title: Regionalization: collateral benefits of emergency preparedness activities.
abstract: BACKGROUND
  To assess the impact of regionalization of Kansas counties associated with emergency preparedness since 2002 via local health departments (LHDs).
  
  
  METHODS
  Three focus groups were conducted in May 2005 with 31 Kansas health department employees. Most participants were public health administrators, women, and 40 years or older.
  
  
  RESULTS
  Regionalization was perceived as "absolutely necessary" by participants and resulted in improved collaboration and communication among LHDs. The process supported the development of relationships, trust, and mutual respect among LHDs and other governmental agencies. Participants agreed that LHD functioning has improved the delivery and availability of public health services, increased the efficiency and timeliness of operations, and enhanced public health's visibility in emergency preparedness efforts. Moreover, regionalization added resources to LHDs including personnel, knowledge, technology, technical expertise, and fiscal resources. Dissatisfaction with regionalization was associated with insufficient funding, frustration with changing preparedness guidelines, and differences between state and local expectations. Participants identified four issues necessary to sustain regions: funding, documented benefits, commitment from LHDs and their communities, and engagement from local elected officials.
  
  
  CONCLUSIONS
  The regionalization process has been beneficial for LHDs and produced tangible and intangible benefits. Barriers to regionalization expansion should be addressed for additional collaborative ventures.
authors.affiliation: Department of Preventive Medicine and Public Health, University of Kansas School of Medicine, Wichita, KS 67214, USA. rwettaha@kumc.edu
authors.forename: Ruth
authors.initials: R
authors.lastname: Wetta-Hall
authors.forename: Gina M
authors.initials: GM
authors.lastname: Berg-Copas
authors.forename: Elizabeth
authors.initials: E
authors.lastname: Ablah
authors.forename: Mary Beth
authors.initials: MB
authors.lastname: Herrmann
authors.forename: Susan
authors.initials: S
authors.lastname: Kang
authors.forename: Shirley
authors.initials: S
authors.lastname: Orr
authors.forename: Craig
authors.initials: C
authors.lastname: Molgaard
mesh_terms: D000328:Adult; D003142:Communication; D003299:Cooperative Behavior; D004189:Disaster Planning / Q000458:organization & administration*; D005260:Female; D005380:Financing, Government; D017144:Focus Groups; D006801:Humans; D007373:Interinstitutional Relations; D007615:Kansas; D009111:Local Government; D008297:Male; D008875:Middle Aged; D015980:Public Health Practice; D012040:Regional Health Planning / Q000458:organization & administration*