Introduction to the Symposium: Nonprofit Organizations as Key Partners in the Development, Delivery and Evaluation of Health and Human Services
Norris-Tirrell, Dorothy, Journal of Health and Human Services Administration
Nonprofit and government agencies in the United States have a long history of working together at the local, state, and federal levels for community awareness and education, information gathering, policy creation, direct service delivery, and performance evaluation, particularly in the health and human services arena. In fact, it is hard to imagine today how our society's health and human service concerns would be met without nonprofit providers. Governments have long utilized and subsidized nonprofit agencies to deliver services (Young, 1999) and, as Smith and Lipsky (1993) emphasize, nonprofit organizations rely on government for financial support. Both government and nonprofit agencies have unique roles to play in this important and mutually beneficial partnership. While there is no "typical" partnership, funding has become a primary aspect of government-nonprofit relations. As such, government grants and contracts accounted for 29.4% of nonprofit revenues in 2005 (Blackwood, Wing, and Pollak, 2008).
Chartered by state level governments and recognized by the U.S. Internal Revenue Service for additional tax exemption/deductibility status, the landscape of nonprofit organizations is diverse ranging from homeless shelters, job training programs, and HIV clinics to museums, civic groups, and professional associations. This diverse set of organizations numbers at almost 2 million tax exempt organizations registered with the IRS (The Urban Institute, 2009), an increase of 27.5% since 1995 (Blackwood, Wing, and Pollak, 2008). What these organizations have in common is an identified public or collective purpose. Individually and as a sector, nonprofit organizations add essential dimensions of responsiveness, expression, and innovation to the implementation of democracy in the United States.
Nonprofit organizations in the area of health and human services (see Table 1) represented 29 percent of the 975,777 public charity nonprofits registered in April 2009 (NCCS, 2009). These numbers do not include the many churches and other faith-based institutions without official nonprofit status who also supply services to a growing population in need.
This symposium focuses on the nonprofit-government partnerships in health and human services. The articles included here cover a range of health and human service policy areas from development disabilities and mental health to geriatric education. They recognize a variety of tools for nurturing and sustaining nonprofit-government partnerships including training centers, fee-for-service arrangements, performance assessment, collaborative activities, and communitywide needs assessment.
In their article, Medicaid Fee for Service Reimbursement and the Delivery of Human Services of Individuals with Developmental Disabilities or Severe Mental Illness: Negotiating Cost, Melissa A. Walker and Jason E. Osterhaus examine how federal, state and local government agencies negotiate cost for the delivery of human services. The article uses the Medicaid funded services to individuals with development disabilities or severe mental illness in Sedgwick County, Kansas, as the focus of study. The data was collected from 30 interviews with executive directors of nonprofit agencies, the directors and key staff of the locally designated community development disability organization and community mental health centers, and state human services officials, agency annual reports and financial statements, and related state expenditure and revenues for development disability and mental health services. The varying perspectives of government and nonprofit agencies in determining funding levels and provision strategies provide insight into how each attempts to manage cost.
Beth Eschenfelder's article Using Community-based Needs Assessments to Strengthen Nonprofit-Government Collaboration and Service Delivery offers a case study of a community needs assessment conducted by the local Salvation Army in Clearwater, Florida. …