House
File
2389
-
Introduced
HOUSE
FILE
2389
BY
COMMITTEE
ON
HUMAN
RESOURCES
(SUCCESSOR
TO
HSB
591)
(COMPANION
TO
SF
2159
BY
COMMITTEE
ON
HUMAN
RESOURCES)
A
BILL
FOR
An
Act
relating
to
public
health
including
public
health
1
modernization
and
boards
of
health.
2
BE
IT
ENACTED
BY
THE
GENERAL
ASSEMBLY
OF
THE
STATE
OF
IOWA:
3
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(1)
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DIVISION
I
1
IOWA
PUBLIC
HEALTH
MODERNIZATION
ACT
2
Section
1.
Section
135A.2,
Code
2016,
is
amended
to
read
as
3
follows:
4
135A.2
Definitions.
5
As
used
in
this
chapter
,
unless
the
context
otherwise
6
requires,
the
following
definitions
apply:
7
1.
“Academic
institution”
means
an
institution
of
higher
8
education
in
the
state
which
grants
undergraduate
and
9
postgraduate
degrees
in
public
health
or
another
health-related
10
field
and
is
accredited
by
a
nationally
recognized
accrediting
11
agency
as
determined
by
the
United
States
secretary
of
12
education.
For
purposes
of
this
definition,
“accredited”
means
13
a
certification
of
the
quality
of
an
institution
of
higher
14
education.
15
2.
“Accrediting
entity”
means
a
legal,
independent,
16
nonprofit
or
governmental
entity
or
entities
approved
by
the
17
state
board
of
health
for
the
purpose
of
accrediting
designated
18
local
public
health
agencies
and
the
department
pursuant
to
the
19
voluntary
accreditation
program
developed
under
this
chapter
.
20
3.
“Administration”
means
the
operational
procedures,
21
personnel
and
fiscal
management
systems,
and
facility
22
requirements
that
must
be
in
place
for
the
delivery
and
23
assurance
of
public
health
services.
24
4.
“Committee”
means
the
governmental
public
health
25
evaluation
committee
as
established
in
this
chapter
.
26
5.
“Communication
and
information
technology”
means
the
27
processes,
procedures,
and
equipment
needed
to
provide
public
28
information
and
transmit
and
receive
information
among
public
29
health
entities
and
community
partners;
and
applies
to
the
30
procedures,
physical
hardware,
and
software
required
to
31
transmit,
receive,
and
process
electronic
information.
32
6.
2.
“Council”
means
the
governmental
public
health
33
advisory
council
as
established
in
this
chapter
.
34
7.
3.
“Department”
means
the
department
of
public
health.
35
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8.
4.
“Designated
local
public
health
agency”
means
an
1
entity
that
is
either
governed
by
or
contractually
responsible
2
to
a
local
board
of
health
and
designated
by
the
local
3
board
to
comply
with
the
Iowa
public
health
standards
for
a
4
jurisdiction
.
5
9.
“Governance”
means
the
functions
and
responsibilities
6
of
the
local
boards
of
health
and
the
state
board
of
health
to
7
oversee
governmental
public
health
matters.
8
10.
5.
“Governmental
public
health
system”
means
the
system
9
described
in
section
135A.6
local
boards
of
health,
the
state
10
board
of
health,
designated
local
public
health
agencies,
the
11
state
hygienic
laboratory,
and
the
department
.
12
11.
“Iowa
public
health
standards”
means
the
governmental
13
public
health
standards
adopted
by
rule
by
the
state
board
of
14
health.
15
12.
6.
“Local
board
of
health”
means
a
county
or
district
16
board
of
health.
17
13.
7.
“Organizational
capacity”
means
the
governmental
18
public
health
infrastructure
that
must
be
in
place
in
order
to
19
deliver
public
health
services.
20
14.
“Public
health
region”
means,
at
a
minimum,
one
of
six
21
geographical
areas
approved
by
the
state
board
of
health
for
22
the
purposes
of
coordination,
resource
sharing,
and
planning
23
and
to
improve
delivery
of
public
health
services.
24
15.
“Public
health
services”
means
the
basic
public
health
25
services
that
all
Iowans
should
reasonably
expect
to
be
26
provided
by
designated
local
public
health
agencies
and
the
27
department.
28
16.
“Voluntary
accreditation”
means
verification
of
a
29
designated
local
public
health
agency
or
the
department
that
30
demonstrates
compliance
with
the
Iowa
public
health
standards
31
by
an
accrediting
entity.
32
17.
“Workforce”
means
the
necessary
qualified
and
competent
33
staff
required
to
deliver
public
health
services.
34
8.
“Public
health
system
”
means
all
public,
private,
and
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voluntary
entities
that
contribute
to
the
delivery
of
public
1
health
services
within
a
jurisdiction.
2
Sec.
2.
Section
135A.3,
Code
2016,
is
amended
to
read
as
3
follows:
4
135A.3
Governmental
public
health
system
modernization
——
5
lead
agency.
6
1.
The
department
is
designated
as
the
lead
agency
in
this
7
state
to
administer
this
chapter
.
8
2.
The
department,
in
collaboration
with
the
governmental
9
public
health
advisory
council
and
the
governmental
public
10
health
evaluation
committee,
shall
coordinate
implementation
11
of
this
chapter
including
but
not
limited
to
the
voluntary
12
accreditation
of
designated
local
public
health
agencies
and
13
the
department
in
accordance
with
the
Iowa
public
health
14
standards.
Such
implementation
administration
shall
include
15
evaluation
of
and
quality
improvement
measures
for
the
16
governmental
public
health
system.
17
Sec.
3.
Section
135A.4,
Code
2016,
is
amended
to
read
as
18
follows:
19
135A.4
Governmental
public
health
advisory
council
——
20
legislative
intent
.
21
1.
It
is
the
intent
of
the
general
assembly
that
Iowa’s
22
governmentally
sponsored
public
health
system
be
effective,
23
efficient,
well-organized,
and
well-coordinated
in
order
to
24
have
the
greatest
impact
on
the
improvement
of
health
status
25
for
all
Iowans.
The
governmental
public
health
advisory
26
council
is
intended
to
support
this
goal,
and
is
established
to
27
provide
recommendations
to
the
director
of
the
department
to
28
support
improved
organization
and
delivery
of
critical
public
29
health
services
across
the
state.
30
1.
2.
A
governmental
public
health
advisory
council
31
is
established
to
advise
the
department
and
make
policy
32
recommendations
to
the
director
of
the
department
concerning
33
administration,
implementation,
and
coordination
of
this
34
chapter
and
to
make
recommendations
to
the
department
and
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the
state
board
of
health
regarding
the
governmental
public
1
health
system.
The
council
shall
meet
at
least
quarterly.
The
2
council
shall
consist
of
no
fewer
than
fifteen
members
and
3
no
more
than
twenty-three
twenty-eight
members.
The
members
4
shall
be
appointed
by
the
director.
The
director
may
solicit
5
and
consider
recommendations
from
professional
organizations,
6
associations,
and
academic
institutions
in
making
appointments
7
to
the
council.
8
2.
Council
members
shall
not
be
members
of
the
governmental
9
public
health
evaluation
committee.
10
3.
Council
members
shall
serve
for
a
term
of
two
years
and
11
may
be
reappointed
for
a
maximum
of
three
consecutive
terms
.
12
Initial
appointment
shall
be
in
staggered
terms.
Vacancies
13
shall
be
filled
for
the
remainder
of
the
original
appointment.
14
4.
The
membership
of
the
council
shall
consist
of
all
15
of
the
following
members
who
satisfy
all
of
the
following
16
requirements:
17
a.
One
member
who
has
expertise
in
injury
prevention.
18
b.
One
member
who
has
expertise
in
environmental
health.
19
c.
One
member
who
has
expertise
in
emergency
preparedness.
20
d.
One
member
who
has
expertise
in
health
promotion
and
21
chronic
disease
prevention.
22
e.
One
member
who
has
epidemiological
expertise
in
23
communicable
and
infectious
disease
prevention
and
control.
24
f.
a.
One
member
representing
each
of
Iowa’s
six
public
25
health
regions
Twelve
members
who
is
represent
various
26
subfields
of
public
health.
These
members
shall
provide
27
geographical
representation
from
all
areas
of
the
state.
Each
28
of
these
members
shall
be
an
employee
of
a
designated
local
29
public
health
agency
or
member
of
a
local
board
of
health.
30
Such
members
shall
include
a
minimum
of
one
local
public
health
31
administrator
and
one
physician
member
of
a
local
board
of
32
health.
33
g.
b.
Two
members
who
are
representatives
of
the
34
department.
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h.
c.
The
director
of
the
state
hygienic
laboratory
at
the
1
university
of
Iowa,
or
the
director’s
designee.
2
i.
d.
At
least
one
representative
two
representatives
3
from
academic
institutions
which
grant
undergraduate
and
4
postgraduate
degrees
in
public
health
or
other
related
health
5
field
and
are
accredited
by
a
nationally
recognized
accrediting
6
agency
as
determined
by
the
United
States
secretary
of
7
education.
For
purposes
of
this
paragraph,
“accredited”
means
8
a
certification
of
the
quality
of
an
institution
of
higher
9
education
.
10
j.
e.
Two
members
who
serve
on
a
county
board
of
11
supervisors.
12
f.
At
least
one
economist
who
has
demonstrated
experience
in
13
public
health,
health
care,
or
a
health-related
field.
14
g.
At
least
one
research
analyst.
15
k.
h.
Four
nonvoting
,
ex
officio
members
who
shall
consist
16
of
four
members
of
the
general
assembly,
two
from
the
senate
17
and
two
from
the
house
of
representatives,
with
not
more
than
18
one
member
from
each
chamber
being
from
the
same
political
19
party.
The
two
senators
shall
be
designated,
one
member
each,
20
by
the
majority
leader
of
the
senate
after
consultation
with
21
the
president
and
by
the
minority
leader
of
the
senate.
The
22
two
representatives
shall
be
designated,
one
member
each,
by
23
the
speaker
of
the
house
of
representatives
after
consultation
24
with
the
majority
leader
of
the
house
of
representatives
and
by
25
the
minority
leader
of
the
house
of
representatives.
26
l.
i.
A
member
of
the
state
board
of
health
who
shall
be
a
27
nonvoting
,
ex
officio
member.
28
5.
The
council
may
utilize
other
relevant
public
29
health
expertise
when
necessary
to
carry
out
its
roles
and
30
responsibilities.
31
6.
The
council
shall
do
all
of
the
following:
32
a.
Advise
the
department
and
make
policy
recommendations
to
33
the
director
of
the
department
and
the
state
board
of
health
34
concerning
administration,
implementation
,
and
coordination
of
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this
chapter
and
the
governmental
public
health
system
.
1
b.
Propose
to
the
director
public
health
standards
2
that
should
may
be
utilized
for
voluntary
accreditation
of
3
designated
local
public
health
agencies
and
the
department
that
4
include
but
are
not
limited
to
the
organizational
capacity
and
5
by
the
governmental
public
health
service
components
described
6
in
section
135A.6,
subsection
1
,
by
October
1,
2009
system
.
7
c.
Recommend
to
the
department
an
accrediting
entity
and
8
identify
the
roles
and
responsibilities
for
the
oversight
and
9
implementation
of
the
voluntary
accreditation
of
designated
10
local
public
health
agencies
and
the
department
by
January
2,
11
2010.
This
shall
include
completion
of
a
pilot
accreditation
12
process
for
one
designated
local
public
health
agency
and
the
13
department
by
July
1,
2011
Develop
and
implement
processes
for
14
longitudinal
evaluation
of
the
public
health
system
including
15
collection
of
information
about
organizational
capacity
and
16
public
health
service
delivery
.
17
d.
Recommend
to
the
director
strategies
to
implement
18
voluntary
accreditation
of
designated
local
public
health
19
agencies
and
the
department
effective
January
2,
2012.
20
e.
Periodically
review
and
make
recommendations
to
the
21
department
regarding
revisions
to
the
public
health
standards
22
pursuant
to
paragraph
“b”
,
as
needed
and
based
on
reports
23
prepared
by
the
governmental
public
health
evaluation
committee
24
pursuant
to
section
135A.5
.
25
d.
Determine
what
process
and
outcome
improvements
in
the
26
governmental
public
health
system
are
attributable
to
voluntary
27
accreditation.
28
e.
Assure
that
the
evaluation
process
is
capturing
data
to
29
support
key
research
in
public
health
system
effectiveness
and
30
health
outcomes.
31
f.
Develop
and
make
recommendations
for
improvements
to
the
32
public
health
system.
33
g.
Make
recommendations
for
resources
to
support
the
public
34
health
system.
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f.
h.
Review
rules
developed
and
adopted
by
the
state
board
1
of
health
under
this
chapter
and
make
recommendations
to
the
2
department
for
revisions
to
further
promote
implementation
3
of
this
chapter
and
modernization
of
the
governmental
public
4
health
system.
5
g.
i.
Form
and
utilize
subcommittees
as
necessary
to
carry
6
out
the
duties
of
the
council.
7
j.
Annually
submit
a
report
on
the
activities
of
the
council
8
to
the
state
board
of
health
by
July
1.
9
Sec.
4.
Section
135A.8,
subsections
2
and
3,
Code
2016,
are
10
amended
to
read
as
follows:
11
2.
The
fund
is
established
to
assist
local
boards
of
health
12
and
the
department
with
the
provision
of
governmental
public
13
health
system
organizational
capacity
and
public
health
service
14
delivery
and
to
achieve
and
maintain
voluntary
accreditation
15
in
accordance
with
the
Iowa
public
health
standards
.
At
least
16
seventy
percent
of
the
funds
shall
be
made
available
to
local
17
boards
of
health
and
up
to
thirty
percent
of
the
funds
may
be
18
utilized
by
the
department.
19
3.
Moneys
in
the
fund
may
be
allocated
by
the
department
20
to
a
local
board
of
health
for
organizational
capacity
and
21
service
delivery.
Such
allocation
may
be
made
on
a
matching,
22
dollar-for-dollar
basis
for
the
acquisition
of
equipment,
23
or
by
providing
grants
to
achieve
and
maintain
voluntary
24
accreditation
in
accordance
with
the
Iowa
public
health
25
standards
.
26
Sec.
5.
Section
135A.9,
Code
2016,
is
amended
to
read
as
27
follows:
28
135A.9
Rules.
29
The
state
board
of
health
shall
adopt
rules
pursuant
to
30
chapter
17A
to
implement
this
chapter
which
shall
include
but
31
are
not
limited
to
the
following:
32
1.
Incorporation
of
the
Iowa
public
health
standards
33
recommended
to
the
department
pursuant
to
section
135A.4,
34
subsection
6
.
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2.
A
voluntary
accreditation
process
to
begin
no
later
than
1
January
2,
2012,
for
designated
local
public
health
agencies
2
and
the
department.
3
3.
1.
Rules
relating
to
the
operation
of
the
governmental
4
public
health
advisory
council.
5
4.
Rules
relating
to
the
operation
of
the
governmental
6
public
health
system
evaluation
committee.
7
5.
2.
The
application
and
award
process
for
governmental
8
public
health
system
fund
moneys.
9
6.
Rules
relating
to
data
collection
for
the
governmental
10
public
health
system
and
the
voluntary
accreditation
program.
11
7.
3.
Rules
otherwise
necessary
to
implement
the
chapter.
12
Sec.
6.
REPEAL.
Sections
135A.5,
135A.6,
135A.7,
and
13
135A.10,
Code
2016,
are
repealed.
14
DIVISION
II
15
STATE
AND
DISTRICT
BOARDS
OF
HEALTH
16
Sec.
7.
Section
136.3,
subsection
5,
Code
2016,
is
amended
17
by
striking
the
subsection.
18
Sec.
8.
Section
136.3,
subsections
6
and
8,
Code
2016,
are
19
amended
to
read
as
follows:
20
6.
Assure
that
the
department
complies
with
Iowa
Code
,
and
21
administrative
rules
,
and
the
Iowa
public
health
standards
.
22
For
this
purpose
the
board
shall
have
access
at
any
time
to
all
23
documents
and
records
of
the
department.
24
8.
Advise
or
make
recommendations
to
the
director
of
public
25
health,
governor,
and
general
assembly
relative
to
public
26
health
and
advocate
for
state
and
local
public
health
to
comply
27
with
the
Iowa
the
importance
of
public
health
standards
for
28
state
and
local
public
health
.
29
Sec.
9.
Section
137.102,
subsection
10,
Code
2016,
is
30
amended
by
striking
the
subsection.
31
Sec.
10.
Section
137.104,
subsection
1,
paragraph
b,
32
unnumbered
paragraph
1,
Code
2016,
is
amended
to
read
as
33
follows:
34
Make
and
enforce
such
reasonable
rules
and
regulations
not
35
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inconsistent
with
law
,
and
the
rules
of
the
state
board
,
or
1
the
Iowa
public
health
standards
as
may
be
necessary
for
the
2
protection
and
improvement
of
the
public
health.
3
Sec.
11.
Section
137.105,
subsection
1,
paragraph
c,
Code
4
2016,
is
amended
to
read
as
follows:
5
c.
All
members
of
a
district
board
shall
be
appointed
by
6
the
county
board
of
supervisors
from
each
county
represented
by
7
the
district.
Each
county
board
of
supervisors
shall
appoint
8
at
least
one
but
no
more
than
three
members
to
the
district
9
board
,
and
each
county
board
of
supervisors
shall
appoint
the
10
same
number
of
members
to
the
district
board.
There
shall
11
be
no
more
than
one
board
of
supervisors
member
from
any
12
participating
county
on
the
district
board
.
13
Sec.
12.
Section
137.106,
subsection
1,
Code
2016,
is
14
amended
to
read
as
follows:
15
1.
A
written
narrative
that
explains
how
the
formation
of
a
16
district
board
will
increase
organizational
capacity
and
attain
17
the
capability
to
provide
population-based
and
personal
public
18
health
services
compared
with
operating
as
individual
county
19
boards
.
20
Sec.
13.
Section
137.111,
Code
2016,
is
amended
to
read
as
21
follows:
22
137.111
District
treasurer
and
auditor.
23
Upon
establishment
of
a
district
board,
the
district
board
24
shall
designate
a
treasurer
of
a
county
within
its
jurisdiction
25
to
serve
as
treasurer
of
the
district
health
department,
and
26
shall
designate
the
an
auditor
of
the
same
county
to
serve
as
27
auditor
of
the
district
health
department.
The
A
treasurer
or
28
auditor
of
any
county
within
the
district
may
also
serve
in
29
the
capacity
of
treasurer
or
auditor
of
the
district
health
30
department,
respectively,
or
the
district
board
may
contract
31
with
a
third
party
to
act
as
the
treasurer
or
auditor
of
the
32
district
health
department.
A
county
treasurer’s
and
the
or
33
county
auditor’s
official
bonds
shall
bond
may
extend
to
cover
34
their
respective
duties
performed
on
behalf
of
the
district
35
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health
department.
A
county
treasurer
shall
not
serve
in
1
the
capacity
of
district
health
department
treasurer
without
2
consent
from
the
county
and
agreement
from
the
treasurer
to
3
perform
this
function,
and
a
county
auditor
shall
not
serve
4
in
the
capacity
of
district
health
department
auditor
without
5
consent
from
the
county
and
agreement
from
the
auditor
to
6
perform
this
function.
7
EXPLANATION
8
The
inclusion
of
this
explanation
does
not
constitute
agreement
with
9
the
explanation’s
substance
by
the
members
of
the
general
assembly.
10
This
bill
relates
to
public
health,
including
the
Iowa
11
public
health
modernization
Act
and
the
state
and
district
12
boards
of
health.
13
The
bill
amends
provisions
in
Code
chapter
135A
(public
14
health
modernization
Act).
The
bill
eliminates
and
amends
15
definitions
used
in
the
Code
chapter
and
eliminates
the
16
requirements
for
voluntary
accreditation
of
designated
local
17
public
health
agencies
and
the
department
of
public
health
18
and
the
required
development
and
use
of
Iowa
public
health
19
standards.
20
The
bill
changes
the
size
and
composition
of
the
21
governmental
public
health
advisory
council
to
include
a
22
maximum
of
28
members
and
to
specifically
include
12
members
23
representing
various
subfields
of
public
health
from
local
24
public
health
agencies
and
local
boards
of
health
from
all
25
geographic
areas
of
the
state,
at
least
two
representatives
26
from
academic
institutions,
at
least
one
economist
who
has
27
demonstrated
experience
in
public
health,
health
care,
or
28
a
health-related
field,
and
at
least
one
research
analyst.
29
The
bill
eliminates
certain
duties
of
the
council
and
30
prescribes
additional
duties
including:
(1)
to
develop
and
31
implement
processes
for
longitudinal
evaluation
of
the
public
32
health
system
including
collection
of
information
about
33
organizational
capacity
and
public
health
services
delivery,
34
(2)
to
determine
what
process
and
outcome
improvements
in
the
35
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governmental
public
health
system
are
attributable
to
voluntary
1
accreditation,
(3)
to
assure
that
the
evaluation
process
is
2
capturing
data
to
support
key
research
in
public
health
system
3
effectiveness
and
health
outcomes,
(4)
to
develop
and
make
4
recommendations
for
improvements
to
the
public
health
system,
5
(5)
to
make
recommendations
for
resources
to
support
the
public
6
health
system,
and
(6)
to
annually
submit
a
report
on
the
7
activities
of
the
council
to
the
state
board
of
health
by
July
8
1.
9
The
bill
eliminates
the
governmental
public
health
10
evaluation
committee
which
was
established
to
develop
and
11
implement
the
evaluation
of
the
governmental
public
health
12
system
and
voluntary
accreditation
program,
the
specified
13
organizational
capacity
components
and
public
health
service
14
components
of
a
governmental
public
health
system,
and
the
15
governmental
public
health
system
and
accreditation
data
16
collection
system
which
was
to
monitor
the
implementation
and
17
effectiveness
of
the
governmental
public
health
system
based
on
18
the
Iowa
public
health
standards.
19
The
bill
eliminates
directives
to
adopt
rules
that
relate
20
to
the
provisions
of
the
Act
eliminated
in
the
bill
and
also
21
eliminates
the
section
of
the
Act
that
established
a
civil
22
penalty
for
a
local
board
of
health
or
local
public
health
23
agency
fraudulently
claiming
accreditation.
The
bill
also
24
makes
conforming
changes
in
the
Code
chapters
relating
to
state
25
and
district
boards
of
health
to
reflect
the
changes
to
the
26
public
health
modernization
Act.
27
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