North Carolina Public Health Law

S.L. 2013-309 prohibits local ordinances limiting the portion size of soft drinks, and provides immunity from liability for various parties in the food industry for claims arising out of an individual’s obesity or weight gain resulting from the long-term consumption of food.

This section of the 2013 Regulatory Reform Act imposes temporary limits on city or county ordinances regulating areas that are also regulated by state or federal laws adopted or enforced by specified environmental agencies. The limits appear to apply only to city or county ordinances and not to other types of local regulations, such as local board of health rules.

S.L. 2013-122 enacts the Private Well Water Education Act, which amends existing G.S. 87-97.

This section of the 2013 Appropriations Act increases the annual permit fees for many food and lodging establishments, and designates the portion of the fees that may be retained by the state and the portion that must be returned to local health departments. It also defines the term “temporary food establishment.”

North Carolina local health departments have the duty to inspect and grade the sanitation of most establishments that prepare or serve food. G.S. 130A-248. Environmental health specialists carry out these inspections in accordance with state administrative rules and issue permits to establishments that receive passing sanitation grades. The general rule is that a food establishment may not operate if it has not been inspected and permitted. However, G.S. 130A-250 exempts some establishments from this requirement, including private clubs.

Section 11 of the 2013 Regulatory Reform Act addresses food sanitation in bed and breakfast homes. Prior law authorized the regulation of “private homes offering bed and breakfast accommodations to eight or fewer persons per night.” State administrative rules implementing this law created and defined the term “bed and breakfast home” as “a private home offering bed and breakfast accommodations to eight or fewer persons per night for a period of less than a week,” and specified the standards such an establishment must meet to qualify for a food service permit.

Section 19 of the 2013 Regulatory Reform Act amends both the state building code and provisions of the public health code that give local health departments the duty to inspect lodging establishments. The amendments require lodging establishments to install and maintain carbon monoxide detectors in enclosed spaces, including sleeping rooms, that either have a fossil fuel burning heater, appliance or fireplace, or share a wall, floor or ceiling with an enclosed space that has one of those items.

Owners and other persons in charge of residences, businesses, and other places of public assembly must provide an approved wastewater system to ensure that human waste is collected, treated, and disposed in a manner that protects public health. G.S. 130A-335. Local health departments inspect on-site wastewater systems and issue permits for them to operate if they comply with applicable state regulations, which are found in Title 15A of the North Carolina Administrative Code.

Section 35 of the 2013 Regulatory Reform Act amends G.S. 87-97, the law that requires local health departments to have a program for inspecting, testing, and permitting private drinking water wells. A local health department must issue a construction or repair permit for a well that meets health and safety requirements established in state or local rules.

This section of 2013’s Regulatory Reform Act directs the Commission for Public Health to amend and clarify the rules implementing the statewide ban on smoking in restaurants and bars. Specifically, the new rules must clarify the definition of “enclosed area,” which determines the parts of a restaurant or bar in which smoking is prohibited. A bar or restaurant is allowed (but not required) to permit smoking in areas that are not enclosed.

Health care providers should be aware of this new law, because it requires the disclosure of protected health information in prescribed circumstances. When a disclosure of protected health information is required by state law, it is permitted by the federal HIPAA Privacy Rule (see 45 CFR 164.512(a)). The portion of the law described in this summary is effective December 1, 2013.

S.L. 2013-23 enacts several provisions intended to encourage individuals to seek help for themselves or others experiencing drug overdoses or alcohol-related medical emergencies. It also establishes the conditions under which a health care provider may prescribe naloxone (an antidote to opiate overdoses) to a person at risk of experiencing an opiate-related drug overdose, or to someone who may be in a position to assist such a person.

S.L. 2013-45 amends G.S. 130A-125, the state law that established the newborn screening program to identify conditions in infants that can benefit from early detection and treatment.

S.L. 2013-5 limits North Carolina’s participation in implementing the federal Affordable Care Act (ACA) in two ways: by declining to expand Medicaid eligibility to adults who are ineligible under categorical Medicaid programs, and by directing state agencies and institutions not to participate in the implementation of a health benefits exchange in North Carolina. The law became effective March 6, 2013.

S.L. 2013-43 provides for the adoption of statewide rules pertaining to requests for or release of pathological materials.