Need: Public health departments in Colorado's rural San Luis Valley region desired to share public health services to improve health outcomes in the region.
Intervention: Six counties joined in a public health cross-jurisdictional sharing arrangement. The partnership has served as a forum for sharing and evaluating opportunities to improve health access and core public health services.
Results: The partnership has enabled health departments to share expertise and develop regional projects to provide a broader range of public health services.
The San Luis Valley in southern Colorado is a
geographically isolated area. Its 80,256 square miles
include 3 rural and 3 frontier counties. Because
Colorado's public health system is decentralized, each of
these counties is served by a local health department
with their own board of health. In order to optimize
resources and staff, leaders of the 6 counties' health
departments formalized a cross-jurisdictional sharing
(CJS) partnership in 2013.
The San Luis Valley Public Health
Partnership (SLVPHP) serves as a coalition of San
Luis Valley's local public health directors. By
collaborating to build capacity, their mission is to
develop and sustain public health systems to improve
health outcomes throughout the valley.
SLVPHP methods include sharing projects and staff when
needed, working together to meet state planning
requirements, and offering support and technical
assistance to community coalitions. To standardize their
partnership, they developed common guiding principles and
an operating agreement. Every 3 years, county
commissioners approve an inter-governmental agreement
affirming the counties' support of these shared
The SLVPHP is made up of the following public health
Alamosa County Public Health Department
Conejos County Public Health and Nursing Service
Costilla County Public Health Agency
Silver Thread Public Health District on behalf of
This collaborative model has allowed SLVPHP to support
each public health department in their responsibilities
and new initiatives that benefit the group. SLVPHP shares
services and functions, including:
Emergency preparedness and response planning and
Epidemiology including the investigation of
tuberculosis, salmonella, rabies, food-borne illnesses,
as well as the prevention of HIV and childhood lead
Child fatality reviews
Home health services
A breastfeeding coalition
A regional environmental health
program (retail food safety, recreational water
inspection, and institutional inspections)
The partnership serves as a forum for exchanging
information and exploring new ideas. Partners meet
monthly to review current projects, hear presentations
from subject-matter experts and community partners, and
explore new opportunities for sharing information and
Prior to the partnership, environmental health
services were provided by the state. SLVPHP implemented a
regional environmental health program that made it
possible to deliver services catered to the local
priorities in the region.
SLVPHP obtained funding in 2016 from the Colorado
State Innovation Model to improve access to care and reduce
behavioral health stigma over a 3-year period. Funding
supported a public education campaign and the integration
of behavioral health into primary care settings.
SLVPHP received the
National Health Security Award from the National
Association of County and City Health Officials (NACCHO)
acknowledging their creation of a regional disaster
health response system. This award was given to 6 health
departments that have implemented various health
Recruitment and retention is a common problem in rural
areas, and turnover of program directors is especially
disruptive to operations. The partnership is an
additional support system for new directors,
significantly shortening their learning curve.
With limited staff, time, and resources, the partnership
is cautious about how many projects they take on. Funding
from the Preventative Block Grant through the Colorado
Department of Public Health and Environment supports a
part-time partnership coordinator position. A lack of
sustained full-time funding impacts SLVPHP's capacity to
develop new initiatives and to work upstream to address
health equity issues.
A state initiative to modernize public health funding is
underway. Planning and capacity analyses consumed a
substantial amount of time in 2019 across agencies.
Public communication has had challenges. Some areas of
the Valley have less than adequate wireless access, and
no single media outlet reaches all citizens.
Please contact the models and innovations contact directly for the most complete and current information
about this program. Summaries of models and innovations are provided by RHIhub for your convenience. The
programs described are not endorsed by RHIhub or by the Federal Office of Rural Health Policy. Each rural
community should consider whether a particular project or approach is a good match for their community’s
needs and capacity. While it is sometimes possible to adapt program components to match your resources, keep
in mind that changes to the program design may impact results.