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In 2014 the U.S. Centers for Disease Control and Prevention (CDC) published the first edition of the Model Aquatic Health Code (MAHC). This document represented the inaugural introduction of a federal policy guideline with a direct focus in the area of aquatic venue operation and maintenance with the sole purpose of improving the nature of public health in the field. The Indiana State Department of Health (ISDH) began the review and adoption process soon after the policy’s release. The ISDH process is proposed as one method for others to consider. The background and history of the MAHC are presented in this manuscript along with an overview of the adoption process to date that has been employed by the State of Indiana. In addition, information is provided on the Diffusion of Innovations Theory (DIT) as a possible method for assessing the long-term adoption of the MAHC on a national level.