Navigating Sharing Arrangements: Leveraging the Power of the Roadmap

Gianfranco Pezzino, Director

A Message from the Director of the Center for Sharing Public Health Services

On the Road Again

At the Center for Sharing Public Health Services, we believe in the power of the journey to drive you toward your destination. This principle comes alive in one of our flagship tools — the Roadmap — which guides health departments through the process of developing sharing arrangements across boundaries.

In our May Director’s Message, we shared recent changes we’ve made to our approach and strategies, including rethinking what it means to engage in cross-jurisdictional sharing (CJS). As our definition of CJS has evolved, so have our tools. The Roadmap recently underwent updates to reflect our new definition. In addition, because of situations prompted by the COVID-19 pandemic, we developed an expedited version of the Roadmap to facilitate sharing arrangements in specific situations that do not allow for or necessitate the application of the full Roadmap model. This Director’s Message breaks down the two versions of the Roadmap, as well as when to use each.

What is the Roadmap?

The Roadmap to Develop Sharing Initiatives in Public Health includes three distinct phases to guide health departments through the process of considering or establishing sharing arrangements. Phase One is focused on exploring, Phase Two on preparing and planning, and Phase Three on implementing, monitoring and improving.

Within each phase, the Roadmap addresses a broad range of topics and poses specific questions to discuss and answer. In the new version of the Roadmap, these questions have been updated to encompass considerations for arrangements with partners outside of governmental public health. Partners working through the Roadmap are encouraged to move through the phases chronologically, as each builds on the one before it.

What is the Expedited Roadmap?

The Expedited Roadmap is a pared down version of the full Roadmap. It includes the same three phases, but fewer questions. It was born out of a recognition that in emergency situations there may not be time to discuss and debate all of the steps included in the full Roadmap.

Which Roadmap Should I Use?

The full Roadmap remains the preferred tool when developing sharing arrangements and should be used in most scenarios. As we’ve learned over the years by supporting health departments as they develop sharing arrangements, there are many details to work through in order for these partnerships to be successful. However, we recognize that extenuating circumstances emerge that make using the full Roadmap difficult or impossible. Some scenarios that could necessitate using the Expedited Roadmap include:

  • During an emergency (e.g., large outbreak or other immediate public health threat) when time does not allow all the steps of the full Roadmap to be completed.
  • When the sharing arrangement in question is narrow in scope or brief in duration.
  • When partners know that they need to work on a narrow aspect of a sharing arrangement and have no interest in covering other details in the full Roadmap.

Even when using the Expedited Roadmap, we encourage individuals to be familiar with the elements included in the full Roadmap. We know it can be tempting to select only the sections that feel most applicable to your scenario, but navigating through the full Roadmap — or at least understanding the landmarks — will better serve the long-term success of a sharing arrangement.

Final Stop

In addition to questions and actions to consider, both versions of the Roadmap include resources intended to support you in your journey to a successful sharing arrangement. For those who need it, we hope the Expedited Roadmap will serve you when unexpected situations arise.

At the Center, we will continue to update our resources to be responsive to the needs of the public health community. Feedback about your experience with the Roadmap, Expedited Roadmap or any of our other tools is always welcome — just email us at

— Gianfranco Pezzino, Director