Interlocal Collaboration and Local Fiscal Structure: Do State Incentives Matter?

Interlocal collaboration is considered an important tool for cost-saving. States, therefore, have incentivized interlocal collaboration in different ways. To understand the budgetary consequences of interlocal collaboration and state incentives, we examine counties in Nebraska where the State uses two incentive mechanisms—resource restrictions and additional access to restricted revenues granted to counties with collaboration. This study finds that county expenditures are lower when they spend more through collaboration. While this lower spending is related to lower revenues in counties less constrained by state restrictions, the results for counties more constrained are unclear. State incentive structures may matter for such variations.     

Power in Aggressor-Victim Relationships: Exploring Social,Physical, Gender- and Ethnicity-Based Power

Journal of Youth and Adolescence - Theory highlights power in aggressor-victim relationships, yet empirical work assessing dyadic power is largely absent. Variability in power balance versus...     

Performing Regulation: Transcending Regulatory Ritualism in HIV Clinics

Sociolegal scholars suggest that regulatory encounters often are occasions for displaying a surface compliance decoupled from day‐to‐day practice. Yet ethnographic data from five highly regulated HIV clinics show that regulatory encounters open opportunities both for ritualism and—surprisingly—for transcending ritualism. Using a theatrical analogy, we argue that improv performance is the technology that enables regulatory inspectors and clinic staff to transcend ritualism. As regulatory encounters unfold, clinics' carefully prepared performances sometimes change into more cooperative interactions where inspectors and regulatees hash out details about how rules will be applied and even work together on reports for the regulators' supervisors. By “performing together,” regulatory inspectors gain access to the clinic's backstage where they can assess clinic workers' deeper conformity to ethical and scientific norms. But such joint performances are less likely where cultural divides and material scarcity make it difficult for clinic staff to gain inspectors' trust.     

Political strategies for hi-tech development:the case of a university-related research park

The development of a research park at The University of Connecticut has been frustrated for a decade by a series of bureaucratic and political obstacles. Problems associated with contracting out to a private developer and using a mixed implementation model, the regulatory reviews by state agencies, and the role of local authorities have been compounded by adoption of multiple objectives and the intervention of exogenous factors. Plural actors and polylateral political relationships restrict the university's ability to control and guide the project and to achieve the desired benefits. Among the many lessons drawn from the case are the need for careful design of the developmental model, realistic political assessments and economic analyses, and recognition that such projects require time measured in decades before they are likely to succeed.     

The Continuing Evolution of Medicare Hospice Policy

This case study traces the creation and evolution of Medicare hospice policy. The Medicare hospice benefit, created in 1982, emphasizes palliative rather than curative care. It focuses on quality of life for the dying patient and family and encompasses medical, psychological, and spiritual care. Because no standard hospice care practices existed before this benefit was implemented, Medicare rules almost exclusively dictated the structure and delivery of services. Despite initial concerns about low use, spending averaged 17 percent per year between 1991 and 2001, largely driven by increased enrollment, covered days, services provided, and inflation. A rich accumulation of research studies and analyses of specific aspects of the hospice program provides an opportunity for a retrospective analysis of the program's genesis, impact on health care delivery, and implications for future policy decisions.