Local health government (local health departments) is established to carry out critical public health responsibilities under state laws and local ordinances and to meet the needs and the expectations of their communities (Turnock, p.188). The most dramatic change in the structure of public health practice has been the development of local health agencies. They share public health responsibilities with their state agencies. However, top priorities for local health departments are communicable disease control, environmental health services, and children's health. They do this by providing a common core of services that generally include adult and child vaccinations, tuberculosis screening/treatment, community nutrition services, community assessment/awareness/education, food safety inspections, and health education. (Turncock, B.