Summary of, and comparison with, existing or proposed federal regulations
There appears to be no existing or proposed federal regulations that address the activities to be regulated by the proposed rules.
Comparison with rules in adjacent states
Illinois:
The Illinois Department of Public Health outlines local health department’s required personnel and practice standards in 77 Ill. Admin. Code 600. An executive officer, public health administrator, and medical health officer are required personnel. Practice standards are activities that demonstrate a local health department is fulfilling the core functions of public health. To obtain provisional certification, local health departments must commit to a series of planning activities conducted within the local health department jurisdiction resulting in the development of an organizational capacity assessment, a community health needs assessment, and a community health plan. A 5-year certification may be granted once the community health needs assessment and a community health plan are submitted.
Iowa:
641 Iowa Admin. Code Chap. 80 outlines local public health services. The purpose of the local public health services contract is to implement the core public health functions, deliver essential public health services, and increase the capacity of local boards of health to promote health people and healthy communities. Local health departments are or may be contractors of the Iowa Department of Public Health and are required to provide evidence that they engage in an annual evaluation. Additionally, the Iowa Department of Public Health participates in the national Gaining Ground initiative to support voluntary accreditation and quality improvement. See http://idph.iowa.gov/mphi/gaining-ground. Michigan:
Requirements of local health departments are set forth in MCL 333.2431. Local health departments are required to report annually to the Michigan Department of Community Health on their satisfaction of requirements, including having a plan of organization and demonstrated ability to provide required services. Local health departments must keep records and afford access to the records by authorized state, federal, and local officials for audit and review purposes necessary to verify and assure the accuracy and acceptability of the reports, as a condition of receiving state funding. The state engages in an annual review of the program statement and budget for local health departments.
Minnesota:
The Minnesota Department of Health enters into agreements with community health boards for the development and maintenance of a system of community health services. Community health boards must submit a community health assessment and community health improvement plan to the Minnesota Department of Health at least every five years, implementing a performance management process, and annually report to the commissioner on a set of performance measures and be prepared to provide document of ability to meet performance measures. Minn. Stat. 145A.07 subd. 1a. (2)-(4).
Summary of factual data and analytical methodologies
The department relied on the following sources to draft the proposed rule and to determine the impact on local health departments.
The department formed an Advisory Committee consisting of local health officers from the State of Wisconsin as well as a member from the Wisconsin Counties Association. Advisory Committee members reviewed current services offered by local health departments and considered numerous public health models. The Advisory Committee also considered the impact of the proposed rule on local health departments. Committee members recommended utilizing the Foundational Public Health Service model as the basis for revising this rule. Proposed rule revision language was drafted based on the recommendations of this committee.
In addition, the department reviewed the following:
Analysis and supporting documents used to determine effect on small business
None. The proposed rule affects only local health departments.
Effect on small business
Revisions to ch. DHS 140 are expected to have no impact on small businesses. Agency contact person
Melanie Johnson
Phone: 608 266-1348
Statement on quality of agency data
The data sources referenced and used to draft the rules and analyses are accurate, reliable, and objective and are discussed in the “Summary of factual data and analytical methodologies.”
Place where comments are to be submitted and deadline for submission
RULE TEXT
SECTION 1. DHS 140.02 is repealed.
SECTION 2. DHS 140.03 (1m) is created to read:
DHS 140.03 (1m): “Community health improvement plan” means the written plan developed by a local health department with the involvement of key policy makers and the general public to implement the services and functions specified under s. 250.03 (1) (L), pursuant to s. 251.05 (3) (c), Stats., and the requirements of this chapter. SECTION 3. DHS 140.04 to DHS 140.07 are repealed and recreated to read:
DHS 140.04 Level I local health department.
(1) Required Services. A level I local health department shall provide leadership for developing and maintaining the public health system within its jurisdiction by conducting all of the following:
(a) Surveillance and investigation.
1. Collect and analyze public health data to do all of the following:
a. Identify health problems, environmental public health hazards, and social and economic risks that affect the public’s health.
b. Guide public health planning and decision-making at the local level.
c. Develop recommendations regarding public health policy, processes, programs, or interventions, including the community health improvement plan.
2. Conduct timely investigations of health problems and environmental public health hazards in coordination with other governmental agencies and stakeholders.
3. Establish written protocols for obtaining laboratory services at all times.
(b) Communicable disease control.
1. Conduct activities required of local health departments under ch. DHS 144, relating to immunization of students.
2. Comply with the requirements of ch. DHS 145, relating to prevention, monitoring, conducting epidemiological investigations, and control of communicable diseases, including outbreaks.
3. Improve public recognition and awareness of communicable diseases and other illnesses of public health importance.
4. Provide or facilitate community-based initiatives to prevent communicable diseases.
(c) Other disease prevention.
1. Develop and implement interventions intended to reduce the incidence, prevalence or onset of chronic diseases or to prevent or ameliorate injuries that are the leading causes of disability and premature death in the local health department’s jurisdiction, as identified in the community health assessment or the most recent state public health agenda.
2. Link individuals to needed personal health services.
3. Identify and implement strategies to improve access to health services.
(d) Emergency preparedness and response.
1. Participate in the development of response strategies and plans in accordance with local, state, and national guidelines to address public health emergencies as defined in s. 323.02 (16), Stats. 2. Participate in public health preparedness exercises.
3. Communicate and coordinate with health care providers, emergency service providers, and other agencies and organizations that respond to a disaster, outbreak or emergency.
4. Define the role of public health personnel in responding to a disaster, outbreak, or emergency, and activate these personnel during any such occurrence.
5. Maintain and execute an agency plan for providing continuity of operations during a disaster, outbreak, or emergency, including a plan for accessing resources necessary for response or recovery.
6. Issue and enforce emergency health orders, as permitted by law.
7. Establish processes to ensure the local health department is immediately notified of an actual or potential disaster, outbreak, or emergency.
8. Implement strategies intended to protect the health of vulnerable populations during a disaster, outbreak, or emergency.
(e) Health promotion.
1. Develop and implement interventions, policies, and systems to promote practices that support positive public health outcomes and resilient communities.
2. Disseminate relevant, accurate information and evidence-informed prevention guidance to the public health system and community.
