Who appoints and supervises the local health director?
The appointment of the local health director varies by type of local public health agency. For a county or district health department, the local health director is appointed by the county or district board of health after consultation with all applicable boards of county commissioners.[1] The same procedure is followed by a public health authority board when it appoints the public health authority director.[2]
The director of a consolidated human services agency is appointed by the county manager with the advice and consent of the consolidated human services board.[3] The consolidated human services director then appoints a person who meets the statutory qualifications of a local health director, with the approval of the county manager. This person may be designated to serve as the local health director for the jurisdiction, if the consolidated director delegates the role.[4]
Local Public Health Agency | Appointment of Director | Statute |
County health department (single-county) | Board of health, after consulting with the board of county commissioners | G.S. 130A-40 |
District board of health (multi-county) | Board of health, after consulting with the boards of county commissioners of all counties in the district | G.S. 130A-40 |
Public health authority (single- or multi-county) | Public health authority board, after consulting with the board(s) of county commissioners served by the authority | G.S. 130A-45.4 |
Consolidated human services agency | County manager appoints CHS director with the advice and consent of the board; CHS director appoints a person who meets local health director qualifications with the approval of a county manager | G.S. 153A-77 |
If the county commissioners have abolished the board of health pursuant to G.S. 153A-77(a), then the commissioners have all the powers and duties of the local board of health. For a county health department, this includes the power to directly appoint the local health director. For a consolidated human services agency, this includes the power to advise and consent to the county manager’s appointment of the consolidated human services director.
A local health director is supervised by the governing body or person who appointed him or her.
[1] G.S. 130A-40. Although the board of health must consult with the commissioners, the statute does not require the commissioners to consent to or approve the appointment. The law does not specify how consultation with the commissioners is carried out. An informal survey of local health directors conducted in 2008 by Jill Moore, UNC School of Government, revealed that practices varied, but two common components were involvement of the commissioner member of the board of health in the recruitment process, and approval of the health director’s salary by the board of county commissioners. (Survey question and de-identified responses on file with Professor Moore.)
[2] G.S. 130A-45.4.
[3] G.S. 153A-77(e).
[4] By statute, the CHS director acquires the legal powers and duties of a local health director; however, he or she may delegate most of the powers and duties to the person who meets local health director qualifications or another appropriate person. See G.S. 130A-6 (“Whenever authority is granted by this Chapter upon a public official, the authority may be delegated to another person authorized by the public official.”). While generally quite broad, this authority to delegate may be limited by another statute. For example, the law that permits a local health director to embargo food or drink in some circumstances specifies that the embargo authority may not be delegated to local environmental health specialists. G.S. 130A-21.
