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The Oregon Administrative Rules contain OARs filed through August 15, 2015
 
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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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