How does a public health authority compare to the public hospital authority that operates in Cabarrus County?

In Cabarrus County, public health services are provided through a “public hospital authority.” Special legislation was enacted in 1997 that allowed for this unique arrangement.[1]  There are many similarities between public health authorities and public hospital authorities. For example, they both provide public health services, and have governing boards and directors. They are both “authorities,” which means that they are public entities that are somewhat independent from the county or counties that created them. As independent entities, they have the authority to enter into contracts, employ legal counsel and staff, and purchase insurance. They are also both responsible for their own budgets and financial management.

There are, however, some key differences between the two types of authorities: 

  • Governing board:  The members of the governing board of a hospital authority are called “commissioners.”  The law requires the appointment of between six and thirty commissioners and the chair of the board of county commissioners appoints all of the members (G.S. 131E-18). A hospital authority commissioner may be removed by the chair of the board of county commissioners for inefficiency, neglect of duty, or misconduct in office (G.S. 131E-22).
  • Powers and duties:  A hospital authority has many of the same powers and duties as a public health authority but there are a few additional ones that are worth noting. Specifically, the hospital authority may borrow money (i.e., issue revenue bonds) and exercise the power of eminent domain (i.e., acquire real property by condemnation). See G.S. 131E-23, 131-24. In addition, the hospital authority has quite a few powers and duties directly related to the operation and staffing of a hospital. See G.S. 131E-23.
  • Conflict of interest:  Commissioners and employees of a hospital authority are subject to a separate law governing conflict of interest related to ownership interests in hospital facilities, contracts, and services (G.S. 131E-21).
  • Jurisdiction: A hospital authority may be created by a single county (or a city) and its jurisdiction may extend 10 miles beyond the county’s border (G.S. 131E-20). The law does not allow for a multi-county public hospital authority but there could be agreements in place to provide services in other counties.



[1]S.L. 1997-502, Section 12 (“Any county which, on or prior to July 1, 1997, established a hospital authority board composed of no more than seven members under the provisions of Part B of Article 2 of Chapter 131E of the General Statutes may, by resolution adopted by its board of county commissioners and with the approval of the State Health Director, assign that authority board the powers, duties, and responsibilities to provide public health services as outlined in G.S. 130A-1.1. Thereafter, such authority board shall act as the local board of health for the county together with such additional powers, duties, and authority assigned to it by the board of county commissioners.”)

Topics - Local and State Government