Case Study: Public Health Shared Services: Northeast Kansas (NEK) Multi-County Health Department

The Northeast Kansas (NEK) Multi-County Health Department is a collaboration between three rural counties: Atchison, Brown and Jackson. It operates as a single agency, but provides public health services in each county. It also operates a home health agency, which is located in the city of Hiawatha and serves all three counties. The arrangement allows the counties to share one administrator and one accountant between all four locations. The counties receive many benefits by offering public health services through this sharing arrangement, such as staffing efficiencies, a revenue stream from the home health agency (which contributes to the financial stability of the entire health department), and moral support among peers from different counties.

Available online:

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

  • Background / History: In the late 1960s, the three counties participated in regional health council meetings.
  • Governance: A board of directors provides governance for the NEK Multi-County Health Department.
  • Tribal Issues: The NEK Multi-County Health Department covers an area that is home to all four sovereign nation Tribes in Kansas.

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

  • Why? / Phase One: There were two main goals for the combined health department. First, the health council wanted to provide the public health services the community needed. Second, they wanted to pool populations and resources in order to compete with larger counties for grants.
  • Governance / Phase Two: A board of directors provides governance for the NEK Multi-County Health Department.
  • Implementation and Management / Phase Three: A federal grant provided funds to plan and develop a multi-county health department through an interlocal agreement in accordance with Kansas statute (K.S.A. 12-2901). As part of the planning process, a national consultant was brought in to help setup the department’s structure.
  • Monitoring and Improving / Phase Three: Over the years, the NEK Multi-County Health Department has responded to a variety of changes.