A public health department in a community without Medicaid ; organizational response to multi-functional responsibility

Abstract

Public health care institutions and especially public health agencies have been the focus of concern and consternation. The organizational development of the Department of Health Services in Maricopa County, Arizona, is described in which the Division of Public Health assumed broad responsibilities in the provision of primary care services. Both the organizational structure and the management system developed to support it have allowed the Division to maintain responsiveness, flexibility, and accountability in meeting its multiple functional responsibilitie