The changes include the following: 1) definitions are updated to include "evidence-based services" and define "primary care specialty"; 2) the section requiring a joint negotiation of specific standards between the Utah Department of Health (UDOH) and each local health department (LHD) is removed so that the standards in this rule apply to all LHDs; 3) the section on corrective action is revised to clarify the process by which UDOH will communicate and the LHD will respond when a LHD might be or is out of compliance; 4) the requirements for a Local Health Officer (LHO) are separated into a separate section, and requirements are updated, including removing the requirement for a physician LHO to have a master's degree plus experience and requiring all nonphysician LHOs to have a master's degree. The requirements for a LHD to employ or contract with a physician if the LHO is not a physician are clarified. While an exemption to the standards may be granted for a LHO in position, the ability to grant an exemption after that time is removed; 5) a requirement is added for a LHD to employ an epidemiologist; 6) Personal Health Services is expanded to include population health services reflecting current public health practice. Several outdated requirements are removed and replaced by a simpler requirement to conduct community assessments and develop evidence-based programs to address identified priorities. A requirement to provide epidemiology services was added; 7) Environmental Health Programs is simplified to clarify that the LHD is responsible to enforce state rules in this area. Several responsibilities that relate to the Department of Environmental Quality (DEQ) were removed; 8) a Public Health Emergency Preparedness section is added to address this area that has emerged since the last rule revision; and 9) other out-of-date requirements are removed in several areas.