Reinvigorating public health core functions: restructuring Los Angeles county's public health system

In 1997, the Los Angeles County Department of Health Services launched an effort to revitalize its Public Health Services division. County investments resulted in the creation of 241 new positions, facilitating the establishment of new offices addressing neglected chronic disease prevention, staff development, training, and communication. Service effectiveness and community responsiveness were enhanced by decentralizing leadership through eight Area Health Offices and strengthening partnerships with private health care providers, community-based organizations, and managed care organizations. Infrastructure enhancements included the development of program performance measures, countywide health indicators, a central health assessment and epidemiology office, and a new countywide biennial survey.