Assessment Tool for Public Health Existing CJS Arrangements: Detailed Survey

What is it? A self-administered survey designed to allow potential CJS partners a detailed and specific understanding of existing shared service arrangements among potential partners.

When can I use it? When detailed information is required for specific sharing decisions and discussions, this survey will provide detailed information about agreements, their purposes, and their characteristics that may provide helpful information to agencies in exploring or planning sharing initiatives. It will be most useful when utilized at the very beginning of any CJS planning process. The information collected can also generate suggestions for realignment and improvements of some of the existing sharing agreements.

How do I use it? One survey should be completed by each of the public health agencies involved in the cross‐jurisdictional sharing activities of interest. The length of administration will vary with the number of shared services being described, but is expected to take about 30 minutes to complete. If the information needed to complete the survey is not readily available, the time necessary may increase.

What is next? This survey is easier to administer and analyze if it is done electronically. For assistance in setting up an electronic version of the survey or for any other questions, please contact Gianfranco Pezzino at The results from each partner should be discussed and compared so that areas of inconsistency in understanding and/or preexisting relationships between partners can be known by all partners. Additional tools are available from the Center for Sharing Public Health Services to help partners examine and discuss important factors in designing their CJS agreements.

We are offering this tool in two different formats. Print the PDF if you want to use the survey as written. Select the Word file if you want to make changes to the survey before distributing it.

Assessment Tool – Existing CJS Arrangements: Detailed Survey (PDF)

Assessment Tool – Existing CJS Arrangements: Detailed Survey (Microsoft Word)