Difference between revisions of "Intergovernmental Management"

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Federal programs administered through the states and local governments and state programs carried out by local governments must be managed cooperatively. The process of managing programs involves officials working to solve problems that combine legal, technical, political, and project tasks.
 
Federal programs administered through the states and local governments and state programs carried out by local governments must be managed cooperatively. The process of managing programs involves officials working to solve problems that combine legal, technical, political, and project tasks.
  
Most domestic programs are administered through intergovernmental means in the U.S. federal system: federal-state-local, state-local, and local-local. They also employ nongovernmental organizations. The process of managing across jurisdictional boundaries is called “intergovernmental management” (IGM) by professionals and academics. IGM is the process of solving problems across the boundaries of jurisdictions that interrelate legal, political, technical, and project-related tasks in making programs work. The functions and processes of IGM are normally practiced by elected and appointed administrative officials, although on occasion legislative officials become involved in the processes of facilitating projects or clarifying policy aims.
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Intergovernmental management (IGM) has become an integral practice in federal systems as they increasingly broaden general government programs to include constituent governments (provinces, states, regions), local governments and special districts, as well as by externalization through nonprofit and for profit organizations, primarily by contracting. Today myriad-like complex boundary-spanning actions involve the affairs between federal governments and their constituent partners in various working dynamics. In its overlapping functions and complexities IGM can be thought of as involving four analytical frameworks: 1) the application of law and politics; 2) operations involving deepening jurisdiction interdependencies; 3) governments’ externalized policy making and service delivery; and, 4) networking and formal networks representing multiple organizations or parts of them working together to accomplish joint tasks.  
  
=== INTERGOVERNMENTAL INSTRUMENTS ===
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These activities take place to some degree within the tiers of governments of federal systems and in federalizing systems. For example, in the Netherlands which is not federal, IGM takes place between the state and provinces, municipalities, and special boards (water, planning, environment, transport). In federalizing Spain, the central government in Madrid interacts and transacts with its seventeen regions or Autonomous Communities, along with provinces, comarcas (intermunicipal service districts), mancomunides (also municipal service districts), municipalities, public-private joint ventures, and submunicipal neighborhood councils. In the United States IGM includes the federal government, the states and territories, state-created substate planning districts, federally established substate units (transportation, emergency management), counties, special intermunicipal districts, school districts, municipalities and town and townships (rural). Connections between these entities are regularly at work managing  intergovernmental relations (IGR) in systems where practice involves overlapping as opposed to hierarchical authority.  
The management of programs almost always entails actions relating to the more common “action instruments” of intergovernmental relations. They are listed in Figure 1, classified by whether they are primarily economic, legal, administrative, or political in nature. Of the twenty-four actions illustrated, the most prevalent are related to grants, audits, tax policies, loans, regulation, intergovernmental agreements, basic laws, program standards, and intersectoral networks and councils.
 
  
=== PROGRAM MANAGEMENT ===
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As a result of increasing federal growth and complexity, IGM in countries like the U.S. is a product of federal development among the four core IGM features – law and politics, unit interdependency (including NGOs), government-NGO partnerships, and interconnected networks and networking. At the same time the various government agencies remain as viable, authoritative bodies, indeed as key players. Today governments are part of complex adaptive systems that incorporate interoperable systems that are increasingly digitized and employing open-source technology. Also, IGM systems are faced with the latest technical support in collaborative management (e.g., artificial intelligence).  
Three brief examples of managing programs illustrate the heavy involvement of administrative officials in programming within American federalism. First, a city wishes to preserve a historic three-square-block area near its central business district. It must first go through a federally required and state government–managed process of designation, which entails citizen hearings, financial feasibility studies, cost estimates for restoration, a plan of use, and ultimately a city council ordinance. If approved, the area is designated on the National Register of Historic Places. This allows building owners involved in rehabilitating their property to qualify for tax credits. After designation, the city can help developers qualify for state and federal funds and low-interest loans. There will follow numerous other contacts and negotiations to actually restore the buildings and arrange use.
 
  
Second, a county government is trying to attract a high-technology business within its borders. It will try to leverage some of its own money to gain resources from several federal and state programs. It could access U.S. Economic Development Administration funds to help with the land purchase, use Community Development Block Grants funds to pay for part of the construction, adopt an ordinance to use state-authorized/supervised tax increment financing (a program that devotes future tax increases to improvements) to pay for site improvement and infrastructure, secure state venture capital funds as a partial investment in the company, access U.S. Department of Labor funds for workforce training, and secure road improvement money from federal and state highway funding streams. Each of these efforts will require extensive work in making applications, negotiating with state/federal officials over purposes and details, seeking approvals from the county council and the potential investor, holding public hearings, and meeting a host of funding and program requirements.
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The multifaceted process of managing federal programs can be illustrated by examining a program that affects every citizen, that of ensuring that a healthy drinking water supply is available. The [[Safe Drinking Water Act of 1974|U.S. Safe Drinking Water Act]] (SWDA) of 1974 expanded the federal role in monitoring and standard setting to protect human health and the regulation of water supplies. The program delegates inspection and enforcement to the states, and some states have further delegated authority to local governments. States are required to have programs that include statutory and regulatory enforcement authority adequate to ensure compliance, a system of conducting inspections of public water supply systems (sanitary surveys), a process to certify laboratories that test for contaminants, and management provisions. The U.S. Environmental Protection Agency (EPA) pays around three-quarters of these programs’ operating costs, which includes a loan program for improvement of facilities. Most important is the requirement in the Act for the EPA to issue standards for any contaminant that may have an adverse effect on human health and that is known to occur in public drinking water supplies. In these ways IGM reaches through the entire federal system.
  
'''FIGURE 1. Action Instruments of Intergovernmental Relations'''
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The U. S. Medicaid program also demonstrates the core aspects of IGM. Title XIX of the [[Social Security Act of 1935|Social Security Act]], funds health care for the poor (also low income elderly, disabled persons). In terms of expenditures, it is the largest single intergovernmental program in the United States. This federal-state program involves the federal government setting minimum requirements for state provided benefits, eligibility, the reimbursement of health care providers, and for establishing administrative rules that states must follow. States, if they choose to fund them, may expand the services and populations eligible for the program. Each year the states must file and then negotiate a “state plan” relating to how they intend to operate their programs. The plan involves literally thousands of administrative details that are subject to interpretation, and in recent years several different kinds of “waivers” or excepted actions that permit states to fund services that would not otherwise be allowed, as well as a few dozen “assurances” that certain cross program federal standards are to be met.
{| class="wikitable"
 
|-
 
| 1. Economic Devices
 
* Grants or subventions (general revenue/unrestricted, broad/bloc, targeted/categorical)
 
* Fiscal audits
 
* Tax policies (reciprocal taxation schedules, tax abatements/forgiveness, tax sharing, tax transfers, tax cession)
 
* Intergovernmental loans
 
* Shared (with private sector and other governments) capital projects and investments, shared venture capital investments
 
* Intergovernmental fiscal study/equalization commissions
 
* Procurement of goods, services, and/or personnel from other governments
 
2. Legal Approaches
 
* Intergovernmental regulation (program requirements, crossover rules, crosscutting requirements), executive orders, direct regulation, partial preemption, total preemption by higher level government
 
* Cooperative agreements to jointly operate a program (e.g. health statistics, emergency management, and internal security)
 
* Intergovernmental agreements (e.g. joint fire services, combined libraries, special education cooperatives, and mutual aid for police emergencies)
 
* Interdependent legal actions (joint environmental action, joint workplace regulation, and joint income tax format agreements)
 
* Basic laws on governmental structure, local taxation, local civil service, local powers
 
3. Administrative Practices
 
* Program standards and requirements
 
* Contracts for services/programming between governments
 
* Exchange of personnel
 
* Program audits (look behind reviews)
 
* Regional/metropolitan governments or special authorities
 
* Negotiated performance programs (in lieu of controls and requirements)
 
4. Political/Government Bodies
 
* Intersectoral/intergovernmental networks and councils
 
* Councils of governments (regional, metropolitan)
 
* Intergovernmental associations (municipalities, counties, mayors, local councils, and local civil service unions)
 
* Intergovernmental lobbying/representation
 
* Elected official to elected official contacts
 
* Political party channels
 
|}
 
 
 
Third, the Medicaid program, Title XIX of the Social Security Act, funds health care for the poor. In terms of expenditures, it is the largest single intergovernmental program in the United States. This federal-state program involves the federal government setting minimum requirements for benefits, eligibility, and the reimbursement of health care providers, and establishing administrative rules that states must follow. States can then expand on the minimum requirements in regard to eligibility and services funded if they wish. Each year the states must file and then negotiate a “state plan” relating to how they intend to operate the program. The plan involves literally thousands of administrative details that are subject to interpretation, and in recent years several different kinds of “waivers” or excepted actions that permit states to fund services that would not otherwise be allowed, as well as a few dozen “assurances” that certain crossprogram federal standards are met. During the plan year, state officials will engage in literally thousands of inquiries, subagreements, contracts, and informational transactions with local government and medical vendors, as well as with federal officials. Also, pages and pages of fiscal and program reporting will be collected. Finally, some two years or so after plans have been executed, the paper reporting will be audited by other federal officials. While the proportion of Medicaid spending on administration is quite small compared to its very large budget, no one has been able to estimate the cost impact of the paperwork burden or the extensive administrative time up and down the line that this program takes.
 
 
 
=== WATER QUALITY MANAGEMENT TASKS: LEGAL, TECHNICAL, POLITICAL, AND PROJECT ===
 
The multifaceted process of managing federal programs can be illustrated by examining one program that affects every citizen, that of ensuring that a healthy drinking water supply is available. The U.S. Safe Drinking Water Act (SWDA) of 1974 expanded the federal role in monitoring and standard setting to protect human health and the regulation of water suppliers. The program delegates inspection and enforcement to the states, and some states have further delegated authority to local governments. States are required to have programs that include statutory and regulatory enforcement authority adequate to ensure compliance, a system of conducting inspections of public water supply systems (sanitary surveys), a process to certify laboratories that test for contaminants, and other management provisions. The U.S. Environmental Protection Agency (EPA) pays around three-quarters of the costs of operating these programs, which includes a loan program for improvement of facilities. Most important for this illustration is the requirement in the act for the EPA to issue standards for any contaminant that may have an adverse effect on human health and that is known to occur in public drinking water supplies.
 
 
 
The legal issues involved are the published revisions of the Arsenic Rule in 2001 and the Drinking Water State Revolving Fund established in 1996 under amendments to SWDA. The EPA changed the Arsenic Rule from 50 parts per billion (ppb) to 10 ppb after the National Academy of Science concluded that the old level could not protect against nonfatal and fatal bladder and lung cancers and that the new level will reduce the frequency of other health effects such as diabetes, developmental problems, gastrointestinal illness, and heart disease. The rule applies to community and nontransit noncommunity water systems, 97 percent of which are small systems that serve fewer than 10,000 persons. Clearly the greatest challenge will be to help very small water systems overhaul or convert their systems at costs that will not be excessive financial burdens on their small customer bases.
 
 
 
Technically it means that over 3,000 community and 1,100 nontransit noncommunity systems have to overhaul their systems, the majority of which serve 500 or fewer users. Fortunately, several technologies are 90–95 percent effective, for example, modified lime softening, modified coagulation/filtration, coagulation-assisted microfiltration, oxidation filtration, and others. Some water suppliers are consolidating into larger systems or are finding new water sources. The total cost for investments in these treatment technologies is estimated to be about $900 million plus an additional $120 million in operating costs. Most states have begun to address the issue of small-system compliance with the Arsenic Rule, along with such other rules as one for uranium, by accelerating inspections and by devoting portions of their Revolving Loan Funds to upgrade small systems. In addition, other funding sources (mostly loans) are available: the U.S. Department of Agriculture/Rural Development, state-administered Community Development Block Grant funds (small cities), the Economic Development Administration, and state water resources programs. Grants or loans in some combination are available through one or more of these sources to assess water system needs, to procure an engineer’s report, and to introduce new technologies.
 
  
The political process in small communities begins with finding a local official who is willing to take the lead in orchestrating the process. Most often it is the mayor, or it could be the city clerk, who may be the only full-time official. In others it might be a council member who “volunteers” to take on this administrative process. In larger cities it would be the city administrator or city manager, working along with the city engineer. Whoever leads the political process, it begins with contacting people in the state environmental agency to learn about the process and requirements, and to learn what steps need to be taken. In some states the different funding sources meet together to help smaller communities work the different sources. At this point the city will learn about the key role of hiring a consulting engineer, who will have to prepare reports and plans. The local official taking the lead will have to go back to the community and convince the city council to pass an ordinance putting the process of securing an engineering report and construction/treatment plan in motion. Normally a prior notification public hearing/meeting must also be held to seek public input on all available options, siting issues, environmental impacts, and costs. If the water system is to be consolidated with other systems either by clustering nearby communities or by establishing a new regional water system, then extensive political negotiations with other communities will ensue. After all of this processing, the local lead official can prepare applications for project funding.
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During each planning year, state Medicaid officials engage in literally thousands of inquiries, subagreements, contracts, and informational transactions with local governments and medical vendors, as well as with federal officials. Also, pages and pages of fiscal and program reporting will be collected. Finally, some two years or so after plans have been executed, the paper reporting will be audited by other federal officials. While the proportion of Medicaid spending on administration is relatively small compared to its very large budget, no one has been able to estimate the cost impact of the paperwork burden or the extensive administrative time up and down the line that this program takes. It is “quintessentially IGM” with all of its audits, rules, standards, jurisdictions, vendors, etc.  
  
The extensive project-related managerial activities then prevail over this Arsenic Rule process. The state agency receives the application that includes community financial data and the engineering consultant’s report (which can be paid for by small grants). The report is reviewed for three basic concerns: feasibility of the user charge system to repay loans, city financial capability, and the environmental assessment review. The engineering report is also separately reviewed. When all reports are acceptable (and the thirty-day hearing is held), planning and design are approved. Then the process involves fee review and technical review of health effects by the state, and all federal cross-program assurances are checked. After any necessary revisions are negotiated, an approval letter for construction is issued. At this point the community must pass what is normally a routine loan authorizing resolution(s) or bond ordinance through its council if the existing revenue debt obligates the water rate. Then the loans from the various sources mentioned earlier are transacted and closed. At this point, which can take from three to six months, the community can open bids for construction. The construction phase finalizes the project, which will have a similarly involved sequence orchestrated by some manager and including the consulting engineer, city attorney, and city council/village board.
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<p>
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</p>
  
=== MANAGERS IN THE HORIZONTAL AND VERTICAL SYSTEM ===
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=== Managers in the Horizontal and Vertical System ===
Managers do more than talk on the phone, e-mail, or make personal contacts when they are working on programs within the federal system. Figure 2, taken from Agranoff and McGuire’s ''Collaborative Public Management'' (2003) study of city economic development, lists twenty-one distinct type of IGM practices. They are both vertical (that is, those devices used for working with state and federal governmental officials) and horizontal (working with other local governments, NGOs, and the private sector). The vertical IGM instruments are of two types, those that try to make some form of adjustment within the system within the boundaries of the policy intent of programs and those designed to determine information or joint understandings. The horizontal instruments either serve particular investment projects or help develop or maintain networks of officials. The frequency of these actions, of course, varies from jurisdiction to jurisdiction, but all twenty-one activities are regular instruments used by managers. In sum, these are the instruments used to coordinate programs—that is, to help make programs work within a given situation.
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Managers do more than talk on the phone, e-mail, or make personal contacts when they are working on applying and adjusting programs within the federal system. Figure 1, taken from Agranoff and McGuire’s Collaborative Public Management (2003) study of city economic development, identifies twenty-one distinct types of IGM practices. They are both vertical (that is, those devices used for working with state and federal government officials) and horizontal (working with other local governments, NGOs, and the private sector). The vertical IGM instruments are of two types: those that try to make some form of adjustment within the system within the boundaries of the policy intent of programs; and those designed to determine information or joint understandings. The horizontal instruments either serve particular investment projects or help develop or maintain networks of officials. The frequency of these actions, of course, varies from jurisdiction to jurisdiction, but all of these activities are regular instruments used by managers. In sum, these are the instruments used to coordinate/manage programs across lines– that is, to help make programs work within a given situation.
  
'''FIGURE 2. Intergovernmental Management Practices'''
 
 
{| class="wikitable"
 
{| class="wikitable"
 
|-
 
|-
Line 73: Line 31:
 
| Structural design (horizontal) || Development and maintenance of organizations or networks for program design and implementation || Engage in joint policy making; Seek policy-making assistance; Consolidate policy effort; Contracted planning or implementation; Employ joint financial incentives; Access technical resources
 
| Structural design (horizontal) || Development and maintenance of organizations or networks for program design and implementation || Engage in joint policy making; Seek policy-making assistance; Consolidate policy effort; Contracted planning or implementation; Employ joint financial incentives; Access technical resources
 
|}
 
|}
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'''FIGURE 1. Intergovernmental Management Practices'''
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The interactive strategies in Figure 1 demonstrate that many actors potentially hold sway over the IGM process. Policy and program implementation involves many actors and opportunities to adapt, adjust and apply programs in different ways. Pressman and Wildavsky’s notable study, Implementation, reveal the myriad steps, negotiations and trade-offs in a single economic development program. There is more. Reed (2014) has introduced the implementation practice of "operational localism,” in his research in educational policy, where the various forces of local politics combined with technical and managerial forces to constrain local ability and willingness to respond to certain federal directives. In education, he called these forces as leading to a “hybrid education state.”
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Another step to consider are the discretionary adjustment actions by “street level bureaucrats,” police officers, welfare case workers, teachers, license examiners, whose discretion is “shared” at the most basic, thus the street level. The rules and standards rarely cover all situational circumstances. At this stage of policy implementation, many and differing moral dilemmas open up well beyond any standards of efficiency by those who mediate between the state and society. As a result, front line workers regularly make “street level” decisions that affect policy (Zacka 2017). Thus IGM involves quite a long chain of actors in application.
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IGM has both its direct and indirect features. Its direct features are more visible and include grant/contract proposals, award letters, legal prohibitions, standards, requirements, assurances, audits and monitoring, and formal reporting. In managerial action, IGM is indirect. It was once identified by Rosenthal, as “indirect” with four distinct conditions:
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<UL><UL>
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<LI>Partial accountability – program delivery requires that state or local (NGO, public or private) agencies be partially but not fully accountable to a federal (and/or state) agency.
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<LI>Mixed objectives – those who are responsible for some aspect of the program are likely to differ, in some important respects, on the program objectives.
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<LI>Continuity – programs are likely to continue, as opposed to some one-time project.
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<LI>Interorganizational activity – involves mechanisms developed for exchanging resources, information, and authority across formal organizational boundaries.
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</UL></UL>
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Indeed, these reciprocal administrative actions and transactions are particularly reflective of the U.S. and other federal situations, coupled with localism and the absence of a large federal bureaucratic presence.
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IGM is also an emergent feature known in many countries as executive [[federalism]], that involves joint working sessions between central and state/provincial/conferences to negotiate and settle finance and other policy issues. It is a common aspect in Canada, South Africa, Australia, India, and Malaysia. Australia also employs a Council of Australian Governments, that includes local governments, and a discussion forum for identifying and resolving major policy issues.
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Other IGM features abound today. Brazil’s Constitution explicitly grants local governments powers to contract for local services, e.g. public transport and waste collection, while intermunicipal transport is a state government competency that requires high levels of state and local collaborative management. Algonquin Provincial Park in Ontario, Canada, is one of the few parks that is “managed” for both timber cutting and recreation. This dual result came about after knowledge-based political negotiations and compromise among varied and competing interests, a not uncommon phenomenon in IGM. In Australia local government is responsible for recreation, open spaces, infrastructure—wheras public transport, electricity, education, hospitals and healthcare are state or territorial. As a result for local management, governments must operate as part of a local network. Finally, the movement toward participatory democracy—citizens and citizen groups—as a basic unit of policy input and programming design have become regular features in Austria, Germany, Belgium, Nigeria, Spain and Switzerland. In these countries, the origins of IGM can thus be most basic in level of origin and begin to expand multilevel governance, interactive policy-making and program design at early (local) stages.
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=== Selected Intergovernmental Instruments: ===
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In established federal systems like the United States and a variety of tools or instruments of IGR have emerged. These approaches are familiar to those who work in the boundary crossing world of IGM. “Agencies” now refers to both NGO organizations and government agencies.
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1. Government Approaches
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<UL><UL>
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<LI> Limited powers/intergovernmental public—private organizations: Area-based multigovernment or super municipal/county representative bodies that have no formal or have limited powers over aspects of planning or programming, e.g., transportation metropolitan planning organizations, area agencies on aging, workforce development boards, regional planning boards, rural development councils, museum or zoo authorities.
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<LI> Joint venture: Two or more agencies seek to invest in and launch an auxiliary operation – e.g., a business or spin-off café or service station – as part of their respective programs while maintaining the rest of their operations independently. Based on shared risk capital, with shared liability.
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<LI> Joint stock venture: Engagement similar to a joint venture, but the participating agencies raise capital by selling stock in the operation. Liability is limited to the joint venture.
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<LI>Joint commissions: Private multiorganization bodies that evaluate standards of operation, entry and exit to a field, and sometimes outcomes that are licensed or “franchised” under public auspices, e.g., accreditation of hospitals, rehabilitation facilities, geographic information systems specialists, and social workers.
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<LI>Dedicated task forces: Multisector, ad hoc bodies charged to look at a particular problem; and to study, research, and propose tentative solutions to public problems that cut across multiple populations, jurisdictions, communities, etc.
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<LI>Grants: Payments from a donor government agency to a recipient, public or NGO, normally for the provision of service by the grantee.
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<LI>Regulation: Legally enforceable rules that govern expected behaviors or outcomes that require administrative arrangements by the regulator and regulated.
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<LI>Government loans/loan guarantees: For a loan, state or U.S. Treasury funds are loaned to other governments or private-sector borrowers; for a guarantee, government enters into an agreement with a private lender to make full payment if the borrow defaults on the loan.
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<LI>Vouchers: Government provision of a subsidy, normally transmitted intergovernmentally and through NGOs, that grants limited purchasing power to individual clients to choose among designated goods or services.
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<LI>Contract for services: A written, binding (and legal) agreement by one agency or organization to supply direct services to another agency.
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<LI>Interagency agreements: Written collaboration supports between two or more code departments or agencies within the same government (e.g., social services and parks and recreation departments, economic development and tourism).
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<LI>Informal discussions/sharing of information: Nonbinding exchanges by personnel of two or more agencies focused on some program purpose.
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<LI>Informal cooperation: A nonbinding connection (required by law, contract, written exchange) between two agencies to improve programming.
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<LI>Parallel action: An agreement, usually formally adopted, between two or more agencies/operations to pursue a common course of action. The decisions are agreed upon jointly, but their implementation requires individual action by the agencies/organizations involved.
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<LI>Continuous public open source facility use: One organization makes sustained noncontractual use of another public facility, e.g. schools and public libraries and museums, small city governments and county planning agencies, community organizations and public buildings, small town leaders and agricultural extension service, chambers of commerce, and small business development centers in colleges.
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<LI>Conference approach: Bringing together, at regular intervals, representatives of given agencies/organizations within an area to discuss common problems, exchange information, and develop agreements on issues of mutual interest.
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<LI>Shared staff: Specialists and professionals perform tasks or services on loan for a cooperating agency but remain on the sending agency’s payroll.
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<LI>Outreach/liaison staff: Employees of one organization assigned to work primarily or exclusively with another agency, e.g. police in schools, social workers in mental health centers, occupational health and safety specialists in shipyards, ambulance crews in fire stations, etc.
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</UL></UL>
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2.  Formal Public – NGO Arrangements
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<UL><UL>
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<LI>Advisory boards: Citizens, community leaders, service clients, students and parents representing different organized and nonorganized interests meet with public officials, provide advice, respond to proposals and/or actively participate in plans and proposals.
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<LI>Councils/federations of agencies: Information sharing, information creation, and sometimes pooled fundraising, with no or few decisional controls over an agency’s operations.
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<LI>Compact: Two or more agencies/organizations undertake mutual obligations, for example, to serve clients from neighboring communities where no services are organized.
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<LI>Transfer of functions: Shifting of an agency’s particular service, e.g., nursing, intake, case management, to another agency more adequate in knowledge, experience and/or resources.
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<LI>Limited partnership: Two or more agencies/organizations formally agree to work together and integrate certain functions while remaining separate in their core operations (e.g., fund-raising, public relations, financial management, and supportive health services).
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<LI>Formal agreements with a philanthropic body: Written compact to work with a philanthropic entity for research, funding, and public relations. 
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<LI>Integrated services/partnerships: Two or more agencies/organizations contractually or legally agree to unify one or more of their services into one operation while operating separately on other functions. Normally involves intake/assessment, case management, evaluation and assessment, support or management services.
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<LI>Formal networking: Multiparty agency involvement in regularized, organized multiagency/multiorganization bodies that exchange information, build mutual capabilities, build collaborative services strategies, and solve programming/policy problems at points of service.
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<LI>Agency merger: Two or more agencies/operations form a new, blended agency that combines the mission and efforts of the dissolved units, a complete and final integration move. Over time, program design, operation, evaluation, and management functions are unified.
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</UL></UL>
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<p>
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</p>
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=== IGM in Action: State Medicaid Waivers, Local Community Development ===
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Two programs illustrate IGM in action:  the Medicaid Waiver is largely a federal-state-NGO program; , and Community Development Block Grants are primarily local.
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Adopted by [[U.S. Congress|Congress]] in 1981, the Medicaid 1915c Home and Community Based Services HCBS Waiver is a Congressional delegation of authority to the executive branch to permit selective deviations from the law. HCBS allows states to apply for a state plan to provide home and community services to people who are aged, disabled, or experience some form of intellectual and developmental disability (I/DD) that in the absence of the alternative home- and community-based services, would remain or be at-risk of being placed in a Medicaid facility such as a nursing or other such home or intermediate care (ICF/ID). Services include case management, adult day care and habilitation, supported employment, environmental modifications, homemaker, personal supports, respite care, transportation and a series of health services. HCBS cannot be used to pay for room and board; however, cash assistance such as Supplemental Security Income (SSI) is available for income-eligible persons for these purposes. Moreover, HCBS has proven to be instrumental in state implementation of the U.S. Supreme Court’s L.C. vs. Olmstead (1999) that opened the door for expanded community services for the disabled as a right. The federal government began to use HCBS to “guide” states in implementating this landmark decision.
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Medicaid HCBS was primarily expected to curb nursing home growth. While states are not required to access HCBS funds, they found them to be attractive because it gives them an opportunity to target client size, expand services, and respond to state-based advocacy groups while retaining the right to control service areas and cap enrollments. For example, available data for year 2011, HCBS Waiver spending totaled $31.4 billion in federal, state, and local government outlays, serving more than 685,828 persons. The spending available for 2013 average was $45,795 per person. For I/DD persons, HCBS funds about half of all I/DD federal, state, and local public spending, varying by state. In contrast, state institutional populations (16 or more) were at 24,675 in 2013, with 35 of 37 states surveyed reducing their census. Meanwhile, 80 percent of out-of-home placements in 2013 are now in settings of six or fewer persons. Finally, each state varies with regard to meeting the challenge of IGM network building and the vigor with which it integrates persons at the community level. In sum the HCBS has made a significant impact on reducing hospital visitations.
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The extent and breadth of HCBS Networks can be illustrated by in Figure 2 with the following IGM network map for the I/DD Waiver:
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“IGM involves a lot of people at various levels of the public and private sectors.”
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{| class=wikitable
 +
|-
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!''Public Agencies''!! ''Secondary NGOs'' !! ''Primary Services and Client-Contact Delivery Agencies'' !! ''Support Services and Subcontractors''
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|-
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|1. Federal CMS Regional Office (authorization, oversight performance review)<p>
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2. Federal Office of Developmental Rehabilitative Services</p><p>
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3. State Homes and Services agency – division of I/DD (program), Medicaid Policy Office (financing), Department of Public Health (standards)</p><p>
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4. Federal Justice/issues of client rights (protection)</p><p>
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5. State Attorney General (represent state interests)</p><p>
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6. State legislative commissions (I/DD, Medicaid)</p><p>
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7. Governor’s I/DD Planning Council</p><p>
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8. County Welfare agencies where programs are county - administered</p>
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|1. Administrative support contractor(s) (eligible, claims processing, case referrals)<p>
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2. Advocacy group 1 (families, clients, client advocates, interested citizens)</p><p>
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3. Advocacy group 2 ARF (trade association of service delivery agencies)</p><p>
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4. Advocacy group 3 (rights and interests of the disabled)</p><p>
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5. University-based Center(s) for Excellence (research, demonstration, training)</p><p>
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6. Other research facilities</p>
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|1. Nonprofit and for-profit nursing homes<p>
 +
2. Nonprofit and for-profit group homes and supported living arrangements</p><p>
 +
3. Nonprofit and for-profit day programs and workshops (vocational, activity)</p><p>
 +
4. Home-based services agencies (training, habilitation, medical support)</p><p>
 +
5. Assistance for clients living with their families</p><p>
 +
6. Care/services provided by family members (limited)</p>
 +
|
 +
1. Medical/health <p>
 +
2. School systems (under 21)</p><p>
 +
3. Dental</p><p>
 +
4. Legal</p><p>
 +
5. Transportation</p><p>
 +
6. Vocational rehabilitation</p><p>
 +
7. Assistive devices</p><p>
 +
8. Pharmacies</p><p>
 +
9. Habilitative recreation</p><p>
 +
10. Others</p>
 +
|}
 +
'''Figure 2: The IGR Network in Residential and Non-Residential Services for I/DD Under the Medicaid Waiver'''
 +
 +
The second program, the [[Block Grants|Community Development Block Grant]] (CDBG) program, is illustrative of federal-local-NGO programs. It allows cities of various sizes to employ its complex public-private governing environment’s potential, if a city chooses to actively combine federal-state-local programs into development strategies. For example, if a city wishes to expand its industrial park it may apply for venture capital money, collateralized by local business pledges of investment. The process might follow the following hypothetical sequence: First, the city will determine its priorities. Second, the city’s department of community development regularly conducts a strategic economic development planning process, which involves governmental and nongovernmental organization officials, as well as business leaders and its development corporation. Third, the city’s annual update of its block grant plan allows for the revision of priorities in spending to support needed projects. City officials express their need for funds to state officials and suggest the possibility of slightly altering the requirements of the venture capital program. If the state declines, the city officials may pursue infrastructure development funds from another state program and approach two federal government agencies with a freeway exit proposal. The city’s strategic activity leads to adjustments in the CDBG program, a minor redirection of a state infrastructure grant, and extensive negotiations and appeals with the U.S. Economic Development Administration and the state Housing and Economic Development Authority over eligibility for assistance. If all goes well, the city receives a mixture of state infrastructure funds and federal money, along with enhanced financial support from local investors. In the end the city will become deeply engaged in administering these programs with local and NGO partners.
 +
 +
=== Conclusion: IGM Globally ===
 +
 +
As a result of internet communication and globalization subnational governments in federal systems have now become part of the global order, participating in several international organizations and formal networks that cross national boundaries. Examples include the European Union’s Committee on Regions, that include nearly 350 regional and local bodies and Cities for Climate Protection, that also include some 350 local governments dedicated to promoting local initiatives for dealing with the effects of climate change.
  
=== MANAGEMENT: A KEY FEDERALISM TASK ===
 
Several forces converge to make managing within federalism a core activity of officials at all levels. First, there are high numbers of intergovernmental programs. In addition to the approximately 1,000 programs listed in the U.S. ''Catalogue of Federal Domestic Assistance'', (http://12.46.245.173/cfda/cfda.html) states offer hundreds of their own programs, which have increased in number in the past several decades. For example, the typical state has adopted up to thirty economic development programs or instruments since the 1970s. Second, the United States has a tradition of separation of governments and powers. Each level of government has different legislative and administrative branches, and at the local level many different types of government exist. Third, there is a tradition of jurisdictional autonomy in the United States. Every city or village, county government, and state government can claim some degree of independence or freedom from interference from higher levels as well as the right to pursue their own aims, even with programs that come from elsewhere. Fourth, the number of actors involved in programs has increased in recent years. In addition to governments, nongovernmental organizations such as private firms and nonprofit agencies have important implementation roles in programs. These new actors share intergovernmental administration with those who are inside governments. Fifth, many programs like the Arsenic Rule within SDWA have become very complicated, calling for legal, technical, and political skills to facilitate action. This has put a premium on administrative actors and program specialists. And sixth, there is increased concern for accountability and performance in programs. This means that there is more managerial activity involved in planning, reviewing, negotiating, and auditing. Together, these forces call attention to the less visible but important managerial aspect in American federalism.
 
  
 
{| class="wikitable"
 
{| class="wikitable"
 
|-
 
|-
 
| '''BIBLIOGRAPHY:'''  
 
| '''BIBLIOGRAPHY:'''  
Robert Agranoff and Michael McGuire, ''Collaborative Public Management: New Strategies for Local Government'' (Washington, DC: Georgetown University Press, 2003); Catalog of Federal Domestic Assistance, http://12.46.245.173/cfda/cfda.html; John J. Gargan, ed., ''Handbook of State Government Administration'' (New York: Marcel Dekker, 2000); Denise Scheberle, ''Federalism and Environmental Policy'' (Washington, DC: Georgetown University Press, 1997); and David B. Walker, ''The Rebirth of Federalism'', 2nd ed. (New York: Chatham House, 2000).
+
Robert Agranoff, Crossing Boundaries for Intergovernmental Management (Washington, D.C.: Georgetown University Press 2017); Robert Agranoff and Michael McGuire, Collaborative Public Management: New Strategies for Local Governments (Washington, D.C.: Georgetown University Press 2003); Roscoe C. Martin, Metropolis in Transition (Washington, D.C., U.S. Housing and Home Finance Agency, GPO: 1963); Jeffery L. Pressman and Aaron Wildavsky. Implementation (Berkley: University of California Press 1973); Douglas S. Reed, Building the Federal Schoolhouses: Localism and the American Federal State. (Oxford: Oxford University Press 2014); Steven R. Rosenthal, “New Directions in Evaluating Intergovernmental Programs”, Public Administration Review 44: 469-76; Bernardo Zacka, When The State Meets the Street: Public Service and Moral Agency (Cambridge, MA: Harvard University Press 2017).  
 
|}
 
|}
  
==== Robert Agranoff ====
+
Robert Agranoff
 +
 
 +
Last updated: June 2018
  
 
SEE ALSO: [[County Government]]; [[Economic Development]]; [[Education]]; [[Environmental Policy]]; [[Executive Orders]]; [[Federal-State Relations]]; [[Grants-in-Aid]]; [[Health Care Policy]]; [[Intergovernmental Lobbying]]; [[Intergovernmental Relations]]; [[Local Government]]; [[Medicaid]]; [[Political Parties]]; [[Preemption]]; [[Safe Drinking Water Act of 1974]]; [[Social Security Act of 1935]]; [[State Government]]
 
SEE ALSO: [[County Government]]; [[Economic Development]]; [[Education]]; [[Environmental Policy]]; [[Executive Orders]]; [[Federal-State Relations]]; [[Grants-in-Aid]]; [[Health Care Policy]]; [[Intergovernmental Lobbying]]; [[Intergovernmental Relations]]; [[Local Government]]; [[Medicaid]]; [[Political Parties]]; [[Preemption]]; [[Safe Drinking Water Act of 1974]]; [[Social Security Act of 1935]]; [[State Government]]

Latest revision as of 00:56, 26 September 2018

Federal programs administered through the states and local governments and state programs carried out by local governments must be managed cooperatively. The process of managing programs involves officials working to solve problems that combine legal, technical, political, and project tasks.

Intergovernmental management (IGM) has become an integral practice in federal systems as they increasingly broaden general government programs to include constituent governments (provinces, states, regions), local governments and special districts, as well as by externalization through nonprofit and for profit organizations, primarily by contracting. Today myriad-like complex boundary-spanning actions involve the affairs between federal governments and their constituent partners in various working dynamics. In its overlapping functions and complexities IGM can be thought of as involving four analytical frameworks: 1) the application of law and politics; 2) operations involving deepening jurisdiction interdependencies; 3) governments’ externalized policy making and service delivery; and, 4) networking and formal networks representing multiple organizations or parts of them working together to accomplish joint tasks.

These activities take place to some degree within the tiers of governments of federal systems and in federalizing systems. For example, in the Netherlands which is not federal, IGM takes place between the state and provinces, municipalities, and special boards (water, planning, environment, transport). In federalizing Spain, the central government in Madrid interacts and transacts with its seventeen regions or Autonomous Communities, along with provinces, comarcas (intermunicipal service districts), mancomunides (also municipal service districts), municipalities, public-private joint ventures, and submunicipal neighborhood councils. In the United States IGM includes the federal government, the states and territories, state-created substate planning districts, federally established substate units (transportation, emergency management), counties, special intermunicipal districts, school districts, municipalities and town and townships (rural). Connections between these entities are regularly at work managing intergovernmental relations (IGR) in systems where practice involves overlapping as opposed to hierarchical authority.

As a result of increasing federal growth and complexity, IGM in countries like the U.S. is a product of federal development among the four core IGM features – law and politics, unit interdependency (including NGOs), government-NGO partnerships, and interconnected networks and networking. At the same time the various government agencies remain as viable, authoritative bodies, indeed as key players. Today governments are part of complex adaptive systems that incorporate interoperable systems that are increasingly digitized and employing open-source technology. Also, IGM systems are faced with the latest technical support in collaborative management (e.g., artificial intelligence).

The multifaceted process of managing federal programs can be illustrated by examining a program that affects every citizen, that of ensuring that a healthy drinking water supply is available. The U.S. Safe Drinking Water Act (SWDA) of 1974 expanded the federal role in monitoring and standard setting to protect human health and the regulation of water supplies. The program delegates inspection and enforcement to the states, and some states have further delegated authority to local governments. States are required to have programs that include statutory and regulatory enforcement authority adequate to ensure compliance, a system of conducting inspections of public water supply systems (sanitary surveys), a process to certify laboratories that test for contaminants, and management provisions. The U.S. Environmental Protection Agency (EPA) pays around three-quarters of these programs’ operating costs, which includes a loan program for improvement of facilities. Most important is the requirement in the Act for the EPA to issue standards for any contaminant that may have an adverse effect on human health and that is known to occur in public drinking water supplies. In these ways IGM reaches through the entire federal system.

The U. S. Medicaid program also demonstrates the core aspects of IGM. Title XIX of the Social Security Act, funds health care for the poor (also low income elderly, disabled persons). In terms of expenditures, it is the largest single intergovernmental program in the United States. This federal-state program involves the federal government setting minimum requirements for state provided benefits, eligibility, the reimbursement of health care providers, and for establishing administrative rules that states must follow. States, if they choose to fund them, may expand the services and populations eligible for the program. Each year the states must file and then negotiate a “state plan” relating to how they intend to operate their programs. The plan involves literally thousands of administrative details that are subject to interpretation, and in recent years several different kinds of “waivers” or excepted actions that permit states to fund services that would not otherwise be allowed, as well as a few dozen “assurances” that certain cross program federal standards are to be met.

During each planning year, state Medicaid officials engage in literally thousands of inquiries, subagreements, contracts, and informational transactions with local governments and medical vendors, as well as with federal officials. Also, pages and pages of fiscal and program reporting will be collected. Finally, some two years or so after plans have been executed, the paper reporting will be audited by other federal officials. While the proportion of Medicaid spending on administration is relatively small compared to its very large budget, no one has been able to estimate the cost impact of the paperwork burden or the extensive administrative time up and down the line that this program takes. It is “quintessentially IGM” with all of its audits, rules, standards, jurisdictions, vendors, etc.

Managers in the Horizontal and Vertical System

Managers do more than talk on the phone, e-mail, or make personal contacts when they are working on applying and adjusting programs within the federal system. Figure 1, taken from Agranoff and McGuire’s Collaborative Public Management (2003) study of city economic development, identifies twenty-one distinct types of IGM practices. They are both vertical (that is, those devices used for working with state and federal government officials) and horizontal (working with other local governments, NGOs, and the private sector). The vertical IGM instruments are of two types: those that try to make some form of adjustment within the system within the boundaries of the policy intent of programs; and those designed to determine information or joint understandings. The horizontal instruments either serve particular investment projects or help develop or maintain networks of officials. The frequency of these actions, of course, varies from jurisdiction to jurisdiction, but all of these activities are regular instruments used by managers. In sum, these are the instruments used to coordinate/manage programs across lines– that is, to help make programs work within a given situation.

Type of Practice Use in IGM Purposes of Practice
Discretion-seeking (vertical) Requesting and granting local “asymmetrical” treatment not technically or apparently within standards or regulations Waivers; Model program efforts; Policy changes; Funding innovation; Negotiated flexibility; Trading compliance for performance results
Information-seeking (vertical) Seeking and providing program details and/or reaching operating understandings regarding program operations Seek program availability and eligibility; Seek program operation information; Seek interpretation of standards; Seek new funding; Seek technical assistance
Project-based (horizontal) Leverage and engagement of public and private resources to accomplish plans, projects, and other efforts Develop managerial partnerships in projects; Seek financial resources from partners; Combine or leverage financial resources; Build financial partnerships for projects
Structural design (horizontal) Development and maintenance of organizations or networks for program design and implementation Engage in joint policy making; Seek policy-making assistance; Consolidate policy effort; Contracted planning or implementation; Employ joint financial incentives; Access technical resources

FIGURE 1. Intergovernmental Management Practices

The interactive strategies in Figure 1 demonstrate that many actors potentially hold sway over the IGM process. Policy and program implementation involves many actors and opportunities to adapt, adjust and apply programs in different ways. Pressman and Wildavsky’s notable study, Implementation, reveal the myriad steps, negotiations and trade-offs in a single economic development program. There is more. Reed (2014) has introduced the implementation practice of "operational localism,” in his research in educational policy, where the various forces of local politics combined with technical and managerial forces to constrain local ability and willingness to respond to certain federal directives. In education, he called these forces as leading to a “hybrid education state.”

Another step to consider are the discretionary adjustment actions by “street level bureaucrats,” police officers, welfare case workers, teachers, license examiners, whose discretion is “shared” at the most basic, thus the street level. The rules and standards rarely cover all situational circumstances. At this stage of policy implementation, many and differing moral dilemmas open up well beyond any standards of efficiency by those who mediate between the state and society. As a result, front line workers regularly make “street level” decisions that affect policy (Zacka 2017). Thus IGM involves quite a long chain of actors in application.

IGM has both its direct and indirect features. Its direct features are more visible and include grant/contract proposals, award letters, legal prohibitions, standards, requirements, assurances, audits and monitoring, and formal reporting. In managerial action, IGM is indirect. It was once identified by Rosenthal, as “indirect” with four distinct conditions:

    • Partial accountability – program delivery requires that state or local (NGO, public or private) agencies be partially but not fully accountable to a federal (and/or state) agency.
    • Mixed objectives – those who are responsible for some aspect of the program are likely to differ, in some important respects, on the program objectives.
    • Continuity – programs are likely to continue, as opposed to some one-time project.
    • Interorganizational activity – involves mechanisms developed for exchanging resources, information, and authority across formal organizational boundaries.

Indeed, these reciprocal administrative actions and transactions are particularly reflective of the U.S. and other federal situations, coupled with localism and the absence of a large federal bureaucratic presence.

IGM is also an emergent feature known in many countries as executive federalism, that involves joint working sessions between central and state/provincial/conferences to negotiate and settle finance and other policy issues. It is a common aspect in Canada, South Africa, Australia, India, and Malaysia. Australia also employs a Council of Australian Governments, that includes local governments, and a discussion forum for identifying and resolving major policy issues.

Other IGM features abound today. Brazil’s Constitution explicitly grants local governments powers to contract for local services, e.g. public transport and waste collection, while intermunicipal transport is a state government competency that requires high levels of state and local collaborative management. Algonquin Provincial Park in Ontario, Canada, is one of the few parks that is “managed” for both timber cutting and recreation. This dual result came about after knowledge-based political negotiations and compromise among varied and competing interests, a not uncommon phenomenon in IGM. In Australia local government is responsible for recreation, open spaces, infrastructure—wheras public transport, electricity, education, hospitals and healthcare are state or territorial. As a result for local management, governments must operate as part of a local network. Finally, the movement toward participatory democracy—citizens and citizen groups—as a basic unit of policy input and programming design have become regular features in Austria, Germany, Belgium, Nigeria, Spain and Switzerland. In these countries, the origins of IGM can thus be most basic in level of origin and begin to expand multilevel governance, interactive policy-making and program design at early (local) stages.

Selected Intergovernmental Instruments:

In established federal systems like the United States and a variety of tools or instruments of IGR have emerged. These approaches are familiar to those who work in the boundary crossing world of IGM. “Agencies” now refers to both NGO organizations and government agencies.

1. Government Approaches

    • Limited powers/intergovernmental public—private organizations: Area-based multigovernment or super municipal/county representative bodies that have no formal or have limited powers over aspects of planning or programming, e.g., transportation metropolitan planning organizations, area agencies on aging, workforce development boards, regional planning boards, rural development councils, museum or zoo authorities.
    • Joint venture: Two or more agencies seek to invest in and launch an auxiliary operation – e.g., a business or spin-off café or service station – as part of their respective programs while maintaining the rest of their operations independently. Based on shared risk capital, with shared liability.
    • Joint stock venture: Engagement similar to a joint venture, but the participating agencies raise capital by selling stock in the operation. Liability is limited to the joint venture.
    • Joint commissions: Private multiorganization bodies that evaluate standards of operation, entry and exit to a field, and sometimes outcomes that are licensed or “franchised” under public auspices, e.g., accreditation of hospitals, rehabilitation facilities, geographic information systems specialists, and social workers.
    • Dedicated task forces: Multisector, ad hoc bodies charged to look at a particular problem; and to study, research, and propose tentative solutions to public problems that cut across multiple populations, jurisdictions, communities, etc.
    • Grants: Payments from a donor government agency to a recipient, public or NGO, normally for the provision of service by the grantee.
    • Regulation: Legally enforceable rules that govern expected behaviors or outcomes that require administrative arrangements by the regulator and regulated.
    • Government loans/loan guarantees: For a loan, state or U.S. Treasury funds are loaned to other governments or private-sector borrowers; for a guarantee, government enters into an agreement with a private lender to make full payment if the borrow defaults on the loan.
    • Vouchers: Government provision of a subsidy, normally transmitted intergovernmentally and through NGOs, that grants limited purchasing power to individual clients to choose among designated goods or services.
    • Contract for services: A written, binding (and legal) agreement by one agency or organization to supply direct services to another agency.
    • Interagency agreements: Written collaboration supports between two or more code departments or agencies within the same government (e.g., social services and parks and recreation departments, economic development and tourism).
    • Informal discussions/sharing of information: Nonbinding exchanges by personnel of two or more agencies focused on some program purpose.
    • Informal cooperation: A nonbinding connection (required by law, contract, written exchange) between two agencies to improve programming.
    • Parallel action: An agreement, usually formally adopted, between two or more agencies/operations to pursue a common course of action. The decisions are agreed upon jointly, but their implementation requires individual action by the agencies/organizations involved.
    • Continuous public open source facility use: One organization makes sustained noncontractual use of another public facility, e.g. schools and public libraries and museums, small city governments and county planning agencies, community organizations and public buildings, small town leaders and agricultural extension service, chambers of commerce, and small business development centers in colleges.
    • Conference approach: Bringing together, at regular intervals, representatives of given agencies/organizations within an area to discuss common problems, exchange information, and develop agreements on issues of mutual interest.
    • Shared staff: Specialists and professionals perform tasks or services on loan for a cooperating agency but remain on the sending agency’s payroll.
    • Outreach/liaison staff: Employees of one organization assigned to work primarily or exclusively with another agency, e.g. police in schools, social workers in mental health centers, occupational health and safety specialists in shipyards, ambulance crews in fire stations, etc.

2. Formal Public – NGO Arrangements

    • Advisory boards: Citizens, community leaders, service clients, students and parents representing different organized and nonorganized interests meet with public officials, provide advice, respond to proposals and/or actively participate in plans and proposals.
    • Councils/federations of agencies: Information sharing, information creation, and sometimes pooled fundraising, with no or few decisional controls over an agency’s operations.
    • Compact: Two or more agencies/organizations undertake mutual obligations, for example, to serve clients from neighboring communities where no services are organized.
    • Transfer of functions: Shifting of an agency’s particular service, e.g., nursing, intake, case management, to another agency more adequate in knowledge, experience and/or resources.
    • Limited partnership: Two or more agencies/organizations formally agree to work together and integrate certain functions while remaining separate in their core operations (e.g., fund-raising, public relations, financial management, and supportive health services).
    • Formal agreements with a philanthropic body: Written compact to work with a philanthropic entity for research, funding, and public relations.
    • Integrated services/partnerships: Two or more agencies/organizations contractually or legally agree to unify one or more of their services into one operation while operating separately on other functions. Normally involves intake/assessment, case management, evaluation and assessment, support or management services.
    • Formal networking: Multiparty agency involvement in regularized, organized multiagency/multiorganization bodies that exchange information, build mutual capabilities, build collaborative services strategies, and solve programming/policy problems at points of service.
    • Agency merger: Two or more agencies/operations form a new, blended agency that combines the mission and efforts of the dissolved units, a complete and final integration move. Over time, program design, operation, evaluation, and management functions are unified.

IGM in Action: State Medicaid Waivers, Local Community Development

Two programs illustrate IGM in action: the Medicaid Waiver is largely a federal-state-NGO program; , and Community Development Block Grants are primarily local.

Adopted by Congress in 1981, the Medicaid 1915c Home and Community Based Services HCBS Waiver is a Congressional delegation of authority to the executive branch to permit selective deviations from the law. HCBS allows states to apply for a state plan to provide home and community services to people who are aged, disabled, or experience some form of intellectual and developmental disability (I/DD) that in the absence of the alternative home- and community-based services, would remain or be at-risk of being placed in a Medicaid facility such as a nursing or other such home or intermediate care (ICF/ID). Services include case management, adult day care and habilitation, supported employment, environmental modifications, homemaker, personal supports, respite care, transportation and a series of health services. HCBS cannot be used to pay for room and board; however, cash assistance such as Supplemental Security Income (SSI) is available for income-eligible persons for these purposes. Moreover, HCBS has proven to be instrumental in state implementation of the U.S. Supreme Court’s L.C. vs. Olmstead (1999) that opened the door for expanded community services for the disabled as a right. The federal government began to use HCBS to “guide” states in implementating this landmark decision.

Medicaid HCBS was primarily expected to curb nursing home growth. While states are not required to access HCBS funds, they found them to be attractive because it gives them an opportunity to target client size, expand services, and respond to state-based advocacy groups while retaining the right to control service areas and cap enrollments. For example, available data for year 2011, HCBS Waiver spending totaled $31.4 billion in federal, state, and local government outlays, serving more than 685,828 persons. The spending available for 2013 average was $45,795 per person. For I/DD persons, HCBS funds about half of all I/DD federal, state, and local public spending, varying by state. In contrast, state institutional populations (16 or more) were at 24,675 in 2013, with 35 of 37 states surveyed reducing their census. Meanwhile, 80 percent of out-of-home placements in 2013 are now in settings of six or fewer persons. Finally, each state varies with regard to meeting the challenge of IGM network building and the vigor with which it integrates persons at the community level. In sum the HCBS has made a significant impact on reducing hospital visitations.

The extent and breadth of HCBS Networks can be illustrated by in Figure 2 with the following IGM network map for the I/DD Waiver: “IGM involves a lot of people at various levels of the public and private sectors.”


Public Agencies Secondary NGOs Primary Services and Client-Contact Delivery Agencies Support Services and Subcontractors
1. Federal CMS Regional Office (authorization, oversight performance review)

2. Federal Office of Developmental Rehabilitative Services

3. State Homes and Services agency – division of I/DD (program), Medicaid Policy Office (financing), Department of Public Health (standards)

4. Federal Justice/issues of client rights (protection)

5. State Attorney General (represent state interests)

6. State legislative commissions (I/DD, Medicaid)

7. Governor’s I/DD Planning Council

8. County Welfare agencies where programs are county - administered

1. Administrative support contractor(s) (eligible, claims processing, case referrals)

2. Advocacy group 1 (families, clients, client advocates, interested citizens)

3. Advocacy group 2 ARF (trade association of service delivery agencies)

4. Advocacy group 3 (rights and interests of the disabled)

5. University-based Center(s) for Excellence (research, demonstration, training)

6. Other research facilities

1. Nonprofit and for-profit nursing homes

2. Nonprofit and for-profit group homes and supported living arrangements

3. Nonprofit and for-profit day programs and workshops (vocational, activity)

4. Home-based services agencies (training, habilitation, medical support)

5. Assistance for clients living with their families

6. Care/services provided by family members (limited)

1. Medical/health

2. School systems (under 21)

3. Dental

4. Legal

5. Transportation

6. Vocational rehabilitation

7. Assistive devices

8. Pharmacies

9. Habilitative recreation

10. Others

Figure 2: The IGR Network in Residential and Non-Residential Services for I/DD Under the Medicaid Waiver

The second program, the Community Development Block Grant (CDBG) program, is illustrative of federal-local-NGO programs. It allows cities of various sizes to employ its complex public-private governing environment’s potential, if a city chooses to actively combine federal-state-local programs into development strategies. For example, if a city wishes to expand its industrial park it may apply for venture capital money, collateralized by local business pledges of investment. The process might follow the following hypothetical sequence: First, the city will determine its priorities. Second, the city’s department of community development regularly conducts a strategic economic development planning process, which involves governmental and nongovernmental organization officials, as well as business leaders and its development corporation. Third, the city’s annual update of its block grant plan allows for the revision of priorities in spending to support needed projects. City officials express their need for funds to state officials and suggest the possibility of slightly altering the requirements of the venture capital program. If the state declines, the city officials may pursue infrastructure development funds from another state program and approach two federal government agencies with a freeway exit proposal. The city’s strategic activity leads to adjustments in the CDBG program, a minor redirection of a state infrastructure grant, and extensive negotiations and appeals with the U.S. Economic Development Administration and the state Housing and Economic Development Authority over eligibility for assistance. If all goes well, the city receives a mixture of state infrastructure funds and federal money, along with enhanced financial support from local investors. In the end the city will become deeply engaged in administering these programs with local and NGO partners.

Conclusion: IGM Globally

As a result of internet communication and globalization subnational governments in federal systems have now become part of the global order, participating in several international organizations and formal networks that cross national boundaries. Examples include the European Union’s Committee on Regions, that include nearly 350 regional and local bodies and Cities for Climate Protection, that also include some 350 local governments dedicated to promoting local initiatives for dealing with the effects of climate change.


BIBLIOGRAPHY:

Robert Agranoff, Crossing Boundaries for Intergovernmental Management (Washington, D.C.: Georgetown University Press 2017); Robert Agranoff and Michael McGuire, Collaborative Public Management: New Strategies for Local Governments (Washington, D.C.: Georgetown University Press 2003); Roscoe C. Martin, Metropolis in Transition (Washington, D.C., U.S. Housing and Home Finance Agency, GPO: 1963); Jeffery L. Pressman and Aaron Wildavsky. Implementation (Berkley: University of California Press 1973); Douglas S. Reed, Building the Federal Schoolhouses: Localism and the American Federal State. (Oxford: Oxford University Press 2014); Steven R. Rosenthal, “New Directions in Evaluating Intergovernmental Programs”, Public Administration Review 44: 469-76; Bernardo Zacka, When The State Meets the Street: Public Service and Moral Agency (Cambridge, MA: Harvard University Press 2017).

Robert Agranoff

Last updated: June 2018

SEE ALSO: County Government; Economic Development; Education; Environmental Policy; Executive Orders; Federal-State Relations; Grants-in-Aid; Health Care Policy; Intergovernmental Lobbying; Intergovernmental Relations; Local Government; Medicaid; Political Parties; Preemption; Safe Drinking Water Act of 1974; Social Security Act of 1935; State Government