Regional Approaches to Public Health Service Delivery: Possibilities and Politics

Sharing services across local public health agencies is an approach for agencies to deal with the challenges of economic pressures, an aging workforce, and public health accreditation on the provision of public health services in rural communities. In Colorado, no local public health agencies have merged into district agencies in more than 60 years. However, a variety of “regional approaches” have been developed over time, in the form of sharing services, staff and funds across agencies. Until work over the past two years, these approaches had not been cataloged, mapped and analyzed. The Colorado Association of Local Public Health Officials and Colorado Department of Public Health and Environment have worked to understand the legal and political influences on the development and maintenance of regional approaches through projects including an agency annual reporting process, survey and key informant interview research, and a site visit-based assessment project. Combined, these projects, provide a multi-layered view of the regional approaches in Colorado, as well as insight into the influences and barriers to providing shared services. This presentation will highlight various types of regional approaches, describe the legal and political influences of current approaches and discuss potential approaches from the system level.