Abstract P.L. 93–641, the National Health Planning and Resources Development Act of 1974, created a network of Health Systems Agencies and placed an emphasis on consumer participation in planning. However, the formation of health planning boards is by itself no assurance of consumer participation. More than 200 HSAs have now received federal designation, and in many cases consumers have had little real participation in planning. This paper examines major obstacles to effective consumer board participation and explores ways in which they might be overcome. These obstacles are either administrative in nature, relate to disparities in knowledge among board members, or result from a lack of consumer constituency support and organization. It is concluded that, for participation to work, new initiatives are needed to increase the knowledge of consumer board members, increase public involvement in health issues and planning, and increase the number and capacity of health consumer organizations.
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