This article uses data from a study commissioned by the Illinois Public Health Institute in 2007 as part of the Robert Wood Johnson Foundation Multistate Learning Collaborative Grant for exploring accreditation of health departments. Local health departments in Illinois were surveyed on their self-assessed performance in meeting a set of performance standards derived from the Illinois Practice Standards and the Operational Definition of a Functional Local Health Department. All state-certified local health departments were represented in the survey by the 81 respondents. The lowest scores were observed in the evaluate standard (evaluate programs and provide quality assurance in accordance with applicable professional and regulatory standards to ensure that programs are consistent with plans and policies, and provide feedback on inadequacies and changes needed to redirect programs and resources). The findings suggest that new approaches are needed to better integrate evaluation in local health departments beginning with training designed specifically for and informed by local health department administrators.