On May 11, 2001, the Bureau of Primary Health Care notified West Alabama Health Services, doing business as Family HealthCare of Alabama, that it was terminating $6 million in grants due to non-compliance and amid allegations of financial mismanagement and fraud. West Alabama Health Services, a not-for-profit organization, operated 19 community health centers that provided preventive and primary care services for 17 counties in Alabama. This disruption of health services engendered considerable stakeholder debate. Within this context, the authors examine how a small, newly established rural health center and a well-established, federally qualified community health center responded to this crisis. The authors use a stakeholder analysis framework to highlight how key relationships with stakeholders may change with the perceived credibility of the organizational leaders and the legitimacy of their actions.
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References
1.
AgleB.R., MitchellR.K., and SonnenfeldJ.A. (1999). “Who Matters to CEOs? An Investigation of Stakeholder Attributes and Salience, Corporate Performance, and CEO Values.” Academy of Management Journal42(5):507–525.
2.
BlairJ.D. and FottlerM.D. (1990). Changes in Health Care Management: Strategic Perspectives for Managing Key Stakeholders. San Francisco: Jossey-Bass.
3.
Bureau of Primary Health Care (2000). Governing Board Handbook. Bethesda, MD: Department of Health and Human Services, Health Resources and Services Administration.
4.
CarrollA.B. (1991). “The Pyramid of Corporate Social Responsibility: Toward the Moral Management of Organizational Stakeholders.” Business Horizons34(4):39–48.
5.
CarrollA.B. (1995). “Stakeholder Thinking in Three Models of Management Morality: A Perspective with Strategic Implications,” in NasoJ. (ed.). Understanding Stakeholder Thinking. Helsinki: LSR-Publication.
6.
ClarksonM.B.E. (1995). “A Stakeholder Framework for Analyzing and Evaluating Corporate Social Performance.” Academy of Management Review20(2):92–111.
7.
CountsK.I. (2001). “Oakman Clinic Not First in Company to Close Its Doors.” Daily Mountain Eagle. May 24.
8.
Daily Mountain Eagle (2001). “Five Companies to Take Family Healthcare's Place: Good News for Oakman, Sipsey Residents.” July 23.
9.
DeWittR. (2001a). “Greene County Residents Fear Loss of Facilities for Health Care.” Tuscaloosa News February 14.
10.
DeWittR. (2001b). “Embattled Health Agency CEO Says He Inherited Messy Situation.” Tuscaloosa News April 4.
11.
DeWittR. (2001c). “Feds Call for Health Board to Step Down.” Tuscaloosa News April 21.
12.
DeWittR. (2001d). “Split Board of Family Healthcare Tries to Oust CEO.” Tuscaloosa News April 24.
13.
DeWittR. (2001e). “Fraud Alleged at Eutaw Health Canter.” Tuscaloosa News April 25.
14.
DeWittR. (2001f). “Feds Recognize Ousted Members of Health-Care Board at Meeting.” Tuscaloosa News May 11.
15.
DeWittR. (2002g). “Health Firm Still Divided as Probe Continues.” Tuscaloosa News May 15.
16.
DeWittR. (2001h). “Eutaw Clinic Loses $6 Million in Grants.” Tuscaloosa News May 19.
DeWittR. (2001j). “Hospital Caught in Web of Family Healthcare Crisis.” Tuscaloosa News May 29.
19.
DeWittR. (2001k). “Governor Asked to Intervene in ‘Crisis’.” Tuscaloosa News (June 12.
20.
DeWittR. (2001k). “Company May Close Rural Clinics.” Tuscaloosa News June 16.
21.
DeWittR. (2001m). “Agency Gets Funds to Keep Clinics Open, For Now.” Tuscaloosa News June 21.
22.
DeWittR. (2001n). “Bibb, Sumter to Get Health Clinics.” Tuscaloosa News July 23.
23.
DeWittR. (2001o). “Whatley Will Help Clinic, m but from Afar.” Tuscaloosa News June 24.
24.
DeWittR. (2001p). “Examiner Appointed to Oversee Eutaw Clinic.” Tuscaloosa News June 29.
25.
DeWittR. (2001q). “Hospital Steps in for Embattled Clinic.” Tuscaloosa News Juky 4.
26.
DeWittR. (2001r). “Report Details Health Care Agency's Demise.” Tuscaloosa News August 13, (2001s). “Sessions, Federal Officials Tour West Alabama Health Center.” Tuscaloosa News August 17.
27.
DeWittR. (2001t). “Health Agency's Records Searched.” Tuscaloosa News September 3.
DeWittR. (2001v). “Report: Clinic Has Toys, Drugs Missing.” Tuscaloosa News December 8.
30.
DeWittR. (2002a). “Health Agency Makes a New Start.” Tuscaloosa News February 11.
31.
DeWittR. (2002b). “Collapse of One Health Agency Has Forced Another to Expand Its Role.” Tuscaloosa News August 12.
32.
DonaldsonT. (1999). “Making Stakeholder Theory Whole.” Academy of Management Review24(2):237–241.
33.
DonaldsonT. and PrestonL.E. (1995). “The Stakeholder Theory of the Corporation: Concepts, Evidence, and Implications.” Academy of Management Review20(1):65–91.
34.
FottlerM.D.. (1989). “Assessing Key Stakeholders: Who Matters in Hospitals and Why?” Hospitals & Health Services Administration34(4):525–546.
35.
FreemanR.E. (1984). Strategic Management: A Stakeholder Approach. Marshfield, MA: Pitman.
36.
FreemanR.E. (1999). “Divergent Stakeholder Theory.” Academy of Management Review24(2):233–236.
37.
FreemanR.E. and EvanW.M. (1990). “Corporate Governance: A Stakeholder Interpretation.” Journal of Behavioral Economics19(4): 337–359.
38.
FroomanJ. (1999). “Stakeholder Influence Strategies.” Academy of Management Review24(2):191–205.
39.
GioiaD.A. (1999). “Practicability, Paradigm, and Problems in Stakeholder Theorizing.” Academy of Management Review24(2):228–232.
40.
JonesR.M. and WicksA.C. (1999). “Convergent Stakeholder Theory.” Academy of Management Review24(2):206–221.
41.
MasonR.Q. and MitroffI.L. (1981). Challenging Strategic Planning Assumptions. New York: Wiley and Sons.
42.
MintzbergH. (1983). Power In and Around the Organization. Englewood Cliffs, NJ: Prentice-Hall.
43.
MitchellR.K., AgleB.R., and WoodD.J. (1997). “Toward a Theory of Stakeholder Identification and Salience: Defining the Principle of Who and What Really Counts.” Academy of Management Review22(4):853–886.
44.
MundingerM.. (2000). “Primary Care Outcomes in Patients Treated by Nurse Practitioners or Physicians: A Randomized Trial.” Journal of the American Medical Association283(1):59–68.
NasiJ. (ed.) (1995b). “What Is Stakeholder Thinking?” in NasiJ. (ed.). Understanding Stakeholder Thinking. Helsinki: LSR-Publications.
47.
NavarroM. and GoodwinnerP. (2002). “Program-Related Investments,” in IssaacsS.L. and KnickmanJ.R. (eds.). To Improve Health and Health Care. San Francisco: Jossey-Bass.
48.
Office of the Secretary of the State (2002a). “Corporations: Transactions: West Alabama Health Services, Inc.” State of Alabama. Author.
49.
Office of the Secretary of the State (2002b). “Corporations: Transactions: Whatley Health Services. Inc.” State of Alabama. Author.
50.
PfefferJ. and SalancikG.R. (1978). The External Control of Organizations. New York: Harper and Row.
51.
PrestonL.E. (1989). “Stakeholder Management and Corporate Performamce.” Journal of Behavioral Economics19(4):361–375.
52.
PruittD.G. (1995). “Networks and Collective Scripts: Paying Attention to Structure in Bargaining Theory,” in KramerR. and MessickD. (eds.). Negotiation as a Social Process. Thousand Oaks, CA: Sage.
53.
RhenmanE. and StymmeB. (1965). Foresagsledningien Foramder;ig Varld. Stockholm: Aldus/Bonniers.
SavageG.T.. (1992). “Urban-Rural Hospital Affiliations: Assessing Control, Fit and Stakeholder Issues Strategically.” Health Care Management Review17(1):35–49.
56.
SavageG.T.. (2000). “Beyond Managed Costs.” Health Care Management Review25(1):93–108.
57.
SavageG.T.. (1991). “Strategies for Assessing and Managing Stakeholders.” Academy of Management Executive5(2):61–75.
58.
SavageG.T. and RoboskiA.M. (2001). “Integration as Systems amd Metworks: A Strategic Stakeholder Analysis,” in FottlerM.D., SavageG.T., and BlairJ.D. (eds.). Advances in Health Care Management. New York: JAI Press.
59.
SchoemakerP.J.H. (1995). “Scenario Planning: A Tool for Strategic Thinking.” Sloan Management Review36(2):25–46.
60.
StraussA. (1963). “The Hospital and Its Negotiated Order,” in FreidsonE. (ed.). The Hospital In Modern Society. New York: Free Press.
61.
StraussA. (1963). Negotiations. San Francisco: Jossey-Bass.
62.
TrevinoL.K. and WeaverG.R. (1999). “The Stakeholder Research Tradition: Converging Theorists-Not Convergent Theory.” Academy of Management Review24(2):222–227.
63.
WilliamsonO.E. (1975). Markets and Hierarchies. New York: Free Press.
