AR Code § 14-262-106 (2020)
2020 Arkansas Code|Title 14 - Local Government|Subtitle 16 - Public Health And Welfare Generally|Chapter 262 - Local Health Authorities|§ 14-262-106. County or district health departments — Establishment

 (a) Any county may, by proper order of the county court, establish and maintain a county health department.  (b) Any two (2) or more counties may, with approval of the State Board of Health and, by order of the county court of the respective counties, establish and maintain a district health department.  (c) As used in this act, unless the context otherwise requires, “department” means a county or district health department which shall consist of a public health officer and all other personnel employed or retained under the provisions of this act.  (d)  (1) Whenever a petition requesting the establishment and maintenance of a county health department is signed by fifteen percent (15%) or more of the qualified electors of a county and is presented to the county court of that county, the county court shall, by an order, instruct the county clerk to certify to the county board of election commissioners the proposition of the establishment and maintenance of such a health department, and the county board of election commissioners shall make provision for submitting the proposition to the electors of the county at the next general election.  (2) If a majority of all the votes cast upon the proposition is in favor of it, the county court shall immediately proceed to establish a health department.    (e)  (1) Whenever a petition requesting the establishment and maintenance of a multiple-county health department is signed by fifteen percent (15%) or more of the qualified electors in each of at least two (2) adjacent counties, is presented to the respective county courts, and is approved by the State Board of Health, each county court shall, by an order, instruct its respective county clerk to certify to its county board of election commissioners the proposition of the establishment and maintenance of such a health department, and the county board of election commissioners shall make provision for submitting the proposition to the electors of the county at the next general election.  (2) If a majority of all the votes cast upon the proposition in each county is in favor of it, the several county courts shall immediately proceed to organize a multiple-county health department and shall agree on the conditions governing the organization and operation of the department and the apportionment of the cost thereof.    (f) In the event three (3) or more counties have joined in petitioning for the establishment and maintenance of a multiple-county health department and not all of the counties shall vote in favor of the proposition, but two (2) or more do vote in favor of the proposition, then, with the approval of the State Board of Health, they shall proceed to organize a multiple-county health department; however, no county shall be forced to participate in the establishment and maintenance of a multiple-county health department that votes “NO” regarding the creation of the health unit.  (g) No county, whether in a multiple unit or otherwise, voting “NO” regarding the establishment and maintenance of a county health department shall be forced to create a health unit.