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Cross-Jurisdictional Sharing of Public Health Services


Health departments of all types and sizes are sharing services and exploring cross-jurisdictional sharing and collaboration arrangements more frequently.

Cross-jurisdictional sharing (sometimes referred to as CJS) is a growing strategy used at state, tribal, local, and territorial levels to address opportunities and challenges such as tight budgets, increased burden of disease, and regional planning needs.

What Is Cross-Jurisdictional Sharing of Services in Public Health?

Cross-jurisdictional sharing is “the deliberate exercise of public authority to enable collaboration across jurisdictional boundaries to deliver essential public health services” (Center for Sharing Public Health Services, 2013).

Cross-jurisdictional sharing can range from supporting informal arrangements to more formal changes in structure. In public health, cross-jurisdictional sharing often occurs between health departments or agencies serving two or more jurisdictions. Collaboration allows communities to solve issues or problems that cannot be easily solved by a single organization or jurisdiction.

Examples of cross-jurisdictional sharing include

  • Regionalization of health departments, such as through the consolidation of two or more health departments
  • Sharing staff between two or more health departments, such as an epidemiologist or sanitarian that supports multiple health department jurisdictions   
  • Sharing defined services, such as laboratory testing services or inspection services
  • Collaborative assessment and planning processes that include two or more health departments and leads to shared priorities; examples might include regional preparedness plans, cross-border plans, or community health improvement plans

Accordion Title

Key Concepts & Definitions

Describes the concept of cross-jurisdictional sharing and how these approaches may vary in different locations

More on key concepts & definitions

CDC Activities & Resources

Describes how CDC is advancing and promoting cross-jurisdictional sharing and highlights selected examples of CDC initiatives and tools

More on activities & resources

Stories & General Resources

Provides links to additional resources

More on stories & general resources


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