CJS Implementation and Impact Measurement Program

The Center for Sharing Public Health Services has selected four sites to participate in its new CJS Implementation and Impact Measurement Program, which focuses on calculating the impact that CJS initiatives can have on public health functions and programs.

The sites, which were selected through a competitive process, will conduct baseline and follow-up measurements to show if a CJS approach allows them to improve effectiveness and efficiency in the delivery of selected public health services. The sites may measure efficiency by calculating how the CJS initiative changes revenues or costs, or how it modifies the time or steps needed to carry out a program or function. They may measure effectiveness by calculating how the CJS initiative impacts reach to target populations, dissemination of information, provision of services not available before the CJS agreement, quality of services, customer satisfaction, or preventive behaviors. Detailed measurement plans will be developed by each site in collaboration with the Center as part of the program.

A description of each site’s CJS initiative is below, along with preliminary measurement plans.

Northern Michigan Public Health Alliance

The Northern Michigan Public Health Alliance, in collaboration with two hospital systems, is conducting a community health assessment and improvement initiative in a contiguous 16-county region of approximately 400,000 people in rural Northern Michigan.

The alliance, which consists of six health departments, was formed through a memorandum of understanding (MOU) signed by the chairs of the six boards of health. It is guided by a steering committee that consists of the six health officers.

Preliminary measurement plans are to assess efficiency by comparing the time and cost of conducting the regional community health assessment against the time and cost each agency would have expended conducting its own assessment. Preliminary plans to measure effectiveness are to describe quality enhancements that result from conducting one regional health assessment instead of separate assessments.

Horizon Public Health (Minnesota)

Last year, three previously independent health departments in West Central Minnesota consolidated into one health department called Horizon Public Health. This new, five-county regional public health organization serves approximately 67,000 people.

Preliminary plans are to assess efficiency by comparing administrative costs as a percentage of the entire budget before integration against those same costs after integration. Preliminary plans to assess effectiveness include comparing the reach to a high-risk population before and after integration.

Public Health Regional Networks (North Dakota)

North Dakota has four regional networks that are each governed by joint powers agreements. North Dakota public health units will work together through the public health regional networks to share environmental health activities related to on-site septic systems. They plan to develop uniform ordinances within the networks and share inspection and enforcement activities among public health units.

Impact measures being considered include measuring changes in revenue to assess the efficiency of the sharing arrangement. To measure effectiveness, the project team may measure program reach or the quality of its septic tank inspection activities.

Washington and Ozaukee County Health Departments (Wisconsin)

The health departments in Washington and Ozaukee Counties in Wisconsin have merged into one health department that serves 220,000 residents. As part of that merger, they will implement a shared information technology system that includes electronic health records and billing.

Preliminary conversations on impact measures have focused on measuring changes in revenue to assess the efficiency of the sharing arrangement, and changes in quality in areas such as access to data, staff support, and customer satisfaction to assess its effectiveness.