Savings, Service and Sensitivities: The Rural New

Transcript:Savings, Service and Sensitivities: The Rural New:
Savings, Service and Sensitivities: The Rural New York Cross Jurisdictional Sharing Experience Donald W. Rowe, PhD Director Office of Public Health Practice, University at Buffalo, State University of New York Paul Pettit, MSL Public Health Director Genesee and Orleans County Background Programmatic and fiscal environment National State Local National View Politics Continued downward trend in money and resources Annual uncertainty with funding streams Large difference in delivery system from state to state Accreditation - focus New York State View Politics NYS structure State DOH, regional/district offices, county LHDs State adopts/sets direction – carried out LHDs New focus by NYS Health Commissioner Provide reimbursements/funding to Counties Grants, article 6 – state aid Local Health Department View Shrinking county budgets – NYS tax cap Focus on mandates Limited capacity for “add-on's” Reducing direct service delivery Certified Home Health Agencies County run nursing homes Mental health clinical services 2014 – NYS budget – tax rebates tied to staying with cap and shared services County Collaboration efforts - Healthy Orleans Network LHD Workforce LHD Workforce Need for Collaboration – background to Cross Jurisdictional Sharing Current Federal, State & local environment Limited resources on the ground Philosophical shift facilitators vs. doers New reality for government including Public Health RWJF – Shared Services Learning Community Grant Two year study (2013-14) through the Kansas Institute focused on cross jurisdictional activities in public health 75 public health departments and 26 local and state governments - explore ways to share resources with the goal of providing more efficient and effective public health services $125,000 over to two years to study cross jurisdictional services (CJS) across geographical barriers 3 - on site project meetings & site visits at each participating project Applied through Lake Plains Community Care Network RWJF –Cross Jurisdictional Sharing Grant 16 sites were identified and accepted into the project Notified of award in early December 2012 National Announcement released January 31st. Definitions Cross-jurisdictional sharing is the deliberate exercise of public authority to enable collaboration across jurisdictional boundaries to deliver essential services. Collaboration means working across boundaries and in multi-organizational arrangements to solve problems that cannot be solved – or easily solved – by single organizations or jurisdictions.* *Source: Rosemary O’Leary, School of Public Affairs and Administration, University of Kansas 12 “Handshake” MOU Information sharing Equipment sharing Coordination Service provision agreements Mutual aid agreements Purchase of staff time Joint projects addressing all jurisdictions involved Shared capacity Inter-local agreements