Mitchell F. Rice

Inner-city hospital closures/relocations: Race, income status, and legal issues

Hospital closures/relocations are occurring with increasing frequency in the United States and these actions are alleged to have adverse consequences for racial-minorities and low-income individuals. This paper through an examination and review of the literature discusses the reasons why hospitals close/relocate, examines the legal issues and questions that have arisen over decisions leading to hospital closures/relocations and discusses the implications of hospital closures/relocations on the health care of inner-city minorities and low-income individuals. The conclusion suggests that for inner-city indigents hospital closure/relocations means only one thing--a decline in hospital care. If the present trend in hospital closures/relocations continues, a few for-profit hospital chains may have the responsibility for determining community health needs based on what services are most profitable and who will be the recipient of these services.

Did Adarand Kill Minority Set-Asides?

Federal minority contracting opportunities serve as a major point of entry for socially and economically disadvantaged business entrepreneurs and small business concerns into the mainstream of American business enterprise. In 1994, the Minority Business Development Agency (MBDA) in the U.S. Department of Commerce reported that the value of all federal minority business enterprises prime and subcontracting procurement was 14.6 billion dollars or 8.3 percent of the total federal procurement (Parrott-Fouseca, n.d.). This amount represented an increase of more than 100 percent since 1984. Further, 68 of the top 100 Black Enterprise Magazine businesses are federal government contractors (Parrott-Fouseca, n.d.). About 32 of the top 100 largest African American firms and 17 of the top 100 largest Hispanic firms were or had been in the Section 8(a) program of the Small Business Administration (Affirmative Action Review: Report to the President, 1995). In fiscal year 1994, 5.8 billion dollars worth of federal contracts were awarded competitively to minority businesses; representing an increase of some 152 percent from 2.3 billion dollars awarded in fiscal year 1984 (Parrott-Fouseca, n.d.). Additionally, 6.1 billion defense dollars were spent with minority firms in 1994 and from 4.4 to 4.9 billion federal dollars were spent with 5,400 firms in the Section 8 (a) program in 1994 (D. J. Miller and Associates, n.d.; Affirmative Action Review: Report to the President, 1995). Provisions in federal law allowed set-asides to provide opportunities for socially and economically disadvantaged and small business enterprises to win federal contracts. For example. Section 502 of the Small Business Act (Public Law, 95-507) provides: The President shall annually establish government-wide goals for procurement contracts awarded to small business concerns and small business concerns owned and controlled by socially and economically disadvantaged individuals. The Government-wide goal for participation by small business contracts shall be established at not less than 20 percent of the total value of all prime contract awards for each fiscal year. The Government-wide goal for participation by small business concerns owned and controlled by socially and economically disadvantaged individuals shall be established at not less than 5 percent of the total value of all prime contract and subcontract awards. The Section 8(a) program represents some 40 percent of all federal procurement dollars received by small and socially and economically disadvantaged enterprises (Henderson, 1995). Further, the U.S. Department of Defenses Section 1207 programs allows the agency to implement a limited set-aside program for small businesses--in addition to the Section 8(a) program--to meet a statutory goal of 5 percent for socially and economically disadvantaged business enterprises (Public Law, 99-661). The intent of these and other similar federal procurement programs is to address historical patterns of discrimination and poor market access of minority business enterprises (Henderson, 1995). However, a number of these programs were called into question as a result of the Supreme Courts decision in Adarand Constructors, Inc. v. Pena (115 S.Ct. 2097, 1995). The social and political controversy generated by the Adarand decision prompted President Clinton to issue a memorandum on June 19, 1995, to the heads of executive departments and agencies with the following directive: in all programs you administer that use race, ethnicity, or gender as a consideration to expand opportunity or provide groups that have suffered discrimination, I ask you to take steps to ensure adherence to the following policy principles. …

Black health inequities and the American health care system

This paper examines the health care status of blacks in the American health care system and points out that blacks are burdened by a number of health inequities when compared to their white counterparts. The papers central theme is that the degree of governmental commitment in a liberal, pluralistic society is at the foundation of inadequate health care for black Americans. Blacks lack input in the health care politics and decision/policy-making processes. This lack of input has resulted in a health care system that appears to be unresponsive to the health care needs of black Americans. This is most acute in the areas of health manpower planning and health planning. The conclusion suggests that an increase in the number of blacks in the health professions along with more black participation in health decision/policy-making could lead to a substantial improvement in the overall health care of blacks.

Adarand v. pena: turning challenges into opportunities

This article provides a historical and legal overview of preference and set-aside programs. Further, the barriers and driving forces that have influenced preference programs are discussed. Finally, the processes, strategies, programs, and criteria employed at the Metropolitan Washington Airport Authority and Port Authority of New York and New Jersey, to meet the test of strict scrutiny in Adarand, will be explored and analyzed as alternatives for preference programs.

Municipal Service Suits, Local Public Services and Service Equality

WOODROW JONES, JR. San Diego State University Since local public bureaucracies are the key determinants in the quality of urban life, governmental outputs, particularly public services, must be distributed in such a manner to assure that the poor, disadvantaged and minorities receive their proper share of services. A number of researchers have written that public bureaucracies tend to be less responsive to these

Government set-asides, minority business development, and public contracting: introduction

Race-conscious affirmative action programs have been a part of American life for nearly three decades. Race-conscious set-asides are the latest government programs implemented to alleviate the adverse economic impact of racial discrimination and to foster minority business development. Minority business enterprises (MBEs) have been the specific targets of federal, state, and local government enacted set-aside programs with the principal purpose of overcoming the continuing effects of earlier discrimination. Government set-aside programs may be classified as “hard ball” affirmative action programs because they “provide absolute references to members of designated minority groups.(1)

Health care, public policy and the courts: black health status as a civil rights issue.

In the U.S.A. serious differences in the health status between black and white citizens continue to exist. Black Americans are less healthy and receive less health care than while Americans. The discrimination is examined as a civil rights issue with focus on both the policy and judicial perspectives of the application of Title VI of the Civil Rights Act of 1964 and the implementative effects of the Hill-Burton Act of 1946. The application, and compliance and enforcement, of civil rights to health care is complicated by a captivity process involving Federal agencies, by corporate medical rights emphasizing a business approach to health care, and by a liberal pluralistic political arena in which certain influential groups prevail over others. In order for black health status and care to improve in the U.S.A., blacks must continue to utilize the judicial system to seek redress of health care inequities. Second, they must utilize their demonstrated political power to demand better treatment from the medical establishment.

Federal set-asides policy and minority business contracting: understanding the adarand decision

In Adarand Constructors v. Pena (1), the Supreme Court ruled that federal affirmative action preference programs must undergo the “strict scrutiny” standard. A program subject to strict scrutiny is one that cannot pass muster under the Constitutions “equal protection” mandate unless there is a “compelling government interest” in its objectives and the program is “narrowly tailored” to meet the objectives. This paper reviews the Adarand decision and discusses the implications of the decision for minority business federal contracting.

Public contracting, policy preferences and minority business enterprises

About three years ago a Special Issue of the International Journal of Public Administration focused on the topic “Government Set-Asides, Minority Business Development, and Publi Contracting.”(l) Much of the discussion in the issue addressed race conscious government set-aside programs in the aftermath of the U.S. Supreme Court decision in City of Richmond v. J. A. Croson Co. (2) The decision declared unconstitutional a local government minority business set-aside provision designed to help minority business enterprises (MBEs) obtain government contracts. At the time, the decision was applicable only to state and local governmental jurisdictions.(3) Government set-asides involve the practice of providing minority contractors and subcontracting a certain percentage of a public jurisdictions contract dollars. In 1995 the Supreme Court in Adarand v. Pena (4) extended the Croson ruling to include set-aside programs in federal agencies. This Special Issues examines and discusses the Adarand decision and the de...

Inequality, discrimination, and service delivery: A recapitulation for the public administrator

The equitable provision of urban public services has begun to receive increased attention from researchers, administrators, and the courts. Recent research has questioned the view that minority and low-income groups are systematically deprived in the distribution of public services, e.g. police and fire services, libraries, street quality and maintenance, and parks and recreational facilities. This paper reviews empirical studies in urban service distribution and judicial responses to municipal service claims. The research reveals that discimination in service delivery does exist. However, it is difficult to determine empirically in larger cities if a consistent pattern of discrimination exists and whether or not it bears a significant relationship to race or class. Discrimination and inequality on the basis of race has been subject to meticulous judicial prowess benefitting at one time or another the citizen and the municipality. The courts are requiring overwhelming statistical documentation to substant...