HomeMy WebLinkAbout2021-04-13 - AGENDA REPORTS - LOCAL PUBLIC HEALTH DEPT STUDY (2)Agenda Item: 12
CITY OF SANTA CLARITA
' AGENDA REPORT
UNFINISHED BUSINESS Ai
CITY MANAGER APPROVAL: A -Ai 1,
DATE: April 13, 2021
SUBJECT: REVIEW AND DISCUSSION OF AN ANALYSIS RELATED TO THE
FEASIBILITY OF FORMING A LOCAL PUBLIC HEALTH
DEPARTMENT
DEPARTMENT: City Manager's Office
PRESENTER: Jerrid McKenna
RECOMMENDED ACTION
City Council review and discuss the analysis, developed by Management Partners, related to the
feasibility of forming a local public health department.
BACKGROUND
Since the beginning of the pandemic in March 2020, the Los Angeles County Department of
Public Health (DPH) has issued blanket restrictions that have applied to many different
communities, which have been dissimilarly impacted by the COVID-19 Pandemic (Pandemic).
With the disruption caused to the local economy by these restrictions, the City Council
authorized $25,000 to hire a firm to evaluate the potential for establishing a local public health
department at the September 22, 2020, regular City Council meeting. A contract for this service
was executed with Management Partners on December 17, 2020.
Management Partners reviewed more than 25 sources of information ranging from City of Santa
Clarita (City) specific COVID-19 case rates to Los Angeles County (County) financial
documents to better understand the funding needed to provide public health services. As part of
this research, Management Partners also viewed hours of Council meetings and conducted a
comprehensive review of California codes and statutes.
Conclusion
After researching recent case studies and careful consideration of the available options,
Management Partners concludes, "We do not find that there is a compelling case to change the
basic structure of public health regulation. This is due to the expense and complexities that
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would arise and doubts about how much local control is possible given the state's authority in
controlling and regulating public health responses, as well as the regional and even statewide
nature of many such issues." (page 17)
The full report completed by Management Partners is attached to this item for review, in
addition, a summary of key findings from their analysis that has been included in the staff report
below.
Key Findings
City staff reviewed the analysis and has provided the following key findings:
Public Health in California
Statutes regarding public health services are found in the Health and Safety Code,
Government Code, Penal Code, and Code of Regulations. According to the Health and
Safety Code, the California Department of Public Health has statewide authority during
times of emergency, such as the most recent COVID-19 Pandemic. Meaning, during
these times, local or county regulations are superseded by the State. Furthermore, public
health services are most commonly provided by county governments in California. Only
three cities in the state have their own public health department: Long Beach, Pasadena,
and Berkeley. (pages 4-5)
About Los Angeles County DPH
The Los Angeles County DPH is one of the largest organizations in the United States,
serving 85 cities and over 100 unique unincorporated areas. A majority of funding for
operations comes from state, federal, or other governmental agencies (46.3 percent).
DPH's total budget for Fiscal Year 2020/21 was $1.2 billion, which equates to a per
capita cost of $128.32. (page 6)
DPH Services in Santa Clarita
The City has contracted with the County for these services since incorporation in 1987.
The City does not pay directly for these services, rather the funding is derived from
residents' property tax to pay for general pooled County services. The most recent
contract was signed in 2018 and is effective through June 30, 2023. (page 6)
COVID-19
Throughout the Pandemic, the City has experienced a more positive outcome (fewer
cases and deaths) than the County as a whole and when compared to other individual
communities in the County. However, health care restrictions have been imposed
Countywide, causing significant disruption to the local economy. (page 7)
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Table 2. Santa Ciarihi and Nearby Cunmumitie!z' Cnranapirus Experienceas cnrrtpared a ith Ln. Angeles County: Afarch 13, 2020 through
December 13, 2020
Forming a Local Health Department
The State's Health and Safety Code requires the City Council to discontinue County
services via resolution or ordinance by March 1 to be effective July 1 of any given year.
The City must also appoint a health officer to enforce public health laws and regulations
and must, at a minimum, provide a list of required basic services:
Table l California Code tf Regulatioli> §1276: Basic Services
Health Department shall offer at least the following basic services to the
health jurisdiction which it serves:
Collection, tabulation and analysis of all public health statistics
Health education programs
Communicable disease control
Services to promote maternal and child health
Environmental health and sanitation service and programs
Laboratory services
Nutrition services
Chronic disease services
Services directed to social factors affecting health
Occupational health services
Family planning services
Public health nursing services
Based on financial information provided by Los Angeles County, Long Beach, Pasadena,
and Berkeley, the City of Santa Clarita could expect ongoing operating costs ranging
from $23.8 - 29.8 million. This does not include start-up costs such as: office space,
capital equipment, supplies, service contracts, technology, training, data security, legal
services, and risk assessment. Impacts on other existing City departments would also
need to be considered (Human Resources, General Services, and Purchasing). (page 13)
The estimated start up costs, according to a recent report conducted by San Dimas -with a
population of only 33,621-could cost somewhere between $60 to $90 million. Based
upon that figure, the City of Santa Clarita's first year costs could exceed $100 million.
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7ahle 1. A Comparison ofLos Angeles County with Other Callfortna ON Pablic Health Departineitts
Los Angeles
County
Long Beach
Health and
Pasadena
erkeley
Health, Housing
Department
Public Health
Human Services
Public Health
and Community
Services
Population January 1, 2020'
10,172,951
472,227
144,942
122,580
Public Health Budget FY 2020-21
$1,226,240,000
$63,367,979'
$15,SS8,271
$54,578,416'
Public Health Staff (FTEs) FY 2020-21
5,206.00
369.19'
98.39
246.182
Estimated Per Capita Cost
128.32'
134.192
107.42
445.25'
Estimates from cotyomia Deportment of Finance
Long Beach's budget excludes S94 million in housing authority costs and related staffing.
'Housing authority functions, costs and staffing could not be identified or separated out -
'Population figures for Long Beach and Pasadena were subtracted from Los Angeles County population (resulting in o County
population figure of 9,555,B92) since those cities have their own health departments and ore not served by Los Angeles County
Options for Consideration
During their research, Management Partners reviewed the four possible options below for
the City of Santa Clarita outlining advantages and drawbacks of each. Options 1 through
3 highlight significant challenges mostly related to cost and coordination of services, with
option 4 being the preferred option at this time. (pages 13-16)
1) Establish a City Public Health Department
2) Partner with Other Cities in the Area (i.e. Lancaster and Palmdale)
3) A Hybrid Model: Contract with County for Some Services (i.e. hire a public
health officer and take over some health services, but coordinate with the County
for other services)
4) Remain with the County System and Lobby for More Local Input
Case Study
Management Partners reviewed the City of Los Angeles' consideration of forming their
own local public health department in 2013. After reviewing a list of significant
challenges ranging from the cost to provide services to duplication and redundant
services, the City of Los Angeles ultimately decided against this option. (page 9)
ALTERNATIVE ACTION
Other action(s) as determined by the City Council.
FISCAL IMPACT
None by this action.
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ATTACHMENTS
Local Health Memo
Health Officers in CA Code 2018 (available in the City Clerk's Reading File)
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Management
Partners 0
To: Mr. Ken Striplin, City Manager, City of Santa Clarita
From: Andrew Belknap, Senior Vice President
Teri Cable, Senior Management Advisor
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Subject: Analysis of Local Public Health Department Options r
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Date: February 25, 2021 Q
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Executive Summary
Management Partners was retained by the City of Santa Clarita to evaluate the potential for
establishing a local public health department and identify options for doing so. City leaders are
interested in obtaining more local control over public health regulations and actions taken in
response to the current COVID-19 pandemic. This issue arose due to concerns that blanket
regulations imposed across all of Los Angeles County were not appropriate for circumstances in
Santa Clarita.
This memorandum presents the results of this analysis. It begins with background information
on the origins of the issue and then explains the existing public health regulatory environment
in California and in Los Angeles County. Next, research on city -based public health systems is
documented. From this, the memorandum moves to a discussion of the requirements for
establishing a public health department, and finally the options the City of Santa Clarita may
pursue to obtain additional local control.
Our analysis concludes that Santa Clarita could develop a local city -based public health
department or partner with other cities in a joint -powers authority. However, our analysis also
concludes that such a step would be fraught with intergovernmental complexity and expense
and would thrust City leaders into difficult choices.
To appreciate the complexity and difficulty of taking on a public health function, it is important
to understand how public health regulation has evolved in California. As California developed
and urbanized, public health functions became more regional and centralized, largely in
response to the fact that communicable diseases do not respect political boundaries.
Today (and before the intense issues associated with COVID-19 exploded in 2020) local public
health services are predominantly provided at the county level, but subject to state oversight via
the California Department of Public Health. In fact, as the COVID-19 emergency has unfolded,
the relevant regulatory authority regulations were initially made by regional health officers in
1730 MADISON ROAD • CINCINNATI, OHIO 45206 • 513 8615400 • FAx 513 8613480 MANAGEMENTPARTNERS.COM
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the Bay Area and then in Los Angeles County on March 16 and March 19, 2020. Shortly
thereafter (on March 21, 2020) a statewide order was issued, and this has continued to be the
overarching regulation although regional components and variations are recognized with the
approval of the State Public Health Officer. There has been some confusion about seemingly
overlapping state/local regulations and, undoubtably, public health regulatory approaches will
be debated and possibly revised based on experiences with COVID-19.
There are several ways Santa Clarita can gain more local control over public health functions
and they are described in more detail in this memorandum. They range from establishing a full
local public health function, to sub -regional approaches, to providing for more local input at the
county level. However, other than providing more local control, these alternative approaches
do not offer clear improvements; but would add costs and responsibilities to the City of Santa
Clarita's portfolio.
The desire for local control is understandable and Santa Clarita would bring benefit from
tailoring programs and regulations to local circumstances. The Los Angeles County Department
of Public Health is, after all, one of the largest such organizations in the United States, with a
diverse mixture of affected jurisdictions. With such a large organization, even sub -regional
variations present a challenge.
Perhaps the most prominent realization surfaced from this analysis is that true local control of
public health may be something of a mirage. Under current law the State of California has the
final say about health -related issues and based on experience during the current COVID-19
emergency, state leaders exercise this power in the interest of the entire state.
Background
Introduction
The County of Los Angeles (County) provides public health services to the City of Santa Clarita.
As part of the County system, the City is required to follow guidelines and restrictions issued
by the County Department of Public Health (DPH). Recent public health orders issued by the
DPH in response to the COVID-19 pandemic have resulted in operational restrictions that have
seriously impacted many of the County's and City's businesses. This has resulted in job losses
and substantial economic loss.
Los Angeles County is the largest county (by population) in the United States. DPH is also a
large system, providing public health services to 85 cities and over 100 unique unincorporated
areas. Because of its size, the County public health system includes many different
neighborhoods and communities that have been dissimilarly impacted by the COVID-19
pandemic. However, the County has issued guidelines and restrictions based on the statistics,
including the number of cases and resulting deaths of the County as a whole.
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These restrictions have been in effect since early 2020. Most recently, in November 2020 the
County issued a closure order for all restaurants to stop the spread of the virus. The restaurant
industry, which has been devastated by various orders and shutdowns, challenged the order
based on the lack of health data supporting the decision.
The City filed an amicus brief in support of the lawsuit. Judge James Chalfant who adjudicated
the case issued a favorable decision to the plaintiffs, requiring Los Angeles County to provide
scientific evidence to justify extending its orders. The County is appealing that decision.
The decision had limited practical effect in that the Governor issued a stay-at-home order that
became effective on December 6, 2020, which took precedent over the court's decision and
included a closure order for restaurants. The state's decision is being challenged in a separate
court case filed in federal court by some of the same plaintiffs involved in the County lawsuit.
As this memorandum was being finalized in late January 2021 the state lifted its stay-at-home
order and allowed some outdoor dining and personnel care businesses to reopen with limited
occupancies. Los Angeles, like most California counties, aligned current regulations with the
state's latest order and essentially continued guidance and restrictions in accordance with the
most restrictive "purple" tier of the COVID-19 statewide regional regulations.
Due to its lower rate of COVID-19, Santa Clarita leaders are interested in looking at options for
providing its own health services and establishing a local public health department or
partnering with other cities. This report provides a high-level review of the requirements,
funding estimates and factors for consideration by the City.
Project Approach
In completing this analysis, Management Partners reviewed City databases and documents,
budget documents and reports from other jurisdictions, industry reports, health codes, and
viewed various City Council meetings. These are discussed below.
Document Review
To begin this assignment, Management Partners reviewed databases, contracts, correspondence,
City ordinances related to the COVID-19 pandemic. Samples of the documents include:
• City tracking of COVID-19 positive cases rates,
• Contracts with the County for health care,
• Memorandum of Understanding with the County to dispense medical countermeasures,
• City's 2020 correspondence to Governor and to the Board of Supervisors,
• Santa Clarita Municipal Code Title 9: Health and Safety,
• Los Angeles County Code Title 11: Health and Safety,
• City's Agenda report dated September 22, 2020, and
• Payments made to Los Angeles County for public health services.
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Similarly, we reviewed documents from other cities and the County related to the curreht
pandemic, analyses on establishing a separate health department and state statutes that apply to
public health requirements. Samples of the documents reviewed include:
• Los Angeles County COVID-19 data;
• Websites and public health servicesibudgets for Los Angeles County, and the cities of
Long Beach, Pasadena, Berkeley and Vernon;
• Health and Safety Code and California Code of Regulations statutes related to public
health;
• Health Officers in the California Code document;
• City of Los Angeles memorandum titled "Costs, Timeline, and Funding Necessary to create
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a City Public Health Department;"
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• County of Los Angeles Public Health memorandum titled "Impact of City of Los Angeles
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Public Health Protection Act,"
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• City of Beverly Hills report titled "Explore Creating City Public Health Department;"
• Authority and Responsibility of Local Health Officers and Emergencies and Disasters;
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• California State and Local COVID-19 Orders authored by Pillsbury Law;
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• Judge Chalfant's ruling in case titled California Restaurant Owners, Inc./Mark's Engine
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Company No. 28 Restaurant, LLC vs. County of Lost Angeles County of Public Health,
heard in December 2020;
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• Los Angeles County and Alameda County Municipal Service Reviews;
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• California Public Health and Emergency Medical Powers (chapter in California Public
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Health and Emergency Medical Operations Manual 2018-2019; and
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• News articles on Los Angeles County's handling of the pandemic.
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Council Meetings
We are viewed the following City Council meetings and presentations:
• Santa Clarita City Council meeting held on December 22, 2020;
• Former Mayor's Smyth's presentation to the community on December 7, 2020;
• Mayor Miranda's presentation to the community on December 18, 2020;
• Los Angeles City Council meeting dated June 19, 2013; and
• City of Beverly Hills Council meeting dated December 8, 2020.
How Public Health Services are Provided in California
Authority
Statutes regarding public health services are found through various California codes, including
the Health and Safety Code (HSC), Government Code (GC), Penal Code (PC) and Code of
Regulations (CR).
The California Department of Public Health (CDPH) is part of the California Health and
Human Services Agency. CDPH's fundamental responsibilities include infectious disease
control and prevention (such as the coronavirus), food safety, environmental health, laboratory
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services, patient safety, emergency preparedness, chronic disease prevention and health
promotion, family health, health equity, and vital records and statistics. The department has
statewide authority during times of emergency and may take the necessary action to protect
and preserve public health.
HSC § 131080 reads:
The department may advise local authorities and when in its judgement the public health is
menaced, it shall control and regulate their action.
Notwithstanding the state's authority, the responsibility for day-to-day public health lies with F
the local governing body. J
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HSC § 101450 reads as follows: z
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The government body of a city shall take measures necessary to preserve and protect the public z
health, including the regulation of sanitary matters in the city, and including if indicated, the w
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adoption of ordinance, regulations and orders not in conflict with general laws.
Current Practice
Even though cities have the authority by statute, public health services are most commonly
provided by county governments in California. Most cities have delegated this authority and
entered into an agreement with their county to provide these services.
Los Angeles County has a fully developed public health system, operating 14 public health
centers in the County. The two closest to Santa Clarita are in Lancaster and Pacoima.
Based on a report provided by the Auditor Controller of the County, Santa Clarita has not paid
anything directly to the County for its public health services in the last 12 years. However, Santa
Clarita residents and property owners pay indirectly for these services. Revenues to fund
County health services come in large part from the County's general fund, which is largely
derived from property taxes paid by property owners in Santa Clarita and from other
incorporated and unincorporated areas in Los Angeles County. In addition, the State provides
significant funding for health services, derived primarily from income taxes paid by residents of
the State, including those from Santa Clarita. All public health services (expenditures) have
been provided by the County.
Only three cities in the state provide their own health departments: Long Beach and Pasadena
in Los Angeles County and Berkeley in Alameda County.' These city health departments all
came into being in the late 1800s when the cities were originally incorporated. Until
approximately 1920, it was common for cities to have anindependent health department
function. The move to more regional county -based systems began after the flu pandemic of
1918-1919.Over time most cities relied on a county health department. The majority of the 482
cities in California incorporated after 1920 and have never operated a public health function.
'Vernon, in Los Angeles County, also has its own health department, but focuses on providing environmental health
services. Vernon's total population is fewer than 300 residents.
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Table 1 below shows a comparison of populations served and the budgets of these three
departments compared with Los Angeles County.
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Table 1. A Comparison of Los Angeles County with Other California City Public Health Departments
Los Angeles
County
Long Beach
Pasadena
Berkeley
Health and
Health, Housing
Department
Public Health
Human Services
Public Health
and Community
Services
Population January 1, 20201
10,172,951
472,217
144,842
122,580
Public Health Budget FY 2020-21
$1,226,240,000
$63,367,978'
$15,558,271
$54,578,4163
Public Health Staff (FTEs) FY 2020-21
5,206.00
369.182
98.38
246.183
Estimated Per Capita Cost
128.324
134.192
107.42
445.253
!Estimates from California Department of Finance
'Long Beach's budget excludes $94 million in housing authority costs and related staffing.
'Housing authority functions, costs and staffing could not be identified or separated out.
4Population figures for Long Beach and Pasadena were subtracted from Los Angeles County population (resulting in a County
population figure of 9,555,892) since those cities have their own health departments and are not served by Los Angeles County
Public Health Services in Santa Clarita
Santa Clarita has contracted with the County for health services since its inception and in 1998
adopted the County's latest public health codes. The most recent contract was signed in 2018
and will be effective through June 30, 2023. The City has the right to cancel this agreement with
the County effective July 1 of any year with 30 days prior written notice.
Further, a Memorandum of Understanding with the County for dispensing of medical
countermeasures, such as vaccines, during major public health emergencies was signed in 2018
and will be effective for ten years (until January 1, 2028). This agreement can be cancelled by the
City with 60 days prior written notice.
During the current pandemic, City officials have expressed their concerns in letters to the
Governor and to the Board of Supervisors about directives from the state and from the County
Department of Public Health, citing their broad impacts on the City's businesses.
• In May 2020 City leaders requested that the north county cities of Santa Clarita, along
with Lancaster and Palmdale, be allowed to reopen due to their lower incidents of cases
and death.
In November 2020 with the closures of indoor malls and outdoor dining, City leaders
objected to the County's directives which were stricter than state requirements. The
City's objection about prohibiting outdoor dining was based on the lack of science and
data. This was challenged, and as noted above, eventually this dispute ended up in
court.
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Effective December 6, 2020, state officials issued a stay-at-home order that included the closure
of restaurants, including those with outdoor dining. A separate legal challenge to the state's
closure has been filed. As of mid -January 2021, all restaurants in the region are prohibited from
serving or seating patrons outdoors and are restricted to offering food and beverages via
takeout, drive -through, or delivery.
COVID-19 Experience in Santa Clarita
Santa Clarita staff has tracked the City's cases since the pandemic began in March 2020 and
based on the data the City has experienced a more positive outcome (fewer cases and deaths)
than the County as a whole. (Differences are thought to be based on several factors, including
income, education, housing density and types of businesses.) However, health care restrictions
have been imposed countywide.
Figure 1 below shows the City of Santa Clarita's experience during the last nine months
compared with the County of Los Angeles. In general, the number of cases and deaths in the
City have been less than in the County. However, the graph also shows that recently cases and
deaths have risen dramatically.
Figure 1. Los Angeles County and City of Santa Clarita COVID-19 Adjusted Positive Case Rate per
100,000 population
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6,000
5,000
4,000
3,000
2,000
1,000
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3/13/2020 4/13/2020 5/13/2020 6/13/2020 7/13/2020 8/13/2020 9/13/2020 10/13/2020 11/13/2020 12/13/2020
COVID-19 Experience in Lancaster, Palmdale, and Nearby Communities
Leaders in the nearby communities of Lancaster and Palmdale have also floated the idea of
separating from the County system and partnering with Santa Clarita. Both cities, however,
have experienced higher rates of adjusted case and death rates from the virus than the County
as a whole. Statistics in the Castaic, Stevenson Ranch and Val Verde neighborhoods adjacent to
Santa Clarita have been more positive. Table 2 below shows the adjusted case and death rates
reported by the County in these areas.
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Research Conducted in Other Cities
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The City of Los Angeles considered forming its own department in 2013. Los Angeles, with 40%
of the County's population evaluated the formation of a city health department resulting from a
public referendum sponsored by the AIDS Healthcare Foundation. Proponents claimed that the
DPH was unprepared for a major public health emergency and that the City did not receive its
fair share of public health dollars spent. This triggered an in-depth analysis by the city, as well
as by the County of Los Angeles.
As part of that evaluation, the city and county administrative offices identified the following
challenges:
• The cost of public health services could likely require the City of Los Angeles to allocate
general fund revenues and during lean times, reduce other city services to pay for
services.
• Supplemental sources of revenue in addition to monies allocated based on city
population, (particularly grants) would be difficult for a city to obtain. Many of them are
competitive or specified for a county.
• Close coordination between the city and county would be needed. Delays and the
complexity in managing cross -jurisdictional disease investigations could result in
inefficient use of resources and delays in emergency preparedness.
• Having a city department would result in a duplication of administrative infrastructure
and fragmented or redundant services.
• The least senior and inexperienced staff would be laid off from the county and would be
available to be hired by the city.
• Smaller departments like Pasadena and Long Beach provide a more limited scope of
services than the county.
• The loss of revenue from the city could cause the county to constrict its mission and
services.
The City Council ultimately decided against establishing its own health department.
Because of the current pandemic, several Los Angeles County cities are exploring the option of
an independent health department or a joint operation with other cities. Based on media
reports, West Covina, several cities in the San Gabriel Valley area, Lancaster, Palmdale, South
Bay cities and Beverly Hills all have concerns with the shutdowns and their effects on their
business communities. The results of those investigations are unknown at this time.
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Services and Funding of Public Health Departments in Los Angeles County
Management Partners took a closer look at the public health services already provided in the
Los Angeles County area. We reviewed the budgets of the three local agencies, Los Angeles
County, Pasadena, and Long Beach, the services provided by each, along with revenue and
expenditure data. A summary of each budget is shown in Attachments A, B and C.
While these jurisdictions vary in organizational structure, there are substantial similarities in the
services provided and funding sources which may serve to provide insight to Santa Clarita
leaders as they consider their options. Mandated services required by the state are provided as
well as services identified by the governing body as needed in the community. Some budget
highlights of the three departments are shown below.
Los Angeles County's FY 2020-21 budget:
• Total budgeted public health expenditures are $1.2 billion.
• Net county costs are $222.2 million or 18.1% of the public health budget.
• Funds from state, federal and other governmental agencies provide a substantial portion
(46.3%) of funding for the County's public health services.
Pasadena's FY 2020-21 budget:
• Total budgeted public health expenditures are $15.6 million.
• Minimal funding (5.8%) from other sources (which may include the general fund) is
allocated for public health.
• The majority of funding (69.8%) comes from intergovernmental revenues. Licensing and
permit revenues provide 13.7% of the Health Department's funding.
Long Beach's FY 2019-20 budget:
• Long Beach combines its public health services with its housing and human services for
a total budget of $153.4 million.
• Total budgeted public health expenditures are $59.7 million.
• Funds from other agencies provide $37 million (65%) in public health revenues out of a
total of $56.7 million in public health revenue.
• Total department expenditures exceed revenues by $4.4 million. Presumably, the City
has reserves or will allocate general fund revenues to balance its budget.
Requirements and Responsibilities of Establishing a Department
Even though counties provide the majority of health care services as discussed above, cities are
charged with the responsibility, and may establish their own department. If they do, they must
follow state requirements. These requirements are briefly summarized below.
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Appointment of a Health Officer
Each city must appoint a health officer (although this function can be contracted to the county).
HSC § 101460 reads:
Every government body of a city shall appoint a health officer, except when the city has made
other arrangement as specified in this code, for the county to exercise the same powers and duties
within the city, as are conferred upon city health officers by law.
The local health officer is delegated the responsibility for enforcement of public health laws and
regulations.
HSC § 101470 reads:
Each city health officer shall enforce and observe all of the following:
(a) Order and ordinance of the government body of the city pertaining to the public health.
(b) Orders, quarantine and other regulations, concerning the public health prescribed by the
department. z
(c) Statutes relating to the public health.
The health officer must be a physician in good standing. Immediately following an
appointment, the city must notify the California Department of Public Health.
CCR § 1300 reads:
The health officer shall be a graduate of a medical school of good standing and repute and shall be
eligible for a license to practice medicine and surgery in the State of California; provided however
that those health officers on a full-time basis as of September 19, 1947, shall be considered as
meeting the requirements of this section.
HSC § 101465 reads:
Immediately after the appointment of a city health officer the governing body shall notify the
director of the appointment and the name and address of the appointee.
Duties of the Public Health Officer
Health officers have many responsibilities as identified in the various codes that make up
California's statutes. In 2018 the California Health Officers Association updated a reference
document titled "Health Officers in the California Code", which lists the various responsibilities
(submitted to the City under separate cover). The document identifies the code reference for
each responsibility and further categorizes each into one of nine categories:
1. Duty
2. Reporting
3. Consultation
4. Collaboration
5. Authority
6. Approval
2 Department in this context refers to the State Department of Public Health
Packet Pg. M
12.a
Analysis of Local Public Health Department Options
7. Emergency Power
8. Definition
9. Clarification
Page 12
Required Health Services
Basic services required of public health departments are outlined below in Table 3. Added
detail on these services is found in section 1276 of the California Code of Regulations (CCR) and
shown in the Appendix. Health departments are required to provide the basic services listed in
the CCR, but may offer additional, non -mandated services as needed in the community.
Table 3. California Code of Regulations §1276: Basic Services
DepartmentHealth
health jurisdiction which it serves:
Collection, tabulation and analysis of all public health statistics
Health education programs
Communicable disease control
Services to promote maternal and child health
Environmental health and sanitation service and programs
Laboratory services
Nutrition services
Chronic disease services
Services directed to social factors affecting health
Occupational health services
Family planning services
Public health nursing services
Timing of Decision
The decision to have the County provide health care services in a city or to discontinue those
services must be done by resolution or ordinance of the city. The section below addresses the
timing of those decisions, which essentially requires a council decision by March 1 of any year,
with the service change to become effective the following July 1.
HSC § 101380 reads:
The resolution or ordinance shall be adopted and a certified copy served on the clerk of the board
of supervisors on or before the first day of March of any year, and the services of the county health
officer in the city shall commence on the first day of July following service of notice. The services
shall continue indefinitely until the governing body of the city terminates them by adoption of a
resolution and ordinance and service of a certified copy on the clerk of the board of supervisors on
or before the first day of March of any subsequent year. The services of the county health officer
shall terminate on the first day of July following service of notice.
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Page 13
This essentially means that the earliest date Santa Clarita could have its own health officer
would be July 1, 2021. This would require the City to complete its investigations and adopt and
deliver a resolution/ordinance to the Board of Supervisors by March 1, 2021. This is a longer
notice period than required under the City's current contract with the County.
Options for Consideration by Santa Clarita
Management Partners has identified four options for leaders in the City of Santa Clarita to
consider in providing public health care services. Three of these options would allow greater
decision -making authority over public health activities. These options are:
1. Establishing a city health department
2. Partnering with other cities through a joint powers authority or other partnership
arrangement
3. Establishing a hybrid model; appointing a local health officer and contracting for other
public health services
4. Maintain the current contracting arrangement with the County, but lobby for more local
input.
Option 1. Establishing a City Public Health Department
Although the cost of establishing a new City Public Health Department would require
additional evaluation, using the per population costs identified above for the three departments
located in the Los Angeles County area will provide a usable estimate. Based on Table 1 above,
the City could expect ongoing operating costs ranging from $107.42 (Pasadena's estimated per
capita cost) to $134.19 (Long Beach's estimated per capita cost) per person. Based on the City's
population of 221,932 (as of January 1, 2020) estimated annual costs would range from $23.8
million to $29.8 million.
This estimate does not include start-up costs such as:
• Acquisition of laboratory and office space, capital equipment, supplies, service contracts
and information technology.
• Training and associated costs to comply with the Health Insurance Portability and
Accountability Act regulations, the national standard for privacy and protected health
information.
• Data security, legal liability and risk costs.
Impacts on other city departments (Human Resources, the City Attorney's Office, Risk
Management, General Services, Purchasing) would also need to be considered. These could be
substantial and may result in the need for additional staff in those departments.
Advantages
With a city health department, Santa Clarita would have local control to make public
health guidance and set regulations within City boundaries. This would allow the City
to gather, review and assess the public health data and determine its own strategies for
Packet Pg. 187
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Analysis of Local Public Health Department Options
Page 14
addressing issues. Arguably, this would allow the City to better tailor its public health
programs to the needs of the Santa Clarita community.
Drawbacks
1. Decisions made at the local level can be overruled by directives from the California
Department of Public Health. We have seen this occur during the COVID-19 pandemic,
when Pasadena's restaurants were shut down by the Governors' order effective
December 6, 2020.
2. While making health -related decisions at the local level is the primary advantage, these
decisions can be difficult and controversial, especially when decisions affect both public
health and the concerns of businesses, both of which are critical to the public and their
well-being.
3. Providing public health services will require ongoing coordination with the other public
health agencies, as health is not a municipal issue that stops at city boundaries.
4. Health care can be costly, which may require other municipal services to be reduced to
balance the budget. Further, health care costs often rise in excess of consumer price
indices that governments rely on to estimate their expenditures.
5. Establishing a city health department will be a duplication of available local services.
The County has already planned, staffed, and implemented public health programs that
serve the Santa Clarita community.
6. Similarly, the County is more experienced, has greater expertise and more established
linkages with other health care providers than the City is likely to have (at least initially)
in providing public health services. In an emergency, such as a pandemic, this could be
important for sound decision making.
7. It will require substantial effort to establish a local health department. This includes
developing job descriptions, hiring staff, securing facilities, ordering supplies and capital
equipment, setting fees for services, contracting for ancillary services, and designing/
implementing new programs.
8. As a smaller public health operation, the City is likely to have less purchasing power
and economies of scale than those available to the County.
The City is less likely to be competitive for grants than other, more experienced
departments.
Option 2. Partnering with Other Cities in the Area
Other cities in the area, specifically Lancaster and Palmdale, have expressed an interest in
forming their own health departments or forming a multi -city department with Santa Clarita.
The three cities could establish a Joint Powers Authority (JPA) or similar partnership
arrangement to form a health department separate from the County. The JPA could be
expanded initially or later to include other cities.
Packet Pg. 188
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Analysis of Local Public Health Department Options
Page 15
Similarly, the City could partner, contract, or form a JPA with a city that has its own public
health department. The closest one in proximity to Santa Clarita is Pasadena.
For the most part the advantages and drawbacks to this approach are similar to Option 1,
however a few potential differences are noted below.
Advantages
Relative to a stand-alone system, there may be cost advantages with shared costs and
economies of scale.
Drawbacks
Decision making can be difficult in a regional JPA as perspectives and community
needs vary. Cities may experience health care differently, a circumstance that could
lead to conflicts and different priorities in decision making. This could be the case
with any combination of cities.
2. Palmdale and Lancaster are located close to each other but 37 and 44 miles from Santa
Clarita, respectively. Pasadena is 32 miles away. Location of convenient health care
clinics/facilities for all JPA members may be an issue.
3. Health care can be costly and during period of economic hardship, may require other
municipal services to be reduced to balance the budget. This could lead to differences
between members in desired service levels and the ability/priority to fund the JPA.
A similar, but related alternative would be the establishment of a Santa Clarita Valley area
health department that includes neighboring communities such as Castaic, Stevenson Ranch,
Val Verde, and Newhall Ranch. However, since these are unincorporated County areas, it
would likely be difficult to obtain approval from the County to contract public health services to
a new health department.
Option 3. A Hybrid Model: Contract with the County for Some Public Health Services
The City may wish to hire its own health officer, but contract some or all remaining public
health services. The Health and Safety Code provision below appears to allow a city to contract
with the County for some or all public health functions.
HSC § 101400 reads:
The board of supervisors may contract with a city in the county and the governing body of a city
may contract with the county for the performance by health officers or other county employees of
any or all enforcement functions within the city related to ordinances of public health and
sanitation and all inspections and other related functions.
A hybrid model would allow the City of Santa Clarita to make its health care decisions and still
contract with the County of Los Angeles to perform some (but not all) of the public health
functions it currently provides. It is unclear how this would be received by the County, as this
model does not currently exist with any other city in Los Angeles County.
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Page 16
Advantages
1. With a city health officer, Santa Clarita would have some control over public health
decisions and regulations within city boundaries. This would allow the City to gather,
review and assess public health data and determine its own strategies for addressing the
issues.
2. The County would likely be amenable to continue providing the majority of public
health services through a revised contract with the City.
3. The cost of this approach would likely be less than for Options 1 or 2.
Drawbacks
1. Decisions made by the city's health officer can be overruled by state directives from the
California Department of Public Health.
2. While making health -related decisions at the local level is the primary advantage, these
decisions can be difficult and controversial, especially when they affect both public
health and the concerns of businesses, both of which are critical to the public and their
well-being.
3. Having a city health officer will require ongoing coordination with the other public
health agencies, as health is not a municipal issue that stops at city boundaries.
4. Hiring a city health officer and support staff may be costly and will likely be a general
fund expense. The community health officer in Long Beach has responsibility for public
health emergency management and is budgeted at $1.2 million per year.
5. This option may provide less meaningful local control than Options 1 and 2.
Option 4. Remain with the County System and Lobby for More Local Input
City leaders can decide to remain with the County public health system, and address the
concerns of the business community by looking at alternative ways to assist affected businesses.
This is similar to actions the City has already taken in advocating for a more nuanced approach
to regulation. These actions could include:
Suggesting that County DPH establish regional zones or districts for regulatory
purposes when there are verifiable regional differences within the County with respect
to required public health regulations.
Providing funds for additional low-cost business loans or grants.
Lobbying the County Board of Supervisors for more input in public health decision
making, potentially via a subcommittee of local city officials.
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12.a
Analysis of Local Public Health Department Options
Conclusion
Page 17
This analysis provides an overview of the public health system in California and in Los Angeles
County and the possible steps Santa Clarita leaders might consider to gain more local control in
decisions about public health issues. These options include creating a local public health
department, forming a regional JPA to serve multiple cities, or working with County and state
officials to have greater input in decision making.
We do not find that there is a compelling case to change the basic structure of public health
regulation. This is due to the expense and complexities that would arise and doubts about how
much local control is possible given the state's authority in controlling and regulating public
health responses, as well as the regional and even statewide nature of many such issues.
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12.a
Analysis of Local Public Health Department Options
Attachment A —County of Los Angeles Department of Public Health
Page 18
Services Provided
The County Department of Public Health provides an array of public health services to the
community. The department's services are provided in the following areas:
1. Communicable Disease Control and Prevention
a. Acute communicable disease control
b. Tuberculosis control
c. Immunization,
d. Veterinary public health
e. Public health laboratory
2. Health Protection and Promotion
a. Environmental health
b. Community health services
3. Substance Abuse Prevention and Control
4. Children's Medical Services
a. California children's services program
b. Child health and disability prevention program
c. Child welfare public nursing
5. Division of HIV and STD Programs
a. Overall response to HIV and STD infections
6. Antelope Valley Rehabilitation Centers
a. Residential recovery and medical rehabilitation services to alcohol or
drug dependent individuals
7. Administration
a. Support and oversight of department operations
Los Angeles County's FY Z020-21 public health revenues are shown below in Table 4. It shows
that money from state, federal and other governmental agencies provide a substantial portion
(46.3%) of funding for the County's public health services. Net county costs are $222.2 million or
18.1% of the public health budget.
Table 4. County of Los Angeles Department of Public Health Revenues
for FY 2020-21
Federal grants and aid
BudgetRevenues
$226,272,000
18.5%
State aid
$339,689,000
27.7%
Other governmental agencies
$772,000
0.1%
License and permits
$737,000
0.1%
Institutional care
$202,132,000
16.5%
Packet Pg. 192
12.a
Analysis of Local Public Health Department Options
Revenues for FY 2020-21
Charges for services
Budget
$364,000
Percent of Total
0.0%1
Other revenues
$139,579,000
11.4%
Total Public Health Revenues
$909,545,000
74.2%
Intrafund Transfers
$94,450,000
7.7%
Net County Cost to balance
$222,245,000
18.1%
TOTAL
$1,226,240,000
100.0%
Page 19
Less tnan .i% N
Expenditures �
a
In FY 2020-21, Los Angeles County's budgeted expenditures for the Public Health Department Z
are shown in Table 5 below.
Table 5. County of Los Angeles Department of Public Health Expenditures
.•
Communicable Disease Control and Prevention
.• et (in thousands)
$72,552,000
Percent of Total
5.9%
Health Protection and Promotion
$482,853,000
39.4%
Substance Abuse Prevention and Control
$353,341,000
28.8°%
Children's Medical Services
$160,997,000
13.1%
Division of HIV and STD Programs
$94,513,000
7.7%
Antelope Valley Rehab. Centers
$3,476,000
0.3%
Administration
$58,508,000
4.8%
TOTAL
$1,226,240,000
100.0%
Packet Pg. 193
12.a
Analysis of Local Public Health Department Options Page 20
Attachment B—Pasadena Public Health Department
Services Provided
The Pasadena Public Health Department provides public health services to its community with
a population of 144,842. Pasadena is a smaller city than Santa Clarita, but closer in size than
other local departments. The department services are separated into the following areas:
1.
Community Health Services
a.
Maternal, child and adolescent health
b.
Travel clinic
c.
Child health and disability prevention
d.
Disease prevention and control
e.
Lead poisoning prevention
f.
Other related services
2.
Environmental Health
a.
Food protection
b.
Recreational health
c.
Body art
d.
Vector control
e.
Other related services
3.
Health Administration
a.
Medi-Cal administration
b.
HR/payroll
c.
Accounts receivable
d.
Vital records
e.
Budget development and oversight
f.
Other administrative services
4.
Prevention and Policy Programs
a.
Tobacco prevention and control
b.
Nutrition education and obesity prevention
c.
Women, infant and children
d.
Other related services
5.
Social
and Mental Health Services
a.
Substance abuse
b.
HIV surveillance
c.
HIV testing and counseling
d.
Grants for homeless individuals
e.
DMH transitional aged youth
f.
Other related services
_""o __
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Page 21
Pasadena's FY 2020-21 public health revenues are shown below in Table 6. The table shows that
most funding (69.8%) for Pasadena's public health services comes from intergovernmental
revenues. Minimal funding (5.8%) from other sources is allocated for public health.
Table 6. City of Pasadena Public Health Department Revenues
for FY 2020-21
License and permits
Budget'Revenues
$2,131,000
13.7%
Intergovernmental revenue
$10,852,000
69.8%
Charges for services
$607,000
3.9%
Other
$1, 064,000
6.8%
Total Public Health Revenues'
$14,655,000
94.2%
Balance
$903,000
5.8%
TOTAL REVENUES
i
$15,558,000
100.0%
Rounded to nearest thousand
2Includes $38,000 from Homeland Security grant
3Presumably, balance comes from general fund
Expenditures
Pasadena's budgeted expenditures for the Public Health Department during FY 2020-21 are
shown in Table 7 below.
Table 7. City of Pasadena Public Health Department Expenditures
.•
Community Health Services
.• et'
$2,587,000
Percent of Total
16.6%
Environmental Health
$2,211,000
14.2%
Health Administration
$3,967,000
25.5%
Prevention and Policy Programs
$4,743,000
30.5%
Social and Mental Health Services
$2,050,000
13.2%
TOTAL
$15,558,000
100.0%
wunueu tO nearest thousand
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Analysis of Local Public Health Department Options Page 22
Attachment C—Long Beach Department of Health and Human Services
Services Provided
The Long Beach Department of Health and Human Services provides public health, housing
and related human services to its community with a population of 472,217, which is
approximately twice the size of Santa Clarita. The department's services are separated into the
following areas:
1. Physician Services
a. Clinical services
b. Laboratory services
2. Community Health Officer
a. Public health emergency management
3. Environmental Health
a. Environmental health operations
4. Community Health
a. Nutrition services
b. Nursing services
c. Chronic disease and injury prevention
5. Collective Impact and Operations
a. Financial
b. Administrative operations
c. Office of equity
6. Human Services
a. Homeless services
b. Community impact
7. Housing Authority
a. Operations
b. Administrative
Revenues
Long Beach combines its public health services with its housing and human services. The most
recent detail available is for FY 2019-20. Table 8 below shows total revenues of $153.4 million.
Of that, total public health revenues are $56.7 million.
Public health revenues received from other agencies total $37 million. This equates to 65% of
total public health revenues (and 24.1% of total department revenues). Taxes and licenses and
permits contribute 5.3% and 3.1% of total department revenue, respectively.
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Table 8. City of Long Beach, Department of Health and Human Services Revenues
Revenues for FY 2019-20
License and permits
.• t
$4,683,245
Percent of Total
3.1%
Revenue from other agencies (excluding Housing Authority)
$36,965,154
24.1%
Charges for services
$1,074,780
.7%
Taxes
$8,200,000
5.3%
Misc. revenues
$5,808,187
3.8%
Subtotal Public Health Funding'
$56,731,366
Fund Impact (Needed to balance)
$4,414,978
2.9%
Revenues from Housing Authority
$92,215,718
60.1%
TOTAL HEALTH AND HUMAN SERVICES REVENUES
$153,362,062
100.0%
us represents a combination of health and related services with 91% of funding provided by the health fund.
Page 23
In the City's 2020-21 fiscal year update, departmental expenditures are expected to increase to
$157.3 million. Excluding the housing authority, public health services are budgeted at $63.4
million.
Expenditures
The City's budgeted expenditures for the Department of Health and Human Services in
FY 2019-20, are shown in Table 9 below. Total public health expenditures are $59.7 million.
Total department expenditures exceed revenues by $4.4 million. Presumably, the city has
reserves or will allocate general fund revenues to balance its budget.
Table 9. City of Long Beach Health and Human Services Expenditures
Expenditures for FY 2019-20
Physician Services
Budget
$12,074,402
Percent of Total
7.9%
Community Health Officer
$1,175,316
0.8%
Environmental Health
$8,566,912
5.6%
Community Health
$12,828269
8 4%
Collective Impact and Operations
$3,309,841
2.2%
Human Services'
$21,765,383
14.2%
Subtotal Public Health
$59,720,123
Housing Authority
$93,641,939
61.1%
TOTAL PUBLIC HEALTH AND HUMAN SERVICES
$153,362,062
100.0%
iuuues >s,ouu in general funds and $835,800 in Certified Unified Program Agency funds
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Appendix — California Code of Regulations
17 CCR § 1276
§ 1276. Basic Services.
The health department shall offer at least the following basic services to the health
jurisdiction which it serves:
(a) Collection, tabulation and analysis of all public health statistics, including population
data, natality, mortality and morbidity records, as well as evaluation of service records.
(b) Health education programs including, but not necessarily limited to, staff education,
consultation, community organization, public information, and individual and group
teaching, such programs to be planned and coordinated within the department and with
schools, public and voluntary agencies, professional societies, and civic groups and
individuals.
(c) Communicable disease control, including availability of adequate isolation facilities,
the control of the acute communicable diseases, and the control of tuberculosis and the
venereal diseases, based on provision of diagnostic consultative services,
epidemiologic investigation and appropriate preventive measures for the particular
communicable disease hazards in the community.
(d) Medical, nursing, educational, and other services to promote maternal and child
health, planned to provide a comprehensive program to meet community needs in these
fields.
(e) Environmental health and sanitation services and programs in accordance with an
annual plan and program outline as required in Title 17, Section 1328, and approved by
the State Department of Health and the applicable services and program standards as
specified in the State Department of Health "Services in a Local Environmental Health
and Sanitation Program," September 1976. The required services and programs shall
be as follows:
(1) Food.
(2) Housing and institutions.
(3) Radiological health in local jurisdictions contracting with the State Department of
Health to enforce the Radiation Control Law pursuant to Section 25600-25654 and
Sections 25800-25876, Health and Safety Code.
(4) Milk and dairy products in local jurisdictions maintaining an approved milk inspection
service pursuant to Section 32503, Food and Agricultural Code.
(5) Water oriented recreation.
(6) Safety.
(7) Vector control.
(8) Wastes management.
(9) Water supply.
(10) Air sanitation.
(11) Additional environmentally related services and programs as required by the
County Board of Supervisors, City Council, or Health District Board.
(12) And may include land development and use.
(f) Laboratory services, provided by an approved public health laboratory in health
departments serving a population of 50,000 or more. Such laboratories shall provide:
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(1) Services necessary for the various programs of the health department.
(2) Consultation and reference services to further the development of improved
procedures and practices in laboratories employing such procedures related to the
prevention and control of human disease.
(g) Services in nutrition, including appropriate activities in education and consultation for
the promotion of positive health, the prevention of ill health, and the dietary control of
disease.
(h) Services in chronic disease, which may include case finding, community education,
consultation, or rehabilitation, for the prevention or mitigation of any chronic disease.
(i) Services directed to the social factors affecting health, and which may include
community planning, counseling, consultation, education, and special studies.
Q) Services in occupational health to promote the health of employed persons and a
healthful work environment, including educational, consultative and other activities
appropriate to local needs. Where the population of a health jurisdiction exceeds 500
thousand, the program in occupational health shall include a planned and organized
service with trained staff.
(1) "Services in occupational health" shall mean, as a minimum, a program of industrial
sanitation and surveillance of occupational health hazards to insure that places of
employment are maintained in a healthful and sanitary condition. For the purpose of this
section, "sanitary condition" is defined as equivalent to that described in the
"Recommended Standards of Sanitation in Places of Employment" issued by the
California State Department of Health Services. Such services shall be provided by at
least one Occupational Health Sanitarian as defined in Section 1307, or any one of the
occupational health disciplines in Section 1306, with medical, sanitation, and public
health nursing support available.
(2) "Planned and organized service" shall include services in occupational health as
defined above, and in addition the prevention of work -induced illness and disability by
recognizing, evaluating and preventing unhealthful environmental conditions and
practices in places of work.
(3) "Trained staff' shall be defined as follows:
(A) When the health jurisdiction includes a population of 500,000 to 1,000,000, at least
1, and after July 1, 1968, 2 full-time health professionals representing 1 or 2,
respectively, of the disciplines listed in part (4) hereof shall be employed.
(B) When health jurisdictions include more than 1,000,000 population at least 2, and
after July 1, 1968, 3 full-time health professionals representing 2 or 3, respectively, of
the 5 disciplines listed in part (4) hereof shall be employed.
(C) When health jurisdictions include more than 5,000,000 population, at least 10 full-
time health professionals including all 5 of the disciplines listed in part (4) hereof shall
be employed.
(4) Occupational health disciplines include: Occupational Health Physician;
Occupational Health Nursing Consultant; Industrial Hygiene Engineer; Industrial
Hygienist (including sanitarians with appropriate training); and Industrial Hygiene
Chemist as defined in Section 1306.
(k) Appropriate services in the field of family planning, which may include:
(1) Promotion of availability of program elements such as:
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Analysis of Local Public Health Department Options Page 26
(A) Assembling knowledge about family planning, attitudes, values, and information held
by population groups.
(B) Public and professional educational services about the health benefits of family
planning and fertility control methods.
(C) Professional services for sterility correction, fertility control and genetic counseling
for all segments of the population, making available methods acceptable to families of
any religious persuasion.
(D) Evaluation of the adequacy of the community's family planning efforts.
(2) Provision of program elements which are not otherwise likely to be made available,
including family planning services for those groups who cannot reasonably obtain them.
(1) Public health nursing services to provide for the preventive and therapeutic care of }
the population served. a
z
a
al
Packet Pg. 200
Health Officers in the California Code
Second Edition, 2018
Compiled by the Health Officers Association of California
1100 11th Street #323 Sacramento, CA 95814
916-441-7405
kat@calhealthofficers.org
WKWITMENTMANUIT,
Table of Contents
7 1.
Page 1
Page 2
Health Officers in the Code of Regulations Page 29
Isa rMEN r[ 11"ii ,
Page 49
List of Abbreviations
Business and Professions Code - BPC
Civil Code - CIV
Code of Civil Procedure - CCP
Commercial Code - COM
Corporations Code - CORP
Education Code - EDC
Elections Code - ELEC
Evidence Code - EVID
Family Code - FAM
Financial Code - FIN
Fish and Game Code - FGC
Food and Agricultural Code - FAC
Government Code - GOV
Harbors and Navigation Code - HNC
Health and Safety Code - HSC
Insurance Code - INS
Labor Code - LAB
Military and Veterans Code - MVC
Penal Code - PEN
Probate Code - PROB
Public Contract Code - PCC
Public Resources Code - PRC
Public Utilities Code - PUC
Revenue and Taxation Code - RTC
Streets and Highways Code - SHC
Unemployment Insurance Code - UIC
Vehicle Code - VEH
Water Code - WAT
Welfare and Institutions Code - WIC
1
The Words "Health Officer" in the California Code
Summer, 2017
Code
Number
Meaning
Type of
Enacted/
Applies to
Statute
Amended
Designee?
BPC
551
Physicians and others must report
Reporting
1937
Yes
ophthalmia neonatorum in infants to the
(amended
local health officer.
1978)
BPC
554
Health officers must investigate each case
Duty
1937
Yes
of ophthalmia neonatorum in infants, and
(amended
must report these cases to CDPH.
1978)
BPC
2155
In this section of law, which has to do with
Definition
1980
Yes
loans to medical students, the term "the
practice of medicine" does not apply to
"activities performed in the course of
employment as a public health officer."
BPC
2201
In this section of law, which has to do with
Definition
1980
Yes
a physician pilot program, the term "the
practice of medicine" and the term
"medical practice" do not apply to
"activities performed in the course of
employment as a public health officer."
BPC
3502.05
Health officers may act as supervisors of
Emergency
1975
Yes
physician assistants during emergencies.
power
BPC
26200
When a facility is issued a state cannabis
Authority
2016
license within the city, the city takes over
(lack of)
(amended
the county health officer's duty.
2017)
EDC
48205
School absences due to a health officer's
Authority
1976
Yes
quarantine order are excused.
(amended
2016)
EDC
49402
Health officers (or other employees of
Authority
1976
Yes
local health departments) are authorized
to enter into contracts related to health
supervision of K-12 school buildings and
pupil health.
EDC
49403
K-12 school districts must cooperate with
Authority
1976
Yes
local health officers to prevent
(amended
communicable disease. This specifically
2010)
applies to administering immunizations.
EDC
49406
Health officers may recommend TB
Authority
1976
Yes
screening of K-12 school employees more
(amended
frequently than the state law requires,
2014)
which is once every four years.
EDC
51915
K-12 school districts may consider health
Consultation
1977
Yes
officer input when developing a health
education program.
EDC
76403
Community college districts must
Authority
1976
Yes
Code
Number
Meaning
Type of
Enacted/
Applies to
Statute
Amended
Designee?
cooperate with local health officers to
(amended
prevent communicable disease.
1990)
EDC
87408.6 (b)
Health officers may recommend TB
Authority
1976
Yes
screening of community college
(amended
employees more frequently than the state
2016)
law requires, which is once every four
years.
EDC
87408.E (b)
Health officers must determine the need
Duty
1976
Yes
for followup care of community college
(amended
employees who test positive for TB.
2016)
EDC
87408.E (i)
Health officers must provide TB exams
Duty
1976
Yes
free of charge for community college
(amended
employees.
2016)
FAC
7
®
Health officers have the authority to arrest
Authority
1967
Yes
without a warrant anyone violating the
(amended
Food and Agriculture Code.
1979)
FAC
5265
If CDFA determines that aerial pest
Reporting
2008
Yes
spraying is necessary, they must notify the
local health officer.
FAC
12982
Health officers must investigate human
Duty
1972
Yes
health hazards from pesticide use, and
(amended
must "abate the condition." Health
1996)
officers may request assistance from the
Department of Health Services [sic].
FAC
12997.7
Cal EPA must consult with health officers
Consultation
1996
Yes
when it enacts pesticide standards by
(amended
August 31, 2005.
2004)
FAC
19317
Haulers of inedible kitchen grease must
Reporting
1985
Yes
notify the local health officer of the
(amended
termination of any contract in that
2005)
jurisdiction.
FAC
19402
Health officers may inspect horsemeat or
Authority
1969
Yes
animal food records of pet food
manufacturers any time during operating
hours
FAC
33141
A milk inspector must consult with local
Consultation
1967
Yes
health officers before planning
(amended
inspections.
1985)
FAC
35928
Health officers may act in the place of the
Authority
1977
Yes
director of the Department of Food and
and Duty
Agriculture. When they do this, if they find
that raw milk has caused human illness,
they must take steps listed in the code,
including the prohibiting of the sale of the
contaminated milk.
Code
Number
Meaning
Type of
Enacted/
Applies to
Statute
Amended
Designee?
FAC
47062
CDFA must consult with local health
Consultation
2013
Yes
officers when developing small farm food
safety guidelines.
FAC
58504
The County BoS may "provide for"
Duty
1977
Yes
produce donated to a charity to be
inspected by the health officer
FAC
56351 and
A health officer may give a certificate to a
Authority
1971
Yes
58382
produce dealer indicating that produce
(amended
was not fit for human consumption.
1979)
GOV
6276.24
HIV disclosures to blood banks by county
Authority
1998
health officers are exempt from Public
(amended
Records Act
2010)
GOV
6276.30
Blood tests required by the county health
Authority
1998
officer are exempt from the Public
(amended
Records Act.
2015)
GOV
24000
One of the county officers is the county
Definition
1947
health officer.
(amended
2017)
GOV
24304
The county may combine the roles of
Definition
1947
coroner and county health officer.
(amended
1994)
GOV
26602
The sheriff may enforce health officer
Authority
1947
orders.
(amended
2005)
GOV
26808
The county health officer must prepare a
Duty
1970
list of family planning clinics in the county.
GOV
31530
The county health officer shall advise the
Duty
1947
board of retirement on medical matters,
and must attend their meetings if invited
to do so.
GOV
33201
The county health department may be run
Definition
1992
by the health officer or by a qualified
director appointed by the board of
supervisors.
GOV
33202
The county board of supervisors shall
Authority
1992
ensure that the health officer has
(amended
sufficient authority and resources and the
1996)
organizational structure does not impede
the health officer from carrying out duties
GOV
41601
The chief of police has the authority to
Authority
1949
enforce health officer orders
(amended
2005)
GOV
65852.2
When local governments create ordnances
Approval
1880
for accessory dwelling units, they must
(amended
include health officer approval of sewage
2016)
Code
Number
Meaning
Type of
Enacted/
Applies to
Statute
Amended
Designee?
disposal systems, if required.
HNC
777
Vessel pumpout facilities must include a
Definition
1937
notice of who is responsible, which may
(amended
be the local health officer.
1991)
HNC
779
Local health officers must enforce marine
Duty
1937
Yes
sanitation codes (vessel pumpout
(amended
facilities).
1991)
HNC
4160
A county with a port or harbor may
Definition
1937
Yes
appoint a health officer or a board of
health
HSC
1291
Once CDPH has brought an action against
Authority
1973
Yes
a health facility, the local health officer
(amended
may bring an action to enjoin the
1987)
violation.
HSC
1339.7
If the county creates a department to
Definition
1978
Yes
oversee health facilities, that department
(amended
is a county health department overseen by
1985)
a county health officer.
HSC
1379.5
Bi-national health plans with providers in
Reporting
2007
Yes
Mexico must report cases of reportable
diseases to the health officer where the
patient either lives or works in California.
HSC
1603.1
Blood banks must report cases of viral
Reporting
1963
Yes
hepatitis to the local health officer.
(amended
2003)
HSC
1603.1
Physicians, hospitals, and health care
Reporting
1963
Yes
providers must report cases of HIV and
(amended
viral hepatitis to the local health officer.
2003)
HSC
1603.1
Upon finding out about infected blood
Duty
1963
Yes
from a transfusion, the health officer must
(amended
notify the blood bank of its finding.
2003)
HSC
1603.1
A health officer may confidentially disclose
Authority
1963
Yes
to blood banks if previously donated blood
(amended
may be infected.
2003)
HSC
1603.3
Health officers must expunge records after
Duty
1963
Yes
locating and notifying blood donors
(amended
positive for HIV or viral hepatitis.
2003)
HSC
1797.152
The health officers of a region vote on
Duty
1980
Yes
who will be the regional disaster medical
(amended
and health coordinator, which may be a
2013)
county health officer or a few other
possible nominees.
HSC
1797.153
The county health officer and the local
Authority
1980
Yes
EMS agency administrator may act jointly
(amended
as the medical health operational area
2013)
Code
Number
Meaning
Type of
Enacted/
Applies to
Statute
Amended
Designee?
coordinator (MHOAC), or may appoint
another person. The MHOAC must
develop a disaster plan.
HSC
1797.188
Health facilities notify the county health
Reporting
1980
Yes
officer if prehospital emergency personnel
(amended
are exposed to a reportable
2017)
communicable disease.
HSC
1797.188
Health officers must notify prehospital
Duty
1980
Yes
emergency personnel that they have been
(amended
exposed to a communicable disease.
2017)
HSC
1797.188
The health facility or health officer must
Duty
1980
Yes
notify the funeral director before release
(amended
of the body if there is a communicable
2017)
disease exposure as outlined above.
HSC
1797.189
The chief medical examiner -coroner also
Reporting
1980
Yes
must notify the county health officer if
(amended
prehospital emergency personnel are
1996)
exposed to a reportable communicable
disease.
HSC
1797.189
Health officers must notify prehospital
Duty
1980
Yes
emergency personnel that they have been
(amended
exposed to a communicable disease.
1996)
HSC
1797.189
The chief medical examiner -coroner or
Duty
1980
Yes
health officer must notify the funeral
(amended
director before release of the body if there
1996)
is a communicable disease exposure as
outlined above.
HSC
5411.5
When someone spills sewage, they must
Reporting
1967
Yes
immediately notify the local health officer
(amended
or the director of environmental health
2013)
HSC
5412
When the health officer finds
Duty
1967
Yes
contamination of water by sewage, they
(amended
must order abatement.
2001)
HSC
5412.5
When someone spills sewage, they must
Authority
1967
Yes
reimburse the health officer.
(amended
1992)
HSC
5416
The health officer may approve other
Authority
1967
Yes
types of toilets for construction sites other
(amended
than the chemical type and pit toilets
1953)
prescribed by law.
HSC
5460
The health officer may order abatement of
Authority
1940
Yes
contamination, and may bring an action to
(amended
superior court.
1970)
HSC
5463
The health officer may order a
Authority
1949
homeowner to connect their home to the
(amended
Code
Number
Meaning
Type of
Enacted/
Applies to
Statute
Amended
Designee?
sewer system; and may build the
2010)
connections themselves if the homeowner
fails to comply.
HSC
6492.5
The BoS may appoint the county health
Duty
1939
Yes
officer as the health officer of the
(amended
sanitation district.
1972)
HSC
6499
If he/she is the health officer of the
Authority
1939
Yes
sanitation district, the health officer can
(amended
receive reimbursement.
1972)
HSC
6512
No garbage dump can be established
Approval
1939
Yes
without its location being approved by the
(amended
health officer.
2002)
HSC
6542
For purposes of sanitation districts, the
Definition
1939
Yes
term "health officer" means the county
(amended
health officer except when cities have
1996)
designated their own health officer.
HSC
6955.1
The county health officer may determine
Authority
1977
Yes
6982
that a health threat requires an on -site
(amended
wastewater disposal zone to have fewer
1994)
than the 12 voters otherwise required.
HSC
6958
Local health officers are notified of the
Reporting
1977
Yes
intent to form an on -site wastewater
disposal zone.
HSC
6960
Local health officers will review any
Duty
1977
Yes
potential formation of an on -site
wastewater disposal zone and report
his/her findings.
HSC
6960.4
On -site wastewater disposal zone plans
Approval
1977
Yes
first require health officer approval.
Health officers shall not approve plans if
they do not conform to applicable laws.
HSC
7302
Funeral directors and embalmers must
Reporting
1939
Yes
notify health officers of "every contagious
disease on which they may be called."
HSC
7502
A health officer may adopt reasonable
Authority
1939
Yes
rules and regulations for the disinterring,
transporting, or removing human remains.
HSC
11551
Courts may require probationers to submit
Duty
1972
Yes
to a drug test performed by the local
health officer.
HSC
11552
Law enforcement officers may request
Authority
1972
Yes
health officers to test arrestees for drug
addiction.
HSC
11642
Law enforcement must notify health
Reporting
1986
Yes
officers within 24 hours of a seizure of an
(amended
Code
Number
Meaning
Type of
Enacted/
Applies to
Statute
Amended
Designee?
illegal drug lab.
1991)
HSC
11642
Upon learning of an illegal drug lab, the
Duty
1986
Yes
local health officer must either abate the
(amended
public health threat or notify CDPH.
1991)
HSC
12585
Health officers may inspect and
Authority
1995
Yes
quarantine people or places to enforce
CDPH regulations
HSC
17920.3
Health officers can declare a building
Authority
1844
Yes
substandard if there is a health risk from
(amended
an insect, vermin, or rodent infestation;
2015)
mold; or inadequate garbage removal.
HSC
17998.2
If the jurisdiction receives a Community
Possible Duty
2000
Yes
Code Enforcement Pilot Program grant,
(amended
their code enforcement team must
2002)
include either a code -enforcement officer,
city planner, health officer, or comparable
specialist for a minimum of 20 hours a
week.
HSC
18897.4
Health officers must enforce building
Duty
1939
Yes
standards for organized camps.
(amended
2008)
HSC
23164
DHS [sic] will make its toxic mold
Reporting
2001
Yes
guidelines available to local health
officers.
HSC
25180
Health officers must enforce codes for
Duty
1972
Yes
hazardous waste control. Details omitted
(amended
from this document but may be found in
2016)
HSC sections 25100 to 25259.
HSC
25180.5
Health officers will be notified of illegal
Reporting
1972
Yes
and
hazardous waste discharges in their
(amended
25180.7
jurisdiction.
1995)
HSC
25180.7
Health officers must notify local media
Duty
1972
Yes
when there is a hazardous waste discharge
(amended
that may impact public health.
2011)
HSC
25185
In order to enforce hazardous waste
Authority
1972
Yes
control, health officers have the necessary
(amended
authority to enter facilities, stop and
1995)
inspect vehicles, etc.
HSC
25212
Local health officers must regulate
Duty
1997
Yes
hazardous waste related to major
(amended
appliances.
2004)
HSC
25244.23
Health officers cannot divulge trade
Duty
1972
Yes
and 25512
secrets obtained during hazardous waste
(amended
and 25538
enforcement. There is a $1,000 fine and
2012)
possible imprisonment.
Code
Number
Meaning
Type of
Enacted/
Applies to
Statute
Amended
Designee?
HSC
25257.2
The Dept of Toxic Substances Control will
Reporting
2008
Yes
publish guidelines for healthy nail salons,
(amended
and will present the guidelines to local
2016)
health officers.
HSC
25359.5
Health officers may order a property
Authority
1999
Yes
owner to secure a site after a chemical
(amended
spill into the land. Details in statute.
2009)
HSC
25359.6
The Dept of Toxic Substances Control will
Reporting
1999
Yes
notify local health officers of any
(amended
abandoned hazardous waste sites.
2009)
HSC
25359.6
The Dept of Toxic Substances Control and
Duty
1999
Yes
local health officers must keep each other
(amended
informed about abandoned hazardous
2009)
waste sites.
HSC
25400.11
The local health officer may designate
Authority
2005
Yes
and
another local agency to carry out meth lab
(amended
25400.17
cleanup.
2006)
HSC
25400.11
The local health officer may designate a
Authority
2005
Yes
chemical as hazardous for purposes of
(amended
meth lab cleanup.
2006)
HSC
25400.17
The local health officer (or designee, as
Duty
2005
Yes
through
outlined above) has responsibility for
(amended
25400.47
meth lab cleanup. Details in statute.
2012)
HSC
25404
The Secretary of Environmental Protection
Collaboration
1993
Yes
and 25416
will collaborate with local health officers
(amended
and others when developing hazardous
2015)
materials regulations.
HSC
25416
The local health officer may determine
Authority
1985
Yes
that a location is a potential site for public
(amended
exposure to hazardous materials, and may
1997)
request a study by DTSC.
HSC
25416
In any county with a hazardous waste
Collaboration
1985
Yes
disposal facility, DTCS will work with the
(amended
local health officer to distribute certain
1997)
information.
HSC
26101.7
DHS [sic] will include health officers on the
Consultation
2001
Yes
toxic mold taskforce.
HSC
33459
Health officers is a qualified "local agency"
Definition
1990
Yes
for hazardous substance release cleanup.
(amended
2014)
HSC
33459.1
As a local agency, a health officer may
Authority
1990
Yes
take actions as necessary to cleanup a
(amended
hazardous substance. Details in statute.
2002)
HSC
44363
Air districts must disseminate their annual
Reporting
1987
Yes
report to local health officers and others.
Code
Number
Meaning
Type of
Enacted/
Applies to
Statute
Amended
Designee?
HSC
40120 and
All county officers, including the health
Definition
1975
Yes
40157
officer, are ex officio officers of the local
and Duty
district air board, and are required to
perform duties for the air board as they do
for the county.
HSC
101000
Each county Board of Supervisors must
Definition
1995
appoint a health officer
HSC
101005
"The county health officer shall be a
Definition
1995
graduate of a medical college of good
standing and repute. His or her
compensation shall be determined by the
board of supervisors."
HSC
101010
The BoS must notify CDPH when they
Definition
1995
appoint a health officer.
HSC
101025
The county must "take measures as may
Duty
1995
Yes
be necessary to preserve and protect the
public health."
HSC
101029
Sheriffs and peace officers may enforce
Authority
1995
Yes
health officer orders.
HSC
101030
The county health officer must enforce
Duty
1995
Yes
orders and statutes of the county and of
CDPH.
HSC
101035
The health officer must advice the county
Duty
1995
Yes
pension or retirement system, and must
attend meetings when requested.
HSC
101040
The health officer may take preventive
Authority
1995
Yes
action as necessary during an emergency.
HSC
101042
When there is a gas leak, the health officer
Duty
2015
Yes
must order the testing of air, soil, and
water, and make a public health
determination. If there is a threat, the
health officer must notify residents.
HSC
101045
Health officers must make annual
Duty
1995
Yes
inspections of jails, and may be directed to
make additional inspections.
HSC
101050
The health officer must make a list of
Duty
1995
Yes
family planning clinics in the county.
HSC
101060
"The county health officer may designate
Authority
1995
Yes
a nonprofit food distribution agency to
coordinate and facilitate the donation of
food and food products to nonprofit,
charitable corporations."
HSC
101070
Local health officers may take action
Authority
2000
Yes
against people furnishing drugs illegally
HSC
101080
The local health officer may declare a local
Authority
1995
Yes
10
Code
Number
Meaning
Type of
Enacted/
Applies to
Statute
Amended
Designee?
health emergency. The declaration lasts 7
(Amended
days unless further ratified.
2007)
HSC
101030.2
The health officer may order first
Authority
1995
Yes
responders to isolate exposed individuals.
(Amended
The order lasts 2 hours.
2013)
HSC
101030.2
In order to use isolation authority, the
Duty
1995
Yes
health officer must first establish an MOU
(Amended
with first responders in consultation with
2013)
OES.
HSC
101035
During an emergency, a local health
Emergency
1995
Yes
officer may order information about a
Authority
(Amended
chemical spill. They may share this
2006)
information.
HSC
101035
During an emergency, a local health
Emergency
1995
Yes
officer may take and analyze samples as
Authority
(Amended
necessary.
2006)
HSC
101035
After a local health emergency is declared,
Emergency
1995
Yes
other jurisdictions may provide mutual
Authority
(Amended
aid. Expenses are reimbursable by the
2006)
state if it is a local health emergency.
HSC
101037
After a chemical spill, the BoS may
Duty
1995
Yes
delegate to the county health officer the
(Amended
task of interviewing individuals with
1999)
knowledge of the spill.
HSC
101155
The cost of the local public health lab is a
Authority
1996
Yes
legal expenditure of health officer funds.
HSC
101230
If environmental health is not within the
Duty
1995
Yes
local health department, the health officer
(Amended
must delegate environmental health and
1996)
sanitation power to the environmental
health director
HSC
101235
The county health officer (or EH director)
Consultation
1995
Yes
must concur before a county transfers
(Amended
mosquito and vector control services to a
2002)
mosquito and vector abatement district.
HSC
101310
During an emergency, the health officer
Emergency
1995
Yes
has supervision and control over
Authority
(Amended
environmental health and sanitation
1996)
programs.
HSC
101325
The city or county has the authority to
Authority
1995
Yes
levy fees to pay for duties of the health
(Amended
officer.
1996)
HSC
101375
The county health officer has authority to
Authority
1995
Yes
enforce public health laws in cities, if the
city consents by resolution or ordinance.
11
Code
Number
Meaning
Type of
Enacted/
Applies to
Statute
Amended
Designee?
HSC
101400
Cities may contract with counties for
Authority
1995
environmental health and sanitation
duties.
HSC
101460
Each city must appoint a health officer,
Definition
1995
unless it has an arrangement with the
(Amended
county.
1996)
HSC
101480
Upon request of the responsible party, the
Authority
1996
Yes
health officer may supervise the remedial
action required by a release of waste.
HSC
101480
The health officer may be considered the
Authority
1996
Yes
local officer in charge of approving waste
release remedial actions. Details in
statute.
HSC
101828
Either the county health officer or the
Possible Duty
1999
Yes
Family Care Center Medical Director must
serve on the San Luis Obispo County
Hospital Authority.
HSC
102275
The health officer is the local registrar of
Definition
1995
Yes
births and deaths
HSC
102300
Local registrar (health officer) must supply
Duty
1995
Yes
blank forms to those who need them.
HSC
102305
Local registrar (health officer) must
Duty
1995
Yes
examine each certificate before accepting
it.
HSC
102315 to
Local registrar (health officer) must
Duty
1995
Yes
102395
number and sign birth and death
certificates, copy them, and send a copy to
the state. Details in statute.
HSC
102360
Local registrar (health officer) must report
Duty
1995
Yes
deaths of people over age 18 to the local
registrar of voters.
HSC
102400
Live births must be reported to the
Reporting
1995
Yes
registrar (health officer) within 10 days.
HSC
102425
If a parent consents, the names and
Reporting
2014
Yes
addresses of children born with congenital
malformations will be sent to the health
officer.
HSC
102425.1
Local registrar (health officer) must use
Duty
2014
Yes
updated forms after 2016 that say "name
of parent."
HSC
102430
Local health department staff may access
Authority
1995
Yes
birth certificate information if approved by
(amended
health officer.
2014)
HSC
102500
When unidentified children are found who
Reporting
1995
Yes
are alive and under one year of age, a
12
Code
Number
Meaning
Type of
Enacted/
Applies to
Statute
Amended
Designee?
certificate of finding will be filed with the
registrar (health officer)
HSC
102610
Copies of delayed birth certificates will be
Reporting
1995
Yes
sent to the local registrar (health officer)
by the state registrar.
HSC
102685
When an adoption results in a new birth
Reporting
1995
Yes
certificate, the state registrar will send the
new birth certificate to the local registrar
(health officer).
HSC
102865
The coroner will notify the health officer
Reporting
1995
Yes
within 24 hours when gross autopsy
results suggest SIDS.
HSC
102875
The local registrar (health officer) may use
Authority
1995
Yes
an electronic signature on death
(Amended
certificates
2014)
HSC
102950
Each fetal death after 20 weeks will be
Reporting
1995
Yes
reported to the local registrar (health
(Amended
officer) within 8 days.
2007)
HSC
103040.1
Upon request of the parent, the local
Duty
2007
Yes
registrar (health officer) shall issue a
Certificate of Still Birth for fetal deaths
after 20 weeks. They may charge a fee.
HSC
103050
Even when a body is transported across
Duty /
1995
Yes
state lines without a death certificate,
Reporting
(Amended
health officers and others are still
2017)
responsible for reporting communicable
diseases.
HSC
103055
If the death certificate is correct, the local
Duty
1995
Yes
registrar (health officer) shall issue a
(Amended
permit for disposition.
1998)
HSC
103055
The local health officer may set terms on
Authority
1995
Yes
internment permits if the death was from
(Amended
a dangerous infectious disease.
1998)
HSC
103260
The local registrar (health officer) will
Duty
1995
Yes
103375
correct birth certificates as necessary
103440
notify the State Registrar.
103447
HSC
103280
The local registrar (health officer) will
Duty
1995
Yes
correct death certificates as necessary
notify the State Registrar.
HSC
103305
The local registrar (health officer) will
Duty
1995
Yes
correct fetal death certificates as
(Amended
necessary notify the State Registrar.
1996)
HSC
103325
If a birth certificate does not include a
Duty
1995
Yes
name, the local registrar (health officer)
13
Code
Number
Meaning
Type of
Enacted/
Applies to
Statute
Amended
Designee?
will provide a special blank form to fill out
once the baby is named.
HSC
103525
The local registrar (health officer) will
Duty
1995
Yes
provide certified copies of birth, death,
(Amended
and fetal death certificates upon payment
2009)
of appropriate fees. Details in statute.
HSC
103525.5
Some of the fees collected by local
Duty
1995
Yes
103625
registrars (health officers) must be passed
(Amended
103690
along to the State Registrar.
2009)
103692
HSC
103577
The local registrar (health officer) will
Duty
1995
Yes
provide certified copies of a birth
(Amended
certificate to homeless individuals without
2015)
a fee. Details in statute.
HSC
103600
The local registrar (health officer) must
Duty
1995
Yes
keep a true account of all fees.
HSC
103790
Local registrars (health officers) are guilty
Duty
1995
Yes
of a misdemeanor if they fail to perform
their duties.
HSC
103865
CDPH and regional registries for
Authority
2004
Yes
and
Parkinson's Disease may enter into
(amended
103870.1
agreements with local health officers to
2017)
share information.
HSC
103885
CDPH and regional registries for cancer
Authority
1995
Yes
may enter into agreements with local
(Amended
health officers to share information.
2016)
HSC
103900
Physicians must report to the local health
Reporting
1995
Yes
officer patients over the age of 14 who
have disorders characterized by lapses in
consciousness.
HSC
103900
Health officers must report to the DMV
Duty
1995
Yes
patients over the age of 14 who have
disorders characterized by lapses in
consciousness.
HSC
104790
If a local health department wishes to
Possible Duty
1995
Yes
participate in the community dental
disease prevention program, the health
officer must submit an application.
HSC
104840
The county health officer must operate a
Duty
1995
Yes
program to provide topical fluoride to
pupils.
HSC
105200
Physicians suspecting pesticide poison
Reporting
1995
Yes
must immediately notify the health
officer.
HSC
105200
When notified of pesticide poisoning, the
Duty
1995
Yes
14
Code
Number
Meaning
Type of
Enacted/
Applies to
Statute
Amended
Designee?
health officer must immediately notify the
county agriculture commission and others.
HSC
105215
Anyone with knowledge of a pesticide spill
Reporting
1995
Yes
must immediately notify the health
(Amended
officer.
2013)
HSC
105215
When notified of a pesticide spill, the
Duty
1995
Yes
health officer must immediately notify the
(Amended
county agriculture commission and others.
2013)
HSC
103555
Local health officers must enforce laws
Duty
1995
Yes
related to toy safety. Details in statute.
(Amended
2010)
HSC
103335
CDPH may enter into an agreement with
Possible Duty
1995
Yes
local health officers to enforce laws
related to lead in tableware.
HSC
109330
County health officers must cooperate
Duty
1995
Yes
with CDPH when they enforce laws related
to fraudulent drugs or medical devices
related to cancer.
HSC
110597
Local health officers may bring action
Authority
1996
Yes
against producers of contaminated wine.
HSC
110306
CDPH may (but doesn't have to) notify
Reporting
2006
Yes
health officers if a local business has
(Amended
received recalled meat or poultry.
2007)
HSC
110306
Health officers may notify the public of
Authority
2006
Yes
recalled meat and poultry in local
(Amended
businesses. Details in statute.
2007)
HSC
111020
CDPH may authorize the local health
Possible
1995
Yes
officer to enforce food safety laws.
authority
HSC
111105
CDPH may authorize the local health
Possible
1995
Yes
officer to enforce laws around water-
authority
haulers and water vending machines.
HSC
112040
The local health officer may enter and
Authority
1995
Yes
inspect food establishments under certain
(Amended
conditions.
2000)
HSC
112040
All food facility inspections must be
Duty
1995
Yes
reported to CDPH within 60 days.
(Amended
2000)
HSC
112075
The health officer may recommend a
Authority
1995
Yes
license be given to a bottle sterilizer
HSC
112115
The health officer may enforce laws
Authority
1995
Yes
related to bottle sterilization.
(Amended
1999)
HSC
113150
Health officer approval is required before
Approval
1995
Yes
sale of milk can resume after a milk -
transmitted disease in a premises.
15
Code
Number
Meaning
Type of
Enacted/
Applies to
Statute
Amended
Designee?
HSC
113150
Cases of milk -transmitted disease in dairy
Reporting
1995
Yes
workers or their households must be
immediately reported to the health
officer.
HSC
113355
Health officers have primary responsibility
Duty
1995
Yes
for enforcing sanitary conditions in
(Amended
agricultural fields.
1999)
HSC
113774
Health officers are enforcement officers
Definition /
2006
Yes
for purposes of the retail food code.
Duty
(Amended
2007)
HSC
113804
Health officers are hearing officers for
Definition
2006
Yes
purposes of the retail food code.
HSC
113949.1
When notified of a foodborne illness, the
Duty
2006
Yes
health officer must inform the local
(Amended
enforcement agency and the food facility,
2009)
and must investigate the food facility.
HSC
113949.1
Upon investigation of a food facility after
Authority
2006
Yes
an illness is reported, the health officer
(Amended
can close the facility, enforce restrictions,
2009)
or require medical examinations of
employees.
HSC
113950
The health officer (or designated
Duty
2006
Yes
enforcement agency) must exclude or
restrict food employees under certain
circumstances.
HSC
113984
The enforcement officer may set stricter
Authority
2006
Yes
standards for mobile food facilities
(Amended
2015)
HSC
114332.4
The enforcement officer may set stricter
Authority
2006
Yes
standards for temporary, charitable food
facilities
HSC
114363
The enforcement officer may set stricter
Authority
2006
Yes
standards for temporary food facilities
HSC
114376.5
The enforcement officer may enter and
Authority
2014
Yes
inspect the operations of a community
food producer or gleaner.
HSC
114390
Enforcement officers have the right,
Authority
2006
Yes
during reasonable hours, to enter food
(Amended
facilities, cottage food facilities, or vehicles
2012)
transporting food to such a facility.
HSC
114393
Enforcement officers may impound food,
Authority
2006
Yes
equipment, and utensils.
(Amended
2007)
HSC
115700
Inactive well owners must show the health
Reporting
1996
Yes
officer that they intend to use the well in
16
Code
Number
Meaning
Type of
Enacted/
Applies to
Statute
Amended
Designee?
the future or else it will be called
permanently inactive.
HSC
115875
CDPH must consult with local health
Consultation
1995
Yes
officers as it sets and maintains sanitation
(Amended
standards for public beaches.
2011)
HSC
115880
The health officer may ask CDPH to allow
Authority
1995
Yes
alternative water quality assessments for
(Amended
beaches.
2015)
HSC
115880
The health officer is responsible for beach
Duty
1995
Yes
water testing.
(Amended
2015)
HSC
115881
The State Water Resources Control Board
Consultation
2011
Yes
must consult with health officers as it
establishes beach water monitoring
protocols.
HSC
115885
The health officer must inspect beaches,
Duty
1995
Yes
investigate complaints, create a hotline,
(Amended
and notify appropriate agencies.
2011)
HSC
115910
The health officer must submit a monthly
Duty
1995
Yes
report on beach postings and closures to
(Amended
the State Water Resources Control Board.
2010)
HSC
115915
When a public beach fails to meet
Duty
1995
Yes
standards, the health officers must post
(Amended
warnings to the public.
2011)
HSC
116038
No public swimming pool can be built
Approval
1995
Yes
and
without health officer approval.
116049.1
HSC
116053
Health officers must enforce the Building
Duty
1995
Yes
Safety Code as it relates to swimming
pools.
HSC
116055
Health officers have the authority may
Authority
1995
Yes
enter the premises of public swimming
pools for inspection at all reasonable
times.
HSC
116130
Health officers may enter any place to
Authority
1995
Yes
inspect for rodents.
(Amended
2014)
HSC
116140
Health officers must order rodents
Duty
1995
Yes
destroyed when the owner of an infested
(Amended
property does not act.
2014)
HSC
116340
Local health officers or a designee must
Duty
1995
Yes
enforce minimum requirements on state
small water systems (5 to 14 connections).
HSC
116345
Local health officers must submit a
Duty
1995
Yes
monthly report to the State Water
17
Code
Number
Meaning
Type of
Enacted/
Applies to
Statute
Amended
Designee?
Resources Control Board on state small
water systems.
HSC
116675
The State Water Resources Control Board
Loss of
1995
Yes
can take action against a water system
Authority
under the jurisdiction of the health officer
under certain conditions.
HSC
116300
The local health officer may maintain a
Authority
1995
Yes
116310
backflow prevention program. Details in
statute.
HSC
116340
With the approval of the State Water
Possible
1995
Yes
Resources Control Board, a local health
Authority
(Amended
officer may enforce laws related to water
2013)
treatment devices.
HSC
117405
Registration from the health officer is
Authority
1995
Yes
required for septic tank cleaners. Details in
statute.
HSC
117425
Health officers must act on applications
Duty
1995
Yes
for septic tank cleaners within 30 days.
HSC
117655
Health officers (among others) are
Definition
1995
Yes
enforcement officers of the Medical
Waste Management Act.
HSC
117690
The health officer can deem something
Authority
2014
Yes
biohazardous waste.
HSC
113240
If, in the opinion of the local health officer,
Authority
1995
Yes
an animal carcass presents a danger to
(amended
public health, it must be disposed of
2014)
properly.
HSC
113321.1
CDPH shall send a list of registered trauma
Reporting
1997
Yes
scene waste management practitioners to
all local health officers.
HSC
113390
Health officers must enforce the code
Duty
1995
Yes
disallowing common cups.
HSC
113405
The county health officer can declare that
Authority
1995
Yes
packing material is clean.
HSC
113435
Health officers must enforce the code
Duty
1995
Yes
disallowing common towels.
HSC
113460
Health officers may inspect wiping rags at
Authority
1995
Yes
any time during business hours.
HSC
113465
No business may sanitize or sell wiping
Authority
1995
Yes
rags without a permit from the health
officer. Details in statute.
HSC
119301
Health officers are enforcement officers of
Definition
2011
Yes
the Safe Body Art Act
(amended
2013)
HSC
120115
Health officers define the appropriate
Authority
1995
Yes
IV
Code
Number
Meaning
Type of
Enacted/
Applies to
Statute
Amended
Designee?
course of treatment for TB, who is
authorized to observe DOT, and what tests
may be used.
HSC
120130
Health officers must report diseases to
Duty
1995
Yes
CDPH.
(amended
2011)
HSC
120130
CDPH can modify the list of reportable
Consultation
1995
Yes
diseases for which a specimen must be
(amended
submitted after consultation with health
2011)
officers, among others.
HSC
120130
"The health officer may require strict or
Authority
1995
Yes
120240
modified isolation, or quarantine, for any
(amended
case of contagious, infectious, or
2011)
communicable disease, when this action is
necessary for the protection of the public
health."
HSC
120130
Laboratories that receive incomplete
Reporting
1995
Yes
patient information may submit the name
(amended
of the provider to the local health officer.
2011)
HSC
120160
Entities that have flu vaccine must
Authority
1995
Yes
cooperate with the health officer and
(amended
provide an inventory list.
2015)
HSC
120175
When there is a case of a communicable
Duty
1995
Yes
disease in their jurisdiction, the health
officer must take action to prevent the
spread of disease. (Elaborated on in 17
CCR 2501)
HSC
120176
During an outbreak (or when there is a
Authority
2006
Yes
threat of an outbreak), health care
providers, pharmacies, and others must
provide inventories of supplies if the
health officer requests them.
HSC
120185
During an outbreak, the health officer
Duty
1995
Yes
must, if CDPH requests it, report the
actions that are being taken.
HSC
120190
The health officer must report
Duty
1995
Yes
immediately to CDPH any diseases
designated as immediately reportable.
HSC
120195
Health officers must enforce isolation and
Duty
1995
Yes
120200
quarantine orders issued by CDPH, and if
120210
requested by CDPH, must maintain a place
120215
of isolation and quarantine.
HSC
120235
Only the health officer may supervise the
Authority
1995
Yes
lifting of a quarantine.
HSC
120245
City health officers must report diseases to
Duty
1995
Yes
19
Code
Number
Meaning
Type of
Enacted/
Applies to
Statute
Amended
Designee?
the county health officer.
HSC
120250
Physicians, clergy and others who visit
Reporting
1995
Yes
those with contagious disease must report
(amended
information to the health officer.
1996)
HSC
120275
Violation of a CDPH order issued through a
Authority
1995
Yes
health officer is a misdemeanor.
HSC
120280
Violation of a health officer order is a
Authority
1995
Yes
misdemeanor.
HSC
120290
Violation of a verbal warning from a health
Authority
2017
Yes
officer is a misdemeanor under certain
circumstances related to communicable
disease.
HSC
120300
If the health officer requests it, the DA
Authority
1995
Yes
must prosecute violations of health officer
orders.
HSC
120350
County health officers must maintain an
Duty
1995
Yes
immunization program.
HSC
120370
The health officer may temporarily
Authority
1995
Yes
exclude unvaccinated children from school
(amended
if they have been exposed to a disease.
2015)
HSC
120375
School authorities must cooperate with
Authority
1995
Yes
health officers implementing
(amended
immunization programs.
2015)
HSC
120405
Health officers may establish
Authority
1995
Yes
120440
immunization programs for children that
are mobile, temporary, or permit.
HSC
120420
Health officers are entitled to assistance
Authority
1995
Yes
from CDPH on immunization campaigns to
prevent rubella.
HSC
120510
Health officers are entitled to cooperation
Authority
1995
Yes
from CDPH on the prevention and control
of venereal diseases.
HSC
120530
Health officers may recommend CDPH
Authority
1995
Yes
assistance for rural areas treating STDs.
HSC
120535
Public hospitals must admit STD patients if
Authority
1995
Yes
the health officer deems them a menace
to public health.
HSC
120570
Public hospitals will report to the health
Reporting
1995
Yes
officer when a patient with venereal
disease refuses to complete treatment.
HSC
120575
The health officer must "use every
Duty
1995
Yes
available means to ascertain the existence
of cases of infectious venereal diseases
within their respective jurisdictions ... and
to take all measures reasonably necessary
20
Code
Number
Meaning
Type of
Enacted/
Applies to
Statute
Amended
Designee?
to prevent the transmission of infection."
HSC
120595
The health officer may be required to
Duty
1995
Yes
testify in prosecutions related to violation
of quarantine orders or treatment orders.
HSC
120700
The health officer may destroy certain lab
Authority
1995
Yes
reports after two years.
HSC
121015
Physicians may report positive HIV test
Reporting
1995
Yes
results to the local health officer.
(amended
2011)
HSC
121015
The health officer may inform the spouses,
Authority
1995
Yes
sexual partners, or needle sharing
(amended
partners of patients with a positive HIV
2011)
test that they may have been exposed.
HSC
121015
The health officer must destroy records
Duty
1995
Yes
related to positive HIV tests after partner
(amended
notification is done.
2011)
HSC
121015
The health officer must maintain
Duty
1995
Yes
confidentiality of HIV positive patients.
(amended
2011)
HSC
121020
When an infant tests positive for HIV,
Reporting
1995
Yes
social workers will try to find information
(amended
about the mother to report to the health
2013)
officer.
HSC
121022
HIV infections must be reported to the
Reporting
1995
Yes
health officer by name.
(amended
2014)
HSC
121022
Health officers and CDPH must maintain
Duty
1995
Yes
access to anonymous HIV testing at
(amended
alternative testing sites.
2014)
HSC
121022
Health officers must investigate and
Duty
1995
Yes
report any breaches of confidentiality of
(amended
HIV records.
2014)
HSC
121023
Clinical labs must report CD4+ T-Cell test
Reporting
1995
Yes
results to the local health officer of the
(amended
health care facility.
2009)
HSC
121023
Health officers must investigate reports of
Duty
1995
Yes
CD4+ T-Cell test results to determine if
(amended
they are related to a case of HIV. If yes,
2009)
the health officer must report it. If not, the
health officer must destroy it.
HSC
121035
For purposes of HIV confidentiality, a local
Definition
1995
Yes
health agency is any local entity that a
(amended
health officer serves.
2006)
HSC
121235
In implementing the Disease Prevention
Collaboration
2004
Yes
Demonstration Project (to allow
(amended
21
Code
Number
Meaning
Type of
Enacted/
Applies to
Statute
Amended
Designee?
pharmacists to sell syringes without a
2012)
prescription), DHS [sic] must convene an
advisory panel, which includes
representatives from the health officers.
HSC
121349
Together with the city council or board of
Authority
2005
Yes
supervisors, the health officer may
(amended
establish a needle exchange program for
2011)
up to two years.
HSC
121349.3
If there is a needle exchange, the health
Duty
2005
Yes
officer must present a status update to
(amended
the board of supervisors or city council
2011)
annually or biennially.
HSC
121360.5
Health officers may participate in a
Authority
1995
Yes
program to certify TB skin test technicians.
(amended
2009)
HSC
121361
Prisoners with active TB may not be
Authority
1995
Yes
released until the health officer has
(amended
reviewed their treatment plan
2002)
HSC
121361
When a prisoner with active TB is to be
Duty
1995
Yes
released, health officers must review the
(amended
proposed treatment plans within 24 hours
2002)
of receipt.
HSC
121361
When a prisoner with active TB is to be
Reporting
1995
Yes
released on parole, notification will go to
(amended
both the health officer where the prison is
2002)
located and the health officer where the
inmate intends to resign.
HSC
121361
The parole agent of a former inmate with
Coordination
1995
Yes
active TB must coordinate with the local
(amended
health officer for their treatment.
2002)
HSC
121362
Health care providers must inform the
Reporting
1995
Yes
local health officer when a patient ceases
(amended
treatment for TB.
2007)
HSC
121362
The health officer must inform the parole
Duty
1995
Yes
officer if a parolee ceases treatment for
(amended
TB.
2007)
HSC
121363
Health care providers must refer
Reporting
1995
Yes
household contacts of TB patients to the
local health officer for treatment
HSC
121363
The health officer can require household
Authority
1995
Yes
contacts of TB patients to be examined
and treated.
HSC
121364
The health officer may require TB testing
Authority
1995
Yes
in a community when necessary.
HSC
121365
"Each local health officer is hereby
Duty
1995
Yes
22
Code
Number
Meaning
Type of
Enacted/
Applies to
Statute
Amended
Designee?
directed to use every available means to
ascertain the existence of, and
immediately investigate all reported or
suspected cases of active tuberculosis
disease in the jurisdiction, and to ascertain
the sources of those infections."
HSC
121365
Health officers may issue orders as
Authority
1995
Yes
121366
necessary to prevent the spread of TB,
including detention in or admission to a
health facility, isolation, or exclusion.
HSC
121452
Health officers may use state funding for
Authority
2014
Yes
actual costs of TB control.
HSC
121435
Health officers may order TB tests for
Authority
1995
Yes
pupils.
HSC
121515
School districts must cooperate with
Authority
1995
Yes
health officers for TB testing of pupils.
HSC
121525
Health officers may order testing for
Authority
1995
Yes
employees of private K-12 schools.
(amended
2014)
HSC
121525
Positive TB tests will be referred to the
Reporting
1995
Yes
health officer for follow-up care.
(amended
2014)
HSC
121525
TB tests required for employees of private
Duty
1995
Yes
K-12 schools must be provided at no cost
(amended
by the health officer.
2014)
HSC
121540
Health officers have a duty to enforce
Duty
1995
Yes
requirements for TB screening of
employees of private K-12 schools.
HSC
121635
Peace officers must report to the health
Reporting
1995
Yes
officer if police dogs behave abnormally
after biting someone.
HSC
121690
The health officer may issue exemptions
Authority
1995
Yes
for required rabies vaccines.
(amended
2013)
HSC
121705
It is a misdemeanor to violate a health
Authority
1995
Yes
121710
officer's orders to isolate or quarantine an
animal subject to rabies.
HSC
121730
Health officers are considered
Definition
1995
Yes
enforcement officers for the importation
of wild animals.
HSC
121340
When a wild animal is to be quarantined,
Reporting
1995
Yes
notice shall be given to the local health
officer.
HSC
123150
The county health officer may authorize
Authority
1995
Yes
destruction of TB -related x-ray
23
Code
Number
Meaning
Type of
Enacted/
Applies to
Statute
Amended
Designee?
photographs.
HSC
123730
CDPH will keep county health officers
Reporting
1995
Yes
advised of current knowledge of SIDS.
HSC
123740
Local health officers must contact the
Duty
1995
Yes
guardians of infant victims of SIDS for
referral and information. CDPH will
monitor compliance.
HSC
124775
Applications for rural health corps
Duty
1995
Yes
personnel projects must be submitted to
the local health officer, and reviewed
within 30 days.
HSC
124780
If the director goes against health officer
Authority
1995
Yes
recommendations on the rural health
corps applications, they must explain why.
HSC
125085
Positive HIV and HCV test results in
Reporting
1995
Yes
pregnant women will be reported to the
(Amended
local health officer.
2003)
HSC
130115
The governor must appoint either a
Collaboration
1998
Yes
county health officer or a county health
executive to the California Children and
Families Commission.
HSC
131130
A health officer can order someone to
Authority
2006
Yes
stop selling a food, drug, or cosmetic.
(amended
2011)
HSC
150204
A health officer can establish a surplus
Authority
2005
Yes
medication collection program.
(amended
2016)
HSC
102775
Funeral directors will file death certificates
Reporting
1995
Yes
and
with local registrars (health officers)
102780
within 8 days.
HSC
105200
The health officer has the authority to
Authority
1995
Yes
and
investigate cases of pesticide poisoning.
105210
Details in statute.
HSC
116271
The State Water Resources Control Board
Possible
1995
Yes
116330
may, by mutual agreement, delegate to
Authority
(Amended
116500
the local health officer safe drinking water
2014)
enforcement.
LAB
2441
Health officers must enforce the rule
Duty
1953
Yes
requiring all employers must have drinking
(amended
water available for employees.
1996)
LAB
6409
Physicians attending workers with
Reporting
1973
Yes
pesticide poisoning must report to local
(amended
health officer.
2016)
LAB
6712
The Division of Occupational Safety and
Reporting
1973
Yes
Health must report to the local health
(amended
24
Code
Number
Meaning
Type of
Enacted/
Applies to
Statute
Amended
Designee?
officer any time a violation of sanitary field
1996)
laws may result in contaminated food.
PEN
373a
Health officers may notify people to abate
Authority
1872
a nuisance.
(amended
1955)
PEN
374.5
25% of fines from grease waste haulers go
Funding
1872
to the local health officer, if the health
(amended
officer performed the investigation.
2005)
PEN
409.5
Health officers may close an area.
Authority
1872
(amended
1996)
PEN
829.5
Health officers are code enforcement
Definition
2010
officers
(amended
2011)
PEN
1202.1
When sex offenders are tested for HIV,
Duty
1872
tests go to the local health officer. Health
(amended
officers must provide counseling and
2017)
deliver test results.
0d nine
to p F e v e ed-ur-,+0AA @ A d
pFevide that 105A to e rt-s
'lnnnl
Repealed in 2017. Will disappear from
Repealed
future versions of this document.
in 2017.
PEN
1524.1
When referred by prosecutors, health
Duty
1872
officers must provide pre -HIV -test
(amended
counseling to victims of crime. Health
2004)
officers are also responsible for
performing the test and delivering results.
PEN
4018.1
Sheriffs must ask county health officers for
Consultation
1957
information on AIDS to give to inmates.
(amended
1988)
PEN
5008.1
The Director of Corrections must ask
Consultation
1944
county health officers for information on
(amended
AIDS to give to inmates.
1988)
PEN
7503
The county health officer (with others)
Duty
1988
must adopt guidelines delegating
(amended
authority of the chief medical officer of a
2004)
prison.
PEN
7510
For purposes of HIV testing, the county
Definition
1988
health officer can be the chief medical
(amended
officer of a prison.
2012)
PEN
7515
A decision to test a prisoner for HIV may
Approval
1988
be appealed to a three -person panel. This
(amended
panel must be approved by the local
2006)
25
Code
Number
Meaning
Type of
Enacted/
Applies to
Statute
Amended
Designee?
health officer.
PEN
7516
For purposes of HIV testing, the county
Definition
1988
health officer is the chief medical officer of
a city or county jail
PEN
7518
For purposes of HIV testing, the local
Duty
1988
health officer develops guidelines and
(amended
enforces them.
2006)
PEN
7550
DHS [sic] must provide HIV related forms
Reporting
1988
to county [sic] health officers.
PEN
7552
Correctional institutions are encouraged
Approval
1988
to create educational programs for HIV, to
(amended
include at least a pamphlet approved by
2006)
the county health officer
PEN
7553
The county health officer may approve
Authority
1988
DHS [sic] to conduct periodic anonymous
serologic surveys.
PEN
11105
The Attorney General must give relevant
Authority
1953
summary criminal history information to
(amended
the health officer.
2017)
PEN
11419
Peace officers who find bioterrorism
Consultation
1999
agents must notify and consult with the
(amended
local health officer.
2011)
PRC
3270.6
Owners of gas pipelines must notify the
Reporting
2008
Yes
health officer of a leak.
(amended
2015)
PRC
5099.7
Public beach funds may be withheld based
Authority
1996
on reports by the health officer. The
(Duplicative)
health officer's authority is more
specifically outlined in HSC 115885.
PRC
5163
Health officers provide followup care to
Duty
1939
Yes
parks and recs employees with a positive
(amended
TB skin test.
1986)
PRC
5163.1
Health officers may recommend TB tests
Authority
1939
Yes
for parks employees more frequently than
(amended
once every four years, the current
1986)
requirement.
PRC
16053
50% of fines from grease waste haulers go
Funding
2006
Yes
to local health officers, if they were the
(amended
investigator.
2007)
PRC
47115.5
Home -generated sharps manufacturers,
Authority
1989
Yes
when they submit a waste plan, must
(amended
support any plans by the health officer.
2009)
PRC
49620
Animals cannot be cremated within a city
Approval
1989
Yes
except in a facility approved by the health
26
Code
Number
Meaning
Type of
Enacted/
Applies to
Statute
Amended
Designee?
officer.
PUC
777.1
A corporation cannot shut off power or
Authority
1951
Yes
water to a multi -unit structure if a health
(amended
officer says it would be a health threat.
2010)
PUC
8302
Every utility managing a nuclear power
Reporting
1985
Yes
plant must submit to the health officer
twice yearly reports on effluents.
PUC
10009.1
A public utility cannot shut off power or
Authority
1951
Yes
water to a multi -unit structure if a health
(amended
officer says it would be a health threat.
2010)
PUC
12822.1
A municipal utility district cannot shut off
Authority
1951
Yes
power or water to a multi -unit structure if
(amended
a health officer says it would be a health
2009)
threat.
SHC
2808
With their written recommendation,
Authority
1971
Yes
health officers can eliminate proceedings
otherwise required before building a
sewer.
UIC
2626
The term "disability" applies to workers
Authority
1593
Yes
who cannot work because the health
(amended
officer says they may have a
2010)
communicable disease.
VEH
12527
In small counties, the county health officer
Authority
1959
Yes
may exempt volunteer ambulance drivers
(amended
from the requirement to submit to a
2016)
medical examination.
VEH
22505
If a county health officer declares that
Authority
1959
Yes
camping there would be a threat to
(amended
health, the Department of Transportation
1987)
may place signs disallowing parking near
state parks.
WAT
12882.2
Water districts applying for extreme
Consultation
1967
Yes
hardship loans must include
documentation of the threat to public
health, which may come from the health
officer (or CDPH).
WAT
13177.5
OEHHA will inform county health officers
Reporting
1969
Yes
of fish that pose a health risk, and will
(amended
urge health officers to post signs.
2015)
WAT
13193
When the legislature appropriates the
Consultation
1969
Yes
funds, regional water boards must consult
(amended
with health officers and others to compile
2010)
reports on sewage system overflows.
WAT
13225
Regional water boards must report any
Reporting
1969
Yes
case of suspected contamination
(amended
27
Code
Number
Meaning
Type of
Enacted/
Applies to
Statute
Amended
Designee?
2006)
WAT
13271
When notified of a discharge, health
Reporting,
1939
Yes
officers must work with their director of
Duty
(amended
environmental health to determine if
2013)
there is a health risk, and if so, must notify
the public.
WAT
13522
If a health officer finds that contamination
Duty
1969
Yes
has resulted from recycled water, they
(amended
he/she must order abatement.
2010)
WAT
13578
The 2002 Recycled Water Task Force must
Consultation
1991
include one representative of local agency
(amended
health officers [sic].
2010)
WIC
4369.5
The Office of Problem Gambling must
Consultation
1997
write an annual report describing, among
(amended
other things, its linkages with local health
2015)
officers.
WIC
5751.1
If the director of local mental health
Definition
1968
services is not the health officer, certain
(amended
conditions apply.
2012)
WIC
7329
A health officer may take a person into
Authority
1967
Yes
custody within five years of that person's
(amended
escape from a public mental hospital.
2014)
m
The Words "Health Officer" in the California Code of Regulations
Summer, 2017
Number
Meaning
Type of
Enacted/
Applies to
Statute
Amended
Designee?
3 CCR
When required by CDPH, a pet food
Approval
2012
1180.19
slaughtering and processing facility must show
a letter from the health officer stating it is in
compliance.
3 CCR
When necessary for zoo use, CDPH may
Approval
2012
1180.42
exempt slaughterers from certain provisions.
The local health officer must approve the
operation every 90 days.
3 CCR
When required by CDPH, a pet food
Approval
1970
1180.7
slaughtering and processing facility must have
its sewage disposal approved by the health
officer.
3 CCR 6146
Health officers remain subject to pesticide
Clarification
1998
illness reporting requirements regarding liquid
chemical sterilants.
5 CCR 420
School absences due to a health officer's
Authority
1970
quarantine order are excused.
(duplicative)
8 CCR 5199
In cases of health care occupational exposure
Reporting
2009
Lc
to aerosol transmissible disease, employers
must contact the local health officer. Health
care employers must maintain the ability to
communicate with the health officer.
8 CCR 5199
The health officer may require health care
Authority
2009
j�c
employers to give TB assessments to
employees more than annually.
8 CCR 5199
Health care employers must consult with the
Consultation
2009
LI11
local health officer on TB treatment options.
8 CCR 5199
Health officers must have access to an
Authority
2009
LI11
exposure analysis written by a health care
employer after an RATD case exposure.
8 CCR 5199
The local health officer can recommend
Authority
2009
LI11
precautionary removal of an employee after
an exposure incident.
8 CCR 5199
Medical records related to health care
Authority
2009
La
employee exposure to aerosol transmitted
diseases must be made available to the health
officer.
8 CCR 5199
Following recommendations of the local
Consultation
2009
A�apendix F
health officer is included in the sample
workplace alert for communicable diseases.
8 CCR
Health officers may recommend procedures
Authority
2009
5199.1
for zoonotic aerosol transmitted disease.
29
Number
Meaning
Type of
Enacted/
Applies to
Statute
Amended
Designee?
8 CCR
Employee medical records related to zoonotic
Authority
2009
5199.1
aerosol transmitted disease must be made
available to the health officer.
9 CCR 620
If the local mental health director is not the
Definition
1973
health officer, a variety of requirements
(amended
apply.
1988)
9 CCR
Mental health rehabilitation centers must
Reporting
1995
784.15
report unusual incidents to the health officer.
(amended
1997)
9 CCR
Mental health rehabilitation centers must
Reporting
1995
784.16
report reportable diseases to the local health
(duplicative)
(amended
officer.
1997)
9 CCR 10561
Residential alcoholism or drug abuse recovery
Reporting
1985
or treatment facilities must report reportable
(duplicative)
(amended
diseases to the local health officer.
1987)
13 CCR 1108
CDPH may exempt ambulances from certain
Authority
requirements, and may require local health
officer concurrence.
14 CCR
If holidays delay refuse collection, local health
Authority
1978
17331
officers may require more frequent refuse
removal when necessary for public health.
14 CCR
When solid waste facilities are investigated by
Consultation
1977
18303
the enforcement agency for a matter that
(amended
may impact public health, the enforcement
2001)
agency must consider the recommendations
of the health officer.
15 CCR 1121
When developing health education for minors
Consultation
2003
in jails, the health administrator for the jail
must consult with the local health officer.
15 CCR
Detention facilities must develop a plan to
Consultation
1991
1206.5
control TB and other communicable diseases
(amended
in consultation with the county health officer.
2017)
15 CCR 1245
The health officer may waive certain food
Authority
1992
codes in local detention facilities in certain
(amended
circumstances.
2009)
15 CCR 1313
Each juvenile detention facility must be
Duty
1997
inspected by the health officer annually.
(duplicative)
(amended
2013)
15 CCR 1408
When a minor is transferred to a receiving
Reporting
1997
home in another jurisdiction, their health
records will be sent to the health officer.
15 CCR 1410
Health administrators of juvenile facilities will
Consultation
1997
develop written disease control policies in
consultation with the local health officer.
15 CCR 1415
Health administrators of juvenile facilities will
Consultation
1997
30
Number
Meaning
Type of
Enacted/
Applies to
Statute
Amended
Designee?
develop appropriate sex education for minors
(amended
in consultation with the local health officer.
2013)
15 CCR 1454
Blind studies performed in juvenile facilities
Authority
1997
Yes
by health officers are not prohibited.
(amended
2013)
15 CCR 1466
The health officer may waive certain food
Authority
1997
codes in juvenile detention facilities in certain
(amended
circumstances.
2013)
15 CCR 1480
The health officer may approve laundry
Authority
1997
methods for juvenile detention facilities.
(amended
2007)
17 CCR 1004
When samples test positive, blood banks must
Reporting
1976
report syphilis to the local health officer.
(amended
1985)
17 CCR 1027
Labs must report spills of etiologic agents to
Reporting
1961
the local health officer.
(amended
1976)
17 CCR 1084
The health officer may declare any lab to be a
Authority
1971
public health lab if it meets certain
(amended
requirements.
1977)
17 CCR 1250
"The health department shall be under the
Definition
1971
direction of the health officer devoting full
(amended
time to official duties and these duties shall
1985)
constitute his primary responsibility and no
other activities shall interfere with
performance of his official duties."
17 CCR 1256
The state can approve part-time health
Definition
1959
officers in counties with a population of less
(amended
than 25,000.
1985)
17 CCR 1300
"The health officer shall be a graduate of a
Definition
1985
medical school of good standing and repute
and shall be eligible for a license to practice
medicine and surgery in the State of
California."
17 CCR 1365
"The county health officer shall retain powers,
Definition
1984
duties, and responsibilities relating to the
protection of public health as set forth in
Section 452 of the Health and Safety Code."
17 CCR 1367
"The district health officer shall retain powers,
Definition
1984
duties, and responsibilities relating to the
protection of public health as set forth in
Division 1, Part 2, Chapter 6 (commencing
with Section 880) of the Health and Safety
Code."
17 CCR 1369
"The Director of Environmental Health shall
Definition
1984
31
Number
Meaning
Type of
Enacted/
Applies to
Statute
Amended
Designee?
have powers and duties relating to
environmental health and sanitation services
and programs." The powers must be clearly
delineated in writing, and the EH director
must have a clear communication line with
the health officer.
17 CCR 1477
CPDH will send the health officer and others
Reporting
1981
notification on fiscal reports.
(amended
1983)
17 CCR 2500
Health care providers are required to report
Reporting
1945
LbJ
reportable conditions to the health officer. If
(amended
there is no health care provider, any individual
2016)
may report.
17 CCR 2500
In a health care facility where more than one
Reporting
1945
provider knows of a case of a reportable
(amended
disease, the administrator is responsible for
2016)
making sure the case is reported to the health
officer.
17 CCR 2500
The health officer shall not disclose
Duty
1945
information reported.
(amended
2016)
17 CCR 2500
Acute HIV must be reported to the health
Reporting
1945
I<
officer by phone within one working day.
(amended
2016)
17 CCR 2501
The health officer shall take whatever steps
Duty
1955
deemed necessary for the investigation and
Elaboration
(amended
control of any reported disease, including, if
1995)
necessary, examinations of people or animals.
(Elaborates on HSC 120175
17 CCR 2501
If requested to do so by CDPH, the health
Possible Duty
1955
aid.
officer shall conduct a special morbidity and
(amended
mortality study on reportable diseases.
1995)
17 CCR 2501
If the source of infection is outside the local
Duty
1955
jib
jurisdiction, the county shall notify the other
(amended
jurisdiction if known. The health officer must
1995)
also notify them if anyone in that jurisdiction
needs to be quarantined or evaluated. under
whose jurisdiction the infection was probably
contracted if known.
17 CCR 2502
Health officers must provide a weekly disease
Duty
1955
Lal
report to CDPH.
(amended
2016)
17 CCR 2502
Health officers must provide a case summary
Duty
1955
Lb
to CDPH for certain diseases.
(amended
32
Number
Meaning
Type of
Enacted/
Applies to
Statute
Amended
Designee?
2016)
17 CCR 2502
Health officers must provide immediate
Duty
1955
ic-1
phone reports to CDPH for certain diseases.
(amended
2016)
17 CCR 2502
Health officers must provide a case summary
Possible duty
1955
dim
to CDPH for any disease if requested by CDPH.
(amended
2016)
17 CCR 2502
During special investigations, health officers
Duty
1955
eI
will act with the authority of CDPH under GOV
(amended
11131
2016)
17 CCR 2502
Health officers shall not disclose personal
Duty
1955
f and
information except under specified
(amended
circumstances.
2016)
17 CCR 2502
Health officers must disclose information to
Duty
1955
f 1
local, state, or federal public health officials as
(amended
necessary to stop the spread of a disease.
2016)
17 CCR 2505
Public health labs must report certain results
Reporting
1962
to the health officer of the jurisdiction where
(amended
the requesting health care provider resides.
2016)
17 CCR 2505
Health officers shall not disclose personal
Duty
1962
I<
information except under specified
(amended
circumstances.
2016)
17 CCR 2505
Health officers must disclose information to
Duty
1962
la
local, state, or federal public health officials as
(amended
necessary to stop the spread of a disease.
2016)
17 CCR 2503
It is the duty of anyone in charge of a school
Reporting
1955
to report any suspected communicable
disease.
17 CCR 2509
The health officer shall maintain records as
Duty
1955
may be necessary.
17 CCR 2511
"It shall be the duty of the local health officer
Duty
1955
to determine the amount and kind of
communicable disease occurring in his area by
such methods as he deems necessary in order
to obtain knowledge of the general level of
morbidity in his jurisdiction."
17 CCR 2516
The health officer must give specific
Duty
1955
instructions for strict isolation.
17 CCR 2513
The health officer must give appropriate
Duty
1955
instructions for modified isolation.
17 CCR 2520
When quarantine is necessary, the health
Duty
1955
officer shall determine which contacts need to
be quarantined, and shall arrange medical
observation.
17 CCR 2524
The health officer must give instructions for
Duty
1955
33
Number
Meaning
Type of
Enacted/
Applies to
Statute
Amended
Designee?
cleanup of an isolation area.
17 CCR 2526
The health officer may submit a certificate to
Authority
1955
a school stating that a person is free of
(amended
communicable disease.
1988)
17 CCR 2528
If the health officer determines that milk is
Duty
1969
contaminated, he or she must prohibit the
sale of the milk and notify the
producer/distributor.
17 CCR 2530
The health officer may declare that a person
Authority
1955
may go back to work handling food or milk
(amended
after they are no longer capable of
1989)
transmitting disease.
17 CCR 2534
If a laboratory test is required for the release
Duty
1955
Yes
of cases or carriers, the health officer will take
the specimen and deliver it to the public
health lab.
17 CCR 2536
A person subject to quarantine cannot move
Approval
1955
within or between jurisdictions without
approval of the health officer. If the patient is
being moved to a hospital, the health officer
shall make appropriate arrangements.
17 CCR 2538
Funeral arrangements for someone who has
Authority
1955
died of a communicable disease must be
made in accordance with instructions from
the health officer.
17 CCR 2540
"In addition to the requirements stipulated in
Duty
1955
these regulations, the local health officer
(duplicative)
shall, after suitable investigation, take such
additional steps as he deems necessary to
prevent the spread of communicable disease
or a disease suspected of being communicable
in order to protect the public health."
17 CCR 2552
The health officer will investigate any
Duty
1955
suspected case of botulism, and try to prevent
(Amended
the distribution of contaminated food.
2002)
17 CCR 2564
Any newborn case of diarrhea that lasts more
Reporting
1955
aid.
than two days will be reported to the local
health officer.
17 CCR 2564
If two or more cases of newborn diarrhea
Approval
1955
LC-1
occur in a nursery, no new infants will be
admitted to that nursery until it has been
examined and approved by the health officer.
17 CCR 2566
The health officer may release a carrier of
Authority
1955
Lc
diphtheria from isolation under certain
conditions.
34
Number
Meaning
Type of
Enacted/
Applies to
Statute
Amended
Designee?
17 CCR 2566
The health officer shall prohibit the sale of
Duty
1955
eI
milk or milk products if a case of diphtheria
has been found on the premises.
17 CCR 2566
The health officer shall encourage and
Duty
1955
facilitate childhood immunizations against
diphtheria.
17 CCR 2574
Upon receiving a report, the health officer
Duty
1955
Yes
shall investigate the cause of a foodborne
illness outbreak, and will notify the state
health officer and other appropriate local
health officers if the food is distributed in
other jurisdictions.
17 CCR 2582
The health officer shall determine the amount
Duty
1955
of isolation necessary for a person with
leprosy (Hansen's Disease).
17 CCR 2588
Contacts with measles cases do not need to
Authority
1955
be restricted except at the discretion of the
local health officer.
17 CCR 2590
Contacts with meningitis cases do not need to
Authority
1955
be restricted except at the discretion of the
local health officer.
17 CCR 2596
"Contacts of cases of plague shall be kept
Authority
1955
under quarantine until the health officer is
(Amended
satisfied that they have not contracted the
2002)
infection."
17 CCR 2600
Contacts with anterior poliomyelitis cases do
Authority
1955
not need to be restricted except at the
discretion of the local health officer.
17 CCR 2603
Health officer may quarantine imported pet
Authority
1955
birds against psittacosis or other diseases.
(Amended
1999)
17 CCR 2606
People who know of an animal case or rabies
Reporting
1955
must report that to the local health officer.
(Amended
Bites from rabid animals must also be
1986)
reported.
17 CCR 2606
In an area declared to be a rabies area by the
Reporting
1955
state, health officers shall be notified of any
(Amended
bite from a species of animal subject to rabies.
1986)
17 CCR 2606
Rabid animals must be isolated in a manner
Authority
1955
Yes
b 1
approved by the local health officer (or other
(Amended
officer vested with authority by the local
1986)
governing body).
17 CCR 2606
Rabid animals may be sacrificed for testing
Authority
1955
b 1
with the approval of the local health officer.
(Amended
35
Number
Meaning
Type of
Enacted/
Applies to
Statute
Amended
Designee?
1986)
17 CCR 2606
Biting animals may be isolated at the
Authority
1955
LW_C21
discretion of the local health officer (or other
(Amended
officer vested with authority by the local
1986)
governing body).
17 CCR 2606
Biting animals may be sacrificed for testing
Authority
1955
LW_C21
with the approval of the local health officer
(Amended
and the owner.
1986)
17 CCR 2606
Animals bitten by rabid animals must be
Authority
1955
L-1
quarantined in a manner approved by the
(Amended
local health officer (or other officer vested
1986)
with authority by the local governing body).
17 CCR
The local health officer may declare a rabies
Authority
1955
2606.2
quarantine area.
(Amended
1971)
17 CCR
In a rabies area, health officers may approve a
Authority
1957
2606.4
rabies certificate form.
(Amended
2014)
17 CCR
In a rabies area, animal controllers must make
Reporting
1957
2606.4
quarterly reports to the local health officer,
and Duty
(Amended
who must pass them along to CDPH.
2014)
17 CCR 2612
Salmonella patients may be subject to
Authority
1955
aa.
observation by the health officer.
(amended
1983)
17 CCR 2612
Chronic carriers of salmonella may be
Authority
1955
Lb
restricted by the local health officer.
(amended
1983)
17 CCR 2612
Health officers may restrict contacts of
Authority
1955
Lc
salmonella carriers.
(amended
1983)
17 CCR
Health officers may order the quarantine or
Authority
1972
Yes
2612.1
the humane destruction of illegally imported
(amended
turtles.
1977)
17 CCR 2613
Shigella patients may be subject to
Authority
1955
supervision by the health officer, and the
(amended
health officer may also restrict contacts.
1983)
17 CCR 2614
Smallpox contacts may be released from
Authority
1955
quarantine at the discretion of the local
(amended
health officer.
2002)
17 CCR 2614
Health officers must provide smallpox
Duty
1955
vaccination at public expense to anyone
(amended
exposed to smallpox.
2002)
17 CCR 2616
Health officers may restrict contacts of cases
Authority
1955
of streptococcal hemolytic infections.
36
Number
Meaning
Type of
Enacted/
Applies to
Statute
Amended
Designee?
17 CCR 2620
Trachoma patients must be isolated except
Authority
1955
when under treatment that is satisfactory to
the health officer.
17 CCR 2622
The health officer must investigate any cases
Duty
1955
of trichinosis and notify CDPH if the source is a
commercial food service.
17 CCR 2624
Tuberculosis patients must follow the orders
Authority
1955
of the local health officer.
(amended
1969)
17 CCR 2624
Sanitoria or other places of care must notify
Reporting
1955
the local health officer when releasing a
(amended
patient with communicable tuberculosis.
1969)
17 CCR 2624
When someone with latent tuberculosis is
Duty
1955
Yes
placed in a nursing home, the local health
(amended
officer is responsible for continued
1969)
surveillance.
17 CCR 2628
Typhoid fever patients are subject to
Authority
1955
supervision of the local health officer. Health
(Amended
officers may restrict contacts.
1983)
17 CCR 2628
Chronic carriers of typhoid fever must be
Reporting
1955
reported to the local health officer.
(Amended
1983)
17 CCR 2628
Health officers must investigate carriers of
Duty
1955
typhoid fever and must report to CDPH.
(Amended
1983)
17 CCR 2628
Typhoid fever carriers are subject to
Authority
1955
supervision of the local health officer.
(Amended
1983)
17 CCR 2628
The local health officer must contact typhoid
Duty
1955
Yes
fever carriers twice a year, and must report to
(Amended
CDPH.
1983)
17 CCR 2628
Any necessary lab test samples must be taken
Duty
1955
Yes
from typhoid fever carriers by the local health
(Amended
officer or their representative.
1983)
17 CCR 2628
Health officers are involved in the decision as
Authority
1955
to whether to release typhoid fever carriers.
(Amended
1983)
17 CCR 2636
If a health officer finds an unusual prevalence
Duty
1955
ic-1
of venereal disease, they must report it to
(Amended
CDPH.
1973)
17 CCR 2636
Health officers must try to suppress
Duty
1955
Le
prostitution, and shall not issue a certificate of
(Amended
freedom from venereal disease to a known
1973)
prostitute.
37
Number
Meaning
Type of
Enacted/
Applies to
Statute
Amended
Designee?
17 CCR 2636
A health officer may require sample
Authority
1955
submission for venereal disease testing.
(Amended
1973)
17 CCR 2636
Health officers must ascertain the existence of
Duty
1955
L111
and investigate cases of venereal disease.
(Amended
1973)
17 CCR 2636
If a person known to have venereal disease
Reporting
1955
L111
does not receive treatment within ten days,
(Amended
that person will be reported to the health
1973)
officer. If the source is a prostitute, that
information is given to the health officer
immediately.
17 CCR 2636
"In carrying out [STD] investigations, all health
Authority
1955
D21
officers are hereby invested with full powers
(Amended
of inspection, examination and isolation of all
1973)
persons known to be infected with a venereal
disease in an infectious stage, or suspected of
being infected with a venereal disease in an
infectious stage..."
17 CCR 2636
The health officer has a number of duties
Duty
1955
D21
when investigating venereal disease, including
(Amended
providing woman physicians for woman
1973)
patients if requested.
17 CCR 2636
The health officer may require strict isolation
Authority
1955
i I m
for venereal disease patients.
(Amended
1973)
17 CCR 2636
"If any person has knowledge that a person
Reporting
1955
I<
infected with a venereal disease is failing to
(Amended
observe adequate precautions to prevent
1973)
spreading infection, he shall report the facts
at once to the local health officer."
17 CCR
A person working under the health officer can
Authority
2002
2641.45
be considered a health care provider for
(amended
purposes of HIV.
2007)
17 CCR
The health officer is appointed by the local
Definition
2002
2641.50
governing board.
(duplicative)
17 CCR
Health care providers must report HIV cases
Reporting
2002
Yes
2643.5
to the health officer within seven days.
(amended
2007)
17 CCR
Laboratory directors must report HIV cases to
Reporting
2002
Yes
2643.10
the health officer within seven days.
(amended
2007)
17 CCR
The local health officer must report HIV cases
Duty
2002
Yes
2643.15
to CDPH within 45 days.
(amended
2007)
ION
Number
Meaning
Type of
Enacted/
Applies to
Statute
Amended
Designee?
17 CCR 2810
Health care providers must report disorders
Reporting
2000
involving lapses of consciousness in patients
over 14 years of age to the health officer
within seven days.
17 CCR 2812
In certain circumstances, a health care
Reporting
2000
provider is not required to report disorders
involving lapses of consciousness to the
health officer.
17 CCR 6060
The school board must notify the health
Reporting
1986
officer is a pupil is unimmunized and has been
(amended
exposed to a disease.
1996)
17 CCR 6060
The health officer must assess the risk and
Duty
1986
may require exclusion from school if an
(amended
unimmunized child has been exposed to a
1996)
disease.
17 CCR
The county registrar must report out -of-
Reporting
1989
6507.1
hospital births to the local health officer.
(amended
2006)
17 CCR 6608
A school must provide TB certificates to the
Reporting
local health officer within two weeks of the
start of the school year.
17 CCR 6822
If the local Child Health and Disability
Definition
1979
Prevention Program Director is the health
(amended
officer, their salary does not have to be
1980)
reimbursed by the state.
17 CCR 7002
When authorizing a syringe exchange
Consultation
2013
program, CDPH must consult with the local
health officer and law enforcement.
17 CCR 7006
When reauthorizing a syringe exchange
Consultation
2013
program, CDPH must consult with the local
health officer and law enforcement.
17 CCR 7583
For a small water system, the local health
Definition
1953
officer is considered a "health agency."
(amended
Specific duties and authorities are outlined in
2015)
Title 17, Subchapter 1, g u4.
17 CCR 7934
Collectors of vermin must register with the
Duty
1966
local health officer, who must report them to
(amended
the vector management unit within seven
1978)
days.
17 CCR 7935
Rodents who die in quarantine must be
Reporting
1978
reported to the health officer within two days.
17 CCR 7936
The health officer must report wild rodents
Duty
1978
who die in quarantine to the vector
management unit, and must ship them the
carcass.
39
Number
Meaning
Type of
Enacted/
Applies to
Statute
Amended
Designee?
17 CCR 7959
The local health officer is responsible for
Duty
1985
water sampling at public beaches and water -
contact sports areas.
17 CCR 7960
The health officer may post signs and/or
Authority
1985
restrict use of public beaches and water -
contact sports areas.
17 CCR 7961
If a beach is visited by more than 50,000
Duty
1999
people annually, the health officer has duties
to post signs and restrict access under certain
circumstances.
17 CCR 7974
The health officer can declare debris to be
Authority
1984
refuse.
17 CCR 7978
The health officer for a beach is the health
Definition
1984
officer of that jurisdiction.
17 CCR 7979
The health officer may declare that beach
Authority
1985
standards don't apply if a beach is kept as
open space.
17 CCR 7980
Plans for sanitation facilities at public beaches
Approval
1984
must first be approved by the local health
officer.
17 CCR 7983
Water for drinking and bathing at beaches
Approval
1984
must be from a source approved by the health
officer.
17 CCR 7985
Refuse containers approved by the health
Approval
1984
officer must be provided at all public beaches.
17 CCR 7988
Refuse containers approved by the health
Approval
1984
officer must be provided in camping areas at
beaches.
17 CCR 7992
Health officers may approve alternate
Authority
1984
Lc
methods of disposing of non -human waste at
beach campsites.
17 CCR 7992
Each beach campsite must include trailer
Approval
1984
11
sanitation stations approved by the health
officer.
17 CCR 7994
Potable water at beach campsites must be
Approval
1984
from a source approved by the health officer.
17 CCR
Mobile food units may only fill their water
Approval
1972
13609
tanks and empty their waste at facilities
approved by the health officer.
17 CCR
A packaged food for resale at roadside stands,
Approval
1975
13650
open-air facilities, and dairies must be
packaged at a facility approved by the health
officer.
40
Number
Meaning
Type of
Enacted/
Applies to
Statute
Amended
Designee?
17 CCR
The health officer must investigate suspected
Duty
1984
13652
disease transmission at roadside stands,
open-air facilities, and dairies.
17 CCR
After investigating illness at roadside stands,
Authority
1984
13652
open-air facilities, and dairies, the health
officer may require medical examinations,
exclusion of employees, or closing of the
facility.
17 CCR
"Building plans for new construction or
Approval
Yes
13671
remodeling of kitchen ventilation systems in
retail food establishments shall be submitted
for review and approval to either the local
health officer or a duly authorized registered
sanitarian."
17 CCR
An organized camp must submit notice to the
Reporting
1986
30703
local health officer at least 30 days prior to
(amended
beginning operation.
2008)
17 CCR
The health officer must reply to an organized
Duty
1986
30703
camp within seven days of receiving its
(amended
registration, and must forward the
2008)
registration to the State Fire Marshal.
17 CCR
Organized camps must submit registration
Reporting
2008
30704
annually to the local health officer.
17 CCR
Plans for buildings at camps must first be
Approval
1971
Yes
30720
approved by the local health officer, who may
(amended
contract with the Office of the State Architect
2008)
of the State Department of General Services.
17 CCR
Housing at organized camps must be kept in a
Approval
1986
30722
manner satisfactory to the health officer.
(amended
2008)
17 CCR
Garbage must be removed from organized
Approval
1986
30735
camps in a manner satisfactory to the health
(amended
officer.
2008)
17 CCR
Organized camps must have a vector control
Consultation
1984
30736
plan under the guidance of the local health
(amended
officer.
2008)
17 CCR
Organized camps must submit to the health
Reporting
1971
30741
officer any plan to use a lake, stream, river, or
(amended
ocean.
2008)
17 CCR
The health officer may specify conditions
Authority
1971
30741
under which a camp may use a lake, stream,
(amended
river, or ocean.
2008)
17 CCR
The health officer may require immunizations
Authority
1980
30Z50 LbI
for campers or staff at organized camps.
(amended
41
Number
Meaning
Type of
Enacted/
Applies to
Statute
Amended
Designee?
2008)
17 CCR
The health officer may require an organized
Authority
1980
30750 e
camp to staff an infirmary or have an on -call
(amended
physician.
2008)
17 CCR
Camps must report foodborne illness to the
Reporting
1980
30750
health officer promptly.
(amended
2008)
17 CCR
Health officers may enter hotels, motels, and
Authority
30858
other public places for purposes of inspection.
17 CCR
Upon receiving a report of pesticide -related
Duty
Yes
98100
illness, the health officer must send a report
to the Office of Environmental Health Hazard
Assessment, the Director of Pesticide
Regulation, and, for work -related illness or
injury, the Director of Industrial Relations.
19 CCR 2643
Area Hazardous Materials Response Plans
Consultation
must include consultation with the local
health officer about procedures for contacting
local medical providers and about pesticide
drift.
19 CCR 2644
Area Hazardous Materials Response Plans
Consultation
must include consultation with the local
health officer to ensure access to care within
24 hours for those impacted by pesticide drift.
22 CCR
Applications to the California Health Services
Consultation
40127
Corps must first be sent to the health officer,
who has thirty days to respond, if desired.
22 CCR
Applications for financial assistance to Rural
Consultation
40233
Health Services Development Projects must
first be sent to the health officer, who has
thirty days to respond, if desired.
22 CCR
The local health officer can apply certain
Authority
1982
41301
regulations if anyone admitted to school or
day care has tuberculosis.
22 CCR
If a pupil shows proof of a prior TB test within
Authority
41317
the last year, the health officer can determine
next steps.
22 CCR
If a pupil shows proof of current or prior TB
Authority
41319
treatment, the health officer may admit them
to school.
42
Number
Meaning
Type of
Enacted/
Applies to
Statute
Amended
Designee?
22 CCR
Health officers may require TB testing of
Authority
41325
pupils.
22 CCR
Schools must report to the health officer any
Reporting
41329
pupil who may have been exposed to TB and
who has not been examined.
22 CCR
The local health officer may require pupils to
Authority
41329
be excluded from school if they have been
exposed to TB and have not been examined.
22 CCR
Water recyclers must immediately notify the
Reporting
1984
60329
health officer by telephone of the release of
any untreated wastewater.
22 CCR
Small water systems must be approved by the
Approval
1991
64211
local health officer.
(amended
2012)
22 CCR
State small water systems shall submit their
Reporting
1991
64212
quarterly water monitoring reports to the
(amended
health officer.
2015)
22 CCR
State small water systems shall notify the
Reporting
1991
64212
health officer within 48 hours if E. coli is
(amended
found.
2015)
22 CCR
If E. coli is found, state small water systems
Authority
1991
64212
must take corrective action as directed by the
(amended
health officer.
2015)
22 CCR
The "health office" may require monthly
Authority
1991
64212
testing of a state small water system if it has
(amended
bacteriological contamination problems.
2015)
22 CCR
A health officer may declare a water source
Authority
1991
64213
vulnerable to volatile organic compounds.
(amended
2015)
22 CCR
Lab results for organic compounds in state
Reporting
1991
64213
small water systems must be submitted to the
(amended
local health officer.
2015)
22 CCR
State small water systems must comply with
Authority
1991
64213
any corrective actions ordered by the health
(amended
officer related to chemical contaminants.
2015)
22 CCR
State small water systems must show the
Approval
1991
64215
health officer that there is sufficient water
(amended
available.
1992)
22 CCR
The State Water Resources Control Board and
Possible
1993
64251 and
the local health officer can sign a "primacy
Authority
(amended
22 CCR
delegation agreement" giving authority over
2015)
64252
state small water systems to the health
43
Number
Meaning
Type of
Enacted/
Applies to
Statute
Amended
Designee?
officer.
22 CCR
For water systems with less than 200 service
Authority
1994
64449.5
connections, the local health officer can
(amended
determine the rate of testing for color, odor,
2015)
and turbidity.
22 CCR
County health officers may declare a
Authority
1998
64651.91
waterborne microbial disease outbreak.
(amended
2015)
22 CCR
The health officer is an enforcing agent for
Definition
1980
65501
public swimming schools. Associated
and Authority
(amended
authorities are outlined in CCR Chapter 22,
2014)
Title 22, Division 4, Chapter 20.
22 CCR
The health officer may order immediate
Authority
1991
66263.30
removal of hazardous waste if necessary to
protect human health.
22 CCR
The state can seize samples if the health
Authority
1991
66272.1
officer believes them to be hazardous waste.
(amended
1994)
22 CCR
The health officer is an enforcement agency
Definition
1997
66272.60
for purposes of administrative penalties for
(amended
hazardous waste. Associated authorities and
2001)
duties are outlined in CCR Title 22, Division
4.5, Chapter 22, Article 3
22 CCR
While hospital employees must usually be
Authority
1980
70723
tested for tuberculosis annually, the health
(amended
officer may authorize less frequent tests, as
2013)
long as it is at least every four years.
22 CCR
In addition to reportable diseases, general
Reporting
70737
acute care hospitals must also report by
telephone to the health officer any unusual
occurrence or disaster that threatens the
health of patients.
22 CCR
In addition to reportable diseases, acute
Reporting
71535
psychiatric hospitals must also report by
telephone to the health officer any unusual
occurrence or disaster that threatens the
health of patients.
22 CCR
The health officer's name and phone number
Reporting
72321
shall be available at the nurses' station at
skilled nursing facilities.
22 CCR
Skilled nursing facilities must report
Reporting
72537 and
reportable diseases and outbreaks to the
(duplicative)
44
Number
Meaning
Type of
Enacted/
Applies to
Statute
Amended
Designee?
22 CCR
health officer.
72539
22 CCR
In addition to reportable diseases, skilled
Reporting
72541
nursing facilities must also report to the
health officer any unusual occurrence or
disaster within 24 hours.
22 CCR
If a patient has a reportable communicable
Approval
73531
disease, an intermediate care facility must
implement the procedures approved by the
local health officer, which must include
certain elements.
22 CCR
Intermediate care facilities must report
Reporting
73533 and
reportable communicable diseases and
(duplicative)
22 CCR
outbreaks to the health officer.
73535
22 CCR
Intermediate care facilities must report
Reporting
73537
unusual diseases to the health officer.
22 CCR
In addition to reportable diseases,
Reporting
73539
intermediate care facilities must also report to
the "health office" any unusual occurrence or
disaster within 24 hours.
22 CCR
Employees of home health agencies need not
Authority
1995
74723
be tested annually for TB if the health officer
(amended
certifies that less frequent testing is
2013)
warranted.
22 CCR
Home health agencies must report reportable
Reporting
74725 and
diseases and outbreaks to the health officer.
(duplicative)
22 CCR
74727
22 CCR
In addition to reportable diseases, home
Reporting
75053
health agencies must also report to the health
officer any unusual occurrence or disaster
within 24 hours.
22 CCR
Psychology clinics must report to the health
Reporting
75339
officer any unusual occurrence or disaster
within 24 hours.
22 CCR
Intermediate care facilities for the
Consultation
2011
76521
developmentally disabled must develop
disease control protocol "in concurrence"
with the local health officer.
22 CCR
If a patient has a reportable communicable
Approval
76543
disease, an intermediate care facility for the
developmentally disabled must implement
45
Number
Meaning
Type of
Enacted/
Applies to
Statute
Amended
Designee?
the procedures approved by the local health
officer, which must include certain elements.
22 CCR
Intermediate care facilities for the
Reporting
76545 and
developmentally disabled must report
(duplicative)
22 CCR
reportable communicable diseases and
76547
outbreaks to the health officer.
22 CCR
Intermediate care facilities for the
Reporting
76549
developmentally disabled must report
unusual diseases to the health officer.
22 CCR
In addition to reportable diseases,
Reporting
76551
intermediate care facilities for the
developmentally disabled must also report to
the health officer any unusual occurrence or
disaster within 24 hours, and must keep that
record on file for five years.
22 CCR
Habilitative intermediate care facilities for the
Consultation
76916
developmentally disabled must develop
disease control protocol "in concurrence"
with the local health officer.
22 CCR
Habilitative intermediate care facilities for the
Reporting
76922
developmentally disabled must report
(duplicative)
reportable communicable diseases to the
health officer.
22 CCR
In addition to reportable diseases, habilitative
Reporting
76923
intermediate care facilities for the
developmentally disabled must also report to
the health officer any unusual occurrence or
disaster within 24 hours, and must keep that
record on file.
22 CCR
Adult day health centers must report to the
Reporting
78427
health officer any unusual occurrence or
disaster within 24 hours, and must keep that
record on file.
22 CCR
Chemical Dependency Recovery Hospitals
Reporting
79339
must report to the health officer any unusual
occurrence or disaster within 24 hours, and
must keep that record on file for three years.
22 CCR
The health officer's name and phone number
Reporting
1994
79637
shall be available at the nurses' station at
(amended
correctional treatment centers.
2010)
22 CCR
Correctional treatment centers must report
Reporting
1994
79787
reportable communicable diseases and
46
Number
Meaning
Type of
Enacted/
Applies to
Statute
Amended
Designee?
unusual occurrences within 24 hours.
22 CCR
When an inmate with TB will be released,
Reporting
1994
79787
correctional treatment centers must report to
the health officer to which the inmate will be
released.
22 CCR
Community care facilities must report abuse
Reporting
1987
80061
and threats of abuse to the health officer.
(amended
2017)
22 CCR
Social rehabilitation facilities must report
Reporting
1991
81061
abuse, threats of abuse, and epidemic
(amended
outbreaks to the health officer.
2017)
22 CCR
This section deals with adult day programs. It
Reporting
2002
82061
looks like it originally required these programs
(amended
to report epidemic outbreaks and poisonings
2017)
to the local health officer, but recent re -
lettering takes away that meaning.
22 CCR
Residential care facilities for the elderly must
Reporting
87211
report unusual occurrences to the local health
officer within 24 hours.
22 CCR
Residential care facilities for the chronically ill
Reporting
1991
87861
must report abuse, poisoning, and
(amended
catastrophes to the local health officer.
2004)
22 CCR
A foster family agency must report epidemic
Reporting
1993
88061
outbreaks, poisonings, and catastrophes to
(amended
the local health officer.
2000)
22 CCR
A foster family agency must report outbreaks
Reporting
1993
88061
involving two or more children to the local
(amended
health officer.
2000)
22 CCR
Postsurgical Recovery Centers must report
Reporting
1988
97520.1
outbreaks and undue prevalences to the local
(duplicative)
health officer, and cannot admit new patients
until cleared.
22 CCR
Postsurgical Recovery Care Demonstration
Reporting
1988
97530.31
Projects must report reportable
(duplicative)
(amended
and 22 CCR
communicable diseases and outbreaks to the
1990)
97530.33
health officer.
22 CCR
Postsurgical Recovery Care Demonstration
Reporting
1988
97530.35
Projects must report to the health officer any
(amended
unusual occurrence or disaster within 24
1990)
hours, and must keep that record on file for
one year.
47
Number
Meaning
Type of
Enacted/
Applies to
Statute
Amended
Designee?
22 CCR
Child care centers must report epidemic
Reporting
1986
101212
outbreaks, poisonings, and catastrophes to
(amended
the local health officer.
2004)
22 CCR
Child care centers must report outbreaks
Reporting
1986
101212
involving two or more children to the local
(amended
health officer.
2004)
23 CCR 420
Applications for loans for irrigation or
Approval
1961
municipal distribution system projects which
(amended
involve extreme hardship which jeopardizes
1983)
the public health shall be accompanied by a
report by the local health officer or CDPH.
25 CCR 760
The local health officer may approve a
Approval
1979
different ratio of toilets and bathing facilities
(amended
in temporary and seasonal employee housing.
1994)
26 CCR 22-
Water reclamation plants must report any
Reporting
1984
60329
discharge of untreated wastewater to the
(duplicative)
local health officer by telephone.
26 CCR 22-
A state small water system must first be
Approval
1991
64211
approved by the local health officer.
(amended
2012)
26 CCR 22-
State small water systems shall submit their
Reporting
1991
64212 a
quarterly water monitoring reports to the
(duplicative)
(amended
health officer.
2015)
26 CCR 22-
State small water systems shall notify the
Reporting
1991
64212 b
health officer within 48 hours if E. coli is
(duplicative)
(amended
found.
2015)
26 CCR 22-
If E. coli is found, state small water systems
Authority
1991
64212 b
must take corrective action as directed by the
(duplicative)
(amended
health officer.
2015)
26 CCR 22-
The "health office" may require monthly
Authority
1991
64212 c
testing of a state small water system if it has
(duplicative)
(amended
bacteriological contamination problems.
2015)
26 CCR 22-
A health officer may declare a water source
Authority
1991
64213 b
vulnerable to volatile organic compounds.
(duplicative)
(amended
2015)
26 CCR 22-
Lab results for organic compounds in state
Reporting
1991
64213 c
small water systems must be submitted to the
(duplicative)
(amended
local health officer.
2015)
26 CCR 22-
State small water systems must comply with
Authority
1991
64213 d
any corrective actions ordered by the health
(duplicative)
(amended
officer related to chemical contaminants.
2015)
Number
Meaning
Type of
Enacted/
Applies to
Statute
Amended
Designee?
26 CCR 22-
State small water systems must show the
Approval
1991
64215
health officer that there is sufficient water
(duplicative)
(amended
available.
1995)
26 CCR 22-
For water systems with less than 200 service
Authority
1994
64449.5
connections, the local health officer can
(duplicative)
(amended
determine the rate of testing for color, odor,
2015)
and turbidity.
27 CCR
In developing the Unified Program for
Consultation
1994
15100
hazardous materials and hazardous waste
(amended
management, the Secretary of the California
2013)
Environmental Protection Agency must
consult with local health officers.
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Appendix 1: Codes Related to CCLHO
Code
Number
Meaning
Type of
Enacted/
Statute
Amended
PEN
11174.34
CCLHO is included in the California State Child
Collaboration
2004 (amended
and
Death Review Council.
2013)
16481.1
WIC
14134.5
The California Medical Assistance Program will
Consultation
1965 (amended
consult with CCLHO to establish standards for
2015)
perinatal care.
HSC
1797.132
The Interdepartmental Committee on Emergency
Collaboration
1980 (amended
Medical Services will include a representative
2013)
from CCLHO.
HSC
1799.2
CCLHO must submit three county health officer
Collaboration
1980 (amended
names so that the governor can appoint one to
2008)
the Commission on Emergency Medical Services.
HSC
100290
DHCS will submit all its non -emergency
Collaboration
1995
regulations related to local health departments
to CCLHO for comment, and must respond to any
comments made by CCLHO that are not
incorporated.
HSC
100295
DHCS, after consultation with CCLHO, will
Collaboration
1995
establish standards for training for local health
department staff.
HSC
100925
CCLHO is established. "The conference shall
Definition
1995
consist of all legally appointed local health
officers in the state. It shall organize, adopt
bylaws, and shall annually elect officers."
HSC
100925
"The conference may consult with, advise, and
Authority
1995
make recommendations to the department,
other departments, boards, commissions and
officials of federal, state, and local government,
the Legislature, and any other organization or
association on matters affecting health."
HSC
100925
Attendance at two meetings per year is a legal
Authority
1995
charge to the local health department.
HSC
100950
DHCS will adopt regulations only after review and
Authority
1995 (Amended
approval by CCLHO if they relate to CCLHO or to
2012)
state aid to local health departments.
HSC
106675
CCLHO shall have one member on the
Collaboration
1995
Environmental Health Specialist Registration
Committee.
HSC
120130
CDPH can modify the list of reportable diseases
Consultation
1995 (amended
after consultation with CCLHO.
2011)
HSC
120875
The Department of Education must collaborate
Collaboration
1995 (amended
with CCLHO on HIV information they provide to
2006)
schools.
50
HSC
124405
CCLHO will be consulted in the original
Consultation
1995
development of the statewide plan for health
services for special population groups, but
perhaps not subsequent revisions.
HSC
131050
CCLHO is housed in CDPH.
Definition
2006
HSC
131205
CDPH will submit all regulations related to LHDs
Consultation
2006
to CCLHO for review, and shall respond in writing
if they do not follow CCLHO recommendations.
HSC
131210
CDPH will consult with CCLHO to create
Consultation
2006
regulations related to education and experience
standards for LHD personnel.
CCR
22 CCR
Form 700 disclosures from CCLHO should include
Duty
2014 (amended
20100.5
"investments, business positions in business
2017)
entities, and all sources of income (including
receipt of loans, gifts, and travel payments) from
sources that are subject to the regulatory
authority of the Department of Public Health."
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Appendix 2: Outdated / Duplicative Codes Not Listed
FAM 6926 refers to reportable diseases.
GOV 24306.5 applies only to the County of San Diego.
HSC 100125 requires consultation with CCLHO but only by 1984.
HSC 101318 requires consultation with CCLHO but only for 2010 budget year.
HSC 116395 refers to organic chemical contamination training to be completed in the 1980s.
HSC 116064.2 refers to swimming pool forms created by 2010.
HSC 121340 refers to HIV guidelines created by 2005.
HSC 130140 refers to commissions between 1990 and 2000
HSC 130251 is related only to the American Recovery and Reinvestment Act of 2009
HSC 26200 refers to a fungal report due by 2003.
WAT 13193 d refers back to HSC 5412.
WAT 13565 (b) (1) refers to an advisory group to be formed before 2014.
WIC 5366.1 has two references to health officers for people specifically incarcerated between 1967 and
1972.
WIC 14154.15 requires a one-time outreach plan to health officers.
22 CCR 97520.1 says that if a postsurgical recovery facility has an outbreak reportable to the health
officer, they should cease admitting new patients until it is over.
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