30.11.2010 Alpo Jokelainen 1
Kainuu Region and Its Self-Government Experiment
Congress of local and regional authorities, Helsinki 30.11.2010
30.11.2010 Alpo Jokelainen 2
Population of the municipalities of Kainuu 2009 total 82 626
3 128
9 332
3 401 3 918
38 208 10 6979 632
1 5212 789
Turku
Helsinki
Tampere
30.11.2010 Alpo Jokelainen 3
Tilastokeskuksen väestöennuste 2006-2040
2006 2007 2008 2009 2010 2015 2020 2025 2030 2035 2040KAINUU 84 350 83642 82992 82379 81 809 79 399 77 756 76 661 75 679 74 657 73 527Hyrynsalmi 3 015 2962 2911 2862 2 814 2 619 2 500 2 421 2 360 2 303 2 245Kajaani 38 027 37882 37753 37639 37 535 37 118 36 830 36 637 36 389 36 089 35 720Kuhmo 10 072 9902 9747 9599 9 454 8 842 8 374 8 000 7 684 7 393 7 104Paltamo 4 093 4062 4033 4005 3 982 3 877 3 821 3 798 3 778 3 757 3 730Puolanka 3 337 3270 3211 3152 3 097 2 865 2 702 2 591 2 499 2 412 2 334Ristijärvi 1 608 1590 1571 1555 1 541 1 481 1 462 1 464 1 477 1 483 1 483Sotkamo 10 738 10733 10732 10731 10 732 10 727 10 767 10 837 10 872 10 869 10 840Suomussalmi 9 848 9709 9578 9449 9 329 8 792 8 371 8 064 7 822 7 601 7 372Vaala 3 612 3532 3456 3387 3 325 3 078 2 929 2 849 2 798 2 750 2 699
Kainuu population projections (Statistics)
30.11.2010 Alpo Jokelainen 4
The law of Kainuu governance experiment Regional functions (§ 4):
Region planning Regional development Healthcare Social services (except for children´s day-care) Secondary education = upper secondary schools and vocational schools General economic development Cooperation with other regional developers Supervision of the region´s interests Control of state budget funds for Kainuu Law + municipal decisions
30.11.2010 Alpo Jokelainen 5
A centralised arrangement of basic public services enables securing the service quality, availability and economy in Kainuu in the long term, despite the threatening population forecasts.
At the same time, the citizens living in the eight Kainuu municipalities will have equal opportunity to receive basic public services.
The purpose of the experiment
30.11.2010 Alpo Jokelainen 6
The Joint Authority of Kainuu Region(in parentheses is the numbers of employees in 2008,
total 3785) REGIONAL COUNCILREGIONAL COUNCIL
Inspection boardInspection board
REGIONAL BOARDREGIONAL BOARD Executive directorExecutive director
Steering CommitteeSteering Committee
Planning and Development Planning and Development Division (25)Division (25)
Social and Social and Healthcare Healthcare
BoardBoard
Education Education boardboard
Social and Social and Healthcare DivisionHealthcare Division
(2885)(2885)
EducationalEducationalDivisionDivision
(642)(642)
General services (233)General services (233)
Board of KainuuBoard of KainuuVocational Vocational
Institute,Institute,a municipal a municipal enterpriseenterprise
Board of Board of KainuuKainuu
OccupationalOccupationalHealtcareHealtcareenterpriseenterprise
IndividualIndividualCare Care
DivisionDivision
30.11.2010 Alpo Jokelainen 7
Regional Board I- Chairman is executive director Alpo Jokelainen- The regional council appoints for term - 10 other member / municipal law- Vaala`s representative in matters relating to the provincial union tasks - decides internal tasks of the Joint Authority of Kainuu Region
Regional Board II (16 members)- Regional Board I and leaders of local state authorities- decides of the use of development funds => state authorities, “operating budgets”
Regional Board III (34 members + about15 other participants)- MYR assembly (go-operation group)- Regional strategic plan, programme and operational programme, decisions of projects over 500 000 €
Regional Board
30.11.2010 Alpo Jokelainen 8
Municipal contributions to the Joint Authority of Kainuu Region is defined as a percentage of deferred tax.
Deferred tax funding includes revenues (local taxes (19.25%), community taxes and property taxes (2009)) general funding of social and health from the state, additional funding based of sparsely populated area, tax revenue based on the alignment of the state tax and compensations.
Education state grants are paid for the education provider.
Municipal financing for the Joint Authority of Kainuu Region is determined as follows:
30.11.2010 Alpo Jokelainen 9
Kainuu finances (2009)• Total expenditure 315 meur
• Social and health care 237 meur ( 75 %)• Education 48 meur ( 15 %)• Administaration, development and services 22 meur ( 7 %)• Financial expenditure and investments 8 meur ( 3 %)
• Total income 315 meur• Municipal payment 222 meur ( 70 %)• Customer and patient charges 38 meur ( 12 %)• State subsidies and sales revenues 52 meur ( 17 %)• Operating revenues from other services 3 meur ( 1 %)
30.11.2010 Alpo Jokelainen 10
6,46,8
7,67,4
2,2
5,3
4,4
5,8
6,3
5,3
0,0
1,0
2,0
3,0
4,0
5,0
6,0
7,0
8,0
9,0
10,0
2002
2003
2004
2002-2004vuosikeskiarvo
2005
2006
2007
2008
2009
2005-2009vuosikeskiarvo
men
ojen
kas
vu, p
rose
nttia
Sosiaali-jaterveydenhuollontoimintamenojenkasvukokomaassa
Kainuun kuntien sote-menojen keskimääräinen kasvu(asukasluvulla painotettu)
Kainuu maakunnan menojen kasvu (ilman liikelaitoksia)
Growth rate of expenditures, % / year
30.11.2010 Alpo Jokelainen 11
Vuosikatteet ja poistot €/as Kainuu: kunnat + maakunta
0
50
100
150
200
250
300
350
400
450
1995 96 97 98 99 00 01 02 03 04 05 06 07 08 09 10 11 12 13 14
Vuosikate, kunnat Vuosikate, kunnat+maakunta Poistot €/as Vuosikate, kunnat (6000-10000)
Annual margins and depreciation € / resident
30.11.2010 Alpo Jokelainen 12
KAINUU DEVELOPEMENT FUND, V. 2010 TOTAL 61.324 € mill. / DIVISION AND UTILIZATIONS
30.11.2010 Alpo Jokelainen 13
Environmental Health
SOCIAL- AND HEALTH DIRECTOR
Health and disease
management services Family services Senior ziticens services
Families withchildren.social servicesFamilies withchildrenhealth servicesAdult social servicesDisability Services
Senior CitizensServiceRegion I(Kajaani Region)Senior CitizensServiceRegion II(Sotkamo, Kuhmo)Senior Citizens ServiceRegion III(Ylä-Kainuu)Shared Services
Health MonitoringVeterinaryservicesEnviromental´sHealtcarelaboratory
Adult mental healthServicesand addiction treatmentReception andHealth Centre,ActionDental healthcare servicesOperational treatmentConservative treatmentEmergency room Services
Laboratory andpathologyRadiologyPharmaceutical ServiceEquipment ServiceParamedic;Anesthesia andintensive care
Manage-ment,Delelope-mentandPlanning
Management support
Medical services
Kainuu Health
SOCIAL AND HEALTHCARE BOARD
EXECUTIVE EXECUTIVE BOARDBOARD
full-time
in addition of own work
the specialty of corresponding
Division Level: appropriate higher education sector and experience in management.
ORGANIZATION OF SOSIAL AND HEALTH ORGANIZATION OF SOSIAL AND HEALTH DIVISIONDIVISION
30.11.2010 Alpo Jokelainen 14
ORGANIZATION OF EDUCATION DIVISIONORGANIZATION OF EDUCATION DIVISION
BOARD OF EDUCATIONBOARD OF EDUCATION
BOARD OF EDUCATIONBOARD OF EDUCATION
EDUCATION DIVISION DIRECTOREDUCATION DIVISION DIRECTOR
VOCATIONAL EDUCATIONVOCATIONAL EDUCATION UPPER SECONDARYUPPER SECONDARY SCHOOL EDUCATIONSCHOOL EDUCATION
Vocational education servicesVocational education servicesWelfare sectorWelfare sectorCulture (Director of EducationCulture (Director of EducationBusiness and industryBusiness and industryNatural ResourcesNatural ResourcesTourism and CateringTourism and CateringTechnology and Transport SectorTechnology and Transport SectorKuusamo unit / Tourism Kuusamo unit / Tourism
KAO = Kainuu Vocational CollegeKAO = Kainuu Vocational College
Units:Units: Kajaani High SchoolKajaani High School Kuhmo High School Kuhmo High School Sotkamo High SchoolSotkamo High School Filiaal High School Filiaal High School Hyrynsalmi High School Hyrynsalmi High School Paltamo High School Paltamo High School Puolanka High School Puolanka High School Suomussalmi High School Suomussalmi High School
30.11.2010 Alpo Jokelainen 15
REGIONAL BOARD
GENERAL SERVICES
PayrollPayroll
Well-being Well-being and collaborationand collaboration
Personnel-Personnel-ServiceService
and service and service RelationshipRelationship
mattersmatters
SalesSalesActivitiesActivities
AccountingAccounting
CentralCentralwarehousewarehouse
The The procurementprocurement
officeoffice
BuildingBuildingsystemssystems
EngineeringEngineering
Nutrition Nutrition ServicesServices
AdministrativeServices
IT -services Material
ServicesFinancialServices
PersonnelServices
TransportationServices
NutritionServices
TechnicalServices
GeneralGeneralservicesservices
Economic- and Economic- and debt debt
CounselingCounseling servicesservices
Archive- andArchive- and datadata
Protection Protection servicesservices
ORGANIZATION OF GENERAL SERVICESORGANIZATION OF GENERAL SERVICES
30.11.2010 Alpo Jokelainen 16
Regional decision-making works fine• Enlargement of collaboration, productivity increase by 20% • Payroll • ”Accountancy services” • IT -service
Clear synergies • Health services and care for the elderly: a single administrative • No overlapping• Treatment processes are designed, functional • Elderly housing and residential care are in the same unit • Municipality billing is fixed in advance => predictable • Homecare has been increased
Social welfare•Improved legal status of customers•Better quality due to expertize of personnel•Harmonized actions in Field work
Experiences 1
30.11.2010 Alpo Jokelainen 17
Combining of small high school administration and teaching
• adiministrative costs; nearly half off• municipality costs – 50%• wider choice for students
Vocational and secondary education for synergies
• Student welfare services• Finance • Student services • Harmonized operational practices, (quality management system)• IT-systems • Sharing of facilities and equipment • Adult education co-operation • Joint development projects
Experiences 2
30.11.2010 Alpo Jokelainen 18
Experiences 3
- Municipalities finances have been strengthened in 4 years more than 70 000 000 EUR- State provincial operations management capabilities is fierce- The service changes are justified and there is no return to old system - Support services (catering, cleaning, techical services) need for the gathering = productivity, increasing possibilities for better productivity- By strengthening of small municipality economy, the current structure of the municipalities has been able to maintain
30.11.2010 Alpo Jokelainen 19
Summary of social and health services 1
• Focus on health promotion • Investment in research and development to ensure all time improvement
Success criteria
• Deep integration and cohesion• Financing modell• Own research and development increased• Staff commitment
30.11.2010 Alpo Jokelainen 20
• Preventive work and the developement of services has been possible• In the last year people have got services more than in the past • People has been little dissatisfied because it has been necessary to limit doctor´s action desk because of the lack of doctors • There has also been difficulties in access to dental care• Initial assessment of the need for care is well realized • Customer feedback is good, imago is not
Summary of social and health services 2
30.11.2010 Alpo Jokelainen 21
How long is the waiting time for doctor´s in non-hazardious cases? (average)
Kainuu:
Less than 2
weeks
30.11.2010 Alpo Jokelainen 22
Standardized expenditures of social-, health- and elderly care in Finland / Year 2008 (€/people, index=100)Terveyden- ja vanhustenhuollon tarvevakioidut menot sairaanhoitopiireittäin 2008Timo Hujanen, Unto Häkkinen, Mikko Peltola, Terveys- ja sosiaalitalouden yksikkö CHESS, Terveyden ja hyvinvoinnin laitos THL 24.2.2010http://groups.stakes.fi/CHESS/FI/tilastotuotteet/index.htm
Nettomenot Nettomenot, indeksi Tarvekerroin Tarvevakioidut menot, indeksi
Sairaanhoitopiiri Euroa/asukas Koko maa=100 Koko maa=1,00 Koko maa=100Helsinki ja Uusimaa 1738 92 0,84 110Varsinais-Suomi 1927 102 1,01 101Satakunta 1984 105 1,09 97Kanta-Häme 1892 100 1,04 96Pirkanmaa 1871 99 0,99 101Päijät-Häme 1780 94 1,05 90Kymenlaakso 2012 107 1,12 96Etelä-Karjala 1980 105 1,10 95Etelä-Savo 2154 114 1,22 94Itä-Savo 2367 126 1,22 103Pohjois-Karjala 2021 107 1,15 93Pohjois-Savo 2004 106 1,14 93Keski-Suomi 1890 100 1,05 95Etelä-Pohjanmaa 1997 106 1,15 92Vaasa 2060 109 1,04 105Keski-Pohjanmaa 2006 107 1,06 100Pohjois-Pohjanmaa 1802 96 0,98 97Kainuu 1953 104 1,16 89Länsi-Pohja 2063 110 1,10 100Lappi 2015 107 1,05 102
HYKS sha 1744 93 0,83 112Hyvinkään sha 1582 84 0,82 102Lohjan sha 1741 92 0,88 105Länsi-Uudenmaan sha 2213 117 1,03 114Porvoon sha 1740 92 0,89 103
Terveyden- ja vanhustenhuollon tarvevakioidut menot 2008
HUS jaettuna sairaanhoitoalueisiin
30.11.2010 Alpo Jokelainen 23
We have succeeded in:
• expenditure growth has been restrained • availability of services in Kainuu is secured • citizen equality has been improved
Kainuu model transferability and innovations:
• social care, basic and specialized health care are combinated• no overlapping (laboratory, logistics and maintenance of equipment)• unbroken service chain, specialist consultations • economy and funding is fixed in advance, no single action invoicing for municipalities • reducing exces plant locations • ensuring excellence = acute hospital only there, where experts is => dissatisfaction with the smaller municipalities
Summary of social and health services 3
30.11.2010 Alpo Jokelainen 24
Contacts:
Alpo Jokelainen
Region Mayor, Chairman of the Board
Puh. 044 336 6700, [email protected]
Top Related