Group: Health & Human Services - Department of Health

Agency: Health

Line Item: Local Health Departments

Function

Twelve local health departments (LHDs) cover all areas of the State and provide local public health services. There are 6 single-county LHDs with another six LHDs covering the other 23 Utah counties. The State utilizes the local health departments to administer many of the services required by State law. While this line item is for the General Fund block grant funding only, the Utah Department of Health contracts with the LHDs for over 45 other services. The funding for these contracts is appropriated to and included in the various line items of the Department. Additionally, LHDs contract with the Department of Environmental Quality to provide various services.

LHDs summarize their mission as preventing, promoting and protecting the public health.

Statutory Authority

The local health departments are governed by Title 26a, Local Health Authorities, of the Utah Code. This title establishes local health departments, local boards of health, powers and duties of the departments, and various authorized funding mechanisms. In addition, several statutes in the Utah Health Code detail responsibilities and enforcement by local health departments.

• UCA 19-1-201 details the cooperative efforts that should take place between Local Health Departments and the Department of Environmental Quality.
• UCA 26A-1-106 delegates responsibility for 7 basic public health services:
  1. public health administration and support services
  2. maternal and child health
  3. communicable disease control, surveillance, and epidemiology
  4. food protection
  5. solid waste management
  6. waste water management
  7. safe drinking water management
• UCA 26a establishes the following 5 duty areas:
  1. enforcement of State-created minimum performance standards
  2. enforcement of over 200 rules and regulations for the State
  3. investigate and control diseases affecting public health & coordinate with State
  4. public & private school inspection duties
  5. local disaster & disease response plan
• UCA 26A-1-115 indicates that counties have responsibility to make sure their LHDs are adequately funded. There is a local match requirement for State funds, which is 20% as established through rule.
• UCA 26-15 outlines the Health Department's efforts, in conjunction with those of local health departments, in relation to general sanitation, including those dealing with the Indoor Clean Air Act.
• UCA 26-15a outlines the Department's efforts, in conjunction with those of local health departments, in relation to food safety.
• UCA 26-38 is the Utah Indoor Clean Air Act, which restricts smoking in indoor public places, and establishes enforcement authority and penalties for noncompliance.
• UCA 26-42 establishes civil penalties for individuals and/or licensees that sell tobacco products to underage minors.
• UCA 53A-11-305 details the responsibilities and financing of immunizations for students.

Minimum Performance Standards

Statute provided for the Department of Health and the Department of Environmental Quality to create the minimum performance standards for LHDs in the following areas: administration, personal health services, and environmental health programs.

In the area of administration, the administrative rules in R380-40-6 require employment of the following individuals:

1. Qualified local health officer
2. Registered nurse
3. Health educator
4. Registered sanitarian (environmental health)

In the area of personal health services, the administrative rules in R380-40-7 state the following as requirements:

1. Health promotion & risk reduction help assist residents to:
   • obtain the necessary knowledge, skills, capacity, and opportunity to improve and maintain individual, family, and community health
   • use preventive health services, practices, and facilities appropriately
   • understand and participate, where feasible, in decision-making concerning their health care
   • understand and encourage compliance with prescribed medical instructions
   • participate in community health decision making
   • prevent or delay premature death, disease, injury, or disability through services that encourage the long-term adoption of healthy behavior
2. Communicable disease control to include: reporting, surveillance, assessment, epidemiological investigation, and appropriate control measures for vaccine-preventable diseases, sexually transmitted diseases, tuberculosis, AIDS, and other communicable diseases to attempt to prevent, control, or prevent and control epidemics, cases of vaccine-preventable diseases, and the spread of sexually transmitted diseases, AIDS, and tuberculosis.
3. Infant and child health to help prevent illness, injury, and disability; reduce the preventable complications of illness, injury, and disability; maintain health; and foster healthy growth and development. These services shall include: periodic health assessments; screening for and early identification of health and developmental problems; and provision of appropriate treatment, education, or referral.
4. SIDS counseling (Sudden Infant Death Syndrome) - ensure that families are offered counseling services or referred to counseling services.
5. Preventative health & instruction for school-aged children - advocate and promote.
6. Injury control needs are identified and programs or services are available to reduce the occurrence of injury and unintentional death.
7. Chronic disease services which may include screening, referral, education, promotion, and preventive activities related to the prevention of cardiovascular disease, cancer, diabetes, and other chronic diseases to reduce premature morbidity and mortality associated with these diseases.
8. Family planning shall be provided including information to clients who request it and referral in accordance with State law.
9. Healthy families through access to risk appropriate preconceptional, interconceptional, prenatal, intrapartum, and postpartum health services with the objective of lowering the frequency of maternal and infant death, disease and disability, and promoting the development and maintenance of a healthy, nurturing family unit.
10. Dental health services which may include dental health screening, referral, education, promotion, and preventive activities.

In the area of environmental health programs, the administrative rules in R380-40-8 state the following as requirements:

1. Food service establishments to include: the maintenance of an inventory, directory, or listing of establishments; inspections including corrective actions; plan reviews; an information management system; and the dissemination of public information.
2. Public swimming pools to include: the maintenance of an inventory, directory, or listing of facilities; inspections including corrective actions; plan reviews; an information management system; and the dissemination of public information.
3. Inspection of certain facilities to include: the maintenance of an inventory, directory, or listing of facilities; inspections including corrective actions; plan reviews; an information management system; and the dissemination of public information.
4. Safe drinking water to include: the maintenance of an inventory, directory, or listing of systems; inspections including corrective actions; an information management system; and the dissemination of public information.
5. Nuisance complaints to include: inspections including corrective actions; an information management system; and the dissemination of public information.
6. Vector control (mosquito abatement) to include: complaint inspections including corrective actions; an information management system; and the dissemination of public information.
7. Air quality and air pollution control to include: conducting limited inspections of visible emissions including corrective actions; an information management system; and the dissemination of public information.
8. Injury control to include: inspections including corrective actions; an information management system; and the dissemination of public information.
9. Indoor clean air to include: inspections of public facilities including corrective actions; an information management system; and the dissemination of public information.
10. Solid waste to include: an inventory, directory, or listing of locations; inspections including corrective actions; an information management system; and the dissemination of public information.
11. Subsurface waste water systems to include: the maintenance of an inventory, directory, or listing of facilities; inspections including corrective actions; plan reviews; an information management system; and the dissemination of public information.

The block grant is distributed to the LHDs according to a formula. The pass-through funding is appropriated to the Health Department as a separate line item, in order to maintain a clean record of the funding and to distinguish between the Department's administrative budget and the local health departments' State-funded services.

Funding Detail

For analysis of current budget requests and discussion of issues related to this budget click here.