A planning model for needs analysis for subacute care

The purpose of this study is to produce a model to be used by state regulating agencies to assess demand for subacute care. In accomplishing this goal, the study refines the definition of subacute care, demonstrates a method for bed need assessment, and measures the effectiveness of this new level of care. This was the largest study of subacute care to date. Research focused on 19 subacute units in 16 states, each of which provides high-intensity rehabilitative and/or restorative care carried out in a high-tech unit. Each of the facilities was based in a nursing home, but utilized separate staff, equipment, and services. Because these facilities are under local control, it was possible to study regional differences in subacute care demand.^ Using this data, a model for predicting demand for subacute care services was created, building on earlier models submitted by John Whitman for the American Hospital Association and Robin E. MacStravic. The Broderick model uses the "bootstrapping" method and takes advantage of high technology: computers and software, databases in business and government, publicly available databases from providers or commercial vendors, professional organizations, and other information sources. Using newly available sources of information, this new model addresses the problems and needs of health care planners as they approach the challenges of the 21st century. ^

Hazard mitigation element quality in coastal comprehensive plans in a state with strong requirements for hazard mitigation plan elements

This dissertation examines the quality of hazard mitigation elements in a coastal, hazard prone state. I answer two questions. First, in a state with a strong mandate for hazard mitigation elements in comprehensive plans, does plan quality differ among county governments? Second, if such variation exists, what drives this variation? My research focuses primarily on Florida's 35 coastal counties, which are all at risk for hurricane and flood hazards, and all fall under Florida's mandate to have a comprehensive plan that includes a hazard mitigation element. Research methods included document review to rate the hazard mitigation elements of all 35 coastal county plans and subsequent analysis against demographic and hazard history factors. Following this, I conducted an electronic, nationwide survey of planning professionals and academics, informed by interviews of planning leaders in Florida counties. I found that hazard mitigation element quality varied widely among the 35 Florida coastal counties, but were close to a normal distribution. No plans were of exceptionally high quality. Overall, historical hazard effects did not correlate with hazard mitigation element quality, but some demographic variables that are associated with urban populations did. The variance in hazard mitigation element quality indicates that while state law may mandate, and even prescribe, hazard mitigation in local comprehensive plans, not all plans will result in equal, or even adequate, protection for people. Furthermore, the mixed correlations with demographic variables representing social and disaster vulnerability shows that, at least at the county level, vulnerability to hazards does not have a strong effect on hazard mitigation element quality. From a theory perspective, my research is significant because it compares assumptions about vulnerability based on hazard history and demographics to plan quality. The only vulnerability-related variables that appeared to correlate, and at that mildly so, with hazard mitigation element quality, were those typically representing more urban areas. In terms of the theory of Neo-Institutionalism and theories related to learning organizations, my research shows that planning departments appear to have set norms and rules of operating that preclude both significant public involvement and learning from prior hazard events.

A planning model for needs analysis for subacute care

The purpose of this study is to produce a model to be used by state regulating agencies to assess demand for subacute care. In accomplishing this goal, the study refines the definition of subacute care, demonstrates a method for bed need assessment, and measures the effectiveness of this new level of care. This was the largest study of subacute care to date. Research focused on 19 subacute units in 16 states, each of which provides high-intensity rehabilitative and/or restorative care carried out in a high-tech unit. Each of the facilities was based in a nursing home, but utilized separate staff, equipment, and services. Because these facilities are under local control, it was possible to study regional differences in subacute care demand. Using this data, a model for predicting demand for subacute care services was created, building on earlier models submitted by John Whitman for the American Hospital Association and Robin E. MacStravic. The Broderick model uses the "bootstrapping" method and takes advantage of high technology: computers and software, databases in business and government, publicly available databases from providers or commercial vendors, professional organizations, and other information sources. Using newly available sources of information, this new model addresses the problems and needs of health care planners as they approach the challenges of the 21st century.

Process of privatization: Benefits of *reform in management of public housing

The study of the private management of public housing is an important topic to be critically analyzed as the government search for ways to increase efficiency in providing housing for the poor. Public Housing Authorities must address the cost for repairing or replacing the deteriorating housing stock, the increase in the need for affordable housing, and the lack of supply. There is growing pressure on efficient use of public funds that has heightened the need for profound structural reform. An important strategy for carrying out such reform is through privatization. Although privatization does not work in every case, the majority position in the traditional privatization literature is that reliance on private organizations normally, but not always, results in cost savings. ^ The primary purpose of this dissertation is to determine whether a consensus exist among decision-makers on the efficiency of privatizing the management of public housing. A secondary purpose is to review the techniques (best practices) used by the private sector that results in cost-efficiencies in the management of public housing. The study employs the use of a triangulated research design utilizing cross-sectional survey methodology that included use of a survey instrument to solicit responses from the private managers. The study consists of qualitative methods using interviews from key informants of private-sector management firms and public housing agencies, case studies, focus groups, archival records and housing authorities documents. ^ Results indicated that important decision-makers perceive that private managers made a positive contribution to cost-efficiencies in the management of public housing. The performance of private contractors served as a yardstick for comparison of efficiency of services that are produced in-house. The study concluded that private managers made the benefits of their management techniques well known creating a sense of competition between public and private managers. Competition from private contractors spurred municipal worker and management productivity improvements creating better management results for the public housing authorities. The study results are in concert with a review of recent research and studies that also concluded private managers have some distinct advantages to controlling costs in the management of public housing. ^

Performance accountability in the federal-state transportation program: Factors affecting successful implementation

Governmental accountability is the requirement of government entities to be accountable to the citizenry in order to justify the raising and expenditure of public resources. The concept of service efforts and accomplishments measurement for government programs was introduced by the Governmental Accounting Standards Board (GASB) in Service Efforts and Accomplishments Reporting: Its Time Has Come (1990). This research tested the feasibility of implementing the concept for the Federal-aid highway construction program and identified factors affecting implementation with a case study of the District of Columbia. Changes in condition and performance ratings for specific highway segments in 15 projects, before and after construction expenditures, were evaluated using data provided by the Federal Highway Administration. The results of the evaluation indicated difficulty in drawing conclusions on the state program performance, as a whole. The state program reflects problems within the Federally administered program that severely limit implementation of outcome-oriented performance measurement. Major problems identified with data acquisition are: data reliability, availability, compatibility and consistency among states. Other significant factors affecting implementation are institutional barriers and political barriers. Institutional issues in the Federal Highway Administration include the lack of integration of the fiscal project specific database with the Highway Performance Monitoring System database. The Federal Highway Administration has the ability to resolve both of the data problems, however interviews with key Federal informants indicate this will not occur without external directives and changes to the Federal “stewardship” approach to program administration. ^ The findings indicate many issues must be resolved for successful implementation of outcome-oriented performance measures in the Federal-aid construction program. The issues are organizational and political in nature, however in the current environment resolution is possible. Additional research is desirable and would be useful in overcoming the obstacles to successful implementation. ^

The impact of the Miami Cuban exile's political culture on the 1996 fiscal crisis of the city of Miami

The purpose of this study was to determine if the political culture of the Miami Cuban exile community was a significant factor in creating the environment that led to the 1996 fiscal crisis of the City of Miami. The study performed an ethnographic case study that utilized a triangulation strategy which included both qualitative and quantitative methods. Focus groups were conducted to ascertain qualitative and quantitative data as to differences among ethnic and generational groups regarding notions of governance, public administration practices, and overall political values and core beliefs. Quantitative data was obtained through a five year and seven month review of newspaper articles from two periodicals based in Miami-Dade County. A review was also conducted of secondary data in audit and management reports, blue ribbon commission studies, Certified Public Manager (CPM) enrollment, and legal case decisions to examine the administrative practices of the City of Miami leading up to and subsequent to its fiscal crisis. The study found that a political subculture of caudillismo was present in Cuban exile core areas of Miami that appears to have had an influence on the administrative practices and notions of governance that led to the fiscal crisis. The author concludes that an imported foreign political culture has imposed itself as a subculture in core areas of the exile community and that the operationalization of this subculture has manifested itself in non-mainstream notions of governance and public administration practices. ^

Fiscal and organizational determinants of transportation outcomes: A quantitative and qualitative analysis of sustainability factors

Federal transportation legislation in effect since 1991 was examined to determine outcomes in two areas: (1) The effect of organizational and fiscal structures on the implementation of multimodal transportation infrastructure, and (2) The effect of multimodal transportation infrastructure on sustainability. Triangulation of methods was employed through qualitative analysis (including key informant interviews, focus groups and case studies), as well as quantitative analysis (including one-sample t-tests, regression analysis and factor analysis). ^ Four hypotheses were directly tested: (1) Regions with consolidated government structures will build more multimodal transportation miles: The results of the qualitative analysis do not lend support while the results of the quantitative findings support this hypothesis, possibly due to differences in the definitions of agencies/jurisdictions between the two methods. (2) Regions in which more locally dedicated or flexed funding is applied to the transportation system will build a greater number of multimodal transportation miles: Both quantitative and qualitative research clearly support this hypothesis. (3) Cooperation and coordination, or, conversely, competition will determine the number of multimodal transportation miles: Participants tended to agree that cooperation, coordination and leadership are imperative to achieving transportation goals and objectives, including targeted multimodal miles, but also stressed the importance of political and financial elements in determining what ultimately will be funded and implemented. (4) The modal outcomes of transportation systems will affect the overall health of a region in terms of sustainability/quality of life indicators: Both the qualitative and the quantitative analyses provide evidence that they do. ^ This study finds that federal legislation has had an effect on the modal outcomes of transportation infrastructure and that there are links between these modal outcomes and the sustainability of a region. It is recommended that agencies further consider consolidation and strengthen cooperation efforts and that fiscal regulations are modified to reflect the problems cited in qualitative analysis. Limitations of this legislation especially include the inability to measure sustainability; several measures are recommended. ^

Private higher education policy in Ohio, 1980--2006: A case study demonstrating the usefulness of Zumeta's public policy posture model

This study describes the case of private higher education in Ohio between 1980 and 2006 using Zumeta's (1996) model of state policy and private higher education. More specifically, this study used case study methodology and multiple sources to demonstrate the usefulness of Zumeta's model and illustrate its limitations. Ohio served as the subject state and data for 67 private, 4-year, degree-granting, Higher Learning Commission-accredited institutions were collected. Data sources for this study included the National Center for Education Statistics Integrated Postsecondary Data System as well as database information and documents from various state agencies in Ohio, including the Ohio Board of Regents. ^ The findings of this study indicated that the general state context for higher education in Ohio during the study time period was shaped by deteriorating economic factors, stagnating population growth coupled with a rapidly aging society, fluctuating state income and increasing expenditures in areas such as corrections, transportation and social services. However, private higher education experienced consistent enrollment growth, an increase in the number of institutions, widening involvement in state-wide planning for higher education, and greater fiscal support from the state in a variety of forms such as the Ohio Choice Grant. This study also demonstrated that private higher education in Ohio benefited because of its inclusion in state-wide planning and the state's decision to grant state aid directly to students. ^ Taken together, this study supported Zumeta's (1996) classification of Ohio as having a hybrid market-competitive/central-planning policy posture toward private higher education. Furthermore, this study demonstrated that Zumeta's model is a useful tool for both policy makers and researchers for understanding a state's relationship to its private higher education sector. However, this study also demonstrated that Zumeta's model is less useful when applied over an extended time period. Additionally, this study identifies a further limitation of Zumeta's model resulting from his failure to define "state mandate" and the "level of state mandates" that allows for inconsistent analysis of this component. ^

The impact of Round II Urban Empowerment Zones on local communities

In the United States, the federal Empowerment Zone (EZ) program aimed to create and retain business investment in poor communities and to encourage local hiring through the use of special tax credits, relaxed regulations, social service grants, and other incentives. My dissertation explores whether the Round II Urban EZs had a beneficial impact on local communities and what factors influenced the implementation and performance of the EZs, using three modes of inquiry. First, linear regression models investigate whether the federal revitalization program had a statistically significant impact on the creation of new businesses and jobs in Round II Urban EZ communities. Second, location quotient and shift-share analysis are used to reveal the industry clusters in three EZ communities that experienced positive business and job growth. Third, qualitative analysis is employed to explore factors that influenced the implementation and performance of EZs in general, and in particular, Miami-Dade County, Florida. The results show an EZ's presence failed to have a significant influence on local business and job growth. In communities that experienced a beneficial impact from EZs, there has been a pattern of decline in manufacturing companies and increase in service-driven firms. The case study suggests that institutional factors, such as governance structure, leadership, administrative capacity, and community participation have affected the effectiveness of the program's implementation and performance.

The Influence of HOPE VI Public Housing on Public Schools

In the United States, public school enrollment is typically organized by neighborhood boundaries. This dissertation examines whether the federally funded HOPE VI program influenced performance in neighborhood public schools. In effect since 1992, HOPE VI has sought to revitalize distressed public housing using the New Urbanism model of mixed income communities. There are 165 such HOPE VI projects nationwide. Despite nearly two decades of the program’s implementation, the literature on its connection to public school performance is thin. My dissertation aims to narrow this research gap. There are three principal research questions: (1) Following HOPE VI, was there a change in socioeconomic status (SES) in the neighborhood public school? The hypothesis is that low SES (measured as the proportion of students qualifying for the Free and Reduced Lunch Program) would reduce. (2) Following HOPE VI, did the performance of neighborhood public schools change? The hypothesis is that the school performance, measured by the proportion of 5th grade students proficient in state wide math and reading tests, would increase. (3) What factors relate to the performance of public schools in HOPE VI communities? The focus is on non-school, neighborhood factors that influence the public school performance. For answering the first two questions, I used t-tests and regression models to test the hypotheses. The analysis shows that there is no statistically significant change in SES following HOPE VI. However, there are statistically significant increases in performance for reading and math proficiency. The results are interesting in indicating that HOPE VI neighborhood improvement may have some relationship with improving school performance. To answer the third question, I conducted a case study analysis of two HOPE VI neighborhood public schools, one which improved significantly (in Philadelphia) and one which declined the most (in Washington DC). The analysis revealed three insights into neighborhood factors for improved school performance: (i) a strong local community organization; (ii) local community’s commitment (including the middle income families) to send children to the public school; and (iii) ties between housing and education officials to implement the federal housing program. In essence, the study reveals how housing policy is de facto education policy.