The researchers examined intragovernmental activities within four northeastern states to determine their impact on fragmentation in the public health system. They studied the interactions of state administrative agencies in addressing two public health challenges— substance abuse and HIV/AIDS — to better understand how they facilitate or impede efficient and effective implementation of core public health functions. In particular, they: 1) identified the types of intragovernmental activities within state public health systems that are required by law or regulation; 2) described the types of intragovernmental activities that occur in states that are intended to address core public health functions; 3) identified factors influencing the type of engagement and barriers to such activity; and 4) identified models of successful intergovernmental collaboration. The objective of this project was to generate lessons for states about how they can more efficiently and effectively identify and respond to public health problems with scarce resources.