Meeting Summaries

Below are short summaries of the meetings of the Learning Collaborative


While it’s not unusual for decision-makers to consider cross-jurisdictional sharing (CJS) primarily as a tool to reduce costs, in reality the greatest value of these arrangements comes in the form of a more effective public health presence in the community.

Join the Center for Sharing Public Health Services for this webinar, where Health Director Paul Pettit will describe how he used the opportunities presented by combining management teams to gain new efficiencies and make practice improvements for two county health departments in rural western New York.

September 13, 2019

1 p.m. Eastern / 12 noon Central /

11 a.m. Mountain / 10 a.m. Pacific

Register Now!

Webinar: State Health Departments and Cross-Jurisdictional Sharing: How state health departments can help drive efficiency and effectiveness at the local level

State Health Departments and Cross-Jurisdictional Sharing:
How state health departments can help drive 
efficiency and effectiveness at the local level 
You are invited to participate in a webinar hosted by the Center for Sharing Public Health Services focused on state health departments' role in local cross-jurisdictional sharing.
Date: October 9, 2018
Time: 1 p.m. Eastern
12 noon Central
11 a.m. Mountain
10 a.m. Pacific
Title: State Health Departments and Cross-Jurisdictional Sharing:
How state health departments can help drive efficiency and effectiveness at the local level
Cross-jurisdictional sharing (CJS) models typically are established to improve the efficiency and effectiveness of public health programs and outcomes. CJS arrangements may be initiated by local health departments in response to local needs. In addition, state health departments may use CJS to improve the efficiency and effectiveness of state-funded programs or otherwise make system-wide changes.
This webinar will provide an overview of ways in which state health departments can support and initiate CJS arrangements at the local level. It will provide specific examples of how this has been done in Minnesota and Montana. Participants will have an opportunity to pose questions and share their experiences.
Objectives: 1.) Describe state health department strategies that support local health department efforts to establish and operate CJS arrangements.


2.) Describe state health department strategies that use a CJS approach to improve the delivery of state-funded public health services.


Guest Speakers:
Michael Fraser
Chief Executive Officer
Association of State and Territorial Health Officials
Debra Burns
Centers for Health Equity and Community Health
Minnesota Department of Health
Mandi Zanto
Healthy Lifestyles Section Supervisor
Chronic Disease Prevention and Health Promotion Bureau
Public Health and Safety Division
Montana Department of Health and Human Services
The webinar is intended for state health departments, local health departments, policymakers and related state-based associations. 


Event Registration for the Webinar on October 9, 2018
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WEBINAR: Staff Sharing Arrangements for Local Public Health

Join a webinar hosted by the Center for State and Local Government Excellence in collaboration with the Center for Sharing Public Health Services to review recent research that examines the issue of staff sharing arrangements for local public health.

What:  Webinar | Research Review: Staff Sharing Arrangements for Local Public Health
Date:   Thursday, July 19, 2018
Time:   1:00 PM ET
Register at no charge:
Download research:

Just as residents might commute from one jurisdiction to another, public health challenges also travel freely, whether stemming from food poisoning, substance abuse, environmental exposures, or communicable diseases. Rather than take an insular approach to addressing just the issues in one singular area, local public health officials have considered, and in some cases implemented, partnerships as an effective means of containing existing and potential problems, expanding organizational capacity, and effectively managing public health expenditures.

It might seem beneficial to share staff between jurisdictions, but on a practical level, when exploring the concept, there can be a natural hesitation related to existing governance structures, the history between and culture of the jurisdictions, the equitable provision of services, and underlying fiscal arrangements, among other factors.

To help inform these considerations, this report offers a series of case studies on shared staffing arrangements in local public health organizations. These cases were selected for study based on a national environmental scan of arrangements in place and with attention to variation in location, size of jurisdictions, and type of local government. The shared positions covered in these case studies run the gamut from health directors to physicians, nurses, inspectors, social workers, and administrative staff. 


Determining and Distributing Costs of Shared Public Health Services

Center for Sharing Public Health Services Cost Sharing Document Now Available

The Center's document, Determining and Distributing Costs of Shared Public Health Services, is meant to assist public health officials and policymakers as they determine how to share costs in a cross-jurisdictional sharing (CJS) arrangement. Download your copy today!

September 2015 Learning Collaborative

The last meeting of the Learning Collaborative was attended by representatives from MDPH Office of Local and Regional Health, representatives of the DIGs, the TA team, and several former members from MDPH. Additionally, the meeting had special guests Gianfranco Pezzino and Grace Gorenflo from the Center for Sharing Public Health Services who presented on their work as well as leading the DIG members through a self-assessment exercise.

At the end of the meeting many took the time to express their thanks and appreciation for all of their hard work: Geoff Wilkinson from his time at MDPH, Ron O’Connor from the OLRH and Mike Coughlin, also previously from MDPH. Seth also thanked all those involved on behalf of everyone involved with the MA Public Health Regionalization project.

Follow this link for notes and other downloads available from the meeting.

Learning Collaborative Webinar

The webinar focuses on local boards of health ability to access and retain funding necessary to provide local public health services. We review the different funding sources available and how those sources can supplement the local municipal budget line item for public health. We also suggest methods for increasing funding sources through fee and fine collections. Additionally, we provide information on current understanding of available procedures for the collection and disbursement of fees and fines for public health services by local boards of health and their agents.

View a Recording of the webinar

Additionally, below is a copy of the slide deck, and two pieces of supporting materials to the content of the webainar:


March 2015 Learning Collaborative

The Learning Collaborative met on March 5th to discuss sustainability plans for the regional districts.  All 5 sites from the DIG program were represented, as well as information from the Pioneer Valley Planning Commission Municipal Collaboration / Shared Service program on their Hampden County Public Health Nurse Assistance program.  Attached are the notes from the meeting.

Download a copy of the March 5th Learning Collaborative notes


Septermber 2014 Learning Collaborative

Attended by representatives from all 5 DIG sites as well as Hampden County Health Alliance (A CIC Grantee), the meeting was held at the Green Hills Country Club in Worcester. Download a full copy of the notes from the meeting

Mike discusses with the group

Mike discusses with the group

Mike Coughlin, Massachusetts Department of Public Health, updated the representatives on the final year of funding for the DIG project. The Learning Collaborative we will continue to work on sustainability issues as well as evaluating the impact the grant has had on local public health in Massachusetts. Jana Ferguson, from DPH Office of Local and Regional Health, described how the Office will support the DIGs with financial assistance for the DIG LC as well as other technical assistance groups.

The group then reviewed an upcoming Presentation which will be delivered to MDPH Commissioner Bartlett to discuss the Regionalization project. The meeting with the Commissioner will not only brief her on the success of the DIG project, but also make her aware of the goals of the Working Group moving forward.

The districts provided a summary of their project goals and achievements as well as barriers and solutions. Common themes included sustainability issues, workforce development and the long timeline for enacting change.

Pat Libby, Co-Director at the Center for Sharing Public Health Services, reviewed the national effort by the Center. Mr. Libby reported on common themes from the national learning community mirror the themes that we just discussed during this meeting: addressing change, assessing existing and desired capacity, financing shared services, and building on existing regional identity. Mr. Libby also reviewed the factors for success that they’ve identified: prerequisites, facilitating factors, and success in prior collaborations. Click to download a copy of the presentation

Justeen Hyde led a sustainability exercise with the Learning Collaborative asking them to consider what are the most important aspects of sustainability. The issues which resonated most strongly with the group are:Justeen leads group through exercise

  • Financial strategic planning
  • Additional funding
  • Strategic planning and political capital
  • State action, particularly legislative changes.

Review a summary of results from the exercise

April 15th Learning Collaborative

This conference call  included twenty members of the DIGs, the Massachusetts department of Public Health and technical assistance advisers.

Geoff Wilkinson, Senior Policy Advisor at the Massachusetts Department of Public Health, gave an update on the status of funding for the DIGs for year 5 funding (implementation year 4).

The DIGs then held a round-robin discussion specifically addressing their particular issues around sustainability and their strategies for addressing these issues

Nazmim Bhuiya, Institute for Community Health, recently returned from the Keeneland Conference where she presented on the impact of the DIG program on public health services. Preliminary findings from the dashboards were shared and key areas of improvement were highlighted. Improvement areas from 2010 – 2012 include:

  • Submission rates of food reports to DPH
  • MAVEN status: majority of communities participating in the DIGs are on MAVEN and there has been an increase in the completion of the communicable disease reporting
  • Beach inspections are being completed more consistently
  • BOH training has risen significantly

The Regionalization Working Group recently held a conference call and several priorities were identified:

  • Meeting with Commissioner Bartlett
  • Next phase of the Regionalization Project
  • Legislative action for sustainability
  • Legislative action for workforce requirements
  • Working with the PBRN to use data to show how regionalization is improving LPH
  • Created and disseminate communications plan on positive effects of regionalization in MA.

January 7th Learning Collaborative

The latest District Incentive Grant Learning Collaborative (DIG LC) meeting was attended by all 5 of the DIG sites, the TA team, Department of Public Health personnel, and by Sandra Cashman, Centers for Disease Control and Prevention (CDC) Project Officer. Ms. Cashman was at the meeting both as a part of a site visit of the Massachusetts Regionalization Project and because the CDC is very interested in cross jurisdictional sharing (CJS) and she wants to bring key messages back to the CDC to support the ten essential public health services.

Ms. Levy presents to the group as Mr. Wilkinson listens on.

Ms. Levy presents to the group as Mr. Wilkinson listens on.

Geoff Wilkinson, Senior Policy Advisor at the Massachusetts Department of Public Health, provided updates about the State Health Improvement Plan (SHIP) and public health agency accreditation. Dean Harold Cox, Boston University School of Public Health, summarized progress of the national Center for Sharing Public Health Services (Center), which is funded by Robert Wood Johnson Foundation (RWJF) and provided an overview from their website ( Each of the DIG sites delivered an update as to their site and then Mr. Wilkinson introduced brand strategy and communications consultant Michele Levy who, building on the discussion with Shrewsbury Town Manager Dan Morgado in September, led an interactive session to help DIGs create a proactive communications plan.Ms. Levy went over essential parts of a communication plan: establishing a high level goal, identifying your target audience and their concerns and prioritizing them, as well as knowing what you want from them. Ms. Levy stressed that messaging should be should be compelling, concise, clear, consistent and you should be sure to have supporting messages, recognize the differences in your audiences and tailor presentations accordingly. Lastly, she let the group know they should always track their goals and measure their success on tangible results; choose a few things to do, do them well and use their measurements of success to adapt and/or change your plans