Appendix C: Comparing the Organizational Structures of the Different Types of Agencies (Preliminary Report)

How are local health departments organized? Are there differences in organizational structure between the different types of agencies? 

There is no state-­‐mandated organizational structure for local public health agencies. As a result, the agencies have adopted organizational structures that best suit their needs.  While there are several trends and common features across the different types of agencies, there are also quite a few interesting variations. The generic organizational chart shown below offers a starting point for discussion. It represents the core structure that many county health departments have adopted.1 Variations on this core structure are then discussed in the table that follows. While the variations identified below are grouped according to model, the differences are not state-­‐mandated variations tied to particular models.  

This analysis is based on a review of sixty-­‐seven organizational charts from a mix of county health departments, district health departments, one public health authority (Hertford), one hospital authority (Cabarrus), and one consolidated human services agency (Wake). Most of these charts were initially collected as part of the accreditation process and were shared with the researchers upon request. Because agencies are accredited on a rolling basis, some of the charts reviewed were up to four years old. Moreover, given the economic climate over the last few years, some of the health departments may have changed their organizational structure.