The division of the executive branch of government into agencies, departments, boards and commissions is not static: over the course of time in any one state, units are expanded, contracted, created and eliminated. In 1989, Washington state re-established a Cabinet-level Department of Health. The set of decisions made by the Washington legislature and governor included certain programs in the new Department, and excluded others. This study examines these decisions. It combines concepts from organizational theory and political science in a framework which better explains the decisions made than either viewpoint taken alone. This case study used an iterative process combining literature review from both fields and interviews with participants in the Washington State process. No initial theoretical framework or testable hypothesis was advanced. Initial review of several areas of political science and management literature suggested possible areas for exploration. Informants were selected from the executive and legislative branches of government, and from interested associations and local governments. Conceptual perspectives of contingency theory, transaction costs, agenda setting, interest groups and controlling bureaucracy were found to be of value. These were combined into a three stage process model which describes the movement from the emergence of an idea for reorganization, through boundary setting on the potential components, to the legislative action resulting in a redesigned agency. At each stage, different actors dominate the process, and the forces driving decisions shift. This combined model encourages more deliberate and complex analysis of state reorganizations. While providing a useful framework for practitioners engaged in reorganizations, the model should also be subjected to testing in multiple instances to identify gaps and strengthen its usefulness.Dr.P.H.Health PolicyUniversity of Michigan, Horace H. Rackham School of Graduate Studieshttp://deepblue.lib.umich.edu/bitstream/2027.42/104575/1/9532446.pdfDescription of 9532446.pdf : Restricted to UM users only