At Indiana State Health Commissioner Dr. Judy Monroe to learn about the appearance of the virus H1N1 (commonly known as "swine flu") in late April 2009, she had to quickly figure out how to coordinate an effective response to her state highly fragmented health care system, in which more than 90 Local health departments have considerable autonomy. Over the next few months, it will come to rely heavily on the relationships she worked hard to establish with local health authorities became commissioner - but she and her senior advisors also have to struggle to find new ways to communicate and coordinate with their local partners, which are jurisdictions that are significantly different in size, population, resources and the capacity of public health. Case Number 1974.0 "Hide
by David Giles, Arnold Howitt Source: Harvard Kennedy School 21 pages. Publication Date: December 3, 2012. Prod. #: HKS728-PDF-ENG
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