How are board of health members appointed?
The method of appointment varies by type of board, but in all cases, county commissioners are involved. The board of county commissioners appoints the members of a county board of health or a single-county public health authority board.[1] For a district board, the board of commissioners for each county in the district appoints a county commissioner to the board, then those commissioners appoint the remaining members.[2] Multi-county public health authorities are managed similarly, but each board of commissioners may appoint either a commissioner or a commissioner’s designee.[3] Although no law requires it, it is a common practice for the boards of all of these agency types to recommend appointees to the commissioners.
The appointment of consolidated human services board members is managed somewhat differently. The board of county commissioners appoints members from a slate of nominees. When a consolidated board is initially created, the nominees are identified by a nominating committee composed of members of the pre-consolidation boards of health, social services, and mental health, developmental disabilities, and substance abuse services. Subsequent members are appointed by the commissioners from nominees selected by the consolidated human services board.[4]
Local board of health | Method of appointment | Statute |
County board of health 11 members | County commissioners appoint all members. | G.S. 130A-35 |
District board of health 15-18 members | Each county in the district appoints one commissioner to serve on the board. Those commissioners appoint the remaining members. | G.S. 130A-37 |
Public health authority board (single-county) 7-9 members* | County commissioners appoint all members. | G.S. 130A-45.1 |
Public health authority board (multi-county) 8-11 members* | Each county in the authority appoints one commissioner or designee to serve on the board. Those individuals appoint the remaining members. | G.S. 130A-45.1 |
Consolidated human services board Up to 25 members | County commissioners appoint all members from nominees presented by a nominating committee (initial appointments) or the consolidated board (subsequent appointments). | G.S. 153A-77 |
* In some instances, a public health authority may want to apply to the federal government to become a community health center so that it may be eligible for additional funding from specific federal programs. The federal law governing community health centers has strict requirements related to board membership. Therefore, state law allows a public health authority interested in applying for that status to have up to 25 board members.
[1] G.S. 130A-35(b) (county boards of health), 130A-45.1(b) (public health authority board); 153A-77(c) (consolidated human services board).
[2] G.S. 130A-37(b).
[3] G.S. 130A-45.1(b).
[4] G.S. 153A-77(c). The statute specifies that the area mental health board is represented on the nominating committee, even though in most cases mental health may not be part of a consolidated human services agency. The members of the initial board may be appointed to terms of different lengths in order to establish a staggered term structure. Subsequent members are appointed to four-year terms.
