Exam 9: The Local Health Department

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Describe a mixed governance relationship between state and local health agencies, and give an example state. Give an advantage and disadvantage of this type of relationship.

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a. Mixed governance: Local health departments (LHDs) are units of local government or units of a state health agency. Examples: Oklahoma City-County and Tulsa City-County Health Departments in Oklahoma have independent departments, while other regions have offices of the state health department; also Maryland and Wyoming.
b. Advantages: ensuring availability of state-run public health services in smaller communities, while giving broad authority and local control to large communities
c. Disadvantages: inconsistency in policy development and variation in services

Describe the three core functions of local public health departments.

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a. Assessment: collecting, analyzing, and sharing information about the health of the population
b. Policy development: developing public health policies based on scientific knowledge to protect the population served
c. Assurance: enforcing public health laws and regulations, conducting health education and health promotion programs, working to ensure that appropriate health care services are available to individuals

The range of LHD financing is strongly related to population size. Name several sources of revenue for LHDs.

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Revenues come from a variety of sources including:
a. Local government
b. State government
c. Federal funds passed through to the LHD by state agencies (e.g., CDC, Health Resources and Services Administration, Substance Abuse and Mental Health Services Administration)
d. Reimbursement from Medicare, Medicaid, and other insurers
e. Regulatory and patient personal fees
f. Other sources (e.g., grants from private foundations)

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