Case Studies

Shared Services Learning Community Case Studies

The Center for Sharing Public Health Services convened the Shared Services Learning Community in January 2013. It is composed of 16 demonstration sites that are exploring, planning or implementing cross-jurisdictional sharing arrangements. The sites represent 76 public health departments, districts and tribal health agencies that provide services to 126 different geo-political jurisdictions and tribes. Case studies from the learning community appear below.

Southwest Washington

The Southwest Washington Cross-Jurisdictional Sharing project was formed to explore the idea of implementing a governance structure that would support a shared approach to delivering efficient public health services in ways that respect the unique political, organizational and financial realities of four Southwest Washington counties and one tribal nation.

The overall goal of the project was to explore a cross-jurisdictional sharing structure, develop an effective implementation plan and develop a basic set of procedures to ensure the provision of efficient public health services and better health outcomes across the Southwest Washington region.

After several meetings, the team ultimately determined that further pursuit of the original goal would not be productive.

This case study details how the effort progressed, factors that hindered the desired progress and lessons that could inform other jurisdictions interested in similar pursuits.

ICMA Case Studies in Collaboration with the Center

The International City/County Management Association (ICMA), in collaboration with the Center for Sharing Public Health Services, conducted a national survey of local governments in early 2014 to study the use of shared administrative service agreements across local health department jurisdictions. In December 2014, findings from the survey were released in a report, Sharing Administrative Services across Jurisdictions.

ICMA conducted three follow-up case studies to examine in greater depth how the collaborations worked and to identify specific elements that make such agreements successful.

Crittenden County, Kentucky
This case study presents a five-county public health district that provides all administrative and program services for the participating counties.

Prowers County, Colorado
This case study examines how an inter-government agreement (IGA) has been used to enable Prowers County, Colorado to provide public health administrative services for its neighbor, Kiowa County.

Mansfield, Connecticut
This case study features a regional public health district formed by ten towns in Eastern Connecticut, the largest of which provides many administrative services through a long-term service agreement.

Other Case Studies

West Central Public Health Partnership: A Case Study in Public Health Collaboration

Health officials from six counties along Colorado’s Western Slope came together with a common goal of strengthening the region’s public health infrastructure. Their effort culminated in the establishment of the West Central Public Health Partnership (WCPHP). In the years that followed, officials enacted intergovernmental agreements outlining partnership roles and responsibilities, and participants embarked on numerous cross-jurisdictional public health campaigns and programs. This report describes an in-depth evaluation of the WCPHP to identify the organizational elements that contributed to the group’s successes.

Available online:

Shared Services Learning Community: Summaries of Selected Sites

In January 2013, the Center for Sharing Public Health Services convened the Shared Services Learning Community, which consisted of 16 demonstration sites that were involved in cross-jurisdictional sharing (CJS) arrangements. The Center’s work with those sites ended in 2015.

The Center began a new initiative in 2016 to follow up with a subset of those original demonstration sites for an 18-month period. The Center plans to produce case studies on the sites in the future. In the meantime, select a link below for a short summary of each site’s 2013-2015 activities.

Colorado: San Luis Valley Public Health Partnership
Minnesota: Partnership4Health (part of the Minnesota System‐wide Initiative)
Nevada: Carson City‐Douglas County
New York: Genesee‐Orleans Counties
Ohio: Northeast Ohio