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

The goal of this session, presented at the 142nd Annual Meeting of the American Public Health Association, was to learn about two models of CJS arrangements supported by the Center for Sharing Public Health Services and that involve different levels of integration. Horizon Community Health Board (Minnesota) was in the process of pursuing full integration of three existing health departments. Genesee and Orleans Counties (New York) were in the process of integrating many capacities and functions while maintaining distinct health departments with their own governance structure.

Available online (pdf): https://apha.confex.com/apha/142am/webprogram/Paper308073.html

It is included in the CJS Resource Library under the categories listed below. Select a link to find other resources in that category.

  • Accreditation / Essential Services: The presenters offer different models of cross-jurisdictional sharing that can assist local health departments in offering essential services or seeking accreditation.
  • Governance: In terms of the departments that are integrating (MN), 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. In terms of the departments sharing services but maintaining their independence (NY), initial steps have resulted in shared leadership, senior management, and some contractors. 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.

 
This resource is also linked to the Roadmap. Select a link below to read more about each area.

  • Fiscal and Service Implications / Phase Two: Some challenges to the integrating departments (MN) include establishing new fee structures, cost allocations across the participating counties, employee benefits and staffing patterns. In terms of the departments maintaining independence but sharing services (NY), cost savings are being tracked and preliminary results are impressive.
  • Governance / Phase Two: In terms of the departments that are integrating (MN), 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. In terms of the departments sharing services but maintaining their independence (NY), initial steps have resulted in shared leadership, senior management, and some contractors.