Roles for state-level local health liaison officials in local public health surveillance and capacity building.

In 27 state health agencies, local health liaison units or officials (LHLOs) are formally assigned responsibility for fostering a close working relationship between the state health agency and local health departments (LHDs). Yet in most other states, other agency staff carry out these responsibilities informally. Even where formal LHLOs exist, the assigned functions and specific activities vary, with little consistency across states other than serving as a potential or, in most cases, a real and vital linkage between LHDs and the state agency. This linkage places the LHLO in a unique position to have extensive knowledge, data, and information on LHD activities and to play an important role in assessing and improving local public health practice. This report examines aspects of the LHLO-LHD relationship in terms of potential LHLO roles in LHD practice surveillance and capacity building. Surveys of LHLOs and LHDs indicate that both support the development of surveillance tools to measure LHD effectiveness as a means to enhance capacity building efforts. Although LHLOs may not know or have the specific information immediately available to assess local public health practice for LHDs in their state, they report being able to obtain the information if necessary and with sufficient time. Further, LHDs are willing to share information concerning local public health practice with their state health department, particularly with their state LHLO. These findings suggest that LHLOs could be extensively involved in surveillance strategies beyond merely collecting and aggregating information provided by LHDs.