1. Northern Michigan Cross Jurisdictional Sharing Team National Association of Local Boards of Health Salt Lake City, Utah August 14, 2013 Shelley Pinkleman, Chair, Board of Health Linda Van Gills, Health Officer District Health Department #10

2. Northern Michigan Cross Jurisdictional Sharing Team  6 local health departments  640,000 total population  14,124 square land miles 2

3. Motivations for considering cross jurisdictional sharing (CJS) arrangements  6 LHDs have long history of working together and have developed trusting relationships  By working together, cross jurisdictional sharing can achieve specific health outcomes  Smaller health departments need cross jurisdictional sharing in order to survive  CJS can increase and improve public health services 3

4. Why should local boards of health be interested in cross jurisdictional sharing? Some thoughts from our recent discussions in Northern Michigan….. 4

5. Function: Policy Development Lead and contribute to the development of policies that protect, promote and improve public health while ensuring that the agency remains consistent with laws and rules to which it is subject  Respond to opportunities with implementation of health care reform  Negotiate with the multiple Medicaid health plans for more uniformity in rules and regulations  Advocate for reforms in the Michigan Legislature; (ie, NP scope of practice) 5

6. Function: Resource Stewardship Assure the availability of adequate resources (legal, financial, human, technological and material) to perform essential public health services 6  Share Medical Director, Epidemiologist, other staff  Share IT--software, hardware and expertise  Develop common job descriptions, orientation and trainings  Work together to develop major plans (ie Emergency Prep)  Prepare for State and National accreditation

7. Function: Legal Authority Exercise legal authority and understand the roles, responsibilities, obligations And functions of the governing body, health officer and agency staff  Share regulations such as Imminent Danger Order for “spice”  Conduct staff training together for certain Environmental Health programs 7

8. Function: Partner Engagement Build and strengthen community partnerships through education and engagement to ensure the collaboration of all relevant stakeholders  Collaborate beyond jurisdiction with community partners  Nurture regional partnerships to reduce fragmentation and duplication 8

9. Function: Continuous Improvement Routinely evaluate, monitor and set measureable outcomes for improving community health status and the agency/governing body ability to meet its responsibilities  Conduct community health assessment and improvement together  Implement similar evidence-based interventions to common priorities identified in assessments  Submit joint proposals for funding to implement these interventions and for other major projects 9

10. Function: Oversight Assume ultimate responsibility for public health performance in the community by providing necessary leadership and guidance in order to support the agency in achieving measureable outcomes  Develop common metrics for monitoring region- wide 10

11. For additional information Shelley Pinkleman Chair--Board of Health District Health Dept. #10 tmsp26@yahoo.com 989-390-6222 Linda Van Gills Health Officer District Health Dept. #10 lvangills@dhd10.org 231-9028530 11