Health planning in multifunctional regional councils: Baltimore and Houston experience

This article examines the organizational context and political dynamics of health planning in the Baltimore and Houston metropolitan areas, where the comprehensive health planning (CHP) agency operated as part of a council of government. The article analyzes the intraorganizational relationships between the health planning component and its parent council and the decision making process in selected cases in both planning areas. It concludes by weighing the advantages and disadvantages of the governmental model. Some of the problems facing health planners in Baltimore and Houston are common to many public or private CHP agencies (e.g. the subjective and political basis of decision making, the limitations on CHP agency powers, attempts to circumvent requirements for 'need' assessment); but other obstacles are made more difficult (e.g., public officials vetoing planners' decisions) or overcome more easily (e.g. integration of CHP with other regional planning efforts) due to the organizational relationships with the multifunctional planning council. Thus, the examination of CHP in Baltimore and Houston provides perspectives from which to evaluate some of the advantages claimed for the governmental model as an alternative organizational form for health planning.