North Carolina § 130A-4 - Administration.

§ 130A-4. Administration.

Except as provided in subsection (c) of this section, the Secretary shall administer and enforce the provisions of this Chapter and the rules of the Commission. A local health director shall administer the programs of the local health department and enforce the rules of the local board of health. When requested by the Secretary, a local health department shall enforce the rules of the Commission under the supervision of the Department. The local health department shall utilize local staff authorized by the Department to enforce the specific rules. The Secretary of Environmental Quality shall administer and enforce the provisions of Articles 9 and 10 of this Chapter and the rules of the Commission and the Environmental Management Commission adopted thereunder. When requested by the Secretary of Environmental Quality, a local health department shall enforce the rules of the Commission and the rules adopted by the Environmental Management Commission pursuant to G.S. 87-87 under the supervision of the Department of Environmental Quality. The local health department shall utilize local staff authorized by the Department of Environmental Quality to enforce the specific rules. History (1983, c. 891, s. 2; 1995, c. 123, s. 2; 1997-443, s. 11A.56; 2001-474, s. 18; 2006-202, s. 5; 2006-255, s. 13.1; 2011-145, s. 13.3(pp); 2015-241, s. 14.30(u), (v); 2020-74, s. 12(a).) Editor's Note. - Session Laws 2009-451, s. 10.26(a)-(i), provides: "(a) The Department of Health and Human Services (DHHS) shall develop a five-year Public Health Improvement Plan (Plan) by March 31, 2010. In developing the Plan the Secretary shall: "(1) Adopt a list of services and activities performed by local health departments that qualify as core public health functions of statewide significance. "(2) Adopt a list of performance measures with the intent of improving health status indicators applicable to core public health functions of statewide significance that local health departments (LHDs) must provide. "(3) Identify a set of health status indicators to be given priority by LHDs. "Under the Plan, all priorities and health status indicators must incorporate as an essential activity the disparity of diseases amongst populations and locales. "(b) In order for measurable benefits to be realized through the implementation of the Plan, the Plan shall include the adoption of levels of performance necessary to promote: "(1) Uniformity across local health departments, "(2) Best evidence-based services, "(3) National standards of performance, "(4) Innovations in public health practice, and "(5) Reduction of geographic and racial health disparities. "LHDs shall have the flexibility and opportunity to use the resources available to achieve the required performance measures in a manner that best suits the LHD. "(c) The Plan will address the need to provide county health departments with financial incentives to encourage and increase local investment in public health functions. County governments shall not supplant existing local funding with State incentive resources. The Secretary may revise the list of activities and performance measures as appropriate, but before doing so, the Secretary shall provide a written explanation of the rationale for the addition, deletion, or revision. "(d) In developing the Plan the Secretary shall establish and chair the Public Health Improvement Plan Task Force (Task Force), the members and expertise of which shall include: "(1) Local health departments, "(2) Department staff, "(3) Individuals and entities with expertise in the development of performance measures, accountability, and systems management, "(4) Experts in development of evidence-based medical guidelines or public health practice guidelines, and "(5) Individuals and entities that will be affected by the performance measures. "(e) The implementation schedule for the Plan shall be as follows: "(1) July 1, 2009, establish the Task Force to develop the Plan, "(2) March 31, 2010, submit the Plan to the 2010 Regular Session of the 2009 General Assembly, "(3) July 1, 2010, implement the Plan, and "(4) November 15, 2011, and annually thereafter, report on Plan implementation. "(f) The Department will identify the programmatic activities and funding in the Division of Public Health associated with the core functions and activities in the Plan. Funds associated with these activities shall be subject to a flexible spending formula adopted by the Department, as follows: "(1) Beginning in SFY 2010-2011, the flexible spending formula will begin to replace the current spending with a more effective method of funding public health activities at the local level and achieving the results expected. "(2) The Task Force shall identify a reliable and consistent source of State revenue to fund the flexible spending formula. "(3) If sufficient additional revenue is available to implement the Plan, a separate set-aside of available funds would be created. This set-aside would be available to contiguous LHDs that seek to address a specific women's health, child health, or adult health disease or chronic condition, and in doing so, choose to merge into a single Local Health District, thus saving administrative dollars to be focused on public health issues. "(g) Funds appropriated to the Department for flexible spending shall be distributed to county health departments as follows: "(1) Each of the county health departments will receive a base amount to be determined by the DHHS. "(2) The balance of funds in the Flexible Spending Account is to be distributed to the counties on the basis of a formula that takes into consideration the following elements: "a. Population, "b. Per capita income, "c. Rates of: "1. Infant mortality, "2. Teenage pregnancy, "3. Tobacco use, "4. Cancer, "5. Heart disease, "6. Diabetes, and "7. Stroke. "d. Percent of minorities in the county, "e. Body Mass Index (BMI) of public school students, and "f. Other factors as the Secretary may find necessary to achieve the goals of the Plan. "(3) The use of the funds by the LHD would reflect the core public health functions. It will be incumbent upon the LHD to use the funds in a manner that assures its achievement of the performance measures adopted by the Secretary. "(h) To ensure compliance with Department directives, the Task Force shall consider requiring each county health department to submit to the Secretary such data as the Secretary determines is necessary to allow the Secretary to assess whether the county health department has used the funds in a manner consistent with achieving the performance measures associated with this Plan. "(i) Beginning November 15, 2011, and biannually thereafter, the Secretary shall report to the Governor and the General Assembly on: "(1) The distribution of funds to LHDs, "(2) The use of these funds by LHDs, "(3) The specific effect the funding from this Plan has had on: "a. LHDs' performance, "b. Health status indicators, and "c. Health disparities. "The Secretary's initial report will focus on implementation. Subsequent reports will evaluate trends in performance and expenditures." Session Laws 2009-451, s. 1.2, provides: "This act shall be known as the 'Current Operations and Capital Improvements Appropriations Act of 2009'." Session Laws 2009-451, s. 28.3, provides: "Except for statutory changes or other provisions that clearly indicate an intention to have effects beyond the 2009-2011 fiscal biennium, the textual provisions of this act apply only to funds appropriated for, and activities occurring during, the 2009-2011 fiscal biennium." Session Laws 2009-451, s. 28.5, is a severability clause. Effect of Amendments. - Session Laws 2006-202, s. 5, effective August 7, 2006, inserted "and the rules adopted by the Environmental Management Commission pursuant to G.S. 87-87 " in the middle of the first sentence of subsection (d). Session Laws 2006-255, s. 13.1, effective August 23, 2006, inserted "Part 4 of Article 5 and" near the middle of subsection (c). Session Laws 2011-145, s. 13.3(pp), effective July 1, 2011, substituted "Articles 9 and 10" for "Part 4 of Article 5 and Articles 8, 9, 10, 11, and 12" in subsection (c). Session Laws 2015-241, s. 14.30(u), (v), effective July 1, 2015, substituted "Secretary of Environmental Quality" for "Secretary of Environment and Natural Resources" in subsections (c) and (d); and substituted "Department of Environmental Quality" for "Department of Environment and Natural Resources" twice in subsection (d). Session Laws 2020-74, s. 12(a), effective July 1, 2020, added "and the Environmental Management Commission adopted thereunder" at the end of subsection (c).