CDC Activities & Resources

CDC recognizes the value of cross-jurisdictional sharing and its role in fostering these opportunities in public health.

In 2012, the Advisory Committee to the CDC Director adopted recommendations from its State, Tribal, Local and Territorial (STLT) Workgroup to explore and foster cross-jurisdictional sharing. An internal committee, with representation from across CDC, periodically convenes to identify and address opportunities and determine points of discussion with the STLT Workgroup.

CDC fosters or supports cross-jurisdictional sharing opportunities among STLT jurisdictions by

  • Creating funding opportunity announcement language that promotes or allows for shared services and collaboration among jurisdictions or grantees
  • Supporting inter-state sharing around discrete activities or services
  • Supporting or promoting cross-jurisdictional sharing or collaboration through tools, including resources developed through CDC-supported projects managed by national public health partner organizations
  • Providing or supporting funding for technical assistance or training
  • Promoting peer-sharing or supporting demonstration site projects
  • Partnering and actively participating with other national external organizations involved in cross-jurisdictional sharing, such as the Center for Sharing Public Health Services, National Coordinating Centers for PHSSR and Practice-Based Research Networks, and Robert Wood Johnson Foundation

Selected CDC Initiatives That Promote or Foster Cross-Jurisdictional Sharing

Laboratory Efficiencies Initiative (LEI) [PDF – 2.39MB ]
Created with the purpose of building a sustainable public health laboratory system in the US, this initiative helps public health laboratories adopt new, high-efficiency management practices, building a strong platform for current and future test services. The LEI promotes cross-jurisdictional sharing through practices such as sharing of test services across states.

National Program of Cancer Registries
Data collected by local cancer registries enable public health professionals to understand and address the cancer burden more effectively. CDC provides support for states and territories to maintain registries that provide high-quality data. When feasible, the education/training coordinator may be shared among grantees, which also promotes and allows for education or training activities to occur among multiple states.

National Public Health Improvement Initiative (NPHII)
This innovative initiative provided support to health departments or their partners for accelerating public health accreditation readiness activities, implementing performance and improvement management practices and systems, and implementing and sharing practice-based evidence. Language within the NPHII cooperative agreement promoted cross-jurisdictional sharing by encouraging grantees to develop partnerships with other health departments or to support cross-jurisdictional sharing among health departments within their jurisdictions. The NPHII Compendium provides further detail about the impact of this program and includes stories from grantees, such as Massachusetts, which used their funds to advance local coordination efforts.

Environmental Health Specialists Network (EHS-Net)
These environmental health specialists collaborate with epidemiologists and laboratory technicians to identify and prevent environmental factors contributing to foodborne and waterborne illness outbreaks. EHS-Net promotes cross-jurisdictional sharing by encouraging outbreak response teamwork across jurisdictions and disciplines.

Healthy Community Design Initiative
CDC’s Healthy Community Design Initiative integrated evidence-based health strategies into community planning, transportation, and land-use decisions. The initiative

  • Used tools like Health Impact Assessment (HIA), surveillance, and education to improve decision-making
  • Built partnerships with decision-makers and stakeholders
  • Conducted research to identify linkages between health community design, and translated that research into best practices

The initiative promoted cross-jurisdictional sharing by providing tools to help local and state health departments facilitate health and planning collaboration across jurisdictional lines (e.g., regional planning boards, planning departments, state departments of transportation, community-based organizations, etc.). For example, many HIAs occur in regional areas that cross jurisdictional boundaries.

Selected CDC-Supported Tools

The following CDC-supported tools, many developed in collaboration with CDC’s partner public health organizations, can provide assistance in sharing services or cross-jurisdictional sharing activities:

Policy Guide for Public Health Laboratory Test Service Sharing [PDF 1.24MB] and The Practical Guide to Assessing and Planning Public Health Laboratory Service Changes [PDF 4.25MB]
These guides promote cross-jurisdictional sharing through the sharing of test services and policy “lessons learned” across states, procurement strategies, LEAN training, and workforce competencies.

Tribal Health and State Public Health Primers
Supported collaboratively by CDC and the Association of State and Territorial Health Officials (ASTHO), the Knowing Tribal Health and Knowing State Public Health Primer provide tips and assistance on partnerships and collaboration between tribes and states. For example, the tribal health primer explores the history of health-related federal laws for tribal nations and the role of the state health official in establishing partnerships with tribal nations, while the state health primer explores the history of health-related federal laws for state health agencies, the state health governance system, and the role of the tribal health leader in establishing partnerships with state health agencies.

Public Health Accreditation Board (PHAB) National Voluntary Accreditation Program
PHAB is a nonprofit organization leading the national voluntary accreditation program for public health departments. Supported in part by CDC, accreditation is intended to improve and protect the public’s health by advancing the quality and performance of tribal, state, local, and territorial public health departments. Some sites report using cross-jurisdictional sharing strategies to meet standards and create efficiencies. Health departments also can choose to apply for this national voluntary accreditation program through a multi-jurisdictional application process.

Mobilizing for Action through Planning and Partnerships (MAPP)
MAPP, supported by NACCHO and CDC, is a framework for a community health improvement process. MAPP helps communities undertake a collaborative process to assess health status and needs, prioritize public health issues, and identify resources and strategies to address priorities. MAPP is often used by two or more jurisdictions to support a regional approach to developing a community health assessment and community health improvement plan.

Environmental Health Training on Emergency Response (EHTER)
A set of training modules that focus on key environmental health issues and challenges for emergency response, EHTER emphasizes the importance of collaboration across disciplines and jurisdictional lines in responding to emergencies, which often affect multiple jurisdictions. Mechanisms to facilitate such collaboration, such as mutual aid agreements, are discussed.