When Spending Really Is Out of Control
Plus: Progress on Hospital Infections, Another Bunch of Bad Co-Workers, And More
Often, when politicians refer to "out-of-control spending," they're simply talking about spending on programs they don't favor. But the Missouri state auditor's office has written a report that more closely aligns with the kind of thing we consider out-of-control spending. The report revealed that the amount spent by Missouri on its tax credit programs exceeded the amount predicted in fiscal notes by $1.1 billion between 2005 and 2009.
One example: A historic preservation tax credit was supposed to use about $71 million during that period. In fact, the cost was over $600 million. You've got to wonder how an error of that magnitude could be made. The auditor's office suggested that annual and cumulative caps on credits, as well as better ways to analyze credits, could all be helpful to Missouri. Other states should take note.
Here's a way to save lives. Years ago, we excitedly reported about progress that was being made in Pennsylvania at avoiding potentially deadly, hospital-acquired infections by requiring better reporting on the subject. The idea seemed simple. When hospitals had to admit to the numbers of such infections, they were more likely to press doctors and nurses to take steps (as simple as handwashing) to cut down on them.
Now we see that the CDC reports that "central line-associated bloodstream infections dropped by 18 percent overall in 17 states that have mandatory reporting laws in the first six months of 2009 compared with the previous three years. [...] These catheter-related infections kill 31,000 hospitalized patients a year," according to a HealthLeaders Media article.
The article goes on: "Peter Pronovost, MD, medical director of the Center for Innovations in Quality Patient Care at Johns Hopkins University, added that the report's release 'marks a turning point in transparency and accountability for healthcare' with the published results. 'Central line associated bloodstream infections are the polio campaign for the 21st century.'"
Who don't you want to work with? Inspired by GovLoop, a social network for the government community, we asked that question a couple of weeks ago. Your comments continue to flow in, and we'll put together a list of them for you shortly. Meanwhile, just to whet your appetite, here are a few nominees, accompanied by the names of a few contributors brave enough to make them public:
"The Parrot." Someone who repeats everything you say and then makes your boss believe they thought of it first.
— Sunny Israelson, E-Travel manager, Alaska Department of Administration.
"The Pretender." A coworker who invites you to be part of a task force to improve operations (or whatever), gets a lot of great input, reports, etc., but then ends up doing things the way they wanted in the beginning.
— Vicky Moody, nutrition services director, Northeast Health District, Georgia.
"The Obstructionist." An individual who chronically criticizes the work/ideas of others without ever offering a solution.
— Tom McCabe, executive director, Aspen/Pitkin County (Colorado) Housing Authority.
In the same edition of the B&G Report, we discussed city and county fees and the trend to have fees for luxury or extra services. The item ended with the statement, "Residents of all income groups still get a free service from the city."
Thanks to our remarkably careful B&G readers, we can't get away with anything. Ed Jordan, the inspector general of the Florida Department of Education, wrote in to point out the clearly truthful fact that "no service from any government is free — a taxpayer somewhere has to pay for it either with a fee, tax, or payment in some form. There still is no such thing as a free lunch!"
Does your team brainstorm for new and better ideas? Maybe you should reconsider how much emphasis you put on that process. A new Wharton School research paper, which focuses on the private sector, shows that brainstorming with groups may not be the best route to real innovation.
For one thing, some employees will often hold back on offering their best ideas. According to an article about the study in Knowledge@Wharton, an online journal, "Employees might censor themselves to go along with the status quo or to avoid angering a superior. Putting several people in a room together is bound to create a lot of conversation; if everyone contributes, there is less time for individuals to share all of their ideas. Some people may think less critically about a problem because they are happy to let others do the heavy lifting."
Ultimately, the study found, individuals who set out to come up with fresh, new ideas will frequently outdo groups that are given the same task. What's more, researchers found that "a hybrid process — in which people are given time to brainstorm on their own before discussing ideas with their peers" yielded more and better ideas than a purely team-oriented process.
Here are some statistics about what young people want out of a job, from a 2009 survey done by the Partnership for Public Service: Work-life balance (66 percent); being dedicated to a cause (46 percent); feeling secure or stable (46 percent); being competitively or intellectually challenged (40 percent).
What career path do these suggest? Sure sounds a lot like government.
We were reminded of those results by an old friend, Bob Lavigna of the Partnership for Public Services, at the 2010 State Public Health Workforce Summit sponsored by the Association of State and Territorial Health Officials. We'd add that if these attributes don't apply to workers in your government, it's a nice short list of goals.
Our favorite quote this week: "Vision without action is merely a dream. Action without vision just passes the time. Vision with action can change the world."
— Corporate management guru Joel Arthur Barker
Other cities or counties may also be doing this, but we were really impressed when we discovered that Hillsborough County, Florida, is using a blog to get community input about budget questions. In mid-May, for example, the county added a new blog question that focused on the desirability of shifting service delivery to private and non-profit providers. The object is to help further discussion on developing the FY2011 budget by allowing residents to join the discussion. Visitors to the blog can also comment on past questions and read other responses.
Regular readers who recall our interest in civic education will imagine our excitement when we heard about a once-lost, now-rediscovered documentary that follows the construction of a bill and a representative's efforts to pass it in Minnesota. It was produced in 1976 and recently uncovered by the Minnesota Legislative Reference Library. Library Director Robbie LaFleur says: "Many of the scenes and sounds are anachronistic. [...] But the human process of the Legislature that is portrayed is just as real today."
Public Civility Corner. Gail E. Mance-Rios is the deputy director of the Rhode Island Higher Education Assistance Authority. She has some advice for government managers who receive distinctly uncivil e-mails: "While I don't think I have cornered the market on pithy and profound responses to emails dripping with venom, I did find one way to strike a balance. I read the emails in the most upbeat and courteous tone I can muster. There have been times when hearing the message in a different voice (and I don't normally 'hear' voices) sheds some perspective on the issue.
"If that fails, I usually wait 24 hours. In addition, I hand write the response so there won't be any cases of premature sending, we all know how embarrassing that can be. [...] I come from a maternal line of letter writers, so I have learned the craft of literary gamesmanship. Alas, a vanishing art in the world of text messages and IM'ing."