Indiana University Hillsboro County Health Department Case Study

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Getting Started

This week’s case study comes from the public health system. Hillsboro
County Health Department (HCHD) is a municipal department of the county
government and receives all its funding from the county and federal and
state grants. It is accountable to the County Commissioners. HCHD is
responsible for the public health of citizens in Hillsboro County and
accomplishes this task through the following:

  • Collecting, disseminating, and monitoring the health status of the citizens of Hillsboro County.
  • Assessing the accessibility, effectiveness, and quality of health services.
  • Serving as the county’s public health advocate.
  • Studying and reporting health problems and hazards.
  • Enforcing laws and regulations.
  • Overseeing the county’s 110-bed long-term care facility.

This week’s assignment addresses elements from your previous course
work in governance and organizational structure. It is designed to
assess your competence in strategic planning, healthcare systems, and
organizational dynamics and governance. Each are competencies identified
by employers and recognized by the American College of Healthcare
Executives (ACHE).

Upon successful completion of the course material, you will be able to:

  • Analyze and evaluate information to support a decision or recommendation.
  • Analyze potential impacts of decision making in situations both internal and external.
  • Integrate critical analysis to ensure healthcare organizational success.


  • Textbook: The Middleboro Casebook: Healthcare Strategy and Operations
  • Website: OCLS

Background Information

An independent review of HCHD described the department as operating
in five semiautonomous silos, noting the divisions should consolidate
and integrate their services. Then, they made three primary

Recommendation 1: Close the department’s Community
Health and Health Promotion division and/or the Disease Prevention
division and transfer all responsibilities and external funding to the
Community Health Division of Hillsboro Health. The agency has indicated
that it would accept these responsibilities if the transfer included a
five-year commitment for a management fee equal to 15% of the external
funding that accompanied the transfer.

Recommendation 2: Combine the department’s Community
Health and Health Promotion division and/or Disease Prevention division
in a manner that would preserve their existing services but lower their
operational costs by at least 20%. Your assessment of this
recommendation must include an assessment of programmatic impacts and an
explicit statement of the source of the financial savings.

Recommendation 3: Lower the department’s operational
expenses by 15%. Indicate a plan to achieve these savings including
specific staffing reductions.


  1. Review the rubric to make sure you understand the criteria for earning your grade.
  2. Read “Case 9: Hillsboro County Health Department” in the textbook.
  3. Review the material in the Background Information section of this page.
  4. You will be developing a case review report to address some highlighted issues.
    1. The data needed for analysis is included in the case study.
      1. You should utilize this data to provide quantitative justification for your conclusions.
    2. There needs to be, where appropriate, analysis of the data that supports your responses.
      1. Short answers to the questions will not be enough.
  5. The report should be approximately five to seven pages in length.
    1. It is to include a properly formatted title and reference page.
    2. Be sure to use proper APA formatting for headings and citation of tables and graphs.
  6. Address the following questions and provide appropriate quantitative justification to support your conclusions and recommendations:
    1. Assess each recommendation. Assume all grants are transferable.
    2. What should HCHD do and why? Endorse a recommendation.
  7. Turn in your case review report to the instructor by using the Assignment submission page by the end of the workshop.

Welcome to workshop five. This is the last workshop before students
will be preparing their final case study review in workshop six. In
this workshop, students will be assessing the various options available
to the Hillsboro County Health Department. In your response to
assignment 5.2 be sure to provide quantitative justification. Also,
remember to cite outside sources to support your thoughts and ideas.

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