S-5094

   Amend Senate File 2432 as follows:
   1.  By striking everything after the enacting clause and inserting: 
   <Section 1.  Section 135.105B, subsection 3, Code 2026, is amended to read as follows:
   3.  Following development of the voluntary guidelines, cities or counties may elect to utilize the guidelines in developing and administering local programs through city or county health departments on a city, county, or multicounty basis or may request that the state develop and administer the local program. However, cities and counties are not required to develop and administer local programs based upon the guidelines.
   Sec. 2.  Section 135I.1, subsection 2, Code 2026, is amended to read as follows:
   2.  “Local board of health” means a city, county, or district board of health the same as defined in section 137.102.
   Sec. 3.  Section 137.102, subsections 1 and 2, Code 2026, are amended by striking the subsections.
   Sec. 4.  Section 137.102, subsection 10, Code 2026, is amended to read as follows:
   10.  “Local board of health” means a city, county, board or a district board of health.
   Sec. 5.  Section 137.103, subsection 1, Code 2026, is amended by striking the subsection and inserting in lieu thereof the following:
   1.  A city shall not maintain a city board of health or a city health department. Each city shall perform the city’s public health services through the city’s local board of health.
   Sec. 6.  NEW SECTION.  137.103A  County boards.
   1.  A county board shall execute an agreement with each county hospital located in the county that the county board represents to allow for sharing of facilities, health care services, and administrative resources.
   2.  A county board may submit an application to the department to waive the requirement in subsection 1 by providing the department evidence of all of the following:
   a.  The county board has access to an alternative means of providing health services comparable to those provided by the county hospital with which the county board would otherwise be required to contract.
   b.  The alternative means of providing health services is more cost-effective for the county board than contracting with the county hospital.
   3.  A county board that applies for a waiver under subsection 2 must submit a letter explaining the county board’s decision to apply for the waiver to the county board’s county board of supervisors.
   Sec. 7.  Section 137.104, subsection 1, paragraph b, subparagraph (1), Code 2026, is amended by striking the subparagraph.
   Sec. 8.  Section 137.105, subsection 1, paragraph a, Code 2026, is amended by striking the paragraph.
   Sec. 9.  EFFECTIVE DATE.  This Act takes effect January 1, 2027.>
   2.  Title page, by striking lines 1 through 4 and inserting <An Act eliminating a city’s ability to create a city board of health or a city health department, and including effective date provisions.>

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MIKE BOUSSELOT