What options for local public health agency type and governance are available only to commissioners in counties with populations exceeding 425,000?

Under current law, the boards of commissioners of such counties have two options:

• The commissioners may abolish any or all of their local human services boards (including the board of health) and directly assume the powers and duties of the abolished board(s).[1]
• The commissioners may establish a consolidated human services agency, in which public health, mental health, and social services are provided by a single agency governed by a consolidated human services board.[2]

[2]G.S. 153A-77(b). This option is available to a county that meets two conditions: (1) has a population exceeding 425,000, and (2) has a county-manager form of government pursuant to G.S. 153A-81. Tyrrell is the only North Carolina county that does not have a county-manager form of government pursuant to G.S. 153A-81. Personal communication, Professor Carl Stenberg, UNC School of Government (February 2012).