Senator Michael S. Kennedy proposes the following substitute bill:


1     
LOCAL HEALTH DEPARTMENT REVISIONS

2     
2023 GENERAL SESSION

3     
STATE OF UTAH

4     
Chief Sponsor: Karen M. Peterson

5     
Senate Sponsor: Michael S. Kennedy

6     

7     LONG TITLE
8     General Description:
9          This bill enacts provisions related to local health department governance.
10     Highlighted Provisions:
11          This bill:
12          ▸     requires the Department of Health and Human Services and the Department of
13     Environmental Quality, when reviewing policies or rules that affect local health
14     departments, to make certain determinations;
15          ▸     requires the Department of Health and Human Services and local health
16     departments to report on funding received from each county to accomplish
17     minimum performance standards;
18          ▸     clarifies that the Department of Health and Human Services and the Department of
19     Environmental Quality must have a funding formula for allocating contract funds
20     outlined in administrative rule;
21          ▸     creates a reporting requirement; and
22          ▸     makes technical changes.
23     Money Appropriated in this Bill:
24          None
25     Other Special Clauses:

26          None
27     Utah Code Sections Affected:
28     AMENDS:
29          19-1-201, as last amended by Laws of Utah 2020, Chapter 256
30          26A-1-115, as last amended by Laws of Utah 2018, Chapter 330
31          26A-1-116, as last amended by Laws of Utah 1991, Chapter 112 and renumbered and
32     amended by Laws of Utah 1991, Chapter 269
33          26B-1-207, as renumbered and amended by Laws of Utah 2022, Chapter 255
34     

35     Be it enacted by the Legislature of the state of Utah:
36          Section 1. Section 19-1-201 is amended to read:
37          19-1-201. Powers and duties of department -- Rulemaking authority --
38     Committee -- Monitoring environmental impacts of inland port.
39          (1) The department shall:
40          (a) enter into cooperative agreements with the Department of Health and Human
41     Services to delineate specific responsibilities to assure that assessment and management of risk
42     to human health from the environment are properly administered;
43          (b) consult with the Department of Health and Human Services and enter into
44     cooperative agreements, as needed, to ensure efficient use of resources and effective response
45     to potential health and safety threats from the environment, and to prevent gaps in protection
46     from potential risks from the environment to specific individuals or population groups;
47          (c) coordinate implementation of environmental programs to maximize efficient use of
48     resources by developing, in consultation with local health departments, a Comprehensive
49     Environmental Service Delivery Plan that:
50          (i) recognizes that the department and local health departments are the foundation for
51     providing environmental health programs in the state;
52          (ii) delineates the responsibilities of the department and each local health department
53     for the efficient delivery of environmental programs using federal, state, and local authorities,
54     responsibilities, and resources;
55          (iii) provides for the delegation of authority and pass through of funding to local health
56     departments for environmental programs, to the extent allowed by applicable law, identified in

57     the plan, and requested by the local health department; and
58          (iv) is reviewed and updated annually;
59          (d) make rules, in accordance with Title 63G, Chapter 3, Utah Administrative
60     Rulemaking Act, as follows:
61          (i) for a board created in Section 19-1-106, rules regarding:
62          (A) board meeting attendance; and
63          (B) conflicts of interest procedures; and
64          (ii) procedural rules that govern:
65          (A) an adjudicative proceeding, consistent with Section 19-1-301; and
66          (B) a special adjudicative proceeding, consistent with Section 19-1-301.5;
67          (e) ensure that training or certification required of a public official or public employee,
68     as those terms are defined in Section 63G-22-102, complies with Title 63G, Chapter 22, State
69     Training and Certification Requirements, if the training or certification is required:
70          (i) under this title;
71          (ii) by the department; or
72          (iii) by an agency or division within the department; and
73          (f) subject to Subsection (2), establish annual fees that conform with Title V of the
74     Clean Air Act for each regulated pollutant as defined in Section 19-2-109.1, applicable to a
75     source subject to the Title V program.
76          (2) (a) A fee established under Subsection (1)(f) is in addition to a fee assessed under
77     Subsection (6)(i) for issuance of an approval order.
78          (b) In establishing a fee under Subsection (1)(f), the department shall comply with
79     Section 63J-1-504 that requires a public hearing and requires the established fee to be
80     submitted to the Legislature for the Legislature's approval as part of the department's annual
81     appropriations request.
82          (c) A fee established under this section shall cover the reasonable direct and indirect
83     costs required to develop and administer the Title V program and the small business assistance
84     program established under Section 19-2-109.2.
85          (d) A fee established under Subsection (1)(f) shall be established for all sources subject
86     to the Title V program and for all regulated pollutants.
87          (e) An emission fee may not be assessed for a regulated pollutant if the emissions are

88     already accounted for within the emissions of another regulated pollutant.
89          (f) An emission fee may not be assessed for any amount of a regulated pollutant
90     emitted by any source in excess of 4,000 tons per year of that regulated pollutant.
91          (g) An emission fee shall be based on actual emissions for a regulated pollutant unless
92     a source elects, before the issuance or renewal of a permit, to base the fee during the period of
93     the permit on allowable emissions for that regulated pollutant.
94          (h) The fees collected by the department under Subsection (1)(f) and penalties
95     collected under Subsection 19-2-109.1(4) shall be deposited into the General Fund as the Air
96     Pollution Operating Permit Program dedicated credit to be used solely to pay for the reasonable
97     direct and indirect costs incurred by the department in developing and administering the
98     program and the small business assistance program under Section 19-2-109.2.
99          (3) The department shall establish a committee that consists of:
100          (a) the executive director or the executive director's designee;
101          (b) two representatives of the department appointed by the executive director; and
102          (c) three representatives of local health departments appointed by a group of all the
103     local health departments in the state.
104          (4) (a) The committee established in Subsection (3) shall:
105          [(a)] (i) review the allocation of environmental quality resources between the
106     department and the local health departments including whether funds allocated by contract
107     were allocated in accordance with the formula described in Section 26A-1-116;
108          [(b)] (ii) evaluate rules and department policies that affect local health departments in
109     accordance with Subsection (4)(b);
110          [(c)] (iii) consider policy changes proposed by the department or by local health
111     departments;
112          [(d)] (iv) coordinate the implementation of environmental quality programs to
113     maximize environmental quality resources; and
114          [(e)] (v) review each department application for any grant from the federal government
115     that affects a local health department before the department submits the application.
116          (b) When evaluating a policy or rule that affects a local health department, the
117     committee shall:
118          (i) compute an estimate of the cost a local health department will bear to comply with

119     the policy or rule;
120          (ii) specify whether there is any funding provided to a local health department to
121     implement the policy or rule; and
122          (iii) advise whether the policy or rule is still needed.
123          (c) Before November 1 of each year, the department shall provide a report to the
124     Administrative Rules Review and General Oversight Committee regarding the determinations
125     made under Subsection (4)(b).
126          (5) The committee shall create bylaws to govern the committee's operations.
127          (6) The department may:
128          (a) investigate matters affecting the environment;
129          (b) investigate and control matters affecting the public health when caused by
130     environmental hazards;
131          (c) prepare, publish, and disseminate information to inform the public concerning
132     issues involving environmental quality;
133          (d) establish and operate programs, as authorized by this title, necessary for protection
134     of the environment and public health from environmental hazards;
135          (e) use local health departments in the delivery of environmental health programs to
136     the extent provided by law;
137          (f) enter into contracts with local health departments or others to meet responsibilities
138     established under this title;
139          (g) acquire real and personal property by purchase, gift, devise, and other lawful
140     means;
141          (h) prepare and submit to the governor a proposed budget to be included in the budget
142     submitted by the governor to the Legislature;
143          (i) in accordance with Section 63J-1-504, establish a schedule of fees that may be
144     assessed for actions and services of the department that are reasonable, fair, and reflect the cost
145     of services provided;
146          (j) for an owner or operator of a source subject to a fee established by Subsection (6)(i)
147     who fails to timely pay that fee, assess a penalty of not more than 50% of the fee, in addition to
148     the fee, plus interest on the fee computed at 12% annually;
149          (k) prescribe by rule reasonable requirements not inconsistent with law relating to

150     environmental quality for local health departments;
151          (l) perform the administrative functions of the boards established by Section 19-1-106,
152     including the acceptance and administration of grants from the federal government and from
153     other sources, public or private, to carry out the board's functions;
154          (m) upon the request of a board or a division director, provide professional, technical,
155     and clerical staff and field and laboratory services, the extent of which are limited by the
156     money available to the department for the staff and services; and
157          (n) establish a supplementary fee, not subject to Section 63J-1-504, to provide service
158     that the person paying the fee agrees by contract to be charged for the service to efficiently use
159     department resources, protect department permitting processes, address extraordinary or
160     unanticipated stress on permitting processes, or make use of specialized expertise.
161          (7) In providing service under Subsection (6)(n), the department may not provide
162     service in a manner that impairs another person's service from the department.
163          (8) (a) As used in this Subsection (8):
164          (i) "Environmental impacts" means:
165          (A) impacts on air quality, including impacts associated with air emissions; and
166          (B) impacts on water quality, including impacts associated with storm water runoff.
167          (ii) "Inland port" means the same as that term is defined in Section 11-58-102.
168          (iii) "Inland port area" means the area in and around the inland port that bears the
169     environmental impacts of destruction, construction, development, and operational activities
170     within the inland port.
171          (iv) "Monitoring facilities" means:
172          (A) for monitoring air quality, a sensor system consisting of monitors to measure levels
173     of research-grade particulate matter, ozone, and oxides of nitrogen, and data logging equipment
174     with internal data storage that are interconnected at all times to capture air quality readings and
175     store data; and
176          (B) for monitoring water quality, facilities to collect groundwater samples, including in
177     existing conveyances and outfalls, to evaluate sediment, metals, organics, and nutrients due to
178     storm water.
179          (b) The department shall:
180          (i) develop and implement a sampling and analysis plan to:

181          (A) characterize the environmental baseline for air quality and water quality in the
182     inland port area;
183          (B) characterize the environmental baseline for only air quality for the Salt Lake
184     International Airport; and
185          (C) define the frequency, parameters, and locations for monitoring;
186          (ii) establish and maintain monitoring facilities to measure the environmental impacts
187     in the inland port area arising from destruction, construction, development, and operational
188     activities within the inland port;
189          (iii) publish the monitoring data on the department's website; and
190          (iv) provide at least annually before November 30 a written report summarizing the
191     monitoring data to:
192          (A) the Utah Inland Port Authority board, established under Title 11, Chapter 58, Part
193     3, Port Authority Board; and
194          (B) the Legislative Management Committee.
195          Section 2. Section 26A-1-115 is amended to read:
196          26A-1-115. Apportionment of costs -- Contracts to provide services -- Percentage
197     match of state funds -- Audit.
198          (1) (a) The cost of establishing and maintaining a multicounty local health department
199     may be apportioned among the participating counties on the basis of population in proportion
200     to the total population of all counties within the boundaries of the local health department, or
201     upon other bases agreeable to the participating counties.
202          (b) Costs of establishing and maintaining a county health department shall be a charge
203     of the county creating the local health department.
204          (c) Money available from fees, contracts, surpluses, grants, and donations may also be
205     used to establish and maintain local health departments.
206          (d) As used in this Subsection (1), "population" means population estimates prepared
207     by the Utah Population Committee.
208          (2) The cost of providing, equipping, and maintaining suitable offices and facilities for
209     a local health department is the responsibility of participating governing bodies.
210          (3) Local health departments that comply with all department rules and secure advance
211     approval of proposed service boundaries from the department may by contract receive funds

212     under Section 26A-1-116 from the department to provide specified public health services.
213          (4) Contract funds distributed under Subsection (3) shall be in accordance with Section
214     26A-1-116 and policies and procedures adopted by the department.
215          (5) Department rules shall require that contract funds be used for public health
216     services and not replace other funds used for local public health services.
217          (6) (a) (i) All state funds distributed by contract from the department to local health
218     departments for public health services shall be matched by those local health departments at a
219     percentage determined by the department in consultation with local health departments.
220          (ii) Counties shall have no legal obligation to match state funds at percentages in
221     excess of those established by the department and shall suffer no penalty or reduction in state
222     funding for failing to exceed the required funding match.
223          (b) By October 1 of each year, the department, in consultation with each local health
224     department, shall submit a written report to the Social Services Appropriations Subcommittee
225     describing, for the preceding five fiscal years, each county's annual per capita contribution to a
226     local health department that is used to meet the minimum performance standards described in
227     Section 26A-1-106.
228          (c) A county may submit an additional written report separate from the report described
229     in Subsection (6)(b) to the Social Services Appropriations Subcommittee outlining a county's
230     contribution to public and community health in the county through other methods that are
231     additional to the annual per capita contribution described in Subsection (6)(b).
232          (7) (a) Each local health department shall cause an annual financial and compliance
233     audit to be made of its operations by a certified public accountant. The audit may be conducted
234     as part of an annual county government audit of the county where the local health department
235     headquarters are located.
236          (b) The local health department shall provide a copy of the audit report to the
237     department and the local governing bodies of counties participating in the local health
238     department.
239          Section 3. Section 26A-1-116 is amended to read:
240          26A-1-116. Allocation of state funds to local health departments -- Formula.
241          (1) (a) On or before July 1, 2024, each of the following shall establish in rule a formula
242     for allocating state funds by contract to local health departments:

243          (i) the department; and
244          (ii) [The Departments of Health and Environmental Quality shall each establish by rule
245     a formula for allocating state funds by contract to local health departments.] the Department of
246     Environmental Quality.
247          (b) This formula shall provide for allocation of funds based on need.
248          (c) Determination of need shall be based on population unless the department making
249     the rule establishes by valid and accepted data that other defined factors are relevant and
250     reliable indicators of need.
251          (d) The formula shall include a differential to compensate for additional costs of
252     providing services in rural areas.
253          (2) [(a) The formulas established under Subsection (1) shall be in effect on or before
254     July 1, 1991.]
255          [(b)] (a) [The] Except as provided in Subsection (2)(b), the formulas apply to all state
256     funds appropriated by the Legislature to [the Departments of Health and Environmental Quality
257     for local health departments.] any of the following for local health department use:
258          (i) the department; or
259          (ii) the Department of Environmental Quality.
260          [(c)] (b) The formulas do not apply to funds a local health department receives from:
261          (i) sources other than the [Departments of Health and] department or the Department of
262     Environmental Quality; [and] or
263          (ii) the [Departments of Health and] department or the Department of Environmental
264     Quality:
265          (A) to operate a specific program within the local health department's boundaries
266     which program is available to all residents of the state;
267          (B) to meet a need that exists only within the local health department's boundaries; and
268          (C) to engage in research projects.
269          Section 4. Section 26B-1-207 is amended to read:
270          26B-1-207. Policymaking responsibilities -- Regulations for local health
271     departments prescribed by department -- Local standards not more stringent than
272     federal or state standards -- Consultation with local health departments -- Committee to
273     evaluate health policies and to review federal grants.

274          (1) In establishing public health policy, the department shall consult with the local
275     health departments established under Title 26A, Chapter 1, Local Health Departments.
276          (2) (a) In accordance with Title 63G, Chapter 3, Utah Administrative Rulemaking Act,
277     the department may prescribe by administrative rule made in accordance with Title 63G,
278     Chapter 3, Utah Administrative Rulemaking Act, reasonable requirements not inconsistent
279     with law for a local health department as defined in Section 26A-1-102.
280          (b) Except where specifically allowed by federal law or state statute, a local health
281     department, as defined in Section 26A-1-102, may not establish standards or regulations that
282     are more stringent than those established by federal law, state statute, or administrative rule
283     adopted in accordance with Title 63G, Chapter 3, Utah Administrative Rulemaking Act.
284          (c) Nothing in this Subsection (2), limits the ability of a local health department to
285     make standards and regulations in accordance with Subsection 26A-1-121(1)(a) for:
286          (i) emergency rules made in accordance with Section 63G-3-304; or
287          (ii) items not regulated under federal law, state statute, or state administrative rule.
288          (3) (a) As used in this Subsection (3):
289          (i) "Committee" means the committee established under Subsection (3)(b).
290          (ii) "Exempt application" means an application for a federal grant that meets the
291     criteria established under Subsection (3)(c)(iii).
292          (iii) "Expedited application" means an application for a federal grant that meets the
293     criteria established under Subsection (3)(c)(iv).
294          (iv) "Federal grant" means a grant from the federal government that could provide
295     funds for local health departments to help them fulfill their duties and responsibilities.
296          (v) "Reviewable application" means an application for a federal grant that is not an
297     exempt application.
298          (b) The department shall establish a committee consisting of:
299          (i) the executive director, or the executive director's designee;
300          (ii) two representatives of the department, appointed by the executive director; and
301          (iii) three representatives of local health departments, appointed by all local health
302     departments.
303          (c) The committee shall:
304          (i) evaluate[:]

305          [(A)] the allocation of public health resources between the department and local health
306     departments including whether funds allocated by contract were allocated in accordance with
307     the formula described in Section 26A-1-116; [and]
308          [(B)] (ii) evaluate policies and rules that affect local health departments in accordance
309     with Subsection (3)(g);
310          [(ii)] (iii) consider department policy and rule changes proposed by the department or
311     local health departments;
312          [(iii)] (iv) establish criteria by which an application for a federal grant may be judged
313     to determine whether it should be exempt from the requirements under Subsection (3)(d); and
314          [(iv)] (v) establish criteria by which an application for a federal grant may be judged to
315     determine whether committee review under Subsection (3)(d)(i) should be delayed until after
316     the application is submitted because the application is required to be submitted under a
317     timetable that makes committee review before it is submitted impracticable if the submission
318     deadline is to be met.
319          (d) (i) The committee shall review the goals and budget for each reviewable
320     application:
321          (A) before the application is submitted, except for an expedited application; and
322          (B) for an expedited application, after the application is submitted but before funds
323     from the federal grant for which the application was submitted are disbursed or encumbered.
324          (ii) Funds from a federal grant under a reviewable application may not be disbursed or
325     encumbered before the goals and budget for the federal grant are established by:
326          (A) a two-thirds vote of the committee, following the committee review under
327     Subsection (3)(d)(i); or
328          (B) if two-thirds of the committee cannot agree on the goals and budget, the chair of
329     the health advisory council, after consultation with the committee in a manner that the
330     committee determines.
331          (e) An exempt application is exempt from the requirements of Subsection (3)(d).
332          (f) The department may use money from a federal grant to pay administrative costs
333     incurred in implementing this Subsection (3).
334          (g) When evaluating a policy or rule that affects a local health department, the
335     committee shall determine:

336          (i) whether the department has the authority to promulgate the policy or rule;
337          (ii) an estimate of the cost a local health department will bear to comply with the policy
338     or rule;
339          (iii) whether there is any funding provided to a local health department to implement
340     the policy or rule; and
341          (iv) whether the policy or rule is still needed.
342          (h) Before November 1 of each year, the department shall provide a report to the
343     Administrative Rules Review and General Oversight Committee regarding the determinations
344     made under Subsection (3)(g).