142nd APHA Annual Meeting and Exposition

Annual Meeting Recordings are now available for purchase

Sharing Public Health Functions and Capabilities: Models of Full and Partial Integration

142nd APHA Annual Meeting and Exposition (November 15 - November 19, 2014): http://www.apha.org/events-and-meetings/annual
Wednesday, November 19, 2014 : 1:30 PM - 1:50 PM

Kenneth Oakley, PhD, MS, MBA, FACHE , Lake Plains Community Care Network, Batavia, NY
Sandy Tubbs, RN, PHN , Douglas County Public Health, Alexandria, MN
Increasingly, local health officials and policymakers are turning to shared public health functions and capabilities across political boundaries as a means of increasing efficiencies and effectiveness.  The Center for Sharing Public Health services, funded by the Robert Wood Johnson Foundation, supports and captures the learning from 16 teams across the country that are engaged in a range of activities related to exploring, developing, implementing, and/or improving cross-jurisdictional sharing (CJS).  The goal of this session is to learn about two models of CJS arrangements that are supported by the Center and involve different levels of integration.

Fully integrating two or more health departments’ capacities and functions is a fairly daunting task, made more so as the number of health departments increases.  Horizon Community Health Board (Minnesota) is in the process of pursuing full integration of three existing health departments.  Leadership has made a commitment to staff that they all will be offered a position in the newly established organization; all existing facilities will continue to be used; and a new governance and financing structure is being developed.  Some challenges include establishing new fee structures, cost allocations across the participating counties, employee benefits and staffing patterns.

Genesee and Orleans Counties (New York) are in the process of integrating many capacities and functions while maintaining distinct health departments with their own governance structure.  Initial steps have resulted in shared leadership, senior management, and some contractors.  Now that labor issues have been successfully resolved, a next step will be to phase in shared field staff.  Some challenges include understanding how to provide shared leadership in a manner that satisfies all stakeholders, aligning current policies and practices, and institutionalizing collaboration between the governance structures.  Cost savings achieved through this arrangement are being tracked and preliminary results are quite impressive.

Learning Areas:

Administration, management, leadership
Public health or related organizational policy, standards, or other guidelines
Public health or related public policy

Learning Objectives:
Describe three challenges to successfully transition health departments into a new, single entity. Describe a partially integrated model of sharing public health capacities and functions. Describe three challenges to successfully develop a partially integrated model of CJS

Keyword(s): Leadership, Local Public Health Agencies

Presenting author's disclosure statement:

Qualified on the content I am responsible for because: Sandy Tubbs, RN, PHN, has been Director of Douglas County Public Health since 2001 and also serves as Director of Stevens Traverse Grant Public Health. She has over 25 years’ experience working in local public health as well as nearly 20 years’ experience in public health administration. Ms. Tubbs is an active member of the Local Public Health Association of MN, having served in several leadership positions including its Chairperson in 1997.
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.