IA SSB3135

Transfers all powers and duties from local boards of health and local health departments to county boards of health and district boards of health, eliminating city boards of health as a separate governance structure.

Requires counties not part of a district to establish a county board to oversee public health matters, including creating a fiscal plan with proposed expenditures, revenues, and funding details.

Mandates county boards execute agreements with county hospitals for sharing facilities, health care services, and administrative functions.

Provides an optional process for two or more geographically contiguous counties to merge and form a district board of health to increase efficiencies and enhance public health service delivery.

Redefines key terms in Iowa Code Chapter 137 ("Local Public Health Governance Act"), removing references to city boards and city health departments while consolidating definitions around county and district board structures.