Criteria for Cross-Jurisdictional Sharing in Public Health Perspectives from a literature review, health officers interviews and policymakers discussion groups in the Northwoods Shared Services Project, April 2014

A Roadmap for Sharing: Explore Prepare & Plan Implement & Improve Source: Center for Sharing Public Health Services A Roadmap for Sharing: Explore Prepare & Plan Implement & Improve

Goals and Expectations: Is in alignment with our mission and core values Evidence based and when applicable, designed to improve population health Accomplish at least one of the following: Achieve an essential public health service Advance initiatives in a priority area in our community health plan Enhance the quality of the existing service Improve capacity for achieving public health accreditation Goals and Expectations: Why Consider CJS?

Assures adequate service levels for the investment of resources for our agency The agreement is clear about which services will NOT be shared, including: Functions (e.g. billing, human resources, information technology) Programs and Capacity (e.g. WIC, environmental health, epidemiology, lab) Scope of the Agreement

Partners and Stakeholders Have experience working together in CJS agreements, trust each other and have an understanding of the culture and history of each jurisdiction Adequate support for the CJS from policymakers, constituents, clients, and other stakeholders who may be affected by it Partners and Stakeholders Relationships Public Support

Partners and Stakeholders The proposed outcomes, service model and delivery, and staffing model feasible and supported by the partners, stakeholders and others affected by the CJS initiative. The partners are in agreement on their respective roles and responsibilities and they are willing to enter into a written agreement. Partners and Stakeholders Policymaker & Stakeholder Support Written Agreements

Fiscal & Service Implications Is there a service benefit such as: New services for less money than could be achieved by doing it alone Enhanced quality of service for an affordable investment? Fiscal & Service Implications Service

Fiscal & Service Implications Is there a fiscal benefit such as: Savings through avoiding capital costs over the medium and long term (3-10 years) Reduced annual rates of increase in expenditures Decreased annual operating cost No increase in annual operating costs Lower than expected rate of increase in annual operating costs? Fiscal & Service Implications Fiscal

Fiscal & Service Implications Funding is adequate to support staff and resources needed to meet program/service outcomes Funds pay for the increased indirect costs to the lead agency Funding is at least 2 – 5 years versus one-time, one year funding that is unlikely to be sustainable There is a plan for sustainable funding Fiscal & Service Implications Funding

The lead agency has experience managing CJS arrangements and the appropriate infrastructure in place for all reporting requirements Leadership Lead Agency

Can we recruit staff from the area workforce with the desired expertise in the location(s) needed? Personnel

Criteria for Cross-Jurisdictional Sharing in Public Health In Summary: Goals and Expectations Scope of the Agreement Partners and Stakeholders Fiscal and Service Implications Leadership Personnel Criteria for Cross-Jurisdictional Sharing in Public Health

Acknowledgements: This work was funded by a grant from the Robert Wood Johnson Foundation and the Center for Sharing Public Health Services Fiscal Agent and Contact for the Grant: Marathon County Health Department www.co.marathon.wi.us/Departments/HealthDepartment Northwoods Public Health Community: Shared Services Learning Community Grant

Grant Partners: Ashland County Health & Human Services Bayfield County Health Dept. Florence County Health Dept. Forest County Health Dept. Iron County Health Dept. Lac Courte Oreilles Band of Lake Superior Chippewa LCO - send reminders to her also Langlade County Health Dept. Lincoln County Health Dept. Marathon County Health Dept. Marinette County Health & Human Services Oneida County Health Dept. Portage Co. Health & Human Services Dept. Price Co. Health & Human Services Sawyer County Health & Human Services Shawano-Menominee Counties Health Department Taylor County Health Dept. Vilas County Health Dept. Wood County Health Dept. Northwoods Public Health Community: Shared Services Learning Community Grant