Case #1974.0

Confronting a Pandemic in a Home Rule State: The Indiana State Department of Health Responds to H1N1

Publication Date: December 03, 2012
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When Indiana State Health Commissioner Dr. Judy Monroe learned of the emergence of H1N1 (commonly referred to as Swine Flu) in late April 2009, she had to quickly figure out how to coordinate an effective response within her states highly balkanized public health system, in which more than 90 local health departments wielded considerable autonomy. Over the next several months, she would come to rely heavily on relationships she had worked hard to establish with local health officials upon becoming commissioner--but she and her senior advisors would also have to scramble to find new ways to communicate and coordinate with their local partners, who represented jurisdictions that varied considerably in terms of size, population demographics, resources, and public health capacity.

Learning Objective:
This case emphasizes how state public health officials worked to coordinate a response with almost 100 independent local health units during the 2009 H1N1 pandemic. It prompts students of public administration and management to think about the challenges of intergovernmental relations within a heavily decentralized system and asks students to consider ways in which public officials can better facilitate effective collaboration for routine operations as well as for crisis events.

Other Details

Case Author:
David Giles
Faculty Lead:
Arnold Howitt
Pages (incl. exhibits):
United States