Frank J. Thompson

Minority Groups in Public Bureaucracies Are Passive and Active Representation Linked

Do minority civil servants actively represent the minority community more than white officials do ? Many observers express doubts. Clearly, there are formidable barriers to nonwhite civil servants acting as representatives of their racial groups. Nonetheless, existing evidence suggests that nonwhite officials do serve in this capacity under certain circumstances. A major task for students of public administration is to specify what these circumstances are. The author notes several societal and job related factors which increase prospects that minority officials will actively represent their racial communities.

Executive Federalism and Medicaid Demonstration Waivers: Implications for Policy and Democratic Process

Executive federalism emphasizes collaboration between the executive branches at the national and state levels to transform grant programs through the implementation process. In this regard, Medicaid demonstration waivers loomed large during the presidencies of Bill Clinton and George W. Bush. This article documents and compares the volume and substance of section 1115 Medicaid waiver activity under the two presidencies. From the perspective of policy performance, Medicaid demonstration waivers provide modest support for the view that states serve as laboratories for policy learning in the health care arena. More broadly, the waivers have not yielded a major solution to the problem of the uninsured and are unlikely to do so. At the same time, they have not (as some have suggested) been a subterranean force for the erosion of Medicaid. To the contrary, these waivers have often enhanced health services for low-income people; above all, they have helped preserve Medicaid as an entitlement by undercutting support for those seeking to convert the program into a block grant. From the perspective of the democratic process, we find that Congress has been a more significant player in shaping waivers than the executive federalism model suggests. While the decision processes surrounding Medicaid waivers often fall short of democratic standards with respect to transparency and opportunities for public input, they still compare favorably to certain alternatives.

State Implementation Effort and Federal Regulatory Policy: The Case of Occupational Safety and Health

The states play pivotal roles in implementing the protective regulatory policies of the federal government. In this capacity they often profoundly shape who gets what from these programs. A well-rounded theory of the policy process requires precise specification of why some states try harder than others to implement Washingtons regulatory policies. This article tests four important theories (wealth, partisan, group, and organizational search) in an attempt to explain state implementation effort under one major regulatory program--the Occupational Safety and Health Act of 1970. State participation and enforcement vigor comprise the two major dimensions of implementation effort examined. The theories prove the most useful in explaining enforcement vigor. In this regard, a path analysis discloses that while wealth and interest group theories contribute to understanding, organizational-search theory is the best predictor of enforcement vigor. Partisan theory predicts the least. The study sheds light on a neglected aspect of regulatory policy and helps lay the cornerstone for a general theory of state implementation effort.

Drug Testing in the Federal Workplace: An Instrumental and Symbolic Assessment

How effective is thefederal governments employee drug-testing program? Frank Thompson, Norma Riccucci, and Carolyn Ban offer an assessment thatfocuses on both the instrumental and symbolic rationales for the program. They find little evidence to support contentions that drug testing improves workplace efficiency, nor do theyfind supportfor arguments that it promotes public health or reduces crime.

Back-Off Not Backlash in Medicaid Managed Care

No discussion of the political controversy surrounding managed care can ignore Medicaid. A joint federal-state initiative born as a political afterthought to Medicare in 1965, Medicaid provides health insurance to from 35 to 40 million low-income people. The proportion of the population covered by Medicaid has almost doubled, increasing from 5.6 percent of the population under 65 in 1984 to nearly 11 percent in the late 1990s. Medicaid also provides support to nearly 10 percent of Medicare recipients. The number of Medicaid eligibles seems likely to increase over the next several years as previously adopted federal mandates requiring the coverage of poor children become operational and states use funds available through the new Children’s Health Insurance Program that can extend Medicaid coverage to other low income children (National Center for Health Statistics 1998: 361–364). This essay briefly traces the rise of Medicaid managed care in the 1990s. We argue that, although Medicaid has escaped the politics of backlash surrounding managed care more generally, forces are at work eroding the initial enthusiasm for placing Medicaid enrollees in managed care. This erosion will not trigger a major retreat from Medicaid managed care but it will prompt some states to back off from initiatives to extend capitated plans to ever larger segments of the Medicaid population. The technical and political issues involved in extending managed care to special-needs populations as well as the exit of commercial firms from Medicaid managed care have begun to slow its momentum.

The Rise of Executive Federalism Implications for the Picket Fence and IGM

The ascendance of federal grants to states and localities as a major tool of government action has fueled scholarly interest in building a better theory of intergovernmental management (IGM). It has also spawned an enduring metaphor, “picket-fence federalism,” which has done much to shape thinking about the context and nature of IGM. More recently, however, a competing conceptual lens called “executive federalism” (EF) has emerged. Proponents of this perspective contend that administrative discretion looms increasingly large in shaping who gets what from federal grants, that vastly greater dependence on program waivers has driven this development, and that political executives—both elected and appointed—play a growing role in the administration of grant programs. To the degree that the EF lens accurately captures developments, it challenges the conceptual and empirical underpinnings of both the picket-fence model and IGM. This article provides a preliminary test of the EF perspective by examining the case of Medicaid. It charts a research agenda that would more fully probe the implications of EF for a theory of IGM.

New Federalism and Health Care Policy: States and the Old Questions

The New Federalism that evolved under the Reagan administration tends to grant states more discretion in the implementation of health care programs. It thereby rekindles old concerns about the commitment, capacity, and progressivity of the states. This paper reviews recent policy developments and reconsiders state performance from the vantage point of the mid-1980s. While hard evidence remains elusive, a plausible case exists that any gap between the states and Washington on commitment, capacity, and progressivity has diminished. State administrative capacity in particular has probably increased. The continued presence of substantial variation among the states needs to be underscored, however. Moreover, the relentless imperative of economic development, or migration, theory sets severe limits on how far states can go in adopting redistributive measures to assure adequate medical care for the poor. Given current federal laws, the most optimistic, plausible scenario envisions the rise of a technical politics of efficiency in the states. In spite of state limitations, health policy reformers need to pay increased attention to their potential role.

Commitment to the Disadvantaged among Urban Administrators: The Case of Minority Hiring.

This paper examines potential correlates of attitudinal commitment to minority hiring among urban personnel officials. The authors hypothesized that sociopolitical beliefs concerning equality would be particularly powerful predictors of attitudes toward recruit ing nonwhites, but that work-related beliefs, professional characteristics, community relationships, and personal attributes would explain additional variance in commitment to hiring minorities. Sociopolitical and work-related beliefs do achieve substantial correlations with attitudes toward recruiting nonwhites, but the three other clusters of independent variables account for less variance than expected. A concluding section examines some implications of the data for minority hiring practices in urban bureau cracies.

States' Commitment to Medicaid before the Affordable Care Act: Trends and Implications

Medicaid insures more than 65 million low-income people, and the Affordable Care Act of 2010 gives states the option to enroll millions more. Historical trends in state Medicaid effort possess important implications for health policy going forward. Nearly all states steadily ratcheted up their Medicaid effort in the period from 1992 to 2009, holding out promise that most will sustain their programs and ultimately participate in the expansion authorized by the Affordable Care Act. But the growth in Medicaid over this period did not appreciably curtail vast geographic disparities in program benefits that threaten to undermine the goals of health reform.

Deregulation at the EEOC: Prospects and Implications

This essay examines the prospects for deregulation at the Equal Employment Opportunity Commission (EEOC) in the 1980s. Enforcement reduction rather than target or standards deregulation seems most likely to surface. While this development may in part spring from EEOC deference to particular policy preferences dominant in the White House, the decline in or limited growth of the agencys resources will probably be more important. Specifically, austerity may well contribute to enforcement reduction by reinforcing the EEOCs propensity to emphasize complaint processing rather than self-initiated investigations into patterns of discrimination. Of particular relevance for students of public administration, enforcement reduction by the EEOC may well be more in evidence in the private as opposed to the public sector. The implications of these developments for compliance with equal employment opportunity laws receive attention.