The purpose of the LHER is to serve as a guide to Practice Standards implementation and as an assessment tool for the local health agency's performance in the implementation of the Practice Standards. Three components, including:

Section I: Local Health Evaluation Report/Questionnaire

Section II: Budget by Funding Source

Section III: Supplemental LHER Forms A-F

NOTE: It is highly recommended that one become familiar with the forms in Sections I and II by reviewing the samples provided before completing them on line. The NJPortal will automatically “time-out” or shut down after thirty minutes (30). Information not completed and submitted before then will be lost and the user will be obligated to start over.

This questionnaire must be completed online through the State's Portal ( Instructions for access to LHER system through State's Portal).

The questionnaire is designed with either yes/no or scaled responses. The scaled responses are based on the level of completion.

The online system will automatically award points to each answer in Section I that will be computed by subsection and in total once the report has been submitted. The information and data provided, as part of the LHER, will be maintained in a NJDHSS centralized database and will serve as a partial resource for determining baseline capacities and performance and to monitor and evaluate trends. The scoring system has been developed in order to provide information on strengths and weaknesses for the purpose of process improvement and system development. It is not intended as a monitoring device for local health department activities.

Simple 'yes' and 'no' answers are valued at 0 or 3 points, 0 for a 'no' answer and 3 for 'yes'. Percentages (where provided), refer to the level of completion or degree of activity for that item. Specifically, the scaled responses are based on the following conditions and will be awarded points as indicated:

Not Met, 0 to 25 percent completion=0 points
Partially Met, 26 to 50 percent completion=1 point
Substantially Met, 51 to 75 percent completion=2 points and
Met, 76 to 100 percent completion=3 points

Responses to questions in Section I (the Questionnaire) may be corrected during completion. However, once the information has been submitted, it cannot be changed. Completed forms are available for review or printing.

Sample Questionnaire (This blank form can be printed as a hard copy)

Jump to Portal

Section II: Budget by Funding Source

This form must be completed online through the State's Portal ( Instructions for access to LHER system through State's Portal).

You will also find a Glossary of Terms which provides further detail for both the Activity Categories as well as the Funding Sources.

Please print out a copy of the Budget by Funding source chart prior to entering the Portal to prepare the data for entering. Once the information has been submitted, it cannot be changed.

Sample for Budget by Funding Source (This blank form can be printed as a hard copy)

Jump to Portal

Section III: Supplemental Forms

All the forms in Section III are fillable, meaning they should be downloaded and saved to the computer’s hard drive and completed off line.

This section consists of various supplementary documents identified by one of the following corresponding letters:

LH2 A is Health Officer Certification
LH2 B is the Best Practices and Capacity and Performance form
LH2 C is the Program Management Leadership Staff Chart
LH2 D is the Record of Employee Education and Training Contact Hours form
LH2 E is the Community Organizations and Agencies Working in Partnership form
LH2 F is Board of Health Approval Form

Form B: Core Activities

Information should be provided for all Core Activities (Sections I-A through I-F) unless they have been formally waived. Do not use "Not Applicable (N/A)" if an activity has not been provided and has not been waived. Each line of data within each activity provided by your health department requires an entry (See GENERAL, below.). If there are no participants/services in a given category, indicate that with a zero. Please do not leave any spaces blank!

Form B: Elective Activties

Elective activities which are being provided should be completed in full. It is not necessary to put N/A next to those elective activities not being provided.

Form B: General

Services provided by contracting agencies or individuals such as health educators and VNA's or Home Health Agencies which are directly funded by the local health department should be accounted for and reported where applicable (e.g. STD, Cancer, TB, Health Promotion).

Several activities request information on the number of unduplicated users and the number of total visits. For example, 1,500 visits for a CHC may have been recorded; however, of those 1,500 visits, only 1,000 children were seen. The number of unduplicated users is 1,000; the number of total visits 1,500.

After completing section III, please send all forms (A, B, C, D, E, and F) to the Department at: