In a matter of minutes on the afternoon of April 27, 2011, a massive and powerful tornado leveled 1/8 of the area of Tuscaloosa, AL, a city of approximately 90,000 people and home to the University of Alabama. Doctrine called for the County Emergency Management Agency (EMA) to take the lead in organizing the response to the disaster - but one of the first buildings destroyed during the event housed the County EMA offices, leaving the agency completely incapacitated. Thus, in the minutes and hours following the tornado, the City of Tuscaloosa found itself largely on its own as it began implementing a response. Fortunately, the city had taken several steps in the preceding years to prepare for responding to a major disaster. This included having sent a delegation of close to 70 city officials and community leaders, led by Tuscaloosa Mayor Walter Maddox, to a week-long training organized by FEMA. "Ready in Advance" reveals how that training, along with other preparedness activities undertaken by the city, would pay major dividends in the aftermath of the tornado, as the mayor and his staff - coordinating with an array of local, state, and federal counterparts - set forth to respond to one of the worst disasters in Tuscaloosa's history. Case number 2056.0
When Dr. John Kitzhaber became Oregon's Governor in January 2011, the state faced a reported $2 billion deficit in the state's Medicaid budget. Consequently, Kitzhaber, working in partnership with his top health policy advisors and an array of stakeholders, undertook a multi-year effort to transform the state's Medicaid delivery system. At the time, that system consisted of separate managed care organizations for different kinds of providers; but in July 2012 the state unveiled its first coordinated care organizations (CCOs), local "umbrella" groups that would bring together an area's health care providers in a single managed care setting. The case details the effort to design, implement, and begin to evaluate CCOs. After providing background on the history of health care reform in Oregon and the recent passage of the federal Affordable Care Act, it overviews the effort to bring together an array of local stakeholders to develop a blueprint for CCOs, the subsequent focus on gaining approval for CCOs from the state legislature and federal government, and finally the process of implementing CCOs and beginning to gauge their impact. The case concludes in March 2015 when Governor Kitzhaber resigned amid concerns about the state's efforts to establish Cover Oregon, the organization set up to create the state's health insurance exchange under the federal Affordable Care Act.
In spring 2009, North Dakota experienced some of the worst flooding in state history. This case describes how the state's National Guard responded by mobilizing thousands of its troops and working in concert with personnel and equipment from six other states as well as an array of federal, state, and local stakeholders. Specifically, after providing background on the North Dakota National Guard and the state's susceptibility to flooding, the case captures how Guard officials developed and practiced a plan ("Operation Rollback Water") to respond to the floods and how they then had to adapt that plan as the crisis escalated and conditions changed. In particular, the Guard had to work with a large amount of federal resources that arrived amid the crisis, it had to respond to demands for extensive and rapid assistance from a range of municipalities, and it had to endure a prolonged event that taxed Guard members in the field and the operations and management team that supported them. The case concludes with an epilogue that describes how the Guard applied the lessons it learned from the 2009 floods in response to a similar disaster in 2011.
In spring 2009, North Dakota experienced some of the worst flooding in state history. This case describes how the state's National Guard responded by mobilizing thousands of its troops and working in concert with personnel and equipment from six other states as well as an array of federal, state, and local stakeholders. Specifically, after providing background on the North Dakota National Guard and the state's susceptibility to flooding, the case captures how Guard officials developed and practiced a plan ("Operation Rollback Water") to respond to the floods and how they then had to adapt that plan as the crisis escalated and conditions changed. In particular, the Guard had to work with a large amount of federal resources that arrived amid the crisis, it had to respond to demands for extensive and rapid assistance from a range of municipalities, and it had to endure a prolonged event that taxed Guard members in the field and the operations and management team that supported them. The case concludes with an epilogue that describes how the Guard applied the lessons it learned from the 2009 floods in response to a similar disaster in 2011.
In spring 2009, North Dakota experienced some of the worst flooding in state history. This case describes how the state's National Guard responded by mobilizing thousands of its troops and working in concert with personnel and equipment from six other states as well as an array of federal, state, and local stakeholders. Specifically, after providing background on the North Dakota National Guard and the state's susceptibility to flooding, the case captures how Guard officials developed and practiced a plan ("Operation Rollback Water") to respond to the floods and how they then had to adapt that plan as the crisis escalated and conditions changed. In particular, the Guard had to work with a large amount of federal resources that arrived amid the crisis, it had to respond to demands for extensive and rapid assistance from a range of municipalities, and it had to endure a prolonged event that taxed Guard members in the field and the operations and management team that supported them. The case concludes with an epilogue that describes how the Guard applied the lessons it learned from the 2009 floods in response to a similar disaster in 2011.
In summer 2010, unusually intense monsoon rains in Pakistan triggered slow-moving floods that inundated a fifth of the country and displaced millions of people. This case describes how Pakistan's government responded to this disaster and highlights the performance of the country's nascent emergency management agency, the National Disaster Management Authority. It also explores the integration of international assistance, with a particular focus on aid from the international humanitarian community and the U.S. military. Case number 2015.0
In late 2008, government officials in Summit County, Ohio began to discuss the possibility of combining the county's three public health districts. These early discussions set the stage for more than two years of negotiations that eventually led to the consolidation of the health departments in late 2010 and early 2011. This case tells the story of why and how officials in Summit County combined their public health districts and includes an epilogue that describes the consolidated agency's first year of operations. Case number 1987.0
In late 2008, government officials in Summit County, Ohio began to discuss the possibility of combining the county's three public health districts. These early discussions set the stage for more than two years of negotiations that eventually led to the consolidation of the health departments in late 2010 and early 2011. This case tells the story of why and how officials in Summit County combined their public health districts and includes an epilogue that describes the consolidated agency's first year of operations. Case number 1987.1
On one side, a loose network of protesters made arrangements for dramatizing their opposition to the WTO and international trade practices. At the same time, public safety officials from local, state, and federal agencies developed security plans for the public areas near the locus of the ministerial meetings. Their aim was to ensure that the talks proceeded smoothly while preserving the activists' rights to peaceful protest. Throughout the planning process, local leaders operated on the assumption that the tolerant ethos of the Pacific Northwest would prevail. This assumption proved terribly wrong, however, when, on the opening day of the talks, law enforcement officials lost control of the crowds gathered outside the meeting venue. Readers are asked to consider what lessons can be drawn from this ultimately inadequate security planning process. How might security planners have thought differently about how to prepare for the conference? What should they have anticipated in advance? How could they have developed a better awareness of protesters' activities and plans? HKS Case Number 1897.1
On one side, a loose network of protesters made arrangements for dramatizing their opposition to the WTO and international trade practices. At the same time, public safety officials from local, state, and federal agencies developed security plans for the public areas near the locus of the ministerial meetings. Their aim was to ensure that the talks proceeded smoothly while preserving the activists' rights to peaceful protest. Throughout the planning process, local leaders operated on the assumption that the tolerant ethos of the Pacific Northwest would prevail. This assumption proved terribly wrong, however, when, on the opening day of the talks, law enforcement officials lost control of the crowds gathered outside the meeting venue. Readers are asked to consider what lessons can be drawn from this ultimately inadequate security planning process. How might security planners have thought differently about how to prepare for the conference? What should they have anticipated in advance? How could they have developed a better awareness of protesters' activities and plans? HKS Case Number 1897.0