B&G Report: Last-Minute Meetings, Mental Health and Data on Child Deaths

All the public-sector management news you need to know.
by | August 21, 2014

We've frequently made the case that total transparency isn't always a goal to which cities and states should aspire. But a recent ruling from South Carolina's Supreme Court makes us feel like transparency zealots.

In June, according to an article in Statehouse Report, the court decided that government public meeting agendas may not need to be made public. That means that a state or local agency could call a meeting, and then decide -- at the last minute -- to discuss a particularly contentious topic without giving the relevant advocates notice that their issue was coming up.

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There will be more discussion about this in the state legislature in the future. But if the ruling stands, we fear that South Carolina could turn itself into the "gotcha" state.

It’s remarkable to us how many government websites don’t provide phone numbers for individual officials. Many require all contacts be made by e-mailing a general mailbox (and then praying for a response). All sorts of frustrations can ensue from calling a general number. Consider this: We just made a call to a reasonably lofty government official in Indiana. The phone rang, and then we got a recording. The following is precisely what it said:

"Welcome to our voicemail system. You have reached the mailbox of [telephone number]. Thank you for using the voicemail system. Goodbye.”

At that point, it hung up on us. Clearly someone, somewhere, doesn't understand that the point of a voicemail system is to take a message and not to merely affirm its existence without actually providing any service.

New York's governor, Andrew Cuomo, has the pleasant task of spending a $4.2 billion windfall from legal settlements. "We could do more infrastructure, we could do more to invest in education and we could do more to cut taxes," he said, according to the New York Daily News. In addition, the state is considering other options like paying down debt.

We think it's a grand idea to use money for one-shot investments in infrastructure that might even help boost the state's economy. He gets an A for that one. And we find it difficult to argue against putting money into education, assuming that doesn't build up the cost base to an unsupportable degree. We grade that a U for uncertain. As for paying debt? Another A.

But cutting taxes? We live in New York. It would be our taxes that would be cut. But does the governor anticipate that litigation is going to be a steady source of income to make tax cuts supportable over the long term? If not, don't temporarily affordable tax cuts ripple into an uncertain future where they could either be reversed or require cuts in services? What grade does that get? In our opinion, it's the first letter of the the word "fiscal."

Many observers worry that governments risk losing important details on medical care costs if they shift to managed care. A recent report from the U.S. Government Accountability Office highlighted one aspect of this problem: Neither the states nor the federal government have strong data on improper payments in managed care. That's because efforts to track incorrect expenditures are geared to fee-for-service systems. The report also notes that claims data in Medicaid managed care can be difficult to obtain on both the federal and state level.

“People ask the difference between a leader and a boss. The leader leads, and the boss drives.” -- Theodore Roosevelt

Periodically, we run an item in the B&G Report about public-sector leadership, as we believe that’s integral to effective management. But the truth is, we ignore the vast majority of potential items about leadership because they don’t seem as though they’d be genuinely useful to our readers. That’s why we were intrigued by a column in Forbes called, “Three Reasons Why Most Leadership Advice Is Completely Worthless.

The three reasons cited are:

  1. the men and women who are genuinely leading don’t have the time to read lengthy articles about leading,
  2. it rarely comes from people who have actually led, and
  3. leadership can’t be taught via bullet points.

This isn’t to dismiss all the articles, but it does help explain why many aren’t worth the time.

Here's a knotty conundrum -- and we'd be curious to hear your opinions. A couple of weeks ago, according to the News Tribune, the Washington state Supreme Court outlawed the practice of warehousing mentally ill patients in hospital emergency rooms, which don't have the appropriate capacity to help them deal with their problems. They can be in these hospitals for weeks or months until they get treatment in another type of facility. Many of these people have been required by the state, against their will, to be placed in a "treatment" facility.

On the other hand, this Supreme Court ruling doesn’t address the fact that the state isn't providing the resources to provide more appropriate space -- and so will likely put a growing number of people in need on the streets. This isn't the kind of thing that makes pedestrians jump for joy. What's a state to do?

While mental health issues are hardly a new area of concern for government managers, they're emerging as one of the most important topics in state government. There's talk of consolidating mental health services, dealing with inmates' mental health and increasing funding for mental health care and a growing number of access issues from coast to coast.

So if the topic isn't high up on your state's legislative or executive branch list of issues to start addressing now, it would be wise to put it there sooner rather than later.

When demands for social services are great and resources are tight, there's often a push toward risk assessment. It's hard to argue against the notion that money should be spent where it can do the most good. Consider an analysis of child deaths from abuse and neglect in Florida: By providing data about which children are in the most danger, the state can target its services more effectively. Some of the findings of the most recently released report, which covers deaths in the state between 2007 and 2013, include the following: Prior in-home services lower the odds of death by 90 percent; a child's period of greatest risk is between the ages of 0 and 2 (when 75 percent of all maltreatment deaths occur); physical disability increases the odds of death by a multiple of 17; and an intellectual disability increases the odds by 11. The report also has a number of recommendations for improving data collection in order to enhance the usefulness of the information in the future.

And yet more screwy data. There are lots of reports, studies and articles that talk about the benefits to children of half-day and full-day school kindergarten and preschool programs. It’s certainly a worthwhile topic, and there’s plenty of room for good comparisons between programs. But the problem is that most of these programs are divided into one of these groups -- half or full -- without there being any “standard definition within the research or policy community of a half-day or a full-day program,” according to a recent brief by the New America Foundation.

One example from that work is particularly telling. In Missouri, any program is defined as full-time if it's operating at least three hours a day, five days a week or four hours a day, four days a week. But a number of full-day programs offer twice that many hours. In fact, according to the brief, “a half-day program may be 10 or 15 hours a week, while a full-day program may be 20, 30 or even 40 hours -- as much as four times the amount of class time as a half-day program.” This lack of consistency makes fair comparisons impossible. Would using the precise number of hours be so hard?

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