I agree with Warren that a balance between "strategic directions" and local responsiveness and innovation must be created - and that the balance right now is slanted toward the planners, funders, highly paid consultants who set the directions (with or without input from the local innovators). However, what can we do about it? If we are in the role of the planners, what shoudl we do differently? If we are in the role of the local innovator, how can we leverage our networks, our evidence, even our charisma, to be able to use the funding more aptly? Maybe this is a follow up article....