NC Public Health Systems Research

This page contains updates on public health systems legislation considered by the North Carolina General Assembly during its 2011-12 session. For background information and updates through December 1, 2011, see What public health systems legislation is the General Assembly considering?

These updates are presented in reverse chronological order, with the most recent update first.

Narrative Summary of S.L. 2012-126 (H 438)

A narrative summary of the final legislation is available here.

June 29, 2012: Governor signs H 438

Governor Perdue has signed H 438. The signed version, S.L. 2012-126, is available here. The changes the bill made to North Carolina law are now in effect.

June 21, 2012: H 438 passes final vote, now goes to Governor

The North Carolina House concurred in the Senate's changes to H 438 by a vote of 65-46. This was the final vote in the legislature. The bill will now be sent to the Governor for her consideration.

The version of H 438 that will be sent to the Governor is the third edition, available here. A summary of the key provisions of H 438 is available here.

For additional discussion of what it would mean for the board of county commissioners if the board of health were abolished, see Jill Moore's recent blog post (June 20, 2012).

June 19, 2012: H 438 passes Senate, S 433 remains on calendar

Today, the North Carolina Senate amended and passed H 438. The amendment made the bill identical to the sixth edition of S 433 with one addition: H 438 would prohibit a board of county commissioners from abolishing a public health authority board or including a public health authority in a consolidated human services agency. The third edition of H 438 has been returned to the House for a concurrence vote. If the House concurs, H 438 will be sent to the Governor for her consideration.

Meanwhile, S 433 remains eligible for a concurrence vote in the Senate. It was also on today's Senate calendar, but after H 438 passed, S 433 was re-calendared for Thursday, June 21. If the House concurs in the Senate's changes to H 438, there will be no reason for another vote on S 433 and it probably will be removed from the calendar during the Thursday session. But if the House does not concur in the changes to H 438, the Senate may vote again on S 433. A bill may not be amended during a vote to concur, so if the Senate ends up voting to concur in S 433 the bill sent to the Governor will not contain the provisions relating to public health authorities that were added to H 438 today.  

June 15, 2012: Summary of S 433, Sixth Edition

Yesterday, the North Carolina House approved the sixth edition of S 433. A summary of the bill’s major provisions is available here. The bill has been returned to the Senate, which is likely to vote next week on whether to concur in the House’s version. If the Senate concurs in S 433, it is virtually certain that H 438 (described in earlier updates) will be removed from the Senate calendar and not acted upon further.

June 14, 2012: S 433 passes House

The North Carolina House passed S 433 today. Before the vote, the House amended the bill to require the director of a consolidated human services agency to appoint an individual that meets the requirements of G.S. 130A-40(a), the law that sets out the minimum education and experience qualifications for a local health director. The county manager must approve the appointment. Note that this provision would apply only to consolidated human services agencies, which presently are not required to have a director or other appointed person who meets the statutory qualifications of a local health director.

The bill has been returned to the Senate. If the Senate votes to concur with the changes made by the House, the bill will be sent to the Governor.

June 12, 2012: Updates on H 438, H 1075, and S 433

In our June 8 update, we reported that H 438 had been placed on the Senate calendar for Monday, June 11. The bill was scheduled for a third reading and had an amendment pending. However, when the Senate convened on June 11, it removed the bill from the calendar and re-calendared it for Tuesday, June 19.

Also on June 11, the Senate adopted a committee substitute for H 1075. The committee substitute (now H 1075, 3^rdedition) removes the provisions amending G.S. 153A-76 and 153A-77. Those provisions primarily affected consolidated human services agencies and were described in our June 5 update. At this point, H 1075 no longer contains provisions affecting the organization or governance of local public health agencies.

Earlier today, the House Committee on Health and Human Services approved a proposed committee substitute (PCS) for S 433. The PCS is identical to the second edition of H 438, summarized here, with one exception: it does not direct the Division of Public Health to allocate $5 million in funding for the program to create incentives for multi-county local health departments serving populations of 75,000 or more. It retains the provision creating the incentive program, but not the allocation of funds.

June 8, 2012: Update on H 438

Earlier this week H 438 reemerged in the Senate Committee on State and Local Government. H 438 was originally a short bill with effects that appeared to be limited to New Hanover county. On June 5, the Senate committee replaced the original bill with a committee substitute that incorporated much of S 433’s fourth edition, including the provision removing the population threshold from G.S. 153A-77 (the law that allows counties with populations exceeding 425,000 to form a consolidated human services agency and/or abolish their local human services boards, including the board of health, and transfer the abolished boards' powers and duties to the county commissioners). The committee substitute also incorporated the portions of the second edition of H 1075 described in our June 5 update, and proposed a few additional amendments to G.S. 153A-76 and 153A-77. The committee substitute received a favorable report and moved quickly to the Senate floor, where it passed its second reading on June 6. It was scheduled for third reading on June 7 and was taken up on that date, but it was withdrawn from the calendar after a proposed floor amendment prompted some questions. It has been placed on the June 11 Senate calendar for third reading with the floor amendment still pending. The second edition of H 438 is available here, the pending amendment is here, and a summary of the key provisions of the second edition is here. 

June 5, 2012: Update on H 1075

The NC House Committee on Health & Human Services removed most of the provisions affecting local public health from H 1075. The bill is focused on mental health local management entity (LME) governance and the statewide implementation of the 1915(b)/(c) Medicaid waiver. It includes changes to the state consolidated human services agency law (G.S. 153A-77) and the law that authorizes county commissioners to organize county government (G.S. 153A-76). Specifically, it would:

• Prohibit a board of county commissioners from consolidating an area mental health, developmental disabilities, and substance abuse services (MHDDSAS) board into a consolidated human services board.
• Permit a county to form a consolidated human services agency that does not include MHDDSAS.
• Alter the composition and powers and duties of the governing board for a consolidated human services agency that does not include MHDDSAS.
• Require consolidated human services agencies to have merit personnel systems that comply with any applicable federal laws. County commissioners could elect to place consolidated agencies employees under the State Personnel Act.

Most other provisions affecting local public health agencies have been removed, including the provision that would remove the 425,000 population threshold for counties wishing to form a consolidated human services agency. It appears likely those provisions will be addressed in another bill or bills, not H 1075. 

May 24, 2012: New legislation – H 1075 & S 875

Bills introduced in both the House (H 1075) and Senate (S 875) include provisions that could affect local public health agencies. The bills are primarily focused on the state’s public mental health agencies but they also address consolidated human services agencies and local boards. Aimee Wall provides an overview of the bills here.