NC Public Health Systems Research

Background

The General Assembly enacted legislation (S.L. 2012-126) that provides counties with an expanded list of options for how they deliver and govern some human services programs.  In response to this legislation, counties may be considering one or more of the following:

• Having the county commissioners assume the duties of the board of health and/or board of social services.
• Creating a consolidated human services agency that (1) would be responsible for providing public health services, social services, and/or other human services and (2) would be governed by an appointed consolidated human services board.
• Creating a consolidated human services agency that (1) would be responsible for providing public health services, social services, and/or other human services and (2) would be governed by the board of county commissioners.
• Shifting from a single county health department to a district – or multi-county – health department that would be governed by a district board of health.
• Creating a public health authority that would be governed by a public health authority board.
• Other options for changing human service delivery, such as entering into interlocal agreements with neighboring counties for shared services or administrative responsibilities.
• Not making any changes to county human services agencies or governance structures.

County officials may want some assistance as they consider their options and possibly take steps towards change. The School of Government (SOG) received grant funding in 2011 that is dedicated in part to helping local governments evaluate their options. We are committed to working with leaders from several counties or multi-county areas across the state in fall 2012 as they either begin or build upon local conversations about the possibility of changing their approaches to the delivery of some human services programs.

Our intent is to support participating counties’ decision-making processes, not to recommend particular courses of action. Our plan is to make available subject matter experts who can provide information about a county’s options, as well as trained facilitators who can help guide and support a county’s internal discussions. We want to help each participating county find answers to pressing questions and, if appropriate, identify and map out the county’s next steps.

We will be accepting requests for assistance in August and September. We will evaluate the requests and determine how many we can support with the resources that we have available. We may contact requesters for additional information during our evaluation process. If a county’s request is accepted, one of our team members will contact the requester to set up an initial planning meeting.

Commitment

In order for this work to be successful and useful to the county or counties involved, decision makers representing key stakeholder groups should commit to being involved in the discussion. The parties do not need to agree with one another, but they should be willing to engage in an honest and frank dialogue. For example, if a county is interested in discussing the creation of a consolidated human services agency, representatives of the board of county commissioners, county administration, public health, and social services should all be at the table together. If several counties are considering creating a district health department, representatives from the board of county commissioners, county administration, and public health in each county should be prepared to participate. If all of the relevant parties are not interested in participating in this type of group discussion, we ask that you not submit a request at this time.

Process

We would expect each project to follow a unique path, but the general framework for the process will be as follows:

• Application:   The application is available here. It can be completed electronically and submitted via email.  Alternatively, a paper copy may be scanned or faxed. 

• Planning meeting: Once our team has accepted a request, one or more members of the School of Government’s team will visit the community to meet with representatives of the groups involved. The meeting will last about 2 hours. During this initial meeting, we will not discuss substantive issues related to human services. Rather, we will map out a plan for the facilitated discussions to follow. We will want to come away from this planning meeting with clear objectives and an agenda for the initial discussion. The requester must schedule the meeting, identify meeting space, invite the participants, and make any other necessary logistical arrangements. We are responsible for all travel and related expenses for School of Government team members. We may elect to hold this planning meeting by conference call rather than in person.
   
• Facilitated discussion(s): A School of Government facilitator, notetaker, and one or more subject matter experts (depending upon the needs identified in the planning meeting) will visit the community and facilitate 1–2 discussions with the representatives of the groups involved. We expect each discussion to last half of a day or approximately 3–4 hours. The requester must schedule the meeting(s), identify meeting space, invite the participants, and make any other necessary logistical arrangements. We are responsible for all travel and related expenses for School of Government team members and any office supplies or presentation materials required for the meeting. We will also pay for refreshments for the participants (one meal and beverages), although the requester will need to make catering arrangements.

• Follow-up: We will share summary notes with all of the participants after each discussion. Our goal is to provide a structure for productive conversation and to help the stakeholders involved agree upon next steps. Communities are responsible for continuing the conversation after the School of Government’s involvement ends. If a community decides that a change in human services programs is needed, the community (not the School of Government) is responsible for making the plans for change and implementing those plans. If a community would like additional assistance from the School of Government after the discussion(s), we will work with the community to decide whether continuing the work would be useful and, if so, whether resources are available to support the continuation.

Questions?

If you have questions about this process or a pending request, please contact Aimee Wall at 919.843.4957 or wall@sog.unc.edu.