Center Updates

Sharing Successes

May 2022 – At the Center for Sharing Public Health Services (CSPHS), we have been busy distilling what we have learned from the Cross-Sector Innovation Initiative, in partnership with the Public Health National Center for Innovations. In addition to highlighting the work of each of the 10 grantees, we are summarizing the unique role of public health in these efforts, innovations that emerged, and insights about how to use the pillars and adaptive factors from A Framework for Aligning Sectors to further collaboration goals and sustainability. These learnings will be released next month, and we hope you will be able to take advantage of them in your efforts to “rethink boundaries for better health.” 

What We’re Reading at the Center

The team at CSPHS continually seeks externally developed resources – research, analysis and other types of publications – that resonate with our efforts to support resource-sharing efforts and give us new ways to support our partners. Two national reports we are currently reading are: Public Health Forward: Modernizing the US Public Health System, published by the Bipartisan Policy Center, and Staffing Up: Investing to Improve Public Health Services and Protections, published by the Public Health National Center for Innovations and the de Beaumont Foundation.

Public Health Forward: Modernizing the US Public Health System

defines a vision for a modernized public health system in the 21st century and provides a framework of practical, prioritized, and bipartisan actions for policymakers and public health officials to guide strategic investments and decision-making to help translate the vision into a reality with a focus on equity.

These actions described in the Public Health Forward report are derived from several national public health frameworks and reports by pre-eminent public health thought leaders across the country. A unique feature of these recommendations is that they were developed under the guidance of a bipartisan task force and therefore have a level of political support not always seen in proposals to strengthen public health.

Of particular interest to CSPHS is the recommendation to “explore resource sharing arrangements with neighboring departments to fill in gaps or increase effectiveness and efficiency of foundational public health services.” CSPHS has learned the importance of clarifying objectives, taking an approach that balances increased efficiency with enhanced quality, and having a strong level of trust among all partners. These three factors are considered prerequisites for successful sharing arrangements – to the degree that potential collaborators are urged to spend time addressing them before engaging in further planning.

Moreover, successful sharing arrangements begin with a thorough exploration as outlined in Phase 1 of the Roadmap to Develop Sharing Initiatives in Public Health. It is important to invest time up front to identify the drivers for resource sharing and to discuss shared working experiences, potential areas for sharing, and the similarities and differences between organizational culture, as this sets a foundation upon which further work can be built. Skipping steps in the exploration phase is likely to cause delays later, as partners find that an exploration of these issues is necessary to their planning efforts. 

Visit our website for the Roadmap, Success Factors, and other signature tools to assist your journey toward cross-jurisdictional sharing.

Staffing Up: Investing to Improve Public Health Services and Protections

According to this analysis, state and local health departments need to hire a minimum of 80,000 more full-time equivalent positions (FTEs) — an increase of nearly 80% — to provide adequate infrastructure and a minimum package of public health services.

This dire situation is made worse when geographically close health departments end up vying for the same candidate pool, as is often the case in rural areas. About a decade ago, Genesee and Orleans counties, in western New York, were struggling with this very issue. The county administrators agreed to pilot-test a shared leadership team between their two health departments. The arrangement gradually expanded to include all staff, while maintaining the physical facilities in both counties.

Many cost benefits have ensued, including the successful bid to have a (free) Centers for Disease Control and Prevention public health associate assigned to their staff (something out of their reach for a health department serving a smaller population); cost savings with various contracted services; and additional expertise, as additional staff have made it possible to develop more specialized skills that benefit both counties.

Be sure to read the Genesee-Orleans County Health Department story, and other examples of CJS in Action, on our website.

As always, we encourage you to reach out if you need technical assistance or if you are willing to share your resource sharing efforts with the public health practice community. You can email us at