Showing posts with label rural Georgia. Show all posts
Showing posts with label rural Georgia. Show all posts

Tuesday, December 6, 2022

Georgia has weathered the Covid employment loss but not all counties had recovered as of mid-2022

The continuing good news is how Georgia’s employment recovered from Covid-related layoffs and firings, but that overall number ignores how employment changes at the county level has been uneven.

The U.S. Bureau of Labor Statistics has now released job numbers through June 2022, and even as the state added 136,572 jobs between February 2020 and June 2022, 61 counties out of 159 remained below their pre-Covid employment levels. This comes even as Georgia has outpaced the nation in job creation during that period with the state employment rising by 3%, more than twice the 1.4% recorded nationwide.

Counties losing employment

Of the 61 counties, 17 counties were already losing jobs prior to February 2020, so it is more difficult to say how the Covid-related layoffs affected these counties. One county, Burke, is an outlier in that the massive expansion of the Plant Vogtle nuclear facility has distorted the county’s underlying jobs numbers by pushing them up during the height of construction and then seeing them recede as construction comes closer to a conclusion.

For the remaining 43 counties, the employment losses, while not large when measured statewide, can be significant to local economies.

A county-by-county employment count shows that while many of these counties are in rural parts of the state, some counties struggling with continued job losses include Cherokee, Cobb and Clayton counties in the Atlanta metro area, Clarke County (Athens metro area), Richmond County (Augusta metro area), Muscogee County (Columbus metro area), and Bibb County (Macon metro area).

As a percentage of total county employment, the largest losses have occurred in:

Randolph County -289 (-14.7%)

Montgomery County -223 (-14.0%)

Dooly County -447 (-12.6%)

Taliaferro County -21 (-9.7%)

Jones County -354 (-8.3%)

Sumter County -742 (-6.8%)

For the counties in metro areas of the state, the losses remain significant. Clarke County is showing 4,762 fewer jobs (-6.7%) compared to its February 2020 numbers, Muscogee County -3,883 (-4.1%), Bibb County -3,400 (-4.1%), Clayton County -3,912 (-3.2%), Richmond County -2,535 (-2.4%), Cherokee County -190 (-0.3%), and Cobb County -154 (-0.0%).

In total, the 43 counties have lost 30,926 jobs (-2.2%) from February 2020 to June 2022. Keep in mind that these losses have occurred even though Georgia has outpaced the nation in job growth over the same time period.

Counties gaining employment

While the losers have been overlooked, the counties winning the employment battle have also been ignored. Many of these 16 counties, like many of the losing counties, start from a relatively small employment basis, so small net gains can have a large impact on local economies.

For some counties, such as Coweta, Jackson, and Butts, the large percentage increases reflect the Atlanta area’s continued population expansion as rural counties become drawn more into the Atlanta metro region. Jackson County is a good example of a county located along the I-85 corridor with lower land costs and allowing easy access to the Atlanta, Athens, and Gainesville metro areas for workers willing to commute.

A number of these counties are outside metro areas, some in the North Georgia mountain region such as Rabun and Union counties, and while it is hard to measure the work-from-home (WFH) movement, it is likely having an impact on these counties, as well as the possibility that people choosing retirement after Covid-related closures and layoffs also chose to move to these close-to but not in metro areas for quality-of-life reasons.

Morgan County with its employment growth is somewhat similar to Jackson County since it is located on the I-20 corridor, close to the Athens metro area, and offers a favorable work-from-home as well as a retirement environment.

Counties showing large percentage increases in employment between February 2020 and June 2022 include:

Jackson County 9,404 (29.5%)

Berrien County 673 (20.1%)

Bryan County 1,578 (17.4%)

Morgan County 1,226 (16.7%)

Hart County 823 (12.5%)

Lumpkin County 945 (12.4%)

Coweta County 4,879 (12.0%)

Warren County 156 (11.9%)

Marion County 134 (11.9%)

Butts County 850 (11.6%)

Rabun County 593 (11.3%)

Union County 779 (11.3%)

Clinch County 254 (11.0%)

Decatur County 880 (10.8%)

Candler County 348 (10.6%)

Long County 104 (10.1%)


Georgia has certainly benefited from the nation’s economic recovery, post-Covid employment gains, but that benefit has not been shared equally among all of the state’s 159 counties. Some are well-positioned for the next downturn in the economy, if one comes, while others have still not recovered from previous losses. It remains to be seen how state policies will affect these separate groups of counties moving forward in to 2023.

Wednesday, July 12, 2017

Crippling Medicaid Cuts Could Upend Rural Health Services in Georgia


When her pregnancy hit a crisis, Ginger Peebles rushed to her hospital in Swainsboro, Ga., where daughter Brenlee Pepin was born healthy. But that hospital closed a year later, a casualty of the financial problems plaguing rural areas. (Family photo courtesy of Kimberly Howell)
ATLANTA — Each day as Ginger Peebles watches daughter Brenlee grow, she sees the importance of having a hospital close by that delivers babies.
Brenlee’s birth was touch-and-go after Peebles realized something was wrong. “I couldn’t feel the baby move, and my blood pressure was sky-high,” said Peebles, a nurse.
Dr. Roslyn Banks-Jackson, then an OB-GYN specialist at Emanuel Medical Center in Swainsboro, Ga., diagnosed preeclampsia, a potentially lethal complication of pregnancy, and induced labor to save Peebles and the baby. Brenlee was born on Oct. 28, 2014, completely healthy.
Had Peebles given birth the following year, she might not have been so fortunate, she said. Emanuel shuttered its labor-and-delivery unit the next spring, becoming one of a handful of such units in the state to close from 2010 to 2015, most because of budget problems. Another is expected to close this month, said Daniel Thompson, executive director of the Georgia OBGyn Society.Republican bills to replace the federal health law would worsen rural areas’ financial straits through reductions in Medicaid funding. Patient advocates predict that would lead to fewer enrollees, more shutdowns of rural facilities, reduced payments to doctors and fewer programs for people with health needs or disabilities. In the aggregate, such changes threaten the health of thousands of state residents, especially those in rural areas.
“I’ve seen changes, and I’ve seen cuts, but I’ve never seen changes like what’s being proposed in this bill,” said Eric Jacobson, executive director of the Georgia Council on Developmental Disabilities. “This is the first time it’s been this scary.”
Possible Strains On A Lean Budget
One of the key aims of the House and Senate bills is reversing the Affordable Care Act’s expansion of Medicaid. But the legislation also would institute changes to the federal-state health program for low-income residents that could devastate states such as Georgia that didn’t expand Medicaid. Georgia already ranks 45th in the nation in per capita Medicaid spending, according to the Georgia Budget and Policy Institute.
The bills would switch Medicaid from an entitlement — in which the federal government agrees to pay its share of costs for anyone who qualifies for the program — to a system in which the federal government by 2020 would limit its payments and reimburse states based on a per capita formula.
The nonpartisan Congressional Budget Office concluded in a report released June 29 that the Senate plan would slash 35 percent of expected federal Medicaid funding by 2036.
“Cuts now would cripple rural Georgia,” said Dr. Ben Spitalnick, president of the Georgia chapter of the American Academy of Pediatrics.
He said that is because most primary care visits, which include OB-GYN, pediatric and adult care, in the state’s sparsely populated areas rely heavily on Medicaid reimbursements.
The federal cutbacks would have to be offset by the state. But that means taking money from other programs or raising taxes. As a result, state officials facing those shortfalls would likely scale back an already lean Medicaid coverage.
“If you cut back, [people] still go to the hospital, they’ll still need care. No matter what you do, the buck stops somewhere,” said Renee Unterman, a Republican state senator who chairs the health and human services committee. In the end, she added, the cost for that uncompensated care gets passed to taxpayers and consumers through higher health costs and insurance premiums.
Georgia’s rural hospitals have proved vulnerable. Five closed in the past five years and another two merged. Plus, several have closed their emergency rooms.
That translates to a loss of doctors in affected counties. Of Georgia’s 159 counties, 79 do not have an OB-GYN specialist, and 65 do not have a pediatrician, according to 2015 figures from the Georgia AAP and the Georgia OBGyn Society.
Close to 1.7 million Georgians, or nearly 1 in 5 state residents, live in these areas, according to figures from the Rural Health Information Hub.
Improving Pay For Doctors
For 15 years, Georgia Medicaid reimbursed primary care doctors at only 60 percent of the amount that the federal Medicare program reimbursed similar services, said Ward.
But in 2015, the Legislature implemented three rounds of pay increases to primary care doctors, including pediatricians and OB-GYNs, to bring them in line with the Medicare reimbursement.
Many of these doctors are now concerned those rates would be the first to be lowered. “That’s our big fear,” said Rick Ward, executive director of the Georgia chapter of the AAP. “We just clawed our way back and to deal with it again would just be unbelievable.”
Key among those concerns are prenatal care in rural areas. With a maternal mortality rate that is among the worst in the country, OB-GYNs are worried that the cuts would eliminate fragile solutions to doctor shortages that the state has implemented.
For example, pregnant, low-income women in 17 counties around Augusta can arrange for a ride in a van, paid for by Medicaid, for their prenatal visits at the medical school at Augusta University. The service has been vital in keeping these women healthy and insuring successful births. Advocates fear it is the type of program that could face problems if Medicaid funding becomes tight.
People With Disabilities Fearful
Advocates for residents with disabilities worry that home health care would be likely to suffer from the cuts.
That’s because while states are required under Medicaid to pay for nursing home stays, care for people living at home has been optional.
About 38,000 people in the state get the services, also called community-based benefits. Qualifying takes years, and benefits are not guaranteed, even for people who are eligible. Almost 10,000 Georgians are on the waiting list, according to Jacobson, because there is not enough money in the Medicaid budget to cover everyone.
One of those who is getting coverage is Joshua Williams, 22, who has severe cerebral palsy and needs constant care at home and school.
“I’m terrified” that funding cuts could end the program, said his mother, Mitzi Proffitt, 53. “I’d have to quit my job” to take care of him. Williams’ stepfather, Jack Proffitt, 65, has advanced cancer and cannot provide much assistance.Nursing home or institutional care for a year, on average, is $172,280, said Jacobson, while the average home health care is $28,901.
Williams, who is on the dean’s list at East Georgia State College in Swainsboro and loves NASCAR, also admits to being “very scared.” He said if his coverage is discontinued, he would have to drop out of college, ruining his hopes of becoming a sports broadcaster. He is eager to get a part-time job until he graduates.
“I want to work. I don’t want handouts,” he said.
A supporter of President Donald Trump’s, Williams said he is counting on the president to keep disability benefits in place and to ensure that health care is affordable for all.
“He thinks that if Trump knew his story, he’d get on this and fix things,” said Mitzi Proffitt.
“I like him because he’s a businessman, but he said he has heart,” Williams added.
Joshua Williams, who receives home health care services through Medicaid, is worried about funding changes being considered by Congress. But he is counting on President Donald Trump to keep disability benefits in place because “he said he has heart.” (Photo by Virginia Anderson/KHN)

This story was originally published by Kaiser Health News, a nonprofit health newsroom whose stories appear in news outlets nationwide, is an editorially independent part of the Kaiser Family Foundation.