What services or activities are required by the laws governing local health department accreditation in North Carolina?
North Carolina’s accreditation standards were designed to address a local public health agency’s capacity to provide the “ten essential public health services,” a nationally recognized set of services that was adopted in 1994 by a national committee charged with providing a framework for effective public health systems.[1] The ten essential services fall into three categories:
- assessment of community health status and health problems;
- policy development to educate the community about health, solve community health problems, support individual and community health, and protect health and ensure safety; and
- assurance of quality public health and public and private health care services within the community.
The state accreditation law incorporates the ten essential services, and the state accreditation standards specify the activities local agencies must engage in to ensure their capacity to provide those services. The accreditation standards also address local public health agency facilities, administration, and governance.
Table 3: North Carolina Accreditation Standards (10A NCAC Ch. 48)
Category | Essential service | Accreditation benchmarks |
Assessment | Monitor health status to identify community problems | Conduct and disseminate results of regular community health assessments |
Work with health care providers in the community to report reportable diseases and other health-related events and data | ||
Maintain skills and capacity to collect, manage, integrate and display health-related data | ||
Diagnose and investigate health problems and health hazards in the community | Engage in surveillance activities and assess, investigate and analyze health problems, threats and hazards, maintaining and using epidemiological expertise | |
Establish and maintain a system to receive and provide health alerts and public health response for health care providers, emergency responders, and communities on a 24-hour-a-day, 7-day-a-week basis | ||
Be able to respond to a public health emergency on a 24-hour-a-day, 7-day-a-week basis | ||
Maintain and implement epidemiological case investigation protocols providing for rapid detection and containment of communicable disease outbreaks; environmental health hazards; potential biological, chemical and radiological threats | ||
Provide or have access to laboratory capacity capable of providing for rapid detection and containment of communicable disease outbreaks; environmental health hazards; potential biological, chemical and radiological threats | ||
Policy Development | Inform, educate, and empower people about health issues | Provide the general public and elected and appointed officials with information on health risks, health status, and health needs in the community as well as information on policies and programs that can improve community health |
Provide, support, and evaluate health promotion activities designed to influence the behavior of individuals and groups | ||
Mobilize community partnerships to identify and solve health problems | Convene key constituents and community partners to identify, analyze, and prioritize community health issues | |
Develop strategies in collaboration with community partners to solve existing community health problems | ||
Identify and build upon community assets and direct them toward resolving health problems | ||
Develop policies and plans that support individual and community health efforts | Work with local, state and federal policymakers to enact policies, laws, rules, and ordinances that support individual and community health efforts | |
Develop plans to guide the agency’s work | ||
Assurance | Enforce laws and regulations that protect health and ensure safety | Staff shall have knowledge of public health law and an understanding of the relationship between the law and public health practice |
Monitor compliance with public health laws and rules | ||
Enforce public health laws, rules and ordinances | ||
Link people to needed personal health services and assure the provision of health care when otherwise unavailable | Identify populations that are not receiving preventive services or are otherwise underserved with respect to health care | |
Mobilize the community to address health care resource needs | ||
Lead efforts in the community to link individuals with preventive, health promotion, and other health services | ||
Serve as a health care provider when local needs and authority exist, and the agency capacity and resources are available | ||
Assure a competent public health and personal health care workforce | Require staff to meet statutory and regulatory qualifications for their positions | |
Regularly evaluate staff training and development needs and provide opportunities for continuing education, training and leadership development | ||
Build relationships with entities that conduct education or research to enrich public health practice | ||
Promote diversity in the public health workforce | ||
Evaluate effectiveness, accessibility, and quality of personal and population-based health services | Evaluate all services the agency provides for effectiveness in achieving desired outcomes | |
Research for new insights and innovative solutions to health problems | Use research to develop and evaluate public health programs | |
Ensure that its participation in research meets ethical standards | ||
Additional state law requirements | Provide facilities and administrative services | Provide safe and accessible physical facilities and services |
Develop and implement administrative policies and procedures | ||
Operate a secure and effective management information system | ||
Assure the agency’s financial accountability | ||
Governance | The local board of health shall exercise its authority to adopt and enforce rules necessary to protect and promote the public's health | |
The local board of health shall assure a fair and equitable adjudication process | ||
The local board of health members shall be trained regarding their service on the board | ||
The local board of health shall assure the development, implementation and evaluation of local health services and programs to protect and promote the public’s health | ||
The local board of health shall participate in the establishment of public health goals and objectives | ||
The local board of health shall assure the availability of resources to implement the essential services described in G.S. 130A-34.1(e)(2). | ||
The local board of health shall advocate in the community on behalf of public health | ||
The local board of health shall promote the development of public health partnerships |
