Closing institutions in New York State: implementation and management lessons.
This article examines the lessons learned about implementation and management from the closing of six large institutions for people with mental retardation in New York State. Unanticipated problems occurred, despite special attention to implementation issues in policy design and demonstrated management capacity in similar circumstances. A study of the closure experience showed that subtle but important changes in policy as well as changes in the context of implementation confounded the reasonable expectations of success that policymakers, managers, and analysts would normally have under these circumstances. A closer look, however, suggests that this experience should not be surprising. A more appropriate understanding of the role of policy, policymakers, and managers in implementation suggests that the burden falls heavily on middle managers, and that policy management capacity and an intergovernmental management perspective are crucial to implementation success. Moreover, this experience suggests that a broader definition of success that encompasses this normal turbulence of implementation provides a better appreciation of the requirements of implementation.
Castellani
P J
PJ
New York State Office of Mental Retardation and Development Disabilities.
D003155:Community Mental Health Centers / Q000458:organization & administration; D003159:Community-Institutional Relations; D003659:Decision Making, Organizational; D003688:Deinstitutionalization; D005069:Evaluation Studies as Topic; D006271:Health Facility Closure / Q000331:legislation & jurisprudence / Q000379:methods*; D006783:Hospitals, State / Q000331:legislation & jurisprudence / Q000458:organization & administration*; D008607:Intellectual Disability; D009518:New York; D010934:Planning Techniques; D011050:Policy Making; D013221:State Health Plans; D014481:United States