The COVID-19 pandemic brought incredible pain, loss, and challenge to every community. It also brought with it for a requirement for public health leaders to create innovative ways to address this monumental challenge.

Public health leaders faced this new challenge by collaborating in new and innovative ways to provide services they otherwise could not do as effectively or efficiently on their own. Seemingly overnight, public health leaders rose to the spotlight, shared purpose was identified, and collaboration flourished. Across the country, public health used resource and service sharing, also known as cross-jurisdictional sharing.

Service sharing, resource sharing, or cross-jurisdictional sharing (CJS), is when partners share resources across their respective organizational boundaries (e.g., population served, service area, district, or geopolitical jurisdictions) to improve organizational capacity, address public health issues more effectively and efficiently, advance health equity and address problems that cannot easily be solved by a single organization or jurisdiction.

For a decade, the Center for Sharing Public Health Services (The Center) has worked with leaders and innovators from across the country to implement, evaluate, and understand the spectrum of shared service arrangements. The Center has developed a Roadmap for establishing sharing arrangements, identified success factors, and collected many lessons learned from CJS in action. While CJS has been used for decades to provide public health services, the COVID-19 pandemic shone a new light on the value shared services can bring to public health efforts.

Born out of a marriage of convenience, many public health leaders engaged in service sharing arrangements for the first time, or in new ways. While these collaborations were not without challenges, shared epidemiology services, joint testing and vaccine clinics and, multi-jurisdiction communication efforts were some examples of the meaningful role resource sharing played in the public health response to COVID-19.

While the public health world will need to be ready for future emergencies and infectious disease response, the demonstrated value of shared service arrangements reaches to a plethora of public health services. Shared service arrangements have been used to improve informational technology services in the panhandle of Florida, provide public health nursing services in multiple New Jersey townships, and support accreditation efforts in rural Ohio, to name a few. Shared service arrangements and models have also played a role in broader public health system transformation, including a multi-department consolidation and reorganization to advance public health 3.0 in Wisconsin and continuing system transformation efforts in Washington State.