projected    Sources     Non-State      State's         State
 Network, Community                                                 Actions      (Amount of                              X Multiplier)                 Economic                 Government      General      Government
Organization, or State                                                            Grant X %                                                             Return/                     Cost)        Fund)          Cost)
          Office                                                                 Attributable                                                         Office Cost)
                                                                                   to Office
  Virginia Office of       VA      Flex Program        $352,000     100.0%          $352,000      2.2         State           $774,400       $6,416     120.70             $872      $104,377        $5,544      $663,607 In all following Virginia
  Health Policy and                Grant (HRSA)                                                                                                                                                                           Office of Policy and Planning
      Planning                       Year One                                                                                                                                                                             examples; cost was estimated
                                     FY 2004                                                                                                                                                                              for each employee involved in
                                                                                                                                                                                                                          developing the grant and
                                                                                                                                                                                                                          included direct salary,
                                                                                                                                                                                                                          benefits, and a 20% overhead
                                                                                                                                                                                                                          factor.

                                                                                                                                                                                                                          Net return = (% of total cost
                                                                                                                                                                                                                          attributable to source of
                                                                                                                                                                                                                          funding X total economic
                                                                                                                                                                                                                          return) -cost
  Virginia Office of       VA      State Office of     $190,000     100.0%          $190,000      2.2         State           $418,000       $4,776     87.52                $0            $0        $3,904      $337,778 Primary source of funding for
  Health Policy and                 Rural Health                                                                                                                                                                          the State Office of Rural
      Planning                          Grant                                                                                                                                                                             Health functions within the
                                                                                                                                                                                                                          Office of Health Policy and
                                                                                                                                                                                                                          Planning



  Virginia Office of       VA      Primary Care        $139,613     100.0%          $139,613      2.2       Statewide         $307,149       $5,526     55.58              $349       $19,049        $5,177      $282,573
  Health Policy and                Office Grant                                                             Estimate
      Planning

  Virginia Office of       VA      Small Hospital      $126,464     100.0%          $126,464      2.2       Statewide         $278,221       $1,816     153.21             $697      $106,087        $1,119      $170,318 Grants fund are equally
  Health Policy and                 Improvement                                                             Estimate                                                                                                      distributed to qualifying
      Planning                         Grant                                                                                                                                                                              hospitals for a variety of
                                                                                                                                                                                                                          performance improvement
                                                                                                                                                                                                                          projects
  Virginia Office of       VA        Bureau of         $150,000     100.0%          $150,000      2.2         State           $330,000         $649     508.47               $0            $0          $980      $497,325
  Health Policy and                    Health
      Planning                     Providers-State
                                        Loan
                                     Repayment
                                       Grant
  Virginia Office of       VA         Minority          $86,440     10.0%              $8,644     2.2         State            $19,017         $649     29.30              $307        $8,689          $342        $9,679 Provided information only;
  Health Policy and                 Health-PHHS                                                                                                                                                                           collaborated but did not write
      Planning                     Grant (through                                                                                                                                                                         grant
                                   Family Health
                                      Services)




SORH Economic Return Analysis                                                                                           September, 2005                                                                                                                    1
                                                                                                          Template I
                                                                              Grants and Other Non-Grant Funding Flowing to or Through the SORH



       Grantee and         State      Funding       Amount of      Percentage     Dollar Value Economic        Type of      Projected     Total Office Return on    Office Cost Net Return on Office Cost Net Return on       Comments on Assumptions
      Nature of the                   Agency         Grant            of the        of Grant   Multiplier    Multiplier     Economic         Cost      Investment    from Non    Investment    from State     Investment         and Program Notes
Organization Receiving              and Purpose     Received          Grant       Attributable                (County,    Return (Value Attributable ($Returned/1$      State       (Net $    Government        (Net $
        the Grant,                                                 Attributable     to Office               Service Area, Attributable to to Results     Cost) =    Government Returned after Sources (e.g., Returned after
 e.g., Hospital, Clinic,                                            to Office        Actions                  or State)   Office Action                 (Projected    Sources     Non-State      State's         State
 Network, Community                                                  Actions      (Amount of                              X Multiplier)                 Economic                 Government      General      Government
Organization, or State                                                             Grant X %                                                             Return/                     Cost)        Fund)          Cost)
          Office                                                                  Attributable                                                         Office Cost)
                                                                                    to Office
  Virginia Office of       VA       Collections         $150,000     100.0%          $150,000      2.2           State          $330,000      $8,722     37.84              $612       $22,543        $8,110      $298,735
  Health Policy and                from Medical
      Planning                      Scholarship
                                      Defaults
  Virginia Office of       VA       Collections          $20,000     100.0%           $20,000      2.2           State           $44,000     $10,394      4.23                $0            $0       $10,394       $33,606
  Health Policy and                from Nursing
      Planning                      Scholarship
                                      Defaults

  Virginia Office of       VA      State Planning       $811,601     80.0%           $649,281      1.9      Modified State     $1,233,634     $7,901     156.14             $697      $108,130        $7,204    $1,117,602 This is the primary source of
  Health Policy and                Grant                                                                    Wide Estimate                                                                                                  funding for the study of
      Planning                                                                                                 based on a                                                                                                  reducing barriers to insurance
                                                                                                               large % of                                                                                                  coverage for the medically
                                                                                                              funds being                                                                                                  under-insured.
                                                                                                            spent on out-of-
                                                                                                                  state
                                                                                                               consulting



Florida Office of Rural     FL      HRSA FLEX       $ 3,108,000      100.0%         $3,108,000     2.2           State         $6,837,600    $45,600     149.95          $45,600    $6,792,000            $0            $0 FORH costs estimated based
        Health                     Program Grant                                                                                                                                                                           on total costs for five weeks
                                     1999-2004                                                                                                                                                                             of the FLEX coordinator's
                                                                                                                                                                                                                           time (salary, fringe benefits,
Florida Office of Rural     FL        HRSA          $    533,325     100.0%          $533,325      2.2           State         $1,173,315    $24,000     48.89           $12,000      $574,658       $12,000      $574,658 space and indirect costs) per
                                                                                                                                                                                                                           FORH costs estimated based
        Health                      SHIP Grant                                                                                                                                                                             on total costs for five weeks
                                     2002-04                                                                                                                                                                               of the Director's time per year
                                                                                                                                                                                                                           for three grant years. Sources
                                                                                                                                                                                                                           of SORH $'s for Cost
                                                                                                                                                                                                                           estimated at half Federal and
                                                                                                                                                                                                                           half State.
Florida Office of Rural     FL         HRSA         $    900,000     100.0%          $900,000      2.2           State         $1,980,000    $48,000     41.25           $24,000      $966,000       $24,000      $966,000 Based on an annual $150K
        Health                      State Office                                                                                                                                                                           grant. FORH costs estimated
                                    Grant 1999-                                                                                                                                                                            based on total costs for five
                                        2004                                                                                                                                                                               weeks of the Director's time
                                                                                                                                                                                                                           per year for six grant years.
                                                                                                                                                                                                                           Sources of SORH $'s for Cost
                                                                                                                                                                                                                           estimated at half Federal and
                                                                                                                                                                                                                           half State.

  Florida Bureau of         FL      HRSA Rural      $    574,027     25.0%           $143,507      2.2           State          $315,715     $22,800     13.85           $10,000      $128,471       $12,800      $164,443 FORH costs estimated based
 Emergency Medical                  AED Grant                                                                                                                                                                              on and average of total costs
       Services                      2002-04                                                                                                                                                                               for five weeks of the FLEX
                                                                                                                                                                                                                           coordinator's time per year for
                                                                                                                                                                                                                           three grant years.


SORH Economic Return Analysis                                                                                             September, 2005                                                                                                                2
                                                                                                        Template I
                                                                            Grants and Other Non-Grant Funding Flowing to or Through the SORH



       Grantee and         State      Funding       Amount of    Percentage     Dollar Value Economic        Type of      Projected     Total Office Return on    Office Cost Net Return on Office Cost Net Return on         Comments on Assumptions
      Nature of the                   Agency         Grant          of the        of Grant   Multiplier    Multiplier     Economic         Cost      Investment    from Non    Investment    from State     Investment           and Program Notes
Organization Receiving              and Purpose     Received        Grant       Attributable                (County,    Return (Value Attributable ($Returned/1$      State       (Net $    Government        (Net $
        the Grant,                                               Attributable     to Office               Service Area, Attributable to to Results     Cost) =    Government Returned after Sources (e.g., Returned after
 e.g., Hospital, Clinic,                                          to Office        Actions                  or State)   Office Action                 (Projected    Sources     Non-State      State's         State
 Network, Community                                                Actions      (Amount of                              X Multiplier)                 Economic                 Government      General      Government
Organization, or State                                                           Grant X %                                                             Return/                     Cost)        Fund)          Cost)
          Office                                                                Attributable                                                         Office Cost)
                                                                                  to Office

   AJO Community           AZ      Rural Outreach     $198,284     30.0%            $59,485      1.5         County            $89,228      $1,700     52.49                                                               Assistance with identifying
                                                                                                                                                                                     Not                           Not
    Health Center                  Grant (HRSA)                                                                                                                   Not Specified                 Not Specified              grant opportunities and grant
                                                                                                                                                                                  Calculated                    Calculated
                                                                                                                                                                                                                           writing
  Five Various Local       AZ      Rural Health       $349,111     40.0%           $139,644      1.5        Estimated         $209,467     $58,282      3.59                $0             $0        $58,282      $151,185 Aggregated results and cost
       Agencies                    Office Mobile                                                             County                                                                                                        associated with the
                                   Clinics                                                                                                                                                                                 apportioned work of two staff
                                                                                                                                                                                                                           members

  Arkansas Office of       AR      FLEX Grant         $455,000     100.0%          $455,000      2.2          State          $1,001,000    $10,000     100.10          $10,000      $991,000               $0            $0 Second Year FLEX Grant:
  Primary Care and                                                                                                                                                                                                          SORH cost is from FLEX
    Rural Health                                                                                                                                                                                                            funds and is a pro rata share
                                                                                                                                                                                                                            of salary (25%) dedicated to
                                                                                                                                                                                                                            FLEX

Pennsylvania Office of     PA      Flex Grant         $355,000     90.0%           $319,500      2.2          State           $702,900     $40,500     17.36           $40,500      $662,400               $0            $0
    Rural Health
Pennsylvania Office of     PA      Center for          $50,000     50.0%            $25,000      1.5      Modified State       $37,500      $2,000     18.75                $0             $0         $2,000        $35,500 Study was done in
    Rural Health                   Rural                                                                                                                                                                                    collaboration with the
                                   Pennsylvania                                                                                                                                                                             Philadelphia Geriatric Center
                                   Rural Home
                                   Health Study

South Dakota Office of     SD      FLEX Program       $605,000     100.0%          $605,000      2.2          State          $1,331,000    $36,649     36.32           $36,649     $1,294,351              $0            $0 $333,100 of the Grant was for
     Rural Health                  Grant (year 3)                                                                                                                                                                           Network Development. The
                                                                                                                                                                                                                            remainder was for the other
                                                                                                                                                                                                                            four focus areas and
                                                                                                                                                                                                                            administrative cost.




SORH Economic Return Analysis                                                                                           September, 2005                                                                                                                     3
                                                                                                            Template II
                                                                                  Technical Assistance for Funding Effects on Other Organizations



 Organization Served     State     Nature of         Financial Percentage Dollar Value Economic        Type of       Projected Office Cost    Office       Return on    Office Cost   Net Return     Office Cost    Net Return Comments on Assumptions
           and                     Assistance          Results    of the         of Gain Multiplier   Multiplier    Economic Attributable    Charge       Investment     from Non-     Associated     from State    Associated    and Program Notes
      Nature of the                                                Gain     Attributable              (County,          Return  to Results       to     ($Returned/1$         State    with Non-     Government      with State
Organization Receiving                                         Attributable    to Office               Service          (Value             Organization     Cost) =     Government    State Govt.        Sources    Govt. Cost
        the Grant,                                              to Office       Actions               Area, or     Attributable              (if any)     (Projected        Sources Cost (Share of                  (Share of $
 e.g., Hospital, Clinic,                                         Actions    (Amount of                  State)        to Office                            Economic                  $ Returned -                    Returned -
       Network or                                                            Gain X %                                 Action X                              Return/                     Non-State                         State
       Community                                                            Attributable                            Multiplier)                          Office Cost)                Government                    Government
      Organization                                                             to Office                                                                                                    Cost)                         Cost)
    Various Health         VA       Accessing         $75,600    100%           $75,600     2.2         State        $166,320       $5,179      None                             $0            $0        $5,179      $161,141 Twenty one Health
   Department Sites                 Universal                                                                                                                                                                                 Department sites; average
                                  Services Fund                                                                                                                                                                               savings $300 per month per
                                                                                                                                                                                                                              site. Year One results will
                                                                                                                                                                                                                              repeat in subsequent years.
                                                                                                                                                                                                                              Project can be extended to
                                                                                                                                                                                                                              Hospitals and other
                                                                                                                                                                                                                              providers.


   Critical Access         FL    Identify funding     $57,000    10.0%           $5,700     2.2         State         $12,540       $1,300      None         9.6             $1,300       $11,240            $0            $0    HRSA grant awarded to
  Hospitals HRSA                     source,                                                                                                                                                                                    Doctors Hospital - Bonifay
AHRQ HIT Planning                   coordinate                                                                                                                                                                                  on behalf of Florida CAHs;
Grant for feasibility of           participants,                                                                                                                                                                                  FORH identified grant
 obtaining automated               consultation                                                                                                                                                                                  opportunity, coordinated
medication dispensing                                                                                                                                                                                                             meetings with potential
equipment for CAHs                                                                                                                                                                                                              partners, reviewed draft of
                                                                                                                                                                                                                                    application; FLEX
                                                                                                                                                                                                                                  coordinator serves as a
                                                                                                                                                                                                                                 consultant on grant team
                                                                                                                                                                                                                                     with up to a 10%
                                                                                                                                                                                                                                   commitment of time.

    Not Specified          AL     Various Rural     $1,000,000    75%          $750,000     2.2         State      $1,650,000    $200,000       None         8.3                 $0            $0      $200,000    $1,450,000 Aggregate of rural consulting
                                   Consulting                                                                                                                                                                                 assistance provided in one
                                   Assistance                                                                                                                                                                                 year
                                    Projects

 Various Delta Grant       AL    HRSA                $500,000    70.0%         $350,000     2.2         State        $770,000     $20,000       None        38.5             $1,500       $56,250        $2,500       $93,750 Assistance to develop rural
     Recipients                                                                                                                                                                                                               health focus within newly
                                                                                                                                                                                                                              formed Delta counties;
                                                                                                                                                                                                                              resulting in initial award of
                                                                                                                                                                                                                              Delta Health Assessment
                                                                                                                                                                                                                              Grant

   38 Rural Health         CO     Annual RHC         $456,000    100%          $456,000     2.2         State      $1,003,200       $5,000      $100/       200.6            $5,000      $998,200            $0            $0 Cost is estimated. Each of
       Centers                       Forum                                                                                                   organization                                                                     the 38 attending RHCs
                                   Educational                                                                                                                                                                                estimated what the Forum
                                     Forum                                                                                                                                                                                    was worth to them through
                                  including TA                                                                                                                                                                                better billing, coding, etc.
                                    on billing,
                                   coding, etc.




   SORH Economic Return Analysis                                                                                       September, 2005                                                                                                                  4
                                                                                                            Template II
                                                                                  Technical Assistance for Funding Effects on Other Organizations



 Organization Served     State     Nature of         Financial Percentage Dollar Value Economic        Type of       Projected Office Cost    Office       Return on     Office Cost   Net Return      Office Cost     Net Return Comments on Assumptions
           and                     Assistance          Results    of the         of Gain Multiplier   Multiplier    Economic Attributable    Charge       Investment      from Non-     Associated      from State     Associated    and Program Notes
      Nature of the                                                Gain     Attributable              (County,          Return  to Results       to     ($Returned/1$          State    with Non-      Government       with State
Organization Receiving                                         Attributable    to Office               Service          (Value             Organization     Cost) =      Government    State Govt.         Sources     Govt. Cost
        the Grant,                                              to Office       Actions               Area, or     Attributable              (if any)     (Projected         Sources Cost (Share of                    (Share of $
 e.g., Hospital, Clinic,                                         Actions    (Amount of                  State)        to Office                            Economic                   $ Returned -                      Returned -
       Network or                                                            Gain X %                                 Action X                              Return/                      Non-State                           State
       Community                                                            Attributable                            Multiplier)                          Office Cost)                 Government                      Government
      Organization                                                             to Office                                                                                                     Cost)                           Cost)
Canterbury Volunteer      CT     Identification of    $14,900     10%            $1,490     1.5        County          $2,235       $1,300    None           1.7              $1,300           $935              $0            $0
  Fire/Ambulance                      Grant
                                   Opportunity


  Kentucky River         KY         Technical        $190,000     10%           $19,000     1.9        County         $36,100       $5,777    None           6.2              $5,777        $30,323              $0            $0 Projected values arrived at
  Community Care                     Support                                                                                                                                                                                      by using Rural Health Works
HRSA Outreach Grant                                                                                                                                                                                                               Implant data


     Bioterrorism        MT         Planning         $599,516     5%            $29,976     1.5        County         $44,964       $5,000    None           9.0              $5,000        $39,964          $5,000       $39,964 Multi-party initiative
  Preparedness Plan                Committee
        Grant                       Member

Center for Research on   MT      DRAFT Grant         $150,000     10%           $15,000     1.5        County         $22,500       $5,000    None           4.5              $5,000        $17,500              $0            $0 Three year grant funded by
   Chronic Health                Reviewer and                                                                                                                                                                                     NIH
 conditions in Rural              Member of
 Dwellers-NIH Grant              Administrative
                                     Core
                                  Committee

  Hidalgo Medical        NM        Technical         $188,078     2%             $3,762     1.5        County          $5,642       $1,500    None           3.8              $1,500         $4,142        $0                  $0
     Services                      Assistance
HRSA Network Grant

   Oklahoma State        OK        Technical         $279,000    100%          $279,000     2.2         State        $613,800       $3,300    None          186.0       Not Specified      Not        Not Specified      Not
University Cooperative             Assistance                                                                                                                                           Calculated                    Calculated
  Extension Center



   Oklahoma Career       OK        Technical         $180,000    100%          $180,000     2.2         State        $396,000       $2,200    None          180.0       Not Specified      Not        Not Specified      Not
  Technology Center                Assistance                                                                                                                                           Calculated                    Calculated
  Project Home Base

Area Health Education    OK        Technical         $267,000    100%          $267,000     2.2         State        $587,400       $3,200    None          183.6       Not Specified      Not        Not Specified      Not
      Centers                      Assistance                                                                                                                                           Calculated                    Calculated

   Pennsylvania           PA       Technical         $200,000     2%             $4,000     1.2        County          $4,800       $1,000    None           4.8              $1,000         $3,800              $0            $0
Mountains Healthcare               Assistance
 Alliance-Network
       Grant




   SORH Economic Return Analysis                                                                                       September, 2005                                                                                                                     5
                                                                                                            Template II
                                                                                  Technical Assistance for Funding Effects on Other Organizations



 Organization Served     State     Nature of         Financial Percentage Dollar Value Economic        Type of       Projected Office Cost    Office       Return on    Office Cost   Net Return     Office Cost    Net Return Comments on Assumptions
           and                     Assistance          Results    of the         of Gain Multiplier   Multiplier    Economic Attributable    Charge       Investment     from Non-     Associated     from State    Associated    and Program Notes
      Nature of the                                                Gain     Attributable              (County,          Return  to Results       to     ($Returned/1$         State    with Non-     Government      with State
Organization Receiving                                         Attributable    to Office               Service          (Value             Organization     Cost) =     Government    State Govt.        Sources    Govt. Cost
        the Grant,                                              to Office       Actions               Area, or     Attributable              (if any)     (Projected        Sources Cost (Share of                  (Share of $
 e.g., Hospital, Clinic,                                         Actions    (Amount of                  State)        to Office                            Economic                  $ Returned -                    Returned -
       Network or                                                            Gain X %                                 Action X                              Return/                     Non-State                         State
       Community                                                            Attributable                            Multiplier)                          Office Cost)                Government                    Government
      Organization                                                             to Office                                                                                                    Cost)                         Cost)
    11 SoDaCAHP           SD     Assisted sites to   $387,998     80%          $310,398     1.5        County        $465,598     $31,505     None          14.8           $40,500       $558,030            $0            $0
   Network Projects               develop work
                                   plans for the
                                  installation of
                                     network
                                  infrastructure
                                     and staff
                                     training


Appalachian Regional     WV         Technical         $96,032    100%           $96,032     1.5        County        $144,048       $5,000    None          28.8             $3,000       $83,429        $2,000       $55,619 Minimal staff time and travel
Commission Grants for                Support
 McDowell, WVa and
surround communities




   SORH Economic Return Analysis                                                                                       September, 2005                                                                                                                6
                                                                                                                                                   Template III
                                                                                                                                    Evaluation of FLEX/CAH Financial Impacts




    Hospital or       State       Estimated      Estimated      Estimated       Extent to     Dollar Value   Economic      Type of    Projected     Amount of      SORH Cost      Total       Total Return     Return on    Office Cost      Net Return   Office Cost      Net Return      Comments on Assumptions and Program Notes
 Group of Hospitals            Financial Gain Financial Gain    Economic          Which       Attributable   Multiplier   Multiplier  Economic     Flex Grant(s)   Attributable   Costs      on Investment       SORH        from Non-       Associated   from State       Associated
                               (e.g., Through   Year Two         Return       Conversion or     to Office                 (County, Return (Value to Hospital(s)     to Results                 ($Returned/     Operating        State         with Non- Government          with State
                                Conversion to                   Combined       Results Can       Actions                   Service Attributable to   or Other                                   1$ Cost) =       Funds      Government       State Govt.    Sources         Govt. Cost
                                    CAH                          Years if           Be        (Amount of                  Area, or Office Action Organizations                                  (Projected    ($Returned/      Sources       Cost (Share                   (Share of $
                                 Year One)                      Applicable    Attributable to     Grant                     State)   X Multiplier) To Support                                   Economic       1$ Cost) =                   of $ Returned                   Returned -
                                   Through                                    Office Actions Received X                                             Conversion                                   Return/       (Projected                    - Non-State                      State
                                  Improved                                    (Estimate %) Percentage                                                Activities                                Total Cost)     Economic                      Government                    Government
                               Reimbursement                                                  Attributable                                                                                                   Return/SORH                        Cost)                         Cost)
                              or Other Actions                                                 to Office)                                                                                                      Cost Only)


  Bath Community      VA           $1,023,000      unknown       $1,023,000       75%            $767,250       1.7        County      $1,304,325        $20,000         $8,804    $28,804       45.28          148.15            $6,792       $300,769              $0             $0 Before conversion, the hospital was losing $1.62
      Hospital                                                                                                                                                                                                                                                                         million and estimated to lose $2.0 million in its next
                                                                                                                                                                                                                                                                                       fiscal year; after conversion to a CAH, loses were
                                                                                                                                                                                                                                                                                       reduced to $977,000 for a positive variance (gain) of
                                                                                                                                                                                                                                                                                       $1,023,000.

Dickenson Community   VA          $17,500,000 $ 25,000,000      $42,500,000       25%         $10,625,000       1.7        County     $18,062,500        $20,000         $8,804    $28,804      627.08         2,051.62           $6,792      $4,252,356             $0             $0 Prior to CAH conversion the hospital closed with a
      Hospital                                                                                                                                                                                                                                                                         community loss of 200 jobs. Hospital and Office
                                                                                                                                                                                                                                                                                       representatives believe that without CAH status, this
                                                                                                                                                                                                                                                                                       hospital would not have been able to reopen under
                                                                                                                                                                                                                                                                                       new owner and management arrangements. The
                                                                                                                                                                                                                                                                                       estimated revenue for the hospital in the first year
                                                                                                                                                                                                                                                                                       after conversion was $16-19 million; and a estimate
                                                                                                                                                                                                                                                                                       of 17.5 million is used in this example as first year
                                                                                                                                                                                                                                                                                       return on CAH conversion investment by the Office.
                                                                                                                                                                                                                                                                                       The hospital estimated second year revenue of $25
                                                                                                                                                                                                                                                                                       million.


 Stonewall Jackson    VA           $2,300,000     Unknown        $2,300,000       25%            $575,000       1.7        County        $977,500        $20,000         $8,804    $28,804       33.94          111.03            $6,792       $223,703              $0             $0 Estimated first year increase in Medicare
                                                                                                                                                                                                                                                                                       Reimbursement to be achieved after conversion



  Carilion Giles      VA           $1,953,467      unknown       $1,953,467       25%            $488,367       1.7        County        $830,223        $20,000         $8,804    $28,804       28.82          94.30             $6,792       $188,975              $0             $0 The hospital reduced its operating losses from $3.1
 Memorial Hospital                                                                                                                                                                                                                                                                     million to $1.47 million in the first year after
                                                                                                                                                                                                                                                                                       converting to a CAH in October 2002. This change
                                                                                                                                                                                                                                                                                       resulted from a combination of increased CAH
                                                                                                                                                                                                                                                                                       reimbursement and a reduction in expenses,
                                                                                                                                                                                                                                                                                       including 36 jobs. It is strongly felt that CAH
                                                                                                                                                                                                                                                                                       conversion enabled the positive changes that were
                                                                                                                                                                                                                                                                                       made.

  Florida-Heartland    FL          $1,897,553     $1,238,822     $3,136,375       85%          $2,665,919       1.5        County      $3,998,878        $20,000         $7,600    $27,600      144.89          526.17           $27,600      $3,971,278             $0             $0      Estimates of hospital financial gain based on
   Center Hospital,                                                                                                                                                                                                                                                                       difference between excess of operating revenues
      Wauchula                                                                                                                                                                                                                                                                               over operating expenses pre and post CAH
                                                                                                                                                                                                                                                                                            conversion for 2001 and 2002 as reported by
                                                                                                                                                                                                                                                                                               hospitals to the Agency for Health Care
                                                                                                                                                                                                                                                                                         Administration. Costs based on grants to hospitals
                                                                                                                                                                                                                                                                                            for financial feasibility and community needs
                                                                                                                                                                                                                                                                                         assessment plus total costs for five weeks of FLEX
                                                                                                                                                                                                                                                                                                    coordinator's time per hospital.

  Aggregate of Five    FL          $8,523,993   $12,091,324     $20,615,317       85%         $17,523,019       2.2         State     $38,550,643       $140,000        $53,200   $193,200      199.54          724.64      Not Specified       Not        Not Specified      Not
  Florida Hospitals                                                                                                                                                                                                                          Calculated                    Calculated

Alabama Washington    AL             $85,000 $        150,000      $235,000       50%            $117,500       2.2         State        $258,500        $40,000        $10,000    $50,000       5.17           25.85       Not Specified       Not        Not Specified      Not
  County Infirmary                                                                                                                                                                                                                           Calculated                    Calculated
    Conversion

  Valdez Regional     AK             $120,000 $       140,000      $260,000       50%            $130,000       1.5        County        $195,000        $12,000        $10,800    $22,800       8.55           18.06       Not Specified       Not        Not Specified      Not        SORH costs are estimated salary, travel, and
     Authority                                                                                                                                                                                                                               Calculated                    Calculated    incidental costs (app. 60% of an FTE + $12,000 +
                                                                                                                                                                                                                                                                                         incidentals) spread over five hospitals
  Summary of Five     AK           $1,039,163 $     1,107,437    $2,146,600       50%          $1,073,300       2.2         State      $2,361,260        $38,450        $54,000    $92,450       25.54          43.73       Not Specified       Not        Not Specified      Not        SORH costs are estimated salary, travel, and
     Hospitals                                                                                                                                                                                                                               Calculated                    Calculated    incidental costs (app. 60% of an FTE + $12,000 +
                                                                                                                                                                                                                                                                                         incidentals)

   All Hospitals       IA          $2,982,078     Unknown        $2,982,078       50%          $1,491,039       2.2         State      $3,280,286       $196,173        $11,651   $207,824       15.78          281.55      Not Specified       Not        Not Specified      Not        Increased reimbursement projected from 1998
Conversions Through                                                                                                                                                                                                                          Calculated                    Calculated    financial reports.
       2000



     SORH Economic Return Analysis                                                                                                                        September, 2005                                                                                                                                                             7
                                                                                                                                                       Template III
                                                                                                                                        Evaluation of FLEX/CAH Financial Impacts




     Hospital or          State       Estimated      Estimated      Estimated       Extent to     Dollar Value   Economic      Type of    Projected     Amount of      SORH Cost        Total      Total Return     Return on    Office Cost      Net Return   Office Cost     Net Return      Comments on Assumptions and Program Notes
  Group of Hospitals               Financial Gain Financial Gain    Economic          Which       Attributable   Multiplier   Multiplier  Economic     Flex Grant(s)   Attributable     Costs     on Investment       SORH        from Non-       Associated   from State      Associated
                                   (e.g., Through   Year Two         Return       Conversion or     to Office                 (County, Return (Value to Hospital(s)     to Results                  ($Returned/     Operating        State         with Non- Government         with State
                                    Conversion to                   Combined       Results Can       Actions                   Service Attributable to   or Other                                    1$ Cost) =       Funds      Government       State Govt.    Sources        Govt. Cost
                                        CAH                          Years if           Be        (Amount of                  Area, or Office Action Organizations                                   (Projected    ($Returned/      Sources       Cost (Share                  (Share of $
                                     Year One)                      Applicable    Attributable to     Grant                     State)   X Multiplier) To Support                                    Economic       1$ Cost) =                   of $ Returned                  Returned -
                                       Through                                    Office Actions Received X                                             Conversion                                    Return/       (Projected                    - Non-State                     State
                                      Improved                                    (Estimate %) Percentage                                                Activities                                 Total Cost)     Economic                      Government                   Government
                                   Reimbursement                                                  Attributable                                                                                                    Return/SORH                        Cost)                        Cost)
                                  or Other Actions                                                 to Office)                                                                                                       Cost Only)



  Multiple Hospitals       IL          $4,500,000 $ 13,500,000      $18,000,000       80%         $14,400,000       2.2         State     $31,680,000       $520,000       $150,000    $670,000       47.28          211.20      Not Specified       Not       Not Specified      Not        1st year 9 CAHs @ @$500,000 average operating
                                                                                                                                                                                                                                                  Calculated                   Calculated    margin increases per year; 2nd year = 18 CAH at
                                                                                                                                                                                                                                                                                             @$750.000 per hospital; two years of staff expense
                                                                                                                                                                                                                                                                                             included in SORH cost

  35 Critical Access      MN           $8,225,000    Unknown         $8,225,000       50%          $4,112,500       2.2         State      $9,047,500       $150,000        $50,000    $200,000       45.24          180.95      Not Specified       Not       Not Specified      Not        Year one conversion results using an average gain
      Hospitals                                                                                                                                                                                                                                   Calculated                   Calculated    estimate of$235,000/ hospital

  Harrison County         MO            $627,000     Unknown           $627,000       100%           $627,000       1.5        County        $940,500        $25,000         $1,200     $26,200       35.90          783.75      Not Specified       Not       Not Specified      Not
 Community Hospital                                                                                                                                                                                                                               Calculated                   Calculated
  Aggregate Results       MO           $4,788,043    Unknown         $4,788,043       100%         $4,788,043       2.2         State     $10,533,695       $325,000        $15,600    $340,600       30.93          675.24      Not Specified       Not       Not Specified      Not
   from 13 CAHs                                                                                                                                                                                                                                   Calculated                   Calculated

Aggregate of 5 Critical   PA           $1,250,000   Not Specified    $1,250,000       60%            $750,000       2.2         State      $1,650,000 Not Specified     $40,500        $40,500        40.74           40.74      Not Specified       Not       Not Specified      Not
  Access Hospitals                                                                                                                                                                                                                                Calculated                   Calculated


  Custer Community        SD            $111,712    Not Known          $111,712       50%             $55,856       1.5        County         $83,784        $10,000         $2,367     $12,367       6.77            35.40      Not Specified       Not       Not Specified      Not        Primary economic return in first year increase in
       Hospital                                                                                                                                                                                                                                   Calculated                   Calculated    Medicare Reimbursement. "Other SORH costs" are
                                                                                                                                                                                                                                                                                             the apportioned costs of 1.4 FTE staff working on
                                                                                                                                                                                                                                                                                             six completed conversions in FY2001

   Aggregate of 28        TX           $8,247,293   Not Known        $8,247,293       80%          $6,597,834       2.2         State     $14,515,236       $555,000              $0   $555,000       26.15       Not Calculated Not Specified       Not       Not Specified      Not        Increased reimbursement estimated from the
   Critical Access                                                                                                                                                                                                                                Calculated                   Calculated    financial feasibility projects of the first year after
      Hospitals                                                                                                                                                                                                                                                                              conversions. In this case the SORH did not specify
                                                                                                                                                                                                                                                                                             SORH cost but used the total FLEX grant as a cost
                                                                                                                                                                                                                                                                                             factor. This shows a return on total Grant funds,
                                                                                                                                                                                                                                                                                             but not the return on SORH funds.
Notes:
1) Clean data is not readily available and assessment is based on estimates provided by individual hospitals. The financial impacts related to CAH conversion are based on a combination of reimbursement improvements and other service and operational changes that were made in conjunction with
conversion.It is very difficult, without extensive analysis to differentiate the specific CAH impacts from total operational effect. Thus, the CAH impact estimates are most frequently derived from hospital estimates, rather than through specific measurements.
2) In examples where specific financial feasibility studies can be compared to post-conversion results, the impact of CAH conversion may be better estimated. In Virginia,at the time project data was collected, these pre and post-conversion results were unavailable.
3) In some cases the "gain" is a reduction in loses, not a "profit."
4) In the reference cases, one or two years of impacts are shown. Note that improved reimbursement under CAH status results in annual results as long as the hospital remains a CAH. Although it becomes less reasonable for the SORH to take "credit" for the results.
5) When dealing with a hospital that could claim that it was able to avoid closure or was "saved" by CAH designation or which was able to reopen because of gaining CAH status, the arguments can be made in several ways. However, it is very difficult to quantify
the comparative impact of the "alternatives" that would have developed in the community if the CAH had failed, e.g., the development of a FQHC to replace the hospital.
6) Following conversions, there may be job reductions not always job gains, as the hospital seeks to align its services with its resources, even though additional Medicare (and in some state's Medicaid) resources are available. Some hospitals grow in the scope of their
services and in employment and others contract. Care needs to be taken in discussing the impacts on community jobs.




      SORH Economic Return Analysis                                                                                                                           September, 2005                                                                                                                                                                8
                                                                                                      Template IV
                                                                               Educational Programs and Information Clearinghouse Functions



   Description of      State   Source of   Financial    Percentage     Dollar Value Economic      Type of      Projected   Office Cost Return on    Office Cost Net Return on Office Cost Net Return on     Comments on Assumptions and Program
     Initiative                Resources    Results        of the        of Gain    Multiplier   Multiplier    Economic Attributable Investment      from Non    Investment    from State Investment (Net                 Notes
                                            or Grant     Economic      Attributable              (County,       Return     to Results ($Returned/1$     State       (Net $    Government $ Returned after
                                              Size        Impact        to Office                 Service       (Value                   Cost) =    Government Returned after    Sources       State
                                                        Attributable     Actions                 Area, or     Attributable              (Projected    Sources     Non-State                 Government
                                                         to Office     (Amount of                  State)      to Office                Economic                 Government                    Cost)
                                                          Actions       Gain X %                               Action X                  Return/                     Cost)
                                                                       Attributable                           Multiplier)              Office Cost)
                                                                        to Office
 SORH Mini-Grant       CA        State         $8,000      100%              $8,000     1.5        State          $12,000      $3,000     4.00           $3,000       $9,000           $0              $0 Grant administered for the partial costs of
 BiNaitional Health                                                                                                                                                                                       enhancing and republishing of the
   Initiative (aka                                                                                                                                                                                        English/Spanish Glossary for Health Aids;
 California/Mexico                                                                                                                                                                                        since funds are spent in one place although
  Health Initiative)                                                                                                                                                                                      the program is statewide a multiplier of 1.5
                                                                                                                                                                                                          is used

Annual Rural Summit    MD      FLEX and       $12,061      50%               $6,031     2          State          $12,061      $5,000     2.41           $3,000       $4,237           $0              $0 Rural Summit is a partnership with the
                                OPCRH                                                                                                                                                                     MRHA and the FORUM for Rural
                                 Fund                                                                                                                                                                     Maryland. Profits were allocated between
                                                                                                                                                                                                          the MRHA and FORUM. Since some of the
                                                                                                                                                                                                          funds are spent regionally and some of the
                                                                                                                                                                                                          profits spent statewide an adjusted
                                                                                                                                                                                                          multiplier of 2.0 is used.

  Swimming Pool        PA        Fees         $28,600      100%            $28,600      1.5        State          $42,900     $13,600     3.15           $6,800      $14,650        $6,800        $14,650 This project generates $15,000 of operating
Applicators Training                                                                                                                                                                                      gain for the State Office that is applied to
     Program                                                                                                                                                                                              other Office budget items. It is assumed
                                                                                                                                                                                                          that the primary economic gain occurs
                                                                                                                                                                                                          locally with a 1.5 multiplier.

 EMS Continuing         FL      FLEX          $50,500      100%            $50,500      2.2        State         $111,100    $110,840     1.00         $110,840         $260           $0              $0 Financial estimate based on number of
Education CD ROM                Grant                                                                                                                                                                     CEUs times $2 cost per CEU plus $200 per
Phase 1 Distributed                                                                                                                                                                                       CEU in deferred travel expenses. Costs
       2003                                                                                                                                                                                               based on contractual cost plus two weeks of
                                                                                                                                                                                                          FLEX coordinator's time and total costs per
                                                                                                                                                                                                          year.
Hendry Regional 2004    FL      FLEX          $40,000      100%            $40,000      1.5       County          $60,000      $1,637    36.65           $1,637      $58,363           $0              $0 Financial gain due to one year of increased
                                Grant                                                                                                                                                                     reimbursement for outpatient administrative
                                                                                                                                                                                                          expenses realized due to information
                                                                                                                                                                                                          obtained at the 2004 CAH workshop.
                                                                                                                                                                                                          FORH costs estimated based on per hospital
                                                                                                                                                                                                          costs for all three years of workshops.

 Shands at Live Oak     FL      FLEX          $40,000      100%            $40,000      1.5       County          $60,000      $1,637    36.65           $1,637      $58,363           $0              $0 Financial gain due to two years of increased
    2004 - 2005                 Grant                                                                                                                                                                     reimbursement for ER physician downtime
                                                                                                                                                                                                          realized due to information obtained at the
                                                                                                                                                                                                          2004 CAH workshop. FORH costs
                                                                                                                                                                                                          estimated based on per hospital costs for all
                                                                                                                                                                                                          three years of workshops.




  SORH Economic Return Analysis                                                                                      September, 2005                                                                                                               9
                                                                                                            Template V
                                                                                       Economic Impacts of Recruitment and Retention Initiatives
                                                                                             Note: Each Entry in Template V is Spread Over Two Pages


 Organization Served State      Nature of         Estimate of Percentage     Dollar Value Economic      Type of        Projected       Estimated     Percentage Dollar Value        Economic       Projected
           and                 Assistance:       Revenue Gain    of the        of Gain    Multiplier   Multiplier     Economic       NET Revenue        of the          of          Multiplier     Economic
      Nature of the             Physician         Related to      Gain       Attributable              (County,        Return I          Gain to         Gain          Gain                         Return II
Organization Receiving         Recruitment         Specific   Attributable    to Office                 Service         (Value        Hospital(s)    Attributable Attributable to                    (Value
        the Grant,             Support for:       Provider(s)  to Office       Actions                 Area, or     Attributable to (after bad debt, to Office Office Actions                    Attributable to
 e.g., Hospital, Clinic,                            Office      Actions      (Amount of                  State)     Office Action      free care,      Actions                                   Office Action
       Network or                                 Practice(s)                 Gain X %                              X Multiplier)     contractual                                                X Multiplier)
       Community                                                             Attributable                                             allowances)
      Organization                                                            to Office
    Private Practice     VA     One Family           $342,744     25%             $85,686    1.7        County           $145,666       $1,780,000      25%            $445,000        1.7            $756,500
                                 Physician

   Private Practice    VA       One Family           $342,744     95%           $325,607     1.7        County           $553,532       $1,780,000      95%           $1,691,000       1.7          $2,874,700
                                 Physician

  Community Health     VA       One Family           $342,744     95%           $325,607     1.7        County           $553,532       $1,780,000      95%           $1,691,000       1.7          $2,874,700
      Center                     Physician

       Private         VA      One Internist         $325,433     25%            $81,358     1.7        County           $138,309       $1,880,000      25%            $470,000        1.7            $799,000


       Private         VA      One Internist         $325,433     25%            $81,358     1.7        County           $138,309       $1,880,000      25%            $470,000        1.7            $799,000


  Community Health     VA      One Internist         $325,433     95%           $309,161     1.7        County           $525,574       $1,880,000      95%           $1,786,000       1.7          $3,036,200
      Center

     Unspecified       VA      One Internist         $325,433     50%           $162,717     1.7        County           $276,618       $1,880,000      50%            $940,000        1.7          $1,598,000

     Unspecified       VA      One Internist         $398,650     25%            $99,663     1.7        County           $169,426       $1,975,800      25%            $493,950        1.7            $839,715
                               w/Cardiology

     Unspecified       VA      One Internist         $350,572     25%            $87,643     1.7        County           $148,993       $1,654,000      25%            $413,500        1.7            $702,950
                               w/Neurology

     Unspecified       VA     One Internist w/       $348,781     25%            $87,195     1.7        County           $148,232       $1,792,500      25%            $448,125        1.7            $761,813
                               Pulmonology




     SORH Economic Return Analysis                                                                                         September, 2005                                                                         10
                                                                                                             Template V
                                                                                        Economic Impacts of Recruitment and Retention Initiatives
                                                                                              Note: Each Entry in Template V is Spread Over Two Pages


 Organization Served State      Nature of        Anticipated  Percentage      Dollar Value Economic        Projected     Aggregate     Office Cost      Return on    Office Cost  Net Return on   Office Cost Net Return on    Comments on Assumptions
           and                 Assistance:         Savings        of the           of        Multiplier    Economic      Economic      Attributable    Investment     from Non- Investment (Net $ from State Investment (Net      and Program Notes
      Nature of the             Physician            on           Gain            Gain                     Return III       Gains       to Results   ($Returned/1$       State    Returned after Government $ Returned after
Organization Receiving         Recruitment       Recruitment Attributable to Attributable to                (Value     Attributable to                   Cost) =     Government     Non-State       Sources       State
        the Grant,             Support for:         Cost     Office Actions Office Actions                Attributable Office Actions                  (Projected       Sources    Government                  Government
 e.g., Hospital, Clinic,                                                                                   to Office     Projected                  Economic Return/                  Cost)                       Cost)
       Network or                                                                                          Action X       Returns                     Office Cost)
       Community                                                                                          Multiplier)     I+II+III
      Organization
    Private Practice     VA     One Family            $10,000      25%               $2,500     1.7            $4,250      $906,416        $3,294     275.2             $3,294         $903,122          $0               $0 Year one impact; assumes
                                 Physician                                                                                                                                                                                   new physician to area

   Private Practice    VA       One Family            $10,000      95%               $9,500     1.7           $16,150    $3,444,382        $4,070     846.3             $4,070       $3,440,312          $0               $0 Year one impact; assumes
                                 Physician                                                                                                                                                                                   new physician to area

  Community Health     VA       One Family            $10,000      95%               $9,500     1.7           $16,150    $3,444,382        $4,070     846.3             $4,070       $3,440,312          $0               $0 Year one impact; assumes
      Center                     Physician                                                                                                                                                                                   new physician to area

       Private         VA      One Internist          $10,000      25%               $2,500     1.7            $4,250      $941,559        $3,294     285.8             $3,294         $938,265          $0               $0 Year one impact; assumes
                                                                                                                                                                                                                             new physician to area

       Private         VA      One Internist          $10,000      25%               $2,500     1.7            $4,250      $941,559        $3,294     285.8             $3,294         $938,265          $0               $0 Year one impact; assumes
                                                                                                                                                                                                                             new physician to area

  Community Health     VA      One Internist          $10,000      95%               $9,500     1.7           $16,150    $3,577,924        $4,070     879.1             $4,070       $3,573,854          $0               $0 Year one impact; assumes
      Center                                                                                                                                                                                                                 new physician to area

     Unspecified       VA      One Internist          $10,000      50%               $5,000     1.7            $8,500    $1,883,118        $3,488     539.9             $3,488       $1,879,630          $0               $0 Year one impact; assumes
                                                                                                                                                                                                                             new physician to area
     Unspecified       VA      One Internist          $10,000      25%               $2,500     1.7            $4,250    $1,013,391        $3,294     307.6             $3,294       $1,010,097          $0               $0 Year one impact; assumes
                               w/Cardiology                                                                                                                                                                                  new physician to area

     Unspecified       VA      One Internist          $10,000      25%               $2,500     1.7            $4,250      $856,193        $3,294     259.9             $3,294         $852,899          $0               $0 Year one impact; assumes
                               w/Neurology                                                                                                                                                                                   new physician to area

     Unspecified       VA     One Internist w/        $10,000      25%               $2,500     1.7            $4,250      $914,294        $3,294     277.6             $3,294         $911,000          $0               $0 Year one impact; assumes
                               Pulmonology                                                                                                                                                                                   new physician to area




     SORH Economic Return Analysis                                                                                       September, 2005                                                                                                           11
                                                                                                       Template V
                                                                                  Economic Impacts of Recruitment and Retention Initiatives
                                                                                        Note: Each Entry in Template V is Spread Over Two Pages


 Organization Served State    Nature of      Estimate of Percentage     Dollar Value Economic      Type of        Projected       Estimated     Percentage Dollar Value        Economic       Projected
           and                Assistance: Revenue Gain      of the        of Gain    Multiplier   Multiplier     Economic       NET Revenue        of the          of          Multiplier     Economic
      Nature of the           Physician      Related to      Gain       Attributable              (County,        Return I          Gain to         Gain          Gain                         Return II
Organization Receiving       Recruitment      Specific   Attributable    to Office                 Service         (Value        Hospital(s)    Attributable Attributable to                    (Value
        the Grant,           Support for:    Provider(s)  to Office       Actions                 Area, or     Attributable to (after bad debt, to Office Office Actions                    Attributable to
 e.g., Hospital, Clinic,                       Office      Actions      (Amount of                  State)     Office Action      free care,      Actions                                   Office Action
       Network or                            Practice(s)                 Gain X %                              X Multiplier)     contractual                                                X Multiplier)
       Community                                                        Attributable                                             allowances)
      Organization                                                       to Office
       Unspecified       VA One Internist w/    $348,781     50%            $174,391    1.7        County           $296,464       $1,792,500      50%            $896,250        1.7          $1,523,625
                             Pulmonology


     Unspecified       VA   One Internist w/    $352,764     50%           $176,382     1.7        County           $299,849       $1,763,000      50%            $881,500        1.7          $1,498,550
                             Nephrology

     Unspecified       VA   One Internist w/    $326,468     50%           $163,234     1.7        County           $277,498       $1,880,000      50%            $940,000        1.7          $1,598,000
                            Endocrinology


     Unspecified       VA   One Psychiatrist    $238,789     25%            $59,697     1.7        County           $101,485       $1,236,000      25%            $309,000        1.7            $525,300


     Unspecified       VA     One Family        $199,057     50%            $99,529     1.7        County           $169,198         $890,000      50%            $445,000        1.7            $756,500
                                 Nurse
                              Practitioner

     Unspecified       VA    One Women's        $177,840     95%           $168,948     1.7        County           $287,212         $886,000      95%            $841,700        1.7          $1,430,890
                             Health Nurse
                              Practitioner

                       VA     Total Using      $5,071,666   49.2%        $2,488,175     1.7        County         $4,229,897      $26,729,800     49.2%        $13,162,025        1.7         $22,375,443
                              Aggregate of
                              Community
                               Multipliers

                       VA     Total Using      $5,071,666   49.2%        $2,488,175     2.2         State         $5,473,985      $26,729,800     49.2%        $13,162,025        2.2         $28,956,455
                              State-wide
                                Impact
                               Multiplier




     SORH Economic Return Analysis                                                                                    September, 2005                                                                         12
                                                                                                            Template V
                                                                                       Economic Impacts of Recruitment and Retention Initiatives
                                                                                             Note: Each Entry in Template V is Spread Over Two Pages


 Organization Served State     Nature of        Anticipated  Percentage      Dollar Value Economic        Projected     Aggregate     Office Cost      Return on    Office Cost  Net Return on   Office Cost Net Return on    Comments on Assumptions
           and                Assistance:         Savings        of the           of        Multiplier    Economic      Economic      Attributable    Investment     from Non- Investment (Net $ from State Investment (Net      and Program Notes
      Nature of the            Physician            on           Gain            Gain                     Return III       Gains       to Results   ($Returned/1$       State    Returned after Government $ Returned after
Organization Receiving       Recruitment        Recruitment Attributable to Attributable to                (Value     Attributable to                   Cost) =     Government     Non-State       Sources       State
        the Grant,           Support for:          Cost     Office Actions Office Actions                Attributable Office Actions                  (Projected       Sources    Government                  Government
 e.g., Hospital, Clinic,                                                                                  to Office     Projected                  Economic Return/                  Cost)                       Cost)
       Network or                                                                                         Action X       Returns                     Office Cost)
       Community                                                                                         Multiplier)     I+II+III
      Organization
    Private Practice
       Unspecified            One Family
                         VA One Internist w/         $10,000      50%               $5,000     1.7            $8,500    $1,828,589         $3,488    524.3             $3,488       $1,825,101          $0               $0 Year one impact; assumes
                               Physician
                             Pulmonology                                                                                                                                                                                    new physician to area


     Unspecified       VA    One Internist w/        $10,000      50%               $5,000     1.7            $8,500    $1,806,899         $3,488    518.0             $3,488       $1,803,411          $0               $0 Year one impact; assumes
                              Nephrology                                                                                                                                                                                    new physician to area

     Unspecified       VA    One Internist w/        $10,000      50%               $5,000     1.7            $8,500    $1,883,998         $3,488    540.1             $3,488       $1,880,510          $0               $0 Year one impact; assumes
                             Endocrinology                                                                                                                                                                                  new physician to area


     Unspecified       VA    One Psychiatrist        $10,000      50%               $5,000     1.7            $8,500      $635,285         $3,488    182.1             $3,488         $631,797          $0               $0 Year one impact; assumes
                                                                                                                                                                                                                            new physician to area

     Unspecified       VA      One Family             $5,000      50%               $2,500     1.7            $4,250      $929,948         $3,488    266.6             $3,488         $926,460          $0               $0 Year one impact; assumes
                                  Nurse                                                                                                                                                                                     new physician to area
                               Practitioner

     Unspecified       VA     One Women's             $5,000      95%               $4,750     1.7            $8,075    $1,726,177         $4,070    424.1             $4,070       $1,722,107          $0               $0 Year one impact; assumes
                              Health Nurse                                                                                                                                                                                  new physician to area
                               Practitioner

                       VA     Total Using           $150,000     50.5%             $75,750     1.7         $128,775    $26,734,115        $56,972    469.3            $56,972      $26,677,143          $0               $0 Year one impact; assumes
                              Aggregate of                                                                                                                                                                                  new physician to area
                              Community
                               Multipliers

                       VA      Total Using          $150,000     50.5%             $75,750     2.2         $166,650    $34,597,090        $56,972    607.3            $56,972      $34,540,118          $0               $0 Year one impact; assumes
                               State-wide                                                                                                                                                                                   new physician to area
                                 Impact
                                Multiplier




     SORH Economic Return Analysis                                                                                      September, 2005                                                                                                           13
                                                                                                           Template V
                                                                                      Economic Impacts of Recruitment and Retention Initiatives
                                                                                            Note: Each Entry in Template V is Spread Over Two Pages


 Organization Served State      Nature of        Estimate of Percentage     Dollar Value Economic      Type of        Projected       Estimated     Percentage Dollar Value        Economic       Projected
           and                 Assistance:      Revenue Gain    of the        of Gain    Multiplier   Multiplier     Economic       NET Revenue        of the          of          Multiplier     Economic
      Nature of the             Physician        Related to      Gain       Attributable              (County,        Return I          Gain to         Gain          Gain                         Return II
Organization Receiving         Recruitment        Specific   Attributable    to Office                 Service         (Value        Hospital(s)    Attributable Attributable to                    (Value
        the Grant,             Support for:      Provider(s)  to Office       Actions                 Area, or     Attributable to (after bad debt, to Office Office Actions                    Attributable to
 e.g., Hospital, Clinic,                           Office      Actions      (Amount of                  State)     Office Action      free care,      Actions                                   Office Action
       Network or                                Practice(s)                 Gain X %                              X Multiplier)     contractual                                                X Multiplier)
       Community                                                            Attributable                                             allowances)
      Organization                                                           to Office
     Campbellton-        FL      Physician          $300,000     25%             $75,000    1.5        County           $112,500       $1,000,000      25%            $250,000        1.5            $375,000
  Graceville Hospital           Recruitment
                              Support for One
                                  Internist



Various Provider sites   AL   Placement of J-    $24,800,000     40%         $9,920,000     2.2         State        $21,824,000      $62,000,000      40%         $24,800,000        2.2         $54,560,000
                               1 Physicians




Minnesota State Loan     MN    16 Physicians        $640,000     100%          $640,000     2.2         State         $1,408,000       $5,632,000     50.0%          $2,816,000       2.2          $6,195,200
Repayment Program
    2001-2002


 Aggregate of Oregon     OR      4 Family         $1,200,000     50%           $600,000     2.2         State         $1,320,000       $2,800,000     50.0%          $1,400,000       2.2          $3,080,000
  SORH Physician                Physicians
     Placements




Bell Medical Services    SD   J-1 Visa Waiver       $170,000      5%             $8,500     1.5        County            $12,750          $51,500      5.0%              $2,575       1.5               $3,863
                                Application


    Multiple Sites       WI     15 Family         $4,500,000     25%         $1,125,000     2.2         State         $2,475,000      $13,500,000     25.0%          $3,375,000       2.2          $7,425,000
                                Physicians




     SORH Economic Return Analysis                                                                                        September, 2005                                                                         14
                                                                                                            Template V
                                                                                       Economic Impacts of Recruitment and Retention Initiatives
                                                                                             Note: Each Entry in Template V is Spread Over Two Pages


 Organization Served State      Nature of       Anticipated  Percentage      Dollar Value Economic        Projected     Aggregate     Office Cost      Return on    Office Cost  Net Return on   Office Cost Net Return on      Comments on Assumptions
           and                 Assistance:        Savings        of the           of        Multiplier    Economic      Economic      Attributable    Investment     from Non- Investment (Net $ from State Investment (Net        and Program Notes
      Nature of the             Physician           on           Gain            Gain                     Return III       Gains       to Results   ($Returned/1$       State    Returned after Government $ Returned after
Organization Receiving         Recruitment      Recruitment Attributable to Attributable to                (Value     Attributable to                   Cost) =     Government     Non-State       Sources       State
        the Grant,             Support for:        Cost     Office Actions Office Actions                Attributable Office Actions                  (Projected       Sources    Government                  Government
 e.g., Hospital, Clinic,                                                                                  to Office     Projected                  Economic Return/                  Cost)                       Cost)
       Network or                                                                                         Action X       Returns                     Office Cost)
       Community                                                                                         Multiplier)     I+II+III
      Organization
    Private Practice
     Campbellton-        VA
                         FL     One Family
                                 Physician           $23,185      100%             $23,185     1.5           $34,778      $522,278        $23,185    22.53       Not Specified   Not Calculated     Not       Not Calculated Costs based on FLEX mini-
  Graceville Hospital            Physician
                                Recruitment                                                                                                                                                       Specified                  grant for physician
                              Support for One                                                                                                                                                                                recruitment. Year one
                                  Internist                                                                                                                                                                                  impact; assumes new
                                                                                                                                                                                                                             physician to area

Various Provider sites   AL   Placement of J-       $930,000      40%             $372,000     2.2         $818,400    $77,202,400    $125,000       617.6       Not Specified   Not Calculated     Not       Not Calculated Recruitment support for 62
                               1 Physicians                                                                                                                                                       Specified                  primary care physicians;
                                                                                                                                                                                                                             anticipated annual revenues
                                                                                                                                                                                                                             after practices ramp-up


Minnesota State Loan     MN    16 Physicians        $160,000      50%              $80,000     2.2         $176,000     $7,779,200        $16,000    486.2       Not Specified   Not Calculated     Not       Not Calculated
Repayment Program                                                                                                                                                                                 Specified
    2001-2002


 Aggregate of Oregon     OR      4 Family            $55,000      100%             $55,000     2.2         $121,000     $4,521,000        $80,000     56.5       Not Specified   Not Calculated     Not       Not Calculated 1) Based on economic impact
  SORH Physician                Physicians                                                                                                                                                        Specified                  studies, Oregon SORH
     Placements                                                                                                                                                                                                              estimates that one physician
                                                                                                                                                                                                                             generates $300,000 of direct
                                                                                                                                                                                                                             office revenue and $700,000
                                                                                                                                                                                                                             of net hospital revenue per
                                                                                                                                                                                                                             year. (Note: hospital
                                                                                                                                                                                                                             revenues may be understated)
                                                                                                                                                                                                                             2) Cost of recruiter
                                                                                                                                                                                                                             estimated at $15,000 per
                                                                                                                                                                                                                             physician
                                                                                                                                                                                                                             3) SORH cost based on
                                                                                                                                                                                                                             wages, benefits, and other
                                                                                                                                                                                                                             direct and indirect costs
                                                                                                                                                                                                                             associated with .5 FTE
                                                                                                                                                                                                                             project coordinator

Bell Medical Services    SD   J-1 Visa Waiver        $10,000      100%             $10,000     1.5           $15,000       $31,613         $2,000     15.8       Not Specified   Not Calculated     Not       Not Calculated
                                Application                                                                                                                                                       Specified


    Multiple Sites       WI     15 Family           $150,000      100%            $150,000     2.2         $330,000    $10,230,000        $50,000    204.6       Not Specified   Not Calculated     Not       Not Calculated Estimates for all practices are
                                Physicians                                                                                                                                                        Specified                  annual anticipated revenues
                                                                                                                                                                                                                             after practice ramp-ups.




     SORH Economic Return Analysis                                                                                      September, 2005                                                                                                                15
                                                                                                             Template V
                                                                                        Economic Impacts of Recruitment and Retention Initiatives
                                                                                               Note: Each Entry in Template V is Spread Over Two Pages


 Organization Served State    Nature of      Estimate of Percentage         Dollar Value Economic         Type of      Projected         Estimated     Percentage Dollar Value        Economic         Projected
           and               Assistance:    Revenue Gain    of the            of Gain      Multiplier Multiplier      Economic        NET Revenue         of the          of          Multiplier      Economic
      Nature of the           Physician      Related to      Gain           Attributable                 (County,       Return I          Gain to          Gain          Gain                          Return II
Organization Receiving       Recruitment      Specific   Attributable        to Office                    Service        (Value         Hospital(s)    Attributable Attributable to                     (Value
        the Grant,           Support for:    Provider(s)  to Office           Actions                     Area, or Attributable to (after bad debt, to Office Office Actions                        Attributable to
 e.g., Hospital, Clinic,                       Office      Actions          (Amount of                     State)    Office Action       free care,      Actions                                     Office Action
       Network or                            Practice(s)                     Gain X %                                X Multiplier)      contractual                                                  X Multiplier)
       Community                                                            Attributable                                               allowances)
      Organization                                                           to Office
                                            1) Specific sources for physician-generated revenue are limited. For the purpose if this discussion, the Physician Revenue Survey generated in 2004 by Merritt,
                                            Hawkins & Associates was used. This report profiles net inpatient and outpatient revenue generated by various physician specialties. Averages of 2002 and 2004
                                            survey results were used to match most specialties. Revenues generated by physicians increased between 2002 and 2004 in all specialties and in some cases
                                            substantially. The average therefore reflects a conservative estimate. Merritt-Hawkins indicates that the data may be biased to smaller hospitals given the actual
                                            sample obtained. (See www.merritthawkins.com.) For the estimates, it was assumed that either directly or indirectly non-physician providers also generate hospital
                                            revenues. This may be highly variable depending on the actual practice patterns of the providers.

                                            2) Some specialties, e.g., endocrinology, are not represented in the survey; in these cases a straight internal medicine practice estimate is used.

                                            3) In the cases of physicians recruited to practice a combination of internal medicine with a specialty orientation, e.g., internal medicine with additional focus on
                                            cardiology or pulmonology (as is often the case with J-1 Visa program and National Health Service Corp physicians) a composite revenue estimate of 75% internal
                                            medicine and 25% specialty has been used.

                                            4) The Survey reflects inpatient and outpatient hospital revenue only and does not differentiate a physician's office practice from hospital revenue. It is assumed that
                                            office-practice revenue is a separate economic impact.


                                            5) The results reflect only economic quantification and do not reflect positive impacts on access, quality, or outcomes nor the societal savings of healthier populations



                                            6) The primary estimates of the impacts of office practices are derived from the Medical Group Management Association's, 2004, Physician Compensation and
                                            Production Survey (The 2004 Report is based on 2003 data.)


                                            7) A recruitment cost savings estimate of $10,000 per physician and $5000 for non-physician providers was used for the Virginia Office of Health Policy and
                                            Planning examples. To show this aspects of the model, it is assumed that the "savings" could be spent on other expenditures that would in turn generate additional
                                            local economic impact. This may be a questionable assumption in some cases and this part of the equation should only be used in appropriate situations.

                                            8) Some physicians may be retained, rather than recruited, due to Office actions. In these cases, the positive economic impacts could be estimated by estimating the
                                            numbers of months of anticipated revenue that would otherwise be lost during any avoided gaps in availability. For example, a three month gap in general surgery
                                            could equate to a "loss" of $650,000 in inpatient and outpatient revenue.


                                            9) In the cases of nurse practitioners, revenue is estimated at 50% of the revenue that may be generated by a physician.



                                            10) Great care is needed in discussing these results. The results may have dramatic "local" or county impacts, but if some of the volume is shifted from another area
                                            of the state, there may be more limited state impact. In addition, while on one hand the local economic impact is notable, there may be those who see it as an
                                            increase in local community cost (and thus, an increase in the cost to employers.)




     SORH Economic Return Analysis                                                                                            September, 2005                                                                           16
                                                                                                         Template V
                                                                                    Economic Impacts of Recruitment and Retention Initiatives
                                                                                          Note: Each Entry in Template V is Spread Over Two Pages


 Organization Served State     Nature of     Anticipated  Percentage      Dollar Value Economic        Projected     Aggregate     Office Cost      Return on    Office Cost  Net Return on   Office Cost Net Return on    Comments on Assumptions
           and                Assistance:      Savings        of the           of        Multiplier    Economic      Economic      Attributable    Investment     from Non- Investment (Net $ from State Investment (Net      and Program Notes
      Nature of the            Physician         on           Gain            Gain                     Return III       Gains       to Results   ($Returned/1$       State    Returned after Government $ Returned after
Organization Receiving        Recruitment    Recruitment Attributable to Attributable to                (Value     Attributable to                   Cost) =     Government     Non-State       Sources       State
        the Grant,            Support for:      Cost     Office Actions Office Actions                Attributable Office Actions                  (Projected       Sources    Government                  Government
 e.g., Hospital, Clinic,                                                                               to Office     Projected                  Economic Return/                  Cost)                       Cost)
       Network or                                                                                      Action X       Returns                     Office Cost)
       Community                                                                                      Multiplier)     I+II+III
      Organization
    Private Practice     VA   One Family
                               Physician




     SORH Economic Return Analysis                                                                                   September, 2005                                                                                                          17
                                                                                                                         Template VI
                                                                                                             Policy and Reimbursement Initiatives




     Description               State   Dollar Value of    Source of     Percentage      Dollar Value Economic        Type of       Projected      OFFICE       Return on  Office Cost Net Return on Office Cost Net Return on      Comments on Assumptions and
     of Policy or                          Action          Funds            of the     Attributable to Multiplier   Multiplier     Economic         Cost      Investment   from Non    Investment    from State  Investment             Program Notes
Reimbursement Change                                                        Gain          OFFICE                    (County,     Return (Value Attributable ($Returned/1$     State       (Net $    Government      (Net $
                                                                       Attributable to    Actions                    Service     Attributable to to Results     Cost) =   Government Returned after    Sources  Returned after
                                                                       Office Actions   (Amount of                  Area, or     OFFICE Action                (Projected    Sources     Non-State                    State
                                                                                         Gain X %                     State)      X Multiplier)                Economic                Government                Government
                                                                                       Attributable to                                                          Return/                    Cost)                     Cost)
                                                                                          OFFICE                                                                OFFICE
                                                                                                                                                                 Cost)

   Alabama Medicaid            AL      $3,000,000,000     Federal           5%          $150,000,000      2.2         State        $330,000,000      $5,000   66000.00          $2,500 $164,997,500       $2,500 $164,997,500      Coalition initiatives required to
   Coalition Activity                                    Matching                                                                                                                                                                    stabilize the Medicaid fund
                                                          Funds                                                                                                                                                                   matching arrangement (Sources of
                                                                                                                                                                                                                                 funds are estimated as split between
                                                                                                                                                                                                                                          Federal and State)

 Legislation to improve        AZ          $3,000,000       State          85%            $2,550,000      2.2         State          $5,610,000      $8,000    701.25           $4,000   $2,801,000       $4,000    $2,801,000    This is a two year authorization;
         Medicaid                                        Legislature                                                                                                                                                                $1,500,000 per year, OFFICE
   Reimbursement for                                                                                                                                                                                                              instrumental in legislative action
Critical Access Hospitals                                                                                                                                                                                                        (Sources of funds are estimated as
                                                                                                                                                                                                                                  split between Federal and State)


Support for Ambulance          SD          $1,000,000       State           5%               $50,000      2.2         State            $110,000      $2,000     55.00              $0            $0       $2,000     $108,000
Service Improvements                                     Legislature

   Expansion of rural           FL           $440,000       State          25%              $110,000      1.5         State            $165,000      $3,040     54.28              $0            $0       $3,040     $161,960     Based on economic development
 economic development                                    Legislature                                                                                                                                                             operating loan provided to NW FL
   criteria to include                                                                                                                                                                                                              Community Hospital to cover
healthcare facilities (e.g.,                                                                                                                                                                                                       operating expenses during CAH
  NW FL Community                                                                                                                                                                                                                conversion. FORH costs estimated
      Hospital loan)                                                                                                                                                                                                              based on two weeks of the FLEX
                                                                                                                                                                                                                                 coordinator's time and total cost for
                                                                                                                                                                                                                                    one year. County level impact
                                                                                                                                                                                                                                  based on 1.5 economic multiplier.




    SORH Economic Return Analysis                                                                                                September, 2005                                                                                                               18
                                                                                                                      Template VII
                                                                                                              Contracts and Grants Managed




     Type of Contract or  State      Purpose        Dollar Value      Source of     Percentage      Dollar Value Economic Type of           Projected       OFFICE       Return on  Office Cost Net Return on Office Cost Net Return
    Grant Programs; Types                          Total Contract/   Contract or        of the     Attributable to Multiplier Multiplier    Economic          Cost      Investment   from Non    Investment    from State      on
       of Grantees and                                 Grant            Grant          Grant/         OFFICE                  (County,       Return       Attributable ($Returned/1     State       (Net $    Government Investment
      Number of Grants                                                (Funding        Contract        Actions                  Service       (Value        to Results    $ Cost) =  Government Returned after    Sources     (Net $
                                                                                                                                                                                                                                       Comments on Assumptions
                                                                      Agency)      Attributable to (Amount of                 Area, or     Attributable                 (Projected    Sources     Non-State                 Returned
                                                                                                                                                                                                                                          and Program Notes
                                                                                   Office Actions   Grant X %                   State)     to OFFICE                     Economic                Government                after State
                                                                                                   Attributable to                          Action X                      Return/                    Cost)                Government
                                                                                                      OFFICE                               Multiplier)                   OFFICE                                               Cost)
                                                                                                                                                                           Cost)
        Rural Health         CA   Infrastructure       $6,000,000      State           30%            $1,800,000     2.2        State          $3,960,000     $20,000      198.0              $0     Not           $20,000 $3,940,000
    Development Program           Development                        Legislature                                                                                                                 Applicable
                                    for Rural
                                    Providers
        Rural Clinics        CA    Funding for           $441,000      State           20%               $88,200     2.2        State           $194,040     $10,000     19.4               $0     Not           $10,000     $184,040
                                    Technical                        Legislature                                                                                                                 Applicable
                                  Assistance and
                                   Stabilization


    Rural Hospital Capital   FL                       $21,950,000      State           50%           $10,975,000     2.2        State      $24,145,000       $32,000     754.5              $0            $0     $32,000 $24,113,000 FORH costs estimated
    Improvement Program                                              Legislature                                                                                                                                                     based on total costs for five
         1999-2003                                                                                                                                                                                                                   weeks of the Director's time
                                                                                                                                                                                                                                     per year for four years.

    Rural Health Network     FL                        $3,000,000      State           100%           $3,000,000     2.2        State          $6,600,000    $96,000     68.8               $0            $0     $96,000   $6,504,000 Annual appropriation of
    Contracts 1999-2004                                              Legislature                                                                                                                                                      $500,000; cost estimated
                                                                                                                                                                                                                                      based on total cost for 10
                                                                                                                                                                                                                                      weeks of the Director's time
                                                                                                                                                                                                                                      per year for six years.
     Governor's Budget       FL                        $1,000,000       State          85%              $850,000     2.2        State          $1,870,000     $3,120    599.36              $0            $0      $3,120   $1,866,880 Proposal being considered
     Appropriation for                                               Legislature                                                                                                                                                      for the 2005-06 budget
    Rural Health 2005-06                                                                                                                                                                                                              year. FORH activities
                                                                                                                                                                                                                                      include initiation and
                                                                                                                                                                                                                                      development of budget
                                                                                                                                                                                                                                      proposal language and
                                                                                                                                                                                                                                      efforts to coordinate
                                                                                                                                                                                                                                      support from rural partners.
                                                                                                                                                                                                                                      Cost estimated based on
                                                                                                                                                                                                                                      total costs for one week of
                                                                                                                                                                                                                                      Director's and FLEX
                                                                                                                                                                                                                                      Coordinator's time for one
                                                                                                                                                                                                                                      year.
    Office of Rural Health   FL                          $900,000      State           100%             $900,000     2.2        State          $1,980,000     $9,600    206.25              $0            $0      $9,600   $1,970,400 Based on an annual state
         annual state                                                Legislature                                                                                                                                                      appropriation of $150,000
     appropriation 1999-                                                                                                                                                                                                              per year. Costs estimated
             2004                                                                                                                                                                                                                     based on total costs of one
                                                                                                                                                                                                                                      week of the Director's time
                                                                                                                                                                                                                                      per year for six years.




SORH Economic Return Analysis                                                                                                September, 2005                                                                                                                         19
                                                                                                                       Template VII
                                                                                                               Contracts and Grants Managed




     Type of Contract or  State     Purpose        Dollar Value      Source of     Percentage      Dollar Value Economic Type of           Projected       OFFICE       Return on  Office Cost Net Return on Office Cost Net Return
    Grant Programs; Types                         Total Contract/   Contract or        of the     Attributable to Multiplier Multiplier    Economic          Cost      Investment   from Non    Investment    from State       on
       of Grantees and                                Grant            Grant          Grant/         OFFICE                  (County,       Return       Attributable ($Returned/1     State       (Net $    Government Investment
      Number of Grants                                               (Funding        Contract        Actions                  Service       (Value        to Results    $ Cost) =  Government Returned after    Sources      (Net $
                                                                                                                                                                                                                                        Comments on Assumptions
                                                                     Agency)      Attributable to (Amount of                 Area, or     Attributable                 (Projected    Sources     Non-State                  Returned
                                                                                                                                                                                                                                            and Program Notes
                                                                                  Office Actions   Grant X %                   State)     to OFFICE                     Economic                Government                 after State
                                                                                                  Attributable to                          Action X                      Return/                    Cost)                 Government
                                                                                                     OFFICE                               Multiplier)                   OFFICE                                                Cost)
                                                                                                                                                                          Cost)
     Local Health Council   FL                     $8,250,000         State           100%           $1,500,000     2.2        State          $3,300,000     $27,636     119.41              $0           $0      $27,636 $3,272,321 Yearly dollar value based on
     Contracts 1999-2003                                            Legislature                                                                                                                                                        11 LHC contracts @
                                                                                                                                                                                                                                       $150,000 per year for five
                                                                                                                                                                                                                                       years. Primary economic
                                                                                                                                                                                                                                       results estimated based on
                                                                                                                                                                                                                                       contract amounts for two
                                                                                                                                                                                                                                       predominantly rural LHCs
                                                                                                                                                                                                                                       for five years. Costs based
                                                                                                                                                                                                                                       on contract administration
                                                                                                                                                                                                                                       costs per LHC of $2,764
                                                                                                                                                                                                                                       per year for two LHCs for
                                                                                                                                                                                                                                       five years.
     Local Health Council   FL                      $900,000          State           100%          $150,000        2.2        State            $330,000       $5,527     59.70              $0     Not            $5,527     $324,457 Total dollar value based on
       Contracts 2004                                               Legislature                                                                                                                 Applicable                             11 LHC contracts @
                                                                                                                                                                                                                                       $75,000 for one year;
                                                                                                                                                                                                                                       Primary economic results
                                                                                                                                                                                                                                       estimated based on contract
                                                                                                                                                                                                                                       amounts for two
                                                                                                                                                                                                                                       predominantly rural LHCs
                                                                                                                                                                                                                                       @ $75K each for one year.
                                                                                                                                                                                                                                       Cost based on contract
                                                                                                                                                                                                                                       administration cost per LHC
                                                                                                                                                                                                                                       of $2,764 per year for two
                                                                                                                                                                                                                                       LHCs for one year.

      Rural Health Care     ID      Access              $248,000      State           95%           $235,600         2.2       State           $518,320      $29,693      17.5               $0     Not            $29,693     $488,627 Yearly dollar value based on
       Access Program             Enhancement                       Legislature                                                                                                                   Applicable                            11 LHC contracts @
                                                                                                                                                                                                                                        $150,000 per year for five
                                                                                                                                                                                                                                        years. Primary economic
                                                                                                                                                                                                                                        results estimated based on
                                                                                                                                                                                                                                        contract amounts for two
                                                                                                                                                                                                                                        predominantly rural LHCs
                                                                                                                                                                                                                                        for five years. Costs based
                                                                                                                                                                                                                                        on contract administration
                                                                                                                                                                                                                                        costs per LHC of $2,764
                                                                                                                                                                                                                                        per year for two LHCs for
                                                                                                                                                                                                                                        five years.
        Local Health        IN    Annual Grants       $6,817,000      State           10%           $681,700         2.2       State          $1,499,740      $7,000     214.2               $0            $0       $7,000   $1,492,740 Annual grant to Local
        Departments                                                 Legislature                                                                                                                                                         Health Departments;
                                                                                                                                                                                                                                        County allotment is used for
                                                                                                                                                                                                                                        any of ten categories of
                                                                                                                                                                                                                                        services
      Various Hospitals     TX     Permanent          $2,100,000      State           85%          $1,785,000        2.2       State          $3,927,000     $12,000     327.3               $0            $0      $12,000   $3,915,000
                                    Hospital                        Legislature
                                     Capital
                                  Improvement
                                    Program




SORH Economic Return Analysis                                                                                               September, 2005                                                                                                                            20

								
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