Toward Legitimacy through Collaborative Governance: An Analysis of the Effect of South Carolina\u27s Office of Regulatory Staff on Public Utility Regulation

In 2004 the South Carolina General Assembly instituted a major reform to its system of public utility regulation. Previously, the Public Service Commission, the administrative agency in charge of regulating public utilities, both adjudicated utility proceedings and, through its staff,a advocated for the public interest. A scandal concerning revelations of extensive ex parte communications between regulated utilities and members of the Public Service Commission led to the 2004 reform, which created the Office of Regulatory Staff (ORS) as a separate agency to perform the Commission\u27s advocative functions. In my research, I use data on fuel factor proceedings before and after this reform to analyze the effect that ORS has had on public utility regulation to assess whether and how changes to regulatory structure can affect the outcome of regulation. A fuel factor is part of an electricity rate which utilities petition to change on an annual basis as fuel prices fluctuate. Because these proceedings happen so regularly, they provide a robust set of data with which to analyze the impact of ORS on the public utility environment. My research shows that while it is unclear whether ORS has had any effect on the actual fuel factor rates electric utility companies are awarded, these proceedings are now marked by a significantly higher degree of collaboration between utilities and their customers. I argue that this more collaborative process is a significant change to the outcome of regulation because it increases the legitimacy of public utility regulation. Inasmuch as the 2004 reform was motivated by a crisis of legitimacy, ORS has been a successful solution to that crisis

Toward Legitimacy through Collaborative Governance: An Analysis of the Effect of South Carolina\u27s Office of Regulatory Staff on Public Utility Regulation

In 2004 the South Carolina General Assembly instituted a major reform to its system of public utility regulation. Previously, the Public Service Commission, the administrative agency in charge of regulating public utilities, both adjudicated utility proceedings and, through its staff,a advocated for the public interest. A scandal concerning revelations of extensive ex parte communications between regulated utilities and members of the Public Service Commission led to the 2004 reform, which created the Office of Regulatory Staff (ORS) as a separate agency to perform the Commission\u27s advocative functions. In my research, I use data on fuel factor proceedings before and after this reform to analyze the effect that ORS has had on public utility regulation to assess whether and how changes to regulatory structure can affect the outcome of regulation. A fuel factor is part of an electricity rate which utilities petition to change on an annual basis as fuel prices fluctuate. Because these proceedings happen so regularly, they provide a robust set of data with which to analyze the impact of ORS on the public utility environment. My research shows that while it is unclear whether ORS has had any effect on the actual fuel factor rates electric utility companies are awarded, these proceedings are now marked by a significantly higher degree of collaboration between utilities and their customers. I argue that this more collaborative process is a significant change to the outcome of regulation because it increases the legitimacy of public utility regulation. Inasmuch as the 2004 reform was motivated by a crisis of legitimacy, ORS has been a successful solution to that crisis

VA residential substance use disorder treatment program providers’ perceptions of facilitators and barriers to performance on pre-admission processes

Abstract Background In the U.S. Department of Veterans Affairs (VA), residential treatment programs are an important part of the continuum of care for patients with a substance use disorder (SUD). However, a limited number of program-specific measures to identify quality gaps in SUD residential programs exist. This study aimed to: (1) Develop metrics for two pre-admission processes: Wait Time and Engagement While Waiting, and (2) Interview program management and staff about program structures and processes that may contribute to performance on these metrics. The first aim sought to supplement the VA’s existing facility-level performance metrics with SUD program-level metrics in order to identify high-value targets for quality improvement. The second aim recognized that not all key processes are reflected in the administrative data, and even when they are, new insight may be gained from viewing these data in the context of day-to-day clinical practice. Methods VA administrative data from fiscal year 2012 were used to calculate pre-admission metrics for 97 programs (63 SUD Residential Rehabilitation Treatment Programs (SUD RRTPs); 34 Mental Health Residential Rehabilitation Treatment Programs (MH RRTPs) with a SUD track). Interviews were then conducted with management and front-line staff to learn what factors may have contributed to high or low performance, relative to the national average for their program type. We hypothesized that speaking directly to residential program staff may reveal innovative practices, areas for improvement, and factors that may explain system-wide variability in performance. Results Average wait time for admission was 16 days (SUD RRTPs: 17 days; MH RRTPs with a SUD track: 11 days), with 60% of Veterans waiting longer than 7 days. For these Veterans, engagement while waiting occurred in an average of 54% of the waiting weeks (range 3–100% across programs). Fifty-nine interviews representing 44 programs revealed factors perceived to potentially impact performance in these domains. Efficient screening processes, effective patient flow, and available beds were perceived to facilitate shorter wait times, while lack of beds, poor staffing levels, and lengths of stay of existing patients were thought to lengthen wait times. Accessible outpatient services, strong patient outreach, and strong encouragement of pre-admission outpatient treatment emerged as facilitators of engagement while waiting; poor staffing levels, socioeconomic barriers, and low patient motivation were viewed as barriers. Conclusions Metrics for pre-admission processes can be helpful for monitoring residential SUD treatment programs. Interviewing program management and staff about drivers of performance metrics can play a complementary role by identifying innovative and other strong practices, as well as high-value targets for quality improvement. Key facilitators of high-performing facilities may offer programs with lower performance useful strategies to improve specific pre-admission processes