THIS study examines the relation of policy making and program implementation in providing health services to rural medically underserved areas in the United States. In 1975, the Bureau of Community Health Services (BCHS) developed an in-house initiative for integrating the resources under its administrative control to improve health care service capacity in the community. Among the resources it used were those of several legislatively mandated programs such as migrant health centers, family planning, community health centers, and the National Health Service Corps (NHSC). Initially, there was strong support for this integrated approach. Both the executive and legislative branches of government saw the need to end fragmentation of effort and the duplication of services. However, the in-creasing number of integrated sites and Corps physicians has, in the past couple of years, led to a re-examination of Congressional intent. The result has been increasing criticism of the Rural Health Initiative (RHI) approach. Since the RHI is a logical response to the administrative inefficiencies and low retention rates experienced in the National Health Service Corps, why is there such criticism that it threatens the future of the initiatives of the BCHS?. © 1982 Journal of Public Health Policy, Inc.

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rural hygiene geographic distribution Health Policy Medically Underserved Area rural health Health Plan Implementation health care policy therapy Financing, Government United States Community Health Centers National Health Programs