Bud Nicola

Cross-jurisdictional approaches to meeting PHAB standards and achieving accreditation.

W ith more than 2000 public health departments present in the United States, discussions are taking place about how to assure that as many of them as possible provide high-quality services and meet the requirements established for national accreditation. At the same time, resources at all levels (federal, state, and local) are decreasing. As public health departments at all levels (tribal, federal, state, multijurisdictional, and local) face greater challenges with fewer resources, they are looking for ways to deliver services more efficiently and effectively. Crossjurisdictional sharing (the process of sharing resources across jurisdictional borders) has been proposed as a possible solution. This commentary will examine how cross-jurisdictional sharing (CJS) can help public health departments and their partners improve services and capabilities. We also will provide information about a new initiative to explore the use of these arrangements in public health and outline how the Public Health Accreditation Board (PHAB) has modified its accreditation process to acknowledge the influence of CJS. This strategy helps ensure that local health departments can efficiently and effectively deliver the range of services and capabilities necessary to protect and improve the health and well-being of our communities. Some public health leaders see CJS as a possible means of improving local public health performance and effectiveness. Several factors shape this perspective, including the following: