Service and resource sharing leverages public authority and collaboration to deliver critical public health services across jurisdictional boundaries and solve complex challenges that cannot be easily solved. The three primary components of service and resource sharing are:
Approaches to Sharing Arrangements
Service and resource sharing arrangements (SRSAs) in public health can take many different forms. The PHAB Center for Innovation categorizes approaches to SRSAs as follows:
- Local approaches involve two or more local health departments working directly with each other to share services and resources.
- Regional/district approaches refer to services and resources offered by an entity that serves a defined sub-section of a state.
- State level/systemwide approaches refer to services and resources offered by a single, centralized entity and/or a state health department strategy to promote SRSAs among local health departments in the state.
These brief definitions intentionally do not include specific numbers of participating health departments or organizations, and many arrangements could be characterized by more than one approach. Moreover, because a wide diversity of approaches exists it is impossible to develop an exhaustive list of all forms of SRSAs and their characteristics. This approaches document is intended to help health departments and governmental public health systems conceptualize the range of possibilities, provide some examples of successful SRSAs, and stimulate ideas about how to approach efforts to increase the efficiency and effectiveness of governmental public health service delivery in a community, region, or state.
1. Local Approaches
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Two or more health departments share services or resources on an as-needed basis.
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A local health department purchases a service or resource from another local health department.
- Two or more local health departments share a service or program with joint oversight, identical policies and procedures, and shared staff.
- Two or more health departments fully integrate their local health departments usually resulting in a single operational entity.
2. Regional/District Approaches
- State health department establishes regional/district offices to provide all or some public health services.
- State health department funds local health departments to provide specific program services for other local health departments in a designated sub-state area.
- Local health departments purchase services from an entity that serves the sub-state area where the department is located.
- Local health departments establish a regional entity (e.g., partnership, council of governments) to facilitate resource sharing.
3. State Level/Systemwide Approaches
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State health agency provides a service or resource to all local health departments in the state.
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State health agency provides incentives that encourage local health departments to develop SRSAs.
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State health department funds a single local health department to provide a service for all local health departments in the state.
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Local health departments purchase a service from an entity that serves the whole state (e.g., SACCHO, state public health association).
Keys to Success in Service and Resource Sharing
Successful sharing agreements are rooted in clarity, balance, and trust. By prioritizing these keys to success, public health professionals and policymakers can collaborate with one another to create partnerships that are impactful, mutually beneficial, and measurable.
