Noonan (2009), states “The rising rates of unemployment and the growing numbers of uninsured people are exacerbating health disparities in low income and minority communities that already suffer from barriers to care and high rates of chronic disease. ” (para. 1). With the economy in its current state (trying to recover from the financial crisis of 2008) many programs have been affected not only on a national level, but on a state level as well.
This is why at Chartres-Pontchartrain Mental Health Clinic in New Orleans, Louisiana there has been 15% budget cut. This cut has left the clinic without funding for some programs. Given the defined budget constraints from the clinic manager to the department managers, there have been plans to cut and eliminate programs to best address healthcare needs of the Medicaid population for this particular clinic (University of Phoenix, 2013).
How to Make the Decision Harris (1998-2012), states that the decision making process is “the study of identifying and choosing alternatives based on the values and preferences of the decision maker” (para. 1). In management this means making a decision requires one to clearly understand what problem exists and the choices, logic, reasoning, or tools that maybe used to make the logical decision for the good of the organization.
At Chartres-Pontchartrain Mental Health Clinic, decisions have to be made in regards to what programs will be cut from the overall budget. To make these decisions one needs to look over the entire budget and decide which programs will need to be eliminated to continue to service the necessary programs in the health care organization. Taking a closer look at the tools that may be used to make such a critical decision within the clinic. The management team will use the informed decisions toolbox.
This tool box contains guiding developmental skills to help management overcome barriers to keep the organization successful even while in the mist of downsizing. The tool box guidelines are as followed: “(1) framing the management question, (2) finding sources of information, (3) assessing the accuracy of the information, (4) assessing the applicability of the information, (5) assessing the action ability of the evidence, and (6) determining if the information is adequate” (Rundell, Martelli, & Arroyo, 2007, para. 2).
After these guidelines have been establish then management needs to build an environment that is conducive to accepting such major changes throughout. The tool box can help with the transition and keep principles, which are as followed: “(1) recognize and respond to the growing demand for accountability as a strategic issue, (2) establish organizational structures and processes for knowledge transfer, (3) build a questioning organizational culture, and (4) build organizational research capabilities” (Rundell, Martelli, & Arroyo, 2007, para. ). What Decisions Need to Be Made In addition to all the tools that are available to the management team, it is still imperative to make the appropriate decision for the entire clinic. This involves using step one (framing the question) as a guide to get everyone’s input into solving the matter of which programs should be cut from the overall budget. Step two involves finding the source of information, this means finding out what programs should not continue.
For example, the program that collects clothing for the homeless (which is 5% of the budget because it takes one employee to operate, collect, and distribute the clothing) and transportation for people who lives outside the city limits (that takes 10% off the overall budget). Eliminating these two programs will solidify the 15% that is needed to cut cost in the overall budget. Then management staff would have asses the decision to ensure the programs that were cut would be enough to sustain the 15% overall cut in the budget.
Step three shall be solidified by management looking at the cost and savings to the clinic by eradicating the two positions, the gas cost, and operational cost. Step four will be assessing the situation to acknowledge if the downsize would be feasible and if the clinic could withstand downsizing. Management at this stage has to weigh the pros and cons of the situation and agree downsizing would be the appropriate way to go. Step five would include assessing the action plan and moving forward for results.
Step six would include insuring that the right the decision was made and if it has not then the management team would have to go back to make the appropriate decision (restarting the process). Why the Decision Was Made Specifically, the decision to cut two programs at Chartres-Pontchartrain Mental Health Clinic for Medicaid patients was appropriate as the clinic is trying to budget the 15% in cuts from the State of Louisiana (Chartres-Pontchartrain Mental Health Clinic, 2013).
This decision affects the clinic in a positive way as the cuts save the clinic money and it curbs making drastic cuts in the budget. Using the tool box to make the decision has allowed management to take an active approach to the decision and a chance to be accountable for the decisions that were made. Moreover, transferring the knowledge from management level to the non-managerial level employees will take the individual department managers having a schedule meeting with all their employees keeping them abreast of the changing (Chartres-Pontchartrain Mental Health Clinic, 2013).
The top level management will also send emails to everyone within the clinic once the change has happened. Above all, change is necessary in this case scenario to continue to operate this clinic and to provide mental health services to individuals who uses the Medicaid system. With the hit to the economy in 2008 more states are continuing to feel the constraints of this budget crisis. With the state withdrawing some Medicaid benefits, it did leave clinics in the New Orleans area struggling to provide services to under privilege individuals.
Charters clinic was able to make budget cuts to their system without shutting down major services in which its patients relied on. The decision to shut down the clothing store and routes to areas outside the city limits has saved some of the major programs within the clinic. Using the tool box helped management make the effective decision for the life of their clinic during times of financial constraints.