Kansas Regionalization Project
Kansas is the 15th largest state in the United States with respect to square mileage and ranks 33rd with respect to population size. With a population of approximately 2.8 million people, it is one of the least densely populated states in the country. There are 105 counties that make up the state, only 14 of which are considered urban or semi-urban (6 and 8 respectively). The remaining 91 counties are a mixture of rural and frontier counties.
Like other local governmental services, local public health departments in Kansas are funded largely through county tax dollars. As a result, local public health services are directly impacted by population sizes. Rural and frontier counties have had to contend with decreases in county funds as a result of a declining tax base while simultaneously experiencing an increase in responsibilities for protecting the public's health and grappling with newly defined national standards for local public health departments.
The impetus for discussions about regionalization in Kansas has stemmed from the belief that "all people, no matter where they live in Kansas, should reasonably expect to have their health protected with a standard level of public health services." The concept of "regional cooperation" encompasses the belief that the locally-governed health departments must remain intact, and that some (not all) public health responsibilities are best fulfilled across jurisdictions. Kansas' initiative to gradually implement regional cooperation was supported by NACCHO's project, in which local health officials in the North Central Region and Northeast Corner Region agreed to pilot a process to collaboratively identify and address region-wide gaps. This effort addressed legal and financial considerations and implemented a robust communications plan to engender awareness and support among key stakeholders. Learn more about this project from the Kansas case study.
The Kansas Association of Local Health Departments (KALHD) continues to provide leadership for this initiative, with a number of activities that extend beyond the NACCHO-supported project. Visit the KALHD Web site for additional information.