Journal articles on the topic 'Balancing incentives program'

Abstract Medicaid has been at the forefront of policy efforts to “rebalance” long-term services and supports (LTSS) from institutional toward home- and community-based services (HCBS). The Balancing Incentives Program (BIP), authorized under the Affordable Care Act, sought to increase spending on HCBS relative to total LTSS among states that were spending less than 50% of total Medicaid LTSS dollars on HCBS each year. BIP’s benchmark for states to spend more than 50% of LTSS on HCBS was meant to improve states’ infrastructure to ensure an equitable, consumer-friendly process to access HCBS. For the first time, we quantified how states performed on HCBS expenditures. We analyzed state-level HCBS expenditure data for states eligible for BIP (n=35) from 2008 to 2015, which includes several years both before and after BIP implementation. We examined the effect of BIP on HCBS expenditures as a percent of total LTSS spending using fixed-effects modeling which controls for stable characteristics of states and years. We find that BIP states increased HCBS spending relative to non-BIP states, and this effect continued to grow over our study period. In the first year after BIP implementation, BIP states increased spending by 1.8% relative to non-BIP states. The difference in spending between BIP and non-BIP states is even larger in subsequent years (4.8% in year 2, 5.3% in year 3, and 5.8% in year 4). Results indicate that BIP prompted increased state-level spending that continued to rise several years after initial implementation of BIP.

The paper analyses the possibilities of Demand Side Response (DSR) applications from the point of view of an electricity power cluster. Three possible scenarios for DSR mechanisms that facilitate balancing the cluster in short horizon were formulated. Two scenarios include shifting a part of demand that creates unplanned balancing energy in the cluster. In the first scenario, the unplanned balancing energy is moved to hours with lowerprices on the Balancing Market (BM), while in second scenarios we assume that this energy is bought on the competitive market. The third scenario concerns mitigation of investment cost for local distributed resources (DERs) due to DSR program. We present an analysis of monetary savings that has been carried out for exemplary clusters in Polish electrical energy system and based on Polish Balancing Market and Power Exchange data. Although the potential savings per household are too small to create strong incentives for DSR, this amount of money could be notable for the local community as a whole. There is also a big opportunity for increasing the benefits resulting from DSR in case of perceived stronger differentiation of unbalanced prices on BM as well as strong trend for price increase. We believe that presented results may play an important role to draw the potential development directions for national power clusters.

The balancing of supplied energy to energy demand is often very challenging due to unstable power supply and demand load. This challenge causes the level of performance of distribution networks to be lower than expected. Research has however, shown the role of demand response (DR) on the performance of power networks. This work investigates the influence of DR, in the presence of incorporated renewable energy, on technical loss reduction, reliability, environment, energy saved and incentives paid to consumers with the help of PSAT and AIMMS software. Results from simulation have shown that the introduction of renewable energy into a Ghanaian distribution network coupled with implementing the proposed DR improves total energy supply by 9.8% at a corresponding operation cost reduction of 72.79%. The GHG and technical loss reduced by 27.26% and 10.09% respectively. The total energy saving is about 105kWh and 5,394.86kWh, for domestic and commercial loading profiles, respectively. Incentives received by consumers range between 45.14% and 58.55% more than that enjoyed, without renewable energy, by domestic and commercial consumers. The utility benefit also increased by 76.96% and 67.31% for domestic and commercial loads than that without renewable energy. Network reliability improves with implementation of DR. However, the reliability of a grid-connected network is better with a diesel generator only than with the integration of renewable energy. The power distribution companies, therefore, need to consider the implementation of incentive-based demand response program.

In “The Strategy of Sustainable Waste Management: Landfill Management, Recycling, Reduction, and Pollution Prevention,” the enduring problem of solid waste management is presented. As such, this case study deals with a real-life scenario when a recent graduate in the area of journalism and professional writing attempts to branch out and complement her professional interests. With a fresh MPA in hand, Suzanne Rodgers lands a paid internship with a mid-sized city and takes on the responsibility of researching, planning, and implementing a policy and set of recommendations, for the Public Works Department. She interviews the key political and economic actors in Winterville, provides a comprehensive description of the city, researches and analyses the incentives and barriers to change and then sets out to develop a plan for a comprehensive residential recycling effort that contains two options: solid waste management and balancing a landfill fund. This plan and implementation strategy is addressed in a research portfolio. In the final analysis she is faced with the real world issues of public interests and pressures and at a town hall meeting receives the responses from the citizens of Winterville. In this fast moving three-part case study, Suzanne Rodgers faces the real world of citizen input, conflict, and the role of special interests and pressure groups in making and implementing urban policy. The case concludes with measurements that were used in Iowa’s Pollution Prevention Intern Program and a summary of the tonnage of waste and pollution reduction and diversion associated with the program from 2001-2014. Cost savings associated with the intern program over the same period are identified and 2014 yearly savings is presented.

Demand response (DR) involves economic incentives aimed at balancing energy demand during critical demand periods. In doing so DR offers the potential to assist with grid balancing, integrate renewable energy generation and improve energy network security. Buildings account for roughly 40% of global energy consumption. Therefore, the potential for DR using building stock offers a largely untapped resource. Heating, ventilation and air conditioning (HVAC) systems provide one of the largest possible sources for DR in buildings. However, coordinating the real-time aggregated response of multiple HVAC units across large numbers of buildings and stakeholders poses a challenging problem. Leveraging upon the concepts of Industry 4.0, this paper presents a large-scale decentralized discrete optimization framework to address this problem. Specifically, the paper first focuses upon the real-time dispatch problem for individual HVAC units in the presence of a tertiary DR program. The dispatch problem is formulated as a non-linear constrained predictive control problem, and an efficient dynamic programming (DP) algorithm with fixed memory and computation time overheads is developed for its efficient solution in real-time on individual HVAC units. Subsequently, in order to coordinate dispatch among multiple HVAC units in parallel by a DR aggregator, a flexible and efficient allocation/reallocation DP algorithm is developed to extract the cost-optimal solution and generate dispatch instructions for individual units. Accurate baselining at individual unit and aggregated levels for post-settlement is considered as an integrated component of the presented algorithms. A number of calibrated simulation studies and practical experimental tests are described to verify and illustrate the performance of the proposed schemes. The results illustrate that the distributed optimization algorithm enables a scalable, flexible solution helping to deliver the provision of aggregated tertiary DR for HVAC systems for both aggregators and individual customers. The paper concludes with a discussion of future work.

Purpose The purpose of this qualitative, focus group study was to further refine the Resilience-based Diabetes Self-management Education (RB-DSME) recruitment process and intervention, build greater trust in the community, and identify strategies to enhance its sustainability as a community-based intervention in African American church settings. Methods Six 2-hour focus groups (N = 55; 10 men and 45 women) were led by a trained moderator with a written guide to facilitate discussion. Two sessions were conducted with individuals diagnosed with type 2 diabetes mellitus (T2DM) who participated in previous RB-DSME pilot interventions and their family members, two sessions with local church leaders, and two sessions with community healthcare providers who care for patients with T2DM. Two independent reviewers performed content analysis to identify major themes using a grounded theory approach. The validity of core themes was enhanced by external review and subsequent discussions with two qualitative methods consultants. Results There was expressed interest and acceptability of the RB-DSME program. Church connection and pastor support were noted as key factors in building trust and enhancing recruitment, retention, and sustainability of the program. Core themes across all groups included the value of incentives, the need for foundational knowledge shared with genuine concern, teaching with visuals, dealing with denial, balancing the reality of adverse consequences with hope, the importance of social support, and addressing healthcare delivery barriers. Conclusion Focus groups documented the feasibility and potential effectiveness of RB-DSME interventions to enhance diabetes care in the African American community. In clinical practice, inclusion of these core themes may enhance T2DM self-care and treatment outcomes.

Distributed energy resources (DERs) and demand side management (DSM) strategy implementation in smart grids (SGs) lead to environmental and economic benefits. In this paper, a new DSM strategy is proposed for the day-ahead scheduling problem in SGs with a high penetration of wind energy to optimize the tri-objective problem in SGs: operating cost and pollution emission minimization, the minimization of the cost associated with load curtailment, and the minimization of the deviation between wind turbine (WT) output power and demand. Due to climatic conditions, the nature of the wind energy source is uncertain, and its prediction for day-ahead scheduling is challenging. Monte Carlo simulation (MCS) was used to predict wind energy before integrating with the SG. The DSM strategy used in this study consists of real-time pricing and incentives, which is a hybrid demand response program (H-DRP). To solve the proposed tri-objective SG scheduling problem, an optimization technique, the multi-objective genetic algorithm (MOGA), is proposed, which results in non-dominated solutions in the feasible search area. Besides, the decision-making mechanism (DMM) was applied to find the optimal solution amongst the non-dominated solutions in the feasible search area. The proposed scheduling model successfully optimizes the objective functions. For the simulation, MATLAB 2021a was used. For the validation of this model, it was tested on the SG using multiple balancing constraints for power balance at the consumer end.

Purpose Many mentoring relationships incorporate electronic communication. This study aims to examine the effects of communication format and interaction frequency on career and social support felt by the protégé. Design/methodology/approach Surveys followed 39 high-potential protégés over seven months in a mentoring program at a large US manufacturing organization. Findings All pairs but one chose to communicate electronically at least 50 per cent of the time. Less mentoring support was perceived when average media richness was lower (e.g. when pairs communicated more by e-mail); however, this effect was reduced when communication was more frequent. Practicalimplications Mentors and protégés should be trained to understand that average media richness is associated with perceived support and that they should avoid using exclusively low-richness formats (e.g. e-mail). When they do need to use more low-richness formats, they should communicate more frequently. Companies should provide technological support and motivational incentives for mentoring pairs to incorporate high-richness interactions (e.g. face to face) in their mentoring relationships more often. Originality/value This study is the first to our knowledge to examine mixed-media formats in high-potential employee mentoring pairs. In contrast to past work which has randomly assigned participants to communicate only via one format, these participants were allowed to choose their interaction format for each interaction, which is more realistic. The findings have practical value for mentors and protégés in terms of balancing format and interaction frequency.

Abstract The Balancing Incentive Program (BIP) was an optional Medicaid program within the Affordable Care Act. States spending less than 50% of Medicaid long-term services and supports on home and community-based services (HCBS) were eligible for the program and could participate from 2011 to 2015. Participating states received an enhanced federal match in exchange for rebalancing LTSS spending and adopting structural changes to their long-term services and supports system. The purpose of this study is to understand the barriers and facilitators to implementing the BIP in two states. Data was collected through semi-structured interviews with individuals involved in HCBS policy nationally and in Maryland and Texas, including government bureaucrats, consumer advocates, and provider representatives. Findings indicate that factors that facilitated Maryland and Texas’ implementation of the BIP were regular communication with the Centers for Medicare and Medicaid Services and their consultants, Mission Analytics Group, merging the BIP with existing HCBS programs, and the substantial amount of funding associated with the program. On the other hand, the short duration of the BIP presented a challenge for states because they needed to enact multiple changes within a limited period of time. In addition, state procurement and contracting processes impeded the speed with which BIP requirements could be met. Key stakeholders, including consumer advocacy and provider organizations, often felt as though their state implemented the BIP with minimal input from interested groups. The findings indicate that the structure of the Balancing Incentive Program as well as internal state factors influenced the program’s implementation.

Introduction. Today, in the conditions of the COVID-19 pandemic, a number of economic problems have arisen in the country, which can be prevented by improving revenue policy. As the revenue part is formed in the current conditions of the budget decentralization reforms, the risks arising during the pandemic have become an important challenge for the entire economic system of the state and each territorial community in particular. The purpose of the article is to highlight current issues of state regulation of the domestic economy related to global economic challenges and fiscal risk management caused by the COVID-19 pandemic. Results. The high dependence of budget revenues on tax and debt policies, the growth of their role in the economic downturn are analyzed. Emphasis is placed on the need and importance of developing tactics and strategies for budget and tax policies, as well as the possibility of their flexible change in the face of unpredictable economic downturns. The need for state revenue policy to take into account fiscal incentives and fiscal decentralization is indicated. Particular attention is paid to the opportunities and threats posed by the deepening of decentralization processes in Ukraine, emphasis is placed on the components of the financial capacity of local communities and the adequacy of financial resources. It was mentioned that the territorial redistribution of funds must take into account the requirements of the most rational allocation of productive forces, promote business, resolve conflicts that arise in the process of balancing budget revenues and constitutional social obligations. Processes of decentralization of budgetary and tax relations should be accompanied by strengthening of their social orientation. It is noted that the financial literacy of the population plays a significant role in reducing the level of emotional turmoil during economic downturns. At the same time, the study proposed a hypothesis for further research about the dependence of the effectiveness of decentralization policy on the use of modern approaches to financial management at the regional level, which require the implementation of innovative regulatory levers for change management. Conclusions. A number of conclusions and recommendations were formulated. In particular, it is proposed to implement a number of measures to identify and counter the risks of destabilization as a basis for ensuring the financial and economic security of the state. The need to further improvement of the institutional coordination of the application of regional regulatory fiscal instruments and mechanisms with national and international norms and rules was emphasized. It was noted that in the conditions of quarantine restrictions due to the COVID-19 pandemic, the implementation of a set of measures of tax and budget support for citizens, small and medium businesses should be carried out in accordance with a clearly defined and approved program. Keywords: fiscal policy, budget policy, consequences of COVID-19, decentralization, public finance, financial literacy.

Abstract The American Rescue Plan Act (ARPA) includes a one year 10 percentage point increase in the Federal Medical Assistance Percentage for Medicaid-funded home and community-based services (HCBS). The goal is to strengthen state efforts to help older adults and people with disabilities live safely in their homes and communities rather than in institutional settings during the COVID-19 pandemic. This presentation provides a detailed description and analysis of this provision, including issues state governments need to consider when expending the additional federal revenue provided. It also draws lessons from the Affordable Care Act’s Balancing Incentive Program to suggest insights for the potential of ARPA to promote further growth in Medicaid HCBS programs. The presentation concludes by highlighting the importance of instituting strategies and processes for maximizing enhanced federal matching funds under ARPA in preparation for subsequent availability of substantial additional federal resources targeting Medicaid HCBS under other proposed initiatives.

Modern smart grids have proposed a series of demand response (DR) programs and encourage users to participate in them with the purpose of maintaining reliability and efficiency so as to respond to the sustainable development of demand-side management. As a large load of the smart grid, a datacenter could be regarded as a potential demand response participant. Encouraging datacenters to participate in demand response programs can help the grid to achieve better load balancing effect, while the datacenter can also reduce its own power consumption so as to save electricity costs. In this paper, we designed a demand response participation strategy based on two-stage decisions to reduce the total cost of the datacenter while considering the DR requirements of the grid. The first stage determines whether to participate in demand response by predicting real-time electricity prices of the power grid and incentive information will be sent to encourage users to participate in the program to help shave the peak load. In the second stage, the datacenter interacts with its users by allowing users to submit bid information by reverse auction. Then, the datacenter selects the tasks of the winning users to postpone processing them with awards. Experimental results show that the proposed strategy could help the datacenter to reduce its cost and effectively meet the demand response requirements of the smart grid at the same time.

The Balanced Budget Act which became law in 1997 was designed to help stem the increasing in costs of healthcare. The Sustainable Growth Rate (SGR) formula was incorporated into that law as a method of helping balance the budget through a complex formula tying reimbursement to the growth in the economy. Soon after its inception, the flawed nature of the formula, linking the balancing of the federal budget to physician professional fees was realized. Congress has provided multiple short-term fixes known as SGR patches over the years so as to avoid generally progressively larger negative corrections to professional reimbursement. The near annual SGR correction requirement has been compared to Groundhog Day in the legislative arena. Over the years, physician and other providers faced numerous looming, large cuts. Most recently, on April 1, 2015 physicians faced a 21.2% cut in provider payments. To the surprise of many, in April 2015 a bipartisan bicameral effort permanently repealed the Medicare SGR formula for controlling provider payment. The repeal of SGR means the temporary measures to override the growth rate formula will no longer dominate Medicare policy discussions and now the focus turns to continue payment reforms. The MACRA provides physicians and other health care professionals with stable fee update for 5 years and it follows with a new incentive program, termed the Merit-based Incentive Payment System (MIPS) replacing and consolidating preexisting incentive payment programs: meaningful use of electronic health records (EHR), physician quality reporting system, and the value-based payment modified. Thus, payments to clinicians will be subjected to adjustments based on participation in MIPS or other approved alternative payment mechanisms. This legislation also creates numerous other regulations. The MACRA has been criticized for providing insufficient statutory updates, enacting a flawed quality and performance improvement program associated with MIPS and inappropriate use of utilization and payment data. Thus, the MACRA offers physicians a predictable schedule for Medicare rates – a carrot, and controls the physician behaviors with payment reforms analogous to a stick. Thus, it could be said that this legislation embodies some good, bad, and ugly aspects. Key words: Balanced Budget Act, sustainable growth rate, alternative payment models, Medicare Access and CHIP Reauthorization Act of 2015, Merit-based Incentive Payment System, payment reform, payment modernization, health information technology

Economic research on the safety net has evolved over time, moving away from a focus on the negative incentive effects of means-tested assistance on employment, earnings, marriage, and fertility to include the potential positive benefits of such programs to children. Initially, this research on benefits to children focused on short-run impacts, but as we accumulated knowledge about skill production and better data became available, the research evolved further to include important long-run economic outcomes such as employment, earnings, and mortality. Once the positive long-run benefits to children are considered, many safety net programs are cost-effective. However, the current government practice of limiting the time horizon for cost-benefit calculations of policy initiatives often fails to take this into account. Finally, we discuss why child poverty in the United States is still higher than most OECD countries and how research on children and the safety net can better inform policy-making.

The electrical grid has been changing in the last decade due to the presence of renewables, distributed generation, storage systems, microgrids, and electric vehicles. The introduction of new legislation and actors in the smart grid’s system opens new challenges for the activities of companies, and for the development of new energy management systems, models, and methods. A new optimization-based bi-level architecture is proposed for an aggregator of consumers in the balancing market, in which incentives for local users (i.e., microgrids, buildings) are considered, as well as flexibility and a fair assignment in reducing the overall load. At the lower level, consumers try to follow the aggregator’s reference values and perform demand response programs to contain their costs and satisfy demands. The approach is applied to a real case study.

Traditionally, the choices to balance the grid and meet its peaking power needs are by installing more spinning reserves or perform load shedding when it becomes too much. This problem becomes worse as more intermittent renewable energy resources are installed, forming a substantial amount of total capacity. Advancements in Energy Storage System (ESS) provides the utility new ways to balance the grid and to meet its peak demand by storing un-used off peak energy for peak usage. Large sized ESS—mega watt (MW) level—are installed by different utilities at their substations to provide the high speed grid stabilization to balance the grid to avoid installing more capacity or triggering any current load shedding schemes. However, such large sized ESS systems and their required inverters are costly to install, require much space and their efficacy could also be limited due to network fault current limits and impedances. In this paper, we propose a novel approach and trial for 3000+ homes in Singapore of achieving a large capacity of demand management by developing a smart distribution board (DB) in each home with the high speed metering sensors (>6 kHz sampling rate) and non-intrusive load monitoring (NILM) algorithm, that can assist home users to perform the load/appliance profile identification with daily usage patterns and allow targeted load interruption using the smart sockets/plugs provided. By allowing load shedding at device or appliance level, while knowing their usage profile and preferences, this can allow such an approach to become part of a new voluntary interruptible load management system (ILMS) that requires little user intervention, while minimizing disruption to them, allowing ease of mass participation and thus achieving the intended MW demand management capacities for the grid. This allows for a more cost effective way to better balance the grid without the need for generation capacity growth, large ESS investment while improving the way to perform load shedding without disruptions to entire districts. Simply, home users can now know and participate with the grid in interruptible load (IL) schemes to target specific home appliance, such as water heaters or air conditioning, allowing interruptions during certain times of the day, instead of the entire house, albeit with the right incentives. This allows utilities to achieve MW capacity load shedding with millions of appliances with their preferences, and most importantly, with minimal disruptions to their consumers quality of life. In our paper, we will also consider coupling a small sized Home Energy Storage System (HESS) to amplify the demand management capacity. The proposed approach does not require any infrastructure or wiring changes and is highly scalable. Simulation results demonstrate the effectiveness of the NILM algorithm and achieving high capacity grid demand management. This approach of taking user preferences for appliance level load shedding was developed from the results of a survey of 500 households that indicates >95% participation if they were able to control their choices, possibly allowing this design to be the most successful demand management program than any large ESS solution for the utility. The proposed system has the ability to operate in centralized as part of a larger Energy Management System (EMS) Supervisory Control And Data Acquisition (SCADA) that decide what to dispatch as well as in autonomous modes making it simpler to manage than any MW level large ESS setup. With the availability of high-speed sampling at the DB level, it can rely on EMS SCADA dispatch or when disconnected, rely on the decaying of the grid frequency measured at the metering point in the Smart DB. Our simulation results demonstrate the effectiveness of our proposed approach for fast grid balancing.

The article analyzes the causal relationships of the dynamics of inflation processes in Ukraine using the tools of anti-inflationary policy. The main causes of inflationary processes in Ukraine are determined. The main directions for the improvement of anti-inflationary policy in Ukraine are proposed, the main ones being: the development of comprehensive state programs for the development of economic sectors that contribute to the creation of competitive, high-tech and high-tech production, especially in the agro-industrial complex and IT industry; improvement of the monetary policy of the National Bank of Ukraine, which should consist of crediting efficient production in priority sectors of the economy, using a productive issue tool that through a credit channel facilitates the growth of production, import substitution, the saturation of domestic markets with domestic goods, growth of employment and wages; stabilization of the foreign exchange market through currency, banking, and monetary regulation reforms, which are aimed at balancing the development of the foreign exchange market, supporting the development of export-oriented industries with high added value, and creating positive incentives for bringing exporters to the country. Keywords inflation, anti-inflation policy, foreign exchange market, industrial products, consumers, producers, price index, national economy.

Irrigation remains a critical input into farming and, therefore, it remains a proxy for food security and poverty alleviation in developing countries. Despite their role in economic growth and the received investment, irrigation schemes are still underperforming. Among many irrigation schemes, transferring more management responsibilities to farmers proved to be a viable path toward improving performance. However, the large diversity of implementation strategies makes evaluation difficult, while its well-demonstrated benefits have paramount importance to convince reluctant smallholders to take additional roles. In order to address this gap, we analyze the effects of participation on farming outcomes (yield, revenue, net profit) by estimating the treatment effect. We present the case study of a Mubuku small-scale irrigation scheme, Uganda. We provide a framework to construct the Farmers Participation Index while distinguishing farmers into participating and not participating groups. The effects of participation are investigated through econometric methods including nonparametric and semiparametric estimation methods such as a difference in means, a regression adjustment, propensity score matching, and entropy balancing. The analysis reveals a positive and significant treatment effect of participation on farming outcomes. The obtained results endorse the efforts of governmental programs to foster responsibility transfer and the farmers’ role in irrigation management. A strong causal relationship between management and profitability provides incentives for farmers to engage in participation.

Purpose – This study aims to understand how the development of teaching and research competencies affects graduate (MS and PhD level – called stricto sensu courses in Brazil) management professors' work-family relations. Design/methodology/approach – This research is a case study about work-family conflicts in academic careers. The data collection and analysis occurred during the period between June 2009 and January 2012. The population is composed of 45 professors: 33 men and 12 women, corresponding, respectively, to 73 and 27 per cent of the professors in the programs. Eleven female professors and 26 male professors were interviewed in this research. Analysis of work-family conflicts was performed by means of open questions based on three conflict dimensions: time, strain and behavior. Findings – Investment in the development of teaching competencies brings conflicts into work-family relations. Among the three conflict dimensions considered, time stood out. When the conflict dimension was analyzed, more specifically in terms of behavior, it was evident that men perceive the effects of work-family conflicts to a lesser extent, as women suffer more from the triple impact (work, family and studies). Research limitations/implications – Context of a sector within a determined place. Practical implications – This text highlights the importance and current theme of gender and career for researchers and academy. Thus, this paper contributes so society can reflect on the roles men and women hold in the distribution of the responsibilities, highlighting the importance of balancing their division between couples, in family routines and in childcare. Such balance can improve a family's life, providing better conditions so women can manage their careers. Social implications – Likewise, this paper supports public policies that improve the life quality of women or those who will adopt children, such as policies that incentive public and private organizations to extend maternity leave for mothers and adoptive couples, and public policies that contribute so women can proceed in their careers and therefore can contribute to the advancement of society and their own bio-psycho-social development. This text also brings implications in order that organizations design policies that allow all employees to better balance work-time and other life activities in general. Originality/value – By selecting the graduate MS/PhD (stricto sensu) educational sector in particular, it was possible to learn the challenges, difficulties, achievements and limits inherent to the profession (professors), just as it was possible to verify existing conflicts, many times experienced and debated in organizational routines but not identified and shown by academic research in this sector.

Abstract Objectives The Balancing Incentive Program (BIP) was an optional program for states within the Patient Protection and Affordable Care Act to promote Medicaid-funded home and community-based services (HCBS) for older adults and persons with disabilities. Twenty-one states opted to participate in BIP, including several states steadfastly opposed to the health insurance provisions of the Affordable Care Act. This study focused on identifying what factors were associated with states’ participation in this program. Methods Event history analysis was used to model state adoption of BIP from 2011 to 2014. A range of potential factors was considered representing states’ economic, political, and programmatic conditions. Results The results indicate that states with a higher percentage of Democrats in the state legislature, fewer state employees per capita, and more nursing facility beds were more likely to adopt BIP. In addition, states with fewer home health agencies per capita, that devoted smaller proportions of Medicaid long-term care spending to HCBS, and that had more Money Follows the Person transitions were also more likely to pursue BIP. Discussion The findings highlight the role of partisanship, administrative capacity, and program history in state BIP adoption decisions. The inclusion of BIP in the Affordable Care Act may have deterred some states from participating in the program due to partisan opposition to the legislation. To encourage the adoption of optional HCBS programs, federal policymakers should consider the role of financial incentives, especially for states with limited bureaucratic capacity and that have made less progress rebalancing Medicaid long-term services and supports.

Background: Health information technology (HIT) use in home- and community-based services (HCBS) has been hindered by inadequate resources and incentives to support modernization. We sought to understand the ways the Medicaid Balancing Incentive Program (BIP) facilitated increased use of HIT to increase access to HCBS. Method: Qualitative analysis of interviews with 30 Medicaid administrators, service agency providers, and consumer advocates. Results: Although stakeholders perceived several benefits to greater HIT use, they highlighted critical challenges to effective adoption within the long-term services and supports (LTSS) system, including lack of extant expertise/knowledge about HIT, the limited reach of HIT among rural and disabled beneficiaries, burdensome procurement processes, and the ongoing resources required to maintain up-to-date HIT solutions. Conclusion: The structural reforms required by BIP gave states an opportunity to modernize their HCBS systems through use of HIT. However, barriers to HIT adoption persist, underscoring the need for continued support as part of future rebalancing efforts.

Abstract Background Although there is broad agreement that negative carbon emissions may be required in order to meet the global climate change targets specified in the Paris Agreement and that carbon sequestration in the terrestrial biosphere can be an important contributor, there are important accounting issues that often discourage forest carbon sequestration projects. The legislation establishing the California forest offset program, for example, requires that offsets be “real, additional, quantifiable, permanent, verifiable, and enforceable”. While these are all clearly desirable attributes, their implementation has been a great challenge in balancing complexity, expense, and risk. Most forest offset protocols carry similar accounting objectives, but often with different details, (e.g. Richards and Huebner in Carbon Manag 3(4):393–410, 2012 and Galik et al. in Mitig Adapt Strateg Glob Change 14:677–690, 2009). The result is that the complexity, expense, and risk of participation discourage participation and make it more difficult to achieve climate mitigation goals. We focus on the requirements for accounting and permanence to illustrate that current requirements disproportionately disadvantage small landowners. Results The simplified 1040EZ filing system for U.S. income taxes may provide insight for a protocol model that balances reward, effort, and risk, while still achieving the overall objectives of standardized offset protocols. In this paper, we present initial ideas and lay the groundwork behind a “2050EZ” protocol for forest carbon sequestration as a complement to existing protocols. Conclusion The Paris Agreement states that “Parties should take action to conserve and enhance, as appropriate, sinks and reservoirs of greenhouse gases.” The Paris Agreement also refers to issues such as equity, sustainable development, and other non-carbon benefits. The challenge is to provide incentives for maintaining and increasing the amount of carbon sequestered in the biosphere. Monitoring and verification of carbon storage need to be sufficient to demonstrate sequestration from the atmosphere while providing clear incentives and simple accounting approaches that encourage participation by diverse participants, including small land holders.

Older adults in need of assistance often prefer to remain at home rather than receive care in an institution. To meet these preferences, Medicaid invited states to apply for the Balancing Incentive Program (BIP), a program intended to “rebalance” Medicaid-financed long-term services and supports to Home- and Community-Based Services (HCBS). However, only about half of eligible states applied. We interviewed Medicaid administrators to explore why some states applied for BIP whereas others did not. Supportive state leadership and the presence of other programs supporting community-based care were positively related to BIP application. Opposing policy priorities and programs competing for similar resources were negatively related to BIP application. Because states most likely to apply already had policy goals and programs supporting HCBS, BIP may inadvertently widen disparities across states, pushing those on the margins ahead and leaving the ones that are worst off in HCBS support to fall even further behind.

The Affordable Care Act included the opportunity for states to increase spending on Medicaid home and community-based services (HCBS) for older adults and persons with disabilities through the Balancing Incentive Program (BIP). This study utilized comparative case studies to identify the factors that facilitated or impeded states’ implementation of BIP. Findings indicate factors that facilitated the implementation of BIP were communication with the federal government and its contractor, merging BIP with existing HCBS programs, and enhanced federal revenue. On the other hand, the short duration of BIP, state procurement and contracting processes, and the need to incorporate feedback from non-governmental stakeholders and determining how to spend the enhanced revenue proved challenging for some states. This research suggests ways federal and state officials can implement new initiatives to achieve greater rebalancing of Medicaid long-term services and supports for older adults.

ملخص: يهدف البحث إلى التعرف إلى أخلاقيات العمل وعلاقتها بمستوى الاستغراق الوظيفي من وجهة نظر العاملين في وزارة الإسكان والأشغال العامة في غزة، وقد استخدم الباحث المنهج الوصفي التحليلي لهذا الغرض، واستخدام قائمة الاستقصاء كأداة رئيسة لجمع البيانات، وبلغ حجم المجتمع (90) مفردة، وتم الحصول على (71) استبانة بنسبة استرداد 78.9%، واستخدم الباحث أسلوب الحصر الشامل في جمع البيانات، كما تم استخدام برنامج التحليل الإحصائي (spss) كرزمة إحصائية لإدخال ومعالجة البيانات واختبار الفرضيات. أهم النتائج التي توصل إليها البحث: يوجد علاقة ذات دلالة إحصائية بين أخلاقيات العمل ومستوى الاستغراق الوظيفي من وجهة نظر العاملين في وزارة الإسكان والأشغال العامة في غزة .لا توجد فروق ذات دلالة إحصائية عند مستوى دلالة (0.05≥α) بين متوسطات استجابات المبحوثين حول أخلاقيات العمل وعلاقتها بالاستغراق الوظيفي في وزارة الأشغال العامة والإسكان بغزة تعزى للمتغيرات الشخصية عدم موافقة أفراد العينة على فقرات الاستغراق الوظيفي بشكل عام بمتوسط حسابي نسبي يساوي 57.19%.أهم التوصيات التي قدمها البحث:ضرورة الأخذ بعين الاعتبار ترتيب أولويات العلاقة بين مكونات أخلاقيات العمل والاستغراق الوظيفي للعاملين لتحقيق أهداف عينة. البحث وذلك من خلال:وضع برنامج للحوافز والمكافآت الفورية لدعم التصرف الأخلاقي السليم، والسلوك الأخلاقي المتميز منعاً لصور الفساد الإداري والمالي والأخلاقي كالواسطة والمحسوبية عند انجاز المعاملات.التزام الوزارة بالممارسات الأخلاقية السليمة والمدرجة ضمن مدونة السلوك الأخلاقي في الوظيفة العامة.تبني الوزارة ثقافة تنظيمية أخلاقية قوية راسخة تقوم على (معاملة المرؤوسين بعدالة وإنصاف، وإتقان العمل وسرعة الإنجاز، وتحقيق التكامل بين العاملين) مما ينعكس بدوره على تحسين مستوى الاستغراق الوظيفي لدى العاملين.الاهتمام بعوامل أخرى ذات تأثير على العلاقة بين الأخلاقيات والاستغراق الوظيفي منها : (الأجور والمكافآت، الاستقرار والأمان الوظيفي، التوازن بين الحياة والعمل، المشاركة في القرارات والسلوك القيادي والإشرافي في العملالكلمات المفتاحية:الأخلاق ،أخلاقيات العمل ،القيم الأخلاقية ،مدونة السلوك ،الاستغراق الوظيفي، الانغماس الوظيفي. Abstract The research aims to learn about the work ethics and their relation with the level of jobs whole engagement from the perspective of workers in the Ministry of Housing and Public Works in Gaza. The researcher has used the descriptive analytical method for this purpose and a questionnaire as a main tool for data collection. The size of the sample was 90 individuals of which 71 completed questionnaire were obtained representing 78.9% response. The researcher has used the comprehensive limitation method in data collection. The SPSS has been also used as a statistical package in entering and treating the data as well as in selecting the assumptions. Most significant conclusions of the study: 1. There is a statistical relation between the work ethics and the level of job whole engagement from the perspective of workers in the Ministry of Housing and Public Works in Gaza. 2. There are no statistical differences at the level of (a ≤ 0.05 ) between the averages of respondents’ responses about the work ethics and their relation of the job whole engagement in the ministry of Housing and Public Works in Gaza , which can be attributed to the changes in characters . 3. Lack of respondents’ consent to paragraphs of the job whole engagement in general at a relative mathematical mean equaling to 57.19. %. Most Important Recommendations of the Study: 1. There is a need to take into account establishing priorities of the relation between components of the work ethics and the job whole engagement of the workers for the purpose of achieving the objectives of the research sample, through: • A program of incentives and instant rewards to support a proper moral disposition and a distinguished ethical behavior in order to prevent all faces of administrative , financial and moral corruption , such as nepotism and mediation at completion of transactions . • The ministry’s commitment to proper practices included in the code of ethical conduct in public office (job) • The Ministry’s adoption of a strong , well-established ethical organizational culture based on fair and just treatment of subordinates , good performance and fast delivery as well as integration among the workers , which in turn lead to improvement of the workers’ whole engagement in the job . 2. interest and other related effect on the relationship between ethics and Job Engagement including factors (wages, rewards , Job progress and promotion opportunities, social relations, job safety and stability, decision-making sharing, training and learning programs, balancing between personal life and job life). Keywords: ethics – work ethics – ethical values – Code of ethics – Job Engagement

Purpose This paper aims to shed light on the linkage between research and development (R&D) networks and public funding presented in a given period by using network-based evaluation tools as a means of exploring the relational dimension in public projects designed to foster technology R&D activities. Design/methodology/approach This research uses co-occurrence network analysis of relevant public projects to assess how technological associations might occur within the R&D activities of given publicly funded projects as well as conducts correlation analysis to understand the extent to which linkages of R&D activity in technology fields are related to public expenditure. Findings Core technology fields, regarded as eligible to receive continued public funding, are critical for enhancing competitiveness and sustainable growth at the nationally strategic technology level. Thus, the relationship between R&D and the level of government funding for these fields is generally perceived as strong. However, a few technology fields, which did not actively form specific network relationships with other technology fields, are considered to exceptionally drive the largest government support. This trend indicates that the government-funded R&D should be designed and managed not only to curb the inefficiencies existing in the current funding programs but also to achieve the appropriateness for further technology development. Research limitations/implications Despite the comprehensive findings, this study has several limitations. First, it is difficult to control any confounding factors, such as the determinants and constraints of the government budget allocation and expenditure decisions over S&T areas, strategic frameworks for public investment and evolving policy landscapes in technology sectors, which lead to bias in the study results. Second, this study is based on a narrow, single-year data set of a specific field of projects supported by the Korean government’s R&D program. Therefore, the generalization of findings may be limited. The authors assumed that influences caused by confounding variables during the initial phase of the public funding schemes would not be significant, but they did not take into account possible factors that might arise coincident with the subsequent phase changes. As such, the issue of confounding variables needs to be carefully considered in research design to provide alternative explanations for the results that have been ruled out. The limitations of this study, therefore, could be overcome by comparing the outcome difference between subsidized and non-subsidized R&D projects or evaluating targeted funding schemes or tax incentives that support and promote various areas of R&D with sufficiently large, evidence-based data sets. Also, future research must identify and analyze the R&D activities concerning public support programs performed in other countries associated with strategic priorities to provide more profound insight into how they differ. Third, there are some drawbacks to using these principal investigators-provided classification codes, such as subjectivity, inaccuracy and non-representation. These limitations may be addressed by using content-based representations of the projects rather than using pre-defined codes. Finally, the role that government investment in R&D has played in developing new science and manufacturing technologies of materials and components through network relationships could be better examined using longitudinal analysis. Furthermore, the findings suggest the need for further research to integrate econometric models of performance outcomes such as input–output relations into the network analysis for analyzing the flow of resources and activities between R&D sectors in a national economy. Therefore, future research would be helpful in developing a methodological strategy that could analyze temporal trends in the identification of the effects of public funding on the performance of R&D activity and demand. Practical implications Public funding schemes and their intended R&D relationships still depend on a framework to generate the right circumstances for leading and promoting coordinated R&D activities while strengthening research capacity to enhance the competitiveness of technologies. Each technology field has a relatively important role in R&D development that should be effectively managed and supervised to accomplish its intended goals of R&D budgeting. Thus, when designing and managing R&D funding schemes and strategy-driven R&D relations, potential benefits and costs of using resources from each technology field should be defined and measured. In this regard, government-funded R&D activities should be designed to develop or accommodate a coordinated program evaluation, to be able to examine the extent to which public funding is achieving its objectives of fostering R&D networks, balancing the purpose of government funding against the needs of researchers and technology sectors. In this sense, the examination of public R&D relations provides a platform for discussion of relational network structures characterizing R&D activities, the strategic direction and priorities for budget allocation of the R&D projects. It also indicates the methodological basis for addressing the impact of public funding for R&D activities on the overall performance of technology fields. Originality/value The value of this work lies in a preliminary exploratory analysis that provides a high-level snapshot of the areas of metallurgy, polymers/chemistry/fibers and ceramics, funded by the Korean Government in 2016 to promote technological competitiveness by encouraging industries to maintain and expand their competencies.

Purpose The purpose of this paper is to investigate the impact of temperature on residential electricity demand in the city of Greater Accra, Ghana. It is believed that the increasing trend of temperatures may significantly affect people’s lives and demand for electricity from the national grid. Given the recurrent electricity crisis in Ghana, this study will investigate both the current and future residential energy demands in the light of temperature fluctuations. This will inform future power generation using renewable energy resources mix to find a sustainable solution to the recurrent energy demand challenges in Ghana. This study will help the Government of Ghana to better understand the temperature dependence of residential energy demand, which in turn will help in developing behavioral modification programs aimed at reducing energy consumption. Monthly data for the temperature and residential electricity consumption for Greater Accra Region from January 2007 to December 2018 obtained from the Ghana Meteorological Service (GMS) and Ghana Grid Company (Gridco), respectively, are used for the analysis. Design/methodology/approach This study used monthly time series data from 2007 to 2018. Data on monthly electricity demand and temperature are obtained from the Ghana Grid Company and GMS. The theoretical framework for residential electricity consumption, the log-linear demand equation and time series regression approaches was used for this study. To demonstrate certain desirable properties and to produce good estimators in this study, an analysis technique of ordinary least squares measurement was also applied. Findings This study showed an impact on residential electricity requirements in the selected regions of Greater Accra owing to temperature change. The analysis suggests a substantial positive response to an increase in temperature demand for residential electricity and thus indicates a growth of the region’s demand for electricity in the future because of temperature changes. As this analysis projects, the growth in the electricity demand seems too small for concern, perhaps because of the incoherence of the mechanisms used to regulate the temperature by the residents. However, two points should be considered when drawing any conclusions even in the case of Greater Accra alone. First, the growth in the demand for electricity shown in the present study is the growth of demand due only to increasing temperatures that do not consider changes in all the other factors driving the growth of demand. The electricity demand will in the future increase beyond what is induced by temperature, due to increasing demand, population and mechanization and other socioeconomic factors. Second, power consumption understated genuine electricity demand, owing to the massive shedding of loads (Dumsor) which occurred in Ghana from 2012 to 2015 in the analysis period that also applies in the Greater Accra region. Given both of these factors, the growth in demand for electricity is set to increase in response to climate change, which draws on the authorities to prepare more critically on capacity building which loads balancing. The results also revealed that monthly total residential electricity consumption, particularly the monthly peak electricity consumption in the city of Accra is highly sensitive to temperature. Therefore, the rise in temperature under different climate change scenarios would have a high impact on residential electricity consumption. This study reveals that the monthly total residential electricity demand in Greater Accra will increase by up to 3.1%. Research limitations/implications The research data was largely restricted to only one region in Ghana because of the inconsistencies in the data from the other regions. The only climate variable use was temperature because it was proven in the literature that it was the most dominant variable that affects electricity demand, so it was not out of place to use only this variable. The research, however, can be extended to capture the entire regions of the country if sponsorship and accurate data can be obtained. Practical implications The government as the policy and law-making authority has to play the most influential role to ensure adaptation at all levels toward the impact of climate change for residential consumers. It is the main responsibility of the government to arrange enough supports to help residential consumers adapt to climate change and try to make consumers self-sufficient by modification of certain behaviors rather than supply dependent. Government bodies need to carefully define their climate adaptation supports and incentive programs to influence residential-level consumption practices and demand management. Here, energy policies and investments need to be more strategic. The most critical problem is to identify the appropriate adaptation policies that favor the most vulnerable sectors such as the residential sector. Social implications To evaluate both mitigation and adaptation policies, it is important to estimate the effect of climate change on energy usage around the world. Existing empirical figures, however, are concentrated in Western nations, especially the USA. To predict how electricity usage will shift in the city of Greater Accra, Ghana, the authors used regular household electricity consumption data. Originality/value The motivation for this paper and in particular the empirical analysis for Ghana is originality for the literature. This paper demonstrates an adequate understanding of the relevant literature in modern times.

The debate on the social role of museums trundles along in an age where complex associations between community, collections, and cultural norms are highly contested (Silverman 3–4; Sandell, Inequality 3–23). This article questions whether, in the case of community groups whose aspirations often go unrecognised (in this case people with either blindness or low vision), there is a need to discuss and debate institutionalised approaches that often reinforce social exclusion and impede cultural access. If “access is [indeed] an entry point to experience” (Papalia), then the privileging of visual encounters in museums is clearly a barrier for people who experience sight loss or low vision (Levent and Pursley). In contrast, a multisensory aesthetic to exhibition display respects the gamut of human sensory experience (Dudley 161–63; Drobnick 268–69; Feld 184; James 136; McGlone 41–60) as do discursive gateways including “lectures, symposia, workshops, educational programs, audio guides, and websites” (Cachia). Independent access to information extends beyond Braille on toilet doors.Underpinning this article is an ongoing qualitative case study undertaken by the author involving participant observation, workshops, and interviews with eight adults who experience vision impairment. The primary research site has been the National Museum of Australia. Reflecting on the role of curators as storytellers and the historical development of museums and their practitioners as agents for social development, the article explores the opportunities latent in museum collections as they relate to community members with vision impairment. The outcomes of this investigation offer insights into emerging issues as they relate to the International Council of Museums (ICOM) definitions of the museum program. Curators as Storytellers“The ways in which objects are selected, put together, and written or spoken about have political effects” (Eilean Hooper-Greenhill qtd. in Sandell, Inequality 8). Curators can therefore open or close doors to discrete communities of people. The traditional role of curators has been to collect, care for, research, and interpret collections (Desvallées and Mairesse 68): they are characterised as information specialists with a penchant for research (Belcher 78). While commonly possessing an intimate knowledge of their institution’s collection, their mode of knowledge production results from a culturally mediated process which ensures that resulting products, such as cultural significance assessments and provenance determinations (Russell and Winkworth), privilege the knowing systems of dominant social groups (Fleming 213). Such ways of seeing can obstruct the access prospects of underserved audiences.When it comes to exhibition display—arguably the most public of work by museums—curators conventionally collaborate within a constellation of other practitioners (Belcher 78–79). Curators liaise with museum directors, converse with conservators, negotiate with exhibition designers, consult with graphics designers, confer with marketing boffins, seek advice from security, chat with editors, and engage with external contractors. I question the extent that curators engage with community groups who may harbour aspirations to participate in the exhibition experience—a sticking point soon to be addressed. Despite the team based ethos of exhibition design, it is nonetheless the content knowledge of curators on public display. The art of curatorial interpretation sets out not to instruct audiences but, in part, to provoke a response with narratives designed to reveal meanings and relationships (Freeman Tilden qtd. in Alexander and Alexander 258). Recognised within the institution as experts (Sandell, Inclusion 53), curators have agency—they decide upon the stories told. In a recent television campaign by the National Museum of Australia, a voiceover announces: a storyteller holds incredible power to connect and to heal, because stories bring us together (emphasis added). (National Museum of Australia 2015)Storytelling in the space of the museum often shares the histories, perspectives, and experiences of people past as well as living cultures—and these stories are situated in space and time. If that physical space is not fit-for-purpose—that is, it does not accommodate an individual’s physical, intellectual, psychiatric, sensory, or neurological needs (Disability Discrimination Act 1992, Cwlth)—then the story reaches only long-established patrons. The museum’s opportunity to contribute to social development, and thus the curator’s as the primary storyteller, will have been missed. A Latin-American PerspectiveICOM’s commitment to social development could be interpreted merely as a pledge to make use of collections to benefit the public through scholarship, learning, and pleasure (ICOM 15). If this interpretation is accepted, however, then any museum’s contribution to social development is somewhat paltry. To accept such a limited and limiting role for museums is to overlook the historical efforts by advocates to change the very nature of museums. The ascendancy of the social potential of museums first blossomed during the late 1960s at a time where, globally, overlapping social movements espoused civil rights and the recognition of minority groups (Silverman 12; de Varine 3). Simultaneously but independently, neighbourhood museums arose in the United States, ecomuseums in France and Quebec, and the integral museum in Latin America, notably in Mexico (Hauenschild; Silverman 12–13). The Latin-American commitment to the ideals of the integral museum developed out of the 1972 round table of Santiago, Chile, sponsored by the United Nations Educational, Scientific and Cultural Organization (Giménez-Cassina 25–26). The Latin-American signatories urged the local and regional museums of their respective countries to collaborate with their communities to resolve issues of social inequality (Round Table Santiago 13–21). The influence of Brazilian educator Paulo Freire should be acknowledged. In 1970, Freire ushered in the concept of conscientization, defined by Catherine Campbell and Sandra Jovchelovitch as:the process whereby critical thinking develops … [and results in a] … thinker [who] feels empowered to think and to act on the conditions that shape her living. (259–260)This model for empowerment lent inspiration to the ideals of the Santiago signatories in realising their sociopolitical goal of the integral museum (Assunção dos Santos 20). Reframing the museum as an institution in the service of society, the champions of the integral museum sought to redefine the thinking and practices of museums and their practitioners (United Nations Educational, Scientific and Cultural Organization 37–39). The signatories successfully lobbied ICOM to introduce an explicitly social purpose to the work of museums (Assunção dos Santos 6). In 1974, in the wake of the Santiago round table, ICOM modified their definition of a museum to “a permanent non-profit institution, open to the public, in the service of society and its development” (emphasis added) (Hauenschild). Museums had been transformed into “problem solvers” (Judite Primo qtd. in Giménez-Cassina 26). With that spirit in mind, museum practitioners, including curators, can develop opportunities for reciprocity with the many faces of the public (Guarini). Response to Social Development InitiativesStarting in the 1970s, the “second museum revolution” (van Mensch 6–7) saw the transition away from: traditional roles of museums [of] collecting, conservation, curatorship, research and communication … [and toward the] … potential role of museums in society, in education and cultural action. (van Mensch 6–7)Arguably, this potential remains a work in progress some 50 years later. Writing in the tradition of museums as agents of social development, Mariana Lamas states:when we talk about “in the service of society and its development”, it’s quite different. It is like the drunk uncle at the Christmas party that the family pretends is not there, because if they pretend long enough, he might pass out on the couch. (Lamas 47–48)That is not to say that museums have neglected to initiate services and programs that acknowledge the aspirations of people with disabilities (refer to Cachia and Krantz as examples). Without discounting such efforts, but with the refreshing analogy of the drunken uncle still fresh in memory, Lamas answers her own rhetorical question:how can traditional museums promote community development? At first the word “development” may seem too much for the museum to do, but there are several ways a museum can promote community development. (Lamas 52) Legitimising CommunitiesThe first way that museums can foster community or social development is to:help the community to over come [sic] a problem, coming up with different solutions, putting things into a new perspective; providing confidence to the community and legitimizing it. (Lamas 52)As a response, my doctoral investigation legitimises the right of people with vision impairment to participate in the social and cultural aspects of publicly funded museums. The Australian Government upheld this right in 2008 by ratifying the United Nations Convention on the Rights of Persons with Disabilities (and Optional Protocol), which enshrines the right of people with disability to participate in the cultural life of the nation (United Nations).At least 840,700 people in Australia (a minimum of four per cent of the population) experiences either blindness or low vision (Australian Bureau of Statistics 2009). For every one person in the Australian community who is blind, nearly five other people experience low vision. The medical model of disability identifies the impairment as the key feature of a person and seeks out a corrective intervention. In contrast, the social model of disability strives to remove the attitudinal, social, and physical barriers enacted by people or institutions (Landman, Fishburn, and Tonkin 14). Therein lies the opportunity and challenge for museums—modifying layouts and practices that privilege the visual. Consequently, there is scope for museums to partner with people with vision impairment to identify their aspirations rather than respond as a problem to be fixed. Common fixes in the museums for people with disabilities include physical alterations such as ramps and, less often, special tours (Cachia). I posit that curators, as co-creators and major contributors to exhibitions, can be part of a far wider discussion. In the course of doctoral research, I accompanied adults with a wide array of sight impairments into exhibitions at the Museum of Australian Democracy at Old Parliament House, the Australian War Memorial, and the National Museum of Australia. Within the space of the exhibition, the most commonly identified barrier has been the omission of access opportunities to interpreted materials: that is, information about objects on display as well as the wider narratives driving exhibitions. Often, the participant has had to work backwards, from the object itself, to understand the wider topic of the exhibition. If aesthetics is “the way we communicate through the senses” (Thrift 291), then the vast majority of exhibits have been inaccessible from a sensory perspective. For people with low vision (that is, they retain some degree of functioning sight), objects’ labels have often been too small to be read or, at times, poorly contrasted or positioned. Objects have often been set too deep into display cabinets or too far behind safety barriers. If individuals must use personal magnifiers to read text or look in vain at objects, then that is an indicator that there are issues with exhibition design. For people who experience blindness (that is, they cannot see), neither the vast majority of exhibits nor their interpretations have been made accessible. There has been minimal access across all museums to accessioned objects, handling collections, or replicas to tease out exhibits and their stories. Object labels must be read by family or friends—a tiring experience. Without motivated peers, the stories told by curators are silenced by a dearth of alternative options.Rather than presume to know what works for people with disabilities, my research ethos respects the “nothing about us without us” (Charlton 2000; Werner 1997) maxim of disability advocates. To paraphrase Lamas, we have collaborated to come up with different solutions by putting things into new perspectives. In turn, “person-centred” practices based on rapport, warmth, and respect (Arigho 206–07) provide confidence to a diverse community of people by legitimising their right to participate in the museum space. Incentivising Communities Museums can also nurture social or community development by providing incentives to “the community to take action to improve its quality of life” (Lamas 52). It typically falls to (enthusiastic) public education and community outreach teams to engage underserved communities through targeted programs. This approach continues the trend of curators as advocates for the collection, and educators as advocates for the public (Kaitavouri xi). If the exhibition briefs normally written by curators (Belcher 83) reinforced the importance of access, then exhibition designers would be compelled to offer fit-for-purpose solutions. Better still, if curators (and other exhibition team members) regularly met with community based organisations (perhaps in the form of a disability reference group), then museums would be better positioned to accommodate a wider spectrum of community members. The National Standards for Australian Museums and Galleries already encourages museums to collaborate with disability organisations (40). Such initiatives offer a way forward for improving a community’s sense of itself and its quality of life. The World Health Organization defines health as a “state of complete physical, mental and social well-being and not merely the absence of disease or infirmity”. While I am not using quality of life indicators for my doctoral study, the value of facilitating social and cultural opportunities for my target audience is evident in participant statements. At the conclusion of one sensory based workshop, Mara, a female participant who experiences low vision in one eye and blindness in the other, stated:I think it was interesting in that we could talk together about what we were experiencing and that really is the social aspect of it. I mean if I was left to go to a whole lot of museums on my own, I probably wouldn’t. You know, I like going with kids or a friend visiting from interstate—that sort of thing. And so this group, in a way, replicates that experience in that you’ve got someone else to talk about your impressions with—much better than going on your own or doing this alone.Mara’s statement was in response to one of two workshops I held with the support of the Learning Services team at the National Museum of Australia in May 2015. Selected objects from the museum’s accessioned collection and handling collection were explored, as well as replicas in the form of 3D printed objects. For example, participants gazed upon and handled a tuckerbox, smelt and tasted macadamia nuts in wattle seed syrup, and listened to a genesis story about the more-ish nut recorded by the Butchulla people—the traditional owners of Fraser Island. We sat around a table while I, as the workshop mediator, sought to facilitate free-flowing discussions about their experiences and, in turn, mused on the capacity of objects to spark social connection and opportunities for cultural access. While the workshop provided the opportunity for reciprocal exchanges amongst participants as well as between participants and me, what was highly valued by most participants was the direct contact with members of the museum’s Learning Services team. I observed that participants welcomed the opportunity to talk with real museum workers. Their experience of museum practitioners, to date, had been largely confined to the welcome desk of respective institutions or through special events or tours where they were talked at. The opportunity to communicate directly with the museum allowed some participants to share their thoughts and feelings about the services that museums provide. I suggest that curators open themselves up to such exchanges on a more frequent basis—it may result in reciprocal benefits for all stakeholders. Fortifying IdentityA third way museums can contribute to social or community development is by:fortify[ing] the bonds between the members of the community and reaffirm their identities making them feel more secure about who they are; and give them a chance to tell their own version of their history to “outsiders” which empowers them. (Lamas 52)Identity informs us and others of who we are and where we belong in the world (Silverman 54). However, the process of identity marking and making can be fraught: “some communities are ours by choice … [and] … some are ours because of the ways that others see us” (Watson 4). Communities are formed by identifying who is in and who is out (Francois Dubet qtd. in Bessant and Watts 260). In other words, the construction of collective identity is reinforced through means of social inclusion and social exclusion. The participants of my study, as members or clients of the Royal Society for the Blind | Canberra Blind Society, clearly value participating in events with empathetic peers. People with vision impairment are not a homogenous group, however. Reinforcing the cultural influences on the formation of identity, Fiona Candlin asserts that “to state the obvious but often ignored fact, blind people … [come] … from all social classes, all cultural, racial, religious and educational backgrounds” (101). Irrespective of whether blindness or low vision arises congenitally, adventitiously, or through unexpected illness, injury, or trauma, the end result is an assortment of individuals with differing perceptual characteristics who construct meaning in often divergent ways (De Coster and Loots 326–34). They also hold differing world views. Therefore, “participation [at the museum] is not an end in itself. It is a means for creating a better world” (Assunção dos Santos 9). According to the Australian Human Rights Commissioner, Professor Gillian Triggs, a better world is: a society for all, in which every individual has an active role to play. Such a society is based on fundamental values of equity, equality, social justice, and human rights and freedoms, as well as on the principles of tolerance and embracing diversity. (Triggs)Publicly funded museums can play a fundamental role in the cultural lives of societies. For example, the Powerhouse Museum (Museum of Applied Arts and Sciences) in Sydney partnered with Vision Australia to host an exhibition in 2010 titled Living in a Sensory World: it offered “visitors an understanding of the world of the blindness and low vision community and celebrates their achievements” (Powerhouse Museum). With similar intent, my doctoral research seeks to validate the world of my participants by inviting museums to appreciate their aspirations as a distinct but diverse community of people. ConclusionIn conclusion, the challenge for museum curators and other museum practitioners is balancing what Richard Sennett (qtd. in Bessant and Watts 265) identifies as opportunities for enhancing social cohesion and a sense of belonging while mitigating parochialism and community divisiveness. Therefore, curators, as the primary focus of this article, are indeed challenged when asked to contribute to serving the public through social development—a public which is anything but homogenous. Mindful of cultural and social differences in an ever-changing world, museums are called to respect the cultural and natural heritage of the communities they serve and collaborate with (ICOM 10). It is a position I wholeheartedly support. This is not to say that museums or indeed curators are capable of solving the ills of society. However, inviting people who are frequently excluded from social and cultural events to multisensory encounters with museum collections acknowledges their cultural rights. I suggest that this would be a seismic shift from the current experiences of adults with blindness or low vision at most museums.ReferencesAlexander, Edward, and Mary Alexander. Museums in Motion: An Introduction to the History and Functions of Museums. 2nd ed. Lanham, Maryland: AltaMira Press, 2008.Arigho, Bernie. “Getting a Handle on the Past: The Use of Objects in Reminiscence Work.” Touch in Museums: Policy and Practice in Object Handling. Ed. Helen Chatterjee. Oxford: Berg, 2008. 205–12.Assunção dos Santos, Paula. Introduction. Sociomuseology 4: To Think Sociomuseologically. Eds. Paula Assunção dos Santos and Judite Primo. Lisbon: Universidade Lusófona de Humanidades e Tecnologias, 2010. 5–12.Australian Bureau of Statistics. “National Health Survey: Summary of Results (2007- 2008) (Reissue), Cat. No. 4364.0. 2009.” Australian Bureau of Statistics. 12 Feb. 2015 ‹http://www.abs.gov.au/ausstats/abs@.nsf/mf/4364.0›.Belcher, Michael. Exhibitions in Museums. Leicester: Leicester UP, 1991.Bessant, Judith, and Rob Watts. Sociology Australia. 3rd ed. Crows Nest: Allen & Unwin, 2007.Cachia, Amanda. “Talking Blind: Disability, Access, and the Discursive Turn.” Disability Studies Quarterly 33.3 (2013). 23 July 2015 ‹http://dsq-sds.org/article/view/3758›.Campbell, Catherine, and Sandra Jovchelovitch. "Health, Community and Development: Towards a Social Psychology of Participation." Journal of Community & Applied Social Psychology 10.4 (2000): 255–70.Candlin, Fiona. "Blindness, Art and Exclusion in Museums and Galleries." International Journal of Art & Design Education 22.1 (2003): 100–10.Charlton, James. Nothing about Us without Us: Disability Oppression and Empowerment. Berkeley: U of California P, 2000.De Coster, Karin, and Gerrit Loots. "Somewhere in between Touch and Vision: In Search of a Meaningful Art Education for Blind Individuals." International Journal of Art & Design Education 23.3 (2004): 32634.De Varine, Hugues. “Decolonising Museology.” ICOM News 58.3 (2005): 3.Desvallées, André, and François Mairesse. Key Concepts of Museology. Paris: Armand Colin, 2010. 16 Jun. 2015 ‹http://icom.museum/professional-standards/key-concepts-of-museology/›.Disability Discrimination Act 1992 (Cwlth). 14 June 2015 ‹https://www.comlaw.gov.au/Series/C2004A04426›.Drobnick, Jim. “Volatile Effects: Olfactory Dimensions of Art and Architecture.” Empire of the Senses: The Sensual Culture Reader. Ed. David Howes. New York: Berg, 2005. 265–80.Dudley, Sandra. “Sensory Exile in the Field.” Museums Objects: Experiencing the Properties of Things. Ed. Sandra H. Dudley. Abingdon, UK: Routledge, 2012. 161–63.Feld, Steven. “Places Sensed, Senses Placed: Toward a Sensuous Epistemology of Environments.” Empire of the Senses: The Sensual Culture Reader. Ed. David Howes. New York: Berg, 2005. 179–91.Fleming, David. “Positioning the Museum for Social Inclusion.” Museums, Society, Inequality. Ed. Richard Sandell. London: Routledge, 2002. 213–24.Giménez-Cassina, Eduardo. “Who Am I? An Identity Crisis. Identity in the New Museologies and the Role of the Museum Professional.” Sociomuseology 3: To Understand New Museology in the XXI Century. Eds. Paula Assunção dos Santos and Judite Primo. Lisbon: Universidade Lusófona de Humanidades e Tecnologias, 2010. 25–42. Guarini, Beaux. Up Close and Personal: Engaging Collections alongside Adults with Vision Impairment. 2015. 17 June 2015 ‹http://nma.gov.au/blogs/education/2015/06/17/4802/›.Hauenschild, Andrea. Claims and Reality of New Museology: Case Studies in Canada, the United States and Mexico. 1988. 21 June 2015 ‹http://museumstudies.si.edu/claims2000.htm›.Hoyt, Bridget O’Brien. “Emphasizing Observation in a Gallery Program for Blind and Low-Vision Visitors: Art beyond Sight at the Museum of Fine Arts, Houston.” Disability Studies Quarterly 33.3 (2013). 23 July 2015 ‹http://dsq-sds.org/article/view/3737›.International Council of Museums. ICOM Code of Ethics for Museums. Paris: International Council of Museums, 2013. 6 June 2015 ‹http://icom.museum/the-vision/code-of-ethics/›.James, Liz. “Senses and Sensibility in Byzantium.” Museums Objects: Experiencing the Properties of Things. Ed. Sandra H. Dudley. Abingdon, UK: Routledge, 2012. 134–149.Kaitavouri, Kaija. Introduction. It’s All Mediating: Outlining and Incorporating the Roles of Curating and Education in the Exhibit Context. Eds. Kaija Kaitavouri, Laura Kokkonen, and Nora Sternfeld. Newcastle upon Tyne: Cambridge Scholars Publishing, 2013. x–xxi.Lamas, Mariana. “Lost in the Supermarket – The Traditional Museums Challenges.” Sociomuseology 3: To Understand New Museology in the XXI Century. Eds. Paula Assunção dos Santos and Judite Primo. Lisbon: Universidade Lusófona de Humanidades e Tecnologias, 2010. 42–58. Landman, Peta, Kiersten Fishburn, Lynda Kelly, and Susan Tonkin. Many Voices Making Choices: Museum Audiences with Disabilities. Sydney: Australian Museum and National Museum of Australia, 2005. Levent, Nina, and Joan Muyskens Pursley. “Sustainable Museum Acess: A Two-Way Street.” Disability Studies Quarterly 33.3 (2013). 22 July 2015 ‹http://dsq-sds.org/article/view/3742›.McGlone, Francis. “The Two Sides of Touch: Sensing and Feeling.” Touch in Museums: Policy and Practice in Object Handling. Ed. Helen Chatterjee. Oxford: Berg, 2008. 41–60.National Museum of Australia. “Stories Can Unite Us as One.” YouTube 28 May 2015. 16 Jun. 2015 ‹https://www.youtube.com/watch?v=Qwxj_rC57zM›.National Standards Taskforce. National Standards for Australian Museums and Galleries (Version 1.4, October 2014). Melbourne: The National Standards Taskforce, 2014. 20 June 2015 ‹http://www.mavic.asn.au/assets/NSFAMG_v1_4_2014.pdf›.Papalia, Carmen. “A New Model for Access in the Museum.” Disability Studies Quarterly 33.3 (2013). 23 July 2015 ‹http://dsq-sds.org/article/view/3757›.Powerhouse Museum. Living in a Sensory World: Stories from People with Blindness and Low Vision. nd. 18 Feb. 2015 ‹http://www.powerhousemuseum.com/previous/living/›.“Round Table Santiago do Chile ICOM, 1972.” Sociomuseology 4: To Think Sociomuseologically. Eds. Paula Assunção dos Santos and Judite Primo. Lisbon: Universidade Lusófona de Humanidades e Tecnologias, 2010.Royal Society for the Blind | Canberra Blind Society. Canberra Blind Society. nd. 14 Mar. 2015 ‹http://www.canberrablindsociety.org.au/›.Russell, Rosyln, and Kylie Winkworth. Significance 2.0: A Guide to Assessing the Significance of Collections. Adelaide: Collections Council of Australia, 2009. 15 June 2015 ‹http://arts.gov.au/sites/default/files/resources-publications/significance-2.0/pdfs/significance-2.0.pdf›.Sandell, Richard. “Museums and the Combatting of Social Inequality: Roles, Responsibities, Resistance.” Museums, Society, Inequality. Ed. Richard Sandell. London: Routledge, 2002. 3–23.———. "Social Inclusion, the Museum and the Dynamics of Sectoral Change." Museum and Society 1.1 (2003): 45–62.Silverman, Lois. The Social Work of Museums. London: Routledge, 2010.Thrift, Nigel. “Understanding the Material Practices of Glamour.” The Affect Theory Reader. Eds. Melissa Gregg and Gregory Seigworth. Durham: Duke UP, 2010. 289–308.Triggs, Gillian. Social Inclusion and Human Rights in Australia. 2013. 6 June 2015 ‹https://www.humanrights.gov.au/news/speeches/social-inclusion-and-human-rights-australia›. United Nations. Convention on the Rights of Persons with Disabilities. 2006. 16 Mar. 2015 ‹http://www.un.org/disabilities/default.asp?id=150?›.United Nations Educational Scientific and Cultural Organization. United Nations Educational Scientific and Cultural Organisation Round Table on the Development and the Role of Museums in the Contemporary World - Santiago de Chile, Chile 20-31 May 1972. 1973. 18 June 2015 ‹http://unesdoc.unesco.org/images/0002/000236/023679EB.pdf›.Van Mensch, Peter. Towards a Methodology of Museology. Diss. U of Zagreb, 1992. 16 June 2015 ‹http://www.muzeologie.net/downloads/mat_lit/mensch_phd.pdf›.Watson, Sheila. “Museum Communities in Theory and Practice.” Museums and Their Communities. Ed. Sheila Watson. Abingdon, UK: Routledge, 2007. 1–24.Werner, David. Nothing about Us without Us: Developing Innovative Technologies for, vy, and with Disabled Persons. Palo Alto, CA: Healthwrights, 1997.World Health Organization. Mental Health: Strengthening Our Response, Fact Sheet No. 220, Updated April 2014. 2014. 2 June 2015 ‹http://www.who.int/mediacentre/factsheets/fs220/en/›.