The hidden price tag: participation costs and health planning.

The citizen participation program of the Los Angeles County Health Systems Agency represents one of the most ambitious efforts at implementing the public involvement provisions of PL 93-641. The first year of this program is discussed and analyzed through a participation costs theoretical framework. Specific costs which are inherent in the organizational design and introduced by the implementation procedures adopted are identified and discussed. Levels of participation after one year of operation are examined and found consistent with the high cost of participation in this program.