Iowa Administrative Code
Agency 641 - Public Health Department
Chapter 77 - Local Boards of Health
Rule 641-77.8 - Request to Form District Board of Health

a. A written narrative that explains how the formation of a district board of health will attain the capability to provide population-based and personal health services.

b. The composition of the district board of health, including the number of members each county shall appoint pursuant to Iowa Code section 137.105 and the total number of members on the district board of health.

c. Proof of approval by all county boards of supervisors and county boards of health involved in the request to form a district and of the elements included in the formation plan.

d. A service delivery plan. The service delivery plan shall detail how population-based and environmental health services will be delivered throughout the district.

e. The budget and fiscal plan for the proposed district health department. The budget plan shall include an estimate of the proposed expenditures and revenues and an allocation of the revenue responsibilities of each of the counties participating in the proposed district.

f. A table of organization.

g. A personnel system description, including identification of the district health department treasurer and district health department auditor and a section which addresses the employment issues contained in Iowa Code section 137.110.

h. The location of the district health department offices and workforce throughout the jurisdiction. The request shall include a map showing district boundaries.

i. An inventory of the property and equipment in the custody of each county health department and a description as to whether such property and equipment shall remain in the custody of the county health department or shall be transferred to the district health department to become property of the district health department. Property and equipment include any item which costs more than $5,000.

j. An information technology (IT) plan.

k. A proposed date upon which the district board of health shall be formed and established and a timeline for the adoption of district board of health rules and regulations.