142nd APHA Annual Meeting and Exposition

Annual Meeting Recordings are now available for purchase

Public health cross jurisdictional sharing: The rural New York experience

142nd APHA Annual Meeting and Exposition (November 15 - November 19, 2014): http://www.apha.org/events-and-meetings/annual
Wednesday, November 19, 2014 : 12:50 PM - 1:10 PM

Donald W. Rowe, PhD , Office of Public Health Practice, University at Buffalo, School of Public Health and Health Professions, Buffalo, NY
Paul Pettit, MSL , Genesee and Orleans County Health Departments, Batavia, NY
Kenneth Oakley, PhD, MS, MBA, FACHE , Lake Plains Community Care Network, Batavia, NY
Suman Sarker , School of Public Health and health Professions, University at Buffalo, Buffalo, NY
Under enormous fiscal pressures, health departments at the state and local level are seeking innovative solutions that preserve essential public health services, reduce cost and increase efficiency. Rural health departments are disproportionally impacted.  The Robert Wood Johnson Foundation’s Cross Jurisdictional Sharing (CJS) grant program is exploring promising strategies that address these issues. Cross jurisdictional sharing arrangements range from informal agreements around sharing discrete services or programs, to regionalization including the formal merger or consolidation of multiple public health agencies. In New York State, the process began  prior to the CJS grant, with regulatory relief that enabled two or more county health departments to share a common Commissioner or Public Health Director. Genesee and Orleans Counties are rural and demographically similar with a combined population of just over 100,000 and were the first to adopt this strategy resulting in substantial cost savings to both counties. With CJS grant funding it was possible to evaluate the potential for sharing additional resources and service integration. This paper is a year 1 progress report that will articulate the rigorous planning process, early successes, challenges, and planned next steps.  Preliminary results are encouraging from both a cost and efficiency perspective. Combined savings in shared personnel, transportation and contracting expenses derived from joint policy and procedural changes exceeded $340,000 without any decrease in service to both counties.  Political, regulatory and labor issues are under discussion and will shape the direction of the program in year 2 and beyond.

Learning Areas:

Administration, management, leadership
Conduct evaluation related to programs, research, and other areas of practice
Program planning
Public health administration or related administration
Public health or related organizational policy, standards, or other guidelines
Public health or related research

Learning Objectives:
Describe the cross jurisdictional sharing process List three cost center savings Discuss three challenges that will shape future sharing activities Formulate action plans based on lessons learned

Keyword(s): Public Health Administration, Health Systems Transformation

Presenting author's disclosure statement:

Qualified on the content I am responsible for because: Paul Pettit is the Public Health Director for Genesee and Orleans County Health Departments and lifelong resident of Orleans County, New York. He's been with the Orleans County Health Department 15 years and in 2012 became Director over both the Genesee and Orleans County Health Departments through a CJS service project. Paul has a BS degree from the University of Rochester in Environmental Health Sciences and MS degree in Strategic Leadership from Roberts Wesleyan College.
Any relevant financial relationships? No

I agree to comply with the American Public Health Association Conflict of Interest and Commercial Support Guidelines, and to disclose to the participants any off-label or experimental uses of a commercial product or service discussed in my presentation.