SSB 3135 (LSB 6889XC (1) 91)

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 of health and local health departments to county boards of health and district boards of health, and including applicability and effective date provisions.
BE IT ENACTED BY THE GENERAL ASSEMBLY OF THE STATE OF IOWA:

DIVISION I
HEALTH CARE DISTRICTS

    Section 1.  Section 137.101, Code 2026, is amended to read as follows:
   137.101  Title and purpose.
   This chapter shall be known and may be cited as the “Local Public Health Governance Act”. The purpose of this chapter is to define the structure, powers, and duties of local boards of health. This chapter also provides an optional process for counties to merge to form a district board of health in order to increase efficiencies and enhance the delivery and availability of public health services.
    Sec. 2.  Section 137.102, Code 2026, is amended to read as follows:
   137.102  Definitions.
   As used in this chapter unless the context otherwise requires:
   1.  “City board” means a city board of health in existence prior to July 1, 2010.
   2.  “City health department” refers to the personnel and property under the jurisdiction of a city board in existence prior to July 1, 2010.
   1.  “Board of health” means a county board or a district board.
   3.  2.  “Council” means the council on health and human services.
   4.  3.  “County board” means a county board of established to address public health within the county the board represents.
   5.  “County health department” refers to the personnel and property under the jurisdiction of a county board.
   4.  “Department” means the department of health and human services.
   6.  5.  “Director” means the director of health and human services.
   7.  6.  “District” means any two or more geographically a geographic area formed by any number of contiguous counties pursuant to section 137.106.
   8.  7.  “District board” means a board of established to address public health representing at least two geographically contiguous counties formed with approval of the state department in accordance with this chapter, or any district board of health in existence prior to July 1, 2010 within the district the board represents.
   9.  8.  “District health Health department” refers to the personnel and property under the jurisdiction of a district board of health.
   10.  “Local board of health” means a city, county, or district board of health.
   11.  “Officers” means a local board of health chairperson, vice chairperson, and secretary, and other officers which may be named at the discretion of the local board of health.
   12.  “State department” or “department” means the department of health and human services. 
    Sec. 3.  Section 137.103, Code 2026, is amended by striking the section and inserting in lieu thereof the following:
   137.103  County boards.
   1.  If a county is not part of a district, that county shall establish a county board to oversee public health matters within the county.
   2.  a.  The county shall create a fiscal plan for the county’s county board that includes an estimate of proposed expenditures and revenues and a funding plan that details how the county board will receive funding.
   b.  If a city is located within the jurisdiction of more than one board of health, each county or district in which the city is located and the city shall create a contribution plan for the city that details how the city will contribute to each board of health’s funding plan.
   3.  a.  A county board shall execute an agreement with each county hospital located in the county that the county board represents to allow for sharing of facilities, health care services, and administrative resources.
   b.  A county board may apply for a waiver with the department to waive the requirement in paragraph “a” by providing the department evidence of all of the following:
   (1)  The county board has access to an alternative means of providing health services comparable to those provided by the county hospital with which the county board would otherwise be required to contract.
   (2)  The alternative means of providing health services is more cost-effective for the county board than contracting with the county hospital.
   c.  A county board that applies for a waiver under paragraph “b” must submit a letter explaining the county board’s decision to apply for the waiver to each city council of a city that is located in the county board’s county.
   4.  A county may subsequently request to be added to an existing district pursuant to section 137.113, or request to form a district pursuant to section 137.106.
    Sec. 4.  Section 137.104, Code 2026, is amended to read as follows:
   137.104  Local boards Boards of health —— powers and duties.
   Local boards of health shall have the following powers and duties:
   1.  A local board of health shall:
   a.  Enforce state health laws and the department’s rules and lawful orders of the state department.
   b.  Make Adopt and enforce such reasonable rules and regulations not inconsistent with any state or federal law and the rules of the department as may be necessary for the protection and improvement of the public health.
   (1)  Rules of a city board shall become effective upon approval by the city council and publication in a newspaper having general circulation in the city.
   (2)  (1)  Rules of a county board shall become effective upon approval by the county board of supervisors by a motion or resolution as defined in section 331.101, subsection 13, and publication in a newspaper having general circulation in the county.
   (3)  (2)  Rules of a district board shall become effective upon approval by the district board and publication in a newspaper having general circulation in the district that the district board represents.
   (4)  (3)  Before approving any a rule or regulation the local, a board of health shall hold a public hearing on the proposed rule. Any citizen may appear and be heard at the public hearing. A notice of the public hearing, stating the time and place of the hearing and the general nature of the proposed rule, or regulation shall be published in a newspaper having general circulation as provided in section 331.305 in the area served by the local jurisdiction that the board of health represents.
   c.  Employ persons as necessary for the efficient discharge of its the board of health’s duties. Employment practices shall meet the requirements of chapter 8A, subchapter IV, or any civil service provision adopted under chapter 400.
   d.  Provide the names of all local members of the board of health members and officers to the state department.
   e.  Provide minutes of local board of health meetings and reports of the local board of health’s operations and activities to the state department as may be required by the director, by rule, or by contract.
   2.  A local board of health may do all of the following:
   a.  Provide such population-based and personal health services as may be deemed necessary for the promotion and protection of the public health of the public and charge reasonable fees for personal health services. A person An individual shall not be denied necessary services within the limits of available resources because of inability to pay the cost of such services.
   b.  Provide such environmental health services as may be deemed necessary for the protection and improvement of the public health and issue.
   c.  Issue licenses and permits and charge reasonable fees in relation to the construction or operation of nonpublic water supplies or private sewage disposal systems.
   c.  d.  Engage in joint operations and contract with individuals, county hospitals, colleges and universities, the state department, and other public, private, and nonprofit agencies, and individuals or form a district health department to provide personal and population-based public health services.
   d.  e.  By written agreement with the city council of any city within its the board of health’s jurisdiction, enforce appropriate ordinances of the city relating to public health.
   e.  f.  Demand that a raw milk producer provide the board of health with all records required to be retained by the raw milk producer as provided in section 195.6, including any of the following:
   (1)  The coliform count and standard plate count of dairy animals maintained at a raw milk dairy owned or operated by the raw milk producer.
   (2)  The administration of antibiotic drugs to dairy animals maintained at a raw milk dairy owned or operated by the raw milk producer.
    Sec. 5.  Section 137.105, Code 2026, is amended to read as follows:
   137.105  Local boards Boards of health —— membership and meetings.
   1.  Membership, terms, compensation, and vacancies.
   a.  All members of a city board shall be appointed by the city council.
   b.  All members of a county board shall be appointed by the county board of supervisors.
   c.  1.  a.  The membership of a county board shall consist of the following:
   (1)  Two members appointed as agreed upon by a majority of the cities within the county.
   (2)  Two members appointed by the county board of supervisors.
   (3)  One member appointed as agreed upon by a majority of the cities within the county and the county board of supervisors.
   b.  All members of a district board shall be appointed by the county board of supervisors from each county represented by the district board. Each county board of supervisors shall appoint at least one but no more than three two members to the district board.
   d.  c.  Local boards of health shall consist of at least five members. At least one board of health member shall be licensed as a physician under chapter 148, a physician assistant under chapter 148C, an advanced registered nurse practitioner under chapter 152, or an advanced practice registered nurse under chapter 152E.
   e.  d.  A local Each board of health member shall serve for a term of three years. A member is, and shall be eligible for reappointment.
   f.  e.  A local Each board of health member shall serve without compensation, but may be reimbursed for necessary expenses in accordance with rules established by the department or the applicable jurisdiction.
   g.  f.  A local As soon as practicable after a vacancy occurs, a board of health member vacancy due to death, resignation, or other cause shall be filled as soon as possible after shall fill the vacancy exists for the unexpired term of the original appointment.
   2.  Meetings.  A majority of the members of a local board of health shall be considered a quorum and an affirmative vote of the majority of the members present is shall be necessary for a board to take action taken by a local board of health. The majority shall not include any member who has a conflict of interest in the matter being voted on, and a statement by a member that the member that has a conflict of interest exists shall be conclusive for this purpose.
    Sec. 6.  Section 137.106, Code 2026, is amended to read as follows:
   137.106  District boards of health Districts —— request to form.
   1.  The county boards board of supervisors of any two or more number of geographically contiguous counties may at any time submit a request to form a district board to the state department. The formation request shall be in writing, shall be executed by the county boards board of supervisors and the county boards of health for of each county comprising the proposed district board, and shall include but not be limited to all of the following required elements:
   1.  a.  A written narrative that explains how a district board will attain the capability to provide population-based and personal public health services.
   2.  The composition of the district board, including the number of members each county shall appoint pursuant to section 137.105 and the total number of members on the district board.
   3.  Proof of approval by all county boards of supervisors and county boards of health involved in the request to form a district board and of the elements included in the formation plan.
   4.  b.  The proposed district’s service delivery plan.
   5.  c.  The budget and fiscal plan for the proposed district board. The budget fiscal plan shall include an all of the following:
   (1)  An estimate of proposed expenditures and revenues and an allocation for the district.
   (2)  An estimate of the revenue responsibilities of fiscal contributions each of the counties county participating in the proposed district board will contribute to the proposed district.
   6.  d.  A table of An organization.
   7.  A personnel system description, including identification chart that includes the name of the proposed district treasurer and, the proposed district auditor, and a section which addresses the employment issues contained in actions the proposed district will take to maintain compliance with section 137.110.
   8.  e.  The location of the proposed district board offices and workforce throughout the jurisdiction district personnel.
   9.  f.  (1)  An inventory of the property and equipment in the custody of each county board and a description as to of whether such the property and equipment shall remain in the custody of owned by the county or ownership of the property shall be transferred transfer to the proposed district board to become property of the district board.
   (2)  If property or equipment is to remain owned by the county, a proposed agreement between the county and the proposed district for joint use and maintenance of the property or equipment in a manner that allows both the county and the district board to perform the county’s and the district board’s respective duties.
   10.  g.  A timeline for the adoption of district board the proposed district’s rules and regulations.
   h.  Whether the individual counties or the district will be responsible for payment of unemployment compensation for each county employee employed by a county board at the time of formation of the proposed district, but not employed by the district board following formation of the district.
   i.  A description of how property in the proposed district’s custody will be divided if a county withdraws from the proposed district or the proposed district dissolves.
   11.  j.  Other criteria as established by the department by rule of the state department.
   2.  The department shall review each request, approve the formation of a district if the request meets the requirements of this section, and notify each county board of supervisors that submitted the request of the department’s decision.
   3.  Upon receipt of notice of approval as a district, the district shall establish a district board and district board members shall be appointed as specified in section 137.105.
    Sec. 7.  Section 137.109, Code 2026, is amended to read as follows:
   137.109  Organizational structure of district board District boards and district health departments —— tort liability and open records.
   A district board is a governing body for purposes of chapter 670, and a district health department is a municipality for purposes of chapter 670. All meetings of a district board shall comply with the requirements of chapter 21, and all records of a district board and a district health department shall be maintained in accordance with chapter 22.
    Sec. 8.  Section 137.110, Code 2026, is amended to read as follows:
   137.110  District personnel.
   1.  A district board may employ persons individuals as necessary for the efficient discharge of its the district board’s duties. A district board and shall have all the same duties and powers in employing such persons individuals as a county board of supervisors is granted pursuant to section 331.324, with the exception of the authority to provide for support of the civil service commission for deputy sheriffs as specified in section 331.324, subsection 1, paragraph “k”. A district board may employ persons shall give individuals who were employed by one of the counties represented by the district board at the time of the formation of the district board by the counties represented by the district board, or may employ persons who were not employed by such counties preference when hiring new district personnel. The county boards involved shall specify in the request submitted pursuant to section 137.106 whether the individual counties or the district board will be responsible for payment of unemployment compensation for any county employees employed by the county board at the time of formation of the district board but not employed by the district board following formation.
   2.  If the district board employs persons an individual who were was employed by one of the counties represented by the district board at the time of formation of the district board, the district board shall recognize the term of service of the former county employees employee for purposes of all employee benefits offered by the district board to such employees the employee and such employees the employee shall not forfeit accrued vacation, accrued sick leave, or longevity by becoming district board employees.
   3.  Persons An individual who were was covered by county employee life insurance, accident insurance, and health insurance plans prior to becoming a district board employees employee pursuant to this chapter section shall be permitted to apply, prior to becoming a district board employees employee, for life, accident, and health insurance plans that are is available to district board employees so that those persons do the individual does not suffer a lapse of insurance coverage as a result of becoming district board employees.
   4.  The district board may employ or contract with legal counsel, which may include the county attorney of a county within the district, to enforce this chapter and district board rules, represent and defend the district board and its officers and the district board’s employees, provide legal advice to the district board, and perform any other legal duties required by law or and as assigned by the district board. The district board may employ or contract with the county attorney of a county within its jurisdiction.
    Sec. 9.  Section 137.111, Code 2026, is amended to read as follows:
   137.111  District Board of health treasurer and auditor.
   Upon establishment of a district board of health, the district board of health shall designate a treasurer an individual to serve as treasurer of the district board of health’s health department, and shall designate an auditor individual to serve as auditor of the district board of health’s health department. A treasurer or auditor of any county within the district may also serve in the capacity of treasurer or auditor of the district health department, respectively, or the district board may contract with a third party to act as the treasurer or auditor of the district health department. A county treasurer’s or county auditor’s official bond may extend to cover their the county treasurer’s or county auditor’s respective duties performed on behalf of the district a board of health’s health department. 
    Sec. 10.  Section 137.112, Code 2026, is amended to read as follows:
   137.112  District public Public health fund —— budget.
   1.  The district treasurer designated under section 137.111 shall establish a district public health fund from which disbursements may be made in the manner specified for disbursements by law for the disbursement of county funds.
   2.  a.  All moneys received by a district board or district health department for local public health purposes from of health including federal appropriations, state appropriations, local appropriations, fees, gifts, grants, bequests, or other sources shall be deposited in the district public health fund. Expenditures The board of health shall be made from use moneys in the fund on order of the district board for the purpose of carrying out its the board of health’s duties.
   b.  No more than twenty percent of the unexpended balance remaining in the public health fund at the end of each fiscal year shall be maintained in the district public health fund. The remainder of the unexpended balance shall revert be transferred as follows:
   (1)  For a county board, to each city that contributed to the county board’s annual budget in an amount proportionate to the amount the city contributed to the county board’s annual budget.
   (2)  For a district board, to the general funds of the each member counties county in the manner determined by an amount proportionate to the amount the member county contributed to the district board board’s annual budget.
   3.  2.  a.  The district Each board of health shall adopt and certify an annual budget in accordance compliance with section sections 24.17 relating to certification of budgets and section 24.27 relating to protesting budgets and based on the board of health’s fiscal plan created in section 137.103, subsection 2, or section 137.106, subsection 1, paragraph “c”.
   4.  b.  (1)  (a)  This section does not apply to any district board of health or district health department in existence prior to July 1, 2010 A county board shall submit a proposed annual budget to the county board’s county board of supervisors and each city that contributes to the county board’s annual budget.
   (b)  A proposed annual budget shall be considered certified when two-thirds of the entities that contribute to the county board’s annual budget approve the proposed annual budget. If fewer than three entities contribute to a county board’s budget, a proposed annual budget shall be considered certified when all entities that contribute to the county board’s annual budget approve the proposed annual budget.
   (2)  (a)  A district board shall submit a proposed annual budget to each member county that contributes to the district board’s annual budget.
   (b)  A proposed annual budget shall be considered certified when two-thirds of the member counties that contribute to the district board’s annual budget approve the proposed annual budget. If fewer than three counties contribute to a district board’s budget, a proposed annual budget shall be considered certified when all member counties that contribute to the district board’s annual budget approve the proposed annual budget.
    Sec. 11.  Section 137.113, Code 2026, is amended to read as follows:
   137.113  Adding additional counties to a district.
   1.  A county may request to be added to an existing district board by submission and approval of submitting a request, as specified in sections pursuant to section 137.106 and 137.107.
   2.  Upon approval under section 137.106 for a county to join a district, all of the following shall occur:
   a.  The powers and responsibilities of the county’s county board shall immediately transfer to the district board that represents the district.
   b.  All property and equipment in the custody of the county board shall be divided as provided in section 137.106, subsection 1, paragraph “f”.
   c.  The county’s county board shall be dissolved.
    Sec. 12.  Section 137.114, Code 2026, is amended to read as follows:
   137.114  Withdrawal County withdrawal from a district.
   1.  A county may request to withdraw from an existing a district board upon submission of by submitting a request for withdrawal to and approval by the state department. The A request to withdraw shall include a plan to reform its reestablish the requesting county’s county board or join a different district board, information specified in section 137.106, and written approval of the request by from the district board that represents the district from which the county is requesting to withdraw. Any county choosing to withdraw from the district board shall commit to the continuity of services in its county by reestablishing its county board or joining a different district board. The remaining counties in the district
   2.  Upon approving a county’s request to withdraw from a district, the district board that approved the withdrawal shall submit an application including the information specified in section 137.106 to the state department for review as provided in section 137.107 the district as it will exist without the withdrawing county.
   3.  If only one county will remain in a district after the withdrawal of a county, the district shall be dissolved and the remaining county’s county board shall be reestablished.
    Sec. 13.  Section 137.116, Code 2026, is amended to read as follows:
   137.116  Emergency request for funds moneys.
   A local board of health may, during a public health disaster, as that term is defined in section 135.140, or in preparation for or response to such disaster, request additional appropriations moneys which may, upon approval of the director, be allotted allocated from the funds reserved moneys appropriated for that purpose to the extent that funds moneys are appropriated and available. Upon termination of the public health disaster response, the local board of health shall report its to the director on the expenditures by the board of emergency funds to the director the additional moneys.
    Sec. 14.  Section 137.117, Code 2026, is amended to read as follows:
   137.117  Penalties —— criminal and civil.
   1.  Any A person who violates any provision of this chapter or the rules of a local rule adopted by a board of health or any lawful order of the board, its officers, or authorized agents is guilty of a simple misdemeanor. Each additional day of neglect or failure a person fails to comply with such provision this chapter, rule or a rule adopted by a board of health, or lawful order after notice being notified of the violation by the local board of health shall constitute a separate offense.
   2.  A local board of health may impose a civil penalty not to exceed seven hundred fifty dollars for each violation of this chapter or the rules of a rule adopted by the local board of health or any lawful order of the board, its officers, or authorized agents. If the violation is a repeat offense, A board of health may impose a civil penalty not up to exceed one thousand dollars may be imposed for a violation if the board finds the person who committed the violation has previously committed the same violation. The local board of health shall impose and enforce such penalties in the manner provided in section 331.307 for county infractions.
    Sec. 15.  NEW SECTION.  137.118A  City public health functions.
   1.  A city shall perform all public health functions through the county board or district board that represents the city.
   2.  If a city is located within the jurisdiction of multiple boards of health, each county board of supervisors that represents the city, and the city, shall enter into an agreement that details how public health services will be provided to the city.
    Sec. 16.  Section 137.119, Code 2026, is amended to read as follows:
   137.119  Adoption of rules.
   1.  The department shall adopt rules pursuant to chapter 17A to implement and administer this chapter. The department is vested with discretionary authority to interpret the provisions of this chapter.
   2.  A board of health shall not adopt a rule that creates a requirement that is more stringent than what is required by the state unless each city within a county board’s jurisdiction, or each county board of supervisors within a district board’s jurisdiction, agree to the more stringent requirement.
    Sec. 17.  NEW SECTION.  137.120  Interpretation of chapter.
   This chapter shall not be construed to prohibit a county from entering into contracts not contemplated by this chapter to provide necessary public health services in a manner not prohibited by law.
    Sec. 18.  Section 143.1, Code 2026, is amended to read as follows:
   143.1  Authority to employ.
   Any local A board of health as defined in section 137.102, area education agency board, or the school board of any school district may employ public health nurses at periods each year and in numbers as deemed advisable. The council of any city A board of health, or the school board of any school district, or any of them board of health and school board of a school district acting in cooperation, may contract with any a nonprofit nurses’ association for public health nursing service services. The compensation and expenses shall be paid out of the general fund of the political subdivision employing nurses contracting for public health nursing services.
    Sec. 19.  REPEAL.  Sections 137.107, 137.108, and 137.115, Code 2026, are repealed.
    Sec. 20.  EFFECTIVE DATE.  This division of this Act takes effect July 1, 2027.
DIVISION II
TRANSITION PROVISIONS

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