Privatization of government services: Pressure-group resistance and service transparency

Even when efficiency gains can be expected from contracting out municipal services, it surprisingly rarely occurs. Political pressure by interest groups, especially unions, is usually assumed responsible. We argue that the effectiveness of such pressure is actually a function of a service’s “transparency,” which determines voter’s knowledge of the quality and cost of the service as well as the tax burden. A model is presented of the interplay between union opposition to contracting and service transparency. Policies are offered to increase transparency and make contracting optimal for governments.     

Response to Student Participation and Student Involvement

Abstract

Government contracting out of responsibilities for the delivery of social services is an increasingly common phenomenon in these times of economic restraint. This paper argues that this practice, with its inherent technical and philosophical problems, negatively affects social service systems and social work practitioners. The resultant changes are described as having serious implications for social work educators, The argument is made that if educators are to remain relevant to the needs of service consumers, social work students, and welfare agencies, they must carefully reconsider aspects of curriculum planning and student placements as well as faculty involvement in research and advocacy.     

Engagement with Non‐State Service Providers in Fragile States: Reconciling State‐Building and Service Delivery

The OECD questions whether non‐state services in fragile states may delegitimise the state in the eyes of citizens, arguing that ‘state‐building’ depends on governments’ engagement in service management. This article reviews the available evidence to identify what types of engagement are feasible and most likely to contribute to service delivery, or not to damage it. It considers the capacity requirements and the risks associated with state intervention through policy formulation, regulation, contracting and mutual agreements, and concludes by identifying ways of incrementally involving the state, beginning with activities that are least likely to do harm to non‐state provision.     

A Multi-Method Evaluation of the Teen Pregnancy Hotline in Taiwan

The present study examines the outputs and qualities of the thirteen teen pregnancy service hotlines in Taiwan that were funded by the Children’s Bureau in 2004 and 2005. The evaluation was made through agency visits, focus groups, document reviews, call-in tests and the use of a management information system. The results show that the average number of calls was low, and one agency did not receive any calls during the time period examined. The quality of services varied, and the advice provided by the hotline staff was influenced by the value orientation of the agencies. Most callers were adult women, and the major services they received were information and emotional support. The service characteristics were heavily affected by the goals and routine tasks of the agencies as certain agencies applied their existing services to the program without assessing their fitness to the needs of the potential clients. Suggestions for service improvement are provided, including an islandwide hotline to be set up and operated by a single agency with high accountability. Implications for program monitoring and documentation, staff training and knowledge-sharing, and service advertisement and promotion are also discussed.     

Contracting out of basic health facilities in Pakistan: Are the lessons generalizable?

Amid growing support within international development agencies for the privatization of health facilities in developing countries, contracting out of the Basic Health Units (BHUs) in Pakistan has been presented as a success. This article argues for caution in generalizing results from this model. It shows that the model improved service delivery because the organization taking over the BHUs was itself a government‐owned QUANGO (Quasi‐Autonomous NGO); similar concessions would not have been granted to a private provider. Further, the article shows that, given the strong resistance that the model continues to receive from administrators within the state system, development agencies must consider whether models that try to sidestep the bureaucracy instead of working towards installing good practice within the state system, can be viewed as a success.     

Are you ready for ssmos?

While welfare reform altered entitlements, introduced time-limited benefits, and capped reimbursements for administrative costs, little was done to control service utilization by those who remain on welfare, or to realign the financial incentives and administrative infrastructure for the delivery of social services. This essay explores the advent of the Social Service Maintenance Organization and discusses the steps that social service agencies need to take to ready themselves for this altered system of service delivery. Without a thorough understanding of the way in which managed care delivery systems operate, as well as the sophisticated information systems and the financial resources necessary to assume risk, social service agencies will find themselves increasingly ill-equipped to meet the challenges of this new environment.     

Sharing the Baton,Not Passing It: Collaboration between Public and Private Child Welfare Agencies to Reunify Families

ABSTRACT

Increasingly, public sector child welfare agencies are contracting with private agencies for the provision of specialized services to clients while maintaining oversight and case management responsibilities. At the same time, funders, both private and public, are demanding that service providers partner and collaborate with one another. In this article, we present results from a study of a unique partnership between two state child welfare agencies and a private child welfare agency aimed at reunifying families whose children have been removed and placed in foster care. Data was obtained from 41 key informants using a questionnaire and a structured interview. Findings support earlier studies of collaboration, and indicate the strengths of this partnership and factors that facilitated and hindered it. The results have implications for agencies that both contract for and provide a range of child welfare services as well as other interagency relationships.     

Redistributive Policy and Devolution: Is State Administration a Road Block (Grant) to Equitable Access to Federal Funds?

Over the last several decades, block grants have been a keyinstrument by which policy authority is devolved from federalto state governments. Whether the block grant approach producesmore effective redistributive policy management (on equity orefficiency grounds) is an open and central question. We focuson the equity dimension by positing an explanatory frameworkthat links access to federal block grant funding to the transactioncosts associated with intergovernmental grant contracting. Weargue that grant access is a function of both state-level institutionalchoices and the administrative capacity of local governments—whichcombine to influence the salient transaction costs associatedwith grant contracting. We apply our theoretic framework tothe non-entitlement portion of the Community Development BlockGrant (CDBG) program and analyze granting data across distinctinstitutional settings. We find that local administrative capacityis a key to access, indicating that some localities most inneed are least equipped to capture grants, which raises equityconcerns. However, the specific way in which states structurearenas of grant competition can make access more equitable.In short, we show that state-level institutional arrangementscritically affect access to federal block grant funds when thosefunds are allocated through competitive grant contracting tolocal governments.     

Necessary Steps in Designing a Successful Contract

Abstract

Parents with a history of serious mental illness are vulnerable in many ways and are therefore likely to be accessing services from a range of government and community agencies. The use of multiple services, sometimes with conflicting practice frameworks, can result in sub-optimal management of these families. This study surveyed 77 service providers from a range of government and non-government agencies targeting their views regarding parents with a serious mental illness (specified in this study as schizophrenia, bipolar disorder and psychotic depression). They were asked what they perceived were difficulties for this population, interventions required to meet the needs of this group and finally, barriers to effective service delivery. We found that service providers reported that current services were inadequate for these parents. Parent-based interventions were seen as being more beneficial than those targeting children. Lack of liaison between agencies and lack of coordinated service provision were seen as the greatest barrier to effective service delivery. The results highlight the need for policy planners and service providers to develop strategies to ensure effective coordination between services that work with this population.     

Impacts of agency coordination on nonprofit domestic violence and sexual assault programs in communities with STOP formula grant funding

The goals of the current study are (a) to understand the community and state context in which STOP(Services* Training* Officers* Prosecutors)-funded victim service (VS) programs operate, (b) to assess the degree to which receipt of STOP funding for VS programs and the degree of state-level STOP agency support for collaboration among community agencies have led to improved program services and community interaction, and (c) to assess the degree to which improved interaction between community agencies leads to improvements for VS programs. The results show that community interaction between VS programs and other community agencies can improve VS program services as reported by service providers. In addition, the higher the pre-STOP levels of activity around violence against women issues in communities, the more agencies can enhance their service system with STOP funding. Also, STOP funding has facilitated greater levels of change for communities whose pre-STOP attention to violence against women was lower.     

Inequitable Access to Health Services for Older Adults with Diabetes: Potential Solutions on a State Level

Diabetes is a serious global public health challenge. The cost for health services for diabetes care has increased 41% over the past 5 years. Despite escalating health expenditure, the United States continues to have higher rates of diabetes than many other developed countries. There is a need for health care reform in the United States not only in reducing health care costs but also in improving the quality of preventative care. This study presents the testing of a multilevel model investigating variables on the individual and state levels to develop a better understanding of the most important contextual pathways that can lead to providing older adults (50+) with type 2 diabetes with the recommended preventative quality care they require. The model was tested using a three-level repeated cross-sectional design with data from various existing data sources, using a national sample of 181,870 individuals aged 50 years and older. Results showed that differences in state health care systems contributed to inequitable access. Specifically, in a state where there was a higher percentage of adults 65 and older coupled with a shortage of health care professionals, the likelihood of receiving the recommended preventative quality care decreased. Also, older adults living in states with a higher percentage of people with diagnosed diabetes but with a lower-than-average annual per capita health care expenditure fared worse in receiving quality preventative care. Last, older adults in wealthy states with higher percentages of uninsured people had the lowest odds of receiving quality preventative care. Health care reform, similar to what is currently promoted by the Patient Protection and Affordable Care Act of 2010, is recommended to improve the performance of all health care systems in all states.     

People as partners: Facilitating people's participation in public–private partnerships for solid waste management

Cities in developing countries are facing a double dilemma. On one hand, the urban population is growing rapidly, causing a huge increase in demand for waste management services. On the other hand, the traditional public sector is failing to respond to the increased demand for service. The public sector is constrained by resource and institutional limitations. It is often proposed that the solution lies in private sector participation. It is expected that the private sector, with its dynamism and flexibility, may fill in the service delivery gaps by forming partnership with the public sector. However, a third tier—the people—is often overlooked in the service delivery framework. Citizens can contribute significantly to service delivery. They can support the private sector with payment of service charges. But more importantly, they can play an active role in improving accountability and service quality of both public and private sector. This radical shift in people's role, from passive service receivers to active service partners, however, may not occur endogenously. External help from facilitating agencies may enable the public and private sector to form partnership with people for better service delivery. This article examines the role of facilitating agencies in developing tripartite partnership for solid waste management service in Bangladesh. The key lessons learned are: a number of obstacles prevented spontaneous partnership among the public sector, private sector and people; facilitating agencies were able to overcome the obstacles to form partnership of the three; and, the tripartite arrangement resulted in higher accountability and better service delivery.     

Health care innovations for homeless families: Emerging opportunities under Medicaid and the Affordable Care Act

Prior to the Patient Protection and Affordable Care Act of 2010 (the ACA), the US health care system left many low-income families facing limited access to medical care, struggling with high-health costs, or lacking health insurance altogether. The ACA aims to increase access to care, improve the quality of care, and lower total health care costs. While the ACA can benefit all individuals and families, it has significant potential for expanding and improving services for those experiencing homelessness. This paper describes specific opportunities under the ACA and Medicaid that can be used to strengthen services for homeless families and provides examples of efforts under way. It also offers guidance for how homeless service agencies can effect change in their respective states. The examples described here are promising approaches to strengthening homeless services. Pursuing these ideas for homeless families will require initiative, creativity, and perseverance, but recent progress is encouraging.     

Coalitions on mental health and aging: lessons learned for policy and practice

Elders with mental health needs have been poorly served. Private and government agencies have given this issue a low priority, which is reflected in service delivery and funding. Coalitions have developed in states around the country and have engaged in a variety of tasks, including training techniques and collaborative efforts to advocate successfully for appropriate services. While accomplishments vary, the coalitions should continue their work, and others should organize in order to reach the goal of having accessible and appropriate elder mental health services.     

Consumer-directed home and community services programs in eight states: policy issues for older people and government.

This study assesses consumer-directed home and community services for older persons by examining public programs that serve this population in eight states. These programs give beneficiaries, rather than agencies, the power to hire, train, supervise, and fire workers. Most stakeholders interviewed, in addition to the quantitative research, indicate that many older beneficiaries want to and can manage their services, although significant issues arise for persons with cognitive impairments. Research results suggest better, or, at least, no worse, quality of life for beneficiaries when they direct their services, although quality of services remains a contentious issue. For workers, consumer-directed care has some disadvantages, including fewer fringe benefits. With exceptions, state agencies have not provided extensive consumer or worker support or aggressively regulated quality of care.     

Diversity Within Diversity

Summary

Asian American elderly form a heterogeneous group with respect to immigration history, ethnic/cultural background, socioeconomic position, and health and mental health status. This paper provides an overview of the internal heterogeneity within the Asian American elderly population and identifies those who experience multiple stressors affecting their quality of life. Then it discusses barriers to formal service utilization as well as strengths and deficits of informal support systems. To better serve Asian American elders with their multiple needs for health, mental health, and social services, increased funding is recommended for research on this group, diversification of social service programs in coethnic communities, and increased cultural competence in non-Asian social service agencies.     

Planning to Plan: A Process to Involve Child Welfare Agencies in Disaster Preparedness Planning

In the aftermath of Hurricane Katrina when child welfare officials in Louisiana reported they did not know the whereabouts of all their children in foster care, disaster planning in public child welfare became a new area of concern. This article reports on a process of engaging seven public child welfare agencies in planning for disasters that could affect child safety and service delivery. The Washington Metropolitan Area Disaster Planning Project used a strengths-based approach to help agencies responsible for protecting and serving children in foster care and families at risk of abuse and neglect develop plans to augment and continue service delivery and responsiveness in the aftermath of a natural or man-made disaster. The processes of gathering information on disaster responsiveness, interviewing community and professional informants, developing a template to guide disaster planning within the agencies, and implementing a tabletop exercise are described. As a result of this consultation effort agencies became aware that disaster planning at the state and county levels had proceeded without child welfare at the table, that the increase in need for child welfare services during a disaster was not recognized by disaster professionals, and that practicing disaster responsiveness is necessary to assure readiness.     

African American Men,Child Welfare,and Permanency Planning

Summary

Like social services generally, child welfare and permanency planning services have failed to incorporate African American men as significant and serious participants in the service delivery process. Child welfare and permanency planning services have marginalized African American men such that children fail to benefit from the inclusion of these men in the service delivery process. This incomplete and inappropriate approach to permanency planning specifically, and to child welfare services more generally, is a disservice to African American children. Corrective measures are proffered to promote greater inclusion of African American men in child welfare and permanency planning services.     

Sweet and Sour Charity: Experiences of Receiving Emergency Relief in Australia

Abstract

Emergency relief is assistance provided by community agencies to people in financial crisis, usually recipients of income support payments. The present study reports on an exploratory, qualitative study of the experiences of people who seek emergency relief. Semistructured interviews were conducted with 20 emergency relief recipients from seven different agencies. Although the interviewees reported some positive experiences, distinct limitations in the extent of assistance were also perceived. Accountability for appropriate processes and quality assurance in service delivery are important requirements of agencies. Increased government funding to assist agencies to provide more holistic services would lead to more effective outcomes.