Local governments, especially in rural settings, may look to collaborate with neighboring communities to maintain public health services and efficiencies in face of restrictive local budgets. Cross-jurisdictional partnerships of rural health departments have allowed offering an increased range of prevention programs and community health initiatives. Genesee and Orleans counties, in rural Western New York, developed a cross-jurisdictional partnership 7 years ago which has been integral for the coronavirus disease 2019 (COVID-19) response for both county health departments. Using a cross-jurisdictional partnership and a joint incident command structure has allowed a coordinated approach towards contact tracing of COVID-19 confirmed cases.