RESUMO
The 1947 report by Haven Emerson envisioned the widespread delivery of local public health services through organizational patterns that substituted multi-county or regional agencies for locally controlled departments. The 1971 study by Vlado Getting supported the Emerson report and suggested alternative methods to provide public health services via multi-county area health service agencies for rural areas of Illinois. The number of local agencies in the State has doubled since the mid-1960s, yet a majority of rural counties have maintained a single-county health agency rather than forming multi-county arrangements. In effect, potential economies of scale have been forfeited. In northwest Illinois, however, eight local health departments, covering both rural and urban areas, have formed a multi-county consortium to identify and meet several overlapping program needs. This Region I consortium, with a population base of 590,000, was created as a result of the 1981 Omnibus Budget Reduction Act. Through the block grants created by the act, funds became available for preventive health and health promotion activities in fiscal year 1982. Once in place, the consortium provided a cost effective means to manage the Women, Infants, and Children Supplemental Feeding Program (WIC) and some elements of family planning programs in Region I. The consortium approach offers numerous opportunities for future growth and regionalization of services.