Senate Study Bill 3135 - Introduced SENATE FILE _____ BY (PROPOSED COMMITTEE ON LOCAL GOVERNMENT BILL BY CHAIRPERSON WEBSTER) A BILL FOR An Act transferring the powers and duties of local boards 1 of health and local health departments to county boards 2 of health and district boards of health, and including 3 applicability and effective date provisions. 4 BE IT ENACTED BY THE GENERAL ASSEMBLY OF THE STATE OF IOWA: 5 TLSB 6889XC (1) 91 dg/ko
S.F. _____ DIVISION I 1 HEALTH CARE DISTRICTS 2 Section 1. Section 137.101, Code 2026, is amended to read 3 as follows: 4 137.101 Title and purpose . 5 This chapter shall be known and may be cited as the “Local 6 Public Health Governance Act” . The purpose of this chapter is 7 to define the structure, powers, and duties of local boards 8 of health. This chapter also provides an optional process 9 for counties to merge to form a district board of health in 10 order to increase efficiencies and enhance the delivery and 11 availability of public health services. 12 Sec. 2. Section 137.102, Code 2026, is amended to read as 13 follows: 14 137.102 Definitions. 15 As used in this chapter unless the context otherwise 16 requires: 17 1. “City board” means a city board of health in existence 18 prior to July 1, 2010. 19 2. “City health department” refers to the personnel and 20 property under the jurisdiction of a city board in existence 21 prior to July 1, 2010. 22 1. “Board of health” means a county board or a district 23 board. 24 3. 2. “Council” means the council on health and human 25 services. 26 4. 3. “County board” means a county board of established to 27 address public health within the county the board represents . 28 5. “County health department” refers to the personnel and 29 property under the jurisdiction of a county board. 30 4. “Department” means the department of health and human 31 services. 32 6. 5. “Director” means the director of health and human 33 services. 34 7. 6. “District” means any two or more geographically a 35 -1- LSB 6889XC (1) 91 dg/ko 1/ 51
S.F. _____ geographic area formed by any number of contiguous counties 1 pursuant to section 137.106 . 2 8. 7. “District board” means a board of established to 3 address public health representing at least two geographically 4 contiguous counties formed with approval of the state 5 department in accordance with this chapter , or any district 6 board of health in existence prior to July 1, 2010 within the 7 district the board represents . 8 9. 8. District health Health department” refers to the 9 personnel and property under the jurisdiction of a district 10 board of health . 11 10. “Local board of health” means a city, county, or 12 district board of health. 13 11. “Officers” means a local board of health chairperson, 14 vice chairperson, and secretary, and other officers which may 15 be named at the discretion of the local board of health. 16 12. “State department” or “department” means the department 17 of health and human services. 18 Sec. 3. Section 137.103, Code 2026, is amended by striking 19 the section and inserting in lieu thereof the following: 20 137.103 County boards. 21 1. If a county is not part of a district, that county shall 22 establish a county board to oversee public health matters 23 within the county. 24 2. a. The county shall create a fiscal plan for the 25 county’s county board that includes an estimate of proposed 26 expenditures and revenues and a funding plan that details how 27 the county board will receive funding. 28 b. If a city is located within the jurisdiction of more 29 than one board of health, each county or district in which the 30 city is located and the city shall create a contribution plan 31 for the city that details how the city will contribute to each 32 board of health’s funding plan. 33 3. a. A county board shall execute an agreement with each 34 county hospital located in the county that the county board 35 -2- LSB 6889XC (1) 91 dg/ko 2/ 51
S.F. _____ represents to allow for sharing of facilities, health care 1 services, and administrative resources. 2 b. A county board may apply for a waiver with the department 3 to waive the requirement in paragraph “a” by providing the 4 department evidence of all of the following: 5 (1) The county board has access to an alternative means of 6 providing health services comparable to those provided by the 7 county hospital with which the county board would otherwise be 8 required to contract. 9 (2) The alternative means of providing health services is 10 more cost-effective for the county board than contracting with 11 the county hospital. 12 c. A county board that applies for a waiver under paragraph 13 “b” must submit a letter explaining the county board’s decision 14 to apply for the waiver to each city council of a city that is 15 located in the county board’s county. 16 4. A county may subsequently request to be added to an 17 existing district pursuant to section 137.113, or request to 18 form a district pursuant to section 137.106. 19 Sec. 4. Section 137.104, Code 2026, is amended to read as 20 follows: 21 137.104 Local boards Boards of health —— powers and duties. 22 Local boards of health shall have the following powers and 23 duties: 24 1. A local board of health shall: 25 a. Enforce state health laws and the department’s rules and 26 lawful orders of the state department . 27 b. Make Adopt and enforce such reasonable rules and 28 regulations not inconsistent with any state or federal law 29 and the rules of the department as may be necessary for the 30 protection and improvement of the public health. 31 (1) Rules of a city board shall become effective upon 32 approval by the city council and publication in a newspaper 33 having general circulation in the city. 34 (2) (1) Rules of a county board shall become effective 35 -3- LSB 6889XC (1) 91 dg/ko 3/ 51
S.F. _____ upon approval by the county board of supervisors by a motion or 1 resolution as defined in section 331.101, subsection 13 , and 2 publication in a newspaper having general circulation in the 3 county. 4 (3) (2) Rules of a district board shall become effective 5 upon approval by the district board and publication in a 6 newspaper having general circulation in the district that the 7 district board represents . 8 (4) (3) Before approving any a rule or regulation the 9 local , a board of health shall hold a public hearing on the 10 proposed rule. Any citizen may appear and be heard at the 11 public hearing. A notice of the public hearing, stating the 12 time and place of the hearing and the general nature of the 13 proposed rule , or regulation shall be published in a newspaper 14 having general circulation as provided in section 331.305 in 15 the area served by the local jurisdiction that the board of 16 health represents . 17 c. Employ persons as necessary for the efficient discharge 18 of its the board of health’s duties. Employment practices 19 shall meet the requirements of chapter 8A, subchapter IV , or 20 any civil service provision adopted under chapter 400 . 21 d. Provide the names of all local members of the board of 22 health members and officers to the state department. 23 e. Provide minutes of local board of health meetings 24 and reports of the local board of health’s operations and 25 activities to the state department as may be required by the 26 director, by rule, or by contract. 27 2. A local board of health may do all of the following : 28 a. Provide such population-based and personal health 29 services as may be deemed necessary for the promotion and 30 protection of the public health of the public and charge 31 reasonable fees for personal health services. A person An 32 individual shall not be denied necessary services within the 33 limits of available resources because of inability to pay the 34 cost of such services. 35 -4- LSB 6889XC (1) 91 dg/ko 4/ 51
S.F. _____ b. Provide such environmental health services as may be 1 deemed necessary for the protection and improvement of the 2 public health and issue . 3 c. Issue licenses and permits and charge reasonable fees in 4 relation to the construction or operation of nonpublic water 5 supplies or private sewage disposal systems. 6 c. d. Engage in joint operations and contract with 7 individuals, county hospitals, colleges and universities, the 8 state department, and other public, private, and nonprofit 9 agencies , and individuals or form a district health department 10 to provide personal and population-based public health 11 services. 12 d. e. By written agreement with the city council of any 13 city within its the board of health’s jurisdiction, enforce 14 appropriate ordinances of the city relating to public health. 15 e. f. Demand that a raw milk producer provide the board 16 of health with all records required to be retained by the raw 17 milk producer as provided in section 195.6 , including any of 18 the following: 19 (1) The coliform count and standard plate count of dairy 20 animals maintained at a raw milk dairy owned or operated by the 21 raw milk producer. 22 (2) The administration of antibiotic drugs to dairy animals 23 maintained at a raw milk dairy owned or operated by the raw 24 milk producer. 25 Sec. 5. Section 137.105, Code 2026, is amended to read as 26 follows: 27 137.105 Local boards Boards of health —— membership and 28 meetings. 29 1. Membership, terms, compensation, and vacancies. 30 a. All members of a city board shall be appointed by the 31 city council. 32 b. All members of a county board shall be appointed by the 33 county board of supervisors. 34 c. 1. a. The membership of a county board shall consist 35 -5- LSB 6889XC (1) 91 dg/ko 5/ 51
S.F. _____ of the following: 1 (1) Two members appointed as agreed upon by a majority of 2 the cities within the county. 3 (2) Two members appointed by the county board of 4 supervisors. 5 (3) One member appointed as agreed upon by a majority of the 6 cities within the county and the county board of supervisors. 7 b. All members of a district board shall be appointed by the 8 county board of supervisors from each county represented by the 9 district board . Each county board of supervisors shall appoint 10 at least one but no more than three two members to the district 11 board . 12 d. c. Local boards of health shall consist of at least five 13 members. At least one board of health member shall be licensed 14 as a physician under chapter 148 , a physician assistant under 15 chapter 148C , an advanced registered nurse practitioner under 16 chapter 152 , or an advanced practice registered nurse under 17 chapter 152E . 18 e. d. A local Each board of health member shall serve for 19 a term of three years . A member is , and shall be eligible for 20 reappointment. 21 f. e. A local Each board of health member shall serve 22 without compensation, but may be reimbursed for necessary 23 expenses in accordance with rules established by the department 24 or the applicable jurisdiction . 25 g. f. A local As soon as practicable after a vacancy 26 occurs, a board of health member vacancy due to death, 27 resignation, or other cause shall be filled as soon as possible 28 after shall fill the vacancy exists for the unexpired term of 29 the original appointment. 30 2. Meetings. A majority of the members of a local board 31 of health shall be considered a quorum and an affirmative vote 32 of the majority of the members present is shall be necessary 33 for a board to take action taken by a local board of health . 34 The majority shall not include any member who has a conflict 35 -6- LSB 6889XC (1) 91 dg/ko 6/ 51
S.F. _____ of interest in the matter being voted on, and a statement by a 1 member that the member that has a conflict of interest exists 2 shall be conclusive for this purpose. 3 Sec. 6. Section 137.106, Code 2026, is amended to read as 4 follows: 5 137.106 District boards of health Districts —— request to 6 form. 7 1. The county boards board of supervisors of any two or 8 more number of geographically contiguous counties may at any 9 time submit a request to form a district board to the state 10 department. The formation request shall be in writing, shall 11 be executed by the county boards board of supervisors and the 12 county boards of health for of each county comprising the 13 proposed district board , and shall include but not be limited 14 to all of the following required elements : 15 1. a. A written narrative that explains how a district 16 board will attain the capability to provide population-based 17 and personal public health services. 18 2. The composition of the district board, including the 19 number of members each county shall appoint pursuant to section 20 137.105 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. b. The proposed district’s service delivery plan. 26 5. c. The budget and fiscal plan for the proposed district 27 board . The budget fiscal plan shall include an all of the 28 following: 29 (1) An estimate of proposed expenditures and revenues and 30 an allocation for the district. 31 (2) An estimate of the revenue responsibilities of fiscal 32 contributions each of the counties county participating in 33 the proposed district board will contribute to the proposed 34 district . 35 -7- LSB 6889XC (1) 91 dg/ko 7/ 51
S.F. _____ 6. d. A table of An organization . 1 7. A personnel system description, including identification 2 chart that includes the name of the proposed district treasurer 3 and , the proposed district auditor , and a section which 4 addresses the employment issues contained in actions the 5 proposed district will take to maintain compliance with section 6 137.110 . 7 8. e. The location of the proposed district board offices 8 and workforce throughout the jurisdiction district personnel . 9 9. f. (1) An inventory of the property and equipment in 10 the custody of each county board and a description as to of 11 whether such the property and equipment shall remain in the 12 custody of owned by the county or ownership of the property 13 shall be transferred transfer to the proposed district board to 14 become property of the district board . 15 (2) If property or equipment is to remain owned by the 16 county, a proposed agreement between the county and the 17 proposed district for joint use and maintenance of the property 18 or equipment in a manner that allows both the county and the 19 district board to perform the county’s and the district board’s 20 respective duties. 21 10. g. A timeline for the adoption of district board the 22 proposed district’s rules and regulations . 23 h. Whether the individual counties or the district will 24 be responsible for payment of unemployment compensation for 25 each county employee employed by a county board at the time of 26 formation of the proposed district, but not employed by the 27 district board following formation of the district. 28 i. A description of how property in the proposed district’s 29 custody will be divided if a county withdraws from the proposed 30 district or the proposed district dissolves. 31 11. j. Other criteria as established by the department by 32 rule of the state department . 33 2. The department shall review each request, approve the 34 formation of a district if the request meets the requirements 35 -8- LSB 6889XC (1) 91 dg/ko 8/ 51
S.F. _____ of this section, and notify each county board of supervisors 1 that submitted the request of the department’s decision. 2 3. Upon receipt of notice of approval as a district, the 3 district shall establish a district board and district board 4 members shall be appointed as specified in section 137.105. 5 Sec. 7. Section 137.109, Code 2026, is amended to read as 6 follows: 7 137.109 Organizational structure of district board District 8 boards and district health departments —— tort liability and open 9 records . 10 A district board is a governing body for purposes of chapter 11 670 , and a district health department is a municipality for 12 purposes of chapter 670 . All meetings of a district board 13 shall comply with the requirements of chapter 21 , and all 14 records of a district board and a district health department 15 shall be maintained in accordance with chapter 22 . 16 Sec. 8. Section 137.110, Code 2026, is amended to read as 17 follows: 18 137.110 District personnel. 19 1. A district board may employ persons individuals as 20 necessary for the efficient discharge of its the district 21 board’s duties . A district board and shall have all the same 22 duties and powers in employing such persons individuals as a 23 county board of supervisors is granted pursuant to section 24 331.324 , with the exception of the authority to provide for 25 support of the civil service commission for deputy sheriffs 26 as specified in section 331.324, subsection 1 , paragraph “k” . 27 A district board may employ persons shall give individuals 28 who were employed by one of the counties represented by the 29 district board at the time of the formation of the district 30 board by the counties represented by the district board, or 31 may employ persons who were not employed by such counties 32 preference when hiring new district personnel . The county 33 boards involved shall specify in the request submitted pursuant 34 to section 137.106 whether the individual counties or the 35 -9- LSB 6889XC (1) 91 dg/ko 9/ 51
S.F. _____ district board will be responsible for payment of unemployment 1 compensation for any county employees employed by the county 2 board at the time of formation of the district board but not 3 employed by the district board following formation. 4 2. If the district board employs persons an individual who 5 were was employed by one of the counties represented by the 6 district board at the time of formation of the district board, 7 the district board shall recognize the term of service of the 8 former county employees employee for purposes of all employee 9 benefits offered by the district board to such employees the 10 employee and such employees the employee shall not forfeit 11 accrued vacation, accrued sick leave, or longevity by becoming 12 district board employees . 13 3. Persons An individual who were was covered by county 14 employee life insurance, accident insurance, and health 15 insurance plans prior to becoming a district board employees 16 employee pursuant to this chapter section shall be permitted to 17 apply , prior to becoming a district board employees employee, 18 for life, accident, and health insurance plans that are is 19 available to district board employees so that those persons do 20 the individual does not suffer a lapse of insurance coverage as 21 a result of becoming district board employees . 22 4. The district board may employ or contract with legal 23 counsel , which may include the county attorney of a county 24 within the district, to enforce this chapter and district board 25 rules, represent and defend the district board and its officers 26 and the district board’s employees, provide legal advice to the 27 district board, and perform any other legal duties required by 28 law or and as assigned by the district board. The district 29 board may employ or contract with the county attorney of a 30 county within its jurisdiction. 31 Sec. 9. Section 137.111, Code 2026, is amended to read as 32 follows: 33 137.111 District Board of health treasurer and auditor. 34 Upon establishment of a district board of health , the 35 -10- LSB 6889XC (1) 91 dg/ko 10/ 51
S.F. _____ district board of health shall designate a treasurer an 1 individual to serve as treasurer of the district board of 2 health’s health department, and shall designate an auditor 3 individual to serve as auditor of the district board of 4 health’s health department. A treasurer or auditor of any 5 county within the district may also serve in the capacity 6 of treasurer or auditor of the district health department, 7 respectively, or the district board may contract with a third 8 party to act as the treasurer or auditor of the district health 9 department. A county treasurer’s or county auditor’s official 10 bond may extend to cover their the county treasurer’s or county 11 auditor’s respective duties performed on behalf of the district 12 a board of health’s health department. 13 Sec. 10. Section 137.112, Code 2026, is amended to read as 14 follows: 15 137.112 District public Public health fund —— budget. 16 1. The district treasurer designated under section 17 137.111 shall establish a district public health fund from 18 which disbursements may be made in the manner specified for 19 disbursements by law for the disbursement of county funds. 20 2. a. All moneys received by a district board or district 21 health department for local public health purposes from of 22 health including federal appropriations, state appropriations, 23 local appropriations, fees, gifts, grants, bequests, or other 24 sources shall be deposited in the district public health fund. 25 Expenditures The board of health shall be made from use moneys 26 in the fund on order of the district board for the purpose of 27 carrying out its the board of health’s duties. 28 b. No more than twenty percent of the unexpended balance 29 remaining in the public health fund at the end of each fiscal 30 year shall be maintained in the district public health fund. 31 The remainder of the unexpended balance shall revert be 32 transferred as follows: 33 (1) For a county board, to each city that contributed to 34 the county board’s annual budget in an amount proportionate to 35 -11- LSB 6889XC (1) 91 dg/ko 11/ 51
S.F. _____ the amount the city contributed to the county board’s annual 1 budget. 2 (2) For a district board, to the general funds of the each 3 member counties county in the manner determined by an amount 4 proportionate to the amount the member county contributed to 5 the district board board’s annual budget . 6 3. 2. a. The district Each board of health shall adopt and 7 certify an annual budget in accordance compliance with section 8 sections 24.17 relating to certification of budgets and section 9 24.27 relating to protesting budgets and based on the board of 10 health’s fiscal plan created in section 137.103, subsection 2, 11 or section 137.106, subsection 1, paragraph “c” . 12 4. b. (1) (a) This section does not apply to any district 13 board of health or district health department in existence 14 prior to July 1, 2010 A county board shall submit a proposed 15 annual budget to the county board’s county board of supervisors 16 and each city that contributes to the county board’s annual 17 budget . 18 (b) A proposed annual budget shall be considered certified 19 when two-thirds of the entities that contribute to the county 20 board’s annual budget approve the proposed annual budget. 21 If fewer than three entities contribute to a county board’s 22 budget, a proposed annual budget shall be considered certified 23 when all entities that contribute to the county board’s annual 24 budget approve the proposed annual budget. 25 (2) (a) A district board shall submit a proposed annual 26 budget to each member county that contributes to the district 27 board’s annual budget. 28 (b) A proposed annual budget shall be considered certified 29 when two-thirds of the member counties that contribute to the 30 district board’s annual budget approve the proposed annual 31 budget. If fewer than three counties contribute to a district 32 board’s budget, a proposed annual budget shall be considered 33 certified when all member counties that contribute to the 34 district board’s annual budget approve the proposed annual 35 -12- LSB 6889XC (1) 91 dg/ko 12/ 51
S.F. _____ budget. 1 Sec. 11. Section 137.113, Code 2026, is amended to read as 2 follows: 3 137.113 Adding additional counties to a district. 4 1. A county may request to be added to an existing district 5 board by submission and approval of submitting a request , as 6 specified in sections pursuant to section 137.106 and 137.107 . 7 2. Upon approval under section 137.106 for a county to join 8 a district, all of the following shall occur: 9 a. The powers and responsibilities of the county’s county 10 board shall immediately transfer to the district board that 11 represents the district. 12 b. All property and equipment in the custody of the 13 county board shall be divided as provided in section 137.106, 14 subsection 1, paragraph “f” . 15 c. The county’s county board shall be dissolved. 16 Sec. 12. Section 137.114, Code 2026, is amended to read as 17 follows: 18 137.114 Withdrawal County withdrawal from a district. 19 1. A county may request to withdraw from an existing a 20 district board upon submission of by submitting a request 21 for withdrawal to and approval by the state department. The 22 A request to withdraw shall include a plan to reform its 23 reestablish the requesting county’s county board or join a 24 different district board, information specified in section 25 137.106 , and written approval of the request by from the 26 district board that represents the district from which the 27 county is requesting to withdraw . Any county choosing to 28 withdraw from the district board shall commit to the continuity 29 of services in its county by reestablishing its county board 30 or joining a different district board. The remaining counties 31 in the district 32 2. Upon approving a county’s request to withdraw from a 33 district, the district board that approved the withdrawal shall 34 submit an application including the information specified in 35 -13- LSB 6889XC (1) 91 dg/ko 13/ 51
S.F. _____ section 137.106 to the state department for review as provided 1 in section 137.107 the district as it will exist without the 2 withdrawing county . 3 3. If only one county will remain in a district after the 4 withdrawal of a county, the district shall be dissolved and the 5 remaining county’s county board shall be reestablished. 6 Sec. 13. Section 137.116, Code 2026, is amended to read as 7 follows: 8 137.116 Emergency request for funds moneys . 9 A local board of health may, during a public health 10 disaster , as that term is defined in section 135.140 , or 11 in preparation for or response to such disaster, request 12 additional appropriations moneys which may , upon approval of 13 the director , be allotted allocated from the funds reserved 14 moneys appropriated for that purpose to the extent that funds 15 moneys are appropriated and available. Upon termination of 16 the public health disaster response , the local board of health 17 shall report its to the director on the expenditures by the 18 board of emergency funds to the director the additional moneys . 19 Sec. 14. Section 137.117, Code 2026, is amended to read as 20 follows: 21 137.117 Penalties —— criminal and civil. 22 1. Any A person who violates any provision of this chapter 23 or the rules of a local rule adopted by a board of health or any 24 lawful order of the board, its officers, or authorized agents 25 is guilty of a simple misdemeanor. Each additional day of 26 neglect or failure a person fails to comply with such provision 27 this chapter , rule or a rule adopted by a board of health , or 28 lawful order after notice being notified of the violation by 29 the local board of health shall constitute a separate offense. 30 2. A local board of health may impose a civil penalty not 31 to exceed seven hundred fifty dollars for each violation of 32 this chapter or the rules of a rule adopted by the local board 33 of health or any lawful order of the board, its officers, or 34 authorized agents . If the violation is a repeat offense, A 35 -14- LSB 6889XC (1) 91 dg/ko 14/ 51
S.F. _____ board of health may impose a civil penalty not up to exceed one 1 thousand dollars may be imposed for a violation if the board 2 finds the person who committed the violation has previously 3 committed the same violation . The local board of health shall 4 impose and enforce such penalties in the manner provided in 5 section 331.307 for county infractions. 6 Sec. 15. NEW SECTION . 137.118A City public health 7 functions. 8 1. A city shall perform all public health functions through 9 the county board or district board that represents the city. 10 2. If a city is located within the jurisdiction of 11 multiple boards of health, each county board of supervisors 12 that represents the city, and the city, shall enter into an 13 agreement that details how public health services will be 14 provided to the city. 15 Sec. 16. Section 137.119, Code 2026, is amended to read as 16 follows: 17 137.119 Adoption of rules. 18 1. The department shall adopt rules pursuant to chapter 17A 19 to implement and administer this chapter . The department is 20 vested with discretionary authority to interpret the provisions 21 of this chapter . 22 2. A board of health shall not adopt a rule that creates a 23 requirement that is more stringent than what is required by the 24 state unless each city within a county board’s jurisdiction, 25 or each county board of supervisors within a district board’s 26 jurisdiction, agree to the more stringent requirement. 27 Sec. 17. NEW SECTION . 137.120 Interpretation of chapter. 28 This chapter shall not be construed to prohibit a county 29 from entering into contracts not contemplated by this chapter 30 to provide necessary public health services in a manner not 31 prohibited by law. 32 Sec. 18. Section 143.1, Code 2026, is amended to read as 33 follows: 34 143.1 Authority to employ. 35 -15- LSB 6889XC (1) 91 dg/ko 15/ 51
S.F. _____ Any local A board of health as defined in section 137.102 , 1 area education agency board, or the school board of any school 2 district may employ public health nurses at periods each 3 year and in numbers as deemed advisable. The council of any 4 city A board of health , or the school board of any school 5 district, or any of them board of health and school board of a 6 school district acting in cooperation, may contract with any a 7 nonprofit nurses’ association for public health nursing service 8 services . The compensation and expenses shall be paid out of 9 the general fund of the political subdivision employing nurses 10 contracting for public health nursing services . 11 Sec. 19. REPEAL. Sections 137.107, 137.108, and 137.115, 12 Code 2026, are repealed. 13 Sec. 20. EFFECTIVE DATE. This division of this Act takes 14 effect July 1, 2027. 15 DIVISION II 16 TRANSITION PROVISIONS 17 Sec. 21. CITY BOARDS OF HEALTH —— TRANSITION TO COUNTY 18 BOARDS AND DISTRICT BOARDS. 19 1. For purposes of this division: 20 a. “City board” means a city board of health. 21 b. “County board”, “district”, and “district board” mean 22 the same as defined in section 137.102, as enacted in division 23 I of this Act. 24 c. “Public health fund” means a fund established pursuant to 25 section 137.112, as enacted in division I of this Act. 26 d. “Transition period” means the period beginning on the 27 date of enactment of this division of this Act and concluding 28 on June 30, 2027. 29 2. During the transition period, each city board shall 30 cooperate with each county board of supervisors representing 31 the counties in which the city board is located to transition 32 the city board’s responsibilities to a county board or a 33 district board. 34 3. During the transition period, each county shall have the 35 -16- LSB 6889XC (1) 91 dg/ko 16/ 51
S.F. _____ authority to create a county board or form a district as if 1 division I of this Act were enacted. 2 4. During the transition period, each county board created 3 and each district board formed under subsection 3 shall have 4 the authority to do all of the following: 5 a. Establish and maintain a public health fund. 6 b. Perform public health functions for the jurisdiction the 7 county board or district board represents. 8 c. Establish policies as necessary to ensure efficient 9 transfer of responsibilities from a city board to the county 10 board or the district board. 11 d. Execute contracts as necessary to establish, implement, 12 and maintain public health functions a city board is 13 transferring to the county board or the district board. 14 e. As permitted by existing contracts, assume contractual 15 obligations on behalf of a city board that is transferring 16 responsibilities to the county board or district board. 17 5. a. At the conclusion of the transition period, all 18 property held by a city board, including all unencumbered and 19 unobligated moneys remaining in a fiscal account maintained by 20 the city board, shall be transferred to the county board or the 21 district board that represents the city in which the city board 22 is located. 23 b. If a city located in a city board’s jurisdiction is 24 located in multiple counties, property shall be transferred 25 according to an agreement executed between the city and each 26 county board of supervisors that represents the city. 27 6. City boards shall identify each contract that will be 28 impacted by this division of this Act. On or before June 30, 29 2027, each city board that is a party to a contract identified 30 by a city board under this subsection shall exercise the 31 option, if available pursuant to the terms of the contract, 32 to terminate the contract. Contracts identified under this 33 subsection that do not provide for termination shall not be 34 renewed or extended at the end of the current contract term. 35 -17- LSB 6889XC (1) 91 dg/ko 17/ 51
S.F. _____ 7. Unless otherwise provided in this division of this Act, a 1 city board shall not enter into, renew, or extend any contract 2 related to the city board’s responsibilities if the term period 3 of the contract would be effective, or the deliverables under 4 the contract would be provided, beyond June 30, 2027. 5 8. a. Each city board is dissolved at the end of the 6 transition period. 7 b. When a city board of health is dissolved, the fiscal 8 plan for the board of health assuming the public health duties 9 of the dissolved city board of health must include a statement 10 of whether the city the dissolved city board of health 11 represented, or the board of health, will be responsible for 12 payment of unemployment compensation for each employee employed 13 by the city board of health at the time the city board of health 14 was dissolved, but not employed by the board of health at the 15 end of the transition period. 16 9. The board of health assuming the public health duties 17 of a dissolved city board of health shall give preference when 18 hiring new board of health personnel to individuals employed 19 by the city board of health at the time of the city board 20 of health’s dissolution. If the board of health employs an 21 individual employed by a city board of health at the time of 22 the city board of health’s dissolution, the board of health 23 shall do all of the following: 24 a. Recognize the term of service of the individual for 25 purposes of all benefits offered by the board of health 26 to the individual, and the individual shall not forfeit 27 the individual’s accrued vacation, accrued sick leave, or 28 longevity. 29 b. If the individual had employee life insurance, accident 30 insurance, and health insurance made available by the city 31 board of health, the individual shall be permitted to apply, 32 prior to becoming a board of health employee, for life, 33 accident, and health insurance that is available to board of 34 health employees so that the individual does not suffer a lapse 35 -18- LSB 6889XC (1) 91 dg/ko 18/ 51
S.F. _____ of coverage. 1 Sec. 22. EFFECTIVE DATE. This division of this Act, being 2 deemed of immediate importance, takes effect upon enactment. 3 DIVISION III 4 HEALTH CARE DISTRICTS CONFORMING CHANGES 5 Sec. 23. Section 10A.531, subsection 7, Code 2026, is 6 amended to read as follows: 7 7. As necessary to avoid duplication and promote 8 coordination of public health inspection and enforcement 9 activities, the department may enter into agreements with local 10 boards of health to provide , as defined in section 137.102, 11 for inspection of tattooing establishments and enforcement 12 activities in accordance with the rules and criteria 13 implemented under this section . 14 Sec. 24. Section 10A.533, subsections 1 and 2, Code 2026, 15 are amended to read as follows: 16 1. If any local a board of health , as defined in section 17 135.1 135.102 , shall fail fails to enforce the department’s 18 rules of the department adopted under this part , or carry 19 out the department’s lawful directions under this part , 20 the department may enforce the same within the territorial 21 jurisdiction of such local board, and for that purpose it may 22 exercise all of the powers given by statute to the local board 23 assume control of the board’s duties, exercise all powers 24 granted to the board , and may employ the necessary assistants 25 personnel to carry out its lawful directions enforce the 26 department’s rules and directions and carry out the district 27 board’s duties . 28 2. All A board of health shall be responsible for the 29 payment of any expenses incurred by the department in 30 determining whether its rules are enforced by a local the board 31 under this part , and in enforcing the same when a local board 32 has failed to do so, shall be paid in the same manner as the 33 expenses of enforcing such rules when enforced by the local 34 board failed to enforce the department’s rules, and in taking 35 -19- LSB 6889XC (1) 91 dg/ko 19/ 51
S.F. _____ the actions necessary to correct the board’s failure . 1 Sec. 25. Section 11.41, subsection 3, Code 2026, is amended 2 to read as follows: 3 3. If the information, records, instrumentalities, and 4 properties sought by the auditor of state are required by law 5 to be kept confidential, the auditor of state shall have access 6 to the information, records, instrumentalities, and properties, 7 but shall maintain the confidentiality of all such information 8 and is subject to the same penalties as the lawful custodian of 9 the information for dissemination of the information. However, 10 the auditor of state shall not have access to the income 11 tax returns of individuals or information in a report to the 12 department of health and human services , to or a local board of 13 health, or to a local health department as that term is defined 14 in section 137.102, that identifies a person infected with a 15 reportable disease. 16 Sec. 26. Section 22.7, subsection 16, Code 2026, is amended 17 to read as follows: 18 16. Information in a report to the department of health and 19 human services , to or a local board of health, or to a local 20 health department as that term is defined in section 137.102 , 21 which identifies a person infected with a reportable disease. 22 Sec. 27. Section 28G.4, subsection 4, Code 2026, is amended 23 to read as follows: 24 4. Require the use of the resource recovery facilities or 25 of facilities necessary to implement solid waste management 26 projects as defined in section 28G.2 , by any person who can be 27 effectively served by the facilities. However, this subsection 28 does not prohibit a private agency from dumping or depositing 29 solid waste resulting from its own residential, farming, 30 manufacturing, mining, or commercial activities on land owned 31 or leased by it if the action does not violate any statute of 32 this state or rules adopted by the environmental protection 33 commission , or local boards of health as that term is defined 34 in section 137.102, or local ordinances. 35 -20- LSB 6889XC (1) 91 dg/ko 20/ 51
S.F. _____ Sec. 28. Section 135.1, Code 2026, is amended by adding the 1 following new subsection: 2 NEW SUBSECTION . 01. “Board of health” means the same as 3 defined in section 137.102. 4 Sec. 29. Section 135.1, subsection 2, Code 2026, is amended 5 to read as follows: 6 2. “Health officer” means the a physician, physician 7 assistant, advanced registered nurse practitioner, or advanced 8 practice registered nurse who is the health officer of the 9 local a board of health. 10 Sec. 30. Section 135.1, subsection 3, Code 2026, is amended 11 by striking the subsection. 12 Sec. 31. Section 135.11, subsection 10, Code 2026, is 13 amended to read as follows: 14 10. Administer healthy aging and essential public health 15 services by approving grants and allocations of state funds 16 to the local boards of health for the purposes of promoting 17 healthy aging throughout the lifespan and enhancing health 18 promotion and disease prevention services, and by providing 19 guidelines for the approval of the grants and allocation of the 20 state funds. Guidelines, evaluation requirements, and formula 21 allocation procedures for the services shall be established by 22 the department by rule. 23 Sec. 32. Section 135.17, subsection 3, Code 2026, is amended 24 to read as follows: 25 3. By May 31 annually, each local board of health shall 26 furnish the department with evidence that each student enrolled 27 in any public or nonpublic school within the local board’s 28 jurisdiction has met the dental screening requirement in this 29 section . 30 Sec. 33. Section 135.19, subsection 2, Code 2026, is amended 31 to read as follows: 32 2. The department shall establish by rule a list of 33 individuals by category who are at increased risk for viral 34 hepatitis exposure. The list shall be consistent with 35 -21- LSB 6889XC (1) 91 dg/ko 21/ 51
S.F. _____ recommendations developed by the centers for disease control 1 and prevention of the United States department of health and 2 human services, and shall be developed in consultation with 3 the Iowa viral hepatitis task force and the Iowa department of 4 veterans affairs. The department shall also establish by rule 5 what information is to be distributed and the form and manner 6 of distribution. The rules shall also establish a vaccination 7 and testing program, to be coordinated by the department 8 through local health departments and boards of health, clinics , 9 and other appropriate locations. 10 Sec. 34. Section 135.27, subsections 1 and 4, Code 2026, are 11 amended to read as follows: 12 1. Program goals. The department shall establish a grant 13 program to energize local communities to transform the existing 14 culture into a culture that promotes healthy lifestyles and 15 leads collectively, community by community, to a healthier 16 state. The grant program shall expand an existing healthy 17 communities initiative to assist local boards of health, in 18 collaboration with existing community resources, to build 19 community capacity in addressing the prevention of chronic 20 disease that results from risk factors including overweight and 21 obesity conditions. 22 4. Eligibility. Local boards Boards of health representing 23 a coalition of health care providers and community and private 24 organizations are eligible to submit applications. 25 Sec. 35. Section 135.33, Code 2026, is amended to read as 26 follows: 27 135.33 Refusal of board to enforce rules. 28 If any local a board shall fail of health fails to enforce 29 the department’s rules of the state department or carry out its 30 lawful the department’s directions, the department may enforce 31 the same within the territorial jurisdiction of such local 32 board, and for that purpose it may exercise all of the powers 33 given by statute to the local board assume control of the 34 board’s duties, exercise all powers granted to the board , and 35 -22- LSB 6889XC (1) 91 dg/ko 22/ 51
S.F. _____ may employ the necessary assistants personnel to carry out its 1 lawful directions enforce the department’s rules and directions 2 and carry out the board’s duties . 3 Sec. 36. Section 135.34, Code 2026, is amended to read as 4 follows: 5 135.34 Expenses for enforcing rules. 6 All A board of health shall be responsible for the payment of 7 any expenses incurred by the state department in determining 8 whether its rules are enforced by a local the board , and in 9 enforcing the same when a local board has failed to do so, 10 shall be paid in the same manner as the expenses of enforcing 11 such rules when enforced by the local board failed to enforce 12 the department’s rules, and in taking the required actions to 13 correct the board’s failure . 14 Sec. 37. Section 135.39D, subsection 2, paragraph b, Code 15 2026, is amended to read as follows: 16 b. A vision screening conducted at a pediatrician’s or 17 family practice physician’s office, a free clinic, a child 18 care center, a local public health department as that term is 19 defined in section 137.102 , a public or accredited nonpublic 20 school, or a community-based organization, or by an advanced 21 registered nurse practitioner or physician assistant. 22 Sec. 38. Section 135.102, subsection 6, Code 2026, is 23 amended to read as follows: 24 6. Model regulations for lead hazard remediation to be used 25 in instances in which a child is confirmed as lead poisoned. 26 The department shall make the model regulations available 27 to local boards of health and shall promote the adoption of 28 the regulations at the local level, in cities and counties 29 implementing lead hazard remediation programs. Nothing in 30 this This subsection shall not be construed as requiring the 31 adoption of the model regulations. 32 Sec. 39. Section 135.103, Code 2026, is amended to read as 33 follows: 34 135.103 Grant program. 35 -23- LSB 6889XC (1) 91 dg/ko 23/ 51
S.F. _____ The department shall implement a childhood lead poisoning 1 prevention grant program which provides federal, state, or 2 other funds moneys to local boards each board of health or 3 cities for the program after standards and requirements for 4 the local program are developed. The department may also 5 use federal, state, or other funds moneys provided for the 6 childhood lead poisoning prevention grant program to purchase 7 environmental and blood testing services from a public health 8 laboratory. 9 Sec. 40. Section 135.104, unnumbered paragraph 1, Code 10 2026, is amended to read as follows: 11 The program by a local A board of health or city receiving 12 funding for an approved childhood lead poisoning prevention 13 grant program shall include: 14 Sec. 41. Section 135.105B, subsection 3, Code 2026, is 15 amended to read as follows: 16 3. Following development of the voluntary guidelines, 17 cities or counties a city or county may elect to utilize the 18 guidelines in developing and administering local programs 19 through city or county health departments on a city, county, 20 or multicounty basis or may request that the state develop 21 and administer the local program through the board of health 22 for the jurisdiction in which the city or county is located . 23 However, cities and counties are a city or a county is not 24 required to develop and administer a local programs program 25 based upon the guidelines. 26 Sec. 42. Section 135.107, subsection 1, Code 2026, is 27 amended to read as follows: 28 1. Provide technical planning assistance to rural 29 communities and counties exploring innovative means of 30 delivering rural health services through community health 31 services assessment, planning, and implementation, including 32 but not limited to hospital conversions, cooperative agreements 33 among hospitals, physician and health practitioner support, 34 recruitment and retention of primary health care providers, 35 -24- LSB 6889XC (1) 91 dg/ko 24/ 51
S.F. _____ public health services, emergency medical services, medical 1 assistance facilities, rural health care clinics, and 2 alternative means which may be included in the long-term 3 community health services assessment and developmental plan. 4 The department shall encourage collaborative efforts of the 5 local boards of health, hospital governing boards, and other 6 public and private entities located in rural communities to 7 adopt a long-term community health services assessment and 8 developmental plan pursuant to rules adopted by the department 9 and perform the duties required of the department in section 10 135B.33 . 11 Sec. 43. Section 135.119, subsection 2, paragraph d, Code 12 2026, is amended to read as follows: 13 d. The program plan shall incorporate a multiyear, 14 collaborative approach for implementation of the plan. The 15 plan shall address how to involve those who regularly work 16 with parents and persons responsible for the care of a 17 child, including but not limited to child abuse prevention 18 programs, child care resource and referral programs, child care 19 providers, family support programs, programs receiving funding 20 through the early childhood Iowa initiative, public and private 21 schools, health care providers, local health departments boards 22 of health , birth centers, and birthing hospitals. 23 Sec. 44. Section 135.146, subsection 3, Code 2026, is 24 amended to read as follows: 25 3. The department shall establish first responder 26 notification procedures regarding the existence of the 27 program by rule, and shall develop, and distribute to first 28 responders, educational materials on methods of preventing 29 exposure to infectious diseases. In administering the program, 30 the department may contract with county and local health 31 departments boards of health , not-for-profit home health care 32 agencies, hospitals, physicians, and military unit clinics. 33 Sec. 45. Section 135A.2, subsection 3, Code 2026, is amended 34 to read as follows: 35 -25- LSB 6889XC (1) 91 dg/ko 25/ 51
S.F. _____ 3. “Designated local public health agency” means an entity 1 that is either governed by or contractually responsible to a 2 local board of health and designated by the local board. 3 Sec. 46. Section 135A.2, subsection 4, Code 2026, is amended 4 to read as follows: 5 4. “Governmental public health system” means local boards of 6 health, the council on health and human services, designated 7 local public health agencies, the state hygienic laboratory, 8 and the department. 9 Sec. 47. Section 135A.2, subsection 5, Code 2026, is amended 10 by striking the subsection. 11 Sec. 48. Section 135A.8, subsections 2, 3, and 4, Code 2026, 12 are amended to read as follows: 13 2. The fund is established to assist local boards of health 14 and the department with the provision of governmental public 15 health system organizational capacity and public health service 16 delivery and to achieve and maintain voluntary accreditation. 17 At least seventy percent of the funds shall be made available 18 to local boards of health and up to thirty percent of the funds 19 may be utilized by the department. 20 3. Moneys in the fund may be allocated by the department 21 to a local board of health for organizational capacity and 22 service delivery. Such allocation may be made on a matching, 23 dollar-for-dollar basis for the acquisition of equipment, 24 or by providing grants to achieve and maintain voluntary 25 accreditation. 26 4. A local board of health seeking matching funds or 27 grants under this section shall apply to the department. The 28 department shall adopt rules concerning the application and 29 award process for the allocation of moneys in the fund and 30 shall establish the criteria for the allocation of moneys in 31 the fund if the moneys are insufficient to meet the needs of 32 local boards of health. 33 Sec. 49. Section 135B.33, subsection 1, unnumbered 34 paragraph 1, Code 2026, is amended to read as follows: 35 -26- LSB 6889XC (1) 91 dg/ko 26/ 51
S.F. _____ Subject to availability of funds, the department of health 1 and human services shall provide technical planning assistance 2 to local boards of health and hospital or rural emergency 3 hospital governing boards to ensure access to such services in 4 rural areas. The department shall encourage the local boards 5 of health and hospital or rural emergency hospital governing 6 boards to adopt a long-term community health services and 7 developmental plan including the following: 8 Sec. 50. Section 135C.1, subsection 19, Code 2026, is 9 amended to read as follows: 10 19. “Physician” has the meaning assigned that term by means 11 the same as defined in section 135.1 , subsection 4 . 12 Sec. 51. Section 135D.2, subsection 20, Code 2026, is 13 amended to read as follows: 14 20. “Public health agency” means an entity that is governed 15 by or contractually responsible to a local board of health or 16 the department to provide services focused on the health status 17 of population groups and their environments. 18 Sec. 52. Section 135I.1, Code 2026, is amended by adding the 19 following new subsection: 20 NEW SUBSECTION . 01. “Board of health” means the same as 21 defined in section 137.102. 22 Sec. 53. Section 135I.1, subsection 2, Code 2026, is amended 23 by striking the subsection. 24 Sec. 54. Section 135I.2, Code 2026, is amended to read as 25 follows: 26 135I.2 Applicability. 27 This chapter applies to all spray pads, swimming pools, 28 and spas owned or operated by local or state government, or 29 commercial interests or private entities including but not 30 limited to facilities operated by cities, counties, public or 31 private school corporations, hotels, motels, camps, apartments, 32 condominiums, and health or country clubs. This chapter does 33 not apply to facilities intended for single family use or to 34 a spray pad, swimming pool, or spa operated by a homeowners’ 35 -27- LSB 6889XC (1) 91 dg/ko 27/ 51
S.F. _____ association or housing cooperative representing seventy-two 1 or fewer dwelling units if the bylaws of the association or 2 cooperative, which also apply to a rental agreement relative 3 to any of the dwelling units, include an exemption from the 4 requirements of this chapter , provide for inspection of the 5 spray pad, swimming pool, or spa by an entity other than 6 the department or local board of health, and assume any 7 liability associated with operation of the spray pad, swimming 8 pool, or spa. This chapter does not apply to a spray pad, 9 swimming pool, or spa used exclusively for therapy under the 10 direct supervision of qualified medical personnel. To avoid 11 duplication and promote coordination of inspection activities, 12 the department may enter into written agreements with a local 13 board of health to provide for inspection and enforcement in 14 accordance with this chapter . 15 Sec. 55. Section 135I.4, subsections 4 and 6, Code 2026, are 16 amended to read as follows: 17 4. Establish and collect fees to defray the cost of 18 administering this chapter . It is the intent of the general 19 assembly that fees collected under this chapter be used to 20 defray the cost of administering this chapter . However, the 21 portion of fees needed to defray the costs of a local board of 22 health in implementing this chapter shall be established by the 23 local board of health. A fee imposed for the inspection of a 24 spray pad, swimming pool, or spa shall not be collected until 25 the inspection has actually been performed. 26 6. Enter into agreements with a local board of health 27 to implement the inspection and enforcement provisions of 28 this chapter . The agreements shall provide that the fees 29 established by the local board of health for inspection and 30 enforcement shall be retained by the local board. However, 31 inspection fees shall not be charged by the department for 32 facilities which are inspected by third-party authorities. 33 Third-party authorities shall be approved by the department. 34 The department shall monitor and certify the inspection and 35 -28- LSB 6889XC (1) 91 dg/ko 28/ 51
S.F. _____ enforcement programs of local boards of health and approved 1 third-party authorities. 2 Sec. 56. Section 135I.6, Code 2026, is amended to read as 3 follows: 4 135I.6 Enforcement. 5 If the department , or a local board of health acting pursuant 6 to agreement with the department , determines that a provision 7 of this chapter or a rule adopted pursuant to this chapter 8 has been or is being violated, the department may withhold 9 or revoke the registration of a spray pad, swimming pool, or 10 spa, or the department or the local board of health may order 11 that a facility or item of equipment not be used, until the 12 necessary corrective action has been taken. The department or 13 the local board of health may request the county attorney to 14 bring appropriate legal proceedings to enforce this chapter , 15 including an action to enjoin violations. The attorney general 16 may also institute appropriate legal proceedings at the request 17 of the department. This remedy is in addition to any other 18 legal remedy available to the department or a local board of 19 health. 20 Sec. 57. Section 136A.5B, subsection 1, unnumbered 21 paragraph 1, Code 2026, is amended to read as follows: 22 In accordance with the duties prescribed in section 136A.3 , 23 the department shall collaborate with state and local health 24 agencies boards of health and other public and private 25 organizations to develop and publish or approve and publish 26 informational materials to educate and raise awareness of 27 cytomegalovirus and congenital cytomegalovirus among women who 28 may become pregnant, expectant parents, parents of infants, 29 attending health care providers, and others, as appropriate. 30 The materials shall include information regarding all of the 31 following: 32 Sec. 58. Section 136A.9, Code 2026, is amended to read as 33 follows: 34 136A.9 Cooperation of other agencies. 35 -29- LSB 6889XC (1) 91 dg/ko 29/ 51
S.F. _____ All state, district, county, and city health or welfare 1 agencies The department and boards of health, as that term is 2 defined in section 137.102, shall cooperate and participate in 3 the administration of this chapter . 4 Sec. 59. Section 136D.3, subsection 2, Code 2026, is amended 5 to read as follows: 6 2. This chapter shall not supersede or duplicate the 7 authority and programs of any other agency of the state or the 8 United States. To avoid duplication and promote coordination 9 of radiation protection activities, the department may 10 enter into written agreements with other state or federal 11 agencies, with local boards of public health, or with private 12 organizations or individuals, to administer this chapter . 13 Sec. 60. Section 137C.2, subsection 6, Code 2026, is amended 14 by striking the subsection. 15 Sec. 61. Section 137C.2, subsection 8, Code 2026, is amended 16 to read as follows: 17 8. “Regulatory authority” means the department or a local 18 board of health that has entered into an agreement with the 19 director pursuant to section 137C.6 for authority to enforce 20 the Iowa hotel sanitation code in its the board of health’s 21 jurisdiction. 22 Sec. 62. Section 137C.6, subsections 2, 3, and 4, Code 2026, 23 are amended to read as follows: 24 2. If a municipal corporation wants its local the municipal 25 corporation’s board of health to license, inspect, and 26 otherwise enforce the Iowa hotel sanitation code within its 27 the board’s jurisdiction, the municipal corporation may enter 28 into an agreement to do so with the director. The director 29 may enter into the agreement if the director finds that the 30 local board of health has adequate resources to perform the 31 required functions. A municipal corporation may only enter 32 into an agreement to enforce the Iowa hotel sanitation code if 33 it also agrees to enforce the rules setting minimum standards 34 to protect consumers from foodborne illness adopted pursuant 35 -30- LSB 6889XC (1) 91 dg/ko 30/ 51
S.F. _____ to section 137F.2 . 1 3. A local board of health that is responsible for enforcing 2 the Iowa hotel sanitation code within its the board of health’s 3 jurisdiction pursuant to an agreement shall make an annual 4 report to the director providing the following information: 5 a. The total number of hotel licenses granted or renewed 6 during the year. 7 b. The amount of money collected in license fees during the 8 year. 9 c. Other information the director requests. 10 4. The director shall monitor local boards each board 11 of health to determine if they are the board of health is 12 enforcing the Iowa hotel sanitation code within their the 13 board of health’s respective jurisdictions. If the director 14 determines that the Iowa hotel sanitation code is enforced by a 15 local board of health, such enforcement shall be accepted in 16 lieu of enforcement by the department in that jurisdiction. 17 If the director determines that the Iowa hotel sanitation 18 code is not enforced by a local board of health, the director 19 may rescind the agreement after reasonable notice and an 20 opportunity for a hearing. If the agreement is rescinded, the 21 director shall assume responsibility for enforcement in the 22 jurisdiction involved. 23 Sec. 63. Section 137C.16, subsection 2, Code 2026, is 24 amended to read as follows: 25 2. A hotel beyond the reach of a central water or sewerage 26 system shall be served by on-site facilities which meet the 27 technical requirements of the local board of health and the 28 department of natural resources. 29 Sec. 64. Section 137C.35, subsection 1, Code 2026, is 30 amended to read as follows: 31 1. This chapter does not apply to bed and breakfast homes as 32 defined in section 137F.1 . However, a bed and breakfast home 33 shall have a smoke detector in proper working order in each 34 sleeping room and a fire extinguisher in proper working order 35 -31- LSB 6889XC (1) 91 dg/ko 31/ 51
S.F. _____ on each floor. A bed and breakfast home which does not receive 1 its drinking water from a public water supply shall have its 2 drinking water tested at least annually by the state hygienic 3 laboratory or the local board of health. 4 Sec. 65. Section 137F.13, Code 2026, is amended to read as 5 follows: 6 137F.13 Water and waste treatment. 7 If a food establishment or food processing plant is served 8 by privately owned water or waste treatment facilities, those 9 facilities shall meet the technical requirements of the local 10 board of health and the department of natural resources. 11 Sec. 66. Section 138.12, subsection 2, Code 2026, is amended 12 to read as follows: 13 2. Written application for such variations shall be filed 14 with the director and local board of health serving the area in 15 which the migrant labor camp is situated. No such variation 16 shall be effective until granted in writing by the director. 17 Sec. 67. Section 138.14, Code 2026, is amended to read as 18 follows: 19 138.14 Communicable diseases reported. 20 The camp operator shall report immediately to the local 21 board of health the name and address of any individual in 22 the camp known to have or suspected of having a communicable 23 disease. Whenever there shall occur in any camp, or portion 24 thereof, a case of suspected food poisoning or an unusual 25 prevalence of any illness in which fever, diarrhea, sore 26 throat, vomiting, or jaundice is a prominent symptom, the 27 camp operator shall report immediately the existence of the 28 condition to the local board of health and the director. 29 Sec. 68. Section 139A.2, Code 2026, is amended by adding the 30 following new subsections: 31 NEW SUBSECTION . 1A. “Board of health” means the same as 32 defined in section 137.102. 33 NEW SUBSECTION . 14A. “Health department” means the same as 34 defined in section 137.102. 35 -32- LSB 6889XC (1) 91 dg/ko 32/ 51
S.F. _____ Sec. 69. Section 139A.2, subsections 17 and 18, Code 2026, 1 are amended by striking the subsections. 2 Sec. 70. Section 139A.3, Code 2026, is amended to read as 3 follows: 4 139A.3 Reports to department —— immunity —— confidentiality 5 —— investigations. 1. The health care provider or public, private, or 7 hospital clinical laboratory attending a person infected 8 with a reportable disease shall immediately report the case 9 to the department. However, when a case occurs within the 10 jurisdiction of a local department, the report shall be made to 11 the local department board of health and to the department. A 12 health care provider or public, private, or hospital clinical 13 laboratory who files such a report which identifies a person 14 infected with a reportable disease shall assist in the an 15 investigation commenced by the department , a local or the 16 board , or a local department of health . The department shall 17 publish and distribute instructions concerning the method of 18 reporting. Reports shall be made in accordance with rules 19 adopted by the department and shall require inclusion of all 20 the following information: 21 a. The patient’s name. 22 b. The patient’s address. 23 c. The patient’s date of birth. 24 d. The sex of the patient. 25 e. The race and ethnicity of the patient. 26 f. The patient’s marital status. 27 g. The patient’s telephone number. 28 h. The name and address of the laboratory. 29 i. The date the test was found to be positive and the 30 collection date. 31 j. The name of the health care provider who performed the 32 test. 33 k. If the patient is female, whether the patient is 34 pregnant. 35 -33- LSB 6889XC (1) 91 dg/ko 33/ 51
S.F. _____ 2. A state or local agency employee or agent shall not 1 have access to personally identifiable information included in 2 a reportable disease report provided to or maintained by the 3 department , or a local board , or a local department, of health 4 unless the employee or agent has completed data confidentiality 5 training. 6 3. a. Any person who, acting reasonably and in good faith, 7 files a report, releases information, or otherwise cooperates 8 with an investigation under this chapter is immune from any 9 liability, civil or criminal, which might otherwise be incurred 10 or imposed for such action. 11 b. A report or other information provided to or maintained 12 by the department , or a local board , or a local department, 13 of health which identifies a person infected with or exposed 14 to a reportable or other disease or health condition, is 15 confidential and shall not be accessible to the public. 16 c. Notwithstanding paragraph “b” , information contained in 17 the report may be reported in public health records in a manner 18 which prevents the identification of any person or business 19 named in the report. If information contained in the report 20 concerns a business, information disclosing the identity of 21 the business may be released to the public when the state 22 epidemiologist or the director determines such a release of 23 information necessary for the protection of the health of the 24 public. 25 4. A health care provider or public, private, or hospital 26 clinical laboratory shall provide the department , local or 27 the board , or local department of health with all information 28 reasonably necessary to conduct an investigation pursuant to 29 this chapter upon request of the department , local or the 30 board , or local department of health . The department may also 31 subpoena records, reports, and any other evidence necessary to 32 conduct an investigation pursuant to this chapter from other 33 persons, facilities, and entities pursuant to rules adopted by 34 the department. 35 -34- LSB 6889XC (1) 91 dg/ko 34/ 51
S.F. _____ Sec. 71. Section 139A.4, subsections 2 and 4, Code 2026, are 1 amended to read as follows: 2 2. The department and the local boards each board of health 3 may impose and enforce isolation and quarantine restrictions. 4 4. The department and local boards each board of health 5 may impose and enforce area quarantine restrictions according 6 to rules adopted by the department. Area quarantine shall be 7 imposed by the least restrictive means necessary to prevent or 8 contain the spread of the suspected or confirmed quarantinable 9 disease or suspected or known hazardous or toxic agent. 10 Sec. 72. Section 139A.6, Code 2026, is amended to read as 11 follows: 12 139A.6 Communicable diseases. 13 If a person, whether or not a resident, is infected with a 14 communicable disease dangerous to the public health, the local 15 board of health shall issue orders in regard to the care of the 16 person as necessary to protect the public health. The orders 17 shall be executed by the designated officer as the local board 18 of health directs or provides by rules. 19 Sec. 73. Section 139A.7, Code 2026, is amended to read as 20 follows: 21 139A.7 Diseased persons moving —— record forwarded. 22 If a person known to be suffering from a communicable disease 23 dangerous to the public health moves from the jurisdiction 24 of a local board of health into the jurisdiction of another 25 local board of health , the local board of health from whose 26 jurisdiction the person moves shall notify the local board of 27 health into whose jurisdiction the person is moving. 28 Sec. 74. Section 139A.8, subsections 6, 7, and 8, Code 2026, 29 are amended to read as follows: 30 6. The local board of health shall furnish the department, 31 within sixty days after the first official day of school, 32 evidence that each person enrolled in any elementary or 33 secondary school has been immunized as required in this section 34 subject to subsection 4 . The department shall adopt rules 35 -35- LSB 6889XC (1) 91 dg/ko 35/ 51
S.F. _____ pursuant to chapter 17A relating to the reporting of evidence 1 of immunization. 2 7. Local boards A board of health shall provide the required 3 immunizations to children in areas where no local provision of 4 these services exists. 5 8. The department, in consultation with the director 6 of the department of education, shall adopt rules for the 7 implementation of this section and shall provide those rules to 8 local school boards and local boards of health . 9 Sec. 75. Section 139A.8A, subsections 1 and 2, Code 2026, 10 are amended to read as follows: 11 1. In the event of a shortage of a vaccine, or in the event 12 a vaccine shortage is imminent, the department may issue an 13 order controlling, restricting, or otherwise regulating the 14 distribution and administration of the vaccine. The order may 15 designate groups of persons which shall receive priority in 16 administration of the vaccine and may prohibit vaccination of 17 persons who are not included in a priority designation. The 18 order shall include an effective date, which may be amended or 19 rescinded only through a written order of the department. The 20 order shall be applicable to health care providers, hospitals, 21 clinics, pharmacies, health care facilities, local boards of 22 health , public health agencies, and other persons or entities 23 that distribute or administer vaccines. 24 2. A health care provider, hospital, clinic, pharmacy, 25 health care facility, local board of health , public health 26 agency, or other person or entity that distributes or 27 administers vaccines shall not be civilly liable in any action 28 based on a failure or refusal to distribute or administer a 29 vaccine to any person if the failure or refusal to distribute 30 or administer the vaccine was consistent with a department 31 order issued pursuant to this section . 32 Sec. 76. Section 139A.9, Code 2026, is amended to read as 33 follows: 34 139A.9 Forcible removal —— isolation —— quarantine. 35 -36- LSB 6889XC (1) 91 dg/ko 36/ 51
S.F. _____ The forcible removal and isolation or quarantine of any 1 infected person shall be accomplished according to the rules 2 and regulations of the local board of health or the rules of 3 the department. 4 Sec. 77. Section 139A.10, Code 2026, is amended to read as 5 follows: 6 139A.10 Fees for removing. 7 The officers designated shall receive reasonable 8 compensation for their services as determined by the local 9 board of health . The amount determined shall be certified and 10 paid in the same manner as other expenses incurred under this 11 chapter . 12 Sec. 78. Section 139A.11, Code 2026, is amended to read as 13 follows: 14 139A.11 Services and supplies —— isolation —— quarantine. 15 If the person under isolation or quarantine or the person 16 liable for the support of the person, in the opinion of the 17 local board of health , is financially unable to secure proper 18 care, provisions, or medical attendance, the local board shall 19 furnish supplies and services during the period of isolation or 20 quarantine and may delegate the duty, by rules, to one of its 21 designated officers board of health personnel . 22 Sec. 79. Section 139A.12, Code 2026, is amended to read as 23 follows: 24 139A.12 County liability for care, provisions, and medical 25 attendance. 26 The local board of health shall provide proper care, 27 provisions, and medical attendance for any person removed 28 and isolated or quarantined in a separate house or hospital 29 for detention and treatment, and the care, provisions, and 30 medical attendance shall be paid for by the county in which the 31 infected person has residence, if the patient or legal guardian 32 is unable to pay. 33 Sec. 80. Section 139A.13A, subsection 1, Code 2026, is 34 amended to read as follows: 35 -37- LSB 6889XC (1) 91 dg/ko 37/ 51
S.F. _____ 1. An employer shall not discharge an employee, or take 1 or fail to take action regarding an employee’s promotion or 2 proposed promotion, or take action to reduce an employee’s 3 wages or benefits for actual time worked, due to the compliance 4 of an employee with a quarantine or isolation order or 5 voluntary confinement request issued by the department, a 6 local board of health , or the centers for disease control and 7 prevention of the United States department of health and human 8 services. 9 Sec. 81. Section 139A.14, Code 2026, is amended to read as 10 follows: 11 139A.14 Services or supplies —— authorization. 12 All services or supplies furnished to persons under this 13 chapter must be authorized by the local board or an officer 14 of the local board of health , and a written order designating 15 the person employed to furnish such services or supplies, 16 issued before the services or supplies are furnished, shall be 17 attached to the bill when presented for audit and payment. 18 Sec. 82. Section 139A.15, Code 2026, is amended to read as 19 follows: 20 139A.15 Filing of bills. 21 All bills incurred under this chapter in establishing, 22 maintaining, and terminating isolation and quarantine, in 23 providing a necessary house or hospital for isolation or 24 quarantine, and in making terminal cleanings, shall be filed 25 with the local board of health . The local board of health 26 at its next regular meeting or special meeting called for 27 this purpose shall examine and audit the bills and, if found 28 correct, approve and certify the bills to the county board of 29 supervisors for payment. 30 Sec. 83. Section 139A.17, Code 2026, is amended to read as 31 follows: 32 139A.17 Approval and payment of claims. 33 The A board of supervisors is not bound by the action of the 34 local board of health in approving the bills, but shall pay the 35 -38- LSB 6889XC (1) 91 dg/ko 38/ 51
S.F. _____ bills for a reasonable amount and within a reasonable time. 1 Sec. 84. Section 139A.25, subsection 1, Code 2026, is 2 amended to read as follows: 3 1. Unless otherwise provided in this chapter , a person who 4 knowingly violates any provision of this chapter , or of the 5 rules of the department or a local board of health , or any 6 lawful order, written or oral, of the department or board , or 7 of their officers or authorized agents, of health is guilty of 8 a simple misdemeanor. 9 Sec. 85. Section 139A.31, Code 2026, is amended to read as 10 follows: 11 139A.31 Report to department. 12 1. Immediately after the first examination or treatment 13 of any person infected with any sexually transmitted disease 14 or infection, the health care provider who performed the 15 examination or treatment shall transmit a report to the board 16 of health of the county in which the infected person resides. 17 The board shall immediately forward the information to the 18 department a . 19 2. A report stating the under this section shall state all 20 of the following: 21 a. The name of the infected person , the . 22 b. The address of the infected person , the . 23 c. The infected person’s date of birth , the . 24 d. The sex of the infected person , the . 25 e. The race and ethnicity of the infected person , the . 26 f. The infected person’s marital status , the . 27 g. The infected person’s telephone number , if . 28 h. If the infected person is female, whether the infected 29 person is pregnant , the . 30 i. The name and address of the laboratory that performed the 31 test , the confirming the sexually transmitted disease. 32 j. The date the test confirming the sexually transmitted 33 disease was found to be positive and the collection date , and 34 the . 35 -39- LSB 6889XC (1) 91 dg/ko 39/ 51
S.F. _____ k. The name of the health care provider who performed the 1 test confirming the sexually transmitted disease . However, 2 when a case occurs within the jurisdiction of a local 3 department, the report shall be made directly to the local 4 department which shall immediately forward the information to 5 the department. 6 3. Reports under this section shall be made in accordance 7 with rules adopted by the department. 8 4. Reports under this section shall be confidential. 9 5. Any person filing a report of a sexually transmitted 10 disease or infection under this section who is acting 11 reasonably and in good faith is immune from any liability, 12 civil or criminal, which might otherwise be incurred or imposed 13 as a result of such filing the report. 14 Sec. 86. Section 139A.33, subsection 3, Code 2026, is 15 amended to read as follows: 16 3. The department may delegate its partner notification 17 duties under this section to local health authorities a board 18 of health or a physician or other health care provider, as 19 provided by rules adopted by the department. 20 Sec. 87. Section 139A.34, Code 2026, is amended to read as 21 follows: 22 139A.34 Examination of persons suspected. 23 The local A board of health shall cause an examination to 24 be made of every person reasonably suspected, on the basis 25 of epidemiological investigation, of having any sexually 26 transmitted disease or infection in the infectious stages to 27 ascertain if such person is infected and, if infected, to 28 cause such person to be treated. A person who is under the 29 care and treatment of a health care provider for the suspected 30 condition shall not be subjected to such examination. If a 31 person suspected of having a sexually transmitted disease or 32 infection refuses to submit to an examination voluntarily, 33 application may be made by the local board of health to the 34 district court for an order compelling the person to submit to 35 -40- LSB 6889XC (1) 91 dg/ko 40/ 51
S.F. _____ examination and, if infected, to treatment. The person shall 1 be treated until certified as no longer infectious to the local 2 board of health or to the department. If treatment is ordered 3 by the district court, the attending health care provider shall 4 certify that the person is no longer infectious. 5 Sec. 88. Section 163.17, Code 2026, is amended to read as 6 follows: 7 163.17 Local boards Boards of health. 8 All local boards of health Each board of health, as that 9 term is defined in section 137.102, shall assist the department 10 in the prevention, suppression, control, and eradication of 11 contagious and infectious diseases among animals, whenever 12 requested to do so. 13 Sec. 89. Section 195.10, subsection 1, unnumbered paragraph 14 1, Code 2026, is amended to read as follows: 15 The department of health and human services acting under 16 chapter 135 , or a local board of health acting under chapter 17 137 , may demand that a raw milk producer provide it with 18 all records required to be kept by the raw milk producer as 19 provided in section 195.6 , including any of the following: 20 Sec. 90. Section 237A.4, Code 2026, is amended to read as 21 follows: 22 237A.4 Inspection and evaluation. 23 The department shall make periodic inspections of licensed 24 centers to ensure compliance with licensing requirements 25 provided in this chapter , and the local boards each board of 26 health , as that term is defined in section 137.102, may make 27 periodic inspections of licensed centers to ensure compliance 28 with health-related licensing requirements provided in this 29 chapter . The department may inspect records maintained by 30 a licensed center and may inquire into matters concerning 31 these centers and the persons in charge. The department 32 shall require that the center be inspected by the director 33 of the department of inspections, appeals, and licensing or 34 a designee for compliance with rules relating to fire safety 35 -41- LSB 6889XC (1) 91 dg/ko 41/ 51
S.F. _____ before a license is granted or renewed. The department or a 1 designee may periodically visit registered child development 2 homes for the purpose of evaluation of an inquiry into matters 3 concerning compliance with rules adopted under section 237A.12 . 4 Evaluation of child development homes under this section may 5 include consultative services provided pursuant to section 6 237A.6 . 7 Sec. 91. Section 238.21, Code 2026, is amended to read as 8 follows: 9 238.21 Other inspecting agencies. 10 Authorized agents of the local a board of health , as that 11 term is defined in section 137.102, in whose jurisdiction a 12 licensed child-placing agency is located may make inspection of 13 the premises. 14 Sec. 92. Section 238.24, subsection 2, paragraph a, Code 15 2026, is amended to read as follows: 16 a. Disclosure made upon inquiry before a court of law, 17 or before some other tribunal, or for the information of the 18 governor, general assembly, medical examiners, director, or 19 local board of health as that term is defined in section 20 137.102, in the jurisdiction where the agency is located. 21 Sec. 93. Section 239B.12, subsection 1, Code 2026, is 22 amended to read as follows: 23 1. To the extent feasible, the department shall determine 24 the immunization status of children receiving assistance under 25 this chapter . The status shall be determined in accordance 26 with the immunization recommendations adopted under section 27 139A.8 , including the exemption provisions in section 139A.8, 28 subsection 4 . If the department determines a child is not 29 in compliance with the immunization recommendations, the 30 department shall refer the child’s parent or guardian to a 31 local public health agency board of health, as that term is 32 defined in section 137.102, for immunization services for the 33 child and other members of the child’s family. 34 Sec. 94. Section 256A.5, subsection 1, Code 2026, is amended 35 -42- LSB 6889XC (1) 91 dg/ko 42/ 51
S.F. _____ to read as follows: 1 1. The board of directors of a school district shall appoint 2 an advisory committee for each family support program. The 3 members shall include participating parents and members of the 4 community which participates in the program, such as members 5 of the district’s local early childhood education committees 6 and representatives of local businesses, service organizations, 7 educators, head start educators, parents, private child care 8 providers, county home extension economists, area education 9 agencies, the school board, the community education advisory 10 board, local social services organizations, the local board 11 of health as that term is defined in section 137.102 , public 12 health care practitioners, maternal and child health care 13 providers, and persons knowledgeable about developmentally 14 appropriate learning and parent or family education programs. 15 The committee shall be responsible for assessing current 16 programs and services for expectant parents and parents of 17 children who are less than six years of age. The committee 18 shall also assist the board of directors of a school district 19 in developing, planning, and monitoring the program and shall 20 submit any recommendations in a report to the board. 21 Sec. 95. Section 263.7, Code 2026, is amended to read as 22 follows: 23 263.7 State hygienic laboratory —— investigations. 24 The state hygienic laboratory shall be a permanent part of 25 the state university of Iowa. It shall make or cause to be made 26 microbiological and chemical examinations and other necessary 27 investigations by both laboratory and field work in the 28 determination of the causes of disease, shall suggest methods 29 of overcoming and preventing the recurrence of the disease, 30 and shall evaluate environmental effects and scientific 31 needs, whenever requested to do so by any state agency, state 32 institution, or local board of health as that term is defined 33 in section 137.102 when the investigation or evaluation is 34 necessary in the interest of environmental quality and public 35 -43- LSB 6889XC (1) 91 dg/ko 43/ 51
S.F. _____ health and for the purpose of preventing epidemics of disease. 1 Sec. 96. Section 263.8, subsection 3, Code 2026, is amended 2 to read as follows: 3 3. The state hygienic laboratory is authorized to perform 4 such other laboratory determinations as may be requested by 5 any state institution, citizen, school, municipality, or local 6 board of health as that term is defined in section 137.102 , 7 and the laboratory is authorized to charge fees covering 8 transportation of samples and the costs of examinations 9 performed upon their request. 10 Sec. 97. Section 331.304, subsection 9, Code 2026, is 11 amended to read as follows: 12 9. A county shall not adopt or enforce any ordinance 13 imposing any registration or licensing system or registration 14 or license fees for or relating to owner-occupied manufactured 15 or mobile homes including the lots, lands, or manufactured 16 home community or mobile home park upon or in which they are 17 located. A county shall not adopt or enforce any ordinance 18 imposing any registration or licensing system, or registration 19 or license fees, or safety or sanitary standards for rental 20 manufactured or mobile homes unless similar registration or 21 licensing system, or registration or license fees, or safety 22 or sanitary standards are required for other rental properties 23 intended for human habitation. This subsection does not 24 preclude the investigation and abatement of a nuisance or 25 the enforcement of a tiedown system, or the enforcement of 26 any rules of the department of health and human services or 27 local board of health , as that term is defined in section 28 137.102, if those rules apply to other rental properties or to 29 owner-occupied housing intended for human habitation. 30 Sec. 98. Section 331.321, subsection 1, paragraph c, Code 31 2026, is amended to read as follows: 32 c. The members of the a county board of health in accordance 33 with or a district board as provided in section 137.105 . 34 Sec. 99. Section 346A.1, subsection 3, Code 2026, is amended 35 -44- LSB 6889XC (1) 91 dg/ko 44/ 51
S.F. _____ to read as follows: 1 3. “Project” means the acquisition by purchase or 2 construction of health centers, additions thereto and 3 facilities therefor, the reconstruction, completion, equipment, 4 improvement, repair or remodeling of health centers, additions 5 thereto and facilities therefor, and the acquisition of 6 property therefor of every kind and description, whether real, 7 personal or mixed, by gift, purchase, lease, condemnation or 8 otherwise and the improvement of the property. “Project” also 9 means the use of funds for the provision of health services 10 by local boards of health pursuant to chapter 137 and the 11 provision of health, welfare or social services which a county 12 is permitted or required by law to provide. 13 Sec. 100. Section 351.36, Code 2026, is amended to read as 14 follows: 15 351.36 Enforcement. 16 Local health Each board of health, as that term is defined in 17 section 137.102, and law enforcement officials shall enforce 18 the provisions of sections 351.33 , 351.35 , this section , and 19 sections 351.37 through 351.43 relating to vaccination and 20 impoundment of dogs . Such public officials , and shall not be 21 responsible for any accident or disease of a dog resulting from 22 the such enforcement of the provisions of said sections . 23 Sec. 101. Section 351.37, subsections 1 and 2, Code 2026, 24 are amended to read as follows: 25 1. A dog shall be apprehended and impounded by a local board 26 of health , as that term is defined in section 137.102, or a law 27 enforcement official if the dog is running at large and the 28 dog is not wearing a valid rabies vaccination tag or a rabies 29 vaccination certificate is not presented to the local board of 30 health or law enforcement official. 31 2. The local board of health , as that term is defined in 32 section 137.102, or law enforcement official shall provide 33 written notice to the owner if the local board of health or law 34 enforcement official can reasonably determine the owner’s name 35 -45- LSB 6889XC (1) 91 dg/ko 45/ 51
S.F. _____ and current address by accessing a tag or other device that 1 is on or a part of the dog. The notice shall be sent within 2 two days after the dog has been impounded. The notice shall 3 provide that if the owner does not redeem the dog within seven 4 days from the date that the notice is delivered, the dog may be 5 humanely destroyed or otherwise disposed of in accordance with 6 law. For purposes of this section , notice is delivered when 7 the local board of health or law enforcement official mails the 8 notice which may be by regular mail. An owner may redeem a 9 dog by having it immediately vaccinated and paying the cost of 10 impoundment. 11 Sec. 102. Section 351.38, Code 2026, is amended to read as 12 follows: 13 351.38 Owner’s duty. 14 It shall be the duty of the owner of any dog, cat or other 15 animal which has bitten or attacked a person or any person 16 having knowledge of such bite or attack to report this act to 17 a local health or law enforcement official. It shall be the 18 duty of physicians and veterinarians to report to the local 19 board of health , as that term is defined in section 137.102, 20 the existence of any animal known or suspected to be suffering 21 from rabies. 22 Sec. 103. Section 351.39, Code 2026, is amended to read as 23 follows: 24 351.39 Confinement. 25 If a local board of health , as defined in section 137.102, 26 receives information that an animal has bitten a person or 27 that a dog or animal is suspected of having rabies, the board 28 shall order the owner to confine such animal in the manner it 29 directs. If the owner fails to confine such animal in the 30 manner directed, the animal shall be apprehended and impounded 31 by such board, and after ten days the board may humanely 32 destroy the animal. If such animal is returned to its owner, 33 the owner shall pay the cost of impoundment. This section 34 shall not apply if a police service dog or a horse used by a law 35 -46- LSB 6889XC (1) 91 dg/ko 46/ 51
S.F. _____ enforcement agency and acting in the performance of its duties 1 has bitten a person. 2 Sec. 104. Section 351.40, Code 2026, is amended to read as 3 follows: 4 351.40 Quarantine. 5 If a local board of health , as that term is defined in 6 section 137.102, believes rabies to be epidemic, or believes 7 there is a threat of epidemic, in its the board of health’s 8 jurisdiction, it may declare a quarantine in all or part of 9 the area under its jurisdiction and such declaration shall 10 be reported to the department of health and human services. 11 During the period of quarantine, any person owning or having a 12 dog in the person’s possession in the quarantined area shall 13 keep such animal securely enclosed or on a leash for the 14 duration of the quarantine period. 15 Sec. 105. Section 364.3, subsection 5, Code 2026, is amended 16 to read as follows: 17 5. A city shall not adopt or enforce any ordinance imposing 18 any registration or licensing system or registration or license 19 fees for or relating to owner-occupied manufactured or mobile 20 homes including the lots, lands, or manufactured home community 21 or mobile home park upon or in which they are located. A 22 city shall not adopt or enforce any ordinance imposing any 23 registration or licensing system, or registration or license 24 fees, or safety or sanitary standards for rental manufactured 25 or mobile homes unless a similar registration or licensing 26 system, or registration or license fees, or safety or sanitary 27 standards are required for other rental properties intended 28 for human habitation. This subsection does not preclude the 29 investigation and abatement of a nuisance or the enforcement of 30 a tiedown system, or the enforcement of any rules of adopted by 31 the department of health and human services or local board of 32 health , as defined in section 137.102, if those rules apply to 33 other rental properties or to owner-occupied housing intended 34 for human habitation. 35 -47- LSB 6889XC (1) 91 dg/ko 47/ 51
S.F. _____ Sec. 106. Section 455B.134, subsection 8, Code 2026, is 1 amended to read as follows: 2 8. Consider complaints of conditions reported to, or 3 considered likely to, constitute air pollution, and investigate 4 such complaints upon receipt of the written petition of any 5 state agency, the governing body of a political subdivision, 6 a local board of health as that term is defined in section 7 137.102 , or twenty-five affected residents of the state. 8 Sec. 107. Section 455B.172, subsection 7, paragraph b, Code 9 2026, is amended to read as follows: 10 b. A local board of health , as defined in section 137.102, 11 is the agency to regulate the construction, reconstruction 12 and abandonment of water wells not otherwise regulated by 13 the department. The local board of health shall not adopt 14 standards relative to the construction, reconstruction and 15 abandonment of wells less stringent than those adopted by the 16 department. 17 Sec. 108. Section 455B.174, subsection 1, Code 2026, is 18 amended to read as follows: 19 1. Conduct investigations of alleged water pollution or of 20 alleged violations of this part 1 of subchapter III , chapter 21 459, subchapter III , chapter 459A , or chapter 459B , or any 22 rule adopted or any permit issued pursuant to this part 1 of 23 subchapter III , chapter 459, subchapter III , chapter 459A , 24 or chapter 459B , upon written request of any state agency, 25 political subdivision, local board of health as that term 26 is defined in section 137.102 , twenty-five residents of the 27 state, as directed by the department, or as may be necessary 28 to accomplish the purposes of this part 1 of subchapter III , 29 chapter 459, subchapter III , chapter 459A , or chapter 459B . 30 Sec. 109. Section 455B.303, subsection 2, Code 2026, is 31 amended to read as follows: 32 2. Local boards of health A board of health, as defined 33 in section 137.102, shall cooperate in the enforcement of the 34 provisions of this part 1 of subchapter IV and the director may 35 -48- LSB 6889XC (1) 91 dg/ko 48/ 51
S.F. _____ seek their a board of health’s aid and delegate administrative 1 duties of the department to the local boards of health board of 2 health in matters relating to solid waste and sanitary disposal 3 projects. 4 Sec. 110. Section 455B.305, subsection 1, paragraphs a and 5 b, Code 2026, are amended to read as follows: 6 a. A permit shall be issued by the director or, at the 7 director’s direction, by a local board of health , as that term 8 is defined in section 137.102, for each sanitary disposal 9 project operated in this state. The permit shall be issued in 10 the name of the city or county or, where applicable, in the 11 name of the public or private agency operating the project. 12 Permits issued pursuant to this section are in addition to any 13 other licenses, permits, or waivers authorized or required by 14 law, including but not limited to chapter 335 . 15 b. Each sanitary disposal project shall be inspected 16 periodically by the department or a local board of health , as 17 that term is defined in section 137.102 . 18 Sec. 111. REPEAL. Section 135.100, Code 2026, is repealed. 19 Sec. 112. EFFECTIVE DATE. This division of this Act takes 20 effect July 1, 2027. 21 EXPLANATION 22 The inclusion of this explanation does not constitute agreement with 23 the explanation’s substance by the members of the general assembly. 24 This bill transfers duties from local boards of health and 25 local health departments to county boards of health (county 26 boards) and district boards of health (district boards). 27 DIVISION I —— HEALTH CARE DISTRICTS. The bill eliminates 28 local boards of health and local health departments. Instead, 29 each county must either create its own county board or join 30 with any number of geographically contiguous counties, with 31 approval from the department of health and human services 32 (HHS), to form a district overseen by a district board. The 33 bill requires cities to perform all public health functions 34 through a county board or a district board (board of health). 35 -49- LSB 6889XC (1) 91 dg/ko 49/ 51
S.F. _____ The bill details the composition of board of health 1 members, the process by which boards of health make their 2 annual budgets, how counties will create funding plans to 3 detail how a county board will be funded, how a city’s public 4 health functions will be divided if the city is within the 5 jurisdiction of multiple boards of health, and how a board of 6 health must get approval from cities and member counties for 7 approval of the board of health’s proposed budget. 8 The bill requires a county board to enter into an agreement 9 with each county hospital located in the county board’s county 10 to provide for the sharing of facilities, health care services, 11 and administrative resources. A county board of health may 12 apply with HHS for a waiver of this requirement by sending HHS 13 evidence of an alternative means of providing health services 14 as detailed in the bill. A county board that applies for such 15 a waiver must submit a letter explaining the county board’s 16 decision to apply for the waiver to each city council of a city 17 that is located in the county board’s county. 18 The bill details the process by which counties may join to 19 form a district to oversee public health in the counties; how 20 powers, duties, and property are transferred from county boards 21 to district boards; how county board property will remain 22 available for district board use if not transferred to the 23 district board; how counties may withdraw from a district; and 24 how counties may apply to join an existing district. 25 The bill requires a district board to give employment 26 preference to individuals who were employed by one of the 27 counties represented by the district board at the time of the 28 district board’s formation. 29 The bill shall not be construed to prohibit a county from 30 creating agreements not contemplated in the bill to provide 31 public health services in a manner not prohibited by law. 32 The bill provides that only a board of health, school board, 33 or area education board (board) may employ a public health 34 nurse. 35 -50- LSB 6889XC (1) 91 dg/ko 50/ 51
S.F. _____ The bill repeals Code sections 137.107 (request reviewed by 1 state department), 137.108 (initial appointment of district 2 board of health), and 137.115 (dissolution of county boards). 3 This division of the bill takes effect July 1, 2027. 4 DIVISION II —— TRANSITION PROVISIONS. The bill provides 5 definitions used in the division, including defining 6 “transition period” as the period beginning on the date of 7 enactment of the division to June 30, 2027. 8 The bill details the process by which city boards of health 9 (city boards) will transfer the city boards’ property, public 10 health responsibilities, and contractual responsibilities 11 to one or more county boards or district boards during the 12 transition period. The bill prohibits city boards from 13 extending or creating new contracts if the term would end, 14 or deliverables under the contract would be provided, beyond 15 June 30, 2027. Each city board is dissolved at the end of the 16 transition period. 17 This division of the bill is effective upon enactment. 18 DIVISION III —— HEALTH CARE DISTRICTS CONFORMING CHANGES. 19 This division makes conforming changes to Code sections 20 10A.531, 10A.533, 11.41, 22.7, 28G.4, 135.1, 135.11, 135.17, 21 135.19, 135.27, 135.33, 135.34, 135.39D, 135.102, 135.103, 22 135.104, 135.105B, 135.107, 135.119, 135.146, 135A.2, 135A.8, 23 135B.33, 135C.1, 135D.2, 135I.1, 135I.2, 135I.4, 135I.6, 24 136A.5B, 136A.9, 136D.3, 137C.2, 137C.6, 137C.16, 137C.35, 25 137F.13, 138.12, 138.14, 139A.2, 139A.3, 139A.4, 139A.6 through 26 139A.12, 139A.13A through 139A.15, 139A.17, 139A.25, 139A.31, 27 139A.33, 139A.34, 163.17, 195.10, 237A.4, 238.21, 238.24, 28 239B.12, 256A.5, 263.7, 263.8, 331.304, 331.321, 346A.1, 29 351.36, 351.37 through 351.40, 364.3, 455B.134, 455B.172, 30 455B.174, 455B.303, and 455B.305. 31 The bill repeals Code section 135.100 (lead poisoning 32 prevention program —— definitions). 33 This division of the bill takes effect July 1, 2027. 34 -51- LSB 6889XC (1) 91 dg/ko 51/ 51