Helping Medicaid recipients stay out of nursing homes can save huge sums of money for the states and the federal government. Additionally, it can provide a better quality of life for many.
A recent study done by Brown University and published in Health Affairs demonstrates the power of one low-tech means for allowing the elderly to remain in their own homes: expanding programs like Meals on Wheels. According to a release for the study, “if every U.S. state in the lower 48 expanded the number of seniors receiving meals by just 1 percent, 1,722 more Medicaid recipients [would] avoid living in a nursing home.” Many states would see net annual savings from the expansion.
One warning: This isn’t a one-size fits all solution. Only about half the states would actually get savings from this investment. But some 22 would wind up spending more.
We’ve written frequently about the hazards of backlogged maintenance on roads. Generally, we focus on the idea that the cost of remediating roads gets bigger and bigger each year, much like an underpaid credit card. But there’s another factor to be taken into account -- the costs to drivers who use these roads.
According to a recent report by TRIP, a national transportation research group, drivers can pay as much as $800 per year extra when they’re using roads in disrepair. The costs accumulate through vehicle deterioration, increased maintenance, fuel consumption and tire wear.
The five large cities (over 500,000 population) with the highest percentage of pavements in poor condition, according to TRIP: Los Angeles-Long Beach-Santa Ana; San Francisco; San Jose; San Diego and Tucson, Ariz.
Most any public-sector employee can tell you how much he or she gets in his paycheck. But what about benefits? To be sure, people know that their benefits are important, but beyond that do they really understand what they’re receiving?
Virginia is making sure that they do. The state already supplies a "total compensation" statement to employees in executive agencies. Now 2013 legislation ensures that this kind of information will also go out to employees in other parts of state government.
Illinois’ fiscal year 2014 budget gives the impression that this deeply troubled state’s finances are finally beginning to turn the corner. But, according to the Institute for Illinois’ Fiscal Sustainability at the Civic Federation, don’t start throwing confetti and putting on party hats.
Although the current year is allowing the state to cut down on unpaid bills, future years will bring “sharp reductions in revenues and further consequences of the unresolved pension crisis, “reports the Civic Federation.
According to a release, “This year was a lost opportunity as legislators failed to prepare for the extreme financial challenges everyone knows are on the immediate horizon . . . ” said Laurence Msall, president of the Civic Federation.
Engaging government employees is a key to the efficient and effective management of states, counties and cities. It’s also the title of a very useful, recently released book by Robert J. Lavigna. Lavigna has spent several decades involved with public-sector human capital management organizations including the state of Wisconsin, Partnership for Public Service and the U.S. Government Accountability Office. He’s currently director of human resources at the University of Wisconsin-Madison.
One of the main themes of Lavigna’s book is that there isn’t a universal approach to improving employee engagement in government agencies. That said, when we called him and asked about the main drivers of engagement in government, he drew on research that the U.S. Merit Systems Protection Board has done to identify six areas that generally drive engagement in government. These are: Pride in the work or workplace; satisfaction with leadership; opportunities to perform well at work; satisfaction with recognition received; the prospect for future personal and professional growth; and positive work environment with some focus on teamwork.
"I didn't run for mayor to be the caretaker of the status quo." -- Philadelphia Mayor Michael Nutter
As far as we’re concened, Otis White is one of the savviest guys around when it comes to American cities. In his blog, he recently addressed the following question: How can public sector leaders respond when they’re faced with a “wall of civic doubt and negativism?” He began with two things that people shouldn’t do. They follow:
Don’t become part of the problem. Specifically, don’t point fingers at others, don’t blame the community for things that go wrong, and don’t give up. And don’t do the opposite, which is to overpromise. Leaders who promise too much (“we can turn this around in 90 days”) end up digging the cynicism hole even deeper when they fail. If you need a slogan, try this one: “Let’s do what we can.” The Missouri State Auditor, Thomas A. Schweich, recently came out with an audit of the St. Louis Public School District that came down pretty hard on the District. Among the issues raised were faulty purchasing policies and procedures. Additionally, the audit pointed out that the district’s financial condition, though improving, is facing new funding challenges in the future. In less than a year from now, it will have to “propose significant cuts again or seek additional funding.”
The auditor also complained that the district was promoting a number of students, stretching state laws in the process, who would be better academically served by repeating a grade. And here’s how it all ties together: “A district official indicated the district does not have the resources to retain all students not reading at the required grade level, and full compliance would place the district in undue financial hardship.”
Interested in wellness programs? One of the Wisconsin Legislative Reference Bureau's bibliographies has just come out on this topic. It’s remarkably helpful.
A September report from the Virginia Indigent Defense Commission shows an upturn in the turnover rate in the state’s public defender offices. We'd bet that other states and counties are experiencing the same phenomenon.
From the report: "The FY13 rate of turnover was 19.24%. This is an increase from the FY12 turnover rate of 13.44%. (The annual rate in FY11 was 14%, FY10 was 13 % and FY09 was 16%). The spike in the turnover rate could be due to several factors including a marginal amount of recovery in the economy, the lack of state employee salary increases for 5 years, and the absence of a bonus tied to a retention period."