1. Cross-Jurisdictional Sharing: Can it work in small jurisdictions? Gianfranco Pezzino, Co-Director, Center for Sharing Public Health Services Sandy Tubbs, Director of of Performance Improvement and Planning, Douglas County Public Health (MN) Kenneth L. Oakley, CEO, Lake Plains Community Care Network and Western New York Rural Area Health Education Center (NY).

2. Who Are We?  Center for Sharing Public Health Services:  Established in May 2012  Managed by the Kansas Health Institute, supported by the Robert Wood Johnson Foundation  Assist public health agencies and policymakers as they consider and adopt CJS approaches by:  Serving as national resource on CJS  Building evidence on appropriate and successful approaches  Producing and disseminating tools, methods and models 2

3. Shared Services Learning Community 3 16 sites 14 states 2-year grants

4. Phase 1: Explore Is CJS a feasible approach to address the issue you are facing? Who should be involved in this effort? Phase 1: Explore Is CJS a feasible approach to address the issue you are facing? Who should be involved in this effort? Phase 2: Prepare and Plan How exactly would it work? Phase 2: Prepare and Plan How exactly would it work? Phase 3: Implement and Improve Let’s do it! Phase 3: Implement and Improve Let’s do it!

5. INTEGRATING LOCAL HEALTH DEPARTMENTS IN WEST-CENTRAL MINNESOTA Sandy Tubbs, PHN Director of Performance Improvement and Planning Horizon Community Health Board

6.  Douglas County – Population 36,009  Grant County – Population 6,018  Pope County – Population 10,995  Stevens County – Population 9,726  Traverse County – Population 3,558 Total Population: 66,306

7. Will integration of three local health departments result in a more efficient and effective Public Health Department with greater capacity to meet the current and future challenges facing our communities? The Question

8. A Cross-Jurisdictional Sharing Team was formed in January 2012 to explore the potential benefits and drawbacks of consolidation. Information has been gathered in 6 primary focus areas including governance, programs and services, personnel and staffing, budget and finance, community partnerships and office facilities. The Process

9. PURSUING INTEGRATION OF PUBLIC HEALTH SERVICES IN GENESEE AND ORLEANS COUNTIES, NY Kenneth L. Oakley, Ph.D. FACHE Chief Executive Officer Lake Plains Community Care Network

10. Saratoga Nassau Queens Kings Suffolk Sullivan Ulster Hamilton Warren Lewis Madison Seneca Ontario Yates Cayuga Tompkins Livingston Monroe Chautauqua Cattaraugus Westchester Franklin St. Lawrence Essex Erie Steuben Broome Tioga Clinton Jefferson Herkimer Washington Oswego Oneida Orleans Niagara Wayne Fulton Onondaga Genesee Montgomery Rensselaer Schenectady Otsego Wyoming Schoharie Albany Cortland Chenango Schuyler Allegany Delaware Columbia Greene Chemung Dutchess Orange Putnam Rockland Bronx New York Richmond Orleans Co. Pop. - 42,600 Land Mass - 391 Sq. Miles Pop. Density - 109 Genesee Co. Pop. - 60,000 Land Mass - 493 Sq. Miles Pop. Density - 111 Wyoming Co. Pop. - 42,000 Land Mass - 593 Sq. Miles Pop. Density - 71 Cows – 53,000 plus

11. Primary Genesee-Orleans CJS Drivers  Diminishing Public Health resources  Difficulties in workforce recruitment, retention and development  Desire to explore readiness for potential accreditation either jointly or independently  Desire to more effectively engage with the larger health care delivery system with an enhanced health and wellness focus

12. Principal Genesee-Orleans Objectives and Process  Shared senior management  Joint community health assessment, planning, and response implementation  Joint purchasing  Standardization of policies, procedures and fee schedules  Cost containment and quality improvement

13. (855) 476-3671 - www.PHSharing.org - PHSharing@KHI.orgwww.PHSharing.orgPHSharing@KHI.org Sandy Tubbs, PHN – (320) 762-3003 - sandyt@co.douglas.mn.ussandyt@co.douglas.mn.us Kenneth L. Oakley, Ph.D., FACHE – (585) 345-6110 - koakley@lakeplains.orgkoakley@lakeplains.org The Center for Sharing Public Health Services is a national initiative managed by the Kansas Health Institute with support from the Robert Wood Johnson Foundation. 13