You are on page 1of 14

829610

research-article2019
ARPXXX10.1177/0275074019829610The American Review of Public AdministrationMerritt

Article

American Review of Public Administration

What Makes an Organization Public? 2019, Vol. 49(4) 411­–424


© The Author(s) 2019
Article reuse guidelines:
Managers’ Perceptions in the Mental sagepub.com/journals-permissions
DOI: 10.1177/0275074019829610
https://doi.org/10.1177/0275074019829610
Health and Substance Abuse Treatment System journals.sagepub.com/home/arp

Cullen C. Merritt1

Abstract
The question “What makes an organization public?” is a leading point of scholarly inquiry in the field of public administration.
This study supplements existing theory on publicness by further exploring the primary influences on an organization’s
publicness—influences identified by analyzing data from in-depth interviews with senior-level managers of mental health and
substance abuse treatment facilities. Results from a grounded theoretical analysis of these managers’ perceptions provide
support for a conceptual framework of organizational publicness in which political authority, horizontal engagement, and
public engagement are associated with higher levels of publicness. Better understanding of the prism through which senior
managers conceptualize publicness may enhance managerial awareness of the most salient structural and institutional
mechanisms that empower treatment facilities to effectively support individuals suffering from mental health disorders such
as substance abuse, emotional distress, and depression.

Keywords
public administration, public management, organization theory, publicness

Introduction facilities located in the Midwestern United States. We chose


senior-level managers operating in this setting as appropriate
The concept of publicness, which underscores an organiza- respondents because they are hierarchically embedded to
tion’s “public” attributes, has become a disciplinary para- interact with their organizations’ internal and external envi-
digm (Riccucci, 2010) among public administration scholars ronments—the contexts from which structural and institu-
who share an intellectual curiosity about the public charac- tional mechanisms associated with publicness emanate
teristics of government, business, and nonprofit organiza- (Bozeman & Bretschneider, 1994; Rainey et al., 1976).
tions (Moulton, 2010). This curiosity has motivated scholars Grounded theory is a systematic technique to probe com-
to carefully conceptualize, measure, and enhance the ana- plex structures and processes at a real-world level (Glaser &
lytic utility of data related to publicness (Bozeman, 1987; Strauss, 1967). It has informed management strategy on mul-
Bozeman & Bretschneider, 1994; Rainey, Backoff, & Levine, tiple issues at the heart of public administration, such as net-
1976). Yet despite a now-established body of scholarship works (Agranoff, 2007), accountability (Romzek, LeRoux,
demonstrating the implications of publicness for manage- & Blackmar, 2012), collaboration (Romzek, LeRoux,
ment strategy (Boyne & Walker, 2010; Bozeman & Moulton, Johnston, Kempf, & Piatak, 2013), and policy implementa-
2011; Bryson, Crosby, & Bloomberg, 2014), the field’s con- tion structures (Sandfort, 2000). However, this approach to
ceptual understanding of publicness lacks a managerial per- theory building has been underutilized for generating insights
spective. Researchers may be unable to adequately analyze about publicness.
the concept of organizational publicness and its implications In this article, we first review the field’s existing
for management strategy without considering how managers approaches to classifying organizations according to public-
themselves view their organizations’ publicness. Accordingly, ness and organizational actors’ perceptions of phenomena
this exploratory study aims to answer the following question:
What are the primary organizational and environmental fac-
tors managers associate with publicness? 1
Indiana University–Purdue University Indianapolis, IN, USA
Using grounded theory methodology, the present study is
Corresponding Author:
among the first to collect perceptual data on organizational
Cullen C. Merritt, Assistant Professor, School of Public and Environmental
publicness. In this study, we aim to identify conceptualiza- Affairs, Indiana University–Purdue University Indianapolis, 801 W.
tions of this complex phenomenon among senior managers Michigan St., BS 4155, Indianapolis, IN 46202, USA.
in the context of mental health and substance abuse treatment Email: merritt1@iupui.edu
412 American Review of Public Administration 49(4)

related to publicness. Second, we describe the data and meth- The Dimensional Publicness Approach
odology. Third, we report managerial perceptions of public-
ness that surfaced from analyzing interviews with senior Dimensional publicness follows “reasonably lengthy theoreti-
managers of mental health treatment facilities. We conclude cal threads” (Bozeman & Bretschneider, 1994, p. 202), includ-
by discussing limitations, scholarly contributions, and practi- ing frameworks established by Dahl and Lindblom (1953) and
cal implications, with an emphasis on how organizational Wamsley and Zald (1973) that compare organizations accord-
publicness may inform management strategy. ing to their exposure to political and economic authority, with
emphasis on the interrelation between ownership and funding
(see also Stark, 2010). According to the dimensional approach,
Existing Frameworks on Organizational organizations are more or less public (as opposed to purely
Publicness public or private) depending on the extent to which they are
subject to political authority. This is determined by the combi-
Publicness research frequently examines internal and envi-
nation of distinct factors alongside government ownership:
ronmental factors associated with management strategy and
level of government funding and degree of exposure to gov-
organizational outcomes, such as behavior and performance.
ernment regulation (Bozeman, 1987). In terms of funding,
Studies in this area have provided clarity on the effects of
public organizations are largely funded by taxation receipts
varying organizational types and frequently employ one of
and funds from political bodies. The degree to which organiza-
two analytical approaches—the core approach or the dimen-
tions are bound to government regulations captures how
sional publicness approach (for a summary of existing frame-
elected officials or their agents use government authority to
works on organizational publicness, see Merritt & Farnworth,
empower or constrain the ability of organizations to enforce (or
2018).
achieve) policies and practices (Hood, James, & Scott, 2000).
While political authority influences organizational publicness,
The Core Approach and the Public-Private economic authority shapes an organization’s privateness and
Distinction sits at the opposite end of the dimensional publicness-private-
ness continuum (Bozeman, 1987; Moulton, 2009; Perry &
The core approach maintains that by virtue of legal owner- Rainey, 1988). Factors influencing economic authority include
ship (or sector designation), government and private organi- private ownership, private funding (e.g., fees paid by service
zations differ in terms of their internal structures and recipients and product consumers), and a market-based mode
processes, environmental conditions, and transactions of social control (Rainey, 2014).
between the organization and external environment (Rainey Much can be understood about organizations by knowing
et al., 1976). The basis for the public-private distinction lies their particular mix of public- and market-based authorities
in the division between political authority and market incen- and where they lie on the publicness-privateness continuum as
tives, and their respective impacts on government and pri- a result (Bozeman, 2013). For example, public administration
vate organizations (Dahl & Lindblom, 1953; Perry & Rainey, scholars frequently analyze the effects of dimensional public-
1988). Whereas the priorities and outcomes of government ness on several organizational processes and outcomes, such
organizations are shaped by the political context of their as those associated with innovation (De Vries, Bekkers, &
work, the priorities and outcomes of private organizations Tummers, 2015), strategic management (Nutt & Backoff,
are largely dictated by their shareholders, clients, and the 1993), and ethical work climate (Wheeler & Brady, 1998;
market economy (Nutt & Backoff, 1993; Walker & Bozeman, Wittmer & Coursey, 1996). Feeney and Welch (2012) and
2011).The different legal statuses of government and private Moulton (2009), building on Richard Scott’s (2008) institu-
organizations, including their differing political and market tional theory framework, identify categories of institutions
contexts, also have implications for numerous management extending beyond political authority (i.e., regulative, norma-
issues, such as personnel constraints, measurement of perfor- tive, and cultural cognitive1) that capture distinct aspects of
mance, emphasis on efficiency versus equity, and clarity publicness and yield implications for public value creation.
regarding the “bottom line” (Allison, 1980). These studies suggest that publicness is not simply a theoreti-
Although an organization’s legal ownership provides a cal instrument for classifying the degree to which an organiza-
useful framework for understanding management strategy tion is public; it also presents implications for management
and organizational outcomes (Clarkson, 1972), Bozeman strategy and performance across sectors (Feeney & Welch,
and Bretschneider (1994) contend that the core approach 2012; Moulton & Feeney, 2010) and service function types
may produce limitations for organizational analysis. In (Antonsen & Jørgensen, 1997).
part, this is because the blurring of sectors presents empiri-
cal challenges to analyzing organizations primarily through
the prism of ownership (Bozeman, 1987; Bozeman &
Publicness and Managers’ Perceptions
Bretschneider, 1994; Dahl & Lindblom, 1953; Wamsley & Despite the known implications of organizational publicness
Zald, 1973). for management strategy, the theoretical understanding of
Merritt 413

publicness in public administration research lacks a manage- health insurance plans similar to their government counter-
rial perspective. Existing research analyzes how organiza- parts. These and related environmental institutions subject
tional actors, such as managers and front-line workers, organizations to greater political authority and contribute to
perceive organizational phenomena related to publicness. the blurring of sectors. Even still, political authority mecha-
For example, these studies offer insight into how organiza- nisms, such as government ownership and funding, may play
tional actors perceive government (Moulton & Feeney, a smaller role than expected in management strategies and
2010), political control (Merritt, Cordell, & Farnworth, program-level outcomes in mental health treatment facilities
2018), their public purpose (Moulton, 2012), and public val- (Boyne, 2002; Heinrich & Fournier, 2004). For example, a
ues (Van der Wal, De Graaf, & Lasthuizen, 2008), sometimes paradox not uncommon in health services is that recipients of
within existing publicness frameworks. However, extant services funded by government may never interact with a
research does not offer insight into managerial perceptions of single government actor (Kettl, 2008). Kettl (2008) notes
the organizational phenomenon of publicness itself. By bet- that “government does not so much run the Medicare and
ter understanding the primary factors that constitute organi- Medicaid programs as leverage them. Trying to leverage
zational publicness through a managerial lens, managers can such complex programs without directly controlling the ser-
more consciously attend to that aspect of the organization to vice-delivery system is the hidden puzzle inside governance
create public value. in the twenty first century” (11). By uncovering other pieces
to the “puzzle inside governance” from the vantage point of
managers operating in mental health and substance abuse
Method
treatment facilities, we might also uncover the perceived
This study explores managerial perceptions of publicness in attributes of publicness that managers identify as shaping
the context of mental health and substance abuse treatment their management strategies.
facilities in the Midwestern United States. We employ
grounded theory methodology, in which “systematic data
Case Selection
collection [can] be used to develop theories that address the
interpretive realities of actors in social settings” (Suddaby, Case selection commenced when we generated a list of facil-
2006, p. 634). This methodology requires an ongoing inter- ities compiled in the Mental Health Treatment Facility
play between data collection and data analysis, which often Locator, an online resource for locating treatment facilities
occur in concert (Fyall, 2016). In the next section, we supported by the Substance Abuse and Mental Health
describe the study’s research setting, case selection, data col- Services Administration, an agency within the U.S.
lection, and data analysis procedures, all of which are part of Department of Health and Human Services. The Locator
a larger ongoing study of the structure, design, and manage- generated over 7,700 government, private, and nonprofit
ment of behavioral health organizations. facilities, and provided the organizational name, physical
address, telephone number, and website address for each
facility. Upon retrieving a list of facilities, we contacted
Research Setting facility managers individually through email correspondence
Mental health and substance abuse treatment facilities pro- and inquired about their willingness to participate in a tele-
vide prevention, treatment, and recovery support for clients phone interview. The formal invitation articulated the back-
suffering from behavioral health illnesses, including emo- ground, purpose, and goals of the study; consent processes;
tional disturbance, depression, and drug use disorders. This and confidentiality associated with results.
setting is appropriate given the intensifying public debate on A total of 26 senior-level managers (e.g., presidents and
the role of government and private organizations in provid- chief operating officers) participated in in-depth interviews
ing mental health and substance abuse treatment (Heinrich & over a span of 6 months. We solicited participants from the
Fournier, 2004). Access to and the effectiveness of these ser- Midwest, the U.S. census region where drug abuse, one
vices are among the central themes of this debate, due in part example of a rapidly escalating mental health disorder, is
to expansion in government financing of private health care most heavily concentrated (Hedegaard, Chen, & Warner,
services (Heinrich & Fournier, 2004; Miller & Moulton, 2015). We entered the case selection stage seeking to obtain
2014; Wheeler & Nahra, 2000). Due to these kinds of struc- a heterogeneous purposive sample of respondents in catego-
tural shifts in the health care industry, mental health and sub- ries such as gender, sector affiliation, and organizational size
stance abuse treatment facilities are neither “purely public” to provide as much insight as possible into the publicness
nor “purely private” (Heinrich & Fournier, 2004); therefore, phenomenon. This study’s approach to case selection for
using only the sector designation of a facility to formulate grounded theory methodology, purposive sampling, is pre-
management strategies to advance organizational objectives scribed by Glaser and Strauss (1967). In addition, our sample
may not be useful. For example, numerous treatment facili- size of 26 respondents is consistent with the parameters of
ties in the business and nonprofit sectors accept client pay- studies prescribing appropriate sample sizes for qualitative,
ments associated with Medicare, Medicaid, and state-financed phenomenological research requiring interviews (Beitin,
414 American Review of Public Administration 49(4)

Table 1.  Descriptive Statistics. mental health and substance abuse treatment facilities. To
prevent response bias, given the possible social desirability
% of sample
Characteristics (N = 26) of publicness attributes, managers were first asked to com-
ment on their interpretations of the influences on organiza-
Gender tional publicness in the general population of treatment
 Female 53.8 facilities. Second, we asked managers to identify characteris-
 Male 46.2 tics of their facility’s publicness and to demonstrate the pres-
Years of experience in current management position ence of these conditions or attributes by providing specific
  <6 38.4 and detailed examples. Third, given that antecedents to the
 6-10 30.8
achievement of public outcomes are often organizational and
 11-15 15.4
environmental mechanisms that are public in nature
  >15 15.4
(Antonsen & Jørgensen, 1997; Bozeman, 2007; Moulton,
Organization’s legal ownership
2009), we asked managers to first identify performance out-
 Government 30.8
 Nonprofit 42.3
comes of their organizations that the broader public consid-
  Private for-profit 26.9 ers important (i.e., public outcomes). Then we asked them to
Organization’s full-time equivalent employees identify organizational and environmental mechanisms that
  <100 57.8 empowered or constrained their facilities’ abilities to achieve
 100-500 23.1 the identified public outcomes. Fourth, managers were asked
 501-1,000 11.5 to envision a scenario in which their organizations were
 1,001-1,500 3.8 underperforming in the public outcomes they aimed to
  >1,500 3.8 achieve (identified in the third prompt question), and to iden-
Organization’s service type tify the internal and external mechanisms that would gener-
  Outpatient treatment center 57.7 ate improvement for each outcome. These prompt questions
  Residential treatment center for adults 34.6 were asked of all respondents, although the semi-structured
  Residential treatment center for children 7.7 format of interviews produced variation in participant-driven
discussions.
Collectively, prompt questions (provided in Table 2)
2002; Creswell, 1998; Thomas & Pollio, 2002). Table 1 pro- enabled us to distinguish organizational and environmental
vides descriptive statistics for the study’s sample. mechanisms associated with publicness—what this research
seeks to identify—from outcomes that result from public-
ness. Prompt questions also facilitated the analysis process
Data Collection
by enabling the researchers to identify consistencies between
We collected data through open-ended, semi-structured tele- those mechanisms managers identified as being associated
phone interviews. The first phase of interviews consisted of with publicness (Prompt Questions 1 and 2) and mecha-
16 managers and took place from January 2017 to March nisms used during the actual (Prompt Question 3) and hypo-
2017. The second phase of interviews involved 10 managers thetical (Prompt Questions 4 and 5) strategic management
and occurred from June 2017 to August 2017. For the first processes specifically aimed at achieving public outcomes
phase, we employed an open and grounded approach to data in organizations.
collection in which the knowledge and experiences of senior
managers exclusively guided emerging themes. The period
Data Analysis
between the first and second phases provided time for the
research team to dissect and process the initial set of inter- To analyze data collected in the first phase of interviews, two
views. The second phase of interviews—while remaining researchers participated in a process of open coding as pre-
committed to openness to new ideas—was more targeted as scribed by Strauss (1987) to identify and categorize patterns
we aimed to confirm emerging publicness themes that sur- emerging from the data. Specifically, each coder engaged in
faced during the first phase of interviews. The semi-struc- a nonlinear and iterative process of reading data closely, tak-
tured format enabled us to perceptively explore questions ing extensive notes, open coding, and constantly comparing
during the second phase of interviews that were raised during codes within and across cases. In doing so, researchers aimed
the first phase. to identify common patterns from manager responses across
Interviews averaged approximately 1 hr in length across all prompt questions, as opposed to those emerging from
the first and second phases. For each phase, we recorded and responses to any single question or select set of questions.
later transcribed interview responses verbatim prior to cod- This process enabled the researchers to unpack codes that
ing and analysis. Interview questions were designed to elicit reflected publicness specifically, versus those that reflected
information about the organizational and environmental open activities and external relationships of any kind.
characteristics associated with publicness in the context of Researchers subsequently aggregated codes into primary
Merritt 415

Table 2.  Prompt Questions and Selected Interview Excerpts.

Political authority Horizontal engagement Public engagement


1. Generally speaking, “A public organization [is] “The accreditation process is a “Regularly getting feedback from
and not considering the government funded and things of driving force . . . to providing the community.” (Nonprofit
organization for which that nature.” (Private manager) the best services and manager)
you work, what does being quality to the community.”
a “public organization” (Nonprofit manager)
mean to you?
2. W hat characteristics “We serve a very indigent “We will open our ears “[Persons with lived experience]
make your facility a population so [we are a] and open our doors and contribute to the credibility of
“public organization”? Medicaid provider. So, we have collaborate with anyone as long the treatment program goal and
standards that we have to adhere as at the end of the day, the achievement . . . There needs to
to through the state. And if we’re clients are taken care of and be a better juncture between
not meeting those standards, that they’re safe. So, I really these [clinician and service
we could be decertified and be think it’s just that top-down recipient] silos to enhance the
put out of business.” (Nonprofit vision of how our organization knowledge that can be gained from
manager) is established as far as that working with [persons with lived
mentality.” (Private manager) experience].” (Private manager)
3. What performance outcomes “We’re also certified through the “The Ohio Association for “It is governed by a volunteer
of your organization Department of Youth Services, Child Caring Agencies, we’re board of directors that
does the broader public which is DYS. We can reach out members of it, and they’re a represent the counties that we
consider important? What to them for specific things as huge resource for us. They serve.” (Nonprofit manager)
characteristics enable well.” (Private manager) answer tons of questions.
your organization to They’re working currently
perform well in these on informing agencies, in all
areas?a the agencies in Ohio, about
Medicaid reform and all those
things.” (Private manager)
4. E nvision a scenario in “We have standards that we “We have a large network “I think we would need to
which your organization is have to adhere to through the which allows us to have have a [client] focus group
not performing effectively state. And if we’re not meeting [access to] a lot of different to understand why this isn’t
enough to achieve the public those standards, we could be programs, which allows us to working. I would also probably
outcome(s) you identified (in decertified and be put out of connect with a lot of different survey some of our clients
Prompt Question 3): As a business. [Our state] does resources . . . For example, here to get their perspective
manager, what strategies have very strict standards for we might send someone who as to what’s working, what’s
or activities do you behavioral health providers so is a woman with a history of not working, why do you feel
implement to improve that could be catastrophic if sexual trauma and borderline this isn’t working. . .I think a
performance in these we’re not performing up to our trait to an inpatient facility lot of times our clients can be
areas?a standards, as well as the federal that’s specific to that our best teachers.” (Private
government’s [standards]. We population.” (Government manager)
do get federal funding and that manager)
federal funding can dry up.”
(Private manager)
5. E nvision a scenario in “When the Office of Medicaid and “We are nationally accredited “The clinicians interview parents
which your organization is Medicare audits you, they pull by CARF . . . We go through and guardians when they’re
not performing effectively records. [If] they have a finding an accreditation process doing the mental health
enough to achieve the public in the records that you didn’t every three years that looks assessment. Parents will know
outcomes you identified (in do something according to their at our entire organization, what their kids respond best
Prompt Question 3): What regulations, they make you not from business practices to as far as intervention, and
outside sources dictate only pay back that money, they to quality of service, and they may not call it therapeutic
your management also take whatever that dollar they hold us to a set of or behavioral intervention, but
decisions when you seek amount is by percentage of the standards under that review.” that’s what we call it . . . We’ve
to improve performance sample and extrapolate that to (Nonprofit manager) seen a correlation with parent
in these areas?a the total that you billed Medicaid involvement and successful
for.” (Government manager) discharge.” (Private manager)

Note. CARF = Commission on Accreditation of Rehabilitation Facilities.


a
Excerpts reflect responses to bolded portion of the prompt question.

dimensions based on thematic relationships. After conduct- coding patterns and themes emerging from data associated
ing these steps independently, the researchers compared with the first phase of interviews to demonstrate intercoder
416 American Review of Public Administration 49(4)

reliability. The researchers engaged in exhaustive discus- Overall, most of the government, private, and nonprofit
sions to resolve discrepancies in coding. Data analysis proce- facilities in the current study received funding from the gov-
dures for the second phase of interviews mirrored that of the ernment. These facilities acquired government funding pri-
first phase and occurred following the development of pre- marily through contracts, grants, Medicaid, Medicare, and
liminary findings. This process ultimately yielded agreement state-financed health insurance plans. According to manag-
on the primary factors respondents associated with public- ers, government funding was associated with publicness
ness across all 26 interviews. Our approach to data analysis because it shaped (a) populations served by facilities, (b) ser-
is consistent with previous studies using grounded theory vices and programs offered by facilities, (c) entities that held
methodology to explore the factors intrinsic to organizational facilities accountable for performance, and (d) performance
phenomena (e.g., Caldwell, Roehrich, & George, 2017; criteria by which facilities were evaluated.
Fyall, 2016). In terms of populations receiving services, funding from
government sources often prescribed that facilities serve indi-
viduals at the low end of the socioeconomic spectrum, a popu-
Findings and Interpretation: Managers’
lation that may otherwise be underserved. For example,
Perceptions of Publicness Medicaid receipts directed services to persons with low income
Findings revealed that managers’ perceptions of organiza- and limited resources. By investing in socioeconomically dis-
tional publicness in the context of mental health and substance advantaged clients and committing to their development as
abuse treatment facilities fell into three dimensions: the extent productive citizens or residents, organizations also benefited
to which a facility (a) is subject to political authority, (b) par- the larger public. Second, government funding shaped the ser-
ticipates in horizontal engagement with external organiza- vices and programs facilities offered, thereby ensuring that ser-
tions, and (c) practices public engagement with the general vices satisfied public functions. Core services such as
public. Respondents demonstrated that these dimensions are, comprehensive substance abuse assessment, HIV testing, and
collectively, intrinsic to publicness within and across govern- discharge planning—as well as ancillary services such as social
ment, private, and nonprofit treatment facilities. skills development and employment counseling for clients—
The primary influences on organizational publicness were improved or newly administered due in large part to gov-
emerged from the study itself, accompanied by consultations ernment funding. Third, government funding situated political
with relevant literature (see Suddaby, 2006). We present our authorities to hold facilities accountable for performance.
results in the following sections, organized by core themes. Although management decisions were mostly self-directed,
Table 2 provides supporting excerpts mapped across core facilities remained accountable to political authorities due to an
publicness themes/dimensions and the prompt questions that expected return on investment. Political authorities are govern-
elicited managerial responses. mental stakeholders who impose accountability that presum-
ably enhances the legitimacy and effectiveness of services with
public value implications (Meijer & Schillemans, 2009).
Political Authority Fourth, government funding shaped the performance criteria
Managers reported that higher levels of political authority by which facilities were evaluated, often yielding an increase in
increased an organization’s publicness. Specifically, manag- procedural prescription on how to achieve performance out-
ers identified government ownership, funding, and regula- comes. A government manager commented,
tion as indicators of political authority. This particular finding
reinforces the significance of government-sector designation There [are] regulatory issues. There is the Office of Medicaid
(Rainey et al., 1976) and other political authority attributes and Medicare. There [are] external auditors that come in . . . All
of those [entities] have a, shall we say, report card, and there
(Bozeman, 1987) in conceptualizing publicness.
[are] rules that have to be followed, and you have to live up to
Managers contended that government ownership provided those rules. There are consequences, there could be monetary
their facilities with a “public responsibility” and a “public consequences.
burden” to fulfill objectives valued by the government, most
notably client outcomes related to substance abuse interven- Likewise, a nonprofit manager remarked,
tion, reduction of recidivism, reentry into community living,
and outreach to underserved populations. In addition, govern- We receive government and federal funding that comes with
ment ownership was identified as an aspect of publicness guidelines that require you to serve and provide quality services
because of the requirement to serve individuals regardless of in a nondiscriminatory way that’s accessible to any and
demographic characteristics, such as race, age, and ethnicity. everyone, and to make the accommodations for persons to get
Facilities that admitted clients based on exclusionary criteria, access to services.
such as organizations serving the veteran or forensic popula-
tions, nonetheless fulfilled a public responsibility required of Managers revealed that government regulation of their
government-owned organizations. facilities most frequently came in the form of requirements
Merritt 417

pertaining to licensure,2 maintenance of 501(c)(3) tax- The Joint Commission, and the National Committee for
exempt status, and more specifically, regulations associated Quality Assurance. By engaging in accreditation procedures,
with the Health Insurance Portability and Accountability mental health and substance abuse treatment facilities volun-
Act, Affordable Care Act, Equal Employment Opportunity tarily expend resources to meet national standards for organi-
Commission, and the Civil Rights for Institutionalized zational structure and treatment processes necessary to
Persons Act. Mechanisms of regulation, enforced at all levels deliver quality care (Friedmann, Alexander, & D’Aunno,
of government, made facilities more public because compli- 1999). Although these national accreditation bodies do not
ance elevated the quality of services and programs offered have the ability to remove a contract or state-issued license,
and protected the rights of personnel. Demonstrating the they subject organizational standards, practices, and policies
effects of regulation, a private manager remarked, of public value to sanctioning and external scrutiny (Teodoro
& Hughes, 2012). Heinrich and Fournier (2004) theorized
Basically every 90 days, if the child is a CHINS, a child in need accreditation as a feature of public organizational form that
of services, they have to go before the court to do what we call a is integral to outcomes in substance abuse treatment facili-
placement review. Years ago, the judges didn’t really want to ties. Moulton (2009) similarly viewed accreditation as a
hear from us. Now they do. So most times, we get a request from mechanism involving activities that “espouse public values”
DCS [the Department of Child Services], we go to court, and we
(p. 892) and thus “contribute to the achievement of public
tell the judge what’s going on because they want to hear it from
the therapist or the case manager.
outcomes [in organizations] across sectors” (p. 889). In the
current study, behavioral health accreditation agencies
While managers often attributed public outcome attain- helped facilitate continuous improvement in facility perfor-
ment to contract requirements and regulatory stipulations, mance with respect to readmission and mortality rates, and
exposure to political authority also facilitated a civic-minded restraint and seclusion measures. Multiple respondents
impetus by empowering organizations to achieve public out- across sectors maintained that accreditation standards sur-
comes. For example, numerous nonprofit managers did not passed standards associated with governmental licensing.
consider legal requirements associated with maintaining tax- According to a private sector manager,
exempt status a legal obligation, but rather an opportunity to
Accreditation, at a minimum, would meet whatever the state
respond to a public need. Still, other managers revealed that requires us to be and do and document. So our accreditation is
political authority produced wasteful oversight and was a more stringent; it’s more strict, if you will . . . [Accreditation
burden to mission attainment, employee role clarity, achieve- has] more requirements about how we do quality improvement,
ment of core and ancillary objectives, and entrepreneurial how we assess our client’s quality of life, things that the state
activities. really doesn’t require of us. The state requires the “bare bones,”
for lack of a better word, [such as] “are a child’s basic needs
met?” and “are things being documented?” and “are they being
Horizontal Engagement safe?” . . . Accreditation considers all of those things and then
Managers reported that higher levels of horizontal engage- some.
ment increased an organization’s publicness. According to
our findings, horizontal engagement captures a principal Furthermore, managers in certain Midwest states noted that
organization’s voluntary formal and informal interactions maintaining a government license is contingent upon national
with one or multiple external organizations in any legal sec- accreditation. A private manager noted,
tor—conditioned upon such engagement explicitly increas-
ing the principal organization’s public value or capacity to If accredited, then the state will step aside and let that
accreditation take precedence. They have since said we, the
achieve public outcomes.3 The social embeddedness a prin-
state, will no longer be in charge of licensure . . . If you have
cipal organization experiences through horizontal engage- accreditation, [the state] deems [your organization] appropriate
ment can institutionalize it within a set of shared norms, as a provider. There are some caveats . . . But by and large, [the
decision-making processes, and discourses, and can conse- state] step[s] aside and lets accrediting bodies handle that.
quently direct the organization toward certain public goals
and values (Bingham & O’Leary, 2006; Hill & Lynn, 2005; According to respondents, engagement with nongovern-
Moulton, 2009). The practices of business firms engaging in mental advocacy organizations such as the National Alliance
joint ventures to increase their own profit, for example, on Mental Illness, Mental Health America, and the United
would not constitute horizontal engagement as conceptual- Way also served as mechanisms of horizontal engagement.
ized by managers in the current study. One respondent indicated that his organization sought advice
Horizontal engagement by a principal organization fre- from a local United Way on how to address a problem per-
quently occurred with nongovernmental national accredita- taining to juvenile justice. The United Way was able to con-
tion agencies, including the Commission on Accreditation of nect the treatment facility with community-based nonprofits
Rehabilitation Facilities (CARF), Council on Accreditation, committed to advancing juvenile welfare. A mental health
418 American Review of Public Administration 49(4)

facility’s engagement with the United Way, in this instance, network, a coalition, partnerships, or informal coordination
produced partnerships that enabled the facility to commit . . . intermittent, temporary, or permanent . . . informational,
greater knowledge and manpower to addressing a public developmental, outreach oriented, or action oriented”
problem. (Bingham & O’Leary, 2006, p. 162). In addition, the conve-
Respondents indicated that a principal organization’s for- ner of horizontal engagement may be any entity affected by
mal interaction with a government organization constituted public problems regardless of sector affiliation (Bryson,
horizontal engagement if the government entity did not pos- Crosby, & Stone, 2006). Informal systems associated with
sess political authority over the principal organization. On such engagement, such as protocols and shared norms, rein-
multiple occasions across distinct facilities, horizontal force the legitimacy of horizontal relations (Emerson,
engagement with government corrections organizations Nabatchi, & Balogh, 2012). Regardless of the structure,
(with no regulatory authority over the participating treatment duration, intensity, sector of the convener, or degree of for-
facilities) enabled treatment centers to meet core public mal structure, a core criterion grounds horizontal engage-
objectives, such as creating a drug-free environment for ment in “morally governed,” voluntary, and noncompetitive
youth and adults. Similarly, a nonprofit manager provided interactions (see Scott, 2008), in contrast to that which is
insight into her organization’s collaboration with a public authoritative in nature. Horizontal engagement is distinct
health department, among other organizations: from political authority because exchanges under the former
are not vertically imposed through legal or governmental
I might need to reach out to the public health department and authority (Moulton, 2009; Stinchcombe, 1997; see Heinrich
say, “Hey, let’s all get together and talk about needle exchange” & Fournier, 2004).
or I might need to reach out to the other hospitals, and we’re Agranoff and McGuire (2001) may have viewed horizon-
going to do a joint project together in terms of making it more tal engagement as a “core public activity” (304, italics
transparent whose got open beds and in a crisis. I think it’s our
ours)—not to be confused with governmental activity—
responsibility to work with anyone in the community that’s
because of the social obligation to create public value in any
going to help benefit the client access to services and better
outcomes. So I think that’s our responsibility, and we can’t be in sector. This social obligation, due in no small part to horizon-
this role like, “That’s your problem.” We all have to be working tal engagement, was often reported as being present in pri-
together. vate organizations despite their traditional commitment to
profit maximization. As Scott (2008, p. 55) made clear, bod-
Finally, respondents indicated that horizontal engagement ies such as accreditation agencies and certain collaboration
occurred through collaboration, in which all organizations partners are “typically viewed as imposing constraints on
involved in a network engaged in mutually beneficial col- social behavior, and so they do. At the same time, they
laborative exchanges to enhance organizational and collec- empower and enable social action. They confer rights as well
tive capacities to achieve public outcomes. Engagement in as responsibilities; privileges as well as duties; licenses as
this respect was most evident when facilities accepted client well as mandates” and “define legitimate means to pursue
referrals, created and maintained an integrated continuum of valued ends.”
care for clients, and secured job placements for clients. A
government manager remarked that his organization does Public Engagement
not independently maintain a public mental health system,
but it turns to a “network of sister government agencies” to Managers reported that higher levels of public engagement
maximize human and financial resources necessary to treat increased an organization’s publicness. Analysis of inter-
clients. Similarly, another government manager who experi- views revealed that public engagement centers on an organi-
enced the value of collaboration commented, zation’s inclusion of the general public in the design, delivery,
and evaluation of its services so as to specifically increase
We have a large network . . . We have homeless teams. We have organizational responsiveness to and capacity to achieve out-
nutrition services. We’ve got weight loss services. We’ve got comes most valued by the broader public.
psychotherapies, specialty medicine. You can get almost At a conventional level, the participation of citizens or
everything you need [here]. If you can’t get it here, we’ll pay for residents in an organization’s public meetings, stakeholder
you to get it somewhere else. advisory committees, and boards of directors facilitated pub-
lic engagement. These and related forums provided channels
The complexity of organizational objectives often neces- for the citizenry and residents to provide feedback—with the
sitates horizontal engagement across policy disciplines, sec- intent of enhancing a facility’s value to the public. One gov-
tors, and levels of government to attain public outcomes ernment manager noted that input from her facility’s board of
(Kettl, 2006; Milward & Provan, 2000; O’Toole, 1997). directors was particularly beneficial because every county in
Horizontal engagement, therefore, includes interorganiza- the facility’s operating district was represented and its mem-
tional, intersectoral, or intergovernmental relationships bers were diverse in relation to race, gender, and culture. In
(Kettl, 2006), and may structurally emerge as “a formal the nonprofit sector, a respondent contended,
Merritt 419

Our board input is important to us in terms of translating Senior managers identified education/training, supervi-
community desires and needs into policy and procedure. sion, and nature of participation (e.g., outreach, clinical,
management, board of directors) as important considerations
Public engagement also occurred when citizens and resi- in integrating citizens and residents into service provision
dents, specifically those who had lived with the challenges that efforts. Furthermore, this form of public engagement must be
organizations in the mental health field were charged with designed to account for existing clinical and management
addressing, formally engaged in a facility’s provision of ser- strengths as well as the learning curve that clinical and
vices. This model of service delivery that integrates persons administrative personnel will experience when working with
with relevant “lived experience” enables individuals to marry the public. Some facilities went as far as creating units or
their roles as community members with their personal experi- divisions specifically designed to support this coproduction
ences as current or former consumers of services to engage in mechanism.
the education of mental health professionals and the caring of According to existing scholarship, the processes through
other clients (Bradstreet, 2006; Byrne, Happell, Welch, & which people (in various capacities/roles) directly and
Moxham, 2013). According to Byrne and colleagues, “inclu- actively participate in public affairs is deemed “the new gov-
sion [of persons with lived experience] in matters as diverse as ernance” (Bingham, Nabatchi, & O’Leary, 2005; J. C.
service delivery, policy formation, participation in interview Thomas, 2013). Cooper, Bryer, and Meek (2006) contended
panels, and the development of new models of care has evolved that “citizen-centered collaborative public management”
from its somewhat tokenistic foundations to become an expec- underscores the role of the public in collaborative manage-
tation within mental health services” (p. 196). Similarly, J. C. ment processes. This bottom-up form of engagement, which
Thomas (2013), identifying the distinct roles of the public as Wildavsky (1987) identified as an “essential task” for orga-
citizens, customers, partners, and volunteers, contends that nizations serving the public, and which sits at the heart of
organizations “must work with members of the public in more Denhardt and Denhardt’s (2002) theory of the New Public
than one of these roles at a time” (p. 786). A nonprofit manager Service, represents an umbrella term that involves numerous
commented that the inclusion of “citizens with lived experi- mechanisms organizations across sectors use to bring people
ence” provided the organization with a “public persona” when together to address issues of public importance (Bingham
delivering services. For instance, persons with lived experience et al., 2005; Nabatchi, 2012; Nabatchi & Amsler, 2014).
developed and vetted one facility’s consumer satisfaction sur- Methods of public engagement range from conventional
vey. Another government organization created an advisory practices, such as executing public hearings and advisory
committee exclusively composed of individuals with lived committees that seek feedback from the public, to “thick”
experience, whose manager stated, methods such as coproduction of services (Leighninger,
2014), which demonstrates that the provision of services is
We have a consumer advisory board. They don’t work for us per the product of efforts jointly taken by both members of the
se, but they work on projects with us. They advise us . . . and general public and organizational officials (Bovaird, 2007;
kind of [have] a say so . . . It’s been incredibly helpful for the
Brudney & England, 1983). To facilitate varying forms of
staff understanding [clinical issues] from a different perspective.
public engagement, organizations need to account for the
various structural means by which citizens and residents may
Persons with lived experience frequently played roles in
influence public outcomes and implement strategic practices
implementation efforts at the clinical level. By coproducing
that will incorporate that influence where suitable (Sowa,
clinical services, citizens and residents added a public-cen-
2015). If participation is intensive, but not diverse and repre-
tered and “value-added” perspective to the organization.
sentative, organizations may fail to engage relevant stake-
Facility coproduction with citizens and residents was, by and
holders and risk inaccurately reflecting the policy preferences
large, associated with better clinical outcomes, improvement
of the target population (Weeks, 2000).
in core and ancillary services, a reduction in complaints from Simply put, public outcomes are more likely to be real-
clients, and improved interactions with service recipients. ized when the formulation and implementation of organiza-
According to a respondent leading a Veterans Affairs Medical tional activities are supported by the collective goals and
Center whose organization integrated persons with lived actions of organizations and the general public (Denhardt &
experience specific to their service-delivery clientele: Denhardt, 2002; Fung, 2006; Nabatchi & Amsler, 2014; Guo
& Neshkova, 2013). Organizational actors and members of
We have veterans at every level of this hospital—from the
the public have different, yet jointly beneficial, perspectives
highest to, I don’t want to use the word “low” because it’s very
restrictive, but you know what I mean. Highest paid to lowest
and roles in an organization’s creation of public value
paid physicians all have [the assistance of] veterans . . . So if you (Stivers, 1994). Citizen and resident participants, for
have a Peer Support Specialist in, say, PTSD or somebody who instance, may be able to “frame problems and priorities in
has been diagnosed with schizophrenia but is living really well, ways that break from professional conceptions yet more
they’ll help people as these peer supports that show our closely match their values, needs, and preferences” (Fung,
commitment to the recovery model. 2006, p. 73). The absence of public engagement may not
420 American Review of Public Administration 49(4)

Figure 1.  Framework for managers’ perceptions of publicness.


Note. The two-sided arrows respectively represent the direct legal, social, and cultural exchanges between political authority (line “a”), horizontal engage-
ment (lines “b”), and public engagement (line “c”) mechanisms and the organization.

only be inappropriate, but inconceivable given the complexi- By and large, managers demonstrated that an organiza-
ties associated with creating public value (Nabatchi, 2012; tion’s overall degree of publicness is based on the extent to
Nelissen, Bemelmans-Videc, Godfroij, & deGoede, 1999). which the amalgamation of mechanisms associated with
political authority, horizontal engagement, and public engage-
ment are institutionalized as formal (vs. informal) and perma-
Discussion
nent (vs. temporary or intermittent). Government ownership
Findings, illustrated in Figure 1, demonstrate that the pri- introduces a high magnitude of publicness compared to other
mary mechanisms managers associate with publicness in the mechanisms because of its highly formal and permanent
mental health and substance abuse treatment arena impose nature.
themselves on organizations in distinct respects; they are The multidimensional conceptual framework emerging
top-down and legally sanctioned via political authority, lat- from this study lays the groundwork for scholars to explore
eral and morally governed via horizontal engagement, and managers’ perceptions of indirect publicness. For example,
bottom-up and culturally supported via public engagement. the indirect influence of political authority on organizations
Moreover, mechanisms related to political authority, hori- might occur when horizontal governance institutions (or
zontal engagement, and public engagement are not created networks) are themselves directly enabled or constrained by
equal and, consistent with North’s (1990) research on institu- political authority, such as third-party regulators who act on
tions, may exert their influence formally or informally. For behalf of government to distribute standards of practice and
example, political authority mechanisms introduce laws and document organizational adherence to those standards, or
sanctions to regulate organizational behavior (Clarkson, when administrative organizations coordinate services in a
1972). Managers and their organizations must appropriately publicly funded network of organizations. Highlighting this
respond or adhere to expectations associated with these type of indirect influence of political authority on the orga-
mechanisms for political authority to attain real value. nization, Salamon (1987, p. 38) contends that
Merritt 421

health and other policy areas, such as education, environ-


instead of the hierarchic, bureaucratic apparatus pictured in mental sustainability, and law enforcement. Such research
conventional images, the concept of third party government would benefit from greater attention to specific domain
emphasizes extensive sharing of responsibilities among public effects and their interactions as well as additional insight into
and private institutions and the pervasive blending of public and the relationship between dimensions; this might require
private roles that is characteristic of the American welfare state .
operationalization of the publicness dimensions that emerged
. . It thus creates a public presence without creating a monstrous
public bureaucracy.
from managers’ perceptions. Future research may also bene-
fit from exploring the primary factors associated with public-
Public engagement might indirectly influence organiza- ness through the lens of other stakeholders of organizational
tions, such as when nongovernmental interest or advocacy outcomes, such as middle managers, front-line workers, citi-
groups represent—and are represented by—nonstate public zens, and elected officials.
actors (i.e., citizens and residents) in a networked policy envi-
ronment. Such interest and advocacy groups promote social Conclusions and Implications
and professional interests, and increasingly represent margin-
In this study, we conducted an exploratory analysis of the
alized populations by “providing an institutionalized voice for
primary factors that senior managers associate with an orga-
the concerns of groups that lack sufficient formal representa-
nization’s publicness in the context of mental health and sub-
tion” in the public policy process, such as women, racial, and
stance abuse treatment facilities. In this setting, the
ethnic minorities, and low-income people (Strolovitch, 2006,
perspectives of managers revealed that mechanisms of pub-
p. 894). The National Alliance on Mental Illness, for instance,
licness include those associated with political authority and
is the nation’s largest grassroots mental health advocacy orga-
with engagement. Government ownership, funding, and reg-
nization and works collaboratively with state organizations ulation are sources of political authority, while engagement
and hundreds of local affiliates to raise awareness and provide can be seen along two dimensions: horizontal and public.
education on mental illness. The indirect influence of public Horizontal engagement refers to certain facility relations
engagement on organizations is present, in this example, when with external organizations that explicitly serve to further the
interest and advocacy groups such as the National Alliance on facility’s efforts in creating public value. Public engagement
Mental Illness establish mechanisms for citizens and constitu- refers to the integration of the general public into the facility
ents to directly shape its mission, vision, and values (Guo & in a manner that explicitly advances public value creation
Saxton, 2010), thereby influencing the programmatic agenda through measures such as citizen and resident participation
and clinical priorities of treatment facilities. on stakeholder advisory committees and coproduction.
Following Bozeman and Bretschneider (1994) and Stark This study suggests that a robust understanding of organi-
(2010), any conceptualization of organizational publicness is zational structures and institutions as they relate to the pub-
not superior to another, including when accounting for man- licness framework generated from the current study might be
agers’ perceptions of publicness generated from the current of great benefit to managers operating in the mental health
study. Each framework “makes the other more complete, and substance abuse treatment system, particularly those
possibly because they each apply to the same organizations seeking to manage organizational publicness. Managing
in different sets of circumstances” (Stark, 2010, p. 23). For publicness—or strategically managing for the creation of
example, managers’ perceptions of publicness might have public value (Bozeman, 2007; Bryson, 2018; Moulton, 2009)
the most to say about how an organization’s publicness is is a complex exercise, due largely to the tensions that result
transmitted although associations with public-serving orga- from managers and organizations operating within multifac-
nizations and the general public directly. eted governance systems. These systems, according to Lynn,
Heinrich, and Hill (2000), involve environmental factors
Caveats, Limitations, and Directions for (e.g., level of external authority or monitoring, funding con-
straints or dependencies, legal institutions or practice, tech-
Future Research nological dynamism), client characteristics and behavior,
This study focused exclusively on managerial perceptions of treatments (e.g., organizational mission and objectives, pro-
organizational publicness. Insights provided in this study gram treatment and technology), structures (e.g., organiza-
offer a basis for subsequent theory development; however, tion type, contractual arrangements, institutional culture and
they are not facts, but rather the embodiment of respondents’ values), and managerial roles and actions (e.g., staff-man-
interpretations—shaped or explained by their roles in a spe- agement relations, accountability mechanisms). A participat-
cific policy context—that cannot be construed as objective ing nonprofit manager articulated a commonly held sentiment
data (Maynard-Moody & Musheno, 2003, p. 23). about operating within this context:
Future research could adopt qualitative or quantitative
methods to further explore or test the salience of this study’s I see an ongoing tension in our system. Tension among those
publicness framework for management strategy in mental regulators that look at what we do, tension among the people who
422 American Review of Public Administration 49(4)

fund us, the organizations that fund us, the government Research (EMPOWER) at Indiana University–Purdue University
organizations that fund us, the political players who engage in the Indianapolis (IUPUI), the Developing Diverse Researchers with
public discourse in [the] community, and the people we serve. InVestigative Expertise (DRIVE) Grant from IUPUI, and the
There’s an interesting dynamic. I could call it a tension among all Summer Research Fellowship from the University of Kansas.
of those parties and, from where I sit, sometimes it’s challenging
to manage those tensions. I may have a government contract that Notes
expects certain things to be accomplished, but that runs into the
1. According to Scott (2008), regulative institutions “involve the
face of a regulatory requirement that I must fulfill . . . There’s a
capacity to establish rules, inspect others’ conformity to them,
court system that remands to our custody a child who is 17 years
and, as necessary, manipulate sanctions—rewards and pun-
old who doesn’t want to live with somebody else, but shouldn’t a
ishment—in an attempt to influence future behavior” (p. 52);
17-year-old have some say in what happens in their life? So those
normative (or associative) institutions “introduce a prescrip-
are the tensions that occur. I think this notion of publicness,
tive, evaluative, and obligatory dimension into social life” (p.
[given] my position and our job as an organization, helps me to
54); cultural cognitive institutions represent “shared concep-
be aware of those tensions so that the people we serve are not
tions that constitute the nature of social reality and the frames
victimized as we work through those tensions.
through which meaning is made” (p. 57).
2. A license is government granted and typically required for
As this manager demonstrates, awareness of the publicness organizations to practice or operate in the mental health and
mechanisms identified by respondents in this study can clar- substance abuse treatment field. Some states refer to their
ify the strategic choices and opportunities available; organi- licensure processes as “certification.”
zations without this awareness may lack the structural 3. In the current study, the “principal” organization is the local
capacity to effectively provide prevention, treatment, and organization whose capacity to achieve public outcomes
recovery support for individuals suffering from mental health increases as a result of horizontal engagement.
and substance abuse disorders. For example, rather than sim-
ply asking whether mechanisms related to publicness should ORCID iD
be introduced, preserved, or terminated, the framework gen- Cullen C. Merritt https://orcid.org/0000-0001-9821-0257
erated from this study could direct managers to consider how
and to what degree they can design organizational structures References
and procedures related to political authority, horizontal
Agranoff, R. (2007). Managing within networks: Adding value to
engagement, and public engagement to enhance organiza- public organizations. Washington, DC: Georgetown University
tional capabilities and capacities. If subsequent research con- Press.
firms the relevance of the conceptual framework introduced Agranoff, R., & McGuire, M. (2001). Big questions in public net-
in this article, managers should consider prioritizing (albeit work management research. Journal of Public Administration
not necessarily maximizing) context-specific mechanisms Research and Theory, 11, 295-326.
associated with political authority, horizontal engagement, Allison, G. T. (1980). Public and private management: Are they
and public engagement in any effort to improve their organi- fundamentally alike in all unimportant respects? In J. M.
zation’s ability to create public value. Shafritz & A. C. Hyde (Eds.), Classics of public administra-
tion (pp. 510-529). Pacific Grove, CA: Brooks/Cole.
Antonsen, M., & Jørgensen, T. B. (1997). The “publicness” of pub-
Acknowledgments
lic organizations. Public Administration, 75, 337-357.
I would also like to thank Barry Bozeman, Katie Cordell, Adam Beitin, B. K. (2012). Interview and sampling. In J. F. Gubrium, J.
Eckerd, Morgan Farnworth, H. George Frederickson, Heather A. Holstein, A. B. Marvasti, & K. D. McKinney (Eds.), The
Getha-Taylor, Leisha Dehart-Davis, Kelly LeRoux, Stephanie SAGE handbook of interview research: The complexity of the
Moulton, Tina Nabatchi, Rosemary O’Leary, Shannon Portillo, and craft (pp. 243-254). Thousand Oaks, CA: Sage.
Jennie Welch for offering helpful comments on earlier drafts of this Bingham, L. B., Nabatchi, T., & O’Leary, R. (2005). The new gov-
study. Any opinions, findings, conclusions, or recommendations ernance: Practices and processes for stakeholder and citizen
expressed in this article are those of the author. participation in the work of government. Public Administration
Review, 65, 547-558.
Declaration of Conflicting Interests Bingham, L. B., & O’Leary, R. (2006). Conclusion: Parallel play,
not collaboration: Missing questions, missing connections.
The author(s) declared no potential conflicts of interest with respect
Public Administration Review, 66, 161-167.
to the research, authorship, and/or publication of this article.
Bovaird, T. (2007). Beyond engagement and participation: User
and community coproduction of public services. Public
Funding Administration Review, 67, 846-860.
The author(s) disclosed receipt of the following financial support Boyne, G. A. (2002). Public and private management: What’s the
for the research, authorship, and/or publication of this article: This difference? Journal of Management Studies, 39, 97-122.
work was supported by the American Political Science Association’s Boyne, G. A., & Walker, R. M. (2010). Strategic management
Paul Volcker Junior Scholar Research Grant Award, the Enhanced and public service performance: The way ahead. Public
Mentoring Program with Opportunities for Ways to Excel in Administration Review, 70, s185-s192.
Merritt 423

Bozeman, B. (1987). All organizations are public: Bridging pub- Friedmann, P. D., Alexander, J. A., & D’Aunno, T. A. (1999).
lic and private organizational theories. San Francisco, CA: Organizational correlates of access to primary care and men-
Jossey-Bass. tal health services in drug abuse treatment units. Journal of
Bozeman, B. (2007). Public values and public interest: Substance Abuse Treatment, 16, 71-80.
Counterbalancing economic individualism. Washington, DC: Fung, A. (2006). Varieties of participation in complex governance.
Georgetown University Press. Public Administration Review, 66, 66-75.
Bozeman, B. (2013). What organization theorists and public policy Fyall, R. (2016). The power of nonprofits: Mechanisms for non-
researchers can learn from one another: Publicness theory as a profit policy influence. Public Administration Review, 76, 938-
case-in-point. Organization Studies, 34, 169-188. 948.
Bozeman, B., & Bretschneider, S. (1994). The “publicness puzzle” Glaser, B., & Strauss, A. (1967). The discovery of grounded theory.
in organization theory: A test of alternative explanations of dif- Chicago, IL: Aldine.
ferences between public and private organizations. Journal of Guo, C., & Saxton, G. D. (2010). Voice-in, voice-out: Constituent
Public Administration Research and Theory, 4, 197-224. participation and nonprofit advocacy. Nonprofit Policy Forum,
Bozeman, B., & Moulton, S. (2011). Integrative publicness: A frame- 1, 1-25.
work for public management strategy and performance. Journal Guo, H., & Neshkova, M. I. (2013). Citizen input in the budget
of Public Administration Research and Theory, 21, i363-i380. process: When does it matter most?. The American Review of
Bradstreet, S. (2006). Harnessing the “lived experience”: Public Administration, 43(3), 331-346.
Formalising peer support approaches to promote recovery. Hedegaard, H., Chen, L.-H., & Warner, M. (2015). Drug-poisoning
Mental Health Review Journal, 11, 33-37. deaths involving heroin: United States, 2000–2013 (NCHS
Brudney, J. L., & England, R. E. (1983). Toward a definition of Data Brief No. 190). Hyattsville, MD: National Center for
the coproduction concept. Public Administration Review, 43, Health Statistics.
59-65. Heinrich, C. J., & Fournier, E. (2004). Dimensions of publicness
Bryson, J. M. (2018). Strategic planning for public and nonprofit and performance in substance abuse treatment organizations.
organizations: A guide to strengthening and sustaining organi- Journal of Policy Analysis and Management, 23, 49-70.
zational achievement. John Wiley & Sons. Hill, C. J., & Lynn, L. E. (2005). Is hierarchical governance in
Bryson, J. M., Crosby, B. C., & Bloomberg, L. (2014). Public value decline? Evidence from empirical research. Journal of Public
governance: Moving beyond traditional public administra- Administration Research and Theory, 15, 173-195.
tion and the new public management. Public Administration Hood, C., James, O., & Scott, C. (2000). Regulation of govern-
Review, 74, 445-456. ment: Has it increased, is it increasing, should it be diminished?
Bryson, J. M., Crosby, B. C., & Stone, M. M. (2006). The design and Public Administration, 78, 283-304.
implementation of cross-sector collaborations: Propositions Kettl, D. F. (2006). Managing boundaries in American adminis-
from the literature. Public Administration Review, 66, 44-55. tration: The collaboration imperative. Public Administration
Byrne, L., Happell, B., Welch, T., & Moxham, L. J. (2013). Things Review, 66, 10-19.
you can’t learn from books: Teaching recovery from a lived Kettl, D. F. (2008). The next government of the United States: Why
experience perspective. International Journal of Mental Health our institutions fail us and how to fix them. New York, NY:
Nursing, 22, 195-204. W.W. Norton.
Caldwell, N. D., Roehrich, J. K., & George, G. (2017). Social value Leighninger, M. (2014). What we’re talking about when we talk
creation and relational coordination in public-private collabo- about the “civic field” (and why we should clarify what we
rations. Journal of Management Studies, 54, 906-928. mean). Journal of Public Deliberation, 10(1), Article 8.
Clarkson, K. W. (1972). Some implications of property rights in Lynn, L. E., Heinrich, C. J., & Hill, C. J. (2000). Studying governance
hospital management. The Journal of Law and Economics, 15, and public management: Challenges and prospects. Journal of
363-384. Public Administration Research and Theory, 10, 233-262.
Cooper, T. L., Bryer, T. A., & Meek, J. W. (2006). Citizen-centered Maynard-Moody, S. W., & Musheno, M. C. (2003). Cops, teachers,
collaborative public management. Public Administration counselors: Stories from the front lines of public service. Ann
Review, 66, 76-88. Arbor: The University of Michigan Press.
Creswell, J. W. (1998). Qualitative inquiry and research design: Meijer, A., & Schillemans, T. (2009). Fictional citizens and real
Choosing among five tradition. Thousand Oaks, CA: Sage. effects: Accountability to citizens in competitive and monopolis-
Dahl, R. A., & Lindblom, C. E. (1953). Politics, economics, and tic markets. Public Administration and Management, 14, 254-291.
welfare. Chicago, IL: The University of Chicago Press. Merritt, C. C., Cordell, K., & Farnworth, M. D. (2018). Less is
Denhardt, R. B., & Denhardt, J. V. (2002). The new public service: more? Publicness, management strategy, and organizational
Serving rather than steering. Public Administration Review, 60, performance in mental health treatment facilities. Public
549-559. Administration Quarterly, 42, 3-31.
De Vries, H., Bekkers, V., & Tummers, L. (2015). Innovation in the Merritt, C. C., & Farnworth, M. D. (2018). Antecedents to man-
public sector: A systematic review and future research agenda. aging publicness: A study of professional and cultural social-
Public Administration, 94, 146-166. ization. In E. C. Stazyk & H. G. Frederickson (Eds.), The
Emerson, K. T., Nabatchi, T., & Balogh, S. (2012). An integrative handbook of American public administration (pp. 244-258).
framework for collaborative governance. Journal of Public London, England: Edward Elgar.
Administration Research and Theory, 22, 1-29. Miller, S. M., & Moulton, S. (2014). Publicness in policy envi-
Feeney, M. K., & Welch, E. W. (2012). Realized publicness at ronments: A multilevel analysis of substance abuse treatment
public and private research universities. Public Administration services. Journal of Public Administration Research and
Review, 72, 272-284. Theory, 24, 553-589.
424 American Review of Public Administration 49(4)

Milward, H. B., & Provan, K. G. (2000). Governing the hollow Sowa, J. E. (2015). Considering the public in public management
state. Journal of Public Administration Research and Theory, research. Journal of Public Administration Research and
10, 359-380. Theory, 26, 584-588. doi:10.1093/jopart/muv011
Moulton, S. (2009). Putting together the publicness puzzle: A Stark, A. (2010). The distinction between public, nonprofit, and for-
framework for realized publicness. Public Administration profit: Revisiting the “core legal” approach. Journal of Public
Review, 69, 889-900. Administration Research and Theory, 21(1), 3-26.
Moulton, S. (2010). Integrating the public in public administration: Stinchcombe, A. L. (1997). On the virtues of the old institutional-
Envisioning the scholarly field in 2020. Public Administration ism. Annual Review of Sociology, 23, 1-18.
Review, 70(S1), S317. Stivers, C. (1994). The listening bureaucrat: Responsiveness in pub-
Moulton, S. (2012). The authority to do good: Publicly respon- lic administration. Public Administration Review, 54, 364-369.
sible behavior among private mortgage lenders. Public Strauss, A. L. (1987). Qualitative analysis for social scientists. New
Administration Review, 72(3), 430-439. York, NY: Cambridge University Press.
Moulton, S., & Feeney, M. K. (2010). Public service in the private Strolovitch, D. Z. (2006). Do interest groups represent the disad-
sector: Private loan originator participation in a public mort- vantaged? Advocacy at the intersections of race, class, and
gage program. Journal of Public Administration Research and gender. Journal of Politics, 68, 894-910.
Theory, 21(3), 547-572. Suddaby, R. (2006). From the editors: What grounded theory is not.
Nabatchi, T. (2012). Putting the “public” back in public values Academy of Management Journal, 49, 633-642.
research: Designing participation to identify and respond to Teodoro, M. P., & Hughes, A. G. (2012). Socializer or signal? How
values. Public Administration Review, 72, 699-708. agency accreditation affects organizational culture. Public
Nabatchi, T., & Amsler, L. B. (2014). Direct public engage- Administration Review, 72, 583-591.
ment in local government. The American Review of Public Thomas, S. P., & Pollio, H. R. (2002). Listening to patients: A
Administration, 44, 63S-88S. phenomenological approach tonursing research and practice.
Nelissen, N., Bemelmans-Videc, M.-L., Godfroij, A., & deGoede, New York: Springer Publishing Company.
P. (1999). Renewing government. Utrecht, The Netherlands: Thomas, J. C. (2013). Citizen, customer, partner: Rethinking the
International Books. place of the public in public management. Public Administration
North, D. C. (1990). Institutions, institutional change and economic Review, 73, 786-796.
performance. Cambridge, UK: Cambridge University Press. Van der Wal, Z., De Graaf, G., & Lasthuizen, K. (2008). What’s
Nutt, P. C., & Backoff, R. W. (1993). Organizational publicness valued most? Similarities and differences between the organi-
and its implications for strategic management. Journal of zational values of the public and private sector. Public admin-
Public Administration Research and Theory, 3, 209-231. istration, 86(2), 465-482.
O’Toole, L. J., Jr. (1997). Treating networks seriously: Practical Walker, R. M., & Bozeman, B. (2011). Publicness and organiza-
and research-based agendas in public administration. Public tional performance. Journal of Public Administration Research
Administration Review, 57, 45-45. and Theory, 21, i279-i281.
Perry, J. L., & Rainey, H. G. (1988). The public-private distinc- Wamsley, G. L., & Zald, M. N. (1973). The political economy of
tion in organization theory: A critique and research strategy. public organizations: A critique and approach to the study of
Academy of Management Review, 13, 182-201. public administration. Public Administration Review, 33, 62-73.
Rainey, H. G. (2014). Understanding and managing public organi- Weeks, E. C. (2000). The practice of deliberative democracy:
zations. San Francisco, CA: John Wiley. Results from four large-scale trials. Public Administration
Rainey, H. G., Backoff, R. W., & Levine, C. H. (1976). Comparing Review, 60, 360-372.
public and private organizations. Public Administration Review, Wheeler, G. F., & Brady, F. N. (1998). Do public-sector and pri-
36, 233-244. vate-sector personnel have different ethical dispositions? A
Riccucci, N. M. (2010). Public administration: Traditions of inquiry study of two sites. Journal of Public Administration Research
and philosophies of knowledge. Washington, DC: Georgetown and Theory, 8(1), 93-115.
University Press. Wheeler, J. R. C., & Nahra, T. A. (2000). Private and public own-
Romzek, B. S., LeRoux, K., & Blackmar, J. M. (2012). A prelimi- ership in outpatient substance abuse treatment: Do we have a
nary theory of informal accountability among network organi- two-tiered system? Administration and Policy in Mental Health
zational actors. Public Administration Review, 72(3), 442-453. and Mental Health Services Research, 27, 197-209.
Romzek, B., LeRoux, K., Johnston, J., Kempf, R. J., & Piatak, J. S. Wildavsky, A. (1987). Choosing preferences by constructing insti-
(2013). Informal accountability in multisector service delivery tutions: A cultural theory of preference formation. American
collaborations. Journal of Public Administration Research and Political Science Review, 81, 3-21.
Theory, 24(4), 813-842. Wittmer, D., & Coursey, D. (1996). Ethical work climates: Comparing
Salamon, L. M. (1987). Of market failure, voluntary failure, and top managers in public and private organizations. Journal of
third-party government: Toward a theory of government- Public Administration Research and Theory, 6, 559-572.
nonprofit relations in the modern welfare state. Nonprofit and
Voluntary Sector Quarterly, 16, 29-49.
Sandfort, J. R. (2000). Moving beyond discretion and outcomes: Author Biography
Examining public management from the front lines of the wel- Cullen C. Merritt, PhD, is an assistant professor in the School of
fare system. Journal of Public Administration Research and Public and Environmental Affairs at Indiana University-Purdue
Theory, 10(4), 729-756. University Indianapolis. His research focuses on the structure,
Scott, W. R. (2008). Institutions and organizations: Ideas and design, and management of social services organizations with an
interests. Thousand Oaks, CA: Sage. emphasis on publicness

You might also like