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Closing institutions in New York State: implementation and management lessons
1New York State Office of Mental Retardation and Development Disabilities.
Summary
Closing large institutions for individuals with intellectual disabilities presented unexpected challenges. Successful implementation requires strong middle management, policy capacity, and an intergovernmental perspective, acknowledging inherent complexities.
Area of Science:
- Public Policy
- Healthcare Management
- Social Services
Background:
- The closure of six large institutions for individuals with mental retardation in New York State was undertaken with careful planning regarding implementation and management.
- Despite attention to policy design and existing management capacity, unanticipated problems arose during the closure process.
Purpose of the Study:
- To examine the lessons learned regarding implementation and management from the closure of these institutions.
- To understand why anticipated success was not realized and to identify critical factors for successful policy implementation.
Main Methods:
- Case study analysis of the closure experiences of six institutions.
- Qualitative examination of policy changes, contextual shifts, and management challenges.
Main Results:
- Subtle policy modifications and changes in the implementation context significantly impacted outcomes.
- Middle managers bore a substantial burden, highlighting their crucial role in implementation.
- Policy management capacity and an intergovernmental management perspective were identified as vital for success.
Conclusions:
- The implementation of large-scale policy changes, like institutional closures, is inherently turbulent and complex.
- A broader definition of success, encompassing this normal turbulence, is necessary for a realistic appreciation of implementation requirements.
- Effective implementation hinges on empowering middle managers and fostering robust policy and intergovernmental management capabilities.