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 by state, tribal, local, and territorial agencies and organizations 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
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Public health governance structures vary from state to state, and understanding these differences can have important implications for cross-jurisdictional sharing.