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ARTICLE 2.
Local Administration.
Part 1. Local Health Departments.
§ 130A-34. Provision of local public health services.
(a) A county shall provide public health services.
(b) A county shall operate a county health department,
establish a consolidated human services agency pursuant to
G.S. 153A-77, participate in a district health department,
or contract with the State for the provision of public
health services.
§ 130A-35. County board of health; appointment; terms.
(a) A county board of health shall be the policy-
making, rule-making and adjudicatory body for a county
health department.
(b) The members of a county board of health shall be
appointed by the county board of commissioners. The board
shall be composed of 11 members. The composition of the
board shall reasonably reflect the population makeup of the
county and shall include: one physician licensed to practice
medicine in this State, one licensed dentist, one licensed
optometrist, one licensed veterinarian, one registered
nurse, one licensed pharmacist, one county commissioner, one
professional engineer, and three representatives of the
general public. All members shall be residents of the
county. If there is not a licensed physician, a licensed
dentist, a licensed optometrist, a licensed veterinarian, a
registered nurse, a licensed pharmacist, or a professional
engineer available for appointment, an additional
representative of the general public shall be appointed. If
however, one of the designated professions has only one
person residing in the county, the county commissioners
shall have the option of appointing that person or a member
of the general public.
(c) Except as provided in this subsection, members of
a county board of health shall serve three-year terms. No
member may serve more than three consecutive three-year
terms unless the member is the only person residing in the
county who represents one of the professions designated in
subsection (b) of this section. The county commissioner
member shall serve only as long as the member is a county
commissioner. When a representative of the general public is
appointed due to the unavailability of a licensed physician,
a licensed dentist, a licensed optometrist, a licensed
veterinarian, a registered nurse, a licensed pharmacist, or
a professional engineer, that member shall serve only until
a licensed physician, a licensed dentist, a licensed
optometrist, a licensed veterinarian, a registered nurse, a
licensed pharmacist, or a professional engineer becomes
available for appointment. In order to establish a uniform
staggered term structure for the board, a member may be
appointed for less than a three-year term.
(d) Vacancies shall be filled for any unexpired
portion of a term.
(e) A chairperson shall be elected annually by a
county board of health. The local health director shall
serve as secretary to the board.
(f) A majority of the members shall constitute a
quorum.
(g) A member may be removed from office by the county
board of commissioners for:
(1) Commission of a felony or other crime involving
moral turpitude;
(2) Violation of a State law governing conflict of
interest;
(3) Violation of a written policy adopted by the
county board of commissioners;
(4) Habitual failure to attend meetings;
(5) Conduct that tends to bring the office into
disrepute; or
(6) Failure to maintain qualifications for
appointment required under subsection (b) of this
section.
A board member may be removed only after the member has
been given written notice of the basis for removal and has
had the opportunity to respond.
(h) A member may receive a per diem in an amount
established by the county board of commissioners.
Reimbursement for subsistence and travel shall be in
accordance with a policy set by the county board of
commissioners.
(i) The board shall meet at least quarterly. The
chairperson or three of the members may call a special
meeting.
§ 130A-36. Creation of district health department.
(a) A district health department including more
than one county may be formed in lieu of county health
departments upon agreement of the county boards of
commissioners and local boards of health having jurisdiction
over each of the counties involved. A county may join a
district health department upon agreement of the boards of
commissioners and local boards of health having jurisdiction
over each of the counties involved. A district health
department shall be a public authority as defined in G.S.
159-7(b)(10).
(b) Upon creation of or addition to a district health
department, the existing rules of the former board or boards
of health shall continue in effect until amended or repealed
by the district board of health.
§ 130A-37. District board of health.
(a) A district board of health shall be the policy-
making, rule-making and adjudicatory body for a district
health department and shall be composed of 15 members;
provided, a district board of health may be increased up to
a maximum number of 18 members by agreement of the boards of
county commissioners in all counties that comprise the
district. The agreement shall be evidenced by concurrent
resolutions adopted by the affected boards of county
commissioners.
(b) The county board of commissioners of each county
in the district shall appoint one county commissioner to the
district board of health. The county commissioner members of
the district board of health shall appoint the other members
of the board, including at least one physician licensed to
practice medicine in this State, one licensed dentist, one
licensed optometrist, one licensed veterinarian, one
registered nurse, one licensed pharmacist, and one
professional engineer. The composition of the board shall
reasonably reflect the population makeup of the entire
district and provide equitable district-wide representation.
All members shall be residents of the district. If there is
not a licensed physician, a licensed dentist, a licensed
optometrist, a licensed veterinarian, a registered nurse, a
licensed pharmacist, or a professional engineer available
for appointment, an additional representative of the general
public shall be appointed. If however, one of the designated
professions has only one person residing in the district,
the county commissioner members shall have the option of
appointing that person or a member of the general public.
(c) Except as provided in this subsection, members of
a district board of health shall serve terms of three years.
Two of the original members shall serve terms of one year
and two of the original members shall serve terms of two
years. No member shall serve more than three consecutive
three-year terms unless the member is the only person
residing in the district who represents one of the
professions designated in subsection (b) of this section.
County commissioner members shall serve only as long as the
member is a county commissioner. When a representative of
the general public is appointed due to the unavailability of
a licensed physician, a licensed dentist, a licensed
optometrist, a licensed veterinarian, a registered nurse, a
licensed pharmacist, or a professional engineer that member
shall serve only until a licensed physician, a licensed
dentist, a licensed optometrist, a licensed veterinarian, a
registered nurse, a licensed pharmacist, or a professional
engineer becomes available for appointment. The county
commissioner members may appoint a member for less than a
three-year term to achieve a staggered term structure.
(d) Whenever a county shall join or withdraw from an
existing district health department, the district board of
health shall be dissolved and a new board shall be appointed
as provided in subsection (c).
(e) Vacancies shall be filled for any unexpired
portion of a term.
(f) A chairperson shall be elected annually by a
district board of health. The local health director shall
serve as secretary to the board.
(g) A majority of the members shall constitute a
quorum.
(h) A member may be removed from office by the
district board of health for:
(1) Commission of a felony or other crime involving
moral turpitude;
(2) Violation of a State law governing conflict of
interest;
(3) Violation of a written policy adopted by the
county board of commissioners of each county in
the district;
(4) Habitual failure to attend meetings;
(5) Conduct that tends to bring the office into
disrepute; or
(6) Failure to maintain qualifications for
appointment required under subsection (b) of this
section.
A board member may be removed only after the member has
been given written notice of the basis for removal and has
had the opportunity to respond.
(i) A member may receive a per diem in an amount
established by the county commissioner members of the
district board of health. Reimbursement for subsistence and
travel shall be in accordance with a policy set by the
county commissioner members of the district board of health.
(j) The board shall meet at least quarterly. The
chairperson or three of the members may call a special
meeting.
(k) A district board of health is authorized to
provide liability insurance for the members of the board and
the employees of the district health department. A district
board of health is also authorized to contract for the
services of an attorney to represent the board, the district
health department and its employees, as appropriate. The
purchase of liability insurance pursuant to this subsection
waives both the district board of health's and the district
health department's governmental immunity, to the extent of
insurance coverage, for any act or omission occurring in the
exercise of a governmental function. By entering into a
liability insurance contract with the district board of
health, an insurer waives any defense based upon the
governmental immunity of the district board of health or the
district health department.
§ 130A-38. Dissolution of a district health department.
(a) Whenever the board of commissioners of each
county constituting a district health department determines
that the district health department is not operating in the
best health interests of the respective counties, they may
direct that the district health department be dissolved. In
addition, whenever a board of commissioners of a county
which is a member of a district health department determines
that the district health department is not operating in the
best health interests of that county, it may withdraw from
the district health department. Dissolution of a district
health department or withdrawal from the district health
department by a county shall be effective only at the end of
the fiscal year in which the action of dissolution or
withdrawal transpired.
(b) Notwithstanding the provisions of subsection (a),
no district health department shall be dissolved without
prior written notification to the Department.
(c) Any budgetary surplus available to a district
health department at the time of its dissolution shall be
distributed to those counties comprising the district on the
same pro rata basis that the counties appropriated and
contributed funds to the district health department budget
during the current fiscal year. Distribution to the counties
shall be determined on the basis of an audit of the
financial record of the district health department. The
district board of health shall select a certified public
accountant or an accountant who is subsequently certified by
the Local Government Commission to conduct the audit. The
audit shall be performed in accordance with G.S. 159-34. The
same method of distribution of funds described above shall
apply when one or more counties of a district health
department withdraw from a district.
(d) Upon dissolution or withdrawal, all rules adopted
by a district board of health shall continue in effect until
amended or repealed by the new board or boards of health.
§ 130A-39. Powers and duties of a local board of health.
(a) A local board of health shall have the
responsibility to protect and promote the public health. The
board shall have the authority to adopt rules necessary for
that purpose.
(b) A local board of health may adopt a more stringent
rule in an area regulated by the Commission for Health
Services or the Environmental Management Commission where,
in the opinion of the local board of health, a more
stringent rule is required to protect the public health;
otherwise, the rules of the Commission for Health Services
or the rules of the Environmental Management Commission
shall prevail over local board of health rules. However, a
local board of health may not adopt a rule concerning the
grading, operating, and permitting of food and lodging
facilities as listed in Part 6 of Article 8 of this Chapter
and as defined in G.S. 130A-247(1), and a local board of
health may adopt rules concerning wastewater collection,
treatment and disposal systems which are not designed to
discharge effluent to the land surface or surface waters
only in accordance with G.S. 130A-335(c).
(c) The rules of a local board of health shall apply
to all municipalities within the local board's jurisdiction.
(d) Not less than 10 days before the adoption,
amendment or repeal of any local board of health rule, the
proposed rule shall be made available at the office of each
county clerk within the board's jurisdiction, and a notice
shall be published in a newspaper having general circulation
within the area of the board's jurisdiction. The notice
shall contain a statement of the substance of the proposed
rule or a description of the subjects and issues involved,
the proposed effective date of the rule and a statement that
copies of the proposed rule are available at the local
health department. A local board of health rule shall become
effective upon adoption unless a later effective date is
specified in the rule.
(e) Copies of all rules shall be filed with the
secretary of the local board of health.
(f) A local board of health may, in its rules, adopt
by reference any code, standard, rule or regulation which
has been adopted by any agency of this State, another state,
any agency of the United States or by a generally recognized
association. Copies of any material adopted by reference
shall be filed with the rules.
(g) A local board of health may impose a fee for
services to be rendered by a local health department, except
where the imposition of a fee is prohibited by statute or
where an employee of the local health department is
performing the services as an agent of the State.
Notwithstanding any other provisions of law, a local board
of health may impose cost-related fees for services
performed pursuant to Article 11 of this Chapter,
"Wastewater Systems," for services performed pursuant to
Part 10, Article 8 of this Chapter, "Public Swimming Pools",
and for services performed pursuant to Part 11, Article 8 of
this Chapter, "Tattooing". Fees shall be based upon a plan
recommended by the local health director and approved by the
local board of health and the appropriate county board or
boards of commissioners. The fees collected under the
authority of this subsection are to be deposited to the
account of the local health department so that they may be
expended for public health purposes in accordance with the
provisions of the Local Government Budget and Fiscal Control
Act.
§ 130A-40. Appointment of local health director.
(a) A local board of health, after consulting with
the appropriate county board or boards of commissioners,
shall appoint a local health director. All persons who are
appointed to the position of local health director on or
after January 1, 1992, must possess minimum education and
experience requirements for that position, as follows:
(1) A medical doctorate; or
(2) A masters degree in Public Health
Administration, and at least one year of
employment experience in health programs or health
services; or
(3) A masters degree in a public health discipline
other than public health administration, and at
least three years of employment experience in
health programs or health services; or
(4) A masters degree in public administration, and
at least two years of experience in health
programs or health services; or
(5) A masters degree in a field related to public
health, and at least three years of experience in
health programs or health services; or
(6) A bachelors degree in public health
administration or public administration and at
least three years of experience in health programs
or health services.
(b) Before appointing a person to the position of
local health director under subsection (a)(5) of this
section, the local board of health shall forward the
application and other pertinent materials of such candidate
to the State Health Director. If the State Health Director
determines that the candidate's masters degree is in a field
not related to public health, the State Health Director
shall so notify the local board of health in writing within
15 days of the State Health Director's receipt of the
application and materials, and such candidate shall be
deemed not to meet the education requirements of subsection
(a)(5) of this section. If the State Health Director fails
to act upon the application within 15 days of receipt of the
application and materials from the local board of health,
the application shall be deemed approved with respect to the
education requirements of subsection (a)(5) of this section,
and the local board of health may proceed with appointment
process.
(c) The State Health Director shall review requests of
educational institutions to determine whether a particular
masters degree offered by the requesting institution is
related to public health for the purposes of subsection
(a)(5) of this section. The State Health Director shall act
upon such requests within 90 days of receipt of the request
and pertinent materials from the institution, and shall
notify the institution of its determination in writing
within the 90-day review period. If the State Health
Director determines that an institution's particular masters
degree is not related to public health, the State Health
Director shall include the reasons therefor in his written
determination to the institution.
(d) When a local board of health fails to appoint a
local health director within 60 days of the creation of a
vacancy, the State Health Director may appoint a local
health director to serve until the local board of health
appoints a local health director in accordance with this
section.
§ 130A-41. Powers and duties of local health director.
(a) A local health director shall be the
administrative head of the local health department, shall
perform public health duties prescribed by and under the
supervision of the local board of health and the Department
and shall be employed full time in the field of public
health.
(b) A local health director shall have the following
powers and duties:
(1) To administer programs as directed by the local
board of health;
(2) To enforce the rules of the local board of
health;
(3) To investigate the causes of infectious,
communicable and other diseases;
(4) To exercise quarantine authority and isolation
authority pursuant to G.S. 130A-145;
(5) To disseminate public health information and to
promote the benefits of good health;
(6) To advise local officials concerning public
health matters;
(7) To enforce the immunization requirements of
Part 2 of Article 7 of this Chapter;
(8) To examine and investigate cases of venereal
disease pursuant to Parts 3 and 4 of Article 6 of
this Chapter;
(9) To examine and investigate cases of
tuberculosis pursuant to Part 5 of Article 6 of
this Chapter;
(10) To examine, investigate and control rabies
pursuant to Part 6 of Article 6 of this Chapter;
(11) To abate public health nuisances and imminent
hazards pursuant to G.S. 130A-19 and G.S. 130A-20;
(12) To employ and dismiss employees of the local
health department in accordance with Chapter 126
of the General Statutes;
(13) To enter contracts, in accordance with The
Local Government Finance Act, G.S. Chapter 159,
on behalf of the local health department. Nothing
in this paragraph shall be construed to abrogate
the authority of the board of county
commissioners.
(c) Authority conferred upon a local health director
may be exercised only within the county or counties
comprising the local health department.
§ 130A-42. Personnel records of district health departments.
Employee personnel records of a district health
department shall have the same protections from disclosure
as county employee personnel records under G.S. 153A-98. For
the purposes of this section, the local health director
shall perform the duties assigned to the county manager
pursuant to G.S. 153A-98 and the district board of health
shall perform the duties assigned to the county board of
commissioners pursuant to G.S. 153A-98.
Part 1A. Consolidated Human Services Agency.
§ 130A-43. Consolidated human services agency; board; director.
(a) Except as otherwise provided by this section
and subject to any limitations that may be imposed by the
board of county commissioners under G.S. 153A-77, a
consolidated human services agency created pursuant to G.S.
153A-77 shall have the responsibility to carry out the
duties of a local health department and the authority to
administer the local public health programs established in
this Chapter in the same manner as a local health
department.
(b) In addition to the powers conferred by G.S. 153A-
77(d), a consolidated human services board shall have all
the powers and duties of a local board of health as provided
by G.S. 130A-39, except that the consolidated human services
board may not:
(1) Appoint the human services director.
(2) Transmit or present the budget for local health
programs.
(c) In addition to the powers conferred by G.S. 153A-
77(e), a human services director shall have all the powers
and duties of a local health director provided by G.S. 130A-
41, except that the human services director may:
(1) Serve as the executive officer of the
consolidated human services agency only to the
extent and in the manner authorized by the county
manager.
(2) Appoint staff of the consolidated human
services agency only upon the approval of the
county manager.
Part 1B. Public Health Authorities Authorized.
§ 130A-45. Title and purpose.
(a) This Part shall be known and may be cited as
the "Public Health Authorities Act".
(b) The purpose of this Part is to provide an
alternative method for counties to provide public health
services. This Part shall not be regarded as repealing any
powers now existing under any other law, either general,
special, or local.
(c) It is the policy of the General Assembly that
Public Health Authorities should have adequate authority to
exercise the powers, rights, duties, functions, privileges,
and immunities conferred upon them by law.
§ 130A-45.01. Definitions.
As used in this Part, unless otherwise specified:
(1) "Authority service area" means the area within
the boundaries of the authority as provided for in
G.S. 130A-45.4.
(2) "Board" means a public health authority board
created under this Part.
(3) "County" means the county which is, or is about
to be, included in the territorial boundaries of a
public health authority when created hereunder.
(4) "County board of commissioners" means the
legislative body charged with governing the
county.
(5) "Department" means the Department of Health and
Human Services.
(6) "Federal government" means the United States of
America, or any agency, instrumentality, corporate
or otherwise, of the United States of America.
(7) "Government" means the State and federal
governments and any subdivision, agency, or
instrumentality, corporate or otherwise, of either
of them.
(8) "Public health authority" means a public body
and a body corporate and politic organized under
the provisions of this Part.
(9) "Public health facility" means any one or more
buildings, structures, additions, extensions,
improvements, or other facilities, whether or not
located on the same site or sites, machinery,
equipment, furnishings or other real or personal
property suitable for providing public health
services; and includes, without limitation, local
public health departments or centers; public
health clinics and outpatient facilities; nursing
homes, including skilled nursing facilities and
intermediate care facilities, adult care homes for
the aged and disabled; public health laboratories;
administration buildings, central service and
other administrative facilities; communication,
computer and other electronic facilities;
pharmaceutical facilities; storage space;
vehicular parking lots and other such public
health facilities, customarily under the
jurisdiction of or provided by public health
departments, or any combination of the foregoing,
with all necessary, convenient or related
interests in land, machinery, apparatus,
appliances, equipment, furnishings, appurtenances,
site preparation, landscaping, and physical
amenities.
(10) "Real property" means lands, lands under
water, structures, and any and all easements,
franchises and incorporeal hereditaments and every
estate and right therein, legal and equitable,
including terms for years and liens by way of
judgment, mortgage or otherwise.
(11) "State" means the State of North Carolina.
§ 130A-45.02. Creation of a public health authority.
(a) A public health authority may be created
whenever a county board of commissioners finds and adopts a
resolution finding that it is in the interest of the public
health and welfare to create a public health authority to
provide public health services as required under G.S. 130A-
34.
(b) A public health authority including more than one
county may be formed upon joint resolution of the county
boards of commissioners and local boards of health having
jurisdiction over each of the counties involved.
(c) After the adoption of a resolution creating a
public health authority, a public health authority board
shall be appointed in accordance with G.S. 130A-45.1.
(d) A county may join a public health authority upon
joint resolution of the boards of commissioners and local
boards of health having jurisdiction over each of the
counties involved.
(e) A public health authority board shall govern the
public health authority. All powers, duties, functions,
rights, privileges, or immunities conferred on the public
health authority may be exercised by the authority board.
(f) The public health authority board shall absorb the
functions, assets, and liabilities of the county or district
boards of health, and that board is dissolved.
(g) For the purpose of Chapter 159 of the General
Statutes, a public health authority is a public authority as
defined in G.S. 159-7(b)(10).
(h) Before adopting a resolution creating a public
health authority, the county board of commissioners shall
hold a public hearing with notice published at least 10 days
before the hearing.
(i) For the purposes of Article 9 of Chapter 131E of
the General Statutes, a public health authority is a person
as defined in G.S. 131E-176(19).
§ 130A-45.1. Membership of the public health authority
board.
(a) A public health authority board shall be the
policy-making, rule-making, and adjudicatory body for a
public health authority and shall be composed of no fewer
than seven members and no more than nine members; except
that in an authority comprising two or more counties, the
board shall be composed of no more than 11 members.
(b) In a single county authority, the county board of
commissioners shall appoint the members of the board; in an
authority comprising two or more counties, the chair of the
county board of commissioners of each county in the
authority shall appoint one county commissioner, or the
commissioner's express designee, to the authority board and
these members shall jointly appoint the other members of the
board.
(c) The members of the board shall include:
(1) At least one physician licensed under Chapter
90 of the General Statutes to practice medicine in
this State, and at least one dentist licensed
under Article 2 of Chapter 90 of the General
Statutes to practice dentistry in this State;
(2) At least one county commissioner or the
commissioner's express designee from each county
in the authority;
(3) At least two licensed or registered
professionals from any of the following
professions: optometry, veterinary science,
nursing, pharmacy, engineering, or accounting;
(4) At least one member from the administrative
staff of a hospital serving the authority service
area; and
(5) At least one member from the general public.
(d) Except as provided in this subsection, members of
the board shall serve terms of three years. Two of the
original members shall serve terms of one year, and two of
the original members shall serve terms of two years.
(e) Any member who is a county commissioner serves on
the board in an ex officio capacity.
(f) Whenever a county shall join or withdraw from an
existing public health authority, the board shall be
dissolved and a new board shall be appointed as provided in
subsection (b) of this section.
(g) Vacancies shall be filled within 120 days for any
unexpired portion of a term.
(h) A chair shall be elected annually by a board. The
authority director shall serve as secretary to the board.
(i) A majority of the members shall constitute a
quorum.
(j) A member may be removed from office by the board
for any of the following:
(1) Commission of a felony or other crime involving
moral turpitude.
(2) Violation of a State law governing conflict of
interest.
(3) Violation of a written policy adopted by the
county board of commissioners of each county in
the authority.
(4) Habitual failure to attend meetings.
(5) Conduct that tends to bring the office into
disrepute.
(6) Failure to maintain qualifications for
appointment required under subsection (c) of this
section.
A board member may be removed only after the member has
been given written notice of the basis for removal and has
had the opportunity to respond.
(k) Board members shall receive no compensation for
their services, but they shall be entitled to reimbursement
for subsistence and travel expenses incurred in the
discharge of their duties.
(l) The board shall meet at least quarterly. The chair
or three of the members may call a special meeting.
§ 130A-45.2. Dissolution of a public health authority.
(a) Whenever the board of commissioners of each
county constituting a public health authority determines
that the authority is not operating in the best health
interests of the authority service area, they may direct
that the authority be dissolved. In addition, whenever a
board of commissioners of a county which is a member of an
authority determines that the authority is not operating in
the best health interests of that county, it may withdraw
from the authority. Dissolution of an authority or
withdrawal from the authority by a county shall be effective
only at the end of the fiscal year in which the action of
dissolution or withdrawal transpired.
(b) Notwithstanding the provisions of subsection (a)
of this section, no public health authority shall be
dissolved without prior written notification to the
Department.
(c) Any budgetary surplus available to a public health
authority at the time of its dissolution shall be
distributed to those counties comprising the authority on
the same pro rata basis that the counties appropriated and
contributed funds to the authority's budget during the
current fiscal year. Distribution to the counties shall be
determined on the basis of an audit of the financial record
of the authority. The public health authority board shall
select a certified public accountant or an accountant who is
subsequently certified by the Local Government Commission to
conduct the audit. The audit shall be performed in
accordance with G.S. 159-34. The same method of distribution
of funds described above shall apply when one or more
counties of an authority withdraw from the authority.
(d) Upon dissolution or withdrawal, all rules adopted
by the board continue in effect until amended or repealed by
the new authority board or boards of health.
§ 130A-45.3. Powers and duties of authority board.
(a) A public health authority shall have all the
powers necessary or convenient to carry out the purposes of
this Part, including the following powers to:
(1) Protect and promote the public health. The
board shall have the authority to adopt rules
necessary for that purpose.
(2) Construct, equip, operate, and maintain public
health facilities.
(3) Use property owned or controlled by the
authority.
(4) Acquire real or personal property, including
existing public health facilities, by purchase,
grant, gift, devise, lease or, with the permission
of the county commissioners, condemnation.
(5) Establish a fee schedule for services received
from public health facilities and make services
available regardless of ability to pay.
(6) Appoint a public health authority director to
serve at the pleasure of the authority board.
(7) Establish a salary plan which shall set the
salaries for employees of the area authority.
(8) To adopt and enforce a professional
reimbursement policy which may include the
following provisions: (i) require that fees for
the provision of services received directly under
the supervision of the public health authority
shall be paid to the authority, (ii) prohibit
employees of the public health authority from
providing services on a private basis which
require the use of the resources and facilities of
the public health authority, and (iii) provide
that employees may not accept dual compensation
and dual employment unless they have the written
permission of the public health authority
director.
(9) Delegate to its agents or employees any powers
or duties as it may deem appropriate.
(10) Employ its own counsel and legal staff.
(11) Adopt, amend, and repeal bylaws for the
conduct of its business.
(12) Enter into contracts for necessary supplies,
equipment, or services for the operation of its
business.
(13) Act as an agent for the federal, State, or
local government in connection with the
acquisition, construction, operation, or
management of a public health facility, or any
part thereof.
(14) Insure the property or the operations of the
authority against risks as the authority may deem
advisable.
(15) Sue and be sued.
(16) Accept donations or money, personal property,
or real estate for the benefit of the authority
and to take title to the same from any person,
firm, corporation, or society.
(17) Appoint advisory boards, committees, and
councils composed of qualified and interested
residents of the authority service area to study,
interpret, and advise the public health authority
board.
(b) A public health authority shall have the power to
establish and operate health care networks and may contract
with or enter into any arrangement with other public health
authorities or local health departments of this or other
states, federal, or other public agencies, or with any
person, private organization, or nonprofit corporation or
association for the provision of public health services,
including managed health care activities; provided, however,
that for the purposes of this subsection only, a public
health authority shall be permitted to and shall comply with
the requirements of Article 67 of Chapter 58 of the General
Statutes to the extent that such requirements apply to the
activities undertaken by the public health authority
pursuant to this subsection. The public health authority may
pay for or contribute its share of the cost of any such
contract or arrangement from revenues available for these
purposes, including revenues arising from the provision of
public health services.
(c) A public health authority may lease any public
health facility, or part, to a nonprofit association on
terms and conditions consistent with the purposes of this
Part. The authority will determine the length of the lease.
No lease executed under this subsection shall be deemed to
convey a freehold interest.
(d) A public health authority shall neither sell nor
convey any rights of ownership the county has in any public
health facility, including the buildings, land, and
equipment associated with the facility, to any corporation
or other business entity operated for profit, except that
nothing herein shall prohibit the sale of surplus buildings,
surplus land, or surplus equipment by an authority to any
corporation or other business entity operated for profit.
For purposes of this subsection, "surplus" means any
building, land, or equipment which is not required for use
in the delivery of public health care services by a public
health facility at the time of the sale or conveyance of
ownership rights.
(e) A public health authority may lease any public
health facility, or part, to any corporation, foreign or
domestic, authorized to do business in North Carolina on
terms and conditions consistent with the purposes of this
Part and with G.S. 160A-272.
(f) A public health authority may exercise any or all
of the powers conferred upon it by this Part, either
generally or with respect to any specific public health
facility or facilities, through or by designated agents,
including any corporation or corporations which are or shall
be formed under the laws of this State.
(g) An authority may contract to insure itself and any
of its board members, agents, or employees against liability
for wrongful death or negligent or intentional damage to
person or property or against absolute liability for damage
to person or property caused by an act or omission of the
authority or of any of its board members, agents, or
employees when acting within the scope of their authority
and the course of their employment. The board shall
determine what liabilities and what members, agents, and
employees shall be covered by any insurance purchased
pursuant to this subsection.
Purchase of insurance pursuant to this subsection waives
the authority's governmental immunity, to the extent of
insurance coverage, for any act or omission occurring in the
exercise of a governmental function. Participation in a
local government risk pool pursuant to Article 23 of Chapter
58 of the General Statutes shall be deemed to be the
purchase of insurance for the purposes of this section. By
entering into an insurance contract with the authority, an
insurer waives any defense based upon the governmental
immunity of the authority.
(h) If an authority has waived its governmental
immunity pursuant to subsection (g) of this section, any
person, or in the event of death, their personal
representative, sustaining damages as a result of an act or
omission of the authority or any of its board members,
agents, or employees, occurring in the exercise of a
governmental function, may sue the authority for recovery of
damages. To the extent of the coverage of insurance
purchased pursuant to subsection (g) of this section,
governmental immunity may not be a defense to the action.
Otherwise, however, the authority has all defenses available
to private litigants in any action brought pursuant to this
section without restriction, limitation, or other effect,
whether the defense arises from common law or by virtue of a
statute.
Despite the purchase of insurance as authorized by
subsection (g) of this section, the liability of an
authority for acts or omissions occurring in the exercise of
governmental functions does not attach unless the plaintiff
waives the right to have all issues of law or fact relating
to insurance in the action determined by a jury. The judge
shall hear and determine these issues without resort to a
jury, and the jury shall be absent during any motion,
argument, testimony, or announcement of findings of fact or
conclusions of law relating to these issues unless the
defendant requests a jury trial on them.
§ 130A-45.4. Appointment of a public health authority
director.
(a) A public health authority board, after
consulting with the appropriate county board or boards of
commissioners, shall appoint a public health authority
director.
(b) All persons who are appointed to the position of
public health authority director must possess minimum
education and experience requirements for that position, as
follows:
(1) A medical doctorate; or
(2) A masters degree in Public Health
Administration, and at least one year of
employment experience in health programs or health
services; or
(3) A masters degree in a public health discipline
other than public health administration, and at
least three years of employment experience in
health programs or health services; or
(4) A masters degree in public administration, and
at least two years of experience in health
programs or health services; or
(5) A masters degree in a field related to public
health, and at least three years of experience in
health programs or health services; or
(6) A bachelors degree in public health
administration or public administration and at
least three years of experience in health programs
or health services.
(c) Before appointing a person to the position of
public health authority director under subdivision (a)(5) of
this section, the authority board shall forward the
application and other pertinent materials of such candidate
to the State Health Director. If the State Health Director
determines that the candidate's masters degree is in a field
not related to public health, the State Health Director
shall so notify the authority board in writing within 15
days of the State Health Director's receipt of the
application and materials, and such candidate shall be
deemed not to meet the education requirements of subdivision
(a)(5) of this section. If the State Health Director fails
to act upon the application within 15 days of receipt of the
application and materials from the authority board, the
application shall be deemed approved with respect to the
education requirements of subdivision (a)(5) of this
section, and the authority board may proceed with the
appointment process.
(d) The State Health Director shall review requests of
educational institutions to determine whether a particular
masters degree offered by the requesting institution is
related to public health for the purposes of subdivision
(a)(5) of this section. The State Health Director shall act
upon such requests within 90 days of receipt of the request
and pertinent materials from the institution, and shall
notify the institution of its determination in writing
within the 90-day review period. If the State Health
Director determines that an institution's particular masters
degree is not related to public health, the State Health
Director shall include the reasons therefor in his written
determination to the institution.
(e) When an authority board fails to appoint a public
health authority director within 60 days of the creation of
a vacancy, the State Health Director may appoint an
authority director to serve until the authority board
appoints an authority director in accordance with this
section.
§ 130A-45.5. Powers and duties of a public health
authority director.
(a) The public health authority director is an
employee of the authority board and shall serve at the
pleasure of the authority board.
(b) An authority health director shall perform public
health duties prescribed by and under the supervision of the
public health authority board and the Department and shall
be employed full time in the field of public health.
(c) An authority health director shall have the
following powers and duties:
(1) To administer programs as directed by the
public health authority board;
(2) To enforce the rules of the public health
authority board;
(3) To investigate the causes of infectious,
communicable, and other diseases;
(4) To exercise quarantine authority and isolation
authority pursuant to G.S. 130A-145;
(5) To disseminate public health information and to
promote the benefits of good health;
(6) To advise local officials concerning public
health matters;
(7) To enforce the immunization requirements of
Part 2 of Article 7 of this Chapter;
(8) To examine and investigate cases of venereal
disease pursuant to Parts 3 and 4 of Article 6 of
this Chapter;
(9) To examine and investigate cases of
tuberculosis pursuant to Part 5 of Article 6 of
this Chapter;
(10) To examine, investigate, and control rabies
pursuant to Part 6 of Article 6 of this Chapter;
(11) To abate public health nuisances and imminent
hazards pursuant to G.S. 130A-19 and G.S. 130A-20;
and
(12) To employ, discipline, and dismiss employees
of the public health authority.
(d) Authority conferred upon a public health authority
director may be exercised only within the county or counties
comprising the public health authority.
§ 130A-45.6. Boundaries of the authority.
A public health authority may provide or contract to
provide public health services and to acquire, construct,
establish, enlarge, improve, maintain, own, or operate, and
contract for the operation of any public health facilities
outside the territorial limits, within reasonable
limitation, of the county or counties creating the
authority, but in no case shall a public health authority be
held liable for damages to those outside the territorial
limits of the county or counties creating the authority for
failure to provide any public health service.
§ 130A-45.7. Medical review committee.
(a) A member of a duly appointed medical review
committee who acts without malice or fraud shall not be
subject to liability for damages in any civil action on
account of any act, statement, or proceeding undertaken,
made, or performed within the scope of the functions of the
committee.
(b) The proceedings of a medical review committee, the
records and materials it produces and the materials it
considers shall be confidential and not considered public
records within the meaning of G.S. 132-1, "Public records"
defined, and shall not be subject to discovery or
introduction into evidence in any civil action against a
public health authority or a provider of professional health
services which results from matters which are the subject of
evaluation and review by the committee. No person who was in
attendance at a meeting of the committee shall be required
to testify in any civil action as to any evidence or other
matters produced or presented during the proceedings of the
committee or as to any findings, recommendations,
evaluations, opinions, or other actions of the committee or
its members. However, information, documents, or records
otherwise available are not immune from discovery or use in
a civil action merely because they were presented during
proceedings of the committee. A member of the committee or a
person who testifies before the committee may testify in a
civil action but cannot be asked about his testimony before
the committee or any opinions formed as a result of the
committee hearings.
§ 130A-45.8. Confidentiality of patient information.
(a) Medical records compiled and maintained by
public health authorities in connection with the admission,
treatment, and discharge of individual patients are not
public records as defined by Chapter 132 of the General
Statutes.
(b) Charges, accounts, credit histories, and other
personal financial records compiled and maintained by public
health authorities in connection with the admission,
treatment, and discharge of individual patients are not
public records as defined by Chapter 132 of the General
Statutes.
§ 130A-45.9. Confidentiality of personnel information.
(a) Except as provided in subsection (b) of this
section, the personnel files of employees or former
employees and the files of applicants for employment
maintained by a public health authority are not public
records as defined by Chapter 132 of the General Statutes.
(b) The following information with respect to each
employee of a public health authority is a matter of public
record: name; age; date of original employment or
appointment; beginning and ending dates, position title,
position descriptions, and total compensation of current and
former positions; and date of the most recent promotion,
demotion, transfer, suspension, separation, or other change
in position classification. In addition, the following
information with respect to each licensed medical provider
employed by or having privileges to practice in a public
health facility shall be a matter of public record:
educational history and qualifications, date and
jurisdiction or original and current licensure; and
information relating to medical board certifications or
other qualifications of medical specialists.
(c) Information regarding the qualifications,
competence, performance, character, fitness, or conditions
of appointment of an independent contractor who provides
health care services under a contract with a public health
authority is not a public record as defined by Chapter 132
of the General Statutes. Information regarding a hearing or
investigation of a complaint, charge, or grievance by or
against an independent contractor who provides health care
services under a contract with a public health authority is
not a public record as defined by Chapter 132 of the General
Statutes. Final action making an appointment or discharge or
removal by a public health authority having final authority
for the appointment or discharge or removal shall be taken
in an open meeting, unless otherwise exempted by law. The
following information with respect to each independent
contractor of health care services of a public health
authority is a matter of public record: name; age; date of
original contract; beginning and ending dates; position
title; position descriptions; and total compensation of
current and former positions; and the date of the most
recent promotion, demotion, transfer, suspension,
separation, or other change in position classification.
§ 130A-45.10. Confidentiality of credentialing
information.
Information acquired by a public health authority or
by persons acting for or on behalf of a public health
authority in connection with the credentialing and peer
review of persons having or applying for privileges to
practice in a public health facility is confidential and is
not a public record under Chapter 132 of the General
Statutes; provided that information otherwise available to
the public shall not become confidential merely because it
was acquired by the authority or by persons acting for or on
behalf of the authority.
§ 130A-45.11. Confidentiality of competitive health care
information.
Information relating to competitive health care
activities by or on behalf of public health authorities
shall be confidential and not a public record under Chapter
132 of the General Statutes; provided that any contract
entered into by or on behalf of a public health authority
shall be a public record unless otherwise exempted by law.
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