Emergency Financial Assistance Research Articles

Peran Penting IMF Dalam Stabilisasi dan Pemulihan Ekonomi Global Di Tengah Krisis Keuangan Internasional

This study aims to determine the important role of the International Monetary Fund (IMF) in global economic stabilisation and recovery efforts, especially in the midst of the international financial crisis. The IMF serves as a critical provider of financial assistance to crisis-affected countries through an emergency lending mechanism, the IMF provides the financial support needed to address urgent economic pressures. In addition, the IMF acts as an economic policy advisor by providing guidance to its member countries. By designing appropriate structural reform programmes and economic policies, the IMF helps countries to recover from the crisis and build a stronger economic base. The importance of international co-operation is also a focus of the IMF in promoting global economic stability. This article has a formulation of the problem of how the IMF's role in providing emergency financial assistance for the economic stabilisation of countries affected by the international financial crisis. The analytical method used by the author is a qualitative approach. The results of the research in this journal are The IMF was established to maintain financial stability and world trade by providing loans to countries facing balance of payments crises that could threaten a country's economy.

Personalizing homelessness prevention: Evidence from a randomized controlled trial

AbstractThrough a randomized controlled trial, we test whether providing personalized case management alongside emergency financial assistance more effectively prevents homelessness than financial assistance alone. For a sample of young adults and families with children who are at risk of homelessness, our results indicate that participants assigned to case management and financial assistance are more likely to access other homeless programs and no less likely to be evicted. Downstream outcomes are mostly unchanged, though arrests increase. Using non‐experimental variation across staff, we find that case management is associated with better outcomes when it is more intensive and pays financial assistance quickly.

Health Care Needs Among People Living with HIV: The Implication of Continuum of Care.

Human immunodeficiency virus remains a major public health problem in Indonesia. People living with HIV (PLWH) have various health problems as result from disease progression that impacts their health care needs. This study aims to explore health care needs and to test the factors associated with health care needs among people living with HIV. A cross-sectional descriptive study design was undertaken with 243 respondents completing a self-reported HIV-Health Care Need Questionnaire. Participants were recruited using the purposive sampling technique from six HIV clinics in West Java, Indonesia. The data were analyzed using descriptive and multiple logistic regression statistical techniques. The majority of the subjects were diagnosed within less than 5 years and have been receiving antiretroviral therapy. Nursing care was indicated as the most needed, offered, and received care. Emergency financial assistance, legal services, insurance premiums, and nutritional intervention were perceived as gaps between needed and received. Characteristics such as age, educational background, having HIV manager, and income were significantly correlated to nutritional care (p< 0.05). Nutritional care was increased by 3.96% if PLWH having HIV manager (CI: 1.17-13.38, p< 0.05). Addressing the gap between health care needs and health offered was important to ensure that care was received appropriately. Continuing assessment of health care needs can provide direction to deliver appropriate care and ensure a comprehensive continuum of care for PLWH.

Spatial patterns of tourism development in Germany

Tourism is one of the most important and dynamic sectors of the world's economy. However, the coronavirus pandemic in 2020–2021 caused significant losses in the tourism industry. The pandemic has also significantly affected the tourism development in Germany, which is one of the world's leading tourist destinations. The article analyzes the dynamics of tourism development in Germany in 2012–2022 and calculates the indicator of the integral index of tourism development in the federal states of Germany. The average values of the initial partial indicators for 2018–2022 are taken, to determine the integral index of tourism development level in the federal lands of Germany, which reflect both absolute and relative parameters of tourism growth. Based on the calculated average integrated index of the tourism development level in the federal lands of Germany, the features of spatial differentiation in the tourism development in the country are clarified. The analysis shows that before the coronavirus pandemic, tourism in Germany was significantly developing. The total number of tourist arrivals by 2020 increased annually by more than 20 %. However, due to the coronavirus pandemic, their number and tourism revenues halved in 2020 and 2021. In 2022, this indicator and other indicators of the development of the German tourism industry tended to improve. Domestic tourists dominate the total number of tourist arrivals. The calculated average integral index of tourism development in the federal lands showed a significant spatial asymmetry in the levels of development of the German tourism industry. According to this index, the federal lands of Germany are divided into five groups: high, high than average, medium, lower than average, and low tourism development levels. The lands of Berlin and Bavaria have a high level of tourism development. These regions are well-known tourist destinations in Germany. They have a rich cultural heritage, abundant natural resources and attractive landscapes, and a large number of tourist accommodation facilities. Mecklenburg-Vorpommern, Hamburg, Schleswig-Holstein, and Baden-Württemberg have a higher level of tourism development than the national average. These lands are characterised by a large number of tourist overnight stays, accommodation facilities, territorial concentrations, and a high intensity of tourism. The western German lands of Lower Saxony and North Rhine-Westphalia have an average level of tourism development. These lands are characterised by high tourist arrivals and the number and capacity of accommodation facilities. However, due to the large area of these territories, they have low indicators of the territorial concentration of tourism activity. Hesse, Rhineland-Palatinate, Bremen, Saxony and Brandenburg have a lower level of tourism development than the German average. These regions are characterised by moderate tourism development indicators. The federal lands of Saxony-Anhalt, Thuringia and Saarland have the lowest level of tourism development due to low volumes of tourist flows and low concentration of accommodation facilities. The German government has introduced several measures to support the tourism industry during the pandemic, including emergency financial assistance, grant support, a special loan program, tax measures, and short-term leave for businesses. It is known that higher tourism development indicators are typical for the lands with the highest level of social and economic development. Tourism is a factor that influences the economic development of both the country and individual federal states. Keywords: integral index of tourism development, Germany, tourism, tourist arrivals, federal state.

Impact of COVID-19 on USDA-certified organic producers: exploring the role of sociodemographic and contextual factors

The demand of local and organic products increased during the first years of the COVID-19 pandemic, and farmers’ risk for transmission and infection also increased. A comprehensive picture on the effects of the pandemic on the organic farmer is not available. This was a cross-sectional survey study on the impact of COVID-19 on United States (US) certified organic producers, specifically on the challenges the pandemic imposed on the farm and the farming community. Data were collected in 2020–2021 through an electronic and paper survey. Participants included organic producers listed in the USDA Organic Integrity Database. Respondents represented producers from 40 states. The most frequently reported farm impacts were market availability (45.6%) and contact with the customer base (34.9%). The most frequently cited farming community impacts were economic hardship (44.2%), customer interaction and access (33.4%), and market availability (32.6%). Female respondents reported slightly more impacts than did male respondents (1.8 vs 1.3, p < .001). Hispanic reported more impacts on average than did non-Hispanic respondents (2.1 vs 1.4, p = .002). Differences by age and education were also found. Only a small percentage applied for and received emergency financial assistance. Results indicate that the pandemic had a multilevel impact on the workforce and on access to the market and costumers. They highlight the role of personal and contextual factors on how the producer experienced the pandemic. Also of relevance is that a high majority of participants did not pursue pandemic-specific assistance. The results of this study may inform research and policy, and interventions to protect and support organic producers in future emergencies.

Estimating the Impact of Emergency Assistance on Educational Progress for Low-Income Adults: Experimental and Nonexperimental Evidence.

Methods for estimating causal impact aim to either remove or reduce bias. This study estimates the degree of bias reduction obtained from regression adjustment and propensity score methods when only a weak set of predictors are available. The study uses an experimental test of providing emergency financial assistance to participants in a job training program to estimate an experimental benchmark and compares it to nonexperimental estimates of the impact of receiving assistance. When estimating the impact of receiving assistance, those who received it constitute the treatment group. The study explores two different comparison groups: those who could have (because they were assigned to the experimental treatment group) but did not receive emergency assistance; and those who could not receive emergency assistance because they were randomly assigned to the experimental control group. It uses these groups to estimate impacts by applying three estimation strategies: unadjusted mean comparison, regression adjustment, and inverse propensity weighting. It then compares these estimates to the experimental benchmark using statistical tests recommended by the within-study comparison literature. The nonexperimental approaches to addressing selection bias suggest large positive impacts. These are statistically different from the experimental benchmark, which shows that receipt of emergency assistance does not improve educational progress. Further, over 90% of the bias from a simple comparison of means remains. Unless a stronger set of predictors are available, future evaluations of such interventions should be wary of relying on these methods for either unbiased estimation of impacts or bias reduction.

A tenacious population: supporting former foster youth in higher ed

PurposeThe purpose of this exploratory paper is to define the characteristics of foster youth, discuss the impacts of trauma on their lives, present results from a foster youth survey conducted at a university in the Midwest to assess the needs of former foster youth and discuss the ways universities can support this vulnerable population of students. Several themes emerged from the study. The financial need emerged at the top. The number of essential needs was striking. For example, more than half of the respondents did not have their basic needs met. These needs included food, medical/dental services, clothing and transportation needs.Design/methodology/approachFaculty researchers who were part of a university task force developed a survey to assess the needs of former foster youth who were enrolled in classes at the time that this research was conducted. The survey was developed and disseminated through Qualtrics, a software that distributed survey links via email in a confidential manner. The survey consisted of a variety of general questions related to participants’ background and demographic information, as well as the specific needs and services that they were interested in receiving. The survey was sent out one-time peer week for three weeks in the late fall semester.FindingsFindings indicated that 9% of respondents (n = 4) ranked the greatest areas of need as being financial assistance for school supplies, medical/dental care and financial aid advice. Similarly, 7% of respondents (n = 3) expressed the greatest needs as being affordable housing, housing during semester breaks, financial support for a laptop, financial counseling, counseling services, emergency financial assistance and internship and career counseling.Research limitations/implicationsLimitations of this research include the use of a small and homogenous participant sample size, with data collected from one university campus. Therefore, results do not necessarily generalize elsewhere and replication is necessary for other geographical regions that include additional participants from varying backgrounds. Because data were not collected from a control group of nonfoster students, it is also unknown whether the identified student needs from this research substantially differ from the general population.Practical implicationsAll students do not need the same support, so a menu of services should be provided. These services could include care packages that include basic academic necessities (e.g., laptops, school supplies, book vouchers, health and beauty supplies), financial literacy training, mentorship opportunities, a one-credit course on independent living skills, providing connections to community resources (e.g., childcare, housing, employment) and targeted advising for this specific student population, many of which who are from the first generation and low-income backgrounds. Another opportunity is to provide, possibly mandate, professional development for faculty and staff on the characteristics and needs of these vulnerable students.Originality/valueInstitutions have an opportunity, and arguably an obligation, to identify these students as early as possible. This can be done through collaboration with state human service departments, high school counselors and using demographic data found in the Free Application for Federal Student Aid form. Recruiting, retaining and supporting this population of students are critical because many have needs similar to other marginalized populations that the authors are so intensely focused on.

The effect of emergency financial assistance on healthcare use

Does providing financial assistance to people who have just experienced an income shock affect their healthcare use? To address this question, we examine healthcare outcomes in a setting where people at risk of homelessness due to an income shock were offered or denied referral to financial assistance quasi-randomly. Among callers who have been screened as eligible for assistance at Chicago’s Homelessness Prevention Call Center (HPCC), some are denied assistance because the availability of funding varies. Conditional on some observable characteristics, funding availability is as-good-as-randomly assigned to callers. We link callers to healthcare utilization records and observe their inpatient hospital stays and emergency department visits. We find that referral to financial assistance has little effect on overall healthcare use–we can reject increases in total utilization greater than 7% of the base rate and decreases of more than 4%. This null effect can be explained, in part, by the fact that the income shock does not significantly change overall healthcare use among those not receiving assistance, suggesting that these individuals can insure health and healthcare demand against these shocks in other ways.

COVID-19 disruptions: impact on athletic identity, career transitions, and life of a developmental tour golfer

ABSTRACT Rationale/Purpose The purpose of the study was to understand the lives and careers of developmental tour golfers through the lens of athletic identity and social identity theory (SIT), with emphasis on decisions related to transition out of golf caused by COVID-19. Design/methodology/approach Eight developmental tour golfers (4 male; 4 female) were interviewed using a semi-structured interview guide during the COVID-19 shutdown of professional sport. Interviews went through a six-stage coding process by two of the authors to produce the final themes of the study. Findings Results indicated that developmental tour golfers (a) faced tougher competition during the lockdown; (b) financial difficulties of developmental tour life were exacerbated by COVID-19; and (c) consequential athletic identity and uncertainty of future career in golf due to COVID-19. Practical implications The study highlights the sometimes-impractical decisions and lifestyle choices golfers will make to achieve their dreams. From a governance standpoint, suggestions of tour consolidation, emergency financial assistance to players, and educational programming are recommended for more successful transitions out of golf. Research Contribution This study contributes to the growing body of athletic identity literature and provides empirical insight into how developmental tour golfers navigate tumultuous career paths, both in normal times and with the added constraints of COVID-19.

Republic of Moldova: 2021 Article IV Consultation and Requests for an Arrangement under the Extended Fund Facility and an Arrangement under the Extended Credit Facility-Press Release; Staff Report; and Statement by the Executive Director for the Republic of Moldova

The 2016–20 ECF/EFF helped rehabilitate Moldova’s banking sector, bolstering macro-financial stability. However, the COVID-19 pandemic, drought in 2020, and the ongoing surge in global energy prices, have slowed economic activity, intensified downside risks, and complicated policy making. While emergency financial assistance under a blended RCF/RFI (100 percent of quota) and SDR allocation (US$236 million) helped cushion the pandemic’s impact, Moldova remains among the poorest countries in Europe with long-standing governance and structural weaknesses inhibiting income convergence.

Disparities and Temporal Trends in COVID-19 Exposures and Mitigating Behaviors Among Black and Hispanic Adults in an Urban Setting

COVID-19, caused by SARS-CoV-2 virus, has disproportionately affected Black and Hispanic communities in the US, which can be attributed to social factors including inconsistent public health messaging and suboptimal adoption of prevention efforts. To identify behaviors and evaluate trends in COVID-19-mitigating practices in a predominantly Black and Hispanic population, to identify differences in practices by self-reported ethnicity, and to evaluate whether federal emergency financial assistance was associated with SARS-CoV-2 acquisition. This survey study was conducted by telephone from July 1 through August 30, 2020, on a random sample of adults who underwent SARS-CoV-2 testing at a safety-net health care system in Chicago during the surge in COVID-19 cases in the spring of 2020. Behaviors and receipt of a stimulus check were compared between participants testing positive and negative for SARS-CoV-2. Differences in behaviors and temporal trends were assessed by race and ethnicity. SARS-CoV-2 infection was assessed using nasopharyngeal quantitative reverse transcriptase-polymerase chain reaction testing. Mitigating behaviors and federal emergency financial assistance were assessed by survey. Race and ethnicity data were collected from electronic health records. Of 750 randomly sampled individuals, 314 (41.9%) consented to participate (169 [53.8%] women). Of those, 159 (51%) self-reported as Hispanic and 155 (49%) as non-Hispanic (120 [38.2%] Black), of whom 133 (84%) and 76 (49%) tested positive for SARS-CoV-2, respectively. For all participants, consistent mask use (public transport: adjusted odds ratio [aOR], 0.00; 95% CI, 0.00-0.34; social gatherings: aOR, 0.10; 95% CI, 0.00-0.50; running errands: aOR, 0.18; 95% CI, 0.07-0.42; at work: aOR, 0.23; 95% CI, 0.07-0.79) and hand sanitizer use (aOR, 0.26; 95% CI, 0.13-0.52) were associated with lower odds of infection. During 3 sampled weeks, mitigation practices were less frequent among Hispanic compared with non-Hispanic participants (eg, mask use while running errands: aOR, 0.26; 95% CI, 0.15-0.46). Hispanic participants were at high risk of infection (aOR, 5.52; 95% CI, 4.30-7.08) and more likely to work outside the home (aOR, 2.05; 95% CI, 1.27-3.30) compared with non-Hispanic participants, possibly because of limited receipt of stimulus checks (aOR, 0.03; 95% CI, 0.02-0.07) or unemployment benefits (aOR, 0.36; 95% CI, 0.16-0.74). In this survey study of adults in a large US city, public health messaging improved preventive behaviors over time but lagged among Hispanic participants; messaging tailored to Hispanic communities, especially for mask use, should be prioritized. Hispanic individuals were at higher risk for infection, more often worked outside the home, and were less likely to have received a stimulus check; this suggests larger studies are needed to evaluate the provision of economic support on SARS-CoV-2 transmission dynamics in low-income populations.

Enhanced Telehealth Case Management Plus Emergency Financial Assistance for Homeless-Experienced People Living With HIV During the COVID-19 Pandemic.

Boston Health Care for the Homeless Program, in Boston, Massachusetts, implemented an intensive telehealth case management intervention combined with emergency financial assistance for 270 homeless-experienced people living with HIV (PLWH) to reduce COVID-19 transmission and promote HIV care retention during Boston's first pandemic peak (March 16-May 31, 2020). Our telehealth model successfully maintained prepandemic case management and primary care contact levels, highlighting the importance of such programs in supporting the care engagement of homeless-experienced PLWH and addressing the dual COVID-19 and HIV epidemics.

Community intervention strategies to reduce the impact of financial strain and promote financial well-being: a comprehensive rapid review.

Financial well-being describes when people feel able to meet their financial obligations, feel financially secure and are able to make choices that benefit their quality of life. Financial strain occurs when people are unable to pay their bills, feel stressed about money and experience negative impacts on their quality of life and health. In the face of the global economic repercussions of the COVID-19 pandemic, community-led approaches are required to address the setting-specific needs of residents and reduce the adverse impacts of widespread financial strain. To encourage evidence-informed best practices, a provincial health authority and community-engaged research centre collaborated to conduct a rapid review. We augmented the rapid review with an environmental scan and interviews. Our data focused on Western Canada and was collected prior to the pandemic (May–September 2019). We identified eight categories of community-led strategies to promote financial well-being: systems navigation and access; financial literacy and skills; emergency financial assistance; asset building; events and attractions; employment and educational support; transportation; and housing. We noted significant gaps in the evidence, including methodological limitations of the included studies (e.g. generalisability, small sample size), a lack of reporting on the mechanisms leading to the outcomes and evaluation of long-term impacts, sparse practice-based data on evaluation methods and outcomes, and limited intervention details in the published literature. Critically, few of the included interventions specifically targeted financial strain and/or well-being. We discuss the implications of these gaps in addition to possibilities and priorities for future research and practice. We also consider the results in relation to the COVID-19 pandemic and its economic consequences.

Measuring Unmet Needs among Persons Living with HIV at Different Stages of the Care Continuum.

Unmet needs can impede optimal care engagement, impacting the health and well-being of people living with HIV (PLWH); yet, whether unmet needs differ by care engagement status is not well understood. Using surveys and qualitative interviews, we examined and compared unmet needs for PLWH (n = 172) at different levels of care engagement. Unmet needs varied only slightly by care status. Survey findings revealed that provision of housing, emergency financial assistance, employment assistance, and food security were the greatest unmet need; for those in care, housing was the greatest unmet need, whereas for those sporadically in care or out of care, employment assistance was the greatest unmet needs. Qualitative interviews likewise illustrated that a lack of financial resources including insurance, housing, employment, and transportation presented barriers to care engagement across all care groups. Our findings indicate that unmet needs among PLWH are complex and multi-faceted across care engagement status.

SWK-06. ANSWERING 900 VOICES: A NATIONAL NONPROFIT ORGANIZATION RESPONDS TO A NATIONWIDE COMMUNITY HEALTH NEEDS ASSESSMENT THAT ELUCIDATED KEY CHALLENGES FACED BY PEDIATRIC BRAIN TUMOR FAMILIES

The five-year relative survival rate for childhood primary brain and other central nervous system tumors is nearly 75 percent (Central Brain Tumor Registry of the United States, 2017). Nevertheless, childhood brain tumor survivors often suffer from lifelong side effects caused by their illness or treatments such as surgery, radiation and chemotherapy. To define the nature and extent of problems survivors and their families face, the Pediatric Brain Tumor Foundation (PBTF), the world’s largest nonprofit solely dedicated to children and teens with brain tumors, conducted a 2017 national community health needs assessment in collaboration with the Sol Price Center for Social Innovation at the University of Southern California. The assessment found that pediatric brain tumor patients and their families face key challenges in four general areas: 1) interpersonal and emotional support, 2) logistical and financial support, 3) information and medical education gathering, and 4) educational and vocational anxieties. In 2020, the PBTF’s response to the 900 assessment participants who represent the thousands living with the effects of this disease includes the launch of a national Peer to Peer Mentoring program to meet the ongoing challenges families face; the disbursement of emergency financial assistance to hundreds of families in the throes of treatment; and the distribution of a resource notebook for newly diagnosed families and a comprehensive guidebook for survivors and their families. The results of the needs assessment suggest additional clear, actionable areas for impact not only by the PBTF but by medical professionals, other nonprofit organizations and governmental agencies.

Increasing Community College Completion Rates Among Low‐Income Students: Evidence from a Randomized Controlled Trial Evaluation of a Case‐Management Intervention

AbstractCommunity college completion rates are low, especially among low‐income students. The existing policy and research attention has primarily focused on academic and financial challenges, but there is ample reason to think that non‐academic obstacles might be key drivers of dropout rates for low‐income students. This study focuses on the role of “life barriers” and investigates the effectiveness of intensive case‐management services for low‐income community college students. We evaluate the impact of the Stay the Course (STC) intensive case‐management program through a multi‐armed randomized controlled trial evaluation conducted between 2013 and 2016 in Fort Worth, Texas. Analysis of administrative records indicates that STC significantly increased persistence and degree completion for women; estimates for the full sample are imprecise. The statistically significant estimates for women imply that STC tripled associate's degree receipt by 31.5 percentage points. We find no difference in outcomes between students in an emergency financial assistance (EFA) only treatment arm and the control group. Given program costs of $4,343 per person, the implied cost per additional associate's degree is $27,140. This study complements existing literature on financial and informational interventions designed to increase completion rates and is most closely related to the smaller literature examining coaching and mentoring interventions.

Emergency Disbursements During COVID-19: Regulatory Tools for Rapid Account Opening and Oversight

More than 100 countries have launched emergency cash disbursement programs to alleviate financial hardships for individuals and households in light of the COVID-19 pandemic. Many of these programs are based in digital payments; however, a lack of official identification, mobile data services and the difficulties in face-to-face interactions restrict potential users from a standard customer due diligence process. Guidance from the Financial Action Task Force (FATF), the global anti-money laundering standards-setting body, encourage the use of innovative solutions for customer onboarding, specifically the risk-based approach and simplified due diligence (SDD). This paper summarizes the range of practice across jurisdictions that have employed a combination of SDD (also known as tiered CDD), licensing of non-bank financial institutions, and digital identification to enroll unbanked individuals into financial accounts so that they could receive COVID-19-related relief cash transfers. As this note concludes, jurisdictions that had adopted such practices were able to quickly ramp-up disbursement programs, bringing tens of millions of beneficiaries into the formal financial system. This report provides an analysis of varied SDD implementations and provides considerations for financial regulators looking to promote appropriate risk mitigation while digitally delivering emergency financial assistance.

A Cautionary Tale about Emergency Financial Assistance without Services: Evidence from a Randomized Controlled Trial Evaluation at a Community College

Community college completion rates are extremely low, especially among low-income students. One potential explanation is that low-income students have limited capacity to overcome financial shocks, such as large medical, legal, or car repair bills. Some programs offer “emergency financial assistance” (EFA) to prevent these events from curtailing educational progress. We test the efficacy of EFA within the context of a broader randomized controlled trial at a community college in Texas. We find no evidence that access to EFA alone leads to improved outcomes. We speculate that EFA will only be effective if it is paired with additional case management services.

Does emergency financial assistance reduce crime?

Does emergency financial assistance reduce criminal behavior among those experiencing negative shocks? To address this question, we exploit quasi-random variation in the allocation of temporary financial assistance to eligible individuals and families that have experienced an economic shock. Chicago's Homelessness Prevention Call Center (HPCC) connects such families and individuals with assistance, but the availability of funding varies unpredictably. Consequently, we can determine the impact of temporary assistance on crime by comparing outcomes for those who call when funds are available to those who call when no funds are available. Linking this call center information to arrest records from the Chicago Police Department, we find some evidence that total arrests fall between 1 and 2 years after the call. For violent crime, police arrest those for whom funds were available 51% less often than those who were eligible but for whom no funds were available. Single individuals drive this decrease. The decline in crime appears to be related, in part, to greater housing stability—being referred to assistance significantly decreases arrests for homelessness-related, outdoor crimes such as trespassing. However, we also find that financial assistance leads to an increase in property crime arrests. This increase is evident for family heads, but not single individuals; the increase is mostly due to shoplifting; and the timing of this increase suggests that financial assistance enables some families to take on financial obligations that they are subsequently unable to meet. Overall, the change in the mix of crime induced by financial assistance generates considerable social benefits due to the greater social cost of violence.

What about Us? Economic and Policy Changes Affecting Rural HIV/AIDS Services and Care

ABSTRACTHealth care budgets and policies are chief drivers in the delivery and access to health services. Place is also a factor that affects patient and provider experiences within the health care system. We examine the impact of policy changes and subsequent budget cuts on rural HIV/AIDS care, support services, and prevention. We interviewed 11 social workers, case managers, and outreach workers who serve rural people living with HIV/AIDS. We conducted telephone interviews inquiring about the effect of economics and policies on direct practice with rural clients. We analyzed data using a content analysis approach. We found several themes from the data. Ryan White funding and policy changes shifted direct practice to a medical case management model. Changes in federal and state poverty levels affected client eligibility for the AIDS Drugs Assistance Program. Policy banning financial support for syringe service programs hindered prevention efforts to reduce HIV/AIDS transmission. Ancillary services were reduced, such as housing assistance, transportation, and emergency financial assistance. In conclusion, we highlight the importance of place-based policies to improve access to healthcare and services. We also provide recommendations for greater inclusion in HIV/AIDS-related policy development, care, and service planning for rural workers.