GRADUAL PHASE DOWN
MAJOR IMPACTS DELAYED 2-3 YEARS
CAPS
INCREASED FLEXIBILITY FOR STATES AND LOCAL GOVERNMENTS
BLOCK GRANTS
WAIVERS (of almost anything)
PERFORMANCE PARTNERSHIPS
REDEFINING OF ENTITLEMENTS
COST SHARING
CONTINUED EXPERIMENTATION
STATE AGENCY REORGANIZATION AND CONSOLIDATION
MEGA AGENCIES
ONE STOP SHOPPING
SERVICE/FUNDING INTEGRATION
ELIMINATION OF STATE MERIT SYSTEM
CONSOLIDATION OF SERVICES AROUND "FUNCTION": WORK, CHILDREN & FAMILIES, "NEEDY"
WORK GROUPS, COMMISSIONS, "BLUE RIBBON" PANELS (LEGISLATIVE OR OTHER)
STATE BUDGET CONTRACTION
STATE TAX CUTS (FOOD SALES, CORPORATE)
GROWING EMPHASIS STATE "RESERVE" FUNDS
CUT/"FREEZE" IN STATE EMPLOYEE POSITIONS
NO COMMUNITY SERVICE EXPANSION
LARGE, GROWING WAITING LISTS
CLOSURE OF LARGE FACILITIES (MONEY, PEOPLE SHIFTED: BUT WHERE?)
PUBLIC AGENCY/SCHOOL FUND-RAISING IN COMPETITION WITH TRADITIONAL CHARITIES
MANAGED HEALTH CARE FOR ALL OF US
FUNDING CAPS, OUTCOME MEASURES
COSTS DRIVING DECISION—MAKING
HEALTH/ACUTE CARE: POOR WOMEN & CHILDREN, ELDERLY & PEOPLE WITH DISABILTIES
LONG TERM HEALTH/BEHAVIORAL CARE: ELDERLY & PEOPLE WITH DISABILITIES
EMERGING ROLE OF INSURANCE COMMISSIONERS
RISK SHARING BY PROVIDERS
"MANAGED CARE" PRINCIPLES APPLIED TO HUMAN SERVICES
CAPITATION RATES
OUTCOME MEASURES
PHASE OUT "FEE FOR SERVICE"
PERFORMANCE CONTRACTS/ACCOUNTABILITY
DECENTRALIZATION OF STATE GOVERNMENT
PRIVATIZATION OF GOVERNMENT FUNCTIONS
MERGERS, NETWORKS, ALLIANCE FORMING
FOCUS ON PURCHASING AND MONITORING ACTIVITIES
CONTRACTING OUT GOVERNMENT PLANNING
MARKET ECONOMY/COMPETITION
CUSTOMER CHOICE
VOUCHERS
PERFORMANCE CONTRACTS / ACCOUNTABILITY
POWER STRUGGLES / TENSION POINTS IN STATES
STATE VS COUNTY OR REGIONAL (AREA) AUTHORITIES
AMONG STATE AGENCIES (E.G., DEPARTMENT OF HUMAN SERVICES - MEDICAID AGENCY)
GOVERNOR VS STATE LEGISLATURE
CENTRALIZATION VS DE-CENTRALIZATION OF DECISION-MAKING
LARGE VS SMALL
PRIVATE VS PUBLIC
NON-PROFIT VS FOR-PROFIT
WINDOWS OF OPPORTUNITY ABOUND WITHIN THE TURBULENCE
TIMING IS CRUCIAL
COLLABORATION IS ESSENTIAL
UCPA, ITS AFFILIATES AND CUSTOMERS MUST...
BUILD ON OUR VALUES
BE PROACTIVE
THINK STRATEGICALLY
LET GO OF THE PAST
EDUCATE OURSELVES AND OTHERS
ORGANIZE AT GRASSROOTS LEVEL
UTILIZE THE MEDIA
This document came to the AACS in March 1997 through AACS Head Start Family Services Coordinator Tami Canter-Powell. She received it through her work on the Partners In Policy Making leadership advovacy group. The group is engaged in a training seminar offered under the auspices of the Kentucky Disabilities Council.
We at Audubon believe Mr. Bergman is quite accurately stating the trends affecting human services delivery now and in the forseeable future.
AACS World Wide Web Pages