The following are external links to codes, statutes, and regulations that detail mandated responsibilities of Local Public Health Departments.

General Requirements

Enforcement of State and Local Laws Related to Public Health

Health & Safety Code section 101030 provides:

101030.  The county health officer shall enforce and observe in the unincorporated territory of the county, all of the following:

• Orders and ordinances of the board of supervisors, pertaining to the public health and sanitary matters.
• Orders, including quarantine and other regulations, prescribed by the department.
• Statutes relating to public health.

Under this provision, LHOs must comply with California law pertaining to public health, both those laws expressed in statute and also the requirements established by regulation. (See Alta-Dena Dairy v. San Diego County (1969) 271 Cal.App.2d 66, 75 [76 Cal.Rptr.510]. )

Organization and Reports of Services, Finances and Expenditures

All legally appointed LHOs are members of the California Conference of Local Health Officers (CCLHO; Health & Safe. Code, § 100925), which reviews and approves some of the regulations that CDPH promulgates (Health & Safe. Code, § 100950.)

Regulations that CCLHO reviews and approves include those regulations described in the provisions of Health and Safety Code section 100295, which states:

"The department, after consultation with and approval by the Conference of Local Health Officers, shall by regulation establish standards of education and experience for professional and technical personnel employed in local health departments and for the organization and operation of the local health departments. These standards may include standards for the maintenance of records of services, finances and expenditures, that shall be reported to the director in a manner and at times as the director may specify." (Health & Safe. Code, § 100295.)

Regulations that CCLHO reviews and approves also include those regulations described in Chapter 3 of Part 3 of Division 101 (commencing with section 101175) of the Health and Safety Code. (Health & Safe. Code, § 100950.)

Requirements of Local Health Officer

Regulations define the time that the health officer is required to dedicate to local health activities. The health officer is required:

1. To direct the health department;
2. To devote full time to official duties, which shall constitute the health officer's primary responsibility; and
3. To ensure that no other activities interfere with performance of the official duties. (17 CCR , § 1250.)
4. Communicable Disease Control. Health and Safety Code section 120175 requires the health officer to implement measures to prevent the spread of disease: "Each health officer knowing or having reason to believe that any case of the diseases made reportable by regulation of the department, or any other contagious, infectious or communicable disease exists, or has recently existed, within the territory under his or her jurisdiction, shall take measures as may be necessary to prevent the spread of the disease or occurrence of additional cases." (Health & Safe. Code, § 120175.) Health officers are required to report local epidemics of disease and the measures to address them to CDPH (Health & Safe. Code, § 120185) , immediately report any outbreak of certain designated diseases (Health & Safe. Code, §§ 120130 and 120190), establish and maintain places of quarantine or isolation (Health & Safe. Code, § 120200), and enforce all orders, rules, and regulations concerning quarantine or isolation prescribed or directed by the department (Health & Safe. Code, § 120195).

Tuberculosis Control

Other requirements of health officers, pertaining specifically to tuberculosis control, include:

1. Report to the Tuberculosis Control Branch within the department any adverse event that he or she determines has resulted from improper tuberculin skin test technician training or performance. (Health & Safe. Code, § 121360.5, subd. (k).) ;
2. Receive reports of transfer of patients infected with tuberculosis (Health & Safe. Code,§ 121361);
3. Receive reports of patients infected with tuberculosis from health care providers (Health & Safe. Code, § 121362) ;
4. Investigate all reported cases of tuberculosis (Health & Safe. Code, § 121365) ;
5. Detain persons infected with tuberculosis (Health & Safe. Code, § 121366);
6. Assess the need for and issue orders related to tuberculosis (Health & Safe. Code, § 121367); and
7. Advise state medical, correctional, and educational institutions regarding the control of tuberculosis (Health & Safe. Code, § 121380)

Miscellaneous Statutory Duties

Various California Codes set forth a broad array of additional requirements for the LHO, including the following provisions:

1. Control, contain, and remediate sites identified by law enforcement personnel as having been potential methamphetamine laboratories. (Health & Safe. Code, §25400.17, et seq.);
2. Develop a written plan for remediation of the methamphetamine laboratory sites.  (Health & Safe. Code, §25400.35.);
3. On notification by law enforcement, determine whether laboratories producing analogs of fentanyl, phencyclidine, and methamphetamine pose an immediate threat to public health and safety and, if so, take corrective action. (Health & Safe. Code, §11642.);
4. Investigate health and sanitary conditions in every county jail (or for city LHOs, all city jails), every other publicly operated detention facility in the county, and all private work furlough facilities and programs established pursuant to Section 1208 of the Penal Code, at least annually. (Health & Safe. Code, §101045.);
5. For county LHOs, identify and list all family planning and birth control clinics in the county.  (Gov. Code,§ 26808; and Health & Safe. Code, §101050, et seq.);
6. Receive and investigate complaints concerning dispensing or furnishing of drugs requiring a prescription, without a license.  (Health & Safe. Code, §101070.);
7. Subject to availability of State funding, test waters on public beaches within the LHO's jurisdiction, respond to reports of sewage spills, and close beaches, if needed. (Health & Safe. Code, §115880, et seq.);
8. Inspect and investigate public beaches to determine if they are in compliance with the applicable standards and report violations to the district attorney. (Health & Safety Code, §115885)
9. Regulate the use of equipment for cleaning septic tanks, chemical toilets, cesspools or sewage seepage pits. (Health & Safe. Code, §117400, et seq.);
10. Enforce legal requirements for small water systems and report on compliance. (Health & Safe. Code, §116340, subd. (b), et seq.);
11. Test probationers and parolees for controlled substances, on Court order. (Health & Safe. Code, §11551.);
12. Receive and process reports of pesticide poisoning or exposure. (Food & Ag. Code, § 12982 and Health & Safe. Code, §105200, et seq.);
13. Issue orders to owners of property where hazardous substance spills have o occurred.  (Health & Safe. Code, §25359.5.);
14. Provide information, support, referrals, and follow-up services to family members and persons with custody and control of a child who dies from Sudden Infant Death Syndrome. (Health & Safe. Code, §123740.);
15. Receive reports of AIDS infections, ensure continued access to anonymous testing sites, and report and investigate any potential or actual breach of confidentiality of HIV public health records.  (Health & Safe. Code, §121022.) ;
16. Inspect each clinical laboratory CD4+ T-Cell test report to determine if the test is related to a case of HIV infection and, if related, report to the State Department of Public Health or, if not related, destroy it. (Health & Safety Code, §121023)
17. Enforce legal requirements pertaining to toys. (Health & Safe. Code, §108550, et seq.);
18. Enforce the prohibition against the manufacture, sale, or possession of poisonous or contaminated toys or toys produced in unsanitary conditions. (Health & Safety Code, §108555)
19. Regulate the issuance of permits for use of industrial wiping rags. (Health & Safe. Code, §118450, et seq.);
20. Receive reports of transfusion-associated AIDS cases, HIV infections, and viral hepatitis infections. (Health & Safe. Code, §1603.1.);
21. Receive and investigate reports of food-borne illnesses. (Health & Safe. Code, §113949, et seq.);
22. Receive reports of the improper disposal of hazardous waste.  (Health & Safe.Code, §25180.5.);
23. Receive copies of plans for construction of public. swimming pools. (Health & Safe. Code, §116038.);
24. Enforce building standards and other regulations pertaining to swimming pools. (Health & Safe. Code, §116053.);
25. Order abatement of contamination of water.  (Health & Safe. Code, §5412.);
26. Receive reports of contagious disease from funeral directors. (Health & Safe. Code, §7302.);
27. Ensure compliance with tuberculosis testing for private, parochial, and nursery school employees. (Health & Safe. Code, §121540,);
28. Receive permits for the importation of wild animals. (Health & Safe. Code, §121840.);
29. Receive and forward to the Department of Motor Vehicles reports of individuals suffering from lapses of consciousness. (Health & Safe. Code, §103900.) ;
30. Organize and operate a program for the topical application of fluoride to the teeth for students in public and private elementary and secondary schools. (Health & Safe. Code, §104840.);
31. Ascertain the existence of cases of infectious venereal diseases within their respective jurisdictions, investigate all cases that probably are not subject to proper control measures, ascertain all sources of infection, and take all measures reasonably necessary to prevent the transmission of infection. (Health & Safe. Code, §120575.);
32. In jurisdictions participating in the clean needle and syringe exchange program, report annually to the LHO's governing body.  (Health & Safe. Code, §121349.3.);
33. Receive reports of recalled meat products. (Health & Safe. Code, §110806.);
34. Receive evidence that legal requirements are met by persons intending to use a previously inactive water well.  (Health & Safe. Code, §115700.);
35. Conduct annual inspections of tattoo parlors.  (Health & Safe. Code, §119304.);
36. Conduct inspections and enforce standards for body art facilities. (Health & Safety Code, §119301, 119319)
37. Enforce building standards related to organized camps. (Health & Safe. Code,§18897.4.);
38. Perform all duties of local registrar of births and deaths.  (Health & Safe. Code,§102275.);
39. Maintain an immunization program. (Health & Safe. Code, §120350.);
40. Regulate materials that require special handling that, when removed from a major appliance, constitute a hazardous waste. (Health & Safe. Code, §25212.);
41. Receive reports of rises in bacterial count of water in public water systems. (Health & Safe. Code, §116450. );
42. Approve establishment of garbage dumps. (Health & Safe. Code, §6512.);
43. Order the abatement of contamination caused by use of recycled water. (Water Code, §13522.);
44. Receive reports, investigate, and report cases of ophthalmia neonatorum. (Bus. & Prof. Code, §554.);
45. Provide for HIV testing in criminal cases involving the transfer of bodily fluids. (Pen. Code, §1524.1.);
46. Prohibit the use, sale, or disposal of milk from cows believed to be infected with typhoid fever, salmonella, bacillary dysentery, diphtheria, respiratory streptococcal infection, brucellosis, or tuberculosis. (Food & Ag. Cod, §35928.); and
47. Notify the public of sewage discharge into water.  (Water Code, §13271.).
48. Have available the services of a public health laboratory. (Health & Safe. Code, 101150, et seq.)
49. Determine exemptions from the mandatory vaccination requirements established in the Regulation and Control of Dogs statutes. (Health & Safety Code, §121690)
50. Upon notification of a spill or accidental release of pesticide, notify the county agricultural commissioner and the Director of Environmental Health Hazard Assessment of each report received. (Health & Safety Code, §105215)

 

Minimum Regulatory Standards for the Local Health Department

In addition to the statutory duties enumerated above, regulations enacted by the Department prescribe minimum standards for local health departments (see Health & Safe. Code, §101185) to observe. These standards, set forth in section 1276 of Title 17 of the California Code of Regulations, include many basic services that local health departments are required to provide:

1. Collection, tabulation and analysis of all public health statistics, including population data, natality, mortality and morbidity records, as well as evaluation of service records.

2. 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.

3. 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.

4. 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.

5. 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 are:

• Food.
• Housing and institutions.
• 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.
• Milk and dairy products in local jurisdictions maintaining an approved milk inspection service pursuant to Section 32503, Food and Agricultural Code.
• Water oriented recreation.
• Safety.
• Vector control.
• Wastes management.
• Water supply.
• Air sanitation.
• Additional environmentally related services and programs as required by the County Board of Supervisors, City Council, or Health District Board.
• And may include land development and use.

6. Laboratory services, provided by an approved public health laboratory in health departments serving a population of 50, 000 or more. Such laboratories shall provide:

• Services necessary for the various programs of the health department.
• 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.

In addition to the language of 1276(f), with regard to the public health laboratories, section 1075 of title 17, California Code of Regulations, provides:

"Each local health department shall have available the services of an official public health laboratory. The laboratory of the State Department of Health is hereby designated as the official laboratory for all local health department jurisdictions not covered by local laboratory service."

Section 1076 requires that these local public health laboratories be approved by the Department. In order to be approved, the laboratory must meet minimum requirements specified in section 1078. These requirements are:

• “Maintain adequate equipment and facilities and sufficient personnel to carry on dependable public health laboratory work.
• Employ procedures, technics (sic), and reporting practices approved by the Department.
• Establish and maintain for a minimum of two years adequate record systems and files of laboratory work done.
• Conduct, maintain, and operate programs, acceptable to the Department, for controlling the quality of test performance.
• Demonstrate satisfactory performance in a proficiency testing program approved by the Department.
• Maintain and conduct the laboratory in a manner approved by the Department.
• Employ personnel as specified.
• Accept specimens for examination as an aid to patient management only from, and issue reports only to, persons licensed under the provisions of the law relating to the healing arts or their representatives.
• Employ procedures and precautions to provide for the safety and health protection of all persons in the laboratory. " (See 17 C. C. R., §1078.)

 

This work may be done under contract.  Under the regulations, a health officer may designate any laboratory as an official public health laboratory to perform any of the basic services, as defined under Section 1276(f).  The designated laboratory is subject to the same requirements as an official public health laboratory.  (See 17 C.C.R., §1084.)

7. 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.

8. Services in chronic disease, which may include case finding, community education, consultation, or rehabilitation, for the prevention or mitigation of any chronic disease.

9. Services directed to the social factors affecting health, and which may include community planning, counseling, consultation, education, and special studies.

10. 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.

11. Appropriate services in the field of family planning.

12. Public health nursing services to provide for the preventive and therapeutic care of the population served."

 

Consequences of Failure to comply with Minimum Standards

Failure to comply with the minimum standards established by the department results in a loss of funding to the local health department not meeting those standards:

"No funds appropriated for the purposes of this article shall be allocated to any local health department whose professional and technical personnel and whose organization and program do not meet the minimum standards established by the department." (Health & Safe. Code, §101260.)

Source: This list is based off the CDPH Office of Legal Services (OLS) 2009 and 2012 memorandum enumerating and briefly describing the mandatory services that are specified in statute or regulation.