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Uniform environmental health code: a modern management tool for progress.

In "Environmental Stealth," Doser and Schmidbauer expressed fear that public health is not being adequately protected where poorly written laws and regulations are "...ignored, waived, compromised, modified or misinterpreted by the responsible regulatory agency." The author expressed a belief that laws and regulations should be viewed as "tools" to get public health work done (1).

A related viewpoint was expressed by Dr. Thomas H. Hatfield in his provocative paper, "The Failure of Sanitarians:"

"Sanitarians are and always have been professionals that apply many different disciplines to control environmental influences on health. ... The true power of our profession -- the ability of the generalist to integrate and apply multiple disciplines -- is the power we must exploit (2)."

Dr. Hatfield also emphasized how appropriately used negotiation skills could help EH professionals avoid the need to make compromises.

The authors of this paper believe these opportunities (for negotiated power and integrity without compromise) are especially present within the matrix of the Uniform Environmental Health Code (UEHC).


The responsibilities of EH professionals go beyond the mere enforcement of laws and routine daily activities. EH professionals also have an obligation to actively advance the cause of EH through review, analysis and participation in EH program advancement and development of modern EH laws (3). Laws and regulations arise out of public perceptions and concerns. EH professionals can help define emerging EH problems and develop solutions based upon sound (practical and scientifically based) health principles (4).

The development, adoption and use of the UEHC in San Bernardino County, California has been a successful response to these needs. It has furnished a proper tool so that multi-disciplined EH professionals have enjoyed jobs well done through "integrated EH power."

The problem

In San Bernardino County, the need for a UEHC began in the 1970s. At that time, county environmental health programs were transferred from the county Department of Public Health to a newly created Department of Environmental Health Services (DEHS). This was made possible by state legislation that recognized the value of independently administered EH programs.

After the transfer, several administrative problems came to the attention of DEHS management:

* EH elements of the county code were merged with traditional medical public health issues;

* Many city codes lacked EH elements or included conflicting county code sections. Code language was cumbersome and antiquated in many instances;

* DEHS was providing services to many cities without contractual or other legal authority. Court challenges to DEHS enforcement efforts were possible where codes and contracts were vague, inconsistent or absent;

* During and after the transfer, several new EH programs were developed that lacked code provisions for their implementation;

* EH programs were being provided to several cities at unequal service levels based upon traditions, unwritten agreements and other non-rational criteria;

* The 1978 California Property Tax Initiative (Prop 13) placed additional burdens on local government. As tax dollars diminished, health service fees were critically needed to support DEHS programs. Service delivery levels needed to be clearly stated in the EH codes and service contracts. Provisions to pay for optional and expanded services were needed; and

* Where EH problems transcended political boundaries, coordinated and uniform EH compliance procedures were needed for efficient solutions.

The need in focus

For DEHS to effectively meet these challenges, a legal tool, the UEHC, was urgently needed that would help assure the public that EH programs were: comprehensive, coordinated, of quality, cost effective, properly identified, prioritized, uniformly delivered, neutral regarding special interests, resourceful in solving multi-faceted problems, free of excessive and duplicative administrative overhead.

Developing the code

The development of the code was a complex and time-consuming task. Grant monies were requested and obtained from the state Department of Health Services -- Special Needs and Priorities Program (SNAP). Many hours were required for research, consultation and negotiation with staff from the 17 cities then in existence.

DEHS staff also spent many hours with representatives from the regulated private sector to ensure that the desired results were realistic and within existing technology. Applicable state laws were referenced and interpreted where appropriate. Special emphasis was placed on using a "plain English" style of writing, avoiding "legalese" wherever possible to promote understanding.

County counsel, city managers and affected parties on advisory committees provided critical review of drafts. Where certain special interests attempted unreasonable compromise, negotiated settlements were obtained and/or support for the position of DEHS was obtained from the county Board of Supervisors (BOS).

DEHS employed a registered environmental health specialist (REHS), who was also a licensed attorney, to help relate public health principles within a legal context. The importance of access to legal help was noted by Grad (5).

The code was adopted by the BOS on December 22, 1986 (6). Within the next year all 17 cities (then in the county) adopted the code and officials of most cities had signed enforcement contracts with DEHS. Subsequently, an additional seven (newly incorporated) cities adopted the code and entered into contracts with DEHS.

The anatomy of the code

The code lists EH programs cafeteria style, beginning with administrative chapters, followed by traditional substantive EH programs: retail food, wholesale food, milk and dairy, foodworker training, domestic water, wastewater, haz-mat emergency response, haz-mat underground storage tanks, medical waste disposal, haz-mat community right-to-know, haz-mat waste minimization and management, local enforcement agency solid waste compliance, environmental code enforcement, land use enforcement, housing and property improvement, environmental health education, vehicle abatement, vector control (which program also is a BOS administered district), plan check, recreational health and new chapters in development (7).

The need for flexibility was recognized and built into the UEHC. Chapters are structured so that optional features allow for enhanced DEHS service delivery where desired by the client city. As chapters become outdated, they can be rewritten and readopted by each city.

A review of the chapters in detail would be too time-consuming for this paper; however, the following highlights from the administrative chapters should be emphasized since they establish the due process foundation for criminal and civil court compliance (when education, notices, hearings and negotiations have been unable to gain administrative compliance).

Chapter 1 -- Authority and Administration

This chapter establishes regulatory authority from a federal, state and county basis. Scope of authority is to be broadly interpreted and includes the right to charge reasonable DEHS fees (as are prescribed in the county code Schedule of Fees). DEHS and its employees are not to be held liable when in "good faith" they reasonably have believed they were acting within the scope of their authority.

Subject to constitutional provisions, the Director and DEHS enforcement officers have authority to investigate for code violations, detain for purposes of investigation, and to issue citations to persons committing misdemeanor or infraction offenses.

The code not only makes it unlawful to interfere, prevent or hinder enforcement officers' activities, it also mandates a one to 10 day jail sentence (without the alternative of a fine) for physical resistance or bodily attack upon an officer.

Compliance with all Freedom of Information statutes is emphasized. Files are to be readily accessible to public inspection subject to specified privacy exclusions. Requestors must identify themselves with an authorized photo ID.

Civil remedies are encouraged where fraud or unfair business practices have occurred. Relief is to include injunctive action and restitution. Criminal remedies concentrate on infractions with scaled fines for first through third offenses. Four or more violations are treated as misdemeanors with substantial fines plus suggested jail times. Additionally, the court may also judge that the offender is liable for all incurred investigative, inspection, cleanup and other actual DEHS costs pertaining to the violation(s).

The code encourages the giving of alternative sentences. (DEHS activities, such as cleaning up litter and related community service have been thought by many judges to be more beneficial to the individual and cost-effective to the public than ordered fines and/or jail time.)

Chapter 2 -- Permits and Hearing Procedures

The chapter gives emphasis to the requirement to separate construction permits prior to the issuance of operational permits. It allows enforcement staff flexibility to require proposals with complex and unique public health and safety risks be accompanied with special studies (paid for by the applicant) to assure a reasonable reduction and elimination of risk.

Administrative due process procedures are covered in detail. Administrative Orders to Show Cause may result in a suspended or revoked permit after a hearing. Under conditions of immediate threat to public health and safety, permits may be summarily suspended (with the right to a hearing within five days of the suspension and reinstatement of the permit if corrections have been made).

Details for administrative hearings are given to assure that due process requirements are met. Hearing officers (who are usually DEHS management or supervisory staff, or from other departments of the county's Environmental Management Group) must have no knowledge of the case; witnesses are sworn to tell the truth; the responding party must be represented by counsel; and parties may cross-examine. Most technical rules of procedure and evidence need not be followed. Informal discussions are allowed and limited amounts of heresay evidence may be admissible.

Chapter 3 -- Public Nuisance Abatement

Twelve categories of specific EH nuisances plus common law public nuisances are enumerated for abatement. Political problems are diminished by first having the elected authority declare a situation to be a public nuisance by resolution prior to abatement activities. Enforcement officers are authorized to abate immediate public hazards upon specified critical conditions.

Where the responsible party or owner refuses to diligently abate a nuisance, the code authorizes DEHS to abate by private contractor, place a lien and file notice of pendency upon the property for abatement costs, and where costs are not paid, to sell the property to recover the delinquent lien.

This process has been extremely effective. Not only have DEHS administrative costs been more fully recovered, DEHS is now taken more seriously when first issuing notices to abate. Additionally, substantial revenues from paid liens are now providing program support to replace diminished tax revenue to DEHS.

When criminal action is appropriate, infractions have been selected as the method of choice. This is because of the stigma (a criminal record) that most prosecutors and judges mentally assign to misdemeanor convictions. Except for certain "glamorous" cases such as haz-mat violations, courts still have a reluctance to view EH problems as serious threats to the public health, safety and welfare.

A major success of the UEHC appears to lie in the synergism it promotes among EH professionals. Although many of them specialize, a majority possess a basic knowledge of most EH disciplines.

Through informal mentor and intern relationships, old and new ideas mix and evolve in dynamic processes. This ongoing chemistry seems to consistently produce fresh solutions to many categories of new and old problems.

Program considerations

With a chronic recession lingering into 1993 and perhaps beyond, the UEHC can also help EH managers more efficiently protect public health within reduced EH budgets. In the 1970s innovative EH county managers in California were starting to obtain substantial revenues through health service fees. In some cases, 90 to 100 percent of program costs were being recovered. This resourcefulness, however, became a double-edged sword in the 1980s, as senior county administrators came to see such revenues as "temporary" subsidies for other ailing county agencies.

As the recession of the 1990s continues, even leaner slices of the revenue pie are likely for state, county and city agencies. Not only are county administrative officers more apt to aggressively seek these "temporary" revenues, city managers may also continue their attempts to siphon off considerable monies by taking over perceived "high revenue" programs which had expensive EH start-up costs during their formative years (e.g., underground tank programs).

EH programs not specifically mandated by statute to be enforced by REHSs are especially vulnerable to city takeover. Private sector contracting (without REHSs) is also being discussed and promoted by some city administrators.

UEHC regarding compliance and enforcement issues

Returning to the frustrations and concerns of Doser and Schmidbauer (in examining why EH laws are not being enforced), perhaps EH managers may wish to closely examine the UEHC as being the right "tool"--right now. Flexibility present in the UEHC allows for an individualized enforcement policy implementation according to the "style" of each director of EH.

Everyone agrees with the definite need to have modern, understandable and easily enforced laws. When statutes and regulations become too complex and without options, enforcers can become discouraged with provisions that do not allow for the exercise of common sense and good judgment in non-typical circumstances.

Joe Martin, retired director of DEHS often told his field staff:

"You have this regulatory line you are commissioned to follow, but depending upon the circumstances of good practice, you may deviate a little to the left or a little to the right of the line, but not too far either way."

Likewise, Dr. Hatfield stated in "The Failure of Sanitarians:"

"...environmental issues are principally in the political realm. The answers will (therefore) be political in nature...Negotiation does not necessarily mean compromise. ...we are simply being more strategic. ...Man-hours spent on documenting precise conditions may be wasteful without empowering sanitarians to make accurate judgments (8)."

Sanford Brown, in his Journal of Environmental Health paper "Inspection Based Enforcement," said:

"Professionalism implies the granting of a certain amount of discretion to the practitioner to use their own judgment, based on expertise and experience, to determine what would be the best in a particular case... if exercised improperly, (discretion) can lead to inconsistency, bias, corruption and malfeasance. When exercised properly, however, discretion is the key to professional enforcement... A legalistic enforcement style is characteristic of the environmental health professional who uses little discretion and whose approach to enforcement is rigid, punitive and police oriented (9)."

In "Redefining Our Mission," Charles D. Treser stated:

"Environmental health practitioners must come to see themselves as agents of change--people who can inform, motivate, encourage, and if necessary, legally force people to adopt behaviors, practices and processes which are ecologically sound and which will result in the enhancement of community health... (and) that they see their fundamental role not as inspectors or regulators, but rather as agents of change... (10)."

Walker, Blackwell and Adrounie, in "Educating the Workforce," believe that emphasis is shifting from the traditional regulatory approach to service and education. The reason, in their opinion, is that the regulatory approach does not always provide needed protection; that over-regulation unnecessarily occurs; investigations are incomplete or slowed to be safe; economic and social implications are not considered; and, balanced decisions are not made (11).

Such beliefs of eminently well qualified environmental health scientists and professionals should be strongly considered. Their views are based not only upon knowledge and experience derived from many years as program administrators and managers, but also from skills (as academicians) to analyze, synthesize and explain the truth of what is happening at the program delivery level.

Ideally, clever managers of environmental health programs with properly trained and motivated professionals could establish themselves as EH consultants to the regulated community, using the force of law only after persuasion and negotiation fails or when an immediate threat to health and safety is apparent.


The age-old debate of education versus enforcement continues and should continue to be examined by environmental health professionals. It is a given that in order to efficiently and effectively get the job done, modern, understandable and comprehensive laws are needed. The UEHC is a model that can be used in many flexible ways.

To paraphrase environmental health scientist and professional Larry Gordon, "Environmental health and protection problems associated with the modern environment are complex and constantly changing. Personnel who do not take affirmative steps to remain current are soon out-of-date and ineffective (12)."

Similarly, in 1979, Morton S. Hilbert stated,

"It was Mahatma Gandhi who said: 'I must move quickly for there go my people and I am supposed to be their leader.' ...If we (REHSs) are to maintain our leadership role, we must move quickly to address the new environmental hazards and to respond to the public concern for effective control of all environmental health problems (13)."

The authors believe that the UEHC will greatly enhance the opportunity for EH professionals to continue to fulfill their leadership responsibilities as environmental health continues to evolve and meets new challenges.


1. Doser, J.G. and T.L. Schmidbauer (1991), Environmental stealth, Calif. J. Environ. Health 14(3):6-7.

2. Hatfield, T.H. (1991), The failure of sanitarians, J. Environ. Health 53(5):23-25.

3. Grad, F.P. (1978), Public Health Law Manual, American Public Health Assoc., Washington, DC.

4. Roberts, R.L. (1988), Quid nunc, health surveyor (What now, health surveyor), J. Australian Inst. of Health Surveyors 20(1):3.

5. Grad, F.P. (1978), Public Health Law Manual, American Public Health Assoc., Washington, DC.

6. ... (1986), Minutes of the board, Board of Supervisors, San Bernardino County, California.

7. ... (1986), Ordinance No. 3105, Board of Supervisors, San Bernardino County, California.

8. Hatfield, T.H. (1991), The failure of sanitarians, J. Environ. Health 53(5):23-25.

9. Brown, S.M. (1989), Inspection based enforcement, J. Environ. Health 51(2):86-88.

10. Treser, C.D. (1990), Redefining our mission, J. Environ. Health, Special Issue, Spring:34-36.

11. Walker, B., V.H. Adrounie, O.F. Blackwell (1990), Educating the workforce, J. Environ. Health 52(4):220-222.

12. Gordon, L. (1991), Year 2000 Education Plan for Environmental Health Science and Protection: Problems, Challenges and Recommendations, U.S. Public Health Service, Bureau of Health Professionals, Albuquerque, NM.

13. Hilbert, M.S. (1979), Challenges to environmental health personnel, J. Environ. Health 41(6):317.

Pamella Bennett, Director of Environmental Health Services, County of San Bernardino, 385 N. Arrowhead Ave., San Bernardino, CA 92415-0160.
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Author:Bennett, Pamella V.
Publication:Journal of Environmental Health
Date:Nov 1, 1993
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