CDC Activities & Resources

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-jursidictional 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 organizatons
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)
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 Public Health Improvement Initiative (NPHII)
Provides 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 promotes 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.

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.

Environmental Health Specialists Network (EHS-Net)
These environmental healthspecialists 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 works to integrate evidence-based health strategies into community planning, transportation, and land-use decisions. The initiative

Uses tools like Health Impact Assessment (HIA), surveillance, and education to improve decision-making
Builds partnerships with decision-makers and stakeholders
Conducts research that identifies linkages between health community design, and translating that research into best practices

The initiative promotes 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:

Laboratory Efficiencies Initiative Tools
Through this initiative of CDC and the Association of Public Health Laboraties (APHL), several tools are available to support shared testing arrangements in laboratories. This includes the 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]. The LEI and LEI Policy Guide promote cross-jurisdictional sharing through the sharing of test services and policy “lessons learned” across states, procurement strategies, LEAN training, and workforce competencies. Additionally the Public Health Laboratory System Database (PHLSD) is a tool to improve local management of information on staff, equipment and testing services and will enable development of a national PHL test services directory.

Tribal Health and State Public Health Primers
Supported collaboratively by the Office for State, Tribal, Local and Territorial Support Tribal Support Unit and the Association of State and Territorial Health Officials (ASTHO), the ASTHO Tribal Health and State Public Health Primers 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 OSTLTS, 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. Health departments can choose to apply for this national voluntary accreditation program through a multi-jurisdictional application process.

National Public Health Performance Standards (NPHPS)
The NPHPS provides tools to help state and local public health systems and governing bodies assess their capacity and improve their performance.

NPHPS Local Public Health System Assessment tool, supported in collaboration with the National Association of County and City Health Officials (NACCHO), can promote cross-jurisdictional sharing and is often used by multiple local public health jurisdictions for regional improvement planning.

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 10 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.