Organizations such as the APHA and the Institute of Medicine state a firm belief in having program standards by which local health departments are compared.  Many theorize inclusion of The National Public Health Performance Standards Program identified ten “Essential Services for Public Health” and the three core functions of public health as named by The Institute of Medicine’s 1988 report, “The Future of Public Health” are essential in the foundation of such a system.  However, population served must also be considered.  Should states be permitted to evaluate the performance of local health departments using a set of standards based on the core functions, programs or services?  This question has been presented to leaders in public health academia; representatives of federal public health agencies and organizations; and health officers on the state, local and territorial levels using the Delphi technique – e-mail was utilized whenever possible.  On the local level, health departments were divided into small, medium, and large categories according to the population of their jurisdiction area.  Results of this series of questionnaires will be discussed and, if a consensus can be reached by presentation time, a suggested approach will be presented.