Monday, July 9, 2018

Health, Fitness and Wellness: The Boilermaker Road Race Weekend 2018

Health, Fitness and Wellness: 
The Boilermaker Road Race Weekend 2018

July 9, 2018

Julie Ann Racino, Author and Editor
Policy, Program Evaluation and Research in Disability

   
      In 2001, I met Bob Ingalls, then race director of the Boilermaker Road Race, "the largest 15K in the Nation" and through his introduction, Ed Bradley who served in 1996 on the formation of the wheelchair division (1980,  Utica Observer-Dispatch, July 10, p.19) and its new mission statement in the integrated road race. To both, I am very thankful for their openness and hospitality to "their lives" and to the continuing role of the Boilermaker in "the life of the local community". 

     As part of community integration studies (See, wikipedia, 2012) in the US, the Boilermaker Road Race served as "an introduction" to the world of running and racing, "wheelchair sports" to Paralympics worldwide, "disability and non-disability elites", business sponsorships and charity fundraising, and the worlds of local "newsmedia " affiliates. It was the year that Catherine "the great" Ndereba set a world record in the Chicago Marathon, John Korir of Kenya won the Boilermaker Race, Paralympian Jessica Galli won the Women's Wheelchair Division of the Boilermaker, and Saul Mendoza won the New York City Marathon (wheelchair division). 

     The report titled, Boilermaker Road Race: Celebrating its 25th Anniversary: An Examination of Road Racing and Wheelchair Racing in the US (Racino, March 2002) is available via Square Market/Community and Policy Studies. Within are records of the historic National Distance Running Hall of Fame, the Youth Run, News Channel 2, "Graphtex as an Affirmative Business", and the Health and Fitness EXPO (held this weekend 2018), among others. Of course, the history of wheelchair sports as activists and as sports medicine can be found on the web and is current in 2018!

Health and Fitness EXPO 2018

     On Saturday, I stopped by the Health and Fitness EXPO which now is held on the grounds of Mohawk Valley Community College, Utica Campus. Documents related to the Oneida County contributions to the community college, also part of a nationwide system of "education in mental health, alcohol and substance abuse", were reviewed during the regular budget process  in 2018 (Racino, slides-city of Rome, County of Oneida, state of New York, federal "legislative" budget, 2018). 

     In 2018, the presenting sponsors were listed as Excellus Blue Cross-Blue Shield (traditional health care leader) and the Fitness Mill (visibly a business system of nautilus, nutrition, and "endurance")  both of which had booths at the Exhibit Hall.  I briefly talked with both "about one of their regional VPs from my neighborhood" and estimating "gummy bears" for a raffle (Excellus, exiting the exhibit hall), and Planet Fitness in Rome, New York and adapted, approved physical routines (for example, with back or neck injuries). 

     Most people do know that our health care system was in crisis (e.g., closing of hospitals, and "opening of urgent care"), that preconditions were excluded, that New York State has offerred new health care plans through exchanges, and the individual mandate for health care versus civil liberties was at the crux of the Repeal and Replace Obamacare at federal administration changes (e.g., Democratic President Obama, 8 years to the Republican President Trump Administration, 2nd year of first term).

 Exhibit Booths: 100 Displays Open for the Public

     AARP (American Association for Retired Persons), as always, received a vote from me on its 2018 flyer on Social Security and the Elections. However, it does indicate that "according to projections by the nonpartisan  Congressional Budget Office, that legislation-tax cut legislation, December 2017- will add more than $1.8 trillion to the federal deficit  by 2028".

     The "Boilermaker" was highlighted in a Magazine A'CCENT, "People and Places of the Mohawk Valley" with the cover photo the Genesis Group's ("under 30 age" professionals) Executive Director  and within SUNY Chancellor Nancy Zimphler (July 2018). The Boilermaker sections is on pp. 28-39 of the Magazine, features volunteer Diane Waskiewicz, keeping safe, preventing running injuries, runners' perks, and mental prep for the race, and "suddenly" perennial playlists-e.g., Deputy Police Chief with "Lose Yourself" by Enimem, and Mayor Chief of Staff, "Higher Ground" by Stevie Wonder, among five others.

    The Utica Academy of Science, a name traditionally reserved for the Hall of Fame Academies, was seeking applications for the 2018-2019 "school year" as a charter science school in Utica, New York. "The lottery date was April 2018" (it's never too early for next year!) in Frankfort, New York, and the Middle School Campus is at 1214 Lincoln Avenue in Utica, New York and the Senior High Campus in Frankfort, New York.  Drones and their use (e.g., suas.modelaircraft.org) were on display separately from this booth on the other side of the Athletic Center. 

     Utica Roadrunners announced their next running events, with development runs (described in the original research report, with Roman Runners- part of national network called Roadrunners of America) on the Parkway Recreation Center every Wednesday from July 11, 2018 to September 19, 2018.  Falling Leaves Race will be held on September 23, and Skeleton Run on October 14, 2018 in Utica, New York. More information is available at http://www.uticaroadrunners. org

     New health booths included information on Hepatitis C and the newest treatment options (e.g., Harvoni as medications option, Hep C conversation guide, sexual transmission risk, and antiviral drugs pegylated interferon and ribavirin). As everyone recalls, the federal Food and Drug Administration (FDA) is responsible for testing the drugs before "marketing", and the new federal HHSA (Health and Human Services Administration) Appointee in Washington comes from the pharmaceutical industry. The front page has "self care strategies" and begins that there are 3.2 million Americans with 3/4ths not aware of an infection which can slowly damage the liver (likely cause of physician visit).

      Mohawk Valley Community College, at the entry to the exhibits, had admission applications available, and MVCC science personnel (e.g., physics, biology) served as a planning committee for the Regional Science Congress held in 2018. The NYS Excelsior Scholarships are also online at http://www.mvcc.edu to make the experience tuition-free. MVCC offers programs from human services, psychology, education, liberal arts/general studies, digital animation, graphic design, criminal justice, computer science, art, engineering, business administration, and STEM programs, among others. 

     Traditional health ranged from the American Heart Association (AHA) with its Go Red for Women campaign, to Mohawk Valley Health System's outpatient rehabilitation programs. As many of your know, Syracuse University was a leader in "facilitated communication" (See, Doug Biklen's wikipedia, 2012, recently retired) which still is represented in the national and worldwide "rehabilitation sciences" (e.g., Racino & Lakin, 1990) booklet as "speech-language pathology" (e.g., Gebbie Speech Clinic, 1978), and the traditional "OT/PT" (occupational and physical therapy). "Both AHA and MVHS" are two separate organizations with the former part of "our traditional national voluntary" (e.g., United Way) networks.

     MVHS is involved in building a new hospital in downtown Utica which "requires eminent domain" evictions of small businesses (current, 2018). The "national owner" of MVHS (approved by Andrew Cuomo and Anthony Picente for a showpiece "hospital system", with Zucker newly named at NYS Health Department) was already known in Rome, New York. Concern was expressed in 2010 at "blocking other healthcare providers and educators" (via "urgent care" news magazine, and "health care personnel" announcements, now to Arc in 2017). "The health care group is involved with behavioral health care, and involuntary care" (not on the table, confirmed in 2017). "At the Arc of Oneida-Lewis Co, the Long Term Services and Supports-LTSS of the Mohawk Valley".

     The "goodie bag" I had was from RunOttawa.CA  advertising with Scotia Bank's Ottawa Marathon and other groups from Timex, Marriott Ottawa, OASIS, Saucony, The Ottawa Hospitals, Kronobar, Ontario, Aquahaulics, TSN1200 Ottawa, Ottawa Lions Track and Field, and Nuun, HTG 5K Sports, Zizu Optics, among others. Appreciated a discussion on Judith Snow of Canada and her leadership in making home and community-based services a reality in our Canadian, North American partner. 

     Other 2018 Exhibitors ranged from :
* Compassion Coalition ("not hospice care?"; also "Mid-York Library System"), 
* Community Wellness Partners (new health care groups with public television ads and health care record access), 
* Sparkly Soul, "Fleece, Stitch & Glitz", and Go Girl Headbands (e.g., young, woman "black" entrepreneurs, and other sales for large companies, dual displays online), 
* Racedots (with a special Boilermaker magnet), 
* The Root Farm (e.g., adaptive fishing, specialized chairs), 
* T-Mobile (with its hot pink marketing), 
* Boilermaker Unity Mile (bands and music), 
* Abraham House (who will receive proceeds from the Utica Monopoly Board), 
* DICK's Sporting Goods (sneakers on display, and yes, gun sales), 
* Cape Cod Marathon, 
* Plexus Worldwide, and other "clinical health groups" or nutrient sales groups (popular probiotics, for "gut health"), 
* NY State Troopers (Would you like a career in law enforcement? woman uniformed trooper), 
* SUEZ (wastewater treatment, Mohawk Valley), 
* Canada Army Run (23 September 2018, Ottawa, Canada)
* Pink Zebra (Executive Consultant) and A&P Master Images (screen printing; NYS women owned business), 
*  Kelleigh's Cause, Chocolate Challenge, Le Moyne College Athletic Center, July 28, 5K and 10K 
* Eveyln's House (i.e., transitional housing for young mothers and babies), 
* Good News Center, Flags for Heroes, November 2-11, 2018, Utica Memorial Parkway
* Johnson Park Center, Utica, NY (e.g., kids camp, food giveaway, youth center), 
* Utica Coffee Roast (enjoyed the pistachio iced coffee, outside vendors), 
* It's a Utica Thing (for Utica greens), 
* Utica, PJ Green Printing, 
* Utica Public Library (audio books, DVD videos, musical cds, urban fiction, new books, "graphic novels", available onsite) at www.uticapubliclibrary.org,
* Utica Children's Museum (museum memberships available), 
* OnPoint for College Utica in the Plymouth Bethesda/Cornerstone Church Building (college applications), 
* Center for Donation and Transplant-NY (application available online), 
* Boilermaker Urban Initiative (featured in the news for its children, and worms display-"soil aeration"; garden plants, e.g., tomatoes), 
* NYS Fairgrounds (Aug 22-Sept 3, 2018),
* Author Table (e.g., Katherine Switzer, and Bill Rodgers); Joe Kelly was also visiting and Julie Ann Racino said hello ("Katherine had a 6 foot high photo, last media"), 
* Boilermaker Store (e.g., Boilermaker "commemorative" brick sales, 2018 Boilermaker logo on glass, running attire),  to
* Oneida County Tourism (Utica, Rome, Verona and Sylvan Beach), and more!

      The Exhibitor Hall was open for two days on Friday and Saturday, and a climbing wall (e.g., now inside the MOST-Museum of Science and Technology in Syracuse, New York) was outside for view by Go Army.  Exhibitor Guidelines are available from the Boilermaker Road Race which has a facebook, twitter, and online site for your convenience. 

Health, Fitness and Wellness in the Age of Public Health

     Health and Human Services Administration (HHSA) and its reorganization from the federal Health, Education and Welfare (HEW) was discussed by Julie Ann Racino as part of a panel at the Northeast Conference on Public Administration (NeCopa) in Fall 2017.  The new administration is proposing another reorganization (e.g., Education and Workforces) which is expected to result in cutbacks in the size of the "federal bureaucracy" which also provides federal to state Medicaid and social services funding, direct federal outsourcing, civil service divisions, and contracting-procurement.  

      Sports medicine, and health and fitness represented a "period in America" which is influencing our classification systems, government programs, businesses and health care industries, university research, and payment or reimbursement schemes for different health care schemes. Wellness, with roots in community mental health, represented a different approach to mind-body-spirit (e.g., native healing, "the humors", acupuncture and alternative medicines) as the "person" in relationship to the "environment" within this context, the management also shifted towards traditional health departments (e.g., responsible for "disease management" and "epidemics"). 

       In New York State,  and through home and community-based services nationwide, the roots of the community United Way and voluntary sectors in conjunction with governments,  "weaves its way through the changing face of health care in America". Community-based services as is Medicaid and Medicare, are still young in America, and business entrepre-neurships have risen in the governmental sectors. Health care financing as community financing is on the rise in America (Racino, 2015) as are the development of NGO services (ethnic, women, disability) and NGO governance worldwide. 

       Health promotion and mental health awareness were popular initiatives in the US which remain represented today, having achieved payment status, the latter often termed "mental health and substance abuse parity". As an example, the concern may be equality in "hospitalization coverage", "home care services", "assessments of need", and "rehabilitation" benefits; specialized plans may be offerred at health care exchanges, similar to a "cancer treatment packages". However, many of the community services continue to have roots in the community support, nationally tested models and evidence-based practices, supported by "practice groups" in the US. 

      The shift in "managed care" providers was viewed skeptically in the 1980s (since a management structure already existed in the US), and even more so today (Racino, 2015). In part, this is due to the widening gap between "what the public is told about health care", what occurs in health care and is funded as health care, and what the public is told are options for health care. In 2018, a primary concern was a "complete takeover of mental health administration" to a MD "non-approved" behavioral sector without any "public warning" of the changes (Racino, 2000). 

     The public has supported its community development, as opposed to "unaware of medical homes", though it has been moved increasingly to specialized service groups. The public finally had in the "intent" (2016; Racino in Smith, 1990) to "give bonuses" to cut parties off health care as opposed to offer health care to those with "preconditions" (current, 2016). And the public health-"environmental justice" groups at ASPA in 2018 were featured in the "worse case scenario" reports on the case of Flint, Michigan water (See, this blogspot, ASPA, Denver). In part, healthcare and human services (e.g., inclusive of "justice services") has reflected the economic security of America and remains tied to its jobs and contracts, business and health care infrastructures, and the future of its children, families and communities. 

Boilermaker Road Race in a Mid-Size, Central New York Community

       We thank the Boilermaker Road Race and the city of Utica for its multi-decade efforts to offer a business and tourism event, in the world of health and fitness tourism. The Road (and Wheelchair) Race is part of an extensive network which parallels other networks such as "arts and crafts businesses",  ecotourism on the environment,  sports tourism,  music businesses and alliances, motorsports networks, "science networks", "disability industries", the "elite museums" and "zoos and aquariums", "engineering and computer sciences", and even academic lectures and tours (e.g., Cornell University Alumni on the Danube River, Europe). 

       Thank you to the sponsors and exhibitors for the 2018 Health and Fitness EXPO, and we hope all the guests in the city of Utica enjoyed their weekend this year. Friday's Utica Observer-Dispatch had the entries lists for the 15K and Youth Run, and Monday is the traditional race results report for the event.  Amanda McGrory, whom I met a few years ago briefly, won the women's wheelchair division yesterday morning, and Saul Mendoza's course record was passed for the first time in 2018 for the men's wheelchair division (courtesy Jason Powless, News Channel 2). More to come!

Author's Publications

Racino, J. (1990). Quotation: Why Supportive Living? Syracuse, NY: Syracuse University, Rehabilitation Research and Training Center on Community Integration. In: Smith, G. (1990). Supportive Living: New Directions for Persons with Developmental Disabilities. Alexandria, VA: National Association of State Mental Retardation Program Directors. 

Racino, J. & Lakin, K.C. (1990). The Rehabilitation Research and Training Centers on Families and Community Living. Syracuse, NY and Minneapolis-St. Paul, MN: Syracuse University and University of Minnesota. 

Racino, J. (1999). Policy, Program Evaluation and Research in Disability: Community Support for All. Binghamton, NY, London, and NY, NY: Haworth Press. 

Racino, J. (2000). Personnel Preparation in Community and Disability: Toward Universal Approaches to Support. Springfield, IL: Charles C. Thomas Publishers. 

Racino, J. (2002, March). The Boilermaker Road Race: Celebrating its 25th Anniversary: An Examination of Road Racing and Wheelchair Racing in the United States.  Rome, NY: Community and Policy Studies.   Square Market/Community and Policy Studies

Racino, J. (2015, March). The Rise in Health Care Financing in the Community. Local Governance Panel (Rivenbark & Racino) Denver, CO: American Society for Public Administration. 

Racino, J. (2017, November).  The State of the Sciences of Deinstitutionalization in the 21st Century. Panel Moderator: Robert Bartlett, University of Vermont.  Burlington, VT: NeCopa. 

Wikipedia, Community integration. (2012). En.wikipedia.org/wiki/community_integration

Supporting Documents

Health and Fitness EXPO, brochures and documents, Saturday, July 7, 2018

News Channel 2, Live Televised Coverage, Sunday, July 8, 2018

Social Media Sites, July 6, 2018, Amanda McGrory (2016 visit, participant 2018), Saul Mendoza (2002 study), Herman Garic (2002 study, participant, 2018), Krige Shabort (Paralympics, participant, 2018) from Kurt Fearnley (2002 study)

Updates: Ed Bradley (passed, 2002 study, New Hartford, NY), Craig Post (retired from racing, post-college and marriage, 2002 study, Rome, NY) 

Utica Observer Dispatch, Special Issue, Friday, July 6, 2018

Report Sales

Square Market/Community and Policy Studies or direct to Community and Policy Studies, 208 Henry Street, Rome, NY 13440-6506 USA.

Courtesy, of Julie Ann Racino, American Society for Public Administration, Section on Health and Human Services Administration, 2018-2019   



      









      

Tuesday, June 19, 2018

US DIRECT SUPPORT WORKFORCE

US DIRECT SUPPORT WORKFORCE IN THE 21ST CENTURY

 Authored by Julie Ann Racino
American Society for Public Administration

June 19-25, 2018

          In 2018, the University of Minnesota (UMN) reaffirmed its leadership role in the US Direct Support Workforce and People with Intellectual and Developmental Disabilities and Other Disabilities in an Issue of IMPACT (Volume 31, No. 1).  The government's "new management" indicates a current workforce crisis termed a "systemic and pervasive failure in the long term services and support system" in the US. The US Senate began a process in 2013 to examine the field of Long Term Care and to introduce the concepts basic to Long Term Services and Supports (LTSS), often within M-LTSS systems of managed care. 

The US Direct Support Workforce, NYS
         In New York State, beginning in the 1970s, we were delighted to be part of the first community group homes in the US, the first state work forces moving into the communities, the first University and Executive Office structures, and the development of new non-profit organizations and their expansion in local communities. Our organizations have mushroomed into NGOs in every state and almost every local community in the US.

        At the time, I was part of opening the state's first community mental health agency, and working with state and local governments to develop planning and review procedures to assure the health and well being of the new residents and the existing community members. And indeed I was among the first to combine the private, non-profit and state, county and local sectors into working groups for the new family support services. Today, the CSEA (government) manager with the notebook on NewsChannel 10 is reminiscent of the first home visits. 

       Over the years, many of the original "programs" became health care funded (Racino, 2015), and for many years bore names such as psychosocial rehabilitation services, independent living and community support services, and even skills (and instrumental skills) of daily living. These schemas were researched, evidence-tested, and were even the base for the WHO (World Health Organization, 1999; WHO, 2013) classification of disabilities. 

Deinstitutionalization and Community Support Workforces

        The world begin to change in response to the exposes of institutions (e.g., Rothman and Rothman's Willowbrook Wars) described in Dr.  Steven J. Taylor's accounts of deinstitutiona-lization in the US (e.g., Taylor & Searl, 1987; Conroy & Bradley, 1985). While most accounts discuss the 1960s exodus, via new drugs, from psychiatric centers in the US, intellectual and developmental disabilities were planned approaches, sometimes with judicial oversight. 

        While the community workforces continued to "simply expect" the traditional federal health care financing (e.g., HCFA) to reform from an old style institutionalized approach, the workforces continued to have strong support from the US Presidents. In 2015, in conjunction with the reform of the IDD (intellectual and developmental disabilities) facilities, Julie Ann Racino presented at ASPA in Chicago (2015) on the necessity for further work to target the nursing facility transformation to LTSS (Long-Term Services and Supports). 

       Indeed a worldwide class of deinstitutionalization researchers were created (e.g., K. C. Lakin of the University of Minnesota; David Felce from the University of Cardiff-Wales), and comparisons were made between population in the institutions and individuals in different models or setting types (e.g., group homes and foster care). Julie Ann Racino, Distinguished Lecturer, described the new 21st Century developments at NeCopa (Northeast Conference of Public Administration) in November 2017. 

Professionalization of the Community Workforces

       As most histories report, organizations such as the Arc began in basements and churches in the 1940s, then reached incorporation, and local-state-national status. The 1970s marked a period of negotiations between the state governments and non-profit organizations (e.g., NYS OMR-DD; Idaho Office of Mental Retardation, California Office of Mental Retardation and Developmental Disabilities; Arkansas Department of Mental Retardation) regarding institutionalized classes, "not necessarily a priority" of organizations such as the Arc-US. This became apparent later when the Arc was instrumental in removing stipulations on cost neutrality on the new Home and Community-Based (HCB) Medicaid Services Waivers (e.g., Smith & Racino, 1988, October) making it easier to serve community classes. This party served as an independent broker at state government and non-profit negotiations, including through decades at the university sector. 

          Direct Support Professionals (DSPs), a new term for the workers associated with the specific National Alliance of Direct Support Professionals, are part of state Chapters from the 1970s and 1980s which called for wage parity with the public sector employees and their established unions. These sectors, by state-e.g., Connecticut, New York and then nationally-ANCOR, NAPRF, repeatedly requested brokerage to better wages, better benefits, and better hours, working conditions, new community services, and professional and academic benefits (e.g., Lensink, State Commissioner, Connecticut; Racino, Rehabilitation Research and Training Center on Community Integration, Syracuse University, 1988). These sectors grew significantly in size, and continue to expand through dedicated legislative funds in states and at the federal levels. Competition in 2018 are reportedly from traditional health care organizations and hospital sectors (organized, union sectors). 

University Education of Community Personnel
     
        Julie Ann Racino's 2000 book Personnel Preparation in Disability and Community Life indicates the community support professional levels associated with the community workforces in the 1990s. These "federally, state and locally tested" models (e.g., "National Issues in Housing", Racino, 1990;  "National Institute on Personal Assistance Services", 1992; "Independent Living and Support Paradigms", 1991; "Changing Roles of Service Workers", 1990; "Support Agencies and the Support Paradigm", 1992) expanded from the traditional medications, goal planning and behavioral interventions of institutional programs, to full scale, inservice programs, preservice and basic to advanced degree programs, continuing education credits, executive education, annual conferences, seminars and planning sessions, certifications and accreditations, licensing, career ladders, national indicators, testing instruments, and self-advocacy and user-directed approaches. 

       From the beginning, Dr. Robert Bogdan (e.g., Bogdan,  Taylor, et al, 1974), our university research director and federal center directors (See, above), expressed concerns regarding professionalization of the workforce as advanced professional degrees were awarded, advanced research studies were approved, extremely high wages were paid to professionals (e.g., Vecchione home) within a home setting as model demonstrations, and conversely, a live-in, companion model was repeatedly preferred (Jean Vanier of L'Arche) which was never adopted (the Arc has live-in variations) by other than the religious groups. This period marked the awarding of the first educational Ph.D.s in community living in the US.

      During this period of the 1980s and 1990s, the government and university sectors supported a "positivistic" approach to evaluation and community development (e.g.,  Taylor & Bogdan, 1994), in contrast to the preceeding period of exposes. Professionalization (Wilensky, 1964), however, was reported as part of a trend worldwide across professions and fields which continues today (e.g., robotics and modernization). The university, NGO and governmental sectors became involved with "daily work" (e.g., development of integrated day services, 1987; parents and supported employment, 1989; foster care and permanency planning, 1987; quality support services, 1986; person-centered planning, 1987) ranging from regulations to legislation, financing, oversight, professional development, and program operations of "dual systems". 

       Waves of parent-professionals and self advocates were described as the product of these endeavors by the "workforce sectors" (e.g., Racino, 2000a to National Democratic Party, 2018, at "Molinaro for Republican Governor, NYS", 2018) which hosted psychologists, social workers, "full state departments and civil service lists", residential agencies, vocational support agencies, housing developments and boards, foster or family care workers, child protective workers, counseling agencies, community services workers, and much more. The community sectors "under the administrations of Clinton and Cuomo" (Andrew Cuomo, 2nd Term, Democratic Governor, NYS, 2018) integrated its traditional community agencies with new ones (e.g., Racino, 1999 to United Way, and then the Muslim Brotherhood and United Way fundraising competitors), and expanded its force and influence in local communities and worldwide. 

       However, the influence of small homes, family living, intermediate care facilities, vocational and residential training, independent living, and community jobs were among the taken for granted job sites for new workers in the fields (See, p.3 IMPACT, Hewitt, MacBeth, Merrill, & Kleist, 2018). The first entry of the residential classes for adults was cited by Racino in 1990 in a Personnel preparation book (Kaiser & McWhorter, 1990) which was current with the work of Michael Smull of the state of Maryland with US Education's Thomas Bellamy (Smull & Bellamy, 1991) to address the community crisis. These initiatives were followed by individual and family support, mixed income housing development, housing and user control, home ownership and natural supports approaches in the local communities (e.g., Bradley, Knoll & Agosta, 1992: Hagner, Snow & Klein, 2006; Ostroff & Racino, 1991). 

The Future: Competing Approaches to Direct Support

        According to the University of Minnesota's School of Education's Impact, the struggle to retain, recruit and maintain staff continues in 2018, together with the need for competency-based credentialing. An excellent racial and gender disparities article by Stephen Campbell (Policy research associate, Bronx, New York, 2018) compares the "entry level" direct support workers, nursing assistants, and home care workers; the comparisons are made on the basis of age, educational attainment, employment status, earnings and income, poverty level, public assistance, and health insurance status. The Impact issue in 2018 also highlights a father and his child with autism spectrum disorder, and confirmed self-directed services in 42 states in 2017. 

         As many of you know, the more likely comparisons are those of the "health care and education" sector on behavioral assistants and aides (See, Larson, et al, 2014 of UMN in Racino, 2014; Racino, 2000), and a hierarchy that includes MDs-psychiatry, Ph.Ds in community and clinical psychology, community and clinical social work, and new Ed.Ds ("generically educated") competing with physicians assistants (e.g., Scheffler & Kirby, 2003). The management and hierarchies are distinctly managed, and have distinctly different career tracks for workers and management, including increasingly in Health and Human Services Administration (Julie Ann Racino, HHSA Executive 2017-2018). 

      The ASPA university sector continues to have a high prevalence of  the traditional industrial complexes of criminal justice-public health-human services ("facility-based") (e.g., Racino, Rolandi, Huston & Bergman, 2017) with a new emphasis on homeland security post 911. Julie Ann Racino consulted with the Criminal Justice (e.g.,  Criminal Justice Review) and Public Administration and the Law Sections (e.g., Disability and the Law, e.g., Employment Law, Family Law) of ASPA beginning in 2015. 

        In particular, the distinctions made in the 1970s and 1980s compared the private and state sectors (thus the value of public servants, ASPA and the Public Sector Workforces, 2018), or seldom, the "unionized to the non-unionized" sectors (See, changing public employee unions of the future, US, Kearney,  2009). These changes have been effected by the "distinct roles" and "divisions" these sectors have been taking on in the ensuing years of "devolution" (Racino, 2017 in US-UK at NeCopa, 2017) and reform of civil service, merit-based systems (e.g., Berry, 2000; Thompson, 2001; current, 2018). 

Workforces at the Legislature

       According to reports at ASPA (American Society for Public Administration, 2015, Seattle, Washington), the corrections workforces are growing in the US taking a greater share of the personnel pie, and "worker pay" is being requested based on emotional distress. In addition, according to all parties, family caregiving and additional wages for the family to maintain a relative at home, e.g., in "early stages of Alzheimer's" is being advocated for at state legislatures throughout the US (AARP, 2017).  

     The Direct Support Workforces, organized at the Gubernatorial and Legislative Levels for decades,  have launched new state initiatives from Community Connections Career Partnership in Ohio, to the #beFair2DirectCare Campaign in New York. Liz Benjamin of Capitol Tonight reported on the NYS legislative developments, hosting panels on non-profit and governmental advocate initiatives in 2017-2018. At the Public Personnel Management levels, workforce diversity and inclusion (Choi, 2011; Guajardo, 2013) will continue as another governmental focus into the coming decade. 

Workforces in Mental Health

     Other workforces under this title were the original Community Support Services (CSS) of the National Institute of Mental Health (NIMH) which have roots in the field of rehabilitation and its expansion to mental health populations; the latter included services such as clubhouse programs as "psychosocial rehabilitation", intensive case management, to new models of consumer-directed services, community behavioral services, and supported housing (e.g., Blank, et al, 1996; Cuomo, 2014; Durbin et al, 1997; Racino, 2014; and Shen et al, 2008).  

     In addition, over 5.6 million adults over age 65 may be involved with substance use and mental health services before the reported mass overuse of "contraindicated drugs" in "nursing facilities" which are highly "aged and disabled". These "governmental" and "NGO" workforces in 2012 (e.g., National Institute on Medicine, 2012) were gearing up for new procedures that will include other secondary conditions such as diabetes and cardiovascular "diseases". In 2018, states and the federal government have invested "in all ages" regarding the opiod epidemic in America. 

Future Workforce Development

    ASPA (American Society for Public Administration) itself published a Special Issue in Spring 2018 on Workforce Management, presenting a New Vision for the Public Sector: Business Acumen, Innovation, Strategic Orientation, Leadership, Culture, Talent, and Technology based upon Human Resources Leadership. Human Capital Management and Strategic Planning and new Workforce Trends include: leaving the federal service prior to a tenth year anniversary, the new talent and Senior Executive recruitment, employee engagement, and the expected retirements leaving an extensive gap in workforce and institutional knowledge. 

      Further cuts through federal department consolidation (e.g., US Department of Education, and US Department of Labor to US Department of Education and Workforces) have been announced by the new "Republican Trump Administration" in 2018. The Centers for Medicaid and Medicare, "under President Barack Obama", hosted within Human Capital and EEO (2012), active workforce management groups which involve workforce compliance (also, new federal "stings" at health care in the community, 2017), person-centered services (at inclusion, equity and diversity, 2016), and social and behavioral services (at the White House Office of Science and Technology, 2016). These complement efforts at the US Senate (2013, LTC and LTSS) on the Long Term Services and Supports (LTSS), often the province of organizations such as Consortium of Citizens with Disabilities (2018). 

US Community Support Workforce: Health, Generic and Specialization Models in the Community

      In 2013, PCA (e.g., personal care, personal attendant or assistant, home health, certified nursing assistants) training standards for the 50 states, US workforce were also highly active (Kraus, 2013), complementing the Direct Support Professionals, Personal Support Specialists, Family Support Workers, Community Living Specialists, and dedicated Program Specialists (e.g., Day or Vocational Programs) (e.g., Bradley & Hierstein, 2015) . Julie Ann Racino served as national advisory to the California University Centers on Personal Assistance Services, and developed the "community support models" in intellectual and developmental disabilities through NIDRR. At ASPA, personnel generally are described as public and private sector personnel with the later achieving Nonprofit Governance, and the Business Sector (e.g., rise in CPAs in government; historic business to federal government) increasingly operating or outsourcing public sector governments. 

     Sherri Larson (2014) and her team at the University of Minnesota, a long time collaborator with Syracuse University's School of Education, proposed an online training and education model (College of Direct Support, generic base, 2018; Racino, 2000a) which includes competencies for aides specializing in:
*  aging and physical disabilities (e.g., Heumann & Racino, 1992);  
*  (social and) behavioral health of state governments (e.g., Racino, 2000b with Taylor, and Meyer-Voeltz, to "behavioral lifestyles", AR UAP, 1994), and 
*  intellectual and developmental disabilities (e.g., Racino with Taylor, Bersani, Shoultz, 2000b.) (See, Technical assistance model of Syracuse University-federal-university-state-local levels).

      These models based upon the original NYSACRA education of the 1980s (e.g., Racino & Schwartz of NY) still rely on continuing education (e.g., Missouri Association on Mental Retardation Keynote and PreConference on "Housing and Support", Racino, 1991) or other university/college departments for courses in budget and finance, housing and community development, and family studies. 
Sherri Larson and Amy Hewitt are part of the deinstitutionalization teams of Robert Bruininks and K. Charlie Lakin; Judith Heumann (and Steven E. Brown) worked for Ed Roberts, founder of Independent Living; and Steven J. Taylor, Henry J. Bersani, Jr., Bonnie Shoultz, and Julie Ann Racino are part of the deinstitutionalization teams of Burton Blatt and Douglas Biklen.

      US states offer public and private sector services daily to US citizens, and in the news today (June 2018), are the detention centers, migrants, and immigrant families which are based upon "civil servants" and "civil servant management" from health and human services, to specialized justice and immigration, and other departments such as education. US states are also active in the provision of new autism spectrum services, HIV-AIDS, and brain injury services in the community (e.g., Consortium of Citizens with Disabilities, 2012, 2018). More information is available in Public Administration and Disability: Community Services Administration (Racino, 2014) at http://www.crcpress.com/authors and more yet to come!

References
       American Association of Retired Persons. (2017). AARP Magazine and AARP Bulletin. Washington, DC: Author. 

      Berry, C.R. (2000). Developments in personnel/human resources management in state government. In J. J. Gargan, Handbook of State Government Administration. (pp. 177-219). NY, NY: Marcel Dekker,, Inc. 

      Blank, M., Jodl, K., McCall, B.R. (1996, Summer). Psychosocial rehabilitation program: characteristics in urban and rural areas. Psychosocial Rehabilitation Journal, 20(1): 3-10,

       Bogdan, R., Taylor, S., Grandpe, B. & Haunes, S. (1974). Let them eat programs: Attendants' perspectives and programming on state wards in state schools. Journal of Health and Social Behavior, 15: 142-151. 

       Bradley, V. & Hierstein, D. (2015, May 31). HSRI National Core Indicator Stability Survey. MA & OR: Human Services Research Institute. 

       Bradley, V., Knoll, J. & Agosta, J. (1992). Emerging in Family Support. Washington, DC: AAMR. 

      Campbell, S. (2018). Racial and gender disparities with the direct support workforces. The Direct Support Workforce and People with Intellectual, Developmental and other Disabilities. IMPACT, 31(1): 16-19. 

      Choi, S. (2011). Diversity and representation in the US federal government: Analysis of the trends of the federal employment. Public Personnel Management, 40.1: 1-25. 

      Conroy, J. & Bradley, V. (1985). The Pennhurst Longitudinal Study: A Report of Five Years of Research and Analysis. Philadelphia, PA: Temple University Developmental Disabilities Center. 

     Consortium of Citizens with Disabilities. (2012). Long Term Services and Supports Task Force. Washington, DC: Author. 

     Cuomo, M.C. (2014). HELP Model of Housing in New York (you tube). Albany, NY: NYS Association of Executives. 

     Durbin, J., Goering, P., Wasylenski, D., & Roth, J. (1997, Winter). Who gets how much of what?: A description of intensive case management. Psychosocial Rehabilitation Journal, 20(3): 49-56. 

     Garrett, K. & Shields, W.J. (Spring 2018). Workforce Management. PA Times, 4(1): 1-37. Washington, DC: ASPA. 

      Guajardo, S.A. (2013). Workforce diversity: An application of diversity and integration indices to small agencies. Public Personnel Management, 42.1: 1-27. 

       Hagner, D., Snow, J., & Klein, J. (2006). Meaning of homeownership for individuals with developmental disabilities. Mental Retardation, 44; 295-303. 

       Heumann, J. & Racino, J. (1992). Independent living and community life: Building coalitions among elders, people with disabilities, and our allies. In E.F. Ansello & N.N. Eustis (Eds.), Aging and Disabilities: Seeking Common Ground. Amityville, NY: Baywood Publishing Co., (pp. 79-90). 

      Hewitt, A., MacBeth, J., Merrill, B., & Kleist, B. (2018, Winter/Spring). Feature Issue: The Direct Support Workforce and People with Intellectual and Developmental and Other Disabilities. IMPACT, 31(1): 1-52.

      Kaiser, A. & McWhorter, C. (1990). Preparing Personnel to Work with Severe Disabilities. Baltimore, MD; Paul H. Brookes. 

      Kearney, R. (2009). Ch. 11: Public employee union of the future.  Labor Relations in the Public Sector (4th Edition). London, Boca Raton, FL,  and NY, NY: CRC Press, Francis and Taylor. 

      Kraus, L. (2013, January 22). PCA Training Standards: Findings from a 50 State Study. San Francisco, CA: University of California.

      Larson, S.,A., Sedlezky, L., Hewitt, A., & Blakeway, C. (2014). Community Support Services Workforce in the US. In J. Racino (Ed.), Public Administration and Disability: Community Services Administration in the US. London, UK and NY, NY: CRC Press. 

     National Institute of Medicine. (2012). The Mental Health and Substance Abuse Workforce for Older Adults. In Whose Hands? Washington, DC: National Institute on Medicine. 

     Ostroff, E. & Racino, J. (1991). There's no place like home: Creating opportunities for housing that people want and control. TASH Housing PreConference. Seattle, WA: The Association of Persons with Severe Handicaps, Subcommittee on Housing, Community Living Committee. 

     Racino, J. (1999). Policy, Program Evaluation and Research in Disability. Binghamton, NY and London: Haworth Press. 

     Racino, J. (2000a). Personnel Preparation in Disability and Community Life. Springfield, IL: Charles C.Thomas Publishers. 

     Racino, J. (2000b). Technical assistance and systems change: The roles of universities and colleges in field training. In J. Racino, Personnel Preparation in Disability and Community Life.  (pp.167-186). Springfield, IL: Charles C. Thomas. 

     Racino, J.A. (2014). Family Support, Family Studies and Community Services. In: J. A. Racino, Public Administration and Disability: Community Services Administration in the US. (pp.  101-122). London, Boca Raton, FL, & NY, NY: CRC Press, Francis and Taylor.

     Racino, J.A. (2015, March). Increase in Health Care Financing in the Community in the 21st Century. Local Governance Panel: W. Rivenbark and J.A. Racino. Chicago, Illinois: American Society for Public Administration. 

     Racino, J., Rolandi, S., Huston, A., & Bergman, A. (2017). Expanding Community Integration Theories to Inclusion, Equity and Sustainability. ASPA Panel Presentation Endorsed by Public Administration Theories. Atlanta, GA: American Society for Public Administration. 

     Racino, J. (2017, November). The State of the Sciences on Deinstitutionalization in the 21st Century. Panel Moderator: Robert Bartlett. Burlington, VT: Northeast Conference on Public Administration. 

     Rothman, D. and Rothman, S.M. (1984). The Willowbrook Wars. NY, NY: Harper & Row. 

     Scheffler, R.M. & Kirby, P.B. (2003). The occupational transformation of the mental health system. Health Affairs, 22(5): 177-188. 

    Shen, L., Smyer, M., Mahoney, K., Simon-Rusinowitz, L., Shinogle, J., Nordstrand, J., Maohney, E., Schauer, C., and delVecchio, P. (2008, November). Consumer-directed care for beneficiaries of mental illness: Lessons from New Jersey's cash and counseling program. Psychiatric Services, 59(11): 1299-1306. 

     Smith, G. & Racino, J. (1988, October). Financing community services. Presentation at the National Home and Community-Based Medicaid Waiver Conference. Eugene, OR: National Association of State Mental Retardation Program Directors and Syracuse University, Rehabilitation Research and Training Center on Community Integration.

     Smull, M. W. and Bellamy, G.W. (1991). Community services for adults with disabilities: Policy challenges in the new support paradigm. In L.H. Meyer, C.A. Peck, and L. Brown (Eds.), Critical Issues in the Lives of People with Severe Disabilities (pp. 527-536). Baltimore, MD: Paul H. Brookes. 

      Taylor, S. & Bogdan, R. (1994). Qualitative research methods and community living. In: M.F. Hayden & B. H. Abery, Challenges for a Service System in Transition (pp. 43-64). Toronto and Sydney: Paul H. Brookes. 

      Taylor, S. & Searl, S. (1987). The disabled in America: History, policy and trends. In P. Knobloch, Understanding Exceptional Children and Youth (pp. 50-64). Boston: Little Brown.

      Thompson, J. (2001, June). The civil service under Clinton: The institutional consequences of disaggregation. Review of Public Personnel Administration, 21(2): 87-113. 

      Wilensky, H.L. (1964, September). The professionalization of everyone? The American Journal of Sociology, LXX (2): 137-146. 

      World Health Organization. (1999). International Classification of Impairments, Disabilities, and Handicaps. Geneva, Switzerland. Geneva: Author.  

     World Health Organization. (2013). International Classification of Functioning, Disability and Health. Geneva: Author. 


Sunday, May 6, 2018

THE ENVIRONMENTAL WARS IN THE 21ST CENTURY

THE ENVIRONMENTAL WARS IN THE 21ST CENTURY

May 2018

Julie Ann Racino, American Society for Public Administration
Section on the Environment and Natural Resources


       In the 21st Century, environmentalists have won one of their greatest global achievements, the Sustainable Development Goals (SDGs) of the United Nations.  These goals offer leadership within a framework of Sustainable Cities and Communities (Goal 11), Affordable, Clean Energy (Goal 7), Climate Action (Goal 13), and Life Below the Water (Goal 14). We commend the International Assembly of the American Society for Public Administration for promoting these goals in the Annual Conference in Denver, Colorado in March 2018. 

      In 2015, the American Society for Public Administration (Section on the Environment and Natural Resources Administration) was presented areas of concern on the environment (e.g., environmental toxins near low income housing, worldwide water and sewage disposal, nuclear accidents and contaminants, war injuries, such as Agent Orange in early family studies). In addition, support for climate change initiatives, clean, wind, solar and green energy, innovative partnerships in rural areas with gender equality at land use, and ecotourism with access passes and symbols at hotels and restaurants were cited among the 11 priorities.

 Political, Science Context on Climate Change

     In September 2014, the Clinton Global Initiatives (CGI) held a plenary session titled: Confronting Climate Change is Good Economics. Twenty percent of the world's population was still without electricity and lights, especially in Asia and Africa. The panel noted the CGI's commitment to Mayor's Climate Action Plan, green infrastructure and the Global Fairness Initiative with new investments in the natural and built environments. The Danish Prime Minister indicated a 40% goal of reduction in CO2 emissions, and an intent to decouple growth from the emission standards. The panel of Intergovernmental Science Policy Platform on Biodiversity and Ecosystems and the Journal on Ecotourism were recommended. 

     In August 2014, the United Nation's Foundation met on the Millenium Development Goals which preceeded the SDGs. The Millenium Development Goals (MDGs) were measured over 15 years and involved inclusion and gender equality, over 600 million young people under the age of 35 on the African continent, the roles of agriculture (e.g., "hectares to 6 women"), the creation of dynamic and profitable businesses, and the environment and sustainability. Of course, "gender views are class, race and income-based", and the world is viewed through social media as part of established networks. The meeting and discussion took place in New York City with US AID agency from 8:30-10:00 am, Monday, August 18, 2014. 

Science of Environmental Justice and Economic Sustainability

     Yesterday, Governor Andrew Cuomo-D of New York mentioned the early formation of an EPA (Environmental Protection Agency) in New York predating the federal EPA (now being attacked as Republican, anti-environmental, Scott Pruitt). In March 2010, the federal EPA collaborated with government and nongovernmental organizations to host a groundbreaking symposium, "Strengthening Environmental Justice Research and Decisionmaking: A Symposium on the Science of Disproportionate Environmental Health Impacts" (American Public Health Association, viewed 3/19/2015).  

    In 2010, CRC Press (one of my academic publishers) released a new book in its series on Environmental and Ecological Risk Assessment: Environmental and Economic Sustainability (Hardisty, 2010). The press on the book highlights the petroleum industry ("fossil fuel energy"), the "intimate relationships" with the environment at "all stages of the life cycle", and economic tools and recent advancements in "valuation of natural resources".  As our New York Governor explained, the Adirondack Park established in 1892 is a form of environmental protection and 69,000 new acres were added to the park (Cuomo, May 4, 2018, Youtube). In 1962, New York's first hydroelectric dam was built in conjunction with the environmental movements (Ibid, 2018). 

SENRA Report on the Earth World Summit

     In December 2015, Julie Ann Racino reported on the World Summit led by UN Secretary General Ba-KiMoon of South Korea and the Climate Change Plan of President Obama's White House. Similar to other global treaties (e.g., international security), the new federal administra-tion under President Donald Trump has not affirmed the prior Executive signatures "of the United States" on international climate change.  In part, the Trump Administration has been repeatedly reported ("maligned") as not only anti-environmental and anti-climate change, but also as anti-science of US universities and US leading scientists. "We were pleased at his direct attendance at the subsequent World Summit, and his efforts to frame an agenda that fits the new US administration, 'duly elected' in the US". 

     In the world history context, we continue to support the International Environmental Programs which are affected by "geopolitical systems changes" and "pollution immigration" as contaminants cross international boundaries (Johnson, 2007, p. 325). Through the decades, we will also note the new 1972 United Nations Environmental Programme, the historic 1992 Environment and Development Conference in Rio de Janeiro, Brazil, and the Conventions on Hazardous Wastes and Their Disposal, Chemical Safety, and even Persistent Organic Pollutants, another science-identified, global hazard (Ibid, 2007). "We thank President Macron of France, in his historic state visit to the US, for citing the importance of the environment and biodiversity in 2018". And, we also will mention, from our experiences in ASPA Denver 2018, that the transfer of environmental concerns to "college or university" economic and justice groups (e.g., Bacot & Damon, 2000) has been done without the support or knowledge of the American public. 

Julie Ann Racino, American Society for Public Administration
SENRA, HHSA, Budget and Finance, 2018
Consultations, Criminal Justice, PA and the Law, ASPA, 2015


Wednesday, March 14, 2018

Health and Human Services Administration Endorses 20 Panels at ASPA Denver 2018

Health and Human Services Administration (HHSA) Section Endorsements of ASPA Panels

        Julie Ann Racino, ASPA 2017-2018 Health and Human Services Executive Committee, visited three panels endorsed by HHSA on Friday, March 9, 2018. ASPA Committee Chair Alexander Henderson of Long Island University served as reviewer on the selection of the panels for the Annual Conference held in Denver, Colorado. 

       The first panel was titled Local Government: Policy Challenges and Solutions and was co-endorsed by the Section on Intergovernmental Administration and Management. Bakry Elmedni of Long Island University stunned this reviewer on the Flint Water Crisis as an arrest of 9 Michigan officials, including criminal manslaughter charges. In addition, the Detroit Water and Sewer Department was "transferred" to the Karagandi Water Authority under a now "often used provision" of emergency management in governments. The second presentation continued to Flint's revenue problems involving "mass bill collection", liens on houses, and declining cities. 

       The third speaker discussed social equity as voting patterns and turnouts in states, and noted "extreme policy positions" at the elections. Voting by "people of color" was disproportionately weak with "the homeless excluded from voting" by lack of state-issued ids. The speaker cited 13 closed primary states in the US., and a drop of 35% of the Democratic party between 2012-2016. The fourth speaker cited the book Just Cities (2011) and a proposed 2013 Neighborhood Park Alliance in New York and Portland, Oregon. "Fund transfers" were discussed as 9 programs, $130 million for 35 underserved parks (Parks Equity Framework), and reallocation of 1/3rd of funds through another Parent Equity Fund

       The second panel was titled Practical Advice for Supporting and Promoting LGBTQIA Social Equity in Public Administration and was held from 1:15 to 2:45 pm in Mineral Hall G at the Hyatt Regency. The LGBT Section was newly endorsed by ASPA, while the PA and Disability Section held three meetings in three US cities (Chicago, IL; Seattle, WA; and Atlanta, GA). The presenta-tion was also endorsed by the Sections on Women in Public Administration, Democracy and Social Justice and Ethics and Integrity in Governance. 

        The Health and Human Service Executive (who has "astronomical health care costs" and a national crisis at universal health care) learned for the first time of "gay police associations" in San Diego, Gay Officers Action League in New York City, Committees of Police Societies, Queer/Radical Associations, and a chart of expansion of "specialized police associations" in the US.  The third speaker discussed the state of transgender-inclusive policy in 365 municipalities and all 50 states using HRC's State of Equality Index (2016). "Areas involved are foster care, hate crimes, housing, adoption, education, employment, and public accommodation". The fourth speaker indicated that the New Orleans Police Department was charged for "failing to provide critical policing services to language minority communities".
   
        The third panel was titled Public Health Challenges in the 21st Century, and was co-endorsed by the Sections on Democracy and Social Justice and Intergovernmental Administration and Management. The program brochure indicates the following: William Swaim (Moderator, CoAuthor), Vanessa Fenley (Presenter), Anita Larson, Emily Brixey, Iseul Choi, Terri Schreiber, Changsoo Song, Mindy Anderson-Knott, Mark Davis, J. Ramon Gil-Garica, Jennifer Rott, and Wayne Wohler. Represented were the University of Colorado at Denver, University of New York at Albany, University of Nebraska at Lincoln, "Opiods and Prescription Drug Monitoring Programs" in Pennsylvania, Denver, CO and an Education Program by the Minnesota Department of Education. 

       Six of the above speakers presented and according to the subsequent question and answer period, none of the speakers are involved with public health's designated "Traumatic Brain Injury" (US Congressional-US states point of responsibility). The urban sustainability and public health nexus addressed chronic health and GHG emissions (e.g., asthma, COPD, heart disease) and physical activity (walkability, built environment), based upon 500 cities (174 city sample, 32 states) and 6 indices from the Centers for Disease Control (CDC) data sets. The second speaker discussed "citizens decision making on selecting health care plans" and perceived performance and satisfaction measures. 

       Private consulting on opiods was highlighted with liberal Colorado politics, a "Coordinating Center at the University of Colorado School of Pharmacy", public surveillaince tools with data analytic software (e.g., NarxCare, OpiSafe), and licensing fees. A presentation on minority health disparities concentrated on underage drinking before age 13 (grades 5-12) with comparisons of Hispanic and non-Hispanic populations, and white and non-white populations. The SAMHSA (federal, mental health and substance abuse) study focused on one Nebraska County, and the research methodologies involved fidelity checks and ANCOVA statistical analyses on race and ethnicity regarding "school education program" to "prevent or stop alcohol use". 

      The final speaker from the Minnesota Education Department (who has a DPA) discussed MN's growing together pilot involving 80% of moms working outside the home, and early intervention and early childhood programs. MN is part of the University of Chicago School Research Consortium in 2018. "An expensive, integrated data systems for early childhood collection" is required and is now available to answer "all policy questions"!

Julie Ann Racino, "Selected Friday Panels Endorsed by Health and Human Services Administration, 2018"                                                    Posted on 3/14/2018

     

Tuesday, March 6, 2018

Public Administration and Disability Or What Happened to Disability Public Policy?

PUBLIC ADMINISTRATION AND DISABILITY IN THE 21ST CENTURY


   Julie Ann Racino
Member, Health and Human Services, and Budget and Finance
American Society for Public Administration 

March 2018

        In 2015, the American Society for Public Administration began a process to inform it membership of the multi-decade efforts to reform institutional to community-based (CBOs) organizations in the US and worldwide. A formation Section on Public Administration and Disability, as an addition to the existing ASPA Chapters and Sections, proposed a series of goals for review by its membership which are highlighted here:

Health and Human Service Goals

1. Disability and Ethnic NGOs and Their Status
2. Academic Education Programs in Public Administration and Disability 
versus Public Health and Management
3. Human Services to Community Health or Dual Transitions at Managed Care
/HealthCare Marketplace
4. Individual, Family and Community Health: One Health Concept vs. 
Behavioral Health Care

Brief Findings:
I. Disability and ethnic NGOs (e.g., the Arc-US, Hispanic Action League) are separate entities and have expanded in the US and worldwide; ASPA's university public administration departments claim to be primarily the latter, as highlighted by Virginia Commonwealth University's Susan Gooden. ASPA PA departments may be accredited to offer both public administration (MPA) and public health (MPH) degrees. 

II. Managed Care is operational in the US, and is not necessarily a preferred management by those governments wishing to achieve universal health care (e.g., health care marketplaces). Managed Long Term Services and Supports (MLTSS) is not the same as LTSS (Long Term Services and Supports). 

III. ASPA's Journal of Health and Human Services Administration published an ecological concept of community in line with individual, family and community health, but the expansion of government funds is heavily behavioral health care. The concern with the latter is its use with involuntary care and its expansion in US and globally. 

Environmental Goals
1. Conversion to Green and Sustainable Government and Contracting Agencies
2. Support of Global Change and Local Environmental Concerns
3. Prevention, Health Promotion, Resiliency, Community Support and Wellness

Brief Findings:
I. ASPA Annual Conference presentations in 2016 and 2017 highlighted sustainability in community and economic development, and ASPA held sessions for its personnel on rules in government contract and procurement. Local and State Government Review held ASPA presentation and discussion sessions.

II. The PA Times in 2017 highlighted by ASPA president Alan Rosenbaum, the Sustainable Development Goals (SDGs) and the contributions of public administration toward a better environment and world. 

III. A resurgence of the concept of resiliency ("bounceback"), new institutes in health promotion, and prevention in the traditional public health concepts (e.g., "tobacco cessation", "disease eradication") were still the most popular concepts with alternative medicine (e.g., "wellness" through yoga, fitness, health bonuses for healthy habits) and community support (at NGO woman CEOs) being overshadowed by other concerns such as community policing in the 21st century.

Budget and Finance Goals
1. Health Care and Community Financing
2. State Categorical Service Systems, Government Personnel, and Contracting
3. Governmental Programs: Medicaid, Medicare, Social Security and Social Security Disability
4. Individual and Family, Consumer-Controlled Budgets

Brief Findings:
I. Julie Ann Racino presented at the 2015 ASPA Annual Conference on Health Care Financing and its Growth in the Community (with William Rivenbank). Presentations of Employment First and its Relationship to Cultural Diversity were held with Sanjay Panday and ASPA universities by Allan Bergman and Julie Ann Racino in Seattle, Washington.

II. ASPA highlighted the federal departments with the new US Centers for Medicaid and Medicare visible as a governmental administration. The federal government itself has been entertaining proposals to privatize Medicaid and Medicare (not advised by this party; similar proposals to privatize jails and prison systems) and a new Supplement on Medicaid and Medicare was published in Public Administration Review

III. Cash for Care (privatization health care schemes) international edited book is now available, in addition to books on direct payments, family policies worldwide, encyclopedia entries in direct payments and user-directed personal assistance, new person-directed conversion plans in Europe and Australia, and laws in Europe on employment support allowances (the latter reported as newly attacked by the elective governments). 

IV. Association for Budgeting and Management (ABFM) is affiliated with ASPA and holds its own Annual Conference with a community orientation to the budget and personnel; the definition of community is the "pre-1970s" one which includes 100-bed private, nursing facilities (no, at forced hospitalization), new assisted living on private, non-profit campuses, "side by side buildings" (educational facilities in disability), rehabilitation and correctional facilities as community.  

V. New US Personnel Administration book by ASPA members which updates through the President Barack Obama federal administration. Literature reviews indicated earlier federal outsourcing as part of federal downsizing and major changes in the US and state civil service systems (public servants).  

Inclusion and Empowerment Goals
1. United Nation's Convention on the Rights of Persons with Disabilities (2006) now cojoined with the UN Convention on the Rights of the Child (2018, UN debates)
2. Deinstitutionalization, Smart Growth, and Community Development
3. Community Participation, Inclusion and Empowerment: Principles and Theories of Families, Independent and Supportive Living, Person-Centered and Employment First

Brief Findings:
I. United Nations, located in New York City, continues to be a hotbed of international action with the new administration and its US Ambassador at the UN Security Council (devastating war in Syria, landmines in Ukraine), human rights reviews by international bodies, International Day of Persons with Disabilities (and UN disability groups), and Ministerial Leadership Speeches, Votes and Actions from the environment to "new world visions" (from the world order, now UN web tv).

II. Julie Ann Racino presented at NeCopa on the State of the Science in Deinstitutionalization in 2017, US-UK relationships in government and public policy, and Community Integration and Inclusion Studies over 40 years (courtesy, leadership Douglas Biklen and the Center on Human Policy, Schools of Education). Mathematica, a private research firm, indicated plans in 2016 for reallocation of community financing varying from the US State of the States in Intellectual and Developmental Disabilities (Braddock, Hemp, et al, 2015).

III. Smart growth and transportation with Transportation America, and Policy Link (excellent, ethnic base, national conferences) represent new national organizations that are represented in America's new urban growth, in the development of modernization of transportation infrastructure, and in plans for pedestrian and bike trails to curb the automobile pollution in the US. Housing panels were featured in Atlanta, Georgia and Seattle, Washington with new government initiatives to address escalating housing costs, support services and homelessness.

IV.  President Barack Obama began the National Institute on Independent Living and Rehabilitation Research (NIDILRR) in the US Department of Health and Human Services Administration in Department of Community Living. Other national institutes, such as those in US Department of Education (e.g., National Institute on Disability Research and Rehabilitation) or US DHHS (e.g., National Institute on Mental Health) continue to provide leadership for national initiatives.

Personnel Goals
1. Compliance with the Americans with Disabilities and Individuals with Disabilities Education Improvement Act
2. Development of the US Direct Professional Workforce for the Government Sectors (and Non-and-For-Profit)
3. Meeting Direct Service Needs of Individuals and Families (e.g., Support and Respite Aides,  Specialized Child Care)

Brief Findings:
I. The education and disability systems are very actively involved with passage of current laws and funding opportunities (e.g., President Barack Obama and funding for housing and HIV-AIDS); on the 1970s standards, ASPA itself (and the court systems themselves) is out of compliance on integration standards (e.g., active Architectural Access Compliance Board). Historic videos online (C-SPAN-3) on the Education of Handicapped Children's Act of 1974 with Judith Heumann, cofounder of World Institute on Disability (See, Joan Leon, 2018). 

II. New efforts to address the US telephone relay system for the deaf and hard of hearing, and taken-for-granted hearing exams for "newborns"; and to make available expanded opportunities for individuals with blindness (including US taken-for-granted cataract surgery which easily and effectively corrects partial blindness). Health care plans on state exchanges may also be packages for cancer treatments or HIV-AIDS planning.

II. The US Direct Professional Workforce (Racino, 2000; Larson et al, 2012) "exited again" as "multiple nationals" intellectual and developmental disabilities, separating from an integrated workforce across state departments and voluntary associations. CCD (Consortium of Citizens with Disabilities) still represents mixed voluntary associations in Washington, DC (e.g., now Autism and Family Support). ASPA members Julie Ann Racino, Allan Bergman, and National Council Members Andrea Huston and Stephen Rolandi were given the prison reform in intellectual and developmental disabilities in 2017. 

III. The new "Behavioral Health Care" became the new term for the personnel related to "substance abuse and mental health" (SA/MH), one of 9 categories of "behavioral health practitioners" (new management groups). Sherri Larson was a behavioral aide early in her own career (Larson in Racino, 2014), and my colleague K. Charlie Lakin's (Lakin & Racino, 1990) IMPACT is based upon the generic "Support and Inclusion Workforces" of Syracuse University with "behavioral multi-decade overlays" in other journals (University of Minnesota). 

IV. More information forthcoming with a major concern its relationship to mass incarceration and growth in corrections workforces and increased budgets devoted to these sectors (being transferred to criminal justice control -"Education reporting"). For example, yesterday (March 5, 2017), new NYS penal law revisions "effective immediately" with televised coverage and "no laws to the viewers". 

V. Thank you for the new books in 2012 (e.g., Carl Dunst and George Singer, our colleagues from the 1980s science centers and universities) and articles (e.g., Chris Hatton, UK on respite; Sherri Larson on specialized aides) which described early childhood, early intervention, early family support, user-directed  services, "federal approved" aides, and family approaches to young children and their futures. 

VI. Schools of Education continue to operate separately from Schools of Public Administration for the most part, for example awarding dual inclusion education degrees (with allowances for work in mental health, private practices). 

Public Policy and Disability Goals
1. Comprehensive and transparent public policy and public policy and human development
2. Development of public administration and disability workforces in the community
3. Public administration and disability: Comparative approaches in the international sector

Brief Findings:
I. Transparency was a primary goal of the Obama Administration, and human development, a hallmark of the Urie Brofenbrenner age has now a new mental health and corrections education "cohort" of Ph.D.s and MDs (e.g., School of Human Ecology, Cornell Weil Medical Center in New York) together with a new undergraduate psychology (e.g., decade of the brain). Thank you to John Eckenrode, immediate past Director and Pat Thayer of the Urie Brofenbrenner Translational Center. 

II. ASPA will continue with leadership in non-profit governance which will affect the future of other non-profit industries in the US and globally, and vice versa. The roles of governments will continue to change in a post-911 era in which defense budgets have escalated over health and human services, with the latter also escalating beyond the budgets of Americans. ASPA does not have a workforce termed disability per se or for that matter, public administration and rehabilitation, though the US Direct Support Workforce (Larson, et al, 2014 in Racino, 2014; Brandt to Trump, 2018) falls under the Nonprofit Governance Section, "Women in Government", Science and Technology, Minority Administration, and Health and Human Services Administration.

III. International sectors and associations continue to be "robust sectors of the economies" and will continue to develop as a distinct sector "from or as governments" in the coming decades. The third sector voluntaries, became literature prominent and include expansive growth in "gender organizations and goals" which are reaching tipping points in personnel in the 21st century. 

IV. State departments are seldom addressed in the literature, other than as one department (e.g., NYS Office of People with Developmental Disabilities); and state departments tend to keep their own reports and archives in government. Federal departments and their reorganizations continued to be reviewed in 2017 (Racino, NeCopa, 2017, e.g., "partial reorganization" of HEW to US DHHS) with an organizational chart describing Administration on Children and Families in Racino, 2014.  Julie Ann Racino offers an introduction in her book, Public Administration and Disability: Community Services Administration in the US (Racino, 2014) at http://www.crcpress.com/authors.

For more information, please feel free to contact Julie Ann Racino, via ASPA in Washington, DC at the Main Office, 1730 Rhode Island Ave., NW, Suite 500, Washington, DC 20036; the author resides in Rome, New York.