Abstract
Israel, like numerous other countries, has experienced the extension of local autonomy and the expansion of non-governmental service providers. Expectations are that there will be pay-offs in terms of economy, efficiency, and service quality. The claims are not accepted universally with respect to normal times. A regional emergency presents a severe test of coordination among organizations with a high degree of autonomy, and the provision of health and other social services to individuals unable to care for themselves. Israel's experience shows both widespread problems among the service providers, and some compensating actions by new participants.
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