I am excited to share a new resource for governing boards of local public health agencies in North Carolina! Local Boards of Health in North Carolina provides local board of health members with the information that they need to understand and execute their powers and duties effectively and lawfully. This book can also be a helpful resource for local health directors, county attorneys, county commissioners, county managers, and others working in public health. The book is now available for purchase here from the UNC School of Government.
What is a Local Board of Health?
North Carolina has a decentralized public health system that is composed of two parts: (1) state-government entities led by state employees and officials who oversee statewide public health services and programs, and (2) eighty-six local health departments (LHDs), which are led by local government officials and employees who oversee public health services and programs in their counties. Of those eighty-six LHDs, eighty currently serve a single county and six serve a district comprising multiple counties.
Every LHD must have a governing board, which is often referred to as the “local board of health.” The composition of the different types of local boards of health varies, but in general, a local board of health includes county commissioners, health care professionals, public health professionals, and members of the general public. Local boards of health have numerous legal powers and duties related to protecting and promoting the health, safety, and well-being of the communities they serve.
More Information About This Book
This book is one installment in a three-part series from the UNC School of Government that also includes Local Social Services Boards in North Carolina by Kristi Nickodem, and Consolidated Human Services Boards in North Carolina by Kristi Nickodem and Kirsten Leloudis.
Among other topics, Local Boards of Health in North Carolina includes chapters that address the following:
- the governmental public health system;
- different types of local health departments in North Carolina and the services that they must provide;
- different types of local boards of health in North Carolina;
- appointment, removal, and term limits for local board of health members;
- the local board of health’s responsibilities related to the local health director, local health department accreditation, rulemaking, adjudications, and setting certain fees charged by the local health department;
- ethical standards, legal prohibitions, liability, and immunity for local boards of health;
- board meetings and procedures, including compliance with North Carolina’s open meetings law; and
- records retention and maintenance, including compliance with North Carolina’s public records law.
A Note for Consolidated Human Services Boards
Under state law (G.S. 153A-77), a board of county commissioners can create a “consolidated human services agency” (CHSA) to “carry out the functions of any combination of commissions, boards, or agencies appointed by the board of county commissioners or acting under and pursuant to the authority of the board of county commissioners, including the local health department […].” Currently, thirty-four counties in North Carolina are served by CHSAs, and all but two of those CHSAs include the local health department. Every CHSA must have a governing board, which is called a “consolidated human services board,” or a “CHS board.” When a CHSA includes the local health department, the CHS board takes on the powers and duties that would otherwise be assigned to a local board of health.
Local Boards of Health in North Carolina includes information about the public health-related powers and duties of a CHS board for a CHSA that includes public health. However, CHS board members and others interested in CHSA governance may wish to instead purchase Consolidated Human Services Boards in North Carolina, a new book from the School of Government that is more tailored to the unique characteristics of CHSAs and CHS boards. Consolidated Human Services Boards in North Carolina also explains a CHS board’s public health-related responsibilities when the CHSA includes the local health department.
Want to know what agency type and board structure are in place in your county or in other counties across the state? Explore our interactive maps of the state on the School of Government’s North Carolina Human Services Hub.
Additional Resources and Programs
Are you new to your role as a leader in your local human services agency, or are you looking for a refresher on core legal topics? Registration is now open for Legal Basics for Human Services Directors and Administrators, which is a multi-day program that will be held in early November 2025. Attendees can also register for an optional half-day program dedicated to child welfare law.
