Background and Drivers for Cross-Jurisdictional Sharing

“Cross-jurisdictional sharing” (CJS) refers to the spectrum of shared approaches to public health service delivery, ranging from sharing a single service, to consolidation or merger of two or more LHDs, and the many variations in between. Increasingly, public health leaders are looking to CJS as a means for multiple local health departments (LHDs), often small and/or rural, to work collaboratively to provide services that meet the needs of their communities, respond to budget pressures and, in some cases, jointly meet the accreditation standards. The current economic crisis has led many policymakers to consider various CJS models as a strategy for cost-savings –often without a working understanding of governmental public health responsibilities and without assessing implications of their decisions on public health. Using a systems-based approach, it is possible to successfully address and accommodate the different drivers that lead public health leaders and policymakers to develop CJS arrangements. The presenting author, a policymaker involved in CJS planning, implementation and revision/expansion of existing CJS arrangements, will describe why he/her decided to explore/pursue CJS, his/her role in CJS activity, challenges, opportunities, successful strategies, and lessons learned from efforts to date. (This panelist will be selected from sites funded by RWJF through a new CJS initiative; selections will be made in August 2012.)