Prince George’s County Joint Center Health Policy

Abstract
The paper addressed the importance of public policy in addressing the
challenges facing the society with a focus on the joint center health
policy formulated by the government of Prince George’s County. The
policy funding options available to the government of Prince Georges’
County include tax revenue, intergovernmental transfers, and donations.
However, these sources of funds are subjected to several restrictions
which are either time or purpose based restrictions. Public policy
decisions affect the receipt of revenue in several ways including the
capacity of the public policy to address societal challenges, enhancing
public participating during formulation and implementation, and linking
public policy decisions with desirable outcomes. Revenue projections may
be affected by different economic conditions such as the global
recession, the rate of unemployment, investment. The government can
counter the current fiscal challenges by using a combination of four
factors namely expenditure cuts, federal stimulus funds, reserves, and
revenue enhancement.
Key words: Public policy, funding options, economic conditions, revenue
projections.
Prince George’s County Joint Center Health Policy
Different jurisdictions address critical issues affecting members of the
public using well designed public policies. According to Hopkins (2013)
public policy refer to an action or principled guide that is used by
administrative branches of government to address a given class of issues
affecting the society in a manner that is consistent with the law and
different institutional customs. This implies that federal, states and
local government can craft public policies with the primary objectives
of protecting the interests and benefiting of their populations.
Although different arms may be willing to address certain issues,
financial constraints often affect the execution of well crafted pubic
policies. This is because the government the public policy could be
expensive to administer, face opposition from some stakeholders, or
requires a long time to accomplish and produce anticipated results. The
joint center health policy is one of the significant measures ever taken
by the government of Prince George’s County to address the issue of
the prevalence of chronic diseases that result from poor eating behavior
especially among the school children.
Background
Prince Georges is a county that is located in the state of Maryland and
has a total population of about 863,420 people (Harrington, 2008). The
government of this county expresses its commitment in addressing issues
of health and human services by providing reliable, affordable, and
easily accessed health services. The joint center health policy was
formulated to counter the health challenges identified through research.
The policy was formulated by a team made by the county government, which
consisted of specialists in different sectors such as public health,
elected officials, health advocacy, education, and residents who were
committed to advancing health through sound policies. The team aimed at
formulating a policy that would result in the establishment of a food
policy council, implementation of active living programs and after
school eating programs for elementary schools. This would be
accomplished by cooperation between the food policy council and
recreation departments operating in the county.
Prince George’s is one of the counties with the highest rates of
mortality prevalence of chronic disease, and morbidity. According to
Harrington (2008) about 69 % of the residents are obese or overweight
while 48 % of the affected residents are children. This means that there
are potential health hazards related to overweight and obesity among the
children and future generation. The research also shows that illnesses
that are caused by obesity and the status of being overweight have been
increasing making Prince George’s county the second in Maryland in
death rate resulting from heart diseases. According to Harrington (2008)
Prince George’s county has an adjusted death rate of 280.4 per 100,000
compared to the state average rate of 252.8. The African Americans are
the most affected population with an average rate of 338.4 per 100,000
compared with the white residents with an average rate of 228.7. These
facts warranted the formulation of a public policy that will help the
county government in addressing the emerging health challenges.
Policy funding options
Similar to other developmental programs initiated by the county
government, the joint center health policy can be financed using
different sources of revenue. First, the local government can use the
revenue collected from local sources. The major sources of revenue that
can help the county in supporting the policy implementation process
include local tax (Estimated to be $ 1,407,009,400 in 2013-2014
financial year and local charges (including license fee and use of money
and property), which are estimated to be $ 35,535,300 in financial year
2013-2014 (Prince George’s County, 2013). However, the government may
face the challenge in financing the new policy using these sources of
funds given the fact that there are other expenses that have been funded
using these revenues in the previous financial years. In addition, the
county budget indicates that the two sources are expected to increase at
insignificant rates of 0.5 % and 3.9 % respectively, thus resulting in
little funds available for a new expense (Prince George’s County,
2013).
The second funding option is grants, which may be sourced from state and
federal governments or non-governmental organizations. The higher layers
of government (including the state government and the federal
government) can make their contribution towards the implementation of
the policy through intergovernmental transfer, which requires the local
government to defend the need for additional transfer or grants. Based
on the budget document intergovernmental revenue seems to be the most
reliable source of revenue for the new policy given the fact that the
state governmental have established a trend of increase in funding local
authorities with a 60 % increase in financial year 2013-2014 (Prince
George’s County, 2013). Although federal grants increased at zero
percent, the local government can convince the federal government about
the need for the policy that will help the county government in
countering the challenges that subjects the county residents to health
risks and danger of death. In addition, the county government can source
for additional funds from well wishers and non-governmental
organizations to supplement the local and intergovernmental transfers
for successful implementation of the policy.
Restrictions placed on different sources of revenue
Prince George’s county has a wide range of policy funding option, but
they are subjected to different forms of restrictions. Restrictions
associated with policy funding are often imposed by agencies or
government bodies providing the funds. Although there are funds with
limited or zero restrictions, restrictions are imposed to ensure the
revenues are well appropriated to accomplish the specific objectives
outlined in the policy document. Financial restrictions may be imposed
in the form of time of policy implementation or purpose of the policy.
Based on the two forms of revenue restrictions, it is evident that the
government of Prince Georges County might face significant fiscal
challenges in implementing the policy in the financial year 2013-2014.
The budgetary provisions contained in the budget document are already
subdivided and allocated to help the local government in pursuing
different objectives during the current financial period. This implies
that the purpose of these allocations cannot be changed for the purpose
of pursuing a new expenditure.
The time restrictions on public revenues (provided by the state and
other local sources) may force the local authority to schedule the
implementation of the policy to begin in the next financial year in
spite of its importance to county residents. Although the county
government has the powers to collect revenue (from taxes and service
charges), the rates are set by the state legislature, which means that
the county government should solicit the parliamentary interventions
before increase the rates to finance the new policy. This may take time
because there is a need for the county government to seek for empirical
evidence of the claims contained in the policy document to convince the
legislature on the purpose to implement the policy recommendations. In
addition, the policy may face opposition from people who feel that there
are other financial obligations that should be prioritized. For example,
some people may feel that public funds should be spent to reduce
inequality in schools and reducing the impacts of chronic diseases
instead of funding after-school activity and eating programs (PGC,
2013).
Apart from time and purpose restrictions, Prince George’s county has
been experiencing several fiscal challenges in the last few financial
periods, which may limit the implementation of new public policies.
According to Prince Georges County (2013) the county government has been
struggling to strike the balance between the increasing costs and
funding reductions. On the revenue side, the county expects a reduction
different sources of funds such as federal revenue, which will reduce by
$ 463,749 (7.91 %), one-time funding will reduce by $ 1,277,000 (100 %)
compared to fiscal period 2011-2012. In addition, the county anticipates
the loss of over $ 450,000 for the next nine years as a result of
financial sequestration. Despite the decrease in revenues collected by
the county government over the years, the expenses have been increasing
thus reducing the capacity of the government to execute its
constitutional mandates. For example, the government anticipates a 13 %
increase in health insurance in the next financial year (Prince Georges
County, 2013). Consequently, the overall county budget will increase by
0.17 %, which limits the chances of the county government to finance the
joint center health policy. This implies that the county government is
restricted by aspects of expenditure and revenue in its efforts to
implement important public policies.
How public policy decisions affect the receipt of revenues
Setting priorities for public policies is a difficult scenario
especially when the society is faced with competing demands. The main
objective of policy makers is to ensure that the political system will
find the importance of acting upon the demands entailed in the policy.
This means that the political support cannot be neglected in decision
making and implementation of public policies. Although the conflict of
interest plays a significant role in the political system during the
determination of public policies that deserve attention, there are key
elements of a public policy that may attract the political system to
allocate and prioritize a given policy over the others. First, the
policy should address societal goals and provide a framework that help
the government in achieving the policy goals (effectiveness) in the
least cost (efficiency) possible (Curtin, 2000). Although public
policies are long-term in nature, policy makers have the responsibility
of ensuring that the policy documents give a clear picture of the needs
being addressed and how the policy will help the society.
A public policy that gives the end user an opportunity to participate in
different ways during its formulation and implementation has higher
probability to attract revenues. This is because public participation
reduces the silo effect where departments work independent of each
other. In addition, attention to process helps the decision or policy
makers to be outcome focused. This involves a careful identification of
how a given public policy will result in the desired change in the
society. Moreover, outcome orientation during the formulation and
implementation of a public policy helps the stakeholders to take full
account of the experiences and needs of people (including individual
members of society, families of groups) who are likely to be affected by
the policy (Curtin, 2000). The public participation and outcome
orientation of a public policy attracts the attention of the legislature
to allocate funds to such policies because they are community centered.
Economic conditions that affect revenue projections
Revenue projections are affected by local, national and global economic
condition, which determines the amount of revenue that the government
(local, state, and federal) will anticipate in a given fiscal period.
Both national and local sources of revenue are directly affected by
economic performance, implying that revenue forecasts cannot neglect the
role of economic conditions in the budgeting process. According to
Office of Management and Budget (2002) sales tax revenue and general
funds source of revenue vary in a direct relationship with changes in
national and local economic conditions that influence employment,
income, commodity prices, and wealth. The global economic recessions are
one of the economic conditions that each level of government cannot
overlook when projecting revenue. For example, the global economic
recession that began in 2007 almost every country in the world by
reducing economic productivity across the globe. Although the world
economies have been expanding, the process has been slow and the impact
of global recession is still felt by many economies in the world
including the Prince George’s County that has experience projects a
reduction of revenue of about $ 45,000 for the next nine years as a
result of financial sequestration (Prince Georges County, 2013).
Investment and employment rates are two economic conditions that affect
revenue projections in the similar ways. This is because the two aspects
of economic growth determine the level of national GDP and personal
income, thus affecting both the state and local budgets (OMB, 2002).
Personal income is a factor of wages, salaries, proprietors’ income,
rental income, personal dividend, and current transfer recipients. These
factors collectively affect the rate of economic growth and development
as well as projected government revenue. The increase in the rate of
investment and employment in a given area increases the base for tax and
service change collection by the government of that area. In the case of
Prince George’s County, the rate of unemployment is lower than the
national wide (the United States) average, but research shows that
unemployment has been increasing with time (The Maryland National
Capital Park and Planning Commission, 2010). This means that the decline
in the rate of industrial investment and employment may result in
projection of less revenue by the county government.
Revenue policy
The main challenge that policy makers are facing in Prince George’s
County is the design of financial policy that will address the reducing
revenue and increasing expenditure. The present study seeks to provide a
financial policy that will help the county in matching spending with
revenue and avoid frequent adjustments. The local government of Prince
George’s County will utilize a combination of four strategies to
balance between reducing revenues and the increase in the government
expenditure, which will help the government in creating a sufficient
reserve for emerging health challenges
Expenditure cuts: The government will reduce or eliminate all
unnecessary forms of expenditure from the budget document. This will
include the removal of job positions that are not needed by the county
at the moment and in the near future. This will result in retention of
employees whose job compensation is commensurate with jobs accomplished.
Federal stimulus funds: The local government will advocate for an
increase in federal and state transfers instead of the decrease in
intergovernmental transfer that has been witnessed in the recent past.
This will be accomplished by setting public policies that address issues
and agenda that is derived from the society. For example, the joint
center health policy is based on the empirical evidence that is
sufficient to convince the state and federal government to intervene by
increase transfer funds.
Reserves: The government shall maintain a 15 % reserve of its annual
revenue, which help in preservation of expenditure patterns during the
period of significant revenue losses. This will protect the local
government from shocks that result from unexpected revenue cuts by the
state government and help the government to address local challenges
with the needed urgency.
Revenue enhancement based on policy: The government will hike sale tax
and income tax rates by 3.25 % to reduce the impact of shrinking tax
base and generate more revenue.
Conclusion
Public policies are effective tools used by the government (federal,
state, and local authorities) to address problems facing the society. By
the use of the joint center health public policy, the local government
of Prince George will be able to address the health challenges that have
subjected the county residents into chronic diseases and risk of death.
Although the local government has the capacity to formulate public
policies that address the immediate challenges facing the county
residents, fiscal challenges curtail the implementation process, thus
reducing the government’s capacity to save residents from emerging
challenges. However, properly formulated public policies may reduce
revenue restrictions and attract the attention of the political system
to allocate additional finance to a given local government. Some of the
policy aspects that may enhance receipt of revenue include the
formulation of public policies that focus on societal goals, encourage
public participation, and creates a link between expenditure and
outcome. In addition, the local government should be able to identify
the key economic conditions that may affect revenue projections. This
can help the government in reducing the impact of unexpected shocks that
arise from revenue cuts or increase in public expenditure.
References
Curtin, R. (2000). Good public policy making: How Australia fares. A
journal of Policy Analysis and Reform, 8 (1), 33-46.
Harrington, D. (2008). Joint Center Place: Prince George’s County (MD)
profile. Pittsburgh, PA: Health Policy Institute.
Hopkins, J. (2013). What is public policy? Baltimore, MD: Institute for
Policy Studies.
Office of Management and Budget (2002). A Citizen’s Guide to the
Federal Budget, FY 2003. Washington, D.C: Office of Management and
Budget.
Prince George’s County (2013). Management and Budget: Approved
operating budget FY 2013. Upper Marlboro: Prince George’s County.
Retrieved November 10, 2013, from HYPERLINK
“http://www.princegeorgescountymd.gov/sites/OMB/Resources/ApprovedBudget
/Pages/default.aspx”
http://www.princegeorgescountymd.gov/sites/OMB/Resources/ApprovedBudget/
Pages/default.aspx
Prince Georges County (2013). Superintendent’s 2013-2014 budget plans.
Upper Marlboro: Prince George’s County.
The Maryland National Capital Park and Planning Commission (2010).
Selected demographic and economic data for Prince George’s County.
Upper Marlboro: Maryland National Capital Park and Planning Commission.
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