Stewart M Kathryn, Beachler Michael, Slayton Deborah
Arkansas Center for Health Improvement, University of Arkansas for Medical Sciences, 5800 West 10th St, Suite 410, Little Rock, AR 72204, USA.
J Rural Health. 2003;19 Suppl:391-6. doi: 10.1111/j.1748-0361.2003.tb01059.x.
Lack of access to affordable capital is a formidable barrier that compromises rural health care infrastructure development in poor rural areas. Commercial lending institutions are often limited in their ability to respond to those needs due to traditional lending criteria: creditworthiness, equity, management ability, experiences, and cash flow or profits. In the Southern Rural Access Program, a development model more frequently used in other sectors has been successfully applied to health care to help clear these hurdles. This paper describes the 5 operational loan funds in Arkansas, Louisiana, Mississippi, South Carolina, and West Virginia receiving support from the Southern Rural Access Program. Two models of loan funds have evolved: those led by health agencies and those led by community development finance institutions whose mission is rural economic development. This paper outlines major distinctive features of these 2 approaches and describes major implementation challenges these loan funds face. Key accomplishments are high-lighted, including the ability to leverage additional resources from state, federal, philanthropic, and private sources through these funds. These loan fund programs provide models for other states interested in improving access to capital to help build the rural health care infrastructure while making health care more economically viable through integration with other community development initiatives.
缺乏获得负担得起的资金的途径是一个巨大的障碍，它损害了贫困农村地区农村医疗基础设施的发展。由于传统的贷款标准，即信用度、股权、管理能力、经验以及现金流或利润，商业贷款机构满足这些需求的能力往往有限。在南方农村医疗准入项目中，一种在其他领域更常用的发展模式已成功应用于医疗保健领域，以帮助消除这些障碍。本文介绍了在阿肯色州、路易斯安那州、密西西比州、南卡罗来纳州和西弗吉尼亚州获得南方农村医疗准入项目支持的5个运营贷款基金。贷款基金已演变成两种模式：由卫生机构牵头的模式和由以农村经济发展为使命的社区发展金融机构牵头的模式。本文概述了这两种方法的主要显著特征，并描述了这些贷款基金面临的主要实施挑战。重点介绍了主要成就，包括通过这些基金从州、联邦、慈善和私人来源撬动额外资源的能力。这些贷款基金项目为其他有兴趣改善资金获取途径的州提供了模式，以帮助建设农村医疗基础设施，同时通过与其他社区发展举措相结合，使医疗保健在经济上更具可行性。
