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The models are described in the 2005 National Profile of Local Health Departments (id.) and the Turning Point project's 2002 State Public Health Law Assessment Report (Gostin, L. O. and Hodge, J. G. Jr., Turning Point Public Health Statute Modernization National Excellence Collaborative, State Public Health Law Assessment Report, 2002, available at <http://www.turningpointprogram.org/Pages/pdfs/statute_mod/phsm_state_ph_law_assessment_report.pdf> [last visited July 1, 2008]). In its 2005 National Profile of Local Health Departments, NACCHO surveyed 2,864 local health departments across the country. Of the 2,300 local health departments that returned the Web-based questionnaire, 79% self-identified as units of local government (decentralized) and 21% as units of the state health department (centralized). See Leep (id.), at 4. The NACCHO study named four categories (centralized, decentralized, mixed, and shared) but used only three categories in the study for purposes of simplification: All local health departments are units of the state health agency, all local health departments are units of local government, and mixed. [last visited July 1, 2008]). In its 2005 National Profile of Local Health Departments, NACCHO surveyed 2,864 local health departments across the country. Of the 2,300 local health departments that returned the Web-based questionnaire, 79% self-identified as units of local government (decentralized) and 21% as units of the state health department (centralized). See Leep (id.), at 4. The NACCHO study named four categories (centralized, decentralized, mixed, and shared) but used only three categories in the study for purposes of simplification: All local health departments are units of the state health agency, all local health departments are units of local government, and mixed.' href=https://scholar.google.com/scholar?q=The+models+are+described+in+the+2005+National+Profile+of+Local+Health+Departments+(id.)+and+the+Turning+Point+project's+2002+State+Public+Health+Law+Assessment+Report+(Gostin,+L.+O.+and+Hodge,+J.+G.+Jr.,+Turning+Point+Public+Health+Statute+Modernization+National+Excellence+Collaborative,+State+Public+Health+Law+Assessment+Report,+2002,+available+at++[last+visited+July+1,+2008]).+In+its+2005+National+Profile+of+Local+Health+Departments,+NACCHO+surveyed+2,864+local+health+departments+across+the+country.+Of+the+2,300+local+health+departments+that+returned+the+Web-based+questionnaire,+79%+self-identified+as+units+of+local+government+(decentralized)+and+21%+as+units+of+the+state+health+department+(centralized).+See+Leep+(id.),+at+4.+The+NACCHO+study+named+four+categories+(centralized,+decentralized,+mixed,+and+shared)+but+used+only+three+categories+in+the+study+for+purposes+of+simplification:+All+local+health+departments+are+units+of+the+state+health+agency,+all+local+health+departments+are+units+of+local+government,+and+mixed.>Google Scholar

This latter structure exists, for example, in Maryland. See, e.g., Maryland Association of Counties, “Forms of Government in Maryland,” available at <http://www.mdcounties.org/counties/forms_of_government.cfm> (last visited June 23, 2008).+(last+visited+June+23,+2008).>Google Scholar

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Arkansas, Delaware, Hawaii, Louisiana Mississippi, New Mexico, Rhode Island, and South Dakota do not have local boards of health. See Leep, supra note 4, at 13.Google Scholar

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Federalism in this context means the theory of government by which powers are divided between a national government and state governments, each with their own areas of substantive jurisdiction. Federal and state preemption is the legal principle that a federal law supercedes or trumps any inconsistent state law or regulation. Similarly, state law may trump or “preempt” local or city law on certain issues.Google Scholar

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HIPAA is the acronym for the Health Insurance Portability and Accountability Act of 1996, Public Law 104–191, which included “administrative simplification” provisions that required Department of Health and Human Services (HHS) to adopt national standards for electronic health care transactions and standards to protect the privacy of those transactions.Google Scholar

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These Centers include the Technical Assistance Legal Center (California), the Tobacco Control Resource Center (Northeastern University, Massachusetts), the Tobacco Law Center (William Mitchell College of Law, Minnesota), Smokefree Environments Law Project (Michigan), the Tobacco Control Policy Legal Resource Center (New Jersey), the Secondhand Smoke Technical Assistance Resource Center (Colorado), and the Tobacco Public Policy Center (Capital University Law School, Ohio).Google Scholar

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Telephone interview with Steve Hitov, Managing Attorney, National Health Law Program, June 12, 2007. NHeLP actually predated the LSC and was started at the University of California, Los Angeles (UCLA) School of Public Health. The LSC, established by Congress in 1974, was an outgrowth of the legal services programs for the poor that had been administered by the Office of Economic Opportunity (OEO) in the late 1960s and early 1970s. At the height of LSC funding, there were approximately 13 legal back up centers, a number of which had academic roots. These centers primarily assisted local legal aid attorneys. When Congress dramatically amended the functions of the LSC as part of an appropriations act in 1996 — placing limits on the types of permissible actions they could undertake (e.g., no class action suits, no assistance for illegal aliens or some classes of legal aliens, no attempts to influence legislation, no litigation regarding welfare reform) — and extended those prohibitions to legal aid programs' use of other sources of funds, NHeLP and other back up centers refused to accept LSC funds and established themselves as independent organizations, committed to assisting local attorneys working with the indigent on issues ranging from health care to housing to welfare.Google Scholar

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These organizations are affiliated with, but not financially supported by, NACCHO.Google Scholar

Association of State and Territorial Health Officials, “About ASTHO,” available at <http://www.astho.org/index.php?template=about_astho.html&PHPSESSID=550f05cea1f363e3a344d94ff1d4b05e> (last visited June 23, 2008).+(last+visited+June+23,+2008).>Google Scholar

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Health Law Advocates, available at <http://www.hla-inc.org> (last visited June 23, 2008). We describe HLA as “health law,” rather than “public health law,” focused because the panel generally accepts cases relating to health care access, delivery, and financing rather public health issues.+(last+visited+June+23,+2008).+We+describe+HLA+as+“health+law,”+rather+than+“public+health+law,”+focused+because+the+panel+generally+accepts+cases+relating+to+health+care+access,+delivery,+and+financing+rather+public+health+issues.>Google Scholar

Furthermore, HLA only accepts cases that fall within its current priorities which include: (1) the Children's Mental Health Access Project; (2) the Divorce Judgment and Health Insurance Project; (3) ensuring access to dental care; (4) fighting for essential hospital services; (5) maximizing access to private health insurers; (6) the Massachusetts Mental Health Parity Project; (7) preserving the safety-net for Massachusetts' most vulnerable residents; (8) supporting access to prescription drugs; (9) the Worcester Mental Health Task Force; (10) working to improve prison health care; and (11) Massachusetts health care reform. Id.Google Scholar

BNA is a publisher of information and analysis products for professionals in law, tax, business, and government. The company's 350 print and electronic products address legal, legislative, regulatory, and economic developments affecting business. These reports are available based on paid subscriptions. BNA currently publishes 15 health related reports.Google Scholar

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Another possibility is a “blog” or online question/answer format. The Baltimore City Health Department hosts an online forum through which city residents can obtain answers to questions relating to environmental health and hygiene regulation. “Ask Inspector O” is a popular, informal service staffed by a city attorney housed in the city health department. See City Health Department, “Ask Inspector O,” available at <http://inspectoro.blogspot.com/> (last visited June 23, 2008).+(last+visited+June+23,+2008).>Google Scholar

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NHeLP, for example, has offices in Washington, D.C., Los Angeles, and Chapel Hill, North Carolina.Google Scholar