Health planning: the equity of the health systems agency funding allocation formula.

Abstract

The funding formula for HSAs prescribed by P.L. 93-641 is based on population. As a result, the amounts HSAs receive range from $175,000 to several million dollars. Yet all are expected to perform essentially the same tasks and the time, cost and staff expertise required are not proportional to population. There are 40 HSAs with populations of under 500,000. Of these, 14 cover over 20,000 square miles and 8 between 10,000 and 20,000 square miles. There are 9 HSAs with populations of 500,000 to 1,000,000 that also have land areas of over 20,000 square miles and densities of under 50 people per square mile. An additional 14 HSAs in this population range (10 with populations of under 600,000) and with low densities cover 10,000-20,000 square miles. It is suggested that a new funding formula based on both population and land area be devised.