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OREGON HEALTH AUTHORITY,

PUBLIC HEALTH DIVISION

 

DIVISION 14
CONFERENCE OF LOCAL HEALTH OFFICIALS


Standards for County and District Health Departments

333-014-0040
Purpose
The purpose of these rules is to establish
minimum standards and administrative rules to:
(1) Define the organization,
operation, and extent of activities required or expected of county and district
health departments to carry out their responsibilities in implementing the public
health laws of this state, and the rules and regulations of the State Public Health
Division.
(2) Assist in the development,
improvement, and support of local health departments in their efforts to promote
and protect the health of Oregon citizens.
(3) Govern the process if
a county or health district makes a decision to relinquish local public health authority
and the actions that the Public Health Division must take following a relinquishment
of local public health authority.
Stat. Auth.: ORS 431.350
Stats. Implemented: ORS 431.345
& 431.375
Hist.: HB 269, f. 4-19-71,
ef. 5-11-71; HD 5-1990, f. & cert. ef. 1-24-90; PH 19-2014(Temp), f. & cert.
ef. 6-20-14 thru 12-17-14; PH 31-2014, f. & cert. ef. 12-17-14
333-014-0042
Definitions
As used in OAR chapter 333, division
14:
(1) "Enforcement" means an
action taken to compel the requirements of the law.
(2) "Local public health
administrator" has the meaning given that term in ORS 431.260.
(3) "Local public health
authority" has the meaning given that term in ORS 431.260.
(4) "Public Health Division"
means the public health division within the Oregon Health Authority.
(5) "Public health law" has
the meaning given that term in ORS 431.260.
Stat. Auth.: ORS 413.042, 431.350
Stats. Implemented: ORS
431.345, 431.380, 431.385
Hist.: PH 19-2014(Temp),
f. & cert. ef. 6-20-14 thru 12-17-14; PH 31-2014, f. & cert. ef. 12-17-14
333-014-0050
Health Department Services
(1) Each county and district health
department shall perform (or cause to be performed) all of the duties and functions
imposed upon it by Oregon Revised Statutes, and by official administrative rules
adopted by the Public Health Division and filed with the Secretary of State. These
duties and functions shall be performed in a manner consistent with Minimum Standards
for Local Health Departments, adopted by the Conference of Local Health Officials
(CLHO).
(2) The following program
areas shall be considered essential, and be specifically included in the overall
annual plan of each county and district health department who shall assure programs
are available:
(a) Control of reportable
communicable disease which includes providing epidemiologic investigations which
report, monitor, and control communicable disease and other health hazards; providing
diagnostic and consultative communicable disease services; assuring early detection,
education, and prevention activities which reduce the morbidity and mortality of
reportable communicable disease; assuring the availability of immunizations for
human and animal target populations; and collecting and analyzing of communicable
disease and other health hazard data for program planning and management to assure
the health of the public;
(b) Parent and child health
which includes education, screening and follow up, counseling, referral, or health
services for family planning, perinatal care, infants, and children;
(c) Health statistics which
includes birth and death reporting, recording, and registration; analysis of health
indicators related to morbidity and mortality; and analysis of services provided
with technical assistance from the Public Health Division;
(d) Information and referral
services to the public regarding local health and human services;
(e) Environmental health
services which includes inspection, licensure, consultation and complaint investigation
of food services, tourist facilities, institutions, public swimming and spa pools,
and regulation of water supplies, solid waste and on site sewage disposal systems.
(3) In addition, each county
and district health department should include or provide for programs in the following
areas (according to the community’s health needs):
(a) Dental health, including
preventive education, promotion of fluoride use and procedures for early detection
and treatment of dental problems;
(b) Emergency preparedness
including participation in the development of the county’s emergency response
plans and internal procedures necessary to carry out the health department’s
role in the plans;
(c) Health education/health
promotion including activities and programs to promote health and assist individuals
and groups to achieve and maintain healthy behaviors;
(d) Laboratory services including
providing diagnostic and screening tests to support public health services which
are in compliance with quality assurance guidelines established by the Public Health
Division;
(e) Medical examiner services
to coordinate the epidemiological investigation of deaths of public health significance
with the county medical examiner;
(f) Nutrition services including
identification and intervention with clients at nutritional risk, and education
and consultation for the promotion of good dietary habits;
(g) Older adult health including
services to reduce morbidity and premature death; detect conditions which impair
functioning; strengthen the ability to remain independent; and to promote physical,
social and emotional well-being;
(h) Primary health care services
including participation in community efforts to promote necessary services and/or
provide health services;
(i) Shellfish Sanitation
(in coastal counties) to monitor harvesting and provide public information to harvesters
of shellfish.
(4) Each county and district
health department, given the specific needs of their local communities, may decide
to implement additional programs.
Stat. Auth.: ORS 431.350
Stats. Implemented: ORS 431.345,
431.385 & 431.416
Hist.: HB 205, f. 3-26-68;
HD 5, 1990, f. & cert. ef. 1-24-90
333-014-0060
Program Plans
(1) Each county and district health
department shall submit an annual plan by May 1 of each year to the Public Health
Division.
(2) The Public Health Division
shall develop the format of the plan in consultation with the Conference of Local
Health officials.
(3) The plan should address
all program areas identified in section (2) of this rule and any that are applicable
in OAR 333-014-0050(3) including:
(a) Program indicators as
defined by CLHO standards and agreed upon by the local health department and the
Public Health Division; and/or
(b) A statement describing
why services defined in OAR 333-014-0050(2) are not being provided.
(4) The annual plan shall
become a key element of the county review done by the Public Health Division.
(5) The Public Health Division
shall provide technical assistance on request to local health departments in developing
the annual plan.
Stat. Auth.: ORS 431.350
Stats. Implemented: ORS 431.385
Hist.: HB 269, f. 4-19-71,
ef. 5-11-71; HD 5-1990, f. & cert. ef. 1-24-90
333-014-0070
Organization
Each county and district health department shall:
(1) Employ a qualified administrator who is responsible for the operation of the health department;
(2) Employ registered nurses licensed by the Board of Nursing, sanitarians registered by the Sanitarians Registration Board, and such other administrative professional, technical, and clerical staff sufficient to carry out the responsibilities of the department;
(3) Employ or contract with a physician licensed by the Oregon Medical Board as health officer;
(4) Use as guidelines for employment the minimum personnel qualifications as defined in the CLHO standards;
(5) Adhere to state or county civil service, merit system, or personnel rule requirements in the selection, promotion, or termination of all health department staff;
(6) Maintain an office open to the public during the normal work week of the local government.
Stat. Auth.: ORS 431.350

Stats. Implemented: ORS 431.345

Hist.: HB 269, f. 4-19-71, ef. 5-11-71; HD 5-1990, f. & cert. ef. 1-24-90
333-014-0080
Relinquishment of Local Public Health
Authority
(1) If a county or health district chooses
to relinquish its local public health authority under ORS 431.375(2) it must submit
a written notice to the Public Health Division that it intends to relinquish its
local public health authority, at least 365 days prior to the date of relinquishment.
The notice must include an explanation of why the county or health district intends
to relinquish public health authority and must include the date of relinquishment.
The date of relinquishment must not be less than 365 days from the date of the notice.
(2) Within 30 days of receipt
of the notice described in section (1) of this rule the Public Health Division will
schedule a public hearing in the affected county or health district to inform the
public on the process of relinquishment and solicit input from the community. The
Public Health Division shall conduct as many public meetings in the affected county
or health district as it deems necessary to obtain public input.
(3) Within 45 days of receipt
of the notice described in section (1) of this rule the Public Health Division must
attempt to schedule a meeting with the governing body of the county, county board
of health or district board of health, as applicable to determine what steps might
be taken to reverse or mitigate the county’s or health district’s proposed
action to relinquish public health authority.
(4) A county or health district
that has relinquished its public health authority:
(a) Is not eligible for funds
under ORS 431.380 or funds that are customarily distributed through an agreement
delegating state public health authority to the county or health district; and
(b) May not be delegated
any authority under ORS 433.855, 446.425, 448.100, 448.170, and 624.510 because
in relinquishing its public health authority it has refused to provide environmental
health services under 431.416(2)(d), or is no longer the local public health authority.
(5) On the date of relinquishment
the county or health district must return any unexpended funds that were distributed
under ORS 431.380, or through any other agreement through which state public health
authority was delegated to a county or health district.
(6) A county or health district
must continue to comply with any contract or agreement with the Public Health Division
that concerns any of the services or activities required by a local public health
authority under OAR 333-014-0050(2), including but not limited to the financial
assistance agreement for local public health services, until the date of relinquishment.
The county or health district must provide notice to the Public Health Division,
in accordance with the termination provisions of the contract or agreement, that
the contract or agreement is terminated as of the date of relinquishment.
(7) The Public Health Division
will reasonably act to take actions necessary to ensure that basic public health
services are provided in the affected county or health district in accordance with
OAR 333-014-0090. Such actions by the Public Health Division do not:
(a) Relieve the county or
health district of its obligations arising during the period of its authority;
(b) Constitute a release
or waiver by the Public Health Division with respect to such obligations; or
(c) Relieve the county or
health district of obligations it may have under state law notwithstanding the relinquishment
of its local public health authority.
(8) A county or health district
that relinquishes its local public health authority remains responsible for fulfilling
the responsibilities of the county or health district, local public health administrator
or local public health department as follows:
(a) Enforce public health
laws under ORS 431.150.
(b) Appoint a local public
health administrator and health officer under ORS 431.418.
(c) Receive reports of reportable
diseases under ORS 433.004.
(d) Investigate reports of
reportable diseases, in coordination with the Public Health Division, under ORS
433.006.
(e) Disease control in schools,
including but not limited to review of administrative records for required vaccinations
and related school exclusions under ORS 433.235 to 433.284 and OAR chapter 333,
division 50.
(f) Receive reports of animal
bites under ORS 433.345.
(g) Permit mass gatherings
under ORS 433.745.
(9) A county or health district
that has relinquished its public health authority may, at any time, request that
its authority be restored. Such a request must be made to the State Public Health
Director in writing and shall include an annual plan, a detailed explanation about
how the issues that led to relinquishment have been addressed, and a plan to transition
authority from the Public Health Division to the county or health district. The
State Public Health Director shall consider the request and respond, in writing,
either granting or denying the request within 90 days of the receipt of the request.
(a) If the request is approved,
the Public Health Division shall identify the date that authority shall be transferred
back to the county or health district.
(b) If the request is denied
the State Public Health Director shall explain the basis for rejecting the request
and shall include information about how the county or health district can address
its deficiencies.
Stat. Auth.: ORS 413.042 & 431.375
Stats. Implemented: ORS 431.375
Hist.: PH 19-2014(Temp),
f. & cert. ef. 6-20-14 thru 12-17-14; PH 31-2014, f. & cert. ef. 12-17-14
333-014-0090
Public Health Division as Local Public
Health Authority
(1) If the local public health authority
has relinquished its public health authority the Public Health Division shall perform
the services or activities necessary to provide basic local public health services
under ORS 431.380 to the extent funds are available, and may contract with a private
person or entity; an agency; or another county or health district to perform all
or part of the necessary public health services or activities. The services that
are considered basic local public health services are those required to fulfill
statutory obligations as follows:
(a) Investigation of reportable
diseases, disease outbreaks, or epidemics under ORS 433.004;
(b) Isolation and quarantine
under ORS 433.121 to 433.142;
(c) Investigation and control
of tuberculosis (TB) under ORS 433.332;
(d) Order the destruction
of animals with rabies under ORS 433.350;
(e) Indoor Clean Air Act
enforcement under ORS 433.875;
(f) Family planning and birth
control services under ORS 435.205;
(g) Initiate and conduct
discussions of family planning under ORS 435.205;
(h) Women, Infants and Children
(WIC) services under ORS 413.500;
(i) Licensure of tourist
accommodations, including hostels, picnic parks, recreation parks and organizational
camps under ORS 446.310 to 446.350;
(j) Licensure of pools and
spas under ORS 448.005 to 448.100;
(k) Restaurant licensure,
including commissaries, mobile units, vending machines and bed and breakfasts under
ORS 624.310 to 624.430; and
(l) Regulation of public
water systems under ORS 448.115 to 448.285
(2) A county or health district
shall be financially responsible for the costs incurred by the Public Health Division
or its contractor in taking enforcement actions as a result of a county or health
district’s relinquishment of local public health authority. Enforcement actions
include but are not limited to:
(a) Any action taken by the
Public Health Division necessary to fulfill a county, health district, local public
health administrator or local public health department obligation described in OAR
333-014-0080(8);
(b) Any action taken by the
Public Health Division under ORS 431.170;
(c) Isolation or quarantine
under ORS 433.121 to 433.142;
(d) Inspections, investigations,
and legally required activities under:
(A) ORS 433.004 and 433.006
(control of communicable disease);
(B) ORS 433.267 (immunization
of school children); or
(C) ORS 433.235 to 433.284
(disease control in schools).
(e) Court actions to ensure
compliance with state public health laws; and
(f) The defense of any Public
Health Division action in court.
(3) Notwithstanding section
(2) of this rule, a county or health district shall not be financially responsible
for an enforcement action as described in section (2) of this rule if the action
was commenced by the Public Health Division under its own authority and not as a
result of the relinquishment of local authority.
(e) The defense of any agency
action in court.
Stat. Author: ORS 413.042, 431.262 &
431.375
Stats. Implemented: ORS 431.170
& 431.375
Hist.: PH 19-2014(Temp),
f. & cert. ef. 6-20-14 thru 12-17-14; PH 31-2014, f. & cert. ef. 12-17-14
333-014-0100
Applicability
(1) OAR 333-014-0080 and 333-014-0090
apply to any county or health district that provides notice of its intent to relinquish
its local public health authority or has relinquished its public health authority
on or after June 20, 2014.
(2) For purposes of these
rules the date of relinquishment is the date the county or health district identifies
in its notice as the date it will no longer be the local public health authority.
Stat. Author: ORS 413.042 & 431.375
Stats. Implemented: ORS 431.375
Hist.: PH 19-2014(Temp),
f. & cert. ef. 6-20-14 thru 12-17-14; PH 31-2014, f. & cert. ef. 12-17-14

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