Establishing
Cross-Jurisdictional
Agreements
A New York Perspective
Background
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New York State receives funds for public
health preparedness & response to
Bioterrorism
– As a state with an international border, we
also receive a carve-out for the Early
Warning Infectious Disease Surveillance
Project (EWIDS)
– The level of funding is based upon the
annual number of border crossings in the
respective states on the CA/MX border.
EWIDS Objectives and Primary
Areas of Focus
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Communication Infrastructure
Epidemiology/Disease Surveillance
Investigation Coordination
Public Information/ Risk Communication
Drill & Exercise to Evaluate the Plans
New York State Map
Our land/water border with Canada is approximately 500 miles in
length touching the Province of Ontario and Quebec
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Michigan began working with the
Province of Ontario in 2004 on the
EWIDS Project
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New York, Minnesota and Wisconsin
joined the group in 2005 and the Great
Lakes Border Health Initiative began as
a multi-state cross jurisdictional group
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New York began working with the
Province of Quebec in 2004 on the
EWIDS Project
Vermont, New Hampshire and Maine
joined with NY and the Northeastern
Border Health Initiative began as a
multi-state cross jurisdictional group
Recent expansion of the NE group will
also include Nova Scotia and New
Brunswick
Developing an Alliance
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Identify critical partners from participating state and Canadian
province on your border……..make a directory
Plan face-to-face meeting for introductions and outline roles and
responsibilities……..move meetings around
Develop a shared understanding of public health emergency
response systems……..use a staffing or flow chart
Set up a steering committee and write a Term-of-Reference as a
guiding document
Set up a sub-committee structure to meet the project’s
objectives
Set up a series of monthly tele-conference calls
Design a work plan as a guide to accomplish project
objectives……..use due dates to prioritize the work
Reality Check (Challenges)
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States can not enter into international agreements of
any kind without Congressional approval
Have the lawyers at the table from the beginning
Cultural, Political and Language differences (Quebec
and Mexico) must be acknowledged and be part of
your alliance plan
Tribal Nations on the border present many unique
circumstances
Scope of the EWIDS Project is extremely broad
Example
Actual EWIDS Grant Objective:

Rapidly detect a bioterrorist event along
the US northern and southern border
through a highly functioning mandatory
reportable disease surveillance system
Example
Actual EWIDS Grant Example:
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Ensure the electronic exchange of
infectious disease related
information(including clinical,laboratory
and environmental data) in standard
formats between the computer systems
of grantee public health department and
those of the counter part agency across
the international border
Federal Guidance has been
limited to date:
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New project with a very broad scope
Complex project with multiple
federal/state/local partners who are all
stakeholds
Example
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Some federal partners include:
DHS,DHHS,USCBP, CDC Division of
Public Health Preparedness and
Division of Global Migration &
Quarantine, USDA
Some state partners include:
DOH,SEMO, LHD, Tribal Nations
Lack of Coordination
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Example:
– International Agreement recently signed between the US and
Canada to link the CDC’s PulseNet system to
PulseNetCanada designed to trace outbreaks of nasty
foodborne pathogens like e.coli
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Example:
– US, Canada and Mexico recently signed an International
Security and Prosperity Agreement to guard our borders
– Entire section on biosecurity at the border with timeframes of
24 months for deliverables on inter-operable disease
surveillance systems
– Draft and sign protocol within 24 months for mutual
assistance and coordination in a cross border emergency
Ideas to Move Forward
(Successes)
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Primary relationships have been
developed
Professionalism of Partners
Many plans are well underway
Commitment to be prepared is there
Federal Partners are listening to needs
expressed by the border states
Summary
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Meet who you want to work with face-to-face and
build the relationship you will need
Write attainable short term goals so some degree of
success is visible and do-able
Create a contact directory for communications and
talk to one another
Set up a Steering Committee and sub-committee
structure and tele-conference frequently with one
another
Write a budget that can accommodate meeting your
goals & objectives
Talk to your federal partners so they can hear what
your up against and then ask for more funding
Contact Information:
Richard Buck, Border Health Manager
Public Health Preparedness Program
NYSDOH
547 River Street
Troy, NY 12180
518.402.7713
[email protected]
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