In July 2024, Session Law (S.L.) 2024-34 was signed into law and made a handful of changes to statutes pertaining to health and human services. Among those changes were amendments to two statutes that impact local health directors, including updates to the experience and education requirements for local health directors and clarification of the role of a local health director within a consolidated human services agency (CHSA). These changes went into effect on August 1, 2024 and will apply to local health director appointments made on or after that date.
Qualifications for Appointment as Local Health Director
In North Carolina, an individual who is appointed to the role of local health director must have certain qualifications, which are set out at G.S. 130A-40(a). Generally, the law requires an individual to have some background and experience in health or public health, which aligns with the nature of the powers and duties that are assigned to a local health director under G.S. 130A-41. Prior to the passage of S.L. 2024-34, satisfaction of one of the following sets of criteria would make a person eligible to be appointed as a local health director:
(1) A medical doctorate;
(2) A master’s degree in public health administration, and at least one year of employment experience in health programs or health services;
(3) A master’s 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;
(4) A master’s degree in public administration, and at least two years of experience in health programs or health services;
(5) A master’s degree in a field related to public health, and at least three years of experience in health programs or health services; or
(6) A bachelor’s degree in public health administration or public administration and at least three years of experience in health programs or health services.
Section 3.(a) of S.L. 2023-34 amends the qualifications described at G.S. 130A-40(a) by revising item (6) in the list above, which describes the education and experience requirements for individuals with a bachelor’s degree. A person can now be eligible for appointment as local health director if they have “a bachelors [sic] degree in a field related to public health and at least seven years of experience in health programs or health services, which must include at least three years of supervisory experience” [emphasis added to denote key changes to the statutory language].
The result? Presumably, more people may be eligible for local health director positions due to the expansion of the category of bachelor’s degrees that qualify someone for the role. On the flip side, candidates for local health director with a bachelor’s degree in fields related to public health will now need to have more years of experience in health programs or services, including several years of work in a supervisory role. Whether a candidate’s bachelor’s degree is in “a field related to public health” is assessed by the State Health Director in accordance with G.S. 130A-40(b)-(c).
These changes will only apply to local health director appointments made on or after August 1, 2024. This means that a local health director who was eligible for their position under the old criteria at G.S. 130A-41(a)(6) and appointed prior to August 1, 2024 can continue in their role.
Local Health Directors in Consolidated Human Services Agencies
Under G.S. 130A-34, every county in North Carolina must provide public health services to its residents by operating a county health department, a district health department, a public health authority, a public hospital authority, or a consolidated human services agency (CHSA).[1] In a county served by a CHSA, the agency is led by a consolidated human services (CHS) director who is appointed by the county manager in accordance with G.S. 153A-77(e). If the CHS director does not meet the education and experience requirements for a local health director at G.S. 130A-40(a), then G.S. 153A-77(e)(9) requires that the CHS director appoint someone who does meet those criteria. This appointment must be made with the consent of the county manager. G.S. 153A-77(e)(1).
The prior language of G.S. 153A-77 held the door open for some ambiguity, however, about the role of the person appointed under G.S. 153A-77(e)(9). The statute only required that a CHS director appoint someone who satisfied the statutory qualifications for a local health director under G.S. 130A-40(a) but was silent about whether that person- or the CHS director- should be the one who wields the powers and takes on the duties assigned to local health directors under state law.
Enter S.L. 2024-34, which amended G.S. 153A-77(e)(9) and brought clarity to this situation. The revised language of G.S. 153A-77(e)(9) now says that the CHS director shall “[a]ppoint, with the county manager’s approval, an individual that meets the requirements of G.S. 130A‑40(a) to serve as the local health director” [emphasis added to denote key changes to the statutory language]. Going forward, if a CHS director does not meet the qualifications at G.S. 130A-40(a) for a local health director and appoints another person who does satisfy those eligibility criteria to the local health director role, the CHS director should delegate the powers and duties of the local health director to that appointed individual. Some CHS directors serve a dual role as the local health director and may continue to do so provided that they personally meet the requirements of G.S. 130A-40(a).
Just like the updates to G.S. 130A-40(a)(6) described in the earlier section of this blog post, the amendment to G.S. 153A-77(e)(9) took effect on August 1, 2024 and applies to appointments made on or after that date.
Questions?
Do you have questions about the information provided in this post, or other questions about the role of a local health director? Feel free to send me an email at kirsten@sog.unc.edu.
Notes
[1] See also G.S. 130A-45.02 (public health authority) and S.L. 1997-502, Sec. 12 (public hospital authority).
