SLGE examines how local health departments have implemented staff-sharing arrangements across geographic boundaries. The research provides important insight on key challenges, how the effort was implemented, financial consideration, outcomes, and lessons learned through two case studies of staff-sharing arrangements in New Jersey and Minnesota. The report also highlights two areas of focus that are critical as local leaders consider sharing staff across jurisdictions: building the business case for cross-jurisdictional sharing and evaluating the success of the arrangement.

Case Studies in Staff Sharing in Local Public Health was developed by the Center for State and Local Government Excellence (SLGE) with support from the Center for Sharing Public Health Services.

The first case study examines Gloucester and Salem counties in New Jersey. There, state law requires that counties have a full-time licensed health officer, but allows the flexibility for that health officer to be shared, which is what Gloucester and Salem counties have done since 2014. The case study reports that rather than each bearing the full expense of a health officer position, sharing a position made it both more economical and more efficient. Other benefits cited in the case study include more uniform and coordinated service delivery, stronger relationships among community partners, and streamlined operational oversight.

The second case study examines the rural counties of Brown, Nicollet, Cottonwood, and Watonwan, in south central Minnesota. These jurisdictions have been sharing the services of the Brown-Nicollet Environmental Health staff since the mid-1990s. The report indicates that all four counties find value in the collaborative approach. The staff-sharing arrangement allows staff to have a pulse on what is happening on at the local level, to respond quickly to local citizens and licensed establishments, and to maintain environmental public health expertise and capacity at the local level.

“These two case studies are important because local health departments are looking for innovative approaches to contain costs while improving the efficiency and effectiveness of local public health services,” said Rivka Liss-Levinson, Ph.D., SLGE director of research and report co-author. “Staff-sharing arrangements are not yet common, but our research finds early successes. This strategy has the potential to be applied across a range of local government departments to save money and provide better public health services,” she said.

In recent years, local public health departments have been asked to do more with less—to provide high-quality public health services, programs, and activities to the people they serve, but with a substantially limited budget. Facing this challenge, local health departments have developed approaches to continue their level of services and programs while reducing costs, including cross-jurisdictional sharing of resources across geographic boundaries— equipment, information, or staff—among one or more local health departments. Sharing personnel, positions, or services can address existing staff shortages, help jurisdictions make the most of available resources, enhance flexibility, improve communication and coordination, and even add capacity for more or improved services.

These new case studies follow two related reports, Staff Sharing Arrangements for Local Public Health and Staff Sharing in Public Health: A Checklist for Communicating with Elected and Appointed Officials.

The Center for State and Local Government Excellence (SLGE) helps local and state governments become knowledgeable and competitive employers so they can attract and retain a talented and committed workforce. SLGE identifies leading practices and conducts research on public retirement plans, health and wellness benefits, workforce demographics and skill set needs, and labor force development. SLGE brings state and local leaders together with respected researchers. Access all SLGE publications at, sign up for the e-newsletter, and follow @4GovtExcellence on Twitter.

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Center for State and Local Government Excellence | 202.256.1445 | [email protected]

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