Strategic response to service system integration

Stephen J Dougherty, Fordham University


This study examines the relationship between the organizational characteristics of voluntary behavioral health providers in Connecticut and their strategic response to the formation of a provider sponsored integrated service system. The study uses a “political - economy” perspective and a conceptual framework using resource dependency theory. In addition, the study tests the hypothesis that the strategic choices made by each agency will have a strong association to the political - economy characteristics of each agency. Voluntary, non-profit providers under contract with the Connecticut Department of Mental Health and Addiction Services to provide behavioral health services during FY 1999 were asked to report on the implemented strategies in response to the proposed service system re-organization begun during the Spring of 1997. Respondents are the agency Executive Director or Chief Executive Officer. The results show the ambiguous nature of a re-organized service system that shifts significant aspects of the system's political and economic infrastructure. Findings indicate that in response to the proposed integrated service delivery system, voluntary organizations prepared themselves for possible organizational expansion rather than consolidation. The findings also showed that larger agencies responded differently than smaller agencies. Agencies with greater economic resources and diversity implemented and prioritized strategies to protect against the possibility of both funding cutbacks and funding expansion. This finding may indicate the economic vulnerability larger agencies have to funding restraint and also their capacity to adopt multiple strategies during periods of economic uncertainty. Smaller agencies have not participated in planning processes or leadership roles to the same extent as larger agencies, a finding which suggests that smaller agencies need to focus more on strategies that would best protect their interests. A striking finding was the relatively low priority assigned by both large and small agencies to strategies that would increase involvement with consumers and family organizations. Human resource development and training received the highest priority rating of any organizational strategy. Agency age was identified as a significant factor, older agencies having a significantly higher priority for strategies that would change fundamental aspects of agency organization, e.g. population and service domain. Overall, findings demonstrate that the voluntary agency's response to the uncertainty of the ISS is by no means uniform and that political - economy factors of individual agencies, along with their age, are significant factors influencing strategic choices relative to a provider sponsored integrated service system.

Subject Area

Social work|Public health|Public administration|Health care|Mental health

Recommended Citation

Dougherty, Stephen J, "Strategic response to service system integration" (1999). ETD Collection for Fordham University. AAI3055973.