KANSAS LOCAL PUBLIC HEALTH SERVICES[1]
(with supporting legal citations including online sources where available)
I.Introduction
A.Local public health authority in Kansas is authorized by statute and is primarily exercised by the:
1.Local Board of Health (Sec. II);
2.Local Health Officer (Sec. III); and
3.Local Health Department (Sec. IV).
B.In Kansas, County Commissions may “charter” out of non-uniform state statutes and adopt, by charter resolution, alternative or substitute provisions.
1.Some local public health statutes are non-uniform.[2]
C.Counties also have home rule powers which authorize the adoption of resolutions on matters of local concern that are not in conflict with state statutes or regulations.
D.Statutory references to the Kansas Statutes Annotated are abbreviated as K.S.A. XX-XXX.
E.Regulatory references to the Kansas Administrative Regulations are abbreviated as K.A.R. XX-X-XXX.
F.Other sources of legal authority or guidance include:
1. Kansas appellate court decisions
2.Kansas Attorney General Opinions.
3.County resolutions (regular and charter)
G.Local public health authorities have duties and powers.
1.Duties are legal obligations that must be complied with.
2.Powers involve the exercise of professional discretion.
H.Local public health authorities also exercise administrative responsibilities.
I.Local public health duties and powers can be divided into three categories.
1.Contagious/Infectious Disease Reporting and Control
2.Nuisance Investigation and Abatement
3.Administrative
II.Local Board of Health
A.Duties
1.Contagious/Infectious Disease Reporting and Control
a.Shall receive reports of cases of listed contagious or infectious diseases from mandated reporters. K.S.A. 65-118(a).[3]
b.Shall exercise and maintain supervision over reported cases of contagious or infectious diseases; see that all cases are properly cared for; and that all statutory requirements for isolation, restriction of communication, quarantine and disinfection are enforced. K.S.A. 65-119.[4]
c.Shall communicate existing conditions of cases without delay to secretary of the state department of health and environment.[5]
d.Shall receive reports of infants (under 6 months) with inflammation, swelling or redness in the eyes from persons, other than licensed physicians, having care of the infant. K.S.A. 65-153c.[6]
2.Nuisance Investigation and Abatement
a.Shall, when notified by the secretary of the state department of health and environment or any citizen, order abatement of:
(i) Any privy, privy vault, or other place used for the deposit of human excreta which permits animals or insects access to the excreta, which produces foul or objectionable odors, or is located so as to make pollution of a domestic water supply probable.
(ii) The collection or accumulation of any organic materials such as swill, meat scraps,dead fish, shells, bones, decaying vegetables, dead carcasses, human or animal excrement, or any kind of offal that may decompose and create an attraction or breeding place for flies, mosquitoes or rodents.
(iii) Any domestic animal pen that pollutes a domestic water supply, underground water bearing formation; or stream in a manner that is hazardous to human health; or is maintained in a manner that creates a fly attraction or breeding place for flies or mosquitoes; or is a rodent harborage or breeding place. K.A.R. 28-5-4.[7]
3.Administrative
a.Shall appoint a local health officer. K.S.A. 65-201.[8]
i.Sedgwick County has chartered out of this statute; the local health officer is appointed by the county manager. Charter Res. No. 54 and Charter Res. No. 58.[9]
B. Powers
1.Contagious/Infectious Disease Reporting and Control
a.May prohibit public gatherings when necessary to control infectious or contagious diseases. K.S.A. 65-119.[10]
2.Nuisance Investigation or Abatement
a.May notify cities that any nuisances, including rank or other vegetation, or ponds of water are a menace and dangerous to the health of the inhabitants of the city, any neighborhood or family. K.S.A. 12-1617e.[11]
b.May examine into all nuisances, sources of filth and causes of sickness that may be injurious to health of county inhabitants. K.S.A. 65-159.[12]
c.May order owner to remove such nuisances, sources of filth and causes of sickness.[13]
d.May receive reports of sanitary quality of water supplied to public and investigate same. K.S.A. 65-163.[14]
e.May report to the secretary of the state department of health and environment any alleged permit violations of municipal water suppliers regarding placement or storage of municipal water treatment residues.[15]
f.May report to the secretary of the state department of health and environment any pollution or polluted condition of any waters of the state. K.S.A. 65-164.[16]
g.May determine an activity or condition constitutes an imminent threat to health or safety of a person to declare a nuisance under the County Nuisance Abatement Code. County Code Sec. 19-43.[17]
3.Administrative
a.May contract with the secretary of the state department of health and environment to assist in administering testing for sickle cell anemia. K.S.A. 65-1,105.[18]
b.May make contract with state board of regents for care and maintenance of obstetrical patientswho are public charges. K.S.A. 65-203.[19]
c.May enter into contracts with the secretary of the state department of health and environment to investigate cases of HIV or AIDS. K.S.A. 65-6003.[20]
III.Local Health Officer
A.Duties
1.Contagious/Infectious Disease Reporting and Control
a.Shall order a person to be examined, on reasonable suspicion a person has tuberculosis in a communicable form. K.S.A. 65-116b.[21]
i.Note: K.S.A. 65-116a, for purposes of the tuberculosis act, defines “health officer” to include the local health officer.[22]
b.Shall instruct persons with active or communicable tuberculosis on precautions necessary to prevent spread of the disease, if they have not been admitted to a treatment facility. K.S.A. 65-116c.[23]
c.Shall investigate, from time to time, whether such persons are following the precautions.[24]
d.Shall file a notice with the county or district attorney whenever any person fails to present themselves for examination if ordered by the local health officer; or the person fails or refuses to follow instructions of the local health officer or private physicians. K.S.A. 65-116d.[25]
e.Shall not restrict a person’s right to select the mode of treatment for active tuberculosis. K.S.A. 65-116h.[26]
f.Shall receive reports of suspected cases of reportable infectious or contagious diseases from mandated reporters. K.S.A. 65-118.[27]
g.Shall keep information reported under K.S.A. 65-118 confidential, subject to certain limited exceptions.[28]
h.Shall exercise and maintain supervision over reported cases of contagious or infectious diseases; see that all cases are properly cared for; and that all statutory requirements for isolation, restriction of communication, quarantine and disinfection are enforced. K.S.A. 65-119.[29]
i.Shall communicate without delay to secretary of the state department of health and environment existing conditions of cases.[30]
j.Shall investigate all cases of acute infectious, contagious or communicable diseases. Charter Res. No. 54 and Charter Res. No. 58.[31]
k.Shall take actions necessary to control, suppress and prevent the spread of smallpox or other contagious or infectious diseases in cities of second or third class. K.S.A. 65-301.[32]
l.Upon receipt of a reported suspected case of rabies, shall determine, during the isolation period, whether a dog, cat or ferret is suffering from rabies; and if not, then shall order its release from isolation. K.A.R. 28-1-13.[33]
m.Shall, if responsible for a local public health agency, adopt and distribute to all authorized personnel a written security policy for the confidentiality of HIV information for the local health department. K.A.R. 28-1-26.[34]
2.Nuisance Investigation and Abatement [None]
3.Administrative
a.Shall serve notice of involuntary mental health treatment commitment proceedings if ordered by the court. K.S.A. 59-2963.[35]
b.Shall serve notice of involuntary alcohol or substance abuse treatment commitment proceedings if ordered by the court. K.S.A. 59-29b63.[36]
c.Shall, on appointment, take an oath, post a bond and notify the secretary of the state department of health and environment of his or her post office address. K.S.A. 65-202.[37]
d.Shall, upon replacement, turn over all records, documents and other articles, and faithfully account to the state, county and local board of health for monies received during his or her term.[38]
e.Shall receive and distribute without delay all forms from the state department of health and environment, and all returns from health care professionals; and keep an accurate record of all transactions.[39]
f.Shall perform such other acts required by the secretary of the state department of health and environment or the local board of health.[40]
g.Shall counsel and advise school boards on inoculations required. K.S.A. 72-5210; 72-5214.[41]
B.Powers
1.Contagious/Infectious Disease Reporting and Control
a.May order a person committed to a tuberculosis treatment facility to be placed apart from others and restrained from leaving the facility. K.S.A. 65-116e.[42]
b.May prohibit public gatherings when necessary to control infectious or contagious diseases. K.S.A. 65-119.[43]
c.May issue a certificate finding that a child is no longer suffering from an infectious or contagious disease in order for the child to be re-admitted to a child care or school facility. K.S.A. 65-122.[44]
d.May authorize a person to leave an isolation or quarantine area. K.S.A. 65-129.[45]
e.May issue orders for persons exposed to an infectious or contagious disease to seek appropriate and necessary evaluation and treatment. K.S.A. 65-129b.[46]
f.May order, if medically necessary and reasonable to prevent the spread of an infectious or contagious disease, or if the person, or the person’s parent or guardian if a minor, refuses vaccination, examination, treatment or testing, for theperson to go to and remain in a place of isolation or quarantine.[47]
g.May order the sheriff, or any deputy or law enforcement officer to assist in the execution and enforcement of any orders issued under K.S.A. 65-129b.[48]
h.May examine laboratory statements, reports, files and records prepared regarding prenatal serological tests for syphilis and hepatitis b. K.S.A. 65-153f.[49]
i.May take up any animal which exposed a person or other animal to rabies. K.S.A. 75-5661.[50]
j.May set conditions of isolation or quarantine if not provided for by statute or regulation. K.A.R. 28-1-5.[51]
k.May alter conditions of isolation or quarantine set by regulation if necessary for greater protection of public health, safety and welfare. K.A.R. 28-1-6.[52]
l.May order any asymptomatic and convalescent person infected with salmonellosis without diarrhea either be excluded from, or allowed to return to, work.[53]
m.May order a dog, cat or ferret causing exposure to rabies be isolated for 10 days. K.A.R. 28-1-13.[54]
n.May determine isolation conditions for horses, cattle and sheep causing exposure to rabies.[55]
o.May determine whether mammals, including rabbits, hares, gerbils, guinea pigs, hamsters, mice, rats, squirrels, chipmunks and other species not known to be involved in the transmission of rabies, need not besacrificed and submitted for laboratory examination for evidence of rabies infection, based on thecircumstances of the potential exposure to rabies incident.[56]
p.May determine the disposition of animals not known to be involved in the transmission of rabies that are maintained in zoological parks.[57]
2.Nuisance Investigation and Abatement
a.May inspect crypts and catacombs. K.S.A. 17-1325.[58]
b.May order sexton or other persons in charge of mausoleum, vault or other burial structure to immediately place same in perfect and sanitary condition; or remove the bodies therefrom. K.S.A. 17-1326.[59]
c.May determine and certify that unsanitary conditions exist that require the installation and utilization of sewers by the development of a sewer district. K.S.A. 19-27a003.[60]
d.May file complaint with secretary of state department of health and environment regarding the sanitary quality of public water supplies. K.S.A. 65-163.[61]
e.May report to the secretary of the state department of health and environment any pollution or polluted condition of any waters of the state. K.S.A. 65-164.[62]
f.May, when notified by the state department of health and environment or the bureau of investigation, make an inspection of an illegal drug manufacturing site. K.S.A. 65-7013.[63]
g.May prohibit property contaminated by illegal drug manufacturing operations from any use if unfit due to contamination.[64]
3.Administrative
a.May provide a statement that a person under guardianship is in need of psychiatric treatment for voluntary admission to a treatment facility. K.S.A. 59-2949.[65]
b.May provide a statement that a person under guardianship is in need of alcohol or substance abuse treatment for voluntary admission to a treatment facility. K.S.A. 59-29b49.[66]
IV.Local Health Department
A.Duties
1.Contagious/Infectious Disease Reporting and Control
a.Shall keep information reported under K.S.A. 65-118 confidential, subject to certain limited exceptions.[67]
2.Nuisance Investigation and Abatement [None]
3.Administrative
a.Shall administer county sanitary code, unless the authority for administering sewage and sewage disposal regulations is assigned by the county commission to another county agency. K.S.A. 19-3703.[68]
b.Shall cooperate with secretary of state department of health and environment for plans for insurance coverage for children involving outreach and maximum enrollment. K.S.A. 38-2001.[69]
c.Shall offer service coordination, within 72 hours, to pregnant women referred to the local health department. K.S.A. 65-1,164.[70]
d.Shall, upon request, provide form to parent requesting removal of a child’s information from the birth defects information system, and on filing of the request, shall forward the request to the secretary of the state department of health and environment. K.S.A. 65-1,244.[71]
e.Shall receive reports from group boarding homes or residential centers for children under 16 years of age regarding residents who are seriously injured or ill. K.A.R. 28-4-275.[72]
f.If requested, shall approve the water source for child and youth care attendant care facilities. K.A.R. 28-4-293.[73]
g.Shall, if funds are available, provide to students without delay tests and inoculations required by statute. K.S.A. 72-5210.[74]
h.Shall be a reviewing department for purposes of the County Adult Entertainment Code; including inspecting establishments. County Code Sec. 17-504.[75]
B.Powers
1.Contagious/Infectious Disease Reporting and Control
a.May identify an area as high-risk for tuberculosis exposure, which then requires operator, program director, staff member, child, or youth, involved in a school age programs who is exposed to an active case of tuberculosis to receive a Mantoux test or chest x-ray. K.A.R. 28-4-590.[76]
b.May identify an area as high-risk for tuberculosis exposure, which then requires individuals working at a birthing center to have additional tuberculin testing. K.A.R. 28-4-1312.[77]
2.Nuisance Investigation and Abatement
a.May approve manner of refuse storage for animal control purposes. County Code Sec. 5.1.[78]
i.The animal control code defines “local health officer” as the health department director or the director’s authorized representative.[79]
3.Administrative
a.May assist the secretary of the state department of social and rehabilitation services in the investigation and determination of abuse, neglect or exploitation of mentally ill, incapacitated or dependent persons. K.S.A. 39-1409.[80]
b.May provide health services to pregnant women. K.S.A. 65-1,161.[81]
c.May offer services for identification and follow up of cases of elevated blood lead levels in children and other high-risk individuals. K.S.A. 65-1,202.[82]
d.May make application, by their governing board, to state for financing of local health department operations. K.S.A. 65-243.[83]
e.May offer dental hygiene services. K.S.A. 65-1456.[84]
f.May contract with a licensed dental health services person to provide services. K.S.A. 65-1466.[85]
g.May certify a child has received required tests and inoculations. K.S.A. 72-5209.[86]
h.May charge a sliding fee for health assessments for students. K.S.A. 72-5214.[87]
i.May develop local environmental protection plans. K.S.A. 75-5657.[88]
j.May approve ponds, rivers and lakes for swimming activities for school age programs. K.A.R. 28-4-594.[89]
k.May coordinate child and youth care services with day-reporting programs. K.A.R. 28-4-596.[90]
Description of Local Public Health Governing Entity Authority
The local public health governing entity authority for Sedgwick County, Kansas, is the Board of County Commissioners of Sedgwick County, Kansas, sitting as the Local Board of Health. The creation of local boards of health is governed by K.S.A. 65-201. The local board of health, in Kansas, is considered a creature of statute, and has only such powers as conferred by the legislature. See, e.g. Lindemann v. Umscheid, 255 Kan. 610, 875 P.2d 964 (1994)(subordinate government agencies have those express and implied powers authorized by statute).
The Board of County Commissioners, in Kansas, however, has been granted statutory home rule to determine their local affairs and government, including but not limited to the powers to: sue and be sued; hold real and personal property; make all contracts and do all other acts in relation to the property and concerns of the county, necessary to the exercise of its corporate or administrative powers. K.S.A. 19-101. The home rule power is to be liberally construed for the purpose of giving counties the largest measure of self-government. K.S.A. 19-101. Boards of County Commissioners also have the power to contract for the protection and promotion of public health and welfare. K.S.A. 19-212 Eleventh.
The home rule power includes the power to elect to opt out any state law, subject to certain exceptions, that the whole or any part of the state act which does not uniformly apply to all counties. K.S.A. 19-101b; Blevins v. Hiebert, 247 Kan. 1, 795 P.2d 325 (1990). The act creating local boards of health, K.S.A 65-201, is a non-uniform law. Kan. Att’y Gen. Op. No. 92-62. The Board of County Commissioners of Sedgwick County, Kansas, has adopted Charter Resolution Nos. 54 and 58, which opt out of K.S.A. 65-201; and that adopts alternative provisions regarding the creation of the local board of health. These resolutions are available online at:
Description of Local Public Health Governing Entity
The Board of County Commissioners of Sedgwick County, Kansas, sitting as the local Board of Health, is a political subdivision of the State of Kansas. Board of County Comm’rs of the County of Sedgwick v. Lewis, 203 Kan. 188, 453 P.2d 46 (1969)(a county is a bodycorporate and politic; created for the purpose of convenient local government, and for public purposes connected with the administration of state government). Counties are also considered quasi-corporations. Id. Depending on the legislative acts involved, counties may also be considered municipalities. See, e.g. K.S.A. 65-205.
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[1]Compiled February 22, 2013.
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