Section 600.100 Statement of Purpose

• This Part has been developed by the Illinois Department of Public Health, in collaboration with the Illinois Association of Public Health Administrators, the Illinois Association of Boards of Health, the Illinois Public Health Association, and the University of Illinois School of Public Health. This Part sets forth requirements for local health departments to be certified by the Department and applies to all local health departments in the state that are conducting or intend to conduct and complete such requirements.

• The Department is committed to the mission of public health-to fulfill society's interest in assuring conditions in which people can be healthy. Because of this commitment, the Department has the responsibility to assure that quality public health services are delivered to Illinois citizens. Where possible, it is in the best interest of Illinois citizens to have public health services delivered at the local level by a local health department. A Certified local health department is a local governmental agency that carries out the core functions of public health, assessment, policy development, and assurance, within its jurisdiction. Any local health department currently recognized by the Department will be eligible to seek certification. Performance of the core public health functions is the unique feature that distinguishes a Certified local health department from any other public health provider in a local area. The practice standards, included in this Part, are activities that demonstrate a local health department is fulfilling the core functions of public health.

• Certification is an eligibility requirement for Local Health Protection Grants awarded by the Department. The Department will make other Department grants available to Certified local health departments, and the Department will give preference to Certified local health departments for certain grants.

 

For the purposes of this Part, the words and phrases defined herein shall have the following meanings:

"Certification" and "Certified" means certification granted to a local health department that meets the requirements set forth in Section 600.210 and Subparts C and D of this Part and is so designated by the Department.

"Community participation" means involvement by representatives of various community interests and groups. (Agency Note: Examples of such interests or groups are ethnic and racial groups, the medical community, mental health and social service organizations, the cooperative extension service, schools, law enforcement organizations, voluntary organizations, the clergy, the business community, economic development agencies, unions, and senior citizens.)

"Contributing factor" means a scientifically established factor that directly affects the level of a risk factor.

"Department" means the Illinois Department of Public Health .

"Director" means the Director of the Illinois Department of Public Health or his designee.

"Equivalent to IPLAN" means an assessment and planning process approved by the Department which meets the requirements set forth in Section 600.410.

"Healthy People 2000" means National Health Promotion and Disease Prevention Objectives, U.S. Department of Health and Human Services, Public Health Service, DHHS publication number (PHS) 91-50212. Healthy People 2000 contains a national strategy for significantly improving the health of the nation during this decade and contains measurable targets for striving toward health promotion and prevention of injuries and diseases.

"Impact objective" means a goal for the level to which a health problem should be reduced. An impact objective is intermediate in length of time and measurable.

"Indirect contributing factor" means a community-specific factor that directly affects the level of the direct contributing factors. These factors can vary greatly from community to community.

"IPLAN" means the Illinois Project for Local Assessment of Needs, a process developed by the Department to meet the requirements set forth in Section 600.410. IPLAN is 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.

"IPLAN Data System" means a data base developed by the Department that contains the required data sets to measure community health indicators for assessment purposes.

"Legally authorized representative" means the person empowered to act on behalf of the local health department and board of health in such matters as executing contracts, signing applications, and undertaking other major administrative tasks.

"Local health department" means a local governmental agency that administers and assures health-related programs and services within its jurisdiction.

"Mandate" or "Mandated program" means those programs and activities that are statutorily required of local health departments by a legislative body, such as a city council, county board, or the General Assembly.

"Outcome objective" means a goal for the level to which a health problem should be reduced. An outcome objective is long term and measurable.

"Proven intervention strategy" means intervention strategy demonstrated to be effective or used as a national model.

"Provisional Certification" and "Provisionally Certified" means certification granted to a local health department that meets the requirements for Provisional Certification set forth in Section 600.210 and is so designated by the Department.

"Risk factor" means a scientifically established factor (determinant) that relates directly to the level of a health problem. A health problem may have any number of risk factors identified for it.

"Substantial compliance" means meeting the requirements set forth in this Part, except for variations from the strict and literal performance of such requirements which result in insignificant omissions and defects, given the particular circumstances and the incidence and history of such omissions and defects. Omissions and defects that have an adverse impact on public health and safety shall not be considered insignificant and shall be considered substantial noncompliance.

Section 600.200 Provisional Certification

• A local health department that serves one or more counties and that is not a Certified local health department may make application for Provisional Certification. Such application shall be submitted to the Department by letter, memorandum, or similar document signed by an authorized representative and shall include a written commitment to the Department to complete IPLAN or an equivalent to IPLAN within two years after Provisional Certification is granted.
  
  
• Upon submission of a complete application, the Department shall have 60 days to review the application. Provisional Certification shall be granted by the Department to any local health department that meets subsection (a) of this Section. Provisional Certification shall expire upon Certification of the local health department or two years after the date Provisional Certification was granted, whichever is shorter. Provisional Certification may be renewed as provided in subsection (c) of this Section.
  
  
• A local health department that has been granted Provisional Certification may apply for renewal of Provisional Certification. Such application shall be made at least 30 days prior to expiration of the Provisional Certification by submitting to the Department a letter, memorandum, or similar document signed by an authorized representative. The application shall describe activities that the local health department performed during the current term of Provisional Certification and future activities that will be undertaken during the renewal term that would be expected to result in the completion of IPLAN or an equivalent to IPLAN.
  
  
• Renewal applications that are complete and received by the Department no later than 30 days prior to the expiration of Provisional Certification shall be considered by the Department.
  
  
• The first renewal of Provisional Certification shall be made if the Department determines, on the basis of the application, that the applicant can be expected to complete IPLAN or an equivalent to IPLAN by conclusion of the renewal term.
  
  
• The second renewal of Provisional Certification shall be made if the Department determines, on the basis of a written explanation submitted by the local health department, in addition to the application for renewal specified in this subsection (c), that the applicant can be expected to complete IPLAN or an equivalent to IPLAN by conclusion of the second renewal term. The explanation shall include documentation of the incomplete elements of IPLAN or an equivalent to IPLAN with their expected completion dates and the reasons why the local health department did not complete IPLAN or an equivalent to IPLAN within the first renewal term.
  
  
• A renewal of Provisional Certification granted by the Department shall not exceed 12 months.
  
  
• No more than two renewals of Provisional Certification shall be granted to a local health department.
  
  
• A provisionally Certified local health department is eligible to apply for a Local Health Department Development Grant, pursuant to the Department's Local Health Department Development Grant Rules (77 Ill. Adm. Code 610).
  
  
• The Department may conduct an on-site review of the local health department and such documents necessary to determine substantial compliance with this Section.
  
  

• A Provisionally Certified local health department may apply for Certification.

• Such application shall be submitted to the Department on forms or in a format provided or prescribed by the Department and shall include a community health needs assessment and a community health plan in accordance with Subpart D of this Part. The application shall be signed by an authorized representative.
• Upon receipt of a complete application, the Department shall have 60 days to review the application to determine if the applicant meets the personnel requirements set forth in Subpart C of this Part and the practice standards set forth in Subpart D of this Part.

• If the Department determines that the applicant is in substantial compliance with Subparts C and D of this Part, Certification shall be granted by the Department.
  
  
• If the Department determines that the applicant is not in substantial compliance with Subparts C and D of this Part, Certification shall be denied and the local health department shall be notified in writing of the denial of Certification. Such notification shall specify the reasons for denial of Certification and shall describe the right of the applicant to request a hearing to appeal the denial of Certification, pursuant to Section 600.510.

• Certification granted to local health departments that apply pursuant to this Section shall expire five years following the date of Certification.

 
• A Certified local health department may apply for renewal of Certification.

• Such an application shall be made at least 60 days prior to the expiration of the Certification period. An application shall be submitted to the Department on forms or in a format provided or prescribed by the Department and shall include a community health needs assessment and a community health plan in accordance with Subpart D of this Part. The application shall be signed by an authorized representative.

• Upon completion of a complete application, the Department shall have 60 days to review the application to determine if the applicant is in substantial compliance with the personnel requirements set forth in Subpart C of this Part and the practice standards set forth in Subpart D of this Part.

• If the Department determines that the applicant is in substantial compliance with Subparts C and D of this Part, Certification shall be renewed by the Department for a five-year period.
 
• If the Department determines that the applicant is not in substantial compliance with Subparts C and D of this Part, renewal of Certification shall be denied and the local health department shall be notified in writing of the denial of Certification. Such notification shall specify the reasons for denial of Certification and shall describe the right of the applicant to request a hearing to appeal the denial of Certification renewal, pursuant to Section 600.510.

• A Certified local health department that at any time during the period for which the local health department has been granted Certification does not meet all applicable requirements for such Certification due to conditions or circumstances beyond the reasonable control of the local health department may make a written request to the Department for a waiver of the requirements set forth in Subparts C and D of this Part.

 
• Conditions or circumstances beyond the reasonable control of the local health department shall include but not be limited to:
 
• Unanticipated or unavoidable lack of qualified personnel necessary to fulfill applicable requirements; or
 
• Disease outbreaks, natural disasters, and other unusual circumstances which may threaten the health and safety of residents and which require re-assignment of personnel to protect the health and safety of residents within the local health department's jurisdiction.
 
• The Department shall grant a waiver if it determines that the local health department meets the conditions or circumstances specified in subsection (d) (1) (A) and (B) of this Section. The Department shall notify the local health department of its decision within 10 working days after the receipt of the request.
 
• A waiver shall be granted for a six-month period or until the conditions or circumstances referred to in subsections (d) (1) (A) and (B) of this Section are remedied, whichever is shorter.
 
• The Department may extend a waiver for two additional six-month periods. All requests for extension of waiver shall be received by the Department at least 15 working days prior to the expiration of the waiver period.
  
  
1. The first extension of the waiver shall be made if the Department determines, on the basis of a written explanation from the local health department, that reasonable progress has been made and the local health department can be expected to be in substantial compliance with applicable requirements of Certification on or before the conclusion of the first extended waiver period.
 
2. The second extension of waiver shall be made if the Department determines, on the basis of a written explanation from the local health department, that reasonable progress has been made and the local health department can be expected to be in substantial compliance with applicable requirements of Certification on or before the conclusion of the second extended waiver period. The explanation shall include documentation of the applicable Certification requirements that are not being met, with the expected dates for completion and the reasons why the local health department was unable to achieve substantial compliance within the first extension period.
 
• The Department shall review the local health department for substantial compliance with Certification requirements upon the expiration of the waiver period or upon request of the local health department. The Department's review shall include only those certification requirements that are the basis for the waiver.
 
• If the Department, based upon its review, determines that the local health department meets the requirements set forth in Subparts C and D of this Part, the local health department shall be considered in substantial compliance with the requirements of Certification, and no further action shall be taken by the Department.
 
• If the Department, based upon its review, determines that the local health department does not meet the requirements set forth in Subparts C and D of this Part and the waiver has expired, the Department shall notify the local health department of its option to request an extension of waiver under this section.
 
• If the Department, based upon its review, determines that the local health department does not meet the requirements set forth in Subparts C and D of this Part and the local health department's request was submitted prior to the expiration of the waiver period, the waiver shall continue until the end of the six-month period.

• The Department may conduct an on-site review of the local health department and such documents necessary to determine substantial compliance with this Section.

 

Section 600.400 Public Health Practice Standards

• Assess the health needs of the community by establishing a systematic needs assessment process that periodically provides information on the health status and health needs of the community.
 
• A community health needs assessment that systematically describes the prevailing health status and health needs of the population within the local health department's jurisdiction shall be conducted at least once every five years.
 
• The assessment shall be conducted through completion of IPLAN or an equivalent to IPLAN that meets the requirements set forth in Section 600.410.
 
• The assessment shall, at a minimum, include an analysis of data contained in the IPLAN Data System provided by the Department for assessment purposes.
 
• The assessment shall include community participation in the health needs assessment process in order to facilitate the identification of community health problems and the setting of priorities from among those health problems.
 
• Community Health needs shall be identified during the community health needs assessment process based on the analysis of data describing the health of the population and on the judgment of the community participants concerning the seriousness of the health problems and needs. The identified health needs shall be priority ranked. Prioritization shall result in the establishment of at least three priority health needs.

• A community health needs assessment shall contain:
 
• A statement of purpose of the community health needs assessment that includes a description of how the assessment will be used to improve health in the community.
 
• A description of the community participation process, a list of community groups involved in the process, and method for establishing priorities.
 
• A description of the health status and health problems most meaningful for the community in the data groupings designated by the Department in the IPLAN Data System.
 
• A description of the process and outcomes of setting priorities.

• Investigate the occurrence of adverse health effects and health hazards in the community by conducting timely investigations that identify the magnitude of health problems, duration, trends, location and populations at risk.

 
• Advocate for public health, build constituencies and identify resources in the community by generating supportive and collaborative relationships with public and private agencies and constituent groups for the effective planning, implementation and management of public health activities. The local health department shall develop and strengthen communication with units of government, health-related organizations, health providers, citizens, and news media;

 
• The local health department shall meet at least annually with representatives of health-related organizations within its jurisdiction to define inter-organizational roles and responsibilities.
 
• The local health department shall disseminate health reports that have been developed by the local health department to the board of health, county board or other legislative bodies within its jurisdiction, the media, and the public.

• Develop plans and policies to address priority health needs by establishing goals and objectives to be achieved though a systematic course of action that focuses on local community needs and equitable distribution of resources, and involves the participation of constituents and other related governmental agencies. Develop a community health plan that addresses at least three priority health needs, identified pursuant to Section 600.400, during each certification period;

 
• The local health department shall include in its community health plan an analysis to establish risk factors for each priority health need, to determine the adequacy of existing resources, and to identify population groups at risk of poor health status within the local health department's jurisdiction.
 
• The community health plan shall present measurable objectives and strategies for intervention for each priority health need.
 
• The local health department shall utilize community participation to assist in the development of the community health plan.
 
• In jurisdictions where a board of health exists pursuant to Section 5-25012 of the Counties Code (Ill. Rev. Stat. 1991, ch. 34, par. 5-25012) [55 ILCS 5/5-25012]; Division 16 or 17 of the Illinois Municipal Code (Ill. Rev. Stat. 1991, ch. 24, par. 11-16-1 and par. 11-17-1 through 11-17-12) [65 ILCS 5/11-16-1 and 5/11-17]; or the Public Health District Act (Ill. Rev. Stat. 1991, ch. 111 1/2 par. 0.01 et seq.) [70 ILCS 905], the local health department shall present the community health plan to the board of health for its review. A community health plan shall be adopted by the board of health.
 
• The local health department shall submit the community health plan to the Department. The plan shall contain:
 
• A statement of purpose of the community health plan that includes how the plan will be used to improve the health of the community;
 
• A description of the process used to develop the community health plan;
 
• A description of each priority including the importance of the priority health need, summarized data and information on which the priority is based, the relationship of the priority to Healthy People 2000 National Health Objectives and subsequent revisions and factors influencing the level of the problem (e.g., risk factors, contributing and indirect contributing factors);
 
• At least one measurable outcome objective covering a five-year time frame related to each priority health need;
 
• At least one measurable impact objective related to each outcome objective; and
 
• At least one proven intervention strategy to address each impact objective. The description should include a discussion of: community resources that will contribute to implementation; estimated funding needed for implementation; and anticipated sources of funding.

• Manage resources and develop organizational structure through the acquisition, allocation and control of human, physical and fiscal resources; and maximizing the operational functions of the local public health systems through coordination of community agencies' efforts and avoidance of duplication of services.

 
• The local health department shall, at least once every five years, perform an organizational capacity self-assessment that meets the requirements set forth in Section 600.410. The local health department shall provide the Department with a statement signed by an authorized representative indicating that the organizational capacity self-assessment was completed by the local health department and reviewed by the board of health.
 
• The local health department shall maintain a current organizational chart which includes all functional elements of the organization and their relationship to each other.
 
• The local health department shall maintain current written job descriptions, minimum qualifications for each position, and written plans or policies regarding staff recruitment, selection, development, and retention.

• Implement programs and other arrangements assuring or providing direct services for priority health needs identified in the community health plan by taking actions which translate plans and policies into services.

 
• Evaluate programs and provide quality assurance in accordance with applicable professional and regulatory standards to ensure that programs are consistent with plans and policies, and provide feedback on inadequacies and changes needed to redirect programs and resources.

 
• The local health department shall conduct periodic reviews of programs, services, and personnel to demonstrate compliance with applicable professional and regulatory standards.
 
• The local health department shall conduct monitoring of programs to assess achievement of mandated programs and progress towards meeting community health objectives as stated in the community health plan.

• Inform and educate the public on public health issues of concern in the community, promoting an awareness about public health services availability, and health education initiatives which contribute to individual and collective changes in health knowledge, attitudes and practices towards a healthier community.

 
• Documentation of each activity conducted pursuant to Subpart D of this Part shall be available for review by the Department upon request.

 

• IPLAN or a planning process equivalent to IPLAN shall meet the following requirements:
 
• The process shall involve community participation in the identification of community health problems, priority-setting, and completion of the community health needs assessment and community health plan.
 
• Community health indicators contained in the IPLAN Data System provided by the Department for assessment purposes or a similar, equally comprehensive data system developed by the local health department shall be utilized to structure the minimal content of the assessment. A local health department may use in its assessment such additional data available, describing the health of its population including natality, mortality, morbidity and risk factors for illness in its jurisdiction.
 
• The process shall result in the setting of priority health needs.
 
• The process shall include an analysis of priority problems that shall lead to the establishment of objectives and strategies for intervention.
 
• The process shall include board of health adoption of the community health plan.
 
• The process for developing a self-assessment of the health department's organizational capacity shall address the following categories: legal authority and counsel; intergovernmental relations; constituency development and education; agency mission and role; data analysis, planning, evaluation and assurance; public policy issues and implementation; budget development and administration, reporting and auditing; personnel administration and staff development; organizational structure and shared resources; and management information systems.
 
• Upon written request of a local health department, the Department shall approve a planning process equivalent to IPLAN if the Department determines that the proposed equivalent planning process complies with the requirements of subsection (a) of this Section. If the local health department is not satisfied with the Department's response to its request made pursuant to this subsection, it may petition the Director to reconsider.
 

Section 600.500 Denial, Suspension or Revocation of Certification

• The Director, after notice and opportunity for hearing, may deny the application for Certification or suspend or revoke the Certification of any local health department in any case in which the Director finds substantial or continued failure to comply with this Part. If, however, the Director finds that the public interest, health, safety, or welfare requires emergency action and if the Director incorporates a finding to that effect in the order, summary suspension of Certification may be ordered pending proceedings for revocation of Certification. Such proceedings shall be promptly instituted and promptly determined.

 
• Such notice shall be made by certified mail or by personal service and shall set forth the particular reasons for the proposed action and provide the local health department with an opportunity to request a hearing. If a written hearing request is not received within 10 days after receipt of the notice by the local health department, the right to a hearing is waived.
  
  

The Rules of Practice and Procedure in Administrative Hearings, 77 Ill. Adm. Code 100, shall apply to all proceedings conducted under this Part, with the exception that where the terms "license" and "licensing" are used in Part 100, the definitions of those terms shall be expanded to include Provisional Certification, and Certification as those terms are defined in this Part.