Lessons Learned from a Regional Strategy for Resource Allocation

Abstract

Two qualitative case studies focus on the allocation of CDC funds distributed during 2002 for bioterrorism preparedness in two Texas public health regions (each as populous and complex as many states). Lessons learned are presented for public health officials and others who work to build essential public health services and security for our nation. The first lesson is that personal relationships are the cornerstone of preparedness. A major lesson is that a regional strategy to manage funds may be more effective than allocating funds on a per capita basis. One regional director required every local department to complete a strategic plan as a basis for proportional allocation of the funds. Control of communicable diseases was a central component of the planning. Some funds were kept at the regional level to provide epidemiology services, computer software, equipment, and training for the entire region. Confirmation of the value of this regional strategy was expressed by local public health and emergency management officials in a focus group 1 year after the strategy had been implemented. The group members also pointed out the need to streamline the planning process, provide up-to-date computer networks, and receive more than minimal communication. This regional strategy can be viewed from the perspective of adaptive leadership, defined as activities to bring about constructive change, which also can be used to analyze other difficult areas of preparedness.

Process Evaluation of a Regional Public Health Model to Reduce Chronic Disease Through Policy and Systems Changes, Washington State, 2010–2014

“…Early buy-in and ongoing involvement from local political and public health leaders is essential for effective implementation of regional public health work. Common facilitators to regional work include a strong history of personal and professional relationships, strong leadership, shared infrastructure, common vision and goals, open communication, clear memorandums of understanding or written agreements between regional partners, and the ability to leverage additional funding to support participation ( 2 , 5 ).…”

“…Public health experts believe regional work can support increased efficacy and efficiency because larger public health delivery systems generally maintain stronger performance measures ( 4 ). Providing greater funding to fewer jurisdictions can also be cost effective ( 2 , 5 ); resource-sharing can eliminate duplication and increase the ability to address challenges that cross jurisdictional boundaries ( 4 ).…”

Systematic Assessment of Nation-Statess Motivations and Capabilities to Produce Biological Weapons

“…Such programs are explicitly permitted by the BWC, and work mainly on novel vaccines [9], early attack detection [43], treatment and protective equipment. These programs also investigate techniques for the early detection of BW attacks [30,34] and the effectiveness of different response measures [8,15]. Besides limiting the damage due to a possible BW attacks, defensive BW programs also reduce the attractiveness of biological attacks by opponents.…”