Purpose The tenuous financial viability of many of Georgia’s rural hospitals has driven increased scrutiny of the hospital authorities (HAs) that own and govern them. HAs are a type of “special district” established in state law to allow for specialization of function, while evading statutes that can limit local government borrowing and multi-year contracts. The paper aims to discuss this issue. Design/methodology/approach This paper uses a case example to introduce transparency and accountability in one local Georgia hospital and expands to include a descriptive analysis of transparency measures in 29 rural Georgia HAs. Findings Findings indicate that, like many other special districts in Georgia and the USA, Georgia’s rural HAs often act more like private entities than the public organizations they are. The lack of transparency demonstrated in this sector limits access to public information and reduces opportunities for citizen engagement, a necessary component of representative institutions. Research limitations/implications This case study is limited to Georgia HAs; however, the data support the lack of accountability and transparency found in many special district governments. Originality/value The lack of transparency in all of the organizations reviewed in this study demonstrates blurred lines between between public matters and private interests and raises questions of transparency, a key value in democracies.
The passage of a stringent immigration law in Alabama in 2011 makes relevant the juxtaposition of clergy and congregant attitudes and behaviors toward illegal immigrants as related to Biblical teachings that require charity to aliens. In order to examine the relationship between religious attitudes and illegal immigration, approximately 426 members of the Alabama clergy completed an anonymous survey in which they provided information about their own and their perceptions about their churches' attitudes and actions toward illegal immigration and their responses to the new law. While congregant political philosophy and ethnicity of congregants create some differences in outlook toward illegal immigration, the great majority of churches continue to provide outreach, regardless of political viewpoint.
Operational and ethical challenges for nursing homes across the United States during the COVID-19 pandemic were daunting, that experience perhaps only a forecast of future epidemics that nursing home administrators and operators may face. This article describes administrator-identified challenges and focuses on how nursing homes might learn from their experiences by increasing flexibility to meet evolving needs, improving quality assurance and disaster planning, using ethics policies and ethical decision-making processes to work through difficult decisions, and leading the way in creating new policies that will make nursing home care safer and more appropriate for patients with ever-changing needs.
With the continued rising cost of health insurance and the fiscal constraints as a result of the 2007-09 economic recession requiring local governments in the U.S. to make cuts in employees, services, and benefits, it appears that on-site health clinics are one method of reducing, or at least, slowing health care costs. This chapter analyzes the use and benefits of such clinics for local government managers that is a new, but potentially effective method of both controlling costs and improving employee health.
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