Dimensional Publicness and Serving the Vulnerable: Analysis of Substance Abuse Treatment Organizations

Abstract

The proliferation of market-based public service delivery raises concerns whether the vulnerable are dully served and what mechanisms may facilitate to serve them well. Using the dimensional publicness theory, the present study examines how ownership, public funding, control and policy environments shape organizations to provide special substance abuse treatment programs for vulnerable groups. The multi-level analyses indicate that public funding and control are two major policy mechanisms toward the realization of public outcomes. Policy environments exercise significant impact on organizations, contingent upon state-wide policies and organizational ownerships. For instance, in states with wider Medicaid coverage, organizations tend to offer less special programs for co-occurring patients; however, private organizations in these states prove more committed to serve multiple vulnerable groups. Further analyses show that policy mechanisms take on different parameters in serving different vulnerable groups, calling for contingent understanding of the dimensional publicness theory and its possible applications. The study concludes with the discussion of theoretical development and its policy implications on serving the vulnerable with substance abuse treatment demands.