Chapter 3701-36 Local Health Departments

As used in rules 3701-36-01 to 3701-36-13 of the Administrative Code:

(A) “Board of health” means the board of health of a city or general health district, or the authority having the duties of a board of health in any city as authorized by section 3709.05 of the Revised Code.

(B) “Department” means the department of health of the state of Ohio.

(C) “Director” means the director of health of the state of Ohio.

(D) “Health commissioner” means the person occupying the office created by section 3709.11 or 3709.14 of the Revised Code for the health district.

(E) “Health district” means each city and general health district provided for by section 3709.01 of the Revised Code or a union of two or more health districts as provided for by section 3709.07, 3709.071, or 3709.10 of the Revised Code.

(F) “Local funds” means locally generated funds, and includes but is not limited to local taxes, unspent and unobligated funds from the previous year, fees for services rendered, license fees, permit fees, contributions, revenues from contracting health districts and revenues from other contractual services provided.

(G) “Local health department” means the operational entity of a general or city health district.

(H) “Minimum standards” means the standards established by the public health council that health districts must meet to receive any state subsidy funds, pursuant to section 3701.342 of the Revised Code.

(I) “Optimal achievable standards” means a concept for distributing subsidy funds beyond those awarded for achieving minimum standards. These standards will be defined by the Director on an annual basis when sufficient funds are allocated by the legislature.

(J) “Performance indicator” means certain criteria that may be used, with or without other criteria, to measure a local health department’s compliance with the minimum and optimal achievable standards.

(K) “Physician” means an individual who is authorized under Chapter 4731. of the Revised Code to practice medicine and surgery, osteopathic medicine and surgery, or podiatry.

(l) “Public health council” means the public health council of the Ohio department of health as created by section 3701.33 of the Revised Code.

HISTORY: Eff 7-1-84; 10-1-01; 1-1-05

Promulgated Under: 119.03

Statutory Authority: 3701.342

Rule Amplifies: 3701.342

R.C. 119.032 review dates: 08/29/2003 and 08/29/2008

(A) This chapter of the Administrative Code establishes minimum and optimal achievable standards for local health districts and a method for payment of subsidy to local health districts that meet the minimum standards of these rules and for payment of increased subsidy to local health districts that meet one or more of the optimal achievable standards of this chapter. This chapter is applicable to all health districts within the state.

(B) This chapter establishes the conditions under which the department of health will award subsidies pursuant to section 3709.32 of the Revised Code. This chapter does not alter:

(1) The responsibility of local health departments to conduct those programs or to enforce laws and rules that are otherwise required by any provision of the Revised Code or Administrative Code, including, but not limited to, these provisions: sections 307.621 to 307.627 of the Revised Code and Chapters 3733. and 3749. of the Revised Code, and Chapters 3701-25, 3701-27, 3701-31, and 3701-35 of the Administrative Code;

(2) The authority of the board of health of any health district in adopting orders and regulations otherwise authorized under sections 3709.20 and 3709.21 of the Revised Code, or any other provision of the Revised Code; or

(3) The responsibility of any person or any other entity for complying with any applicable provision otherwise required by the Revised Code, the Administrative Code or any board of health order or regulation.

HISTORY: Eff 7-1-84; 10-1-01; 1-1-05

Promulgated Under: 119.03

Statutory Authority: 3701.342

Rule Amplifies: 3701.342

R.C. 119.032 review dates: 08/29/2003 and 08/29/2008

Each health district must meet the minimum standards to receive any state subsidy funds.

(A) These minimum standards are:

(1) Submission of a state health district subsidy fund application to the department due January first of each year;

(2) Completion and submission of a report on local health department improvement standards and optional measures on January first of the first year of the state’s biennium;

(3) Completion and submission of center for disease control and prevention performance standards (on-line tool) and submission of a copy to the department by January first of the second year of the state’s biennium, or as determined by the director;

(4) Submission of a completed annual financial report to the department by March first of each year;

(5) Be represented by the health commissioner or the health commissioner’s designee at each conference provided by the Ohio department of health pursuant to section 3701.29 of the Revised Code. The health commissioner shall personally attend one of these conferences and the medical director of a health district with a non-physician health commissioner shall attend at least one session of one of the conferences. The director shall review reasons for failure to comply with this paragraph and may grant an excuse when good cause for the absence has been documented;

(6) Provide administrative leadership by:

(a) Employing a health commissioner;

(b) Employing a registered nurse as nursing director;

(c) Employing a registered sanitarian as environmental health director;

(d) Employing as medical director a doctor of medicine or doctor of osteopathic medicine who is licensed to practice medicine in Ohio and who is actively involved in providing medical leadership to the local health department if the health district has a non-physician health commissioner;

(7) Provision of services for health education; and

(8) Expenditure of a minimum of $3.00 per capita in local funds for public health services per year.

HISTORY: Eff 1-1-05

Promulgated Under: 119.03

Statutory Authority: 3701.342

Rule Amplifies: 3701.342

R.C. 119.032 review dates: 08/29/2008

Each board of health shall provide programs in such a manner that the community will be protected from disease and injury.

(A) To comply with minimum standards under this rule, each local health district shall report the status on:

(1) A surveillance and reporting system that identifies health threats;

(2) Response plans that delineate roles and responsibilities in the event of communicable disease outbreaks and other health risks that threaten the health of people;

(3) Communicable disease investigation and control procedures in place and actions documented;

(4) Urgent public health messages received ad communicated quickly and clearly and actions documented; and

(5) Disease and other health risk responses routinely evaluated for opportunities to improve public health system response.

HISTORY: Eff 1-1-05

Promulgated Under: 119.03

Statutory Authority: 3701.342

Rule Amplifies: 3701.342

R.C. 119.032 review dates: 08/29/2008

Each board of health shall provide for the monitoring of health status.

(A) To comply with minimum standards under this rule, each local health district shall report the status on:

(1) Public health assessment processes and tools in place and continuously maintained and enhanced.

(2) Information about environmental threats and community health status being collected, analyzed, and disseminated at defined intervals.

(3) A community health plan based on an assessment from the information in paragraph (A)(2) of this rule being developed, implemented and evaluated.

HISTORY: Eff 1-1-05

Promulgated Under: 119.03

Statutory Authority: 3701.342

Rule Amplifies: 3701.342

R.C. 119.032 review dates: 08/29/2008

Each board of health shall assure a safe and healthy environment for the community.

(A) To comply with minimum standards under this rule, each local health district shall report the status on:

(1) The health district administering all applicable state environmental health programs so as to be on the state’s approved lists.

(2) Environmental health risks and environmental health illnesses being tracked, recorded, reported and monitored by the district.

(3) Services available to respond to environmental events or other disasters that threaten the public’s health.

(4) Compliance with public health regulation sought through enforcement actions.

(5) Environmental health education provided to the community and regularly evaluated.

HISTORY: Eff 1-1-05

Promulgated Under: 119.03

Statutory Authority: 3701.342

Rule Amplifies: 3701.342

R.C. 119.032 review dates: 08/29/2008

Each board of health shall provide for health promotion services in such a manner that provides community residents access to the necessary knowledge, skills, and opportunities that will enable them to make knowledgeable decisions about individual and community health, to achieve the highest level of wellness, and to experience a minimum of preventable illness, disability, and premature death.

(A) To comply with the standards under this rule, each local health department shall report the status on:

(1) Health promotion services targeted to identified health risks in the community.

(2) Community members actively involved in addressing prevention priorities.

(3) Prevention, health promotion, early intervention, and outreach services provided directly.

HISTORY: Eff 1-1-05

Promulgated Under: 119.03

Statutory Authority: 3701.342

Rule Amplifies: 3701.342

R.C. 119.032 review dates: 08/29/2008

Each board of health shall provide for personal health services to the residents of the community in such a manner that there is access to personal health care that is comprehensive and that promotes achievement and maintenance of optimal health status.

(A) To comply with standards under this rule, each local health department shall report the status on:

(1) Critical personal health services for the community being defined.

(2) Information being available that describes the local health system, including resources critical for public health protection and information about health care providers, facilities, and support services.

(3) Information being collected, monitored, and disseminated regarding trends, which over time, affect access to critical health services.

(4) Plans to reduce specific gaps in access to critical health services being developed and implemented through collaborative efforts.

HISTORY: Eff 1-1-05

Promulgated Under: 119.03

Statutory Authority: 3701.342

Rule Amplifies: 3701.342

R.C. 119.032 review dates: 08/29/2008

Each board of health shall provide for the administration and management of the local health department in a manner that should ensure that the local health department plans, organizes, manages, and coordinates services within its jurisdiction to meet the collective health needs of the population in an effective and efficient manner.

(A) To comply with the standards under this rule, each local health department shall report the status on:

(1) The health district establishing annual goals and priorities for public health programs, which are presented to, and approved by, the board of health. The board of health periodically reviews progress reports on the established goals and priorities.

(2) The health district assuring that staff are in compliance with licensure and certification requirements for public health professionals, that staff are properly oriented, and have access to in-service and continuing education.

(3) Health policy decisions being guided by health assessment and other information.

(4) Confidentiality of health data being protected and health information systems being secure.

(5) The board of health and the health commissioner complying with all relevant state and local legal authorities in governing the health district.

HISTORY: Eff 1-1-05

Promulgated Under: 119.03

Statutory Authority: 3701.342

Rule Amplifies: 3701.342

R.C. 119.032 review dates: 08/29/2008

Pursuant to section 3709.32 of the Revised Code, state subsidy to general and city health districts by the department of health is subject to the following:

(A) No health district shall be eligible for or be paid a state subsidy unless:

(1) The health district has been provided local funds for public health services, as determined by the health commissioner and board of health, totaling at least three dollars per capita, according to the most recent federal decennial census, in calendar year 1986 and succeeding years; provided, however, the director may grant an exception to the requirements of this paragraph when it is shown to his satisfaction that unusually severe economic conditions prevent the health district from receiving adequate tax revenues.

(2) The certification of funds expended by the health district is endorsed by the director.

(3) The health district has submitted, by the time requested, all data, reports, and other information concerning services and costs associated with state subsidy distribution required by the director of health.

(4) The health district has not decreased local funds in the local health department budget in anticipation of using state subsidy funds to provide services normally supported by local revenues.

(5) The local health department is in compliance with the minimum standards contained in this chapter of the Administrative Code adopted pursuant to section 3701.342 of the Revised Code, including:

(a) The requirement as provided in rule 3701-36-03 of the Administrative Code that the health district has been represented by the health commissioner or a designee at each conference provided by the Ohio department of health pursuant to section 3701.29 of the Revised Code, and the health commissioner has personally attended one of these conferences and the medical director of a health district with a non-physician health commissioner has attended at least one session of one of the conferences; and

(b) The requirement that all funds received by the health district, including any state subsidy awarded during the preceding year under section 3709.32 of the Revised Code, have been credited to the budget of the local health department and expended for purposes determined by the health commissioner and board of health in accordance with all applicable laws and rules governing the expenditure of funds.

(B) Each health district meeting the improvement minimum standards and which is otherwise eligible for a state subsidy shall be paid the subsidy to be computed as follows:

(1) Each health district providing health services shall be paid an amount equal to the total paid to the district during calendar year 1983 pursuant to appropriations to the Ohio department of health for the purposes of section 3709.32 of the Revised Code; provided if sufficient funds are not available to pay these amounts to all eligible health districts, a pro rata amount shall be paid;

(2) The balance, if any, of the funds available for subsidy shall be apportioned and paid to each eligible health district providing health services as follows:

(a) Health districts that are in compliance with the minimum standards contained in this chapter of the Administrative Code may be paid up to an amount, which in addition to the amount paid in paragraph (B)(1) of this rule, will be a pro rata amount not to total more than thirty cents on a per capita basis according to the most recent federal decennial census; and

(b) If the amount appropriated by the general assembly in any fiscal year for state health district subsidy exceeds thirty cents per capita for health districts that qualify for any subsidy under this rule, health districts that are in compliance with one or more of the optimal achievable standards contained in this chapter of the Administrative Code may be paid an additional subsidy amount for each optimal achievable standard met, on a per capita basis according to the most recent federal decennial census, as determined by the director. In addition to compliance with one or more of the optimal achievable standards, a health district must comply with all minimum standards to qualify for an additional subsidy.

HISTORY: Eff 1-1-05

Promulgated Under: 119.03

Statutory Authority: 3701.342

Rule Amplifies: 3701.342, 3709.32

R.C. 119.032 review dates: 08/29/2008

(A) To apply for state subsidy payments under section 3709.32 of the Revised Code and this chapter of the Administrative Code, the president of each board of health and the health commissioner of each local health department shall submit to the director on forms provided by the director and shall be submitted no later than the first day of January of each year, the following:

(1) An annual application for state subsidy. The application shall include a certification of the extent of the local health department’s compliance with the improvement standards established by rules 3701-36-03 to 3701-36-09 of the Administrative Code;

(2) An annual subsidy compliance statement; and

(3) Submission of a report on improvement standards or the centers for disease control and prevention national performance standards survey, one each on alternating years or, as determined by the director.

(B) The president of each board of health providing health services in one or more health districts and the chief executive officer of each local health department providing services in one or more health districts shall, on or before the first day of March of each year, submit to the director on forms provided by the director an annual financial report for the preceding calendar year, describing amounts expended which qualify for state health district subsidy funds under section 3701.342 of the Revised Code and this chapter of the Administrative Code. This report shall be certified by the health commissioner and the auditor of the health district specified by section 3709.31 of the Revised Code.

HISTORY: Eff 1-1-05

Promulgated Under: 119.03

Statutory Authority: 3701.342

Rule Amplifies: 3701.342, 3709.32

R.C. 119.032 review dates: 08/29/2008

(A) The director may evaluate the extent to which local health departments comply with the minimum and optimal achievable standards established by Chapter 3701-36 of the Administrative Code by means of the review process provided in this rule. Each local health department which has certified that it is in compliance with minimum or optimal achievable standards in accordance with paragraph (A) of rule 3701-36-11 of the Administrative Code may be evaluated as frequently as the director deems necessary.

(B) The director shall select at least one review team to conduct evaluations of compliance that may be composed of but not limited to one or more members of the staff of local health departments other than that which is being evaluated and of one member of the director’s staff who shall serve as coordinator for the team. The review team shall perform an on-site visit to the local health department and may observe any activities and examine any records of the local health department.

(C) A local health department shall not refuse a review visit, fail to provide team members access to records, or otherwise interfere with the evaluation. The director may base a determination of noncompliance with one or more minimum or optimal achievable standards upon violation of this paragraph.

(D) Within sixty days after the coordinator has received the reviewers’ written reports of the on-site evaluation the director shall notify the local health department of a proposed determination as to the extent of the local health department’s compliance with minimum and optimal achievable standards and of the right to an informal hearing under rule 3701-36-13 of the Administrative Code. The proposed determination shall become final if an informal hearing is not requested within the time specified by paragraph (A) of rule 3701-36-13 of the Administrative Code. If the hearing request is timely, the director shall issue a final determination in accordance with paragraph (B) of rule 3701-36-13 of the Administrative Code.

(E) The director shall not pay state subsidy to a local health department after the date a final determination that the local health department does not comply with one or more minimum standards is issued. The director shall not pay state subsidy to a local health district for an optimal achievable standard after the date a final determination that the local health department does not comply with the standard is issued. For six months after the date the director issues a final determination that a local health department does not comply with minimum standards, the local health department shall not reapply for and shall not be paid state subsidy. Payments shall resume after the local health department is determined to have achieved compliance with the relevant standards.

HISTORY: Eff 1-1-05

Promulgated Under: 119.03

Statutory Authority: 3701.342

Rule Amplifies: 3701.342, 3709.32

R.C. 119.032 review dates: 08/29/2008

(A) A local health department shall be afforded an informal hearing concerning the director’s proposed determination of the extent of the local health department’s compliance with minimum and optimal achievable standards issued under paragraph (D) of rule 3701-36-12 of the Administrative Code if a written request for the hearing is received by the director no later than fifteen days after the date of mailing of the proposed determination.

(B) The informal hearing shall be conducted before the director or the director’s authorized representative no later than thirty days after the director’s receipt of the request. For the hearing, the local health district may present information orally and in writing. The director shall issue a written final determination of the extent of the local health department’s compliance no later than thirty days after the conclusion of the informal hearing.

HISTORY: Eff 1-1-05

Promulgated Under: 119.03

Statutory Authority: 3701.34, 3701.342, 3709.32

Rule Amplifies: 3701.342, 3709.32

R.C. 119.032 review dates: 08/29/2008

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