Rural health departments across the country are under considerable economic constraint as they try to maintain essential health services. A model program designed to assist rural counties in cutting costs by sharing health services has helped two Western New York counties realize health care savings approaching $840,000 over two years without loss of services or jobs. One developer says the program may help remake the landscape of rural health care in the United States.
The project, “The Cross Jurisdictional Sharing Program,” was devised collaboratively by the University at Buffalo School of Public Health and Health Professions (SPHHP), the health departments of Orleans and Genesee counties, and the Lake Plains Community Health Care Network, a nonprofit agency that fosters shared efforts to improve health care and keep it local.
In recognition of its significant contribution to the field of public health, the program has received the 2014 Outstanding Rural Health Program Award from the New York State Association for Rural Health. It was implemented in January 2013, and in its first year, helped the two counties save $400,000 and positioned them for greater efficiencies, further successful integration and greater savings, all with no loss of health care services or jobs in either county. Since then, $400,000 more has been saved, bringing the total two-year savings to about $840,000.
Dr. Donald W. Rowe, director of the Office of Public Health Practice in SPHHP, who helped develop the project, brought an uncommon perspective to the undertaking since he served for 17 years as Genesee County’s director of public health. “State and local health departments across the country are under serious fiscal duress,” Rowe says, “and rural health departments are disproportionally impacted. Because of that, this project will be under scrutiny in rural jurisdictions across the country. The model has broad potential applications in public and private health care organizations, however, and suggests a number of methods by which rural health programs in particular can save money and preserve services.”
“They range from informal agreements around sharing discrete services or programs to regionalization,” Rowe says, “including the formal merger or consolidation of multiple public health agencies. In this case, we helped Genesee and Orleans counties find ways to share administrative and professional services — including a single public health director or commissioner, nursing and environmental health supervision, medical and environmental engineering consulting, and public health emergency preparedness.”
“This model may signal the future of rural public health.” Dr. Rowe says.
As the Western New York program was being developed, the Robert Wood Johnson Foundation (RWJF), in partnership with the Kansas Health Institute, began a study on cross-jurisdictional health care services in the U.S. The foundation selected the Western New York project as one of 16 sites across the country to implement an innovative program model through a grant from the foundation.
“As far as I know,” says Dr. Rowe, “while the other projects are exemplary, ours is the only one to have shown savings in year one and has since demonstrated financial viability and sustainability in year two and beyond.
“Because federal funding sources are impressed with projects in which community agencies work closely with academic centers,” he says, “ UB’s involvement may have helped secure the RWJF grant.
“An added boon for the university,” says Dr. Rowe, “is that Suman Sarker, an alumnus from the Department of Community Health and Health Behavior, provided invaluable hands-on assistance to those putting this program into action. He did an incredible job, working closely with the grantees from Genesee and Orleans counties to produce the deliverables. In turn, he had significant experience in helping to develop and implement a leading-edge, and perhaps influential, public health program.
“Public health has always been my passion,” says Dr. Rowe, “and when a project resulting from university-community collaboration produces such demonstrable and replicable benefits, I think it’s important that we tell the public about it.”