Journal Of Health And Human Services Administration[JOURNAL]
Sun
200 papers
AN UNCERTAIN FEDERALISM: THE STATES AND THE AFFORDABLE CARE ACT.
Plein LC
J Health Hum Serv Adm · 2014 · PMID 27439263
This article provides an initial assessment of the Affordable Care Act's recent implementation experience in the states. Drawing on state-level and regional analyses that have been coordinated by the ACA Implementation N...
This article provides an initial assessment of the Affordable Care Act's recent implementation experience in the states. Drawing on state-level and regional analyses that have been coordinated by the ACA Implementation Network--a cooperative effort involving researchers in 35 states--this article highlights the uncertain policy environment associated with the politics and complexities of the ACA. Understanding the ACA implementation experience requires an appreciation for political context, but must also take into account underlying demographic, market, and state administrative capacity issues in the states. There are indications that the ACA implementation experience is moving from a highly charged partisan nature to a more accommodating posture long associated with intergovernmental relations between the federal and state government in health and human services administration. In short, the key questions going forward will turn on how, not whether, the ACA is implemented.
THE AFFORDABLE CARE ACT AND INCENTIVIZED HEALTH WELLNESS PROGRAMS--A TALE OF FEDERALISM AND SHIFTING ADMINISTRATIVE BURDEN.
Sirpal S
J Health Hum Serv Adm · 2014 · PMID 27439262
The Patient Protection and Affordable Care Act creates new incentives and builds on existing wellness program policies to promote employer wellness programs and encourage opportunities to support healthier workplaces. Th...
The Patient Protection and Affordable Care Act creates new incentives and builds on existing wellness program policies to promote employer wellness programs and encourage opportunities to support healthier workplaces. The proposed rules are promulgated by the Department of Health and Human Services (HHS), the Department of Labor, and the Treasury Department, and seek to encourage appropriately designed, consumer-protective wellness programs in group health coverage. This legislative landscape raises significant federalism concerns insofar as it largely shifts the responsibility for administration of health incentive programs to the states. Little attention has been paid to the shifting "administrative burden" that would thereby ensue. This paper will address the distribution of power in the American federal system vis-à-vis subnational counterparts in the wake of rampant, recent health care reform efforts. This paper will therefore explore the willingness of the national government to delegate policymaking responsibility to state governments in the context of an important aspect of healthcare reform. This, in turn, can be used to assess the distribution of powers between governmental levels--a subject that has received little systematic inquiry to date. Finally, this paper will explore the degree of administrative burden shifting that may likely occur as a result of these changes in health reform and what potential impacts it may have on individual health.
THE CHANGING ROLE OF PRIVATE, NONPROFIT ORGANIZATIONS IN THE DEVELOPMENT AND DELIVERY OF HUMAN SERVICES IN THE UNITED STATES.
Norris-Tirrell D
J Health Hum Serv Adm · 2014 · PMID 27439261
With diverse missions and multiple service provision strategies, nonprofit human services organizations have worked individually and collaboratively to create responses to social problems throughout the history of United...
With diverse missions and multiple service provision strategies, nonprofit human services organizations have worked individually and collaboratively to create responses to social problems throughout the history of United States. This article highlights the important historic roots of the sector in understanding the scope and breadth of nonprofit human service organizations today. Challenges influencing this set of organizations, including the competing values of contracting out versus collaboration and the push-pull of grassroots or community-based versus professionalized orientations, are discussed. The article closes with important questions for nonprofit leaders and policymakers about the role of government in the human services arena.
EDITOR'S INTRODUCTION.
Wachhaus A
J Health Hum Serv Adm · 2014 · PMID 27439260
Abstract loading — click title to view on PubMed.
Future directions in intergovernmental relations.
Baracskay D
J Health Hum Serv Adm · 2013 · PMID 24350555
Abstract loading — click title to view on PubMed.
Faith-based partnerships and foster parent satisfaction.
Howell-Moroney M
J Health Hum Serv Adm · 2013 · PMID 24350554
Throughout the last several decades, there has been a chronic shortage of foster and adoptive families in the United States. Recruiting families to begin the licensure process to become foster and adoptive parents is alr...
Throughout the last several decades, there has been a chronic shortage of foster and adoptive families in the United States. Recruiting families to begin the licensure process to become foster and adoptive parents is already a difficult undertaking. But research shows that a very large proportion of families drop out of the licensure process early on due to frustration or a lack of support. This paper studies two faith-based partnerships that have arisen to create new capacity in the child welfare system. These programs recruit prospective families from churches and then provide training and ongoing support to those families throughout the licensure process. Using survey data collected from program participants, respondent perceptions of the licensure process are compared to a nationally representative sample of foster parents from the National Foster Care Adoptions Attitude Survey. Statistical results demonstrate that participants with the faith-based programs reported much higher levels of satisfaction with the process than the national sample. These findings provide evidence that these faith-based partnerships may provide an important additional source of capacity for an overburdened child welfare system.
Decisional inconsistencies in the management of contaminated, sport-caught fish.
Foran JA, Jia C
J Health Hum Serv Adm · 2013 · PMID 24350553
Persistent toxic pollutants such as polychlorinated biphenyls and mercury accumulate in tissues of fish that are caught and consumed by sport anglers and their families. Unlike commercially-sold fish, the U.S. Food and D...
Persistent toxic pollutants such as polychlorinated biphenyls and mercury accumulate in tissues of fish that are caught and consumed by sport anglers and their families. Unlike commercially-sold fish, the U.S. Food and Drug Administration (FDA) does not regulate sport-caught fish that are contaminated with these and other pollutants. Instead, nearly every state in the U.S. develops and issues consumption advice for contaminated sport-caught fish. We examined fish consumption advice issued by states that border and share waters of the Mississippi River. Our examination identified numerous jurisdictional inconsistencies that threaten the receptivity and credibility of consumption advice and, more important, threaten the health of individuals who consume contaminated sport-caught fish.
Assessment of pandemic preparedness in a socially vulnerable community in south Texas.
Kiltz L, Fonseca D, Rodriguez C … +1 more , Munoz P
J Health Hum Serv Adm · 2013 · PMID 24350552
The purpose of this research was to obtain information about general and pandemic preparedness efforts of residents within San Patricio County in South Texas, as well as to identify the most effective means of communicat...
The purpose of this research was to obtain information about general and pandemic preparedness efforts of residents within San Patricio County in South Texas, as well as to identify the most effective means of communicating the risks posed by pandemic influenza. The population of San Patricio County is socially vulnerable to a variety of disasters, including influenza pandemics due to the unique demographic profile of the county as well as its location on the Gulf Coast. The goals of this study were to help with pandemic planning efforts and to provide recommendations that could serve as a foundation for building more resilient communities within San Patricio County. Clearly the various governmental levels must work together to assist communities prepare for pandemic preparedness but broad, inclusive community participation is also necessary to strengthen community resilience.
Comparative federal health care policy: evidence of collaborative federalism in Pakistan and Venezuela.
Baracskay D
J Health Hum Serv Adm · 2013 · PMID 24350551
Collaborative federalism has provided an effective analytical foundation for understanding how complex public policies are implemented in federal systems through intergovernmental and intersectoral alignments. This has p...
Collaborative federalism has provided an effective analytical foundation for understanding how complex public policies are implemented in federal systems through intergovernmental and intersectoral alignments. This has particularly been the case in issue areas like public health policy where diseases are detected and treated at the local level. While past studies on collaborative federalism and health care policy have focused on federal systems that are largely democratic, little research has been conducted to examine the extent of collaboration in authoritarian structures. This article applies the collaborative federalism approach to the Islamic Republic of Pakistan and the Bolivarian Republic of Venezuela. Evidence suggests that while both nations have exhibited authoritarian governing structures, there have been discernible policy areas where collaborative federalism is embraced to facilitate the implementation process. Further, while not an innate aspect of their federal structures, Pakistan and Venezuela can potentially expand their use of the collaborative approach to successfully implement health care policy and the epidemiological surveillance and intervention functions. Yet, as argued, this would necessitate further development of their structures on a sustained basis to create an environment conducive for collaborative federalism to flourish, and possibly expand to other policy areas as well.
Symposium introduction: challenges of intergovernmental management.
McGuire M
J Health Hum Serv Adm · 2013 · PMID 24350550
Abstract loading — click title to view on PubMed.
Organizations and social worker wellbeing: the intra-organizational context of practice and its impact on a practitioner's subjective well-being.
Shier ML, Graham JR
J Health Hum Serv Adm · 2013 · PMID 24010263
This study aimed to better understand the varied factors that contribute to social worker subjective well-being (SWB) (the social science concept for happiness). Using qualitative methods of inquiry 19 social workers who...
This study aimed to better understand the varied factors that contribute to social worker subjective well-being (SWB) (the social science concept for happiness). Using qualitative methods of inquiry 19 social workers who reported having low to medium levels of workplace and profession satisfaction were interviewed to assess those factors within their lives that they perceived as impacting their well-being. One thematic category from the analysis was aspects of the intraorganizational context of workplaces that can impact social worker SWB. Respondents identified interpersonal workplace relationships, decision-making processes, management/supervisory dynamics, workload and workplace expectations, access to resources and infrastructure support, and inter-organizational relationships as key intra-organizational factors contributing to their overall wellbeing. In conclusion, these findings have practical application within organizations for structured policies and unstructured practices to improve social worker subjective well-being.
Classifying and comparing fundraising performance for nonprofit hospitals.
Erwin CO
J Health Hum Serv Adm · 2013 · PMID 24010262
Charitable contributions are becoming increasingly important to nonprofit hospitals, yet fundraising can sometimes be one of the more troublesome aspects of management for nonprofit organizations. This study utilizes an...
Charitable contributions are becoming increasingly important to nonprofit hospitals, yet fundraising can sometimes be one of the more troublesome aspects of management for nonprofit organizations. This study utilizes an organizational effectiveness and performance framework to identify groups of nonprofit organizations as a method of classifying organizations for performance evaluation and benchmarking that may be more informative than commonly used characteristics such as organizational age and size. Cluster analysis, ANOVA and chi-square analysis are used to study 401 organizations, which includes hospital foundations as well as nonprofit hospitals directly engaged in fundraising. Three distinct clusters of organizations are identified based on performance measures of productivity, efficiency, and complexity. A general profile is developed for each cluster based upon the cluster analysis variables and subsequent analysis of variance on measures of structure, maturity, and legitimacy as well as selected institutional characteristics. This is one of only a few studies to examine fundraising performance in hospitals and hospital foundations, and is the first to utilize data from an industry survey conducted by the leading general professional association for healthcare philanthropy. It has methodological implications for the study of fundraising as well as practical implications for the strategic management of fundraising for nonprofit hospital and hospital foundations.
Supply chain management with cost-containment & financial-sustainability in a tertiary care hospital.
Chandra H, Rinkoo AV, Verma JK … +3 more , Verma S, Kapoor R, Sharma RK
J Health Hum Serv Adm · 2013 · PMID 24010261
Financial crunch in the present recession results in the non-availability of the right materials at the right time in large hospitals. However due to insufficient impetus towards systems development, situation remains di...
Financial crunch in the present recession results in the non-availability of the right materials at the right time in large hospitals. However due to insufficient impetus towards systems development, situation remains dismal even when funds are galore. Cost incurred on materials account for approximately one-third of the total recurring expenditures in hospitals. Systems development for effective and efficient materials management is thus tantamount to cost-containment and sustainability. This scientific paper describes an innovative model, Hospital Revolving Fund (HRF), developed at a tertiary care research institute in Asia. The main idea behind inception of HRF was to ensure availability of all supplies in the hospital so that the quality of healthcare delivery was not affected. The model was conceptualized in the background of non-availability of consumables in the hospital leading to patient as well as staff dissatisfaction. Hospital supplies have been divided into two parts, approximately 3250 unit items and 1750 miscellaneous items. This division is based on cost, relative-utility and case-specific utilization. 0.1 Million USD, separated from non-planned budget, was initially used as seed money in 1998. HRF procures supplies from reputed firms on concessional rates (8-25%) and make them available to patients at much lesser rates vis-à-vis market rates, levying minimal maintenance charges. In 2009-10, total annual purchases of 14 Million USD were made. The balance sheet reflected 1.4 Million USD as fixed deposit investment. The minimal maintenance charges levied on the patients along with the interest income were sufficient to pay for all recurring expenses related to HRF. Even after these expenses, HRF boosted of 0.2 Million USD as cash-in-hand in financial year 2009-10. In-depth analysis of 'balance sheet' and 'Income and Expenditure' statement of the fund for last five financial years affirms that HRF is a self-sustainable and viable supply chain mechanism to ensure availability of the right materials at the right time at a reasonable cost. Thus innovations like HRF will prove robust in rendering quality healthcare at an affordable cost.
Patient assessment in emergency medical services: complexity and uncertainty in street-level patient processing.
Henderson AC
J Health Hum Serv Adm · 2013 · PMID 23484367
Though still a relatively nascent public function, emergency medical services (EMS) agencies have come to constitute a core local government service. The potentially life-saving interventional and palliative treatments p...
Though still a relatively nascent public function, emergency medical services (EMS) agencies have come to constitute a core local government service. The potentially life-saving interventional and palliative treatments provided by EMS personnel are inarguably vital for positive short- and long-term patient outcomes, yet our understanding of the behavior of these individuals during service interactions is limited. This exploratory research begins to narrow this gap in our understanding of street-level bureaucrats in EMS organizations by analyzing semi-structured interviews of paramedics recounting uncertain and complex accounts of street-level patient processing. Results indicate that factors such as paramedic communication skills, influential bystanders with key incident information, and patient identity serve to shape street-level interactions with patients.
Exploring the use of grounded theory as a methodological approach to examine the 'black box' of network leadership in the national quality forum.
Hoflund AB
J Health Hum Serv Adm · 2013 · PMID 23484366
This paper describes how grounded theory was used to investigate the "black box" of network leadership in the creation of the National Quality Forum. Scholars are beginning to recognize the importance of network organiza...
This paper describes how grounded theory was used to investigate the "black box" of network leadership in the creation of the National Quality Forum. Scholars are beginning to recognize the importance of network organizations and are in the embryonic stages of collecting and analyzing data about network leadership processes. Grounded theory, with its focus on deriving theory from empirical data, offers researchers a distinctive way of studying little-known phenomena and is therefore well suited to exploring network leadership processes. Specifically, this paper provides an overview of grounded theory, a discussion of the appropriateness of grounded theory to investigating network phenomena, a description of how the research was conducted, and a discussion of the limitations and lessons learned from using this approach.
The golden goose in the crosshairs: the transition to defined contribution pension plans in the public sector: unintended consequences.
Johnson BR
J Health Hum Serv Adm · 2013 · PMID 23484365
State, county, and local governments are currently facing a myriad of economic issues, based on shrinking tax revenues combined with increased expenditures. Of these, the costs related to defined benefit pension plans ar...
State, county, and local governments are currently facing a myriad of economic issues, based on shrinking tax revenues combined with increased expenditures. Of these, the costs related to defined benefit pension plans are one of the most serious issues facing many public employers. Through a comprehensive review of the existing literature, this article examines how the shift from the defined benefit (DB) to defined contribution (DC) pension plan has the potential to enhance levels of labor unrest due to changes in union militancy, bargaining skills deficits, intra-organizational conflict, and issues related to economic trade-offs. Besides the capacity for immediate and deleterious ramifications in the collective bargaining process, the transition to the DC pension also presents some potentially negative consequences related to human resource management, including changes in the psychological contract, recruitment strategies, employee turnover, and changes in retirement patterns. Recommendations to improve labor relations and human resource management practices in the DC pension environment are also explored.
A call to action: increasing health providers in underrepresented populations through the military.
Harris GL, Lewis EL, Calloway M
J Health Hum Serv Adm · 2012 · PMID 23293808
The state of the nation's health and healthcare disparities looms large and is currently at crisis proportions, so much so, that these issues have been advanced as a national priority. These disparities are known to disp...
The state of the nation's health and healthcare disparities looms large and is currently at crisis proportions, so much so, that these issues have been advanced as a national priority. These disparities are known to disproportionately afflict minorities and disadvantaged groups who become predisposed to certain risks. However, in light of the ever increasing racial and ethnic diversity of the American population, the visible absence of underrepresented minorities (URMs) in the health professions needed to meet these growing needs continues to fuel these crises. The purpose of this paper is thus fourfold. First, to examine the reason (s) for the persistent shortage of underrepresented minorities in the health professions and the associated barriers they encounter in pursuing opportunities in these professions. Second, to determine the degree to which the shortage of URMs contributes to the current state of health and healthcare disparities among certain groups. Third, to identify nontraditional mechanisms like the military as a medium to help increase the number of URMs in the health professions pipeline. Finally, the authors discuss the role of cultural competence as an essential skill set in rendering quality healthcare to minority patients; the strengths and limitations of their findings; and the implications of these findings for future research.
The ups and downs of stem cell research: the impact of policy uncertainty.
Marzotto T, Alt PM
J Health Hum Serv Adm · 2012 · PMID 23293807
Unlike scientists, politicians and the public rarely remain sharply focused on any domestic issue for very long. Without a front page story, a chief executive at the bully pulpit, or an outraged minority, public attitude...
Unlike scientists, politicians and the public rarely remain sharply focused on any domestic issue for very long. Without a front page story, a chief executive at the bully pulpit, or an outraged minority, public attitudes and behaviors about most key domestic problems are short-lived. Anthony Downs has suggested that public policies follow an issue-attention cycle. Our research on the ups and downs of the stem cell debate confirms that public attention wanes when the issue moves off the front page. Public opinion surveys linked with content analysis of national newspapers over a 10 year period confirm that while the scientific community continues to look for a cure, the public no longer expects an instant fix. As public interest in the issue has declined, media coverage is now more about science and less about controversy.
Agenda-building influences on the news media's coverage of the U.S. Food and Drug Administration's push to regulate tobacco, 1993-2009.
Foster C, Thrasher J, Kim SH … +3 more , Rose I, Besley J, Navarro A
J Health Hum Serv Adm · 2012 · PMID 23293806
Citing agenda-building theory, this article examines the influence of three key factors on the news media's coverage of the process of placing tobacco and tobacco products under regulation of the U.S. Food and Drug Admin...
Citing agenda-building theory, this article examines the influence of three key factors on the news media's coverage of the process of placing tobacco and tobacco products under regulation of the U.S. Food and Drug Administration between 1993 and 2009. We analyzed data from a content analysis of 570 news articles from The New York Times and Washington Post and found that the media published significantly more FDA regulation articles during the Clinton administration than during the Bush administration. Our analysis links that imbalance of media coverage to the influence of the president of the United States (Clinton and Bush, during the duration of this study), journalistic routines and real world events. We compared the Clinton and Bush era news coverage on article prominence, article topics, and reasons to support/oppose FDA regulation and found significant differences, which we suggest led to the imbalance of news articles in the two administrations.
Building relationships to strategically impact community initiatives to reduce teen pregnancy.
Clay JA, Sagrestano LM, Finerman R
J Health Hum Serv Adm · 2012 · PMID 23293805
This article explores how researchers can build relationships with community stakeholders to facilitate the establishment of a coordinated and informed community response in the context of teen pregnancy reduction initia...
This article explores how researchers can build relationships with community stakeholders to facilitate the establishment of a coordinated and informed community response in the context of teen pregnancy reduction initiatives. The case study of a Memphis/Shelby County, Tennessee collaborative revolves around a community engagement process founded on four strategies: 1) building policy legitimacy through broad-based participation, 2) seeking funding support for the work of the collaborative, 3) building knowledge of the political landscape, to better identify potential policy champions for the issue, and 4) building a shared understanding of the issue, specifically collecting and discussing reliable data substantiating a community problem and assessing the community's assets and gaps. The article describes the challenge of establishing the policy legitimacy of the problem as well as getting and staying on the public agenda, collecting more segmented information on the target population. A portion of the research effort is funded by the federal demonstration project, from the U. S. DHHS Office of Adolescent Health, Pregnancy Assistance Fund.
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