In response to growing public criticism of the way health maintenance organizations handle behavioral (mental) health problems, public officials in Philadelphia propose a dramatic initiative: a new public agency to replace what had been a privately-run system, albeit supported by public Medicaid funds. But would this be a better way to ensure that some of the city's most deeply-disturbed residents-many with drug, alcohol, and psychiatric problems, many among the ranks of the homeless-get the care they need?

The federal Equal Employment Opportunity Commission is the agency charged with investigation of non-criminal complaints of civil rights-related violations in the U.S. workplace, including racial and gender discrimination. This case describes the agency's efforts to reform its internal procedures do as to deal with a staggering backlog of complaints--nearly 100,000--and up to 19-month waits for resolution. It focuses on key strategic decisions which must set the stage for greater efficiency--particularly the issue of whether every complaint must be processed in the same manner, of whether the agency should find ways to concentrate its effort on complaints judged somehow to be more significant. HKS Case Number 1562.0