House
Study
Bill
518
-
Introduced
SENATE/HOUSE
FILE
_____
BY
(PROPOSED
DEPARTMENT
OF
PUBLIC
HEALTH
BILL)
A
BILL
FOR
An
Act
creating
the
local
public
health
governance
Act,
and
1
providing
penalties.
2
BE
IT
ENACTED
BY
THE
GENERAL
ASSEMBLY
OF
THE
STATE
OF
IOWA:
3
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Section
1.
NEW
SECTION
.
137.100
Title
and
purpose.
1
This
chapter
shall
be
known
and
may
be
cited
as
the
“Local
2
Public
Health
Governance
Act”.
The
purpose
of
this
chapter
is
3
to
define
the
structure,
powers,
and
duties
of
local
boards
4
of
health.
This
chapter
also
provides
an
optional
process
5
for
counties
to
merge
to
form
a
district
board
of
health
in
6
order
to
increase
efficiencies
and
enhance
the
delivery
and
7
availability
of
public
health
services.
8
Sec.
2.
NEW
SECTION
.
137.101
Definitions.
9
As
used
in
this
chapter
unless
the
context
otherwise
10
requires:
11
1.
“City
board”
means
a
city
board
of
health
in
existence
12
prior
to
July
1,
2010.
13
2.
“City
health
department”
refers
to
the
personnel
and
14
property
under
the
jurisdiction
of
a
city
board
in
existence
15
prior
to
July
1,
2010.
16
3.
“Council”
means
a
city
council.
17
4.
“County
board”
means
a
county
board
of
health.
18
5.
“County
health
department”
refers
to
the
personnel
and
19
property
under
the
jurisdiction
of
a
county
board.
20
6.
“Director”
means
the
director
of
public
health.
21
7.
“District”
means
any
two
or
more
geographically
22
contiguous
counties.
23
8.
“District
board”
means
a
board
of
health
representing
24
at
least
two
geographically
contiguous
counties
formed
with
25
approval
of
the
state
department
in
accordance
with
this
26
chapter,
or
any
district
board
of
health
in
existence
prior
to
27
July
1,
2010.
28
9.
“District
health
department”
refers
to
the
personnel
and
29
property
under
the
jurisdiction
of
a
district
board.
30
10.
“Iowa
public
health
standards”
means
Iowa
public
health
31
standards
as
defined
in
section
135A.2.
32
11.
“Local
board
of
health”
means
a
city,
county,
or
33
district
board
of
health.
34
12.
“Officers”
means
a
local
board
of
health
chairperson,
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vice
chairperson,
and
secretary,
and
other
officers
which
may
1
be
named
at
the
discretion
of
the
local
board
of
health.
2
13.
“State
board”
means
the
state
board
of
health.
3
14.
“State
department”
means
the
Iowa
department
of
public
4
health.
5
Sec.
3.
NEW
SECTION
.
137.102
Local
boards
of
health
——
6
jurisdiction.
7
1.
A
city
board
shall
have
jurisdiction
over
public
health
8
matters
within
the
city.
9
2.
A
county
board
shall
have
jurisdiction
over
public
health
10
matters
within
the
county.
11
3.
A
district
board
shall
have
jurisdiction
over
public
12
health
matters
within
the
district.
13
Sec.
4.
NEW
SECTION
.
137.103
Local
boards
of
health
——
14
powers
and
duties.
15
Local
boards
of
health
shall
have
the
following
powers
and
16
duties:
17
1.
A
local
board
of
health
shall:
18
a.
Enforce
state
health
laws
and
the
rules
and
lawful
orders
19
of
the
state
department.
20
b.
Make
and
enforce
such
reasonable
rules
and
regulations
21
not
inconsistent
with
law,
the
rules
of
the
state
board,
or
22
the
Iowa
public
health
standards
as
may
be
necessary
for
the
23
protection
and
improvement
of
the
public
health.
24
(1)
Rules
of
a
city
board
shall
become
effective
upon
25
approval
by
the
council
and
publication
in
a
newspaper
having
26
general
circulation
in
the
city.
27
(2)
Rules
of
a
county
board
shall
become
effective
upon
28
approval
by
the
county
board
of
supervisors
by
a
motion
or
29
resolution
as
defined
in
section
331.101,
subsection
13,
and
30
publication
in
a
newspaper
having
general
circulation
in
the
31
county.
32
(3)
Rules
of
a
district
board
shall
become
effective
upon
33
approval
by
the
district
board
and
publication
in
a
newspaper
34
having
general
circulation
in
the
district.
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(4)
Before
approving
any
rule
or
regulation
the
local
board
1
of
health
shall
hold
a
public
hearing
on
the
proposed
rule.
2
Any
citizen
may
appear
and
be
heard
at
the
public
hearing.
A
3
notice
of
the
public
hearing,
stating
the
time
and
place
and
4
the
general
nature
of
the
proposed
rule
or
regulation
shall
be
5
published
in
a
newspaper
having
general
circulation
as
provided
6
in
section
331.305
in
the
area
served
by
the
local
board
of
7
health.
8
c.
Employ
persons
as
necessary
for
the
efficient
9
discharge
of
its
duties.
Employment
practices
shall
meet
the
10
requirements
of
chapter
8A,
subchapter
IV,
or
any
civil
service
11
provision
adopted
under
chapter
400.
12
d.
Provide
the
names
of
all
local
board
of
health
members
13
and
officers
to
the
state
department.
14
e.
Provide
minutes
of
local
board
of
health
meetings
15
and
reports
of
the
local
board
of
health’s
operations
and
16
activities
to
the
state
department
as
may
be
required
by
the
17
director,
by
rule,
or
by
contract.
18
2.
A
local
board
of
health
may:
19
a.
Provide
such
population-based
and
personal
health
20
services
as
may
be
deemed
necessary
for
the
promotion
and
21
protection
of
the
health
of
the
public
and
charge
reasonable
22
fees
for
personal
health
services.
A
person
shall
not
be
23
denied
necessary
services
within
the
limits
of
available
24
resources
because
of
inability
to
pay
the
cost
of
such
25
services.
26
b.
Provide
such
environmental
health
services
as
may
27
be
deemed
necessary
for
the
protection
and
improvement
of
28
the
public
health
and
issue
licenses
and
permits
and
charge
29
reasonable
fees
in
relation
to
the
construction
or
operation
of
30
nonpublic
water
supplies
or
private
sewage
disposal
systems.
31
c.
Engage
in
joint
operations
and
contract
with
colleges
and
32
universities,
the
state
department,
other
public,
private,
and
33
nonprofit
agencies,
and
individuals
or
form
a
district
health
34
department
to
provide
personal
and
population-based
public
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health
services.
1
d.
By
written
agreement,
with
the
council
of
any
city
within
2
its
jurisdiction,
enforce
appropriate
ordinances
of
the
city
3
relating
to
public
health.
4
Sec.
5.
NEW
SECTION
.
137.104
Local
boards
of
health
——
5
membership
and
meetings.
6
1.
Membership,
terms,
compensation,
and
vacancies.
7
a.
All
members
of
a
city
board
shall
be
appointed
by
the
8
council.
9
b.
All
members
of
a
county
board
shall
be
appointed
by
the
10
county
board
of
supervisors.
11
c.
All
members
of
a
district
board
shall
be
appointed
by
12
the
county
board
of
supervisors
from
each
county
represented
by
13
the
district.
Each
county
board
of
supervisors
shall
appoint
14
at
least
one
but
no
more
than
three
members
to
the
district
15
board,
and
each
county
board
of
supervisors
shall
appoint
the
16
same
number
of
members
to
the
district
board.
There
shall
17
be
no
more
than
one
board
of
supervisors
member
from
any
18
participating
county
on
the
district
board.
19
d.
Local
boards
of
health
shall
consist
of
at
least
five
20
members.
At
least
one
member
shall
be
licensed
as
a
physician
21
under
chapter
148.
22
e.
A
local
board
of
health
member
shall
serve
for
a
term
of
23
three
years.
A
member
is
eligible
for
reappointment.
24
f.
A
local
board
of
health
member
shall
serve
without
25
compensation,
but
may
be
reimbursed
for
necessary
expenses
in
26
accordance
with
rules
established
by
the
state
board
or
the
27
applicable
jurisdiction.
28
g.
A
local
board
of
health
member
vacancy
due
to
death,
29
resignation,
or
other
cause
shall
be
filled
as
soon
as
possible
30
after
the
vacancy
exists
for
the
unexpired
term
of
the
original
31
appointment.
32
2.
Meetings.
A
majority
of
the
members
of
a
local
board
33
of
health
shall
be
considered
a
quorum
and
an
affirmative
34
vote
of
the
majority
of
the
members
present
is
necessary
for
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action
taken
by
a
local
board
of
health.
The
majority
shall
1
not
include
any
member
who
has
a
conflict
of
interest
and
a
2
statement
by
the
member
that
a
conflict
of
interest
exists
3
shall
be
conclusive
for
this
purpose.
4
Sec.
6.
NEW
SECTION
.
137.105
District
boards
of
health
——
5
request
to
form.
6
The
county
boards
of
any
two
or
more
geographically
7
contiguous
counties
may
at
any
time
submit
a
request
to
form
a
8
district
board
to
the
state
department.
The
formation
request
9
shall
be
in
writing,
shall
be
executed
by
the
county
boards
of
10
supervisors
and
the
county
boards
of
health
for
each
county
11
comprising
the
proposed
district
board,
and
shall
include
but
12
not
be
limited
to
the
following
required
elements:
13
1.
A
written
narrative
that
explains
how
the
formation
of
14
a
district
board
will
increase
organizational
capacity
and
15
capability
to
provide
population-based
and
personal
public
16
health
services
compared
with
operating
as
individual
county
17
boards.
18
2.
The
composition
of
the
district
board,
including
the
19
number
of
members
each
county
shall
appoint
pursuant
to
section
20
137.104
and
the
total
number
of
members
on
the
district
board.
21
3.
Proof
of
approval
by
all
county
boards
of
supervisors
22
and
county
boards
of
health
involved
in
the
request
to
form
a
23
district
board
and
of
the
elements
included
in
the
formation
24
plan.
25
4.
The
service
delivery
plan.
26
5.
The
budget
and
fiscal
plan
for
the
proposed
district
27
board.
The
budget
plan
shall
include
an
estimate
of
proposed
28
expenditures
and
revenues
and
an
allocation
of
the
revenue
29
responsibilities
of
each
of
the
counties
participating
in
the
30
proposed
district
board.
31
6.
A
table
of
organization.
32
7.
A
personnel
system
description,
including
identification
33
of
the
district
treasurer
and
district
auditor
and
a
section
34
which
addresses
the
employment
issues
contained
in
section
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137.109.
1
8.
The
location
of
the
district
board
offices
and
workforce
2
throughout
the
jurisdiction.
3
9.
An
inventory
of
the
property
and
equipment
in
the
4
custody
of
each
county
board
and
a
description
as
to
whether
5
such
property
and
equipment
shall
remain
in
the
custody
of
the
6
county
or
shall
be
transferred
to
the
district
board
to
become
7
property
of
the
district
board.
8
10.
A
timeline
for
the
adoption
of
district
board
rules
and
9
regulations.
10
11.
Other
criteria
as
established
by
rule
of
the
state
11
department.
12
Sec.
7.
NEW
SECTION
.
137.106
Request
reviewed
by
state
13
department.
14
The
state
department
shall
review
requests
submitted
15
pursuant
to
section
137.105.
The
state
department,
upon
16
finding
that
all
required
elements
are
present,
shall
present
17
findings
to
the
state
board.
The
state
board
may
approve
the
18
formation
of
a
district
board
and
if
the
formation
is
approved,
19
shall
notify
the
county
boards
from
whom
the
request
was
20
received.
21
Sec.
8.
NEW
SECTION
.
137.107
Initial
appointment
of
22
district
board
of
health.
23
Upon
receipt
of
notice
of
approval
as
a
district
board,
24
district
board
members
shall
be
appointed
as
specified
in
25
section
137.104.
26
Sec.
9.
NEW
SECTION
.
137.108
Organizational
structure
of
27
district
board.
28
A
district
board
is
a
governing
body
for
purposes
of
chapter
29
670
and
a
district
health
department
is
a
municipality
for
30
purposes
of
chapter
670.
All
meetings
of
a
district
board
31
shall
comply
with
the
requirements
of
chapter
21
and
all
32
records
of
a
district
board
and
a
district
health
department
33
shall
be
maintained
in
accordance
with
chapter
22.
34
Sec.
10.
NEW
SECTION
.
137.109
District
personnel.
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1.
A
district
board
may
employ
persons
as
necessary
for
1
the
efficient
discharge
of
its
duties.
A
district
board
shall
2
have
all
the
duties
and
powers
in
employing
such
persons
as
3
a
county
board
of
supervisors
is
granted
pursuant
to
section
4
331.324,
with
the
exception
of
the
authority
to
provide
for
5
support
of
the
civil
service
commission
for
deputy
sheriffs
6
as
specified
in
section
331.324,
subsection
1,
paragraph
“k”
.
7
A
district
board
may
employ
persons
who
were
employed
at
the
8
time
of
the
formation
of
the
district
board
by
the
counties
9
represented
by
the
district
board,
or
may
employ
persons
who
10
were
not
employed
by
such
counties.
The
county
boards
involved
11
shall
specify
in
the
request
submitted
pursuant
to
section
12
137.105
whether
the
individual
counties
or
the
district
board
13
will
be
responsible
for
payment
of
unemployment
compensation
14
for
any
county
employees
employed
by
the
county
board
at
the
15
time
of
formation
of
the
district
board
but
not
employed
by
the
16
district
board
following
formation.
17
2.
If
a
district
board
employs
persons
who
were
employed
18
at
the
time
of
formation
of
the
district
board
by
the
counties
19
represented
by
the
district
board
and
such
employees
were
20
covered
by
collective
bargaining
agreements
with
those
21
counties,
the
collective
bargaining
agreement
of
the
county
22
with
the
largest
population
for
the
year
prior
to
the
formation
23
of
the
district
board
shall
serve
as
the
base
agreement
and
the
24
employees
of
the
other
counties
shall
automatically
be
accreted
25
to
the
bargaining
unit
of
that
collective
bargaining
agreement
26
for
purposes
of
negotiating
the
contracts
in
subsequent
years
27
without
further
action.
If
only
one
collective
bargaining
28
agreement
is
in
effect
among
the
counties
represented
by
the
29
district
board,
that
agreement
may
serve
as
the
base
agreement
30
if
the
counties
so
elect,
and
the
employees
of
the
other
31
counties
represented
by
the
district
board
shall
automatically
32
be
accreted
to
the
bargaining
unit
of
that
collective
33
bargaining
agreement
for
purposes
of
negotiating
the
contracts
34
for
subsequent
years
without
further
action.
The
new
district
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board,
using
the
base
agreement
as
its
existing
contract,
may
1
bargain
with
the
covered
employees
of
the
district
board
for
2
the
next
contract
period.
3
3.
If
the
district
board
employs
persons
who
were
employed
4
by
the
counties
represented
by
the
district
board
at
the
time
5
of
formation
of
the
district
board,
the
district
board
shall
6
recognize
the
term
of
service
of
the
former
county
employees
7
for
purposes
of
all
employee
benefits
offered
by
the
district
8
board
to
such
employees
and
such
employees
shall
not
forfeit
9
accrued
vacation,
accrued
sick
leave,
or
longevity
by
becoming
10
district
board
employees.
11
4.
Persons
who
were
covered
by
county
employee
life
12
insurance,
accident
insurance,
and
health
insurance
plans
prior
13
to
becoming
district
board
employees
pursuant
to
this
chapter
14
shall
be
permitted
to
apply
prior
to
becoming
district
board
15
employees
for
life,
accident,
and
health
insurance
plans
that
16
are
available
to
district
board
employees
so
that
those
persons
17
do
not
suffer
a
lapse
of
insurance
coverage
as
a
result
of
18
becoming
district
board
employees.
19
5.
The
district
board
may
employ
or
contract
with
legal
20
counsel
to
enforce
this
chapter
and
district
board
rules,
21
represent
and
defend
the
district
board
and
its
officers
and
22
employees,
provide
legal
advice
to
the
district
board,
and
23
perform
any
other
legal
duties
required
by
law
or
assigned
by
24
the
district
board.
The
district
board
may
employ
or
contract
25
with
the
county
attorney
of
a
county
within
its
jurisdiction.
26
Sec.
11.
NEW
SECTION
.
137.110
District
treasurer
and
27
auditor.
28
Upon
establishment
of
a
district
board,
the
district
board
29
shall
designate
a
treasurer
of
a
county
within
its
jurisdiction
30
to
serve
as
treasurer
of
the
district
health
department,
and
31
shall
designate
the
auditor
of
the
same
county
to
serve
as
32
auditor
of
the
district
health
department.
The
treasurer’s
33
and
the
auditor’s
official
bonds
shall
extend
to
cover
their
34
respective
duties
performed
on
behalf
of
the
district
health
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department.
A
county
treasurer
shall
not
serve
in
the
capacity
1
of
district
health
department
treasurer
without
consent
from
2
the
county
and
agreement
from
the
treasurer
to
perform
this
3
function,
and
a
county
auditor
shall
not
serve
in
the
capacity
4
of
district
health
department
auditor
without
consent
from
the
5
county
and
agreement
from
the
auditor
to
perform
this
function.
6
Sec.
12.
NEW
SECTION
.
137.111
District
public
health
fund.
7
1.
The
district
treasurer
shall
establish
a
district
public
8
health
fund
from
which
disbursements
may
be
made
in
the
manner
9
specified
for
disbursements
by
law
for
the
disbursement
of
10
county
funds.
11
2.
All
moneys
received
by
a
district
board
or
district
12
health
department
for
local
public
health
purposes
from
federal
13
appropriations,
state
appropriations,
local
appropriations,
14
fees,
gifts,
grants,
bequests,
or
other
sources
shall
be
15
deposited
in
the
district
public
health
fund.
Expenditures
16
shall
be
made
from
the
fund
on
order
of
the
district
board
for
17
the
purpose
of
carrying
out
its
duties.
No
more
than
twenty
18
percent
of
the
unexpended
balance
remaining
in
the
fund
at
the
19
end
of
each
fiscal
year
shall
be
maintained
in
the
district
20
public
health
fund.
The
remainder
of
the
unexpended
balance
21
shall
revert
to
the
general
funds
of
the
member
counties
in
the
22
manner
determined
by
the
district
board.
23
3.
The
district
board
shall
adopt
and
certify
an
24
annual
budget
in
accordance
with
section
24.17
relating
25
to
certification
of
budgets
and
section
24.27
relating
to
26
protesting
budgets.
27
Sec.
13.
NEW
SECTION
.
137.112
Adding
to
district.
28
A
county
may
be
added
to
an
existing
district
board
by
29
submission
and
approval
of
a
request,
as
specified
in
sections
30
137.105
and
137.106.
31
Sec.
14.
NEW
SECTION
.
137.113
Withdrawal
from
district.
32
A
county
may
withdraw
from
an
existing
district
board
upon
33
submission
of
a
request
for
withdrawal
to
and
approval
by
34
the
state
department.
The
request
shall
include
a
plan
to
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reform
its
county
board
or
join
a
different
district
board,
1
information
specified
in
section
137.105,
and
approval
of
the
2
request
by
the
district
board
and,
at
the
recommendation
of
3
the
state
department,
the
state
board.
Any
county
choosing
to
4
withdraw
from
the
district
board
shall
commit
to
the
continuity
5
of
services
in
its
county
by
reestablishing
its
county
6
board
or
joining
a
different
district
board.
The
remaining
7
counties
in
the
district
shall
submit
an
application
including
8
the
information
specified
in
section
137.105
to
the
state
9
department
for
review
as
provided
in
section
137.106.
10
Sec.
15.
NEW
SECTION
.
137.114
Dissolution
of
county
boards.
11
Upon
appointment
of
a
district
board,
the
county
boards
12
involved
shall
be
dissolved
and
their
powers
and
duties
13
specified
in
section
137.103
transferred
to
the
district
board.
14
All
property
and
equipment
in
the
custody
of
the
county
board
15
shall
either
remain
the
property
of
the
county
or
shall
become
16
the
property
of
the
district
board,
as
so
provided
in
the
17
district
board
formation
request
submitted
pursuant
to
section
18
137.105.
19
Sec.
16.
NEW
SECTION
.
137.115
Emergency
request
for
funds.
20
A
local
board
of
health
may,
during
a
public
health
disaster
21
as
defined
in
section
135.140
or
in
preparation
for
or
22
response
to
such
disaster,
request
additional
appropriations
23
which
may
upon
approval
of
the
director
be
allotted
from
the
24
funds
reserved
for
that
purpose
to
the
extent
that
funds
25
are
appropriated
and
available.
Upon
termination
of
the
26
disaster
response,
the
local
board
of
health
shall
report
its
27
expenditures
of
emergency
funds
to
the
director.
28
Sec.
17.
NEW
SECTION
.
137.116
Penalties
——
criminal
and
29
civil.
30
1.
Any
person
who
violates
any
provision
of
this
chapter
or
31
the
rules
of
a
local
board
of
health
or
any
lawful
order
of
the
32
board,
its
officers,
or
authorized
agents
is
guilty
of
a
simple
33
misdemeanor.
Each
additional
day
of
neglect
or
failure
to
34
comply
with
such
provision,
rule,
or
lawful
order
after
notice
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of
violation
by
the
local
board
of
health
shall
constitute
a
1
separate
offense.
2
2.
A
local
board
of
health
may
impose
a
civil
penalty
not
to
3
exceed
seven
hundred
fifty
dollars
for
each
violation
of
this
4
chapter
or
the
rules
of
the
local
board
of
health
or
any
lawful
5
order
of
the
board,
its
officers,
or
authorized
agents.
If
the
6
violation
is
a
repeat
offense
a
civil
penalty
not
to
exceed
one
7
thousand
dollars
may
be
imposed.
The
local
board
of
health
8
shall
impose
and
enforce
such
penalties
in
the
manner
provided
9
in
section
331.307
for
county
infractions.
10
Sec.
18.
NEW
SECTION
.
137.117
Individual
choice
of
11
treatment.
12
Nothing
in
this
chapter
shall
be
construed
to
impede,
limit,
13
or
restrict
the
right
of
free
choice
by
an
individual
to
the
14
health
care
or
treatment
that
the
individual
may
select.
15
Sec.
19.
NEW
SECTION
.
137.118
Adoption
of
rules.
16
The
state
board
of
health
shall
adopt
rules
to
implement
this
17
chapter.
The
department
is
vested
with
discretionary
authority
18
to
interpret
the
provisions
of
this
chapter.
19
Sec.
20.
Section
135I.1,
subsection
2,
Code
2009,
is
amended
20
to
read
as
follows:
21
2.
“Local
board
of
health”
means
a
county,
city,
county,
or
22
district
board
of
health
as
defined
in
section
137.2
137.101
.
23
Sec.
21.
Section
331.321,
subsection
1,
paragraph
c,
Code
24
Supplement
2009,
is
amended
to
read
as
follows:
25
c.
The
members
of
the
county
board
of
health
in
accordance
26
with
section
137.4
137.104
.
27
Sec.
22.
REPEAL.
Chapter
137,
Code
and
Code
Supplement
28
2009,
is
repealed.
29
EXPLANATION
30
This
bill
amends
Code
chapter
137,
relating
to
local
31
boards
of
health.
The
bill
provides
definitions;
establishes
32
jurisdiction
of
city,
county,
and
district
boards
of
health;
33
specifies
powers
and
duties
of
local
boards
of
health,
their
34
membership,
and
meeting
requirements;
provides
a
process
for
35
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two
or
more
geographically
contiguous
counties
to
form
a
1
district
board;
specifies
the
organizational
structure
of
a
2
district
board
as
a
governing
body
for
the
purposes
of
tort
3
liability
of
governmental
subdivisions
and
a
process
for
4
employing
personnel;
provides
for
the
use
of
a
county
treasurer
5
and
auditor
of
a
county
within
the
district
of
the
district
6
board
to
serve
the
district
health
department;
provides
for
7
the
establishment
of
a
district
public
health
fund
including
8
the
unexpended
balance
of
the
fund
at
the
end
of
each
fiscal
9
year;
provides
a
process
for
counties
to
join
or
withdraw
10
from
a
district
board;
provides
for
dissolution
of
county
11
boards
joining
a
district
board;
provides
civil
and
criminal
12
penalties
for
violations
of
the
Code
chapter;
and
provides
for
13
adoption
of
rules
by
the
state
board
of
health
to
implement
the
14
Code
chapter
and
the
department
is
vested
with
discretionary
15
authority
to
interpret
the
provisions
of
the
Code
chapter.
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