The Draft. Act of Financing of the Counties. Noora Heinonen 6 July 2016 UNOFFICIAL TRANSLATION

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Teemu Haavisto
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1 The Draft Act of Financing of the Counties Noora Heinonen 6 July

2 The basic components of the Draft Act of the Financing of the Counties 1) Act concerns only the financial flow between the state and the counties (= separate Act on Central Government Transfers to Local Governments and legislation on the financing flows between a county and service providers) 2) The counties receive income only from the state funding and the client and user fees 3) State funding is computational (= not fully based on actual expenditure) 4) The state funding is not ear-marked; counties have self-rule (autonomy) to decide on the allocation of the funding 5) The counties have limited possibilities to obtain short-term loan either from the private market or from the state 6) Possible changes in the counties statutory tasks will be taken into account in the funding 7) Counties have the powers to charge client and user fees, which are set (= maximum amounts) in the legislation 8) The level of the state funding is reviewed annually 9) The basis/determination of funding is reviews at least every 4th year 10) Financing of year 2019 is based on the actual expenditure by municipalities (based on the financial statement of year 2016 in value of 2019) 11) Transition period years : gradual shift from expenditure-based costs to computational costs 12) The ceiling for the state funding is set on the basis of counties actual expenditure, which is annually reviewed only by using a new county index, which then is added with 1 percentage unit in years and with 0.5 percentage unit from year 2022 onwards 13) If a county face serious liquidity problem, and if a loan is not usable, the government can allocate a state subsidy. A review process will also be started by the state and the county. 14) The work is still ongoing for the design of counties other tasks (e.g. employment services, surveillance authority tasks, sectors of tansport and agriculture) new tasks, Act on financing will eventually also be reviewed (even before it enters into force 2019) 15) The state funding will be paid on a monthly basis to the county without an application

3 Share, % Millions of The basis/determination of funding Social and health care services Per capita 7, ,24 Maakunnan asukasmäärän ja sosiaali- ja terveydenhuollon asukaskohtaisen perushinnan tulo Service needs and circumstances of the regions Age groups 38, ,37 Maakunnan ikäryhmien asukasmäärien ja ikäryhmien perushintojen tulojen summa Determinants/Reasons for the use of health and social care services 48, ,47 Maakunnan tarvekertoimen, maakunnan asukasmäärän ja tarpeen perushinnan tulo. THL laskee jokaiselle maakunnalle sosiaali- ja terveydenhuollon tarvekertoimen Population density 1,0 176,70 Maakunnan asukastiheyskertoimen, maakunnan asukasmäärän ja asukastiheyden perushinnan tulo. Maakunnan asukastiheyskerroin lasketaan jakamalla koko maan keskimääräinen asukastiheys maakunnan asukastiheydellä. Non-native Finnish or Swedish speaking residents 1,0 176,70 Maakunnan vieraskielisyyskertoimen, maakunnan asukasmäärän ja vieraskielisyyden perushinnan tulo. Maakunnan vieraskielisyyskerroin lasketaan jakamalla maakunnan vieraskielisten asukkaiden osuus vastaavalla koko maan keskimääräisellä vieraskielisten asukkaiden osuudella. Promotion of wellbeing and health 1,0 176,70 Maakunnan hyte-kertoimen, maakunnan asukasmäärän ja hyvinvoinnin ja terveyden edistämisen perushinnan tulo. Other services e.g. rescue services Per capita 2,5 441,75 Maakunnan asukasmäärän ja muiden tehtävien asukaskohtaisen perushinnan tulo In total ,

4 The key components of the Draft Act and how to achieve the 3 billion euro savings 1) Shift in the state funding system from expenditure-based costs to computational costs 1) 5 years gradual transition period years 20(19) (in 2019: 100 % expenditure, in 2020: 80 expenditure 20 computational %, in 2021: 60 expenditure - 40 % computational ) 2) Computational costs: 90 % of funding based on (i) the needs of 9 age groups and (ii) the realization of service needs based on illnesses and socio-economic status 2) Annual ceiling for state funding from year 2020 onwards: 1) Counties expenditure level increase will be taken into account on the basis of a new county index, which is composed from the consumer price index (0.40), wage-level index (0.45) and the change of counties employer social security fees (0.15) 2) The increase based on the change (increase) of the county index will be added in years with 1 percentage point and from 2022 onwards on 0,5 percentage point -- Actual costs/expenditure is annually taken into account, but not fully ---> The funding model leads to the savings of 2,8 billion euro by the year The funding system demands/challenges/empowers the counties to improve operational efficiency, manage better the provision of services and service needs as well as define (even to limit) the scope of publicly funded services

5 The baseline scenario of the nominal health and social services expenditure growth in SOME-mallin ennakoima sote-menojen vuotuinen kasvu, % Tuotantokustannusten ennakoitu kasvu (tuottavuus 0 %, nimellisansiot 3 %) Palvelutarpeen kasvu (väestön ikärakenteen aiheuttama paine) 3 mrd. tavoitteen mukainen kasvu Nominal expenditure growth would be approximately 4,5 % In order to achieve the set aim to decrease the 3 billion of social and health care costs, the expenditure should be max. 3 % / year in

6 Mrd. euroa The prediction/forecast of the nominal expenditure growth of social and health care in years ,0 Nimellisten sote-menojen kehitys Maakuntaindeksin ennuste 2,6 % (painot: ATI = 45 %, sotu-maksut = 15 %, KHI = 40%) 28,0 26,0 24,0 22,0 20,0 18, mrd. säästö nykyrahassa = nimellisesti n. 3,7 mrd. Blue = Baseline scenario of expenditure Red = Draft Act on the financing of the counties Yellow = The aim to achieve the 3 billion euro savings Perusura: 1,5 % palvelutarve + 1 % reaalipalkat + 2 % inflaatio Lakiesitys (reaalinen säästö 2,8 mrd.): Maakuntaindeksi + 1 % v ; Maakuntaindeksi + 0,5 % v Tavoiteura (reaalinen 3 mrd. säästötavoite): Maakuntaindeksi + 0,5 % v

7 Steering of the counties resource allocation General Government Fiscal Plan - Set objectives for the counties economy - Assessment of the counties tasks and funding State Budget Negotiations between the State and the counties (Act on Counties 13 ) Steering the investments Sectoral specialized legislation Act on organising social and health care services Act on Client Fees Steering the operations and performance State funding Computational County s autonomy in using the funding State loans and security as well as possiblly state aids in special situations COUNTY COUNTY GROUP Counties joint service utilities Provisions on economy in the Act on Counties (Section 13) Balance of financial flows on operations and investments County s limited powers to take a loan The criteria for the review process are set on the county group

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