The Analysis of Regional Expenditure Responses to Block Grants Transfer from Central Government

The implementation of fiscal decentralization in Indonesia is exactly two decades in year 2021, during this time the policies in the field of transfers to regions have developed with a significant increase in the budget. The budget increasing of transfer to regions is expected to increase the region in providing services to the community and increase development. Furthermore, the objectives of fiscal decentralization are to reduce fiscal gaps and encourage regional governments to be more independent. This study aims to determine the response or behavior of regional spending to transfer funds (block grants) from the central government. The research locus are all districts/cities in West Java, Central Java, and East Java Provinces and used a panel data equation, with variables are regional expenditure, general allocation fund (DAU), sharing allocation fund (DBH), and local revenues (PAD). The results showed that the block grant in the form of DAU encouraged an increase in regional spending. Meanwhile, DBH does not cause a flypaper effect. In the future, in order to achieve the region’s independence, the influence of the flypaper effect from the DAU should be minimized, and the exploration of potential regional revenues needs to be optimized.

The litany of suffering is still heard but not louder: A case study of clinical supervision to school libraries in Indonesia’s four provinces

From 2002 through 2004, the National Library of Indonesia distributed block grants to 250 school libraries in the province of Central Java scattered in 10 districts, 150 school libraries in West Nusa Tenggara for 7 districts, 125 school libraries in South Sumatera in 5 districts while in the province of Bangka Belitung only to one municipality covering 25 school libraries. For three years, a school library which serves only one school received a block grant of 19 million rupiahs or approximately US $2000, while (multiple) school library which serves two or more schools received 29 million rupiahs or around US 3200 all for books. Beside that, there are trainings for library staffs conducted at the province capital as well as at the districts and supervision from the National Library. After three year implementation, the National Library set up two independent teams to evaluate the school library performance, block grant awardees. The first team consists of five consultant on education and librarianship while the second one is an independent consultant bureau. Among the findings are the rise of book usages among school children, rising initiatives among teacher cum teacher in charge of library to correlate the library activities with the class programme and communities’ activities, the provision of separate building for school library especially in South Sumatera. However there anxieties on the continuation of theschool libraries after the project is over, as not all grant-receiving-districts have enough budget to provide finances for the school library operations after the project is over.

Sustainable Financing for New Vaccines in Indonesia: Challenges and Strategies

Immunization is one of the most cost-effective interventions in global health and has a crucial role in achieving 14 of the 17 sustainable development goals (SDGs). The issue of sustainable financing for new vaccines is particularly pertinent as Indonesia transitions away from extensive Gavi support towards a self-financing immunization system. As the current immunization system transitions, practical solutions must be found and applied to provide more flexibility in the budget for financing immunizations without sacrificing the current healthcare system’s needs. Despite the fact that economic evaluation studies are essential as an initial step to ensure financial readiness, the lack of reliable data is the first barrier to Indonesia’s journey toward a self-financing immunization system. To overcome this problem, standardization of data collection strategies and methodologies are required. In particular, Indonesia may have to explore other options to increase revenue for its immunization system, such as through general revenue from the central government, a sector-wide approach to financing, and a national trust fund. To deal with the tight immunization budget and its consequences, Indonesia also has to restructure its immunization system, which can be implemented through province block grants, insurance mandate and subsidy. Taking the potential of a COVID-19 vaccine into account, the Indonesian government should consider a number of costs and issues beyond the development and procurement of vaccines. The costs of delivering vaccines to the remote parts of Indonesia, implementing the necessary infrastructure, and modifying vaccine delivery are also important in this time of transition. These constraints must be addressed in the new self-financing system and other public health efforts must be increased to decrease the burden of infectious disease as Indonesia develops a stronger immunization system.

Improving Outcome Accountability of Block Grants: Lessons Learned From the Preventive Health and Health Services Block Grant Evaluation

The flexibility federal block grants provide recipients poses challenges for evaluation. These challenges include aggregating data on wide-ranging activities grant recipients implement and the outcomes they achieve. In 2014, we began designing an evaluation to address the challenges of assessing outcomes and to improve outcome accountability for the Preventive Health and Health Services Block Grant. Through the use of evaluability assessment methodology, review of existing data and the literature, and key informant interviews, we developed a measurement framework to assess outcomes resulting from recipients’ ability to use grant funds to meet their locally prioritized needs. We argue our evaluation approach demonstrates that block grants, and other similarly flexible programs, can be evaluated through appropriately designed measures. Our efforts challenge the idea that flexibility presents an insurmountable barrier to evaluation and outcome accountability for federal block grants.

The Rise of Block-Granting as a Tool of Conservative Statecraft

This article sheds new light on how conservatism has affected American state development by tracing the history of how block-granting transformed from a bipartisan tool to solve problems of public administration in the 1940s into a mechanism to roll back and decentralize the welfare state that had reached its zenith in the 1960s. By the early 1980s, conservative policymakers had coopted the previously bipartisan tool in their efforts to chip away at the increasingly centralized social welfare system that emerged out of the Great Society. In the early 1980s, Ronald Reagan successfully converted numerous categorical grants into a series of block grants, slashing funding for several social safety net programs. Block-granting allows conservative opponents of the postwar welfare state to gradually erode funding and grant more authority to state governments, thus using federalism as a more palatable political weapon to reduce social welfare spending than the full dismantlement of social programs. However, despite a flurry of successes in the early 1980s, block-granting has not proven as successful as conservatives might have hoped, and recent efforts to convert programs such as Medicaid and parts of the Affordable Care Act into block grants have failed. The failure of recent failed block grant efforts highlights the resilience of liberal reforms, even in the face of sustained conservative opposition. However, conservatives still draw upon the tool today in their efforts to erode and retrench social welfare programs. Block-granting has thus transformed from a bipartisan tool to improve bureaucratic effectiveness into a perennial weapon in conservatives’ war on the welfare state.

Pursuing Medicaid Block Grants with the Healthy Adult Opportunity Initiative: Dressing Up Old Ideas in New Clothes

The Trump administration’s “Healthy Adult Opportunity” waiver follows a long history of Republican attempts to retrench the Medicaid program through block grants and to markedly reduce federal spending while providing states with substantially greater flexibility over program structure. Previous block grant proposals were promulgated under the presidential administrations of Ronald Reagan and George W. Bush, and congressional majorities in Congress, led by House Speaker Newt Gingrich and the House Budget Committee and then Speaker Paul Ryan. Most recently, Medicaid block grants featured prominently in Republican efforts to repeal and replace the Affordable Care Act. This essay traces the history of Republican Medicaid block grant proposals, culminating in the Trump Administration’s Healthy Adult Opportunity initiative. It concludes that the Trump administration’s attempt to convert Medicaid into a block grant program through the waiver process is illegal and, if implemented, would leave thousands of people without necessary medical care. This fact, combined with failed legislative efforts to block grant Medicaid over the last forty years, highlights the substantial roadblocks to radically restructuring a popular program that helps millions of Americans.