Framework of study　

As I stated in the research problem section, this thesis will identify characteristics of the co-ordination of community care services for elderly people through analysis of the services provision in two local government areas of NSW with different demographic compositions. Before addressing these issues, there is a need to expand upon the general theoretical approach to be taken in this thesis.

A literature review indicates that the characteristics of well co-ordinated service in terms of the co-ordination of community care services for elderly people is hypothesized to be a single point of co-ordination, equality of access, continuity of staffing and volunteers, adequate resources and funding and open-line communication between service providers. In order to examine these hypothesis, I would like to discuss 'Decentralization' and 'Inter-Organizational Co-ordination (IOC)' as the conceptual framework of this study.　

Theory of ’Decentralization’

ﾔDecentralizationﾕ is one of the key terms for co-ordinating community services not only in Australia but also in most developed countries. Although federalism is usually regarded as more decentralized system than devolution to rural, urban, metropolitan, or regional governments, as I discussed before, the level of decentralization in Australia is considerably low in legal and financial context. Smith (1985) argues that the development of democracy in local governments by decentralization would have positive benefits for both national and local levels of democracy. In relation to local democracy, he discusses three positive values, which include political equality, accountability and liberty, responsiveness to people. Firstly, political equality will be enhanced by local democracy in civil rights and the provision of extra opportunities for citizens to participate in public policy-making. Secondly, local democracy from the political activity in the local government will reduce the gap between the citizen and the administration and supply opportunities for complaints to the policy-makers. However, local self-government will not preserve the liberty of the individual but the liberty of the local communities against centralizing power. Thirdly, local democracy by decentralization provides the community a unique opportunity for the measurement of 'consumer satisfaction'. In this sense, the local government is better able than central government to respond to changes in demand, to experiment and to anticipate future changes in the community. In relation to community care services for elderly people in Australia I would expect that a single point of co-ordination in the local government area might have a better co-ordination than a wider state/regional government area because local government area will be closest to the local community members and easier for them to access. At the same time, local government should take more active role in the co-ordination of community care services for elderly people in Australia.

Waldfogel (1997) argues that assessment and planning should be done by a locality. The locality is likely to be better positioned to identify its residentsﾕ needs. According to her research in USA, she suggests that "bootstrapping" reform, which provides flexibility and autonomy to local actors to influence the direction of the reforms through continuous monitoring and feedback, is beneficial not just because it is suitable as the nature of reform but also because it allows for learning by doing and learning by monitoring. While local actors will have to be given a greater degree of autonomy, state leadership is essential to facilitate service integration and must continue to play a major role in initial planning, providing incentive funding and technical assistance, and drafting and sponsoring legislation. State governments will be the most effective in these roles if they view themselves as acting in partnership with and learning from the localities in a process of bootstrapping reform (Waldfogel :1997).

Contrary to a positive image of decentralization as ﾒempowering the local communityﾓ, in the Australian context decentralization might mean a shifting of the burden from one level of government to another if local governments can not obtain adequate funds (Local Government and Shire Association:1996). Despite federal/state government negative attitudes to decentralization, a survey of local government in NSW involvement in the HACC in 1993 shows that local government plays a critical role as a planner, provider and a co-funder of a range of aged services. Local governments sponsor 196 Home and Community Care funded services including 59 co-ordination/information/education services (Local Government and Shire Association:1996). This survey also shows that forty seven per cent of those councils in HACC believe that local governments should have a greater role in the HACC program, and in fact 93 per cent of councils involved in HACC believe that local governments should have a voice in HACC planning and decision making (Local Government and Shire Association 1995).

Although the Commonwealth House of Representatives Review and Report in 1994 does not adequately highlight local governmentﾕs long, legitimate and financial involvements in community planning and service provision across many human services especially the HACC program, it recommends that local governments should be recognized as a partner in the planning and delivery of HACC services and participants in Commonwealth/State committees responsible for considering priorities and developing funding proposals (Local Government and Shire Association 1995).

Theory of 'Inter-Organizational Co-ordination (IOC)'

Inter-Organizational Co-ordination (IOC) is significant theory because it is widespread in terms of community care services for elderly people. Comprehensive practices of service provision require the involvement of many organizations acting together. It would be evident when clients need complex service. Because community care services for elderly people involve complex delivery systems which are far beyond the ability of any single organization, IOC becomes essential to implement these complicated service provisions in the local areas (Alexander:1995). It is interesting to note that as the environment becomes more complex, organizations become more specialized; and this increased specialization leads to a greater need for increased IOC (Mulford and Rogers:1982)

Mulford and Rogers (1982) in their research defined IOC as the process whereby two or more organizations create and/or use existing decision rules that have been established to deal collectively with their shared task environment. This definition attempted to 1) emphasize that decision rules can be established by a third party or created by the participants, 2) underlines the importance of shared task environment, 3) focuses on the rules of the collectivity and its attainment of a unique level of goals, 4) stresses joint decisions and action (Mulford and Rogers: 1982). Each organization must be related to a number of different groups, each of which is itself involved in networks of interdependencies. However, Alexander (1996) pointed out the problem with this definition by arguing that IOC can be a process and a structure.

While there are confusions of the concept of co-ordination in the research field, Mulford and Rogers (1982) try to reduce the confusions by a comparison of cooperation and co-ordination processes. Especially, they argue by citing Schermerhonﾕs (1975) literature that finds that organizations A and B relate in order to accomplish their respective individual goals with cooperation. With coordination, the joint decisions and/or actions result in joint outcomes that may be quite different from their initial preferred outcomes.

Mulford and Rogers (1982) discussed with quoting Warren et al. (1974)ﾕs definition of co-ordination as ﾔa structure or process of concerted decision making or action where in the decisions or action of two or more organizations are made simultaneously in part or in whole with some deliberate degree of adjustment ot each other. ﾕ The major focus when co-ordination is viewed as structure is on specifying relationships between the participants: when coordination is viewed as a process, the major concern is with joint decision making (Mulford and Rogers:1982). In this research I would like to discuss IOC as both a structure and a process.　

The lowest level of investment is required in ad hoc (mutual adjustment) types of co-ordination, which usually contain information exchange, referrals, and limited services. These exchanges are generally informal and may be left to practitioners. The next higher level of resource commitment is systematic case coordination, which involves interagency agreements and activities governed by specific rules and procedures. A third level of commitment is called program coordination. This design contains joint programs, mutual assistance, and program modification to improve alignment of system operations (Rogers and Mulford:1982)

Alexander (1995) introduces three organization theories to explain the process of IOC. Exchange theory accounts for organizational behavior by resource dependence and exchange, focuses on mutual adjustment and voluntary co-ordination. Contingency theory and organizational ecology see IOC as a way in which organizations adapt to their environments. Transaction cost theory directly addresses the issue of how organizations evolve and change their forms. In these terms, IOC is defined as the structure of relationships adopted by organizations to minimize their transaction costs. Informal linkages are universal and spontaneous contacts between individuals by creating informal channels of interaction. These channels can form between different units in one organization, and between different organizations, such as telephone calls, ad-hoc meetings, faxed notes, exchanges of letters and shared distribution or mailing lists (Alexander:1995). In complex service delivery systems this inter-organizational network was also coordinated through a system of informal links; interlocking memberships of a relatively small group of individuals on the governing boards and commissions, and advisory committees of the various organizations planning, funding and organizing services for the frail and dependent elderly (Alexander:1995).

Informal links are more common as supplements to formal coordination structures, as substitutes for formal communication channels that have failed, or as ad-hoc precursors to the development of hierarchical forms of coordination. Formal co-ordination structures often facilitate informal links, providing arenas for informal interaction between individuals in their organizational roles. Solidarity or associational bonds, common goals, shared cultural, educational or professional backgrounds make informal links more likely and effective (Alexander :1995).　

It is also clear that IOC is more easily accomplished among organizations which are likely to recognize their mutual interests in concerted action. IOC is difficult to bring about among organizations whose interdependence is quite small, or whose relations and characteristics obscure the interdependence that may in fact exist between them. If interdependence is fairly weak or absent, IOC may offer few or no benefits, and IOC structures may involve costs which offer few prospects of offsetting gains (Alexander :1995)　

Rogers and Mulford (1982) discussed three benefits of consequences with IOC. Firstly, inter-organizational linkages will increase accessibility so that more clients received the service provision. Secondly, continuity of services delivered has been shown to increase with IOC. The development of administrative linkages increased the rational organization of the system by identifying needs, filling gaps, increasing relevancy of programs, and standardizing eligibility requirements. These changes increased the continuity of programs for clients requiring services of different agencies. Thirdly, efficiency was achieved as services were consolidated and more staff were freed to provide direct service. Efficiency was increased as program duplication was reduced and staff expertise increased.

Rogers and Mulford (1982) argued by citing Mott's (1968) statement that centralizing authority or developing a vertical interagency system makes it more difficult for individual agencies to secure public support while in centralized systems member units have little or no autonomy because the coordinator or director makes decisions for the entire system. Reduced public support for an agency may result from participation in interagency programs over which the agency has little or no control. When an agency loses control over its own programs, clients and sponsors usually begin questioning the agency's mission and programs.　

In order to identify the co-ordination pattern of community care services in the two local government areas, I would like to analyze the finding of the service provision system through the research in the two different organizations in relation with these two conceptual framework. Firstly, I will examine the level of local democracy in the service provision system in both organizations in terms of ﾔdecentralizationﾕ. Secondly, I will analyse the level and quality of ﾔInter-Organizational Co-ordinationﾕ in the process and structure of the service provision in both organizations. Also, by using the analysis which links to the two theoretical backgrounds, I will discuss how much and in what way the characteristics of well co-ordinated services in terms of co-ordination of community care services for elderly people are achieved in both organizations.