THE PUBLIC ADMINISTRATION OF INTERNATIONAL SOVEREIGNTY

Abstract: Increasingly, the terms occupying centre stage on the policy agenda in many countries are global in reach. Thus they stretch the operational efficiency and suitability of the fabric of the sovereign state to its limits, and beyond. In particular the issue of global environmental change is demonstrating the need to break new ground in terms of institutions and instruments which provide vehicles for the creation and implementation of public policy "beyond the state". This paper explores the evolution of this situation during this century, and considers the institutional responses to the need for broader and broader geographical expressions of sovereignty.     

“I could not have made it without them”: Examining Trainee Cohort Perspectives on MSW Education for Public Child Welfare

This article reports findings from an evaluation of an MSW child welfare training program focused on increasing retention of knowledgeable, competent and experienced child protective service workers. From qualitative data gathered as part of the process evaluation, we found the cohort effect to be the most salient factor participants experienced as contributing to their successful program completion and their 100% retention rate. Analysis of the cohort effect yielded five themes instrumental in participants' individual and collective success: mutual support, empowerment, belief in self and their finding of a home base which ultimately helped them to launch their professional selves.     

Special report on reimbursement. Medicare program abandons 1986 malpractice rule

Hospitals with claims "properly pending" before fiscal intermediaries or in the courts need do nothing in order to obtain corrected reimbursement for fiscal years so pending. However, to speed processing of corrected reimbursements for fiscal years pending in appeals before the PRRB, hospitals should request that the Board determine its jurisdiction and remand to the fiscal intermediary for payment as soon as possible. It will be helpful to include with any such request a copy of the notice of program reimbursement and the original appeal letter for each fiscal year under appeal. Despite the fact that HCFA Ruling 91-1 effectively concedes that HCFA has applied an invalid regulation to all fiscal years since May 1, 1986, HCFA counsel have stated that HCFA will not permit reopening of closed cost reports to correct the inappropriate apportionment of malpractice insurance costs. Nevertheless, hospitals that do not presently have a claim or appeal pending have several options. Under the Provider Reimbursement Manual, HIM-15, sections 2930-2931, fiscal intermediaries are required to reopen cost reports filed within the three-year reopening period to correct errors. Accordingly, should a fiscal intermediary deny a provider's reopening request, the provider should seriously consider taking an appeal to the PRRB. The PRRB's jurisdiction to review fiscal intermediary denials of requests to reopen cost reports was affirmed by the United States Court of Appeals for the Ninth Circuit, see State of Oregon v. Bowen, 854 F.2d 346 (9th Cir. 1988), a decision that is controlling in California, Oregon, Washington, Nevada, Arizona, Montana, Idaho, Hawaii, Alaska, Guam, and the Northern Mariana Islands.(ABSTRACT TRUNCATED AT 250 WORDS)     

Attrition in the RAND Health Insurance Experiment: a response to Nyman

In a prior article in this journal, John Nyman argues that the effect on health care use and spending found in the RAND Health Insurance Experiment is an artifact of greater voluntary attrition in the cost-sharing plans relative to the free care plan. Specifically, he speculates that those in the cost-sharing plans, when faced with a hospitalization, withdrew. His argument is implausible because (1) families facing a hospitalization would be worse off financially by withdrawing; (2) a large number of observational studies find a similar effect of cost sharing on use; (3) those who left did not differ in their utilization prior to leaving; (4) if there had been no attrition and cost sharing did not reduce hospitalization rates, each adult in each family that withdrew would have had to have been hospitalized once each year for the duration of time they would otherwise have been in the experiment, an implausibly high rate; (5) there are benign explanations for the higher attrition in the cost-sharing plans. Finally, we obtained follow-up health-status data on the great majority of those who left prematurely. We found the health-status findings were insensitive to the inclusion of the attrition cases.     

形形色色的诈骗犯

他们可以直视着你的眼睛,赢得你的信任、融化你的心;他们的过去、现在与将来谎话连篇;他们会像我们化妆一样很容易地变换名字与身份.