Cross-Border TB Care Program Selected for New National Pilot Project to Improve Local Public Health Services

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Health departments in 14 states, including San Diego and Imperial Counties plus Baja California, will explore how “cross-jurisdictional sharing” can lead to greater efficiency and impact

The expanded support that the Puentes de Esperanza program receives from being part of the learning collaborative will help us more effectively respond to cross-border multidrug- resistant TB in the San Diego-Imperial County-Baja California border region.

The Topeka, Kansas-based Center for Sharing Public Health Services recently announced grants totaling $1,927,968 to 16 teams of health departments to explore how “cross-jurisdictional sharing” might better equip them to fulfill their mission of protecting and promoting the health of the communities they serve. Among the grantees selected was a team led by the International Community Foundation (ICF) to formalize and implement cross-jurisdictional sharing (CJS) arrangements between the Counties of San Diego and Imperial, the State of California and the State of Baja California as well as expanded collaboration with local/regional funding partners to ensure the long-term sustainability of a vital cross-border multidrug-resistant tuberculosis (MDR-TB) care and prevention program, Puentes de Esperanza (Puentes).

The planned two-year learning collaborative being led by the Center for Sharing Public Health Services will help Puentes and other participating teams – which include more than 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. As part of its participation in the learning collaborative, ICF and its regional public sector partners will receive $125,000 over two years to support expanded CJS arrangements. ICF and its partners will work to formalize and implement a comprehensive strategy aimed at institutionalizing relationships between the County of San Diego Department of Health & Human Services, the County of Imperial Public Health Department, the State of California Department of Public Health and the State of Baja California Secretariat of Health to promote the continuation and expansion of the binational Puentes MDR-TB program with the active support of regional philanthropic partners.

According to Richard Kiy, ICF President & CEO, “The expanded support that the Puentes de Esperanza program receives from being part of the learning collaborative will help us more effectively respond to cross-border multidrug- resistant tuberculosis (MDR-TB) in the San Diego-Imperial County-Baja California border region, which is home to nearly 6.4 million people.”

Communities across the country rely increasingly on public health departments for services ranging from immunizations and health education to disaster preparedness and response. In recent years, funding for public health has dropped significantly even as the mission of public health departments has continued to expand.

CJS enables health departments to share programs, services and resources across the jurisdictions they serve. The projects being funded are aimed at helping health departments and policymakers test the potential of CJS to expand the quality and availability of services while also improving efficiency. These arrangements can range from addressing technical needs to broader objectives such as the merging of multiple health departments into a single agency. The Center for Sharing Public Health Services is a national initiative managed by the Kansas Health Institute (KHI) with support from the Robert Wood Johnson Foundation (RWJF).

The new project will bring together health officials, policymakers and other key stakeholders in 14 states to identify and share best practices from their experiences in using different types of these sharing arrangements as a strategy to provide more effective and efficient public health services to their communities.

“When it comes to the health of our communities, we rely on strong public health systems,” said Patrick Libbey, Center Co-director. “In recent years, cross-jurisdictional sharing has shown promise as a strategy that can help health departments carry out their mission, and maximize the impact and reach of limited resources.”

KHI was selected to coordinate the grants in large part because of its experience guiding similar work among local health departments in Kansas. That work was led by Dr. Gianfranco Pezzino, a Senior Fellow at KHI, who now serves with Libbey as Co-director of the Center. “Exploring how sharing scarce resources can improve the quality and efficiency of public health services is very important in rural states like Kansas,” Pezzino said. “But it could be just as valuable to public health departments and policymakers in any area. That is one of the ideas being explored by the projects being undertaken by the diverse group of grantees we have chosen.”

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