ABSTRACT
Purpose—The purpose of this paper is to analyze the classical decision making model as applied to restructuring a Department on Aging services for the State of Connecticut. Mandated by the Connecticut legislature in 2007 to reestablish the department, the Department of Social Services (DSS) commissioned Southern Connecticut State University to recommend a structure for the newly legislated department, which had been disbanded by then-Governor Lowell Weicker in 1993.
Design/Methodology/Approach—Qualitative interviews of relevant stakeholders at all levels revealed that while few were satisfied by the current structure of the Department on Aging, there was no consensus concerning the design of a more effective replacement, only deeply held differences. Through the collection and analysis of both qualitative and quantitative data, the decision process on how to best structure aging services becomes hostage to a contingency where this decision model breaks down. The search stage develops a set of alternatives with no clear criteria for rational selection—all choices feature competing sets of strengths and weaknesses, successfully applied by various state agencies.
Findings—Decision makers from various stakeholders did agree on two general criteria: that the new department must be feasible (defined mainly in terms of affordability), and that the new department must be strong (defined mainly in terms of control over resources). In the presence of competing values concerning the optimization of effective services, clarification of feasibility and strength through accounting analysis restored a rational basis for agreement and selection of a satisfactory choice, rationalizing an otherwise paralyzed and political decision process.
Originality/Value—The process used to design the Connecticut Department on Aging offers a paradigm for other states to consider in developing a structure for elderly services. Elder affairs are clearly an area where passion and complexity are heightened. As a result, accounting analysis, tempered to ensure that profits and numbers do not overshadow the socially responsible purpose of the public organization, presented the most rational approach to develop a structure. The process shows that by managing risk and substituting satisfactory for optimal goals, accounting data emerged as a tie-breaker in the presence of strong competing values. Accounting analysis restores a rational basis for agreement by abandoning the realm of idealistic optimal states and linking alternatives to hard budgetary figures. Accounting analysis grounded estimations of risks in terms of real costs, and presented alternatives in terms of incremental budgetary shifts, which are easier to understand and debate than the philosophical nature of what constitutes the ultimate “senior friendly” community. The proposed plan was actually accepted by then-Governor of the State of Connecticut, M. Jodi Rell, who declared a restoration of a Department on Aging, based upon the final recommendations of this study, effective July 1, 2009. However, for budgetary reasons, Bill SB 841 postponed the reestablishment of a state Department on Aging, but did transfer additional programs on July 1, 2010, which included the state-funded portion of the Connecticut Home Care Program for Elders (CHCPE). Since the budgetary problems of the state intensified, the administration of complex elderly programs which involve Medicare and Medicaid continue to be administrated by DSS indefinitely.
Theoretical Background for the Decision-Making Process Modelling under Controlled Intervention Conditions
