How well a local government is able to provide for the needs and preferences of its citizens generally depends on the financial resources available; and, how such resources are allocated, distributed, and managed. Demographics, size of local government, supply and age of infrastructure, financial position of the government, and the local economy represent a few of the factors affecting what public goods and services citizens prefer. Internal systems of accounting and control affect the allocation, distribution, and management of financial resources. As such, these internal systems significantly affect the provision of public goods and services. The research outlined in this study examined the relationship between a government's financial management capacity (independent variable) and its financial condition (dependent variable), while controlling for environmental factors related to governance and demographics. Financial condition was quantitatively measured using financial ratios calculated from a database of over 1,600 U.S. cities compiled by the Government Finance Officers Association. Financial management capacity and its relationship to financial condition were measured with a survey of the chief financial officers of almost 500 of the sample cities. This research was exploratory in nature as there is little empirical evidence with respect to financial management capacity or its relationship to overall financial condition. In this study certain statistically significant moderate correlations were found with respect to financial condition and financial management capacity. However, multiple regression analysis of financial condition and financial management capacity (controlling for governance and socio-economic factors), indicated no statistically significant relationship between them as conceptualized and operationalized for this study. When controlling for certain governance and socio-economic factors, annual limits on increases in assessed property valuations and population were found to be statistically significant with respect to financial condition. Additionally, these control variables increased and decreased financial condition, respectively. A major contribution made to the literature by this study lies in its attempt to establish an empirical relationship between financial management capacity and government performance as measured by financial condition. Based on existing literature as reviewed by this researcher, the testing of this relationship had not been done previously. This study defined and measured both financial management capacity and financial condition in dimensions and indicators that can be used in future research. Additionally, efforts were made to test the internal reliability of both measures. The results of this research indicated there are a number of other financial management capacity and environmental factors influencing financial condition beyond those identified in this study. This research also provided insight regarding the extent financial management capacity affects financial condition even though such relationships were not found to be statistically significant. Because no statistically significant relationships between financial condition and financial management capacity were found in this study, additional research is necessary to further explore this relationship as well as the correlation between the various indicators of these concepts.

This study sought to identify the key determinants that lead individuals to participate in the transportation planning process. Two models of participation, one for the short-term and another for the long-term, were developed to test whether the key internal and external determinants are responsible for influencing a person's willingness to participate. The data for this study came from a mail-back survey that was administered to a random sample of 570 individuals throughout the State of Florida for a response rate of 37.37 percent. The results indicate that the internal motivational determinants exert more influence on a person's short-term willingness to participate as compared to a person's long-term willingness to participate. In addition, the external social capital determinants exert more influence on a person's long-term willingness to participate as compared to a person's short-term willingness to participate. However, only one of the three external citizenship orientation variables, participatory citizenship orientation, was found to be influential in determining a person's short-term willingness to participate. Recommendations were made for public managers to work collaboratively with the public as a participative facilitator, thereby opening up the decision-making process to the general public. One suggested course of action is for public managers to use existing civic organizations as a base for widening an agency's long-term planning outreach programs. In addition, suggestions for future research propose that qualitative studies delve in-depth into the positive/negative feelings related to participation, as well as look at how different public participation techniques may affect a person's willingness to participate, especially as it relates to different time frames.

In the event of a bioterrorist attack, emergency departments are considered the first line of response for all acute levels of care. This study focused on hospital emergency departments in Florida and the activities, policies, and procedures involved in preparing for a bioterrorist attack. Hospital size, location, and system affiliation were related to attaining these levels, and their impact was assessed. Through a cross-sectional survey design, the physical properties of the 77 hospitals (i.e. facilities, equipment, communication systems, etc.), and the social characteristics of the organizations (managerial functions including: planning, training, financial, and environmental characteristics) were examined. One-way analysis of variance and t-tests revealed that bed size was a significant predictor of mean levels of preparedness. In addition, although more hospitals are conducting training activities, a disconnect between plans and communications of said plans still exists along with many deficiencies still needing to be corrected. Study limitations are discussed and important policy implications are presented. Suggestions for improving preparedness levels and implementing new policies include: conducting training exercises, developing community ties and mutual aid agreements, and using information technology with detection of an event and communication of the information garnered from these efforts.

The purpose of this study was to determine whether a coordinated and comprehensive system of care for the uninsured changed the behavior of the uninsured by decreasing non-urgent utilization of the emergency departments within a large, urban county. The literature on emergency department trends and interventions designed to decrease "inappropriate" or non-urgent use of the emergency departments was reviewed and links to relevant theoretical concepts were identified. Utilization data from six emergency departments and six federally qualified health centers were evaluated. Secondary data over a three-year time period were abstracted from patient and organizational records at the hospitals and federally qualified health centers. The utilization data from the emergency departments and health centers were compared. The analysis revealed a significant change in the number of non-urgent visits by self-pay patients at the emergency departments when the health centers expanded. A 32.2 percent decrease in utilization of the emergency departments by self-pay patients was found. Non-parametric tests demonstrated significant differences in the population seen at the emergency departments and the clinics over the three-year study period. Regression analysis demonstrated a statistically significant decrease in non-urgent, self-pay visits at the emergency departments as a result of the increase in self-pay visits at the federally qualified health centers. Further analysis includes forecasting the impact of future federally qualified health centers on emergency department utilization. Recommendations for future research include evaluation of the increased numbers of non-urgent transports from the local emergency medical system by self-pay patients as well as the design of a pilot study to look at the effectiveness of transporting these patients to the federally qualified health centers for care instead of to the local emergency departments.

The American system of governance includes a network of state and local units identified as either general purpose or special purpose governments. The latter are often aligned with, but operate independently of, general purpose governments. Even as these special purpose or special district governments have shown extraordinary growth relative to their general purpose counterparts, there has been little interest in them or the structural characteristics that distinguish their systems for maintaining order and assuring accountable behaviors. In the meanwhile, the literature regarding accountability has been expanded materially in the last several years leading to debates about its form, component parts, objectives, and the preferred means for achieving accountability as an end state. While these concepts may have application to special districts, inquiry has yet to extend to the particular devices required to monitor or control these governments. This research effort closes the knowledge gap by linking this little studied form of government with recent ideas about accountability and the role that citizen participation plays in developing or advancing accountable behaviors. The analysis applies an adaptation of the well known model developed by Romzek and Dubnick (1987) to create an accountability framework and documents the role that public participation plays in influencing accountable behaviors. The analysis culminates in a multivariate model that examines the role of pubic participation in the context of competing influences that might also force accountable behaviors. The research concludes that participation can be an important influence in shaping specific forms of accountable behavior but that other factors are also essential to sustaining accountability. Most notable among these other factors is the role of the workplace environment, defined here in terns of employee interaction, ethics training, purpose, overall sense of commitment and other attributes.

Discrimination and inequality encountered by gays and lesbians in the United States is profuse. A cornerstone of the gay rights movement, equality in the workplace has been a pivotal struggle for gays and lesbians. This study examined the attitudes and opinions of registered nurses (RNs) regarding homosexuals in general and the protection of homosexuals in the workplace through a nondiscrimination policy. The author measured overall homophobic and discriminatory beliefs of the sample using the Attitudes Toward Lesbian and Gay Men (ATLG) Scale; the demographic questionnaire was infused with questions regarding a protective workplace policy. Using T-tests, one-way analysis of variance (ANOVA) and structural equation modeling (SEM), correlations between independent variables (gender, age, religious association, belief in the "free choice" model of homosexuality, education level, exposure to homosexuals through friends and/or family associations, race/ethnicity, and support or non-support of a workplace nondiscrimination policy protective of gay men and lesbians) with the dependent variable of homophobia were explored.

This dissertation examines the public participation activities of State Departments of Transportation (SDOTs) in the United States. A review of existing literature and legal frameworks suggests that an "authentic" public participation results when dimensions of representativeness, use of public inputs, interactiveness, and quality of citizen inputs have been achieved. The study sought to identify conditions that serve as measurements that must presumably be satisfied for authenticity to exist in public participation. The result was a Model of Authentic Public Participation that served as the basis for creation of a new four-tiered methodology to assess the performance of these districts relative to authenticity requirements. This study also sought to identify the key determinants that lead districts to achieve Authentic Public Participation in District public involvement programs. A Predictor Model for Authentic Public Participation was created to test whether the key internal and external determinants are responsible for districts achieving authenticity in their public participation programs. The data for this study came from a mail-back survey that was administered to senior district administrators in 380 State Departments of Transportation districts in the United States. A total of 233 surveys were returned for a response rate of 61.3 percent. The results of the study suggest that most SDOT districts struggle to implement public participation programs that achieve high levels of authenticity. The increased use of public participation tools, specifically those active tools that allow for increased interaction between district staff and the public, can assist districts in achieving higher levels of authenticity in their programs. Of key importance to achievement of authenticity is the willingness of district staff to adopt new ideas and innovation learned from dealings with the public. District public participation programs benefit from training that increases the individual's acceptance of public participation as a valid mechanism for serving the public. Recommendations were made for SDOTs to work toward: • The creation of increased opportunities for the occurrence of Authentic Public Participation • The creation of individual ownership of authenticity in public participation • The creation of community partnerships to foster authenticity in public participation

As the speed of change increases, federal agencies are challenged more often to develop and implement improvements to existing programs, new programs to meet new needs, or adjustments to programs based on changed circumstances of delivery. Built on the foundation of systems theory, expectancy theory, and field theory, this research seeks to explain why some managers do not propose changes in their organizations---even when the very survival of the organization is at risk. By measuring the fields of influence encountered by managers, we find that the chain of command is supportive of change initiatives. Other organizational elements--human resources and legal staff were measured in this research--are, in general, indifferent about the managers' effort to change. Employees, on the other hand, are strongly opposed to any change with even minimal impact on their work habits and conditions. Based on a survey of 201 managers of Army morale, welfare and recreation activities worldwide, this research views the climate for change from the perspective of the activity manager. There are general findings, along with detailed analysis, that support the need for a change to the environment itself. Executives charged with reviewing and approving activity-initiated changes may find this study useful in developing implementation strategies. Managers may take comfort in knowing that their environment is highly consistent with the experiences of other managers. Support staff--particularly legal and human resources offices--may find the perceptions of managers to be incongruent with the service objectives. We hope that everyone can find enlightenment, or perhaps confirmation of their own experiences, in the responses of these managers, and can use this information productively in the management of their areas of responsibility.

The federal program of deinstitutionalizing psychiatric facilities has resulted in a well documented, ever-increasing mentally ill population in the nation's prisons and jails. Historically, the criminal justice system has maintained a laissez-faire attitude toward the mentally ill, and only became involved with the mentally ill when a crime had been committed. As such, the President's Mental Health and Criminal Justice Consensus Project was developed to explore ways that the two systems could work together to address the growing problem of the mentally ill offender. However, challenges arise because the criminal justice system has typically been viewed as a loosely coupled, fragmented system that is unwilling or unable to address the social issue of the mentally ill offender. The concept of coupling between agencies has serious ramifications for the ability of agencies to successfully collaborate. Theoretical foundations for collaboration between mental health and criminal justice agencies lie partly in labeling theory and the drive to avoid the negative stigmatization of the mentally ill by the formal criminal justice system. A second theoretical foundation is found in developmental theories, which seek to explain the development of organizational knowledge and skills, in handling mentally ill offenders, through interaction between the mental health and criminal justice systems. In this study, it is asserted that agencies that are appropriately coupled and have experience with collaboration will perceive greater benefits from the collaborative exchange. Furthermore, this leads to the main hypothesis of the current study that agency coupling and collaborative experience will increase the perception of benefits of collaboration and support of collaborative efforts that deal with mentally ill offenders. To assess the main hypothesis of the current study, a modified Dillman methodology was utilized. The research population consisted of a complete enumeration of the 20 Florida State's Attorneys Offices, the 66 County Sheriffs, the 54 Probation Office Managers, and the 313 municipal law enforcement agencies for a total study population of 453 possible respondents, of which 49% responded. Overall, the findings of the current study illustrate a willingness of agencies to couple with outside agencies to address the phenomenon of the mentally ill offender. The results provide theoretical support for the need to reduce the negative stigma of a mentally ill individual being additionally labeled a criminal offender. The results additionally bolster the belief that the knowledge and skills to do this can best be accomplished through interaction with outside agencies.

Research has shown that female physicians continue to earn less than their male counterparts. From both social justice and feminist perspectives, laws requiring equal pay should provide just income for females as compared to males. However, the literature continues to indicate that in general females earn less than males, a trend that is also true for physicians. Theoretically informed postulates are measured here with structural equation modeling to test the influence of the unique latent construct "specialization" on the income gap while controlling for demographic and contextual variables. The analysis tests the assumption that the influence of specialization is the same for females and males. If the influence of specialization and other variables differs by gender, gender bias in physician income may be conceptually implied. The study uses three waves of data from the Community Tracking Study Physician Survey (CTS). The study finds an income gap between females and males in three waves of the CTS. Gini coefficients show females continue to experience greater income inequality than males, with the Lorenz curves for males being closer to the equality lines. Using 1999 income data, there is a statistically significant income gap between female and male physicians when controlling for weeks worked. Information Technology (IT) use was found to be the most reliable construct measuring the unique latent variable specialization. Structural equation modeling showed indicators of specialization have an influence on the income gap. The variables in the CTS Physician Survey made for a poor construct that failed to measure specialization as a uni-dimensional construct. The variables that influence the income gap were different for females than for males. As policy makers revise or create better laws to protect income equality, gender differences must be taken into consideration.