This study addressed the impact of the external environmental context of individual organizations on their internal structures and service configurations, as they attempted to adapt to a changing political economy, via an examination of a portion of the Georgia child welfare system’s response to the introduction of the principles of managed care. Based, in part, on Hasenfeld’s (1992) notion that institutional and political economy perspectives are the most important theoretical approaches to understanding external influence on the service delivery systems of human services organizations, the current study presents conceptual and analytical models, which also includes network theory. In 1995, members of the Georgia Association of Homes and Services for Children (GAHSC) began sculpting a strategy for addressing managed care approaches to child welfare service delivery and funding in their state. This phenomenon provided an excellent context for studying the external environmental factors associated with the adoption or rejection of a controversial new methodology.
A survey instrument, based on Dillman’s (1978; 1991) Total Design Method, was developed and administered to assess Chief Executive Officers’ and Managers’ perceptions of the influence of external, political and economic, institutional, and network influences on their organizations’ decisions to adopt managed care principles. The sampling frame included all residential child caring agencies licensed by Georgia’s Department of Human Resources’ Office of Regulatory Services (N=114). The final response rate for the survey was 33% (n = 37). Survey items were grouped according to theoretical constructs (i.e., perceived political and economic pressure, perceived institutional pressure, perceived network pressure, and perceived adoption of managed care principles) via the creation of index scores based on responses to the survey items. Regression analyses on the index scores for these four variables provided limited support for political economy theory and network theory as significant predictors for the adoption of managed care principles.
Limitations in the design and implementation of this study are discussed to inform the applicability of these findings to human service organizations. Possible implications are also presented for human services organizations, social work practice, and future research in this area.
