On April 20, 2010 an explosion rocked the Deepwater Horizon drilling rig in the Gulf of Mexico 41 miles off the coast of Louisiana. BP was using the Deepwater Horizon to drill an "ultra-deep" offshore well. The explosion was the result of a "blowout" of the wellhead at the seabed of the Gulf of Mexico, 5,000 beneath the drilling rig. BP was unable to cap the leaking well for nearly 3 months while oil spilled out of the wellhead at a rate of 35,000 to 60,000 barrels per day. By late May, thick crude was fouling Louisiana, Alabama and Florida coastal marshes and beaches. Tourism revenues fell and thousands of miles of fishing grounds were closed. BP was finally able to seal the well (temporarily) on July 14 and then permanently seal the well in September. By that time, an estimated 4.9 million barrels (207 million gallons) of oil had been spilled and nearly 700 miles of coastline had been oiled. Years of damage assessments, restoration projects, claims and lawsuits lay ahead. This case is designed for use in classroom discussions that analyze and dissect the problem and the actions taken. The oil spill disaster and response is analyzed in terms of: (1) situational awareness (cognitive biases in identifying and understanding the magnitude and ramifications of disasters), (2) the concept of "responsible party" and liability in environmental law, (3) the novelty and size of disasters and the scalability of response efforts, (4) the response structure used to manage oil spills, (5) the role of government vs. the private sector "responsible party" in managing the cleanup of environmental accidents, (6) the tensions between local, state and federal governments in managing a crisis, (7) leadership during crisis, (8) disasters as political events, (9) the challenges of managing public perception and expectations during a crisis, (10) the role of public opinion in the shaping of responses to disasters, and (11) the role of the media in shaping the "narrative" of disasters.
Like many other states at the time, Minnesota found itself facing several serious long-term public health challenges in the mid- and late-2000s, including rapidly rising health care costs and residents' increasing vulnerability to chronic diseases arising from unhealthy behaviors like smoking as well as higher obesity rates. Compounding these challenges, in 2008 a major economic recession took hold across the country, prompting states to target health and human services programs for extensive budget cuts. In Minnesota, even as the recession started to subside, analyses of the state budget indicated that it needed new strategies for slowing the growth rate of health care spending; and in response the state legislature passed a major health reform law that, among other things, aimed to reduce costs. A key component of this law was the establishment of the Statewide Health Improvement Program (SHIP), which sought to reduce smoking and obesity rates - two of the main drivers of a number of chronic diseases and, hence, of higher long-term health costs for the state. In designing and launching SHIP, state health officials decided to focus on developing a close partnership with the private sector. This, they believed, would enable them to combine government's wide ranging authorities and subject matter expertise in public health with the private sector's broad reach and its advanced marketing and communication practices and resources. This case tells the story of how leaders of the SHIP initiative worked with businesses and corporate executives in an effort to have as far-reaching an impact as possible. It highlights the mutual advantages of a public-private partnership while also illustrating challenges the two sides encountered as they worked to develop and implement the program. HKS Case Number 2004.0.
By the mid-2000s, Washington State's Department of Health (DOH) had earned a national reputation as an innovative and effective agency. But beginning in 2005, when newly elected Governor Christine Gregoire introduced a state-level performance management system - Government Management Accountability and Performance (GMAP) - DOH and other state entities found themselves having to regularly explain and justify their work through the newly established forum. Based on two similar, but smaller-scale programs - CompStat (created by the New York Police Department in 1994) and CitiStat (used by the City of Baltimore) - GMAP challenged public officials to analyze data in new ways and to rethink the kinds of results that they were accountable for delivering. This case provides background on GMAP's origins and on the general ways in which the initiative was managed, but it focuses primarily on DOH's efforts to comply with the new performance measurement requirements and to meet the expectations of the governor, her staff, and GMAP leadership. In exploring the benefits and challenges of the department's experience with GMAP, the case also raises questions about the applicability and usefulness of such a system for public health, which tends to address complex issues with objectives that are often difficult to quantify. Case number 1994.0
In 2006, with healthcare costs and the number of uninsured rising, Massachusetts passed landmark legislation that aimed to provide health insurance to everyone in the state. A product of bipartisan collaboration between a legislature dominated by Democrats and a Republican governor, the law contained several major innovations, including: mandates requiring residents to purchase health insurance and businesses to contribute toward employees' health care costs; programs to offer subsidized health insurance plans to low-income residents and to help wealthier individuals and small businesses buy coverage from private providers; and an expansion of the state's Medicaid program to cover more children in low-income families. This case explores some of the initial successes of the law's implementation, but also describes a number of challenges associated with it- not least of which was that within a year of the law's passage, Massachusetts, along with the rest of the nation, would endure a severe and protracted recession. Worsening economic conditions not only led to worries about the cost of expanding healthcare coverage, but also had serious implications for wellness initiatives and public health programs, which faced dramatic budget cuts. Exploring both the policy innovations of the law and the negative consequences of a poor economy, the case raises a number of points about the potential benefits of near-universal healthcare - while highlighting some officials' concerns that an overemphasis on expanding coverage could detract from other investments in public health programming. Case number 1995.0
On January 15, 2009, shortly after takeoff from LaGuardia Airport, US Airways Flight 1549 struck a flock of Canada geese. The geese were then sucked into the plane's twin engines, causing total engine failure and the loss of power. Case A of this three-part series recounts how over the following four minutes, Flight 1549's Captain Chesley "Sully" Sullenberger and First Officer Jeffrey Skiles grappled with a variety of extreme challenges. Not only did they have to keep the plane under control, but they also had to quickly decide whether they could make an emergency landing at a nearby airport - or find another alternative to get the plane down safely in one of the most crowded regions in the country. Cases B and C then describe how, after the plane landed in the cold waters of the Hudson River, emergency responders from many agencies and private organizations - converging on the scene without a prior action plan for this type of emergency - scrambled to both rescue passengers and crew and stabilize the aircraft as it began to move downstream. Case Number 1966