The Flex Monitoring Team (FMT) has released a brief on the operation of Critical Access Hospital (CAH) and local health department (LDH) partnerships, an important area of activity to improve population health and address the needs of rural communities. The brief is based on data from the American Hospital Association’s Annual Survey of Hospitals and qualitative interviews with four pairs of CAH/LDH partners. It compares the collaborative and community focused activities of CAHs compared to rural and urban perspective payment system (PPS) hospitals, identifies the challenges and opportunities to improve community collaboration to address community needs. This study found that CAHs are less likely to collaborate with LDH and other community providers than their rural and urban PPS peers. The brief further identifies three opportunities to improve CAH/LDH collaboration by concentrating on local community health needs assessment and implementation strategies, development of local emergency preparedness plans and capacity, and focusing on local collaborating experience during the COVID-19 public health emergency. This brief provides important information that State Flex Programs can use to support local collaboration and population health activities under the population health program area.