The Economic Impact of the Bill Gatton College of Pharmacy

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THE ECONOMIC IMPACT OF THE BILL GATTON COLLEGE OF PHARMACY JANUARY 2018


EAST TENNESSEE STATE UNIVERSITY ADMINISTRATION Dr. Brian Noland ETSU President Dr. Wilsie Bishop ETSU Vice President for Health Affairs

BILL GATTON COLLEGE OF PHARMACY Dr. Debbie Byrd Dean Dr. Adam Welch Associate Dean for Assessment and Academic Affairs Dr. Ralph Lugo Chair of Department of Pharmacy Practice Dr. David Roane Chair of Department of Pharmaceutical Sciences

TABLE OF CONTENTS Executive Summary

1

I. Introduction and History

3

II. Measuring Economic Impact

5

III. The Bill Gatton College of Pharmacy’s Economic Impacts

7

A. B. C. D. E.

Economic Impacts of Spending on College Operations Economic Impacts of Student Spending Economic Impacts of Visitor Spending Total Non-Construction Economic Impacts Construction Economic Impacts

IV. Anticipated Growth of Economic Impacts

11

V. Summary

13

VI. Addendum - Meaning and Methods

14

VII. Addendum - Data

16

Steve Ellis Assistant Dean for Student Affairs Sherry Armitage Director of Operations Aaron Scott Director of Development 423.439.6360 scottap@etsu.edu

Editor Kristen Swing Director of Communications Graphic Design Stephen Russell Creative Manager Principal Photography Charlie Warden, Ron Campbell, Larry Smith

www.etsu.edu/pharmacy

8 8 9 9 10

Mission Statement It is the mission of ETSU Bill Gatton College of Pharmacy to develop progressive, team-oriented pharmacists that improve health care, focusing on rural and underserved communities.


EXECUTIVE SUMMARY – ANNUAL IMPACT

Spending to support college operations generated a total annual statewide increase in economic output of

$531,145

$13,686,821 Includes labor income of over $5M and 119 jobs

Includes labor income of almost $11M and 127 jobs

IN 2017

annual statewide increase in economic output of

annual statewide increase in economic output of

$21,912,152

IN 2026

Spending by campus visitors generated a total

Bill Gatton College of Pharmacy student spending generated a total

spending by the Bill Gatton College of Pharmacy, students and visitors generated an

Includes labor income of more than $200K and 6 jobs

OVERALL ANNUAL STATEWIDE ECONOMIC IMPACT

OF MORE THAN $36M the economic impact of the college will be

$44,177,308 EACH YEAR

BILL GATTON COLLEGE OF PHARMACY

Projected statewide economic impact for the

10-YEAR PERIOD

will total more than

$379M etsu.edu/pharmacy

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EAST TENNESSEE STATE UNIVERSITY


I. INTRODUCTION AND HISTORY For over 40 years, East Tennessee State University (ETSU) has pursued a long-term strategy designed to improve health outcomes for the citizens of Tennessee and the extended Southern Appalachian region. The contributions of the university’s healthrelated academic units and programs have been transformative to the welfare and wellbeing of state residents. The university is recognized as a national leader in rural medical education as well as a leader in addressing pressing health issues such as the current opioid addiction epidemic. As a result, the region’s private health care provider, Ballad Health, has established productive partnerships with the university and the region’s citizens have become strong supporters of the university’s mission. This publicprivate partnership is most clearly demonstrated by the creation of and ongoing contributions of ETSU’s Bill Gatton College of Pharmacy.

it was unlikely that state funding would be available to establish it. As a result, community and university leaders proposed a model for a publically operated, privately funded college of pharmacy that would be part of the university, but funded through private donations and student tuition and fee payments.

Prior to its establishment, local residents and pharmacists within the region encouraged East Tennessee State University to expand its division of health sciences to include a college of pharmacy. With the state’s only pharmacy school, operated by the University of Tennessee, located in Memphis, over 500 miles away, many students in the region faced the option of either attending private schools or paying out-of-state tuition at other pharmacy colleges in order to remain close to home. Adding a pharmacy program to the university’s portfolio of health science colleges, which already included the Quillen College of Medicine, the College of Nursing, the College of Clinical and Rehabilitative Health Sciences, and the College of Public Health, would provide residents with a regional cost-effective alternative to other pharmacy educational opportunities.

The Bill Gatton College of Pharmacy is located on the scenic Mountain Home VA campus in Northeast Tennessee. It is part of the only Academic Health Science Center in the state of Tennessee with the five affiliated colleges—Pharmacy, Medicine, Nursing, Public Health, and Clinical and Rehabilitative Sciences. By partnering with other health sciences units, the Bill Gatton College of Pharmacy is becoming a leader in inter-professional education, a concept that is fast becoming the standard in health care education and practice. The college is currently collaborating with the Quillen College of Medicine to renovate a historic structure on the VA campus that will house state-of-theart simulation laboratories and classrooms. This shared inter-professional education and research center will be completed in 2018.

By 2004, support for the idea of a local college of pharmacy became a significant area of focus. A group of regional health care leaders and citizens approached the leadership of ETSU with a request to consider the establishment of a college. In response, the university’s president, Dr. Paul Stanton, convened a working group to evaluate regional needs and the feasibility of establishing a college of pharmacy. After considerable analysis, and extensive input from health care providers and other community stakeholders, it was determined that there was a clear need for the college. However, given fiscal constraints,

BILL GATTON COLLEGE OF PHARMACY

In response to this proposal, then Tennessee governor Phil Bredesen challenged the citizens of Northeast Tennessee and the Southern Appalachian Region to raise $5 million in 90 days in order to show support of this initiative. The community raised $5 million in 58 days. This demonstration of financial support and initiative resulted in the approval for the creation of the East Tennessee State University College of Pharmacy by the Tennessee Board of Regents and the Tennessee Higher Education Commission in 2005. In 2007, the college was named in honor of Mr. Bill Gatton.

The Bill Gatton College of Pharmacy continues to rely on philanthropic support as a privately funded academic entity that receives no state funding. Drawing upon this generous financial backing and widespread grassroots support, the college has grown and matured from a regional to a national presence. The college’s students and faculty are proud recipients of numerous national awards. Since its creation, the eight graduating classes have produced nearly 600 graduates with licensure pass rates, postgraduate residency match rates, and employment rates consistently above the national average.

etsu.edu/pharmacy

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EAST TENNESSEE STATE UNIVERSITY


II. MEASURING ECONOMIC IMPACT Colleges of pharmacy not only add to a state’s professional workforce, but also are important components of the state’s economy. In 2017, the Bill Gatton College of Pharmacy generated over $11,461,000 in revenues. With a current enrollment of over 300, the Bill Gatton College of Pharmacy students spent over $7,123,000 annually for housing, food, transportation and miscellaneous expenses. In addition to the students’ spending, each year visitors to the campus spend an additional $281,400. Since its creation, the Gatton College of Pharmacy has graduated nearly 600 pharmacists who are pursuing careers in community pharmacy, clinical pharmacy or research and academic teaching. Fiftysix percent of these graduates reside or practice within the state of Tennessee. The college’s faculty

and staff are leaders in pharmacy education through high-quality instruction, cutting-edge research, and regionally relevant community service and Gatton faculty, staff, and students are engaged in local, state, and national policy discussions and lead community outreach and educational efforts related to important health care issues. The spending by the college, its students and visitors generates significant statewide economic impacts. Businesses providing goods and services to the college earn profits, pay their employees and purchase goods and services from their suppliers throughout the state. The effects of this spending upon output, labor earnings and value added are referred to as the college’s economic impacts.

FIGURE 1

Direct Project Spending Leakages: Flows to entities outside of the region

Direct Effects: Direct purchase of labor and material within the region.

Indirect Effects: Local businesses buy from each other to supply direct demands

Induced Effects: Workers’ Household purchases

Total Effect = Direct + Indirect + Induced BILL GATTON COLLEGE OF PHARMACY

X

Multiplier = Total Effect / Direct Effect etsu.edu/pharmacy

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EAST TENNESSEE STATE UNIVERSITY


III. THE BILL GATTON COLLEGE OF PHARMACY’S ECONOMIC IMPACTS The economic impacts of the Gatton College of Pharmacy flow from four different spending streams: spending to fund the operations of the college; student spending in the community for housing, transportation, living expenses and other miscellaneous expenses; spending by visitors either visiting students or attending college events and seminars; and expenditures for new construction. Economic impacts are typically assessed at either the state level or the regional level. When the analysis of the economic impact is confined to a region like the Tri-Cities region which consists of eight counties in Tennessee and Virginia making up the region’s consolidated metropolitan area, the impact of dollars that are spent in other areas of the state are excluded. When the area of analysis is expanded to include the entire state, the amount of leakage is reduced as the broader geographic scope captures the effect of dollar flows to other communities within the state. As a result, statewide economic impacts are somewhat higher than those associated with regional spending and more accurately reflect the impact of the Bill Gatton College of Pharmacy upon the entire state of Tennessee. Accordingly, this report outlines the statewide economic impacts. For clarity the economic impacts of the college are broken out by spending stream and detail the economic impacts arising out of each of the four sources of spending: spending by the college to fund its operations, spending by students for living expenses, spending by visitors to the college and planned construction spending. The impacts of each of these spending streams follow.

Our Generation Rx chapter has been recognized by the American Pharmacists Association as

#1 or #2

in the nation since

2012

From 2015-2017, Generation

Rx trained laypersons and

33,000 over 10,000 health care providers

over

and future health care providers in administering naloxone, a potentially life-saving treatment for someone overdosing on opioids

The Gatton College of Pharmacy reports

26,900

patient encounters annually

Since 2013, faculty, staff and

students have helped collect and properly dispose of more than

5,400 pounds of pharmacy waste,

including controlled substances, through annual Drug Take Back events at sites throughout the region

BILL GATTON COLLEGE OF PHARMACY

etsu.edu/pharmacy

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A. Economic Impacts of Bill Gatton College of Pharmacy Spending on Operations During 2017, student enrollments generated total revenues of about $11,461,000. These revenues funded faculty and staff salaries and benefits, the purchase of supplies and services and other college expenditures. As the pie chart shows, this spending generated significant impacts at the state level. A considerable portion of the direct spending by the college, almost $7,324,650, was used to fund salaries and benefits (labor income), for the college’s 58 faculty and staff members. Indirect and induced impacts generated additional impacts which resulted in a statewide expansion of total economic output of almost $21,912,200. The approximately $10,724,760 in labor income supported 127 jobs statewide and generated $13,214,134 in valued added.

College State Operations Economic Impacts FY 2017-2018 EMPLOYMENT

LABOR INCOME

127

$10,724,763

VALUE ADDED

OUTPUT

$13,214,763

$21,912,152

DIRECT EFFECT

INDIRECT EFFECT

INDUCED EFFECT

B. Economic Impacts of Bill Gatton College of Pharmacy Student Spending Since its opening, the Bill Gatton College of Pharmacy’s entering classes have averaged 75 students yielding a student body of around 300 for the four-year program. In addition to their tuition and fees, students are required to fund their living expenses including housing, transportation costs, food, books, health insurance and miscellaneous expenses. The college estimates that each student will spend $23,745 for these items. Based on average enrollments of 300 students, total annual spending is estimated to be $7,123,500 annually. This direct spending generates an estimated $5,088,461 in labor income statewide, supporting 119 jobs. Total output within the state attributable to student spending is approximately, $13,686,821.

Student Spending State Economic Impacts FY 2017-2018 EMPLOYMENT

LABOR INCOME

119

$5,088,461

VALUE ADDED

OUTPUT

$7,557,298

$13,686,821

DIRECT EFFECT

8

INDIRECT EFFECT

INDUCED EFFECT

EAST TENNESSEE STATE UNIVERSITY


C. Economic Impacts of Bill Gatton College of Pharmacy Visitors Visitor Spending State Economic Impacts FY 2017-2018 The activities at the Bill Gatton College of Pharmacy attract a number of out-of-town visitors to the community. Parents, potential students and friends travel to the region to visit students and/or the college. In addition, researchers and educators attend seminars and conferences and events hosted by the college. Each of these visitors spends money for meals, lodging and associated travel expenses. Based on past years’ figures, approximately 1,063 out-of-town travelers are expected to visit during 2018. The local Convention and Visitors’ Bureau estimates that each visitor spends approximately $135 per day within the region. This figure is supported by other estimates of spending within the region. Based on local estimates, it is assumed that the average visit will last two days. This yields an estimate of annual spending by visitors of $284,435. This spending generates a total statewide economic impact of $531,145 in output and a labor income impact of $213,736, supporting six jobs.

EMPLOYMENT

LABOR INCOME

6

$213,736

VALUE ADDED

OUTPUT

$309,051

$531,145

DIRECT EFFECT

INDIRECT EFFECT

INDUCED EFFECT

D. Economic Impacts for Bill Gatton College of Pharmacy Total Non-Construction When the impacts of all funding streams, excluding planned construction spending, are totaled, the College generated statewide total output impacts of $36,130,118. Labor income impacts totaled $16,026,960 which supported 252 jobs. This economic activity will generate local, state and federal tax collections. Total state and local taxes are estimated to be approximately $1,381,500 and federal taxes of approximately $3,264,400.

Total State Economic Impacts FY 2017-2018 EMPLOYMENT

LABOR INCOME

252

$16,026,960

VALUE ADDED

OUTPUT

$21,080,483

$36,130,118

DIRECT EFFECT

BILL GATTON COLLEGE OF PHARMACY

INDIRECT EFFECT

INDUCED EFFECT

etsu.edu/pharmacy

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E. Bill Gatton College of Pharmacy Economic Impacts Arising Out of Construction In addition to the impacts arising out of spending to support college operations, student spending and visitor spending, there are also significant economic impacts that accrue to the region as a result of college construction activities. The Bill Gatton College of Pharmacy is collaborating with ETSU’s Quillen College of Medicine to fund the construction of an Inter-professional Education and Research Center. The center will be housed in a historic building on the Mountain Home Veterans Affairs campus, next door to the Bill Gatton College of Pharmacy building. After extensive renovation, the facility will house stateof-the-art simulation labs, research space, classrooms, and student study space. The overall cost of construction and renovation of the building will be nearly $13 million. Approximately 50 percent of the expenditures for this project will be provided by the Gatton College of Pharmacy. Construction documents provided by the university’s administration indicate that in 2017 construction expenditures funded by the College totaled approximately $3,301,500 with an additional $2,751,000 in construction expenditures expected in 2018. As the graphic at top right shows, construction expenditures attributable to the Gatton College of Pharmacy in 2017 generated 33 jobs statewide and $1,888,964 in labor income. The total economic impact is estimated to be over $5,967,819. In 2018, construction and design expenditures will support 27 jobs within the state and will generate $1,565,720 in labor income and a total economic impact of $4,960,574. These activities also will have an impact on local, state and federal tax collections. In 2017, construction activities are expected to generate $126,817 in state and local taxes and $250,748 in federal taxes. Construction expenditures in 2018 are expected to generate $101,061 in state and local taxes and $288,061 in federal taxes. There is an important caveat when interpreting these impacts. In as much as construction employment and impacts arise directly out of construction operations, they cease once construction is ended. Further, they are not cumulative in nature. One cannot sum employment in 2017 and 2018 as some of the jobs created in 2017 will not carry forward to 2018. Each year must therefore be evaluated separately.

10

State Construction Economic Impacts FY 2017-2018 EMPLOYMENT

LABOR INCOME

33

$1,888,964

VALUE ADDED

OUTPUT

$2,428,653

$5,967,819

DIRECT EFFECT

INDIRECT EFFECT

INDUCED EFFECT

State Construction Economic Impacts FY 2018-2019 EMPLOYMENT

LABOR INCOME

27

$1,565,720

VALUE ADDED

OUTPUT

$2,013,056

$4,960,574

DIRECT EFFECT

INDIRECT EFFECT

INDUCED EFFECT

EAST TENNESSEE STATE UNIVERSITY


IV. ANTICIPATED GROWTH IN THE BILL GATTON COLLEGE OF PHARMACY’S ECONOMIC IMPACTS It is anticipated that over the next 10 years the Bill Gatton College of Pharmacy’s revenues will increase at a rate of approximately 2 percent per year. Assuming no significant changes in the state and local economic conditions, it is estimated that total college economic impacts in the year 2026 will reach the levels shown in the chart to right.

Total State Economic Impacts 2026

EMPLOYMENT

LABOR INCOME

272

$19,675,814

VALUE ADDED

OUTPUT

$25,885,023

$44,177,308

DIRECT EFFECT

BILL GATTON COLLEGE OF PHARMACY

INDIRECT EFFECT

INDUCED EFFECT

etsu.edu/pharmacy

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EAST TENNESSEE STATE UNIVERSITY


V. SUMMARY As indicated in the accompanying graph, the ETSU Bill Gatton College of Pharmacy is projected to provide an economic impact of more than $379 million to the state of Tennessee between the 10-year period of 2017 and 2026. In addition to serving as an economic engine for the state and region, the pharmacy school continues to excel at its main priority -- graduating an estimated 75 top-quality pharmacists each year who raise the quality of health care available to patients. These are individuals who, without the presence of ETSU’s Gatton College of Pharmacy in Northeast Tennessee, would likely study and relocate to other states to pursue their dreams. These are pharmacists who not only improve the health care of our state, but also contribute to the economies of their communities. More than half (56 percent) of our graduates remain within the state, establishing careers in approximately 90 cities across Tennessee. The ETSU pharmacy school also focuses significant research efforts to issues plaguing the state, especially the areas of Southern Appalachia. From opioid addiction to the spread of hepatitis C, faculty members at the Gatton College of Pharmacy are working tirelessly to bring new solutions to the table. Here again, we can see the potential for further economic impact. The World Health Organization states that better health is “central to human happiness and well-being.” It also, the WHO notes, “makes an important contribution to economic progress….”

49% of

BGCOP students are first-generation students

31% of BGCOP students are from rural zip codes

82% match rate

through the national residency program (National rate is 67%)

Future Total State Economic Impacts (Excluding Possible Construction Economic Impacts) $50,000,000

$44,177,308

$45,000,000

56% of BGCOP

$40,000,000

$35,000,000

$36,130,118

2026

2025

2024

2023

BILL GATTON COLLEGE OF PHARMACY

2022

2021

2020

2019

2018

2017

$30,000,000

graduates reside and practice in Tennessee

etsu.edu/pharmacy

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VI. ADDENDUM - MEANING AND METHODS Economic impact analysis is a widely accepted tool used to assess the effects of increases or decreases in economic activity within a region. Its methodology springs from the work done by Nobel Prize winner Wassily Leontief and involves the “… estimation of economic activity that results from a specific event, facility, government policy, etc. (economic stimulus). This involves identifying economic activity in a given area (community/county/province) that can be attributed to a particular economic stimulus or activity that would not take place in the absence of this stimulus. In other words, economic impact analysis involves the measurement of incremental economic activity. Such incremental economic activity is most often measured in terms of changes in output (sales), income, employment and tax revenues.” Simply stated, economic impacts are changes in a region’s economic activity that arises directly or indirectly out of the addition or elimination of a specific activity, like a college of pharmacy, and the initial spending by individuals or organizations that is an outgrowth of these activities. The extent to which this initial spending promotes economic activity is estimated using economic impact models. Economic impact models examine the activity flows between industries required to satisfy “final demand,” that portion of overall demand that is not used in the production of other outputs inside the regional economy. Final demand includes consumption, investment, government purchases and exports. The economic impacts which the analysis measures are classified as direct economic impacts, indirect impacts, or induced impacts, as depicted in Figure 1. Direct Impacts are those changes in output, employment and earnings that occur as a direct consequence of public or private spending which remains in the affected region. They arise out of spending of “new dollars” brought to the region that are used to fund new construction, the purchase of materials, labor, and ongoing incremental general and administrative expenses. The direct impact of a particular activity may be less than the total dollar amount allocated a particular project. This is because some of these dollars “leak” from the local economy to businesses outside of the region. Only dollars spent locally are reported as direct effects. It should be noted that activities and new facilities that redirect, or displace, local dollars from one business to another create no incremental economic impact. For example, if a new restaurant attracts patrons from existing competitors within a community there is no 14

overall change in the economy since existing economic activity has simply shifted locations. However, if the new restaurant is constructed with dollars from outside of the region and its consumers are non-local consumers, it is attracting additional dollars to the community. The recirculation of these new dollars is the source of the restaurant’s economic impact. As Figure 1 indicates, in order to meet the demands for items associated with the direct effects, the industrial suppliers, retailers, and wholesalers from whom a business or college makes its purchases must also buy goods and services from their suppliers who will in turn make purchases from their suppliers down the supply chain. The expenditures that arise as a consequence of this business-to-business spending are the project’s Indirect Impacts. Indirect impacts reflect the necessity for supplying firms to expand their hiring and materials purchases to meet the direct demands of a project. In addition to the direct and indirect effects, there is additional economic activity within the region as a result of spending by employees of businesses affected by the direct and indirect effects. These employees spend their pay on food, clothing, shelter, consumer goods, and services, thereby creating additional impacts termed the project’s Induced Impact. This spending will further expand the region’s total economic activity by stimulating additional indirect effects. The sum of a project’s direct impacts, indirect impacts, and induced impacts is referred to as the project’s Total Economic Impact. The ratio of the total impact to the direct impact is the activity’s implicit multiplier. Economic impacts are typically reported in terms of several different metrics. Most often, impacts are reported in terms of the total dollar volume of goods and services produced within the relevant region as a result of project spending. This is termed the project’s output impact. In addition to the output impact, the number of jobs or employment within the region supported by this output, the employment impact, is also reported. Labor income, consisting of wages and benefits, and proprietor income is typically reported as the project’s labor income impact. The project’s value added impact is also reported. Value added is an expanded version of labor income in that it is made up of four components: employee compensation and proprietor income plus other property income and indirect business taxes. Value added is the most commonly used measure of the contribution of a region to the national economy as it avoids double counting of intermediate sales. It only captures the “value added” to final products by activities within the region in terms EAST TENNESSEE STATE UNIVERSITY


of changes in total business output or sales, jobs, and labor earnings supported by the overall economic activity and is therefore the new activity’s contribution to a region’s gross regional product. The first step in estimating the impact of economic activity is to define the geographic area that will be primarily affected by the project’s economic activities. The more extensive the geographic area included in the analysis, the smaller the amount of “leakage” from the area. Selecting a broader definition of the geographic region affected as the basis of the analysis, as opposed to a more limited region, will yield higher total impacts. However, the definition of the relevant geographic area should be a function of a variety of factors including the site of the project’s activities, the residential locations of the labor force, the location of supporting industries, and the location of consumers. The intent is to capture a definition of a geographic unit that has strong economic ties and which experiences the bulk of the impacts of the project. The region of analysis is typically a county, a group of counties or a state. The next step in the process is to assign expenditures to the appropriate industrial sector. Each sector has a different relationship with the surrounding business community, and a slightly different impact and

associated specific industry-related multiplier. The economic impacts were modeled using the IMPLAN modeling software. The software was originally developed by the U.S. Forest Service in cooperation with the Federal Emergency Management Agency and the U.S. Department of the Interior’s Bureau of Land Management to assist in land and resource management planning. The software was refined by the University of Minnesota in order to enable its use in non-forestry-related applications. Over the past 15 years, it has become one of the most widely used economic impact analysis modeling packages. It is routinely employed by the U.S. Army Corps of Engineers, the U.S. Department of Agriculture, numerous state and local governments, and a wide variety of private consulting firms. Version 3.0, IMPLAN’s newest version of the model, was used in this analysis. The IMPLAN model employed in this analysis provides information on 536 industrial sectors. Utilizing local, regional, and national data, the model constructs an input-output table that generates multipliers for output, total value added, labor income, employment, and provides estimates of the federal, state, and local taxes generated by the project’s activities.

FIGURE 1 Direct Project Spending Leakages: Flows to entities outside of the region

Direct Effects: Direct purchase of labor and material within the region.

Indirect Effects: Local businesses buy from each other to supply direct demands

Induced Effects: Workers’ Household purchases

Total Effect = Direct + Indirect + Induced BILL GATTON COLLEGE OF PHARMACY

X

Multiplier = Total Effect / Direct Effect etsu.edu/pharmacy

15


VII. ADDENDUM - DATA STATE IMPACTS College Operations Economic Impacts FY 2017-2018 Impact Type Employment Labor Income Value Added Direct Effect 58 $7,324,646 $7,324,646 Indirect Effect 20 $955,181 $1,850,681 Induced Effect 49 $2,444,936 $4,038,807 Total Effect 127 $10,724,763 $13,214,134

Output $11,461,283 $3,429,961 $7,020,908 $21,912,152

Student Spending State Economic Impacts 2017 Impact Type Employment Labor Income Direct Effect 73 $2,844,808 Indirect Effect 22 $1,091,811 Induced Effect 23 $1,151,841 Total Effect 119 $5,088,461

Value Added $3,860,148 $1,793,832 $1,903,318 $7,557,298

Output $7,123,500 $3,254,897 $3,308,243 $13,686,821

Visitor Spending State Economic Impacts 2017 Impact Type Employment Labor Income Direct Effect 5 $129,777 Indirect Effect 1 $35,491 Induced Effect 1 $48,467 Total Effect 6 $213,736

Value Added $170,066 $58,903 $80,082 $309,051

Output $281,400 $107,512 $139,199 $531,145

Total State Economic Impacts 2017 Impact Type Employment Labor Income Value Added Output Direct Effect 136 $10,299,231 $11,354,860 $18,869,398 Indirect Effect 44 $2,082,483 $3,703,416 $6,792,370 Induced Effect 72 $3,645,244 $6,022,207 $10,468,350 Total Effect 252 $16,026,960 $21,080,483 $36,130,118 State Construction Economics 2017 Impact Type Employment Labor Income Direct Effect 16 $990,807 Indirect Effect 8 $472,455 Induced Effect 9 $425,703 Total Effect 33 $1,888,964

Value Added $1,000,006 $725,074 $703,573 $2,428,653

Output $3,301,500 $1,443,503 $1,222,815 $5,967,819

State Construction Economics 2018 Impact Type Employment Labor Income Direct Effect 13 $821,257 Indirect Effect 7 $391,608 Induced Effect 7 $352,855 Total Effect 27 $1,565,720

Value Added $828,883 $600,997 $583,176 $2,013,056

Output $2,751,000 $1,194,221 $1,015,352 $4,960,574

Total State Economic Impacts 2026 Impact Type Employment Labor Income Value Added Output Direct Effect 152 $12,662,915.00 $13,974,639.00 $23,158,872 Indirect Effect 45 $2,537,973.00 $4,517,470.00 $8,234,714 Induced Effect 75 $4,474,925.00 $7,392,914.00 $12,783,723 Total Effect 272 $19,675,814.00 $25,885,023.00 $44,177,308

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EAST TENNESSEE STATE UNIVERSITY


Report prepared by: Dr. Jon Lane Smith East Tennessee State University Bureau of Business and Economic Research College of Business and Technology Dr. Jon L. Smith received his undergraduate degree from Mississippi State University in Business Administration. After military service, he studied at the University of South Carolina where he earned a master’s degree in Transportation and a Ph.D. in Economics. He is a member of the faculty of Economics and Finance. While at East Tennessee State University he has served as the Chairman for the Department of Economics and Finance and currently is the Director for the Bureau of Business and Economic Research. Dr. Smith has conducted numerous economic impact studies and has directed projects for the U.S. Department of Transportation, the U.S. Department of Education, private foundations and municipal governments. His area of expertise is applied economic analysis and economic impact analysis. He is currently the Chairman of the Johnson City Pubic Building Authority, Chairman of the Tri-Cities Airport Authority, Vice Chairman of the Johnson City Industrial Bond Board, and Secretary of the East Tennessee State University Research Foundation. He has been instrumental in establishing international relationships for the ETSU College of Business and Technology and is an honorary faculty member of the University of Applied Sciences in Bremen, Germany.

East Tennessee State University is accredited by the Southern Association of Colleges and Schools Commission on Colleges to award baccalaureate, master’s, education specialist, and doctoral degrees. Contact the Commission on Colleges at 1866 Southern Lane, Decatur, Georgia 30033-4097, telephone 404-679-4500, or http://www.sacscoc.org, for questions about the accreditation of East Tennessee State University. East Tennessee State University Bill Gatton College of Pharmacy’s Doctor of Pharmacy program is fully accredited by the Accreditation Council for Pharmacy Education (ACPE),135 S. LaSalle Street, Suite 4100 Chicago, IL 60603-4810, 312/6643575, fax 312/664-4652, website www.acpe-accredit.org. The ACPE accredits Doctor of Pharmacy programs offered by Colleges and Schools of Pharmacy in the United States and selected non-U.S. sites. ETSU is an AA/EEO employer. ETSU-299-17 1.25M

BILL GATTON COLLEGE OF PHARMACY

etsu.edu/pharmacy


PO Box 70414 Johnson City, TN 37614

VISIT • APPLY • GIVE www.etsu.edu/pharmacy


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