1. Northwoods Shared Services Project: Discussions with Policymakers Ashland County Health & Human Services Committee September 18, 2013

2. A Roadmap for Government Transformation, February 2010, Baker Tilly Virchow Krause, LLP, Local Government Institute. “ Cooperation takes many forms.”

3. 3 “Handshake” MOU Information sharing Equipment sharing Coordination Service provision agreements Mutual aid agreements Purchase of staff time Joint projects addressing all jurisdictions involved Shared capacity Inter-local agreements New entity formed by merging existing LHDs Consolidation of 1 or more LHD into existing LHD Informal and Customary Arrangements Service Related Arrangement Shared Functions with Joint Oversight Regionalization Cross-Jurisdictional Sharing Spectrum Graphic courtesy of the Center for Sharing Public Health Services: http://www.phsharing.org/http://www.phsharing.org/

4. 4 Cross-Jurisdictional Sharing Ashland County What is the Shared Service? Who Participates in the Sharing Arrangement? Who Pays for it?Type of Agreement? Bay Area WIC Program Bayfield County Iron County Federal money passed through state Contract Emergency Preparedness and Planning In existence since 2011 Bayfield County Health Department (lead agency) Red Cliff Indian Tribe Federal public health preparedness allocation Contract Nutrition Education Bayfield County Health Department (lead agency) Reimbursed servicesContract TN Well Testing ProgramPrice CountyDNR grantContract Birth to Three Services Bayfield County Long-Term Care Bayfield County Contract with Ashland Co Health & Human Services Wisconsin Well Woman Program Bad River Indian TribeWWWP State fundingContract with the state of WI Emergency Response Bad River Indian Tribe Bayfield County HD Federal public health preparedness allocation Formal agreement Reproductive HealthBayfield County Health Care Clinic Reimbursed servicesFormal agreement

5. Why enter into a cr0ss-jurisdictional sharing agreement?

6. How do you see shared services improving what the health department does?. “Diseases don’t care about borders.” A Roadmap for Government Transformation, February 2010, Baker Tilly Virchow Krause, LLP, Local Government Institute

7. Based on best practices or successful models for shared services Improves public health capacity, effectiveness, and accountability Collaborative leadership structure is used and decision-making processes are pre-determined Clear fiscal benefit Criteria for Successful Shared Service Arrangements

8. As a policymaker, what would you look for in a cross-jurisdictional sharing agreement? “How services are delivered is more important than who.” A Roadmap for Government Transformation, February 2010, Baker Tilly Virchow Krause, LLP, Local Government Institute

9. A Roadmap for Government Transformation, February 2010, Baker Tilly Virchow Krause, LLP, Local Government Institute. “Cooperation takes many forms.” What level of involvement do you want in shared services?

10. What additional information do you need related to shared services? “Pooling resources just makes sense.”