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The Partnerships Project helps LHDs make strategic decisions about service provision, leverage resources, and form partnerships with other healthcare providers. An important part of the project is Making Strategic Decisions about Service Delivery: An Action Tool for Assessment and Transitioning, a workbook that incorporates case studies and lessons learned.

This workbook demonstrates: (1) how to assess whether to continue providing clinical services; (2) if appropriate, how to transition these services to other community providers; and (3) how to assess community and patient outcomes resulting from the transfer of services. Additionally, it poses questions that need to be considered when making this transition. 

Interactive peer-to-peer trainings are available as a supplement to the workbook. These trainings, provided by NACCHO and LHD staff, are divided into four modules.

  1. A detailed overview on how and why this project was established, its place in the current healthcare environment, and an understanding of the implications of transition from direct to population-based services.
  2. An explanation of how and why the Making Strategic Decisions about Service Delivery workbook was developed, what it includes, and how to use it.
  3. Details on how and why to develop a decision-making plan for transitioning clinical services from the health department to external providers.
  4. A detailed look at the steps involved in transitioning clinical services from the health department to external stakeholders, enabling the health department to focus more resources on population-based services.

The modules, which need not be presented together, are designed for a variety of audiences and can be tailored to individual groups.

NACCHO has also created a 13-minute video that discusses the reasons for transitioning of two successful communities. For more information or to participate in the training, send an e-mail to or call (202) 783-5550.

NACCHO also maintains a database of LHDs in various stages of transitioning one or more clinical services to other parts of the healthcare system. If you have a story to add to the database, contact Also, let us know if your agency would be interested in training or technical assistance in this area.