State and local organizational relationships differ throughout the United States, with states adopting a centralized, shared, decentralized, or mixed governance structure. Give a brief explanation of each of these four organizational models
Centralized – Local health units are primarily led by state employees and the state retains authority over most decisions related to finances, public health orders, and the selection of local health officials.
Shared – Local health units may be led by state or local government employees. If they are led by state employees, the local government has the authority to make key decisions. In states with a shared governance system where LHDs are led by local employees, the SHA retains the authority to make certain key decisions.
Decentralized – Local health units are primarily led by local government employees, and the local governments retain authority over most key decisions.
Mixed – Some local health units are led by state employees and some are led by local government employees; no one arrangement predominates in the state.
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