Health and Safety Code
SUBTITLE F. LOCAL REGULATION OF PUBLIC HEALTH
CHAPTER 121. LOCAL PUBLIC HEALTH REORGANIZATION ACT
SUBCHAPTER A. GENERAL PROVISIONS
Sec. 121.001. Short Title.
This chapter may be cited as the Local Public Health
Reorganization Act.
Acts 1989, 71st Leg., ch. 678, Sec. 1, eff. Sept. 1, 1989.
Sec. 121.002. Definition.
In this chapter, "physician" means a person licensed to
practice medicine by the Texas State Board of Medical Examiners.
Acts 1989, 71st Leg., ch. 678, Sec. 1, eff. Sept. 1, 1989.
Sec. 121.003. Powers of Municipalities and Counties.
(a) The governing body of a municipality or the commissioners
court of a county may enforce any law that is reasonably
necessary to protect the public health.
(b) The governing bodies of municipalities and the
commissioners courts of counties may cooperate with one another
in making necessary improvements and providing services to
promote the public health in accordance with The Interlocal
Cooperation Act (Article 4413(32c), Vernon's Texas Civil
Statutes).
(c) The commissioners court of a county may grant authority
under this subsection to a county employee who is trained by a
health authority appointed by the county under Section 121.021,
by a local health department established under Section 121.031,
or by a public health district established under Section 121.041
and who is not a peace officer. The court may grant to the
employee the power to issue a citation in an unincorporated area
of the county to enforce any law or order of the commissioners
court that is reasonably necessary to protect the public health.
A citation issued under this subsection must state the name of
the person cited, the violation charged, and the time and place
the person is required to appear in court. If a person who
receives a citation under this subsection fails to appear on the
return date of the citation, the court may issue a warrant for
the person's arrest for the violation described in the citation.
Acts 1989, 71st Leg., ch. 678, Sec. 1, eff. Sept. 1, 1989.
Amended by Acts 1991, 72nd Leg., ch. 562, Sec. 1, eff. Aug. 26,
1991.
Sec. 121.004. Local Health Units.
A local health unit is a division of municipal or county
government that provides public health services but does not
provide each service required of a local health department under
Section 121.032(a) or of a public health district under Section
121.043(a).
Acts 1989, 71st Leg., ch. 678, Sec. 1, eff. Sept. 1, 1989.
Sec. 121.005. State and Local Affiliation; Contracts.
(a) A local health unit, local health department, or public
health district may become affiliated with the department to
facilitate the exchange of information and the coordination of
public health services.
(b) To be affiliated with the department, a local health unit,
local health department, or public health district must annually
provide to the department information relating to:
(1) services provided;
(2) staffing patterns; and
(3) funding sources and budget.
(c) The department may contract with a local health unit, local
health department, or public health district for the provision of
public health services.
(d) The board may adopt rules necessary to implement this
section.
Acts 1989, 71st Leg., ch. 678, Sec. 1, eff. Sept. 1, 1989.
Sec. 121.006. Public Health Services Fees; State Support.
(a) The governing body of a municipality, the commissioners
court of a county, or the administrative board of a public health
district may adopt ordinances or rules to charge fees for public
health services.
(b) A municipality, county, or public health district may not
deny public health services to an individual because of inability
to pay for the services. A municipality, county, or public
health district shall provide for the reduction or waiver of a
fee for an individual who cannot pay for services in whole or in
part.
(c) The Uniform Grant and Contract Management Act of 1981
(Article 4413(32g), Vernon's Texas Civil Statutes) and standards
adopted under that Act control, if applicable, if the local
health unit, local health department, or public health district
receives state support for the provision of public health
services.
(d) In this section, "public health services" means:
(1) personal health promotion and maintenance services;
(2) infectious disease control and prevention services;
(3) environmental and consumer health programs;
(4) public health education and information services;
(5) laboratory services; and
(6) administrative services.
Acts 1989, 71st Leg., ch. 678, Sec. 1, eff. Sept. 1, 1989.
Sec. 121.007. Public Health Regions.
(a) The board may designate geographic areas of the state as
public health regions to provide public health services.
(b) The board shall appoint a physician to serve as regional
director for each public health region. The regional director is
the chief administrative officer of the region. The board shall
establish the qualifications and terms of employment of a
regional director.
(c) The board or its designee may require a regional director
to perform the duties of a health authority. The regional
director may perform those duties, as authorized by the board or
commissioner, in a jurisdiction in the region in which:
(1) there is no health authority; or
(2) the health authority fails to perform duties prescribed
by the board under Section 121.024.
(d) At the request of the governing body of a municipality, the
commissioners court of a county, the members of a public health
district or other entity that appointed a health authority, and,
with the concurrence of the board or its designee, a regional
director may serve as health authority for a city, county, or
public health district in the absence or incapacity of the
jurisdiction's appointed health authority.
(e) The board shall adopt procedural rules for requesting and
concurring in the service by a regional director as health
authority under Subsection (d). The rules shall adopt procedures
to prevent duplication of authority by the appointed health
authority and the regional director.
Acts 1989, 71st Leg., ch. 678, Sec. 1, eff. Sept. 1, 1989.
Amended by Acts 1991, 72nd Leg., ch. 118, Sec. 1, eff. Sept. 1,
1991.
Sec. 121.008. Annual Conference.
(a) The board shall hold an annual conference for health
authorities and for directors of local health departments and
public health districts. The commissioner or the commissioner's
designee shall preside over the conference.
(b) A county or municipality may pay necessary expenses
incurred by its health authority or director in attending the
conference.
Acts 1989, 71st Leg., ch. 678, Sec. 1, eff. Sept. 1, 1989.
SUBCHAPTER B. HEALTH AUTHORITIES
Sec. 121.021. Health Authority.
A health authority is a physician appointed under the provisions
of this chapter to administer state and local laws relating to
public health within the appointing body's jurisdiction.
Acts 1989, 71st Leg., ch. 678, Sec. 1, eff. Sept. 1, 1989.
Amended by Acts 1991, 72nd Leg., ch. 118, Sec. 2, eff. Sept. 1,
1991.
Sec. 121.022. Qualifications.
(a) A health authority must be:
(1) a competent physician with a reputable professional
standing who is legally qualified to practice medicine in this
state; and
(2) a resident of this state.
(b) To be qualified to serve as a health authority, the
appointee must:
(1) take and subscribe to the official oath; and
(2) file a copy of the oath and appointment with the board.
Acts 1989, 71st Leg., ch. 678, Sec. 1, eff. Sept. 1, 1989.
Sec. 121.023. Term of Office.
A health authority serves for a term of two years and may be
appointed to successive terms.
Acts 1989, 71st Leg., ch. 678, Sec. 1, eff. Sept. 1, 1989.
Sec. 121.024. Duties.
(a) A health authority is a state officer when performing
duties prescribed by state law.
(b) A health authority shall perform each duty that is:
(1) necessary to implement and enforce a law to protect the
public health; or
(2) prescribed by the board.
(c) The duties of a health authority include:
(1) establishing, maintaining, and enforcing quarantine in
the health authority's jurisdiction;
(2) aiding the board in relation to local quarantine,
inspection, disease prevention and suppression, birth and death
statistics, and general sanitation in the health authority's
jurisdiction;
(3) reporting the presence of contagious, infectious, and
dangerous epidemic diseases in the health authority's
jurisdiction to the board in the manner and at the times
prescribed by the board;
(4) reporting to the board on any subject on which it is
proper for the board to direct that a report be made; and
(5) aiding the board in the enforcement of the following in
the health authority's jurisdiction:
(A) proper rules, requirements, and ordinances;
(B) sanitation laws;
(C) quarantine rules; and
(D) vital statistics collections.
Acts 1989, 71st Leg., ch. 678, Sec. 1, eff. Sept. 1, 1989.
Sec. 121.025. Removal From Office.
A health authority may be removed from office for cause under
the personnel procedures applicable to the heads of departments
of the local government that the health authority serves.
Acts 1989, 71st Leg., ch. 678, Sec. 1, eff. Sept. 1, 1989.
SUBCHAPTER C. MUNICIPALITIES AND COUNTIES WITHOUT ORGANIZED
LOCAL PUBLIC
HEALTH DEPARTMENTS OR DISTRICTS
Sec. 121.028. Appointment of Health Authority.
The governing body of a municipality or the commissioners court
of a county that has not established a local health department or
a public health district may appoint a physician as health
authority to administer state and local laws relating to public
health in the municipality's or county's jurisdiction.
Added by Acts 1991, 72nd Leg., ch. 118, Sec. 3, eff. Sept. 1,
1991.
Sec. 121.029. Delegation of Authority.
(a) A health authority, unless otherwise restricted by law, may
delegate a power or duty imposed on the health authority by the
board, or by this or any other law, to a properly qualified
physician to act while the health authority is absent or
incapacitated.
(b) The physician designated by the health authority must:
(1) meet the qualifications set out in Section 121.022(a);
(2) be appointed as a designee in the same manner as the
appointment of the health authority;
(3) take, subscribe, and file the official oath and
appointment with the board as required by Section 121.022(b);
and
(4) file a certified copy of the written delegation with the
board.
(c) The delegation is effective during the term of the health
authority who made the delegation; however, the health authority
may limit the time to a shorter duration in the written
delegation of authority.
(d) The health authority is responsible for the acts of the
physician to whom the health authority has delegated the power or
duty.
(e) The entity that appoints the health authority and the
designee health authority must adopt procedures for the service
of the designee as health authority under this section. The
procedures shall prevent duplication of authority between the
health authority and the designee and provide notice to the
department when authority is transferred.
Added by Acts 1991, 72nd Leg., ch. 118, Sec. 3, eff. Sept. 1,
1991.
SUBCHAPTER D. LOCAL HEALTH DEPARTMENTS
Sec. 121.031. Establishment.
The governing body of a municipality or the commissioners court
of a county may establish a local health department by majority
vote.
Acts 1989, 71st Leg., ch. 678, Sec. 1, eff. Sept. 1, 1989.
Sec. 121.032. Powers and Duties.
(a) A local health department may perform all public health
functions that the municipality or county that establishes the
local health department may perform.
(b) For purposes of Section 121.005, a local health department
shall be identified by its program of public health services and
shall, at a minimum, provide:
(1) personal health promotion and maintenance services;
(2) infectious disease control and prevention services;
(3) environmental and consumer health programs for the
enforcement of health and safety laws relating to food, water,
waste control, general sanitation, and vector control;
(4) public health education and information services;
(5) laboratory services; and
(6) administrative services.
Acts 1989, 71st Leg., ch. 678, Sec. 1, eff. Sept. 1, 1989.
Sec. 121.033. Department Director.
(a) The governing body of a municipality or the commissioners
court of a county shall appoint the director of the
municipality's or county's local health department.
(b) The director is the chief administrative officer of the
local health department, and if the director is a physician, the
director is the health authority in the local health department's
jurisdiction.
(c) The governing body of a municipality or the commissioners
court of a county may designate a person to perform its
appointment duties under this section.
(d) A director of a local health department who is not a
physician shall appoint a physician as the health authority in
the local health department's jurisdiction, subject to the
approval of the governing body or the commissioners court, as
appropriate, and the board.
(e) The governing body or the commissioners court, as
appropriate, shall set the compensation of the director and the
health authority in its jurisdiction, except that the
compensation, including a salary, may be allowed only for
services actually rendered.
Acts 1989, 71st Leg., ch. 678, Sec. 1, eff. Sept. 1, 1989.
Amended by Acts 1989, 71st Leg., ch. 1100, Sec. 5.07(a), eff.
Sept. 1, 1989.
Sec. 121.0331. Delegation of Authority.
(a) A health authority, unless otherwise restricted by law, may
delegate a power or duty imposed on the health authority by the
board, or by this or any other law, to a properly qualified
physician who is employed by the municipality's or county's local
health department to act while the health authority is absent or
incapacitated.
(b) The physician designated by the health authority must:
(1) meet the qualifications set out in Section 121.022(a);
(2) be appointed as a designee in the same manner as the
appointment of the health authority;
(3) take, subscribe, and file the official oath and
appointment with the board as required by Section 121.022(b);
and
(4) file a certified copy of the written delegation with the
board.
(c) The delegation is effective during the term of the health
authority who made the delegation; however, the health authority
may limit the delegation to a shorter duration in the written
delegation of authority.
(d) The health authority is responsible for the acts of the
physician to whom the health authority has delegated the power or
duty.
(e) The entity or entities that appoint the health authority
and the designee health authority must adopt procedures for the
service of the designee as health authority under this section.
The procedures shall prevent duplication of authority between the
health authority and the designee and provide notice to the
department when authority is transferred.
Added by Acts 1991, 72nd Leg., ch. 118, Sec. 7, eff. Sept. 1,
1991.
Sec. 121.034. Public Health Board.
(a) The governing body of a municipality that establishes a
local health department may provide for the creation of an
administrative or advisory public health board and the
appointment of representatives to that board.
(b) The commissioners court of a county that establishes a
local health department may provide for the creation of an
advisory public health board and the appointment of
representatives to that board.
(c) The director of the local health department is an ex
officio, nonvoting member of any public health board established
for the local health department.
Acts 1989, 71st Leg., ch. 678, Sec. 1, eff. Sept. 1, 1989.
SUBCHAPTER E. PUBLIC HEALTH DISTRICTS
Sec. 121.041. Establishment.
By a majority vote of each governing body, a public health
district may be established by:
(1) two or more counties;
(2) two or more municipalities;
(3) a county and one or more municipalities in the county; or
(4) two or more counties and one or more municipalities in those
counties.
Acts 1989, 71st Leg., ch. 678, Sec. 1, eff. Sept. 1, 1989.
Sec. 121.042. Admission to District.
(a) Any governmental entity, including a school district, may
apply to become a member of a public health district.
(b) The governing body of each member shall review the
application.
(c) The governmental entity may be admitted to membership on
terms acceptable to the applicant and the members if a majority
of the governing body of each member approves the application.
Acts 1989, 71st Leg., ch. 678, Sec. 1, eff. Sept. 1, 1989.
Sec. 121.043. Powers and Duties.
(a) A public health district may perform any public health
function that any of its members may perform unless otherwise
restricted by law.
(b) For purposes of Section 121.005, a public health district
shall be identified by its program of public health services and
shall, at a minimum, provide the services listed for a local
health department under Section 121.032(b).
(c) A public health district may sue and be sued.
Acts 1989, 71st Leg., ch. 678, Sec. 1, eff. Sept. 1, 1989.
Amended by Acts 1991, 72nd Leg., ch. 476, Sec. 3, eff. Aug. 26,
1991.
Sec. 121.044. Cooperative Agreement.
(a) The members of a public health district shall prepare a
written cooperative agreement that sets out fully the terms of
operation of the district.
(b) The terms in a cooperative agreement must include:
(1) organizational structure;
(2) financial administration; and
(3) procedures for:
(A) modification of the cooperative agreement;
(B) admission, withdrawal, and expulsion of members;
(C) dissolution of the district; and
(D) selection and removal of a director.
(c) A cooperative agreement must be:
(1) approved by the governing body of each member; and
(2) signed by the appropriate officers of each governing
body.
(d) A modification of a cooperative agreement must be in
writing. A modification is effective on approval by the
governing body of each member.
(e) A copy of a cooperative agreement and of each modification
shall be:
(1) included in the minutes of the governing body of each
member; and
(2) filed with the clerk of each county and municipality in
the district and with the department.
Acts 1989, 71st Leg., ch. 678, Sec. 1, eff. Sept. 1, 1989.
Sec. 121.045. District Director.
(a) The members of a public health district shall appoint the
director of the district.
(b) The director is the chief administrative officer of the
public health district, and if the director is a physician, the
director is the health authority in the district's jurisdiction.
(c) A member may designate a person to perform its appointment
duties under this section.
(d) A director of a public health district who is not a
physician shall appoint a physician as the health authority for
the district, subject to the approval of the members and the
board.
Acts 1989, 71st Leg., ch. 678, Sec. 1, eff. Sept. 1, 1989.
Amended by Acts 1989, 71st Leg., ch. 1100, Sec. 5.07(a), eff.
Sept. 1, 1989.
Sec. 121.0451. Delegation of Authority.
(a) A health authority, unless otherwise restricted by law, may
delegate a power or duty imposed on the health authority by the
board, or by this or any other law, to a properly qualified
physician who is employed by the public health district to act
while the health authority is absent or incapacitated.
(b) The physician designated by the health authority must:
(1) meet the qualifications set out in Section 121.022(a);
(2) be appointed as a designee in the same manner as the
appointment of the health authority;
(3) take, subscribe, and file the official oath and
appointment with the board as required by Section 121.022(b);
and
(4) file a certified copy of the written delegation with the
board.
(c) The delegation is effective during the term of the health
authority who made the delegation; however, the health authority
may limit the delegation to a shorter duration in the written
delegation of authority.
(d) The health authority is responsible for the acts of the
physician to whom the health authority has delegated the power or
duty.
(e) The entity or entities that appoint the health authority
and the designee health authority must adopt procedures for the
service of the designee as health authority under this section.
The procedures shall prevent duplication of authority between the
health authority and the designee and provide notice to the
department when authority is transferred.
Added by Acts 1991, 72nd Leg., ch. 118, Sec. 7, eff. Sept. 1,
1991.
Sec. 121.046. Public Health Board.
(a) The cooperative agreement of a public health district may
provide for the creation of an advisory or administrative public
health board.
(b) An advisory public health board shall advise the members
and director on matters of public health.
(c) An administrative public health board may adopt substantive
and procedural rules that are necessary and appropriate to
promote and preserve the health and safety of the public.
However, an administrative board may not adopt a rule that is not
specifically authorized by state law, conflicts with a law of
this state, or conflicts with an ordinance of a municipality or
county in the district.
(d) A public health board may perform any function relating to
the operation of the public health district that is required
under the cooperative agreement.
(e) The terms of a cooperative agreement that provides for a
public health board must include:
(1) the composition and number of the representatives that
compose the public health board;
(2) a method for appointing representatives to the public
health board;
(3) the length of the representatives' terms, which must be
staggered;
(4) a requirement that a representative must have resided in
the district for at least three years before the date of the
representative's appointment;
(5) a requirement that each representative serve without
compensation;
(6) the manner in which a vacancy is filled for an unexpired
term;
(7) the procedure and substantive criteria for the removal
of a representative; and
(8) a description of the relationship between the director
and the public health board.
(f) The director is an ex officio, nonvoting member of a public
health board established by the cooperative agreement.
Acts 1989, 71st Leg., ch. 678, Sec. 1, eff. Sept. 1, 1989.
Sec. 121.047. Finances.
The members of a public health district shall pay the costs
necessary to operate the district, including costs for:
(1) staff salaries;
(2) supplies;
(3) suitable offices;
(4) health and clinic centers;
(5) health services and facilities; and
(6) maintenance.
Acts 1989, 71st Leg., ch. 678, Sec. 1, eff. Sept. 1, 1989