Questions and answers about public health-related topics Ask the Experts This page is devoted to sharing information about challenging or unique Public Health topics. Local Boards of Health members, Health Department Directors, and Health Department Staff are invited to submit a question or answers to questions that may benefit others. Please email Merle Green to submit your questions or answers. Disclaimer: The information, views and opinions expressed on this page are those of the authors and are published here for general informational purposes. In the rapidly evolving world of public health, therapeutics, and law, the accuracy of some information may be time-limited. Readers should confirm all information and opinions before making decisions. Q&A Category Legal Ask an Expert: Who is the official Chair for the different governance models of Boards of Health (BOHs) in North Carolina? All “traditional” boards of health (county BOHs, district BOHs, and hospital authority BOHs) are required by state statute to elect a chair on an annual basis. The BOH must have a quorum of BOH members in order to elect a chair and only BOH members can vote (the county manager, for example, would not get to vote). Anyone on the BOH can be elected by their BOH colleagues to serve as chair. Additionally, some BOHs elect a vice-chair who can step in if the chair isn’t available for some reason- but having a vice-chair is entirely optional and is not required by state law. For consolidated human services agencies, the county government has chosen to bring social services and at least one other human services agency (often, but not always, public health), under one roof- thereby collapsing them into a single county agency. The governing board that is then created mirrors this setup and instead of having a separate BOH and DSS boards, you’d have a single consolidated human services (CHS) board that includes representatives from the DSS and public health worlds, as well as members of the public. Under state law, the CHS board, just like a “traditional” BOH, must elect a chair every year- and the chair could be anyone on the CHS board who is properly elected by a majority of their fellow CHS board members at a meeting of the CHS board where there is a quorum present. Finally, there’s the question of who is considered the “chair” if the board of county commissioners (BOCC) dissolves the “traditional” BOH or the CHS board and takes on their functions. It sounds like in some counties where the BOCC serves as the board of health (or the CHS board, in the case of a county with a consolidated human services agency), the perception is that the BOCC’s role as the BOH is separate from the existence/other work of the BOCC. For example, it sounds like in some counties, the BOCC adjourns and then reconvenes (essentially holding an entirely separate meeting) to take up any public health related matters. When the BOCC serves as the BOH (or the CHS board), the “chair” is the same person who was elected to serve as chair of the BOCC under G.S. 153A-39. There is no legal basis for electing a different chair who takes over the gavel only when the BOCC takes up public health related matters. Finally, when the BOCC serves as the BOH, they are required to appoint an advisory committee on public health. There is no law directing the advisory committee to elect a chair, though they could certainly do so. Because the advisory committee is solely advisory in nature, the duties and powers of the chair of the advisory committee would be limited to things like scheduling the advisory committee meetings, and running those meetings. All “traditional” boards of health (county BOHs, district BOHs, and hospital authority BOHs) are required by state statute to elect a chair on an annual basis. The BOH must have a quorum of BOH members in order to elect a chair and only BOH members can vote (the county manager, for example, would not get to vote). Anyone on the BOH can be elected by their BOH colleagues to serve as chair. Additionally, some BOHs elect a vice-chair who can step in if the chair isn’t available for some reason- but having a vice-chair is entirely optional and is not required by state law. For consolidated human services agencies, the county government has chosen to bring social services and at least one other human services agency (often, but not always, public health), under one roof- thereby collapsing them into a single county agency. The governing board that is then created mirrors this setup and instead of having a separate BOH and DSS boards, you’d have a single consolidated human services (CHS) board that includes representatives from the DSS and public health worlds, as well as members of the public. Under state law, the CHS board, just like a “traditional” BOH, must elect a chair every year- and the chair could be anyone on the CHS board who is properly elected by a majority of their fellow CHS board members at a meeting of the CHS board where there is a quorum present. Finally, there’s the question of who is considered the “chair” if the board of county commissioners (BOCC) dissolves the “traditional” BOH or the CHS board and takes on their functions. It sounds like in some counties where the BOCC serves as the board of health (or the CHS board, in the case of a county with a consolidated human services agency), the perception is that the BOCC’s role as the BOH is separate from the existence/other work of the BOCC. For example, it sounds like in some counties, the BOCC adjourns and then reconvenes (essentially holding an entirely separate meeting) to take up any public health related matters. When the BOCC serves as the BOH (or the CHS board), the “chair” is the same person who was elected to serve as chair of the BOCC under G.S. 153A-39. There is no legal basis for electing a different chair who takes over the gavel only when the BOCC takes up public health related matters. Finally, when the BOCC serves as the BOH, they are required to appoint an advisory committee on public health. There is no law directing the advisory committee to elect a chair, though they could certainly do so. Because the advisory committee is solely advisory in nature, the duties and powers of the chair of the advisory committee would be limited to things like scheduling the advisory committee meetings, and running those meetings. If additional information is desired, please contact Kirsten Leloudis, JD at the School of Government at UNC Chapel Hill. Email - kirsten@sog.unc.edu. Note: Answered for the ANCBH BOH Chair Network Working Group on February 3, 2024 Ask an Expert: Does the County Commissioner on the BOH have full voting rights on matters being considered by the board. The board will be sending a recommendation regarding a specific issue to the BOCC for their vote. The question is whether the BOCC member must abstain from voting on the BOH due to the fact that the BOCC will address the same issue at their next meeting? This question is about the role of the county commissioner who also sits ex officio on the board of health. A county commissioner can vote to take action on a recommendation that the board of health (which includes that same county commissioner) made to the commissioners. The fact that the county commissioner serves on both the board of health and board of commissioners does not create a conflict that would require the commissioner to recuse themselves from voting on the recommendation in this situation. For consolidated human services agencies, the county government has chosen to bring social services and at least one other human services agency (often, but not always, public health), under one roof- thereby collapsing them into a single county agency. The governing board that is then created mirrors this setup and instead of having a separate BOH and DSS boards, you’d have a single consolidated human services (CHS) board that includes representatives from the DSS and public health worlds, as well as members of the public. Under state law, the CHS board, just like a “traditional” BOH, must elect a chair every year- and the chair could be anyone on the CHS board who is properly elected by a majority of their fellow CHS board members at a meeting of the CHS board where there is a quorum present. If additional information is desired, please contact Kirsten Leloudis, JD at the School of Government at UNC Chapel Hill. Email - kirsten@sog.unc.edu. Note: Answered September 2024 Can Board of Health members use virtual meeting platforms such as Zoom or Teams for attending board meetings or when discussing budget amendments? Has there been any specific guidance from the state on this issue? Generally, remote meetings held through virtual platforms like Zoom or Teams or over the phone are allowed under NC law. However, you may want to check your board of health policies and other local policies to ensure they don’t prohibit these types of meetings. A meeting that you hold in this manner also needs to be noticed (just like any other board of health meeting) in accordance with NC open meeting laws. If the board holds a meeting using teleconference or other electronic means, the open meetings law requires the board to provide “a location and means whereby members of the public may listen to the meeting.” The board must specify that location information in the notice of the board meeting. At a minimum, this means the board must provide an online meeting link or teleconference information to the public in advance of the meeting. The open meetings law does not require the board to provide any way for members of the public to speak to or communicate with the board during a remote meeting. In other words, members of the public must be able to hear the board meeting, but the board does not have to provide a method for the public to contribute to the board meeting. However, a board may want to provide a way for members of the public to speak during remote meetings if the board has decided (in its own rules of procedure) to routinely allow public comment periods during its meetings. If in your county the Board of County Commissioners (BOCC) serves as the board of health, then there’s one additional wrinkle that’s important to be aware of and that comes from a recent Court of Appeals decision in State of North Carolina v. Anson County. In the past, it was unclear whether or not members of a BOCC who join an official meeting remotely can be counted towards the board’s quorum for the purpose of the board being able to take official action. However, this past summer, the Court of Appeals addressed this question head on and determined that members who join remotely can’t be counted towards the quorum - which means that if your entire meeting is held virtually (rather than in-person), then there’s no quorum, which could inhibit the board from taking official action. This case clearly applies to situations where the BOCC serves as the board of health. Appointed boards of health do not appear to be directly impacted by the court’s decision, it is possible that the court could apply similar analysis to future cases involving a board of health. Kristina Wilson, Assistant Professor of Public Law and Government, UNC School of Government has written about this decision and its implications here: https://canons.sog.unc.edu/2024/08/the-court-of-appeals-addresses-emergency-meetings-and-remote-quorum/. One suggestion she makes is that a BOCC could try to ensure that at least enough members to constitute a quorum show up to the meeting in person so that the board can feel more secure about being able to take official action. (Other members could join remotely, but just wouldn’t be counted towards the quorum). In special situations, your board may also have a workaround for this entire issue: the Court of Appeals specified that board members who aren’t physically present at the meeting but join remotely can be counted towards the quorum if the meeting is being held during a state of emergency declared by the legislature or the governor. If the BOCC (acting as the board of health) does hold entirely remote meetings during the state of emergency, you also need to ensure that you meet the requirements set out at G.S. 166A-19.24 (e.g., if someone is joining by phone rather than video call, they need to announce their name anytime they speak or vote). If additional information is desired, please contact Kirsten E. Leloudis, JD at the School of Government at UNC Chapel Hill. Email - kirsten@sog.unc.edu Note: Answered for the ANCBH BOH Governance Network. Revisions posted December 11, 2024 I have an incoming commissioner appointment. Does the commissioner seat require an oath of office? A county commissioner who is preparing to fill the county commissioner seat on a board of health should take an oath of office before the commissioner begins to exercise any of the powers or duties associated with their board of health role. Although a county commissioner has likely taken an oath of office already for their county commissioner position, that office and the board of health seat are arguably different public offices- and therefore, the cautious approach would be for the commissioner to take a separate oath of office for each role. If additional information is desired, please contact Kirsten E. Leloudis, JD at the School of Government at UNC Chapel Hill. Email - kirsten@sog.unc.edu Note: Answered for the ANCBH BOH Governance Network. Revisions posted January 5, 2025 A duly appointed Board of Health member would like to decline receiving a stipend for attending Board of Health Meetings. Is there anything preventing the Health Director (or county) from allowing them to decline the stipend? For an appointed county board of health, the the statute that applies regarding per diem and reimbursements is G.S. 130A-35. Paragraph (h) says “A member may receive a per diem in an amount established by the county board of commissioners (emphasis added).” Because the law says board members “may” receive a per diem- not that they “shall” receive it- I think it’s probably just fine if a particular board member declines to accept any per diem that is being offered to them. As a best practice and for good recordkeeping purposes, I’d recommend having the board member communicate in writing that they don’t want to receive the per diem (or any other reimbursements they may be entitled to, if that’s also the case). As always, you might also wish to run this by your county attorney, who might have additional insights to offer. f additional information is desired, please contact Kirsten E. Leloudis, JD at the School of Government at UNC Chapel Hill. Email - kirsten@sog.unc.edu Note: Answered for the ANCBH BOH Governance Network. Posted February 9, 2025, Revised February 10 2025

ANCBH Public Health Nursing Conference May 31, 2024 Raleigh, NC 1/1 Photos courtesy of Hannah Rodgers, MPH, ANCBH Board Member and Alecia Smith, Ph.D., Communications and Public Relations Manager Durham County Health Department

Recognition ANCBH Board Members advocating for Public Health Watson S. Rankin Legacy Award 2022-2023 Barbara Ann Hughes, PhD, MPH, RDN, LDN, FADA, FAND was awarded the Rankin Legacy Award at the honors luncheon at the NCPHA Annual Conference in Wilmington. The Rankin Legacy Award is given to a NCPHA member in recognition of their outstanding contributions to public health in NC over the member's lifetime. Her many leadership roles in public health and nutrition organizations include being Past-President, National Association of Local Boards of Health and Past-House of Delegates, Academy of Nutrition & Dietetics Ham Stevens, MD Award 2022 Merle Green, MPH, MBA was presented with the Ham Stephens award, given to individuals who exemplify the qualities of a former health director and friend of public health, Ham Stevens, M.D. Dr. Stevens was largely responsible for bringing administrative health directors and medical health directors together to form the North Carolina Association of Local Health Directors (NCALHD). Merle was recognized for her many achievements in community-based health centers, health promotion, consensus building, volunteer service on community Boards, and leadership in public health. NCALHD also recognized Merle for her mentorship of young health professionals, faculty appointments at several colleges and universities in NC, and for her advocacy for population-based health services. National Association of Local Boards of Health ANCBH is providing leadership at the national level. At the Annual Business Meeting, held on August 2nd 2022 in conjunction with the NALBOH Annual Conference, Benjamin W. Tillett, RPh, PharmD serves as President of NALBOH. Dr. Tillett has provided outstanding leadership to the ANCBH Board as its President and is well qualified to lead NALBOH as they support local Boards of Health in their current and emerging public health challenges. Mary C. Egan Award 2022 Barbara Ann Hughes, PhD, MPH, RDN, LDN, FADA, FAND has received the 2022 Mary C. Egan Award from the APHA (American Public Health Association) Food and Nutrition Section. This national award recognizes the professional contributions and outstanding services of public health nutritionists. The services may include developing new approaches to public health nutrition, mentoring, nutrition education, and addressing special nutrition needs.

DOWNLOAD EXAMPLE OF A LOCAL HEALTH DIRECTOR'S JOB DESCRIPTION

History of ANCBH A newsletter article is presented below. Read a draft outline of the history of ANCBH here. “… Board of health members are the bedrock of local public health, a foundation for our future, and a strength on which we can build.” — Carl Durham, ANCBH Founding Member and First President The following is a small article as it appeared in the September, 2002 ANCBH newsletter. It provides a thumbnail sketch of ANCBH’s return to the status of an all-volunteer association. The author is Barbara Ann Hughes, PhD, a past president of ANCBH. “In 1993, as a way to invest in the education of new Board of Health members across the state, the General Assembly started a $100,000 grant in aid to ANCBH. This arrangement worked fine until the state budget crisis caused the cancellation of this grant in 2001. Fortunately, the Division of Public Health of the University of North Carolina, believed in the value of training, applied for, and was granted $70,000 from the state to continue training. A UNC Board of Health Proposed Training Plan was written on September 24, 2001. An agreement was made between the Division of Public Health and ANCBH to allow for the continued training of local Board of Health members. The agreement, signed on January 14, 2002, provided for employees to be appointed for a period of either 3 or 5 years to carry out this training from within the Institute of Public Health of the Division of Public Health of UNC. Carmine Rocco became a staff member of the Institute for Public Health, and continued to conduct training of local board members. He tendered his resignation to become the Local Health Director for Warren County, North Carolina. The Board of Directors meets quarterly and is committed to offering more and valuable services to its membership.” Historical Outline of the ANCBH This historical outline provides highlights from the Association’s past and it is presented to provide some background information to those who have little information about the Association. 1985 The seed for the Association of North Carolina Boards of Health was sown when a Steering Committee was appointed after a seminar on “The Future of Public Health for Local Boards of Health” held in Chapel Hill, NC. 1986 First Annual Meeting of ANCBH is held in September in Greensboro, NC. Articles of Incorporation were signed in November. 1987 Staff was hired including Vaughan Mamlin Upshaw, a founding member of the National Association of Local Boards of Health (NALBOH). Second Annual Meeting of ANCBH was held in Fayetteville, NC. 1988 Established independent office in Pittsboro, NC. Received IRS tax exempt status. Pilot Board of Health Orientation Program occurred in Charlotte, NC. Third Annual Meeting of ANCBH in Winston-Salem, NC. 1989 ANCBH Board of Directors approved hiring a part-time assistant. Receive $5,000 grant from W. K. Kellogg for research and development of board health manual. Fourth Annual Meeting of ANCBH in Charlotte, NC. W. K. Kellogg approved a grant for $310,311. 1990 Grant Review Committee appointed. 1993 General Assembly allocated a $100,000 grant in aid to ANCBH to invest in the education of new Board of Health members across the state. General Assembly ratified Senate Bill 1505 which included the continuation of a $100,000 grant-in-aid through DHHS to ANCBH to invest in the education of new Board of Health members across the state. 1994 General Assembly grant-in aid continued. 1995 General Assembly grant-in aid continued. First Emeriti Reception was held. 1996 General Assembly grant-in aid continued. 1997 General Assembly grant-in aid continued. Carmine Rocco joins ANCBH as Executive Director in September. 1998 General Assembly grant-in aid continued. 1999 General Assembly grant-in aid continued. David Phillips, teenage son of ANCBH Board member Charles Phillips of Cabarrus County, volunteers to develop and establish the first ANCBH website. 2000 General Assembly grant-in aid continued but funding is in jeopardy. 2001 General Assembly cuts the $100,000 grant in aid to ANCBH. ANCBH entered into a short-term contract with the North Carolina Institute for Public Health to assist with the downsizing. Contract terminated on June 30, 2002. ANCBH receives the North Carolina Public Health Association's Partners in Public Health Distinguished Group Award. 2002 ANCBH Executive Director resigned. NCIPH wins a grant to provide orientation training to local board of health members. ANCBH files are relocated to NCIPH. 2003 ANCBH Board of Directors began to reassess its organization and role with an all-volunteer structure. 2004 ANCBH continued to assess its organization and role, looked back to re-connect with its history, and then began planning for the future. 2005 Bylaws were amended to add an Emeriti membership category. Membership survey was conducted. Affiliation agreement was signed with the National Association of Local Boards of Health (NALBOH). Memorandum of Understanding was signed with the North Carolina Institute for Public Health. Website was evaluated for necessary changes. 2006 The January 2006 annual meeting presented an educational session on accreditation, the most frequently requested topic in the membership survey. The website receives major changes.

National Advocacy Sites American Public Health Association www.apha.org Library of Congress www.loc.gov Research America www.researchamerica.org United States House of Representatives www.house.gov United States Senate www.senate.gov

ANCBH: Presentations and Lectures 2025 International Public Health Agencies. “Protecting the Health of People Across all Nations” A Discussion with Duke University Medical Science Students Presented by Merle Green, Executive Director ANCBH October 20, 2025 View presentation slides

Membership To join ANCBH, please complete and submit your name, email address, phone number, address to our Executive Director, Merle Green, at mgreen4@triad.rr.com and copy to merle.green@alamance-nc.com . Please also indicate what county you serve in. You will be asked for a current resume/CV, a reference letter from your Board of Health Chair or Health Director and a short statement indicating your desire to join the board. Call for Directors Nominations: ANCBH Nominations Committee welcomes nominations for Board of Directors anytime. Download the nominations form here. The Association has four membership categories defined in its bylaws and they are: Institutional Open to North Carolina County or District Boards of Health, County or District Boards of Human Services, and Public Health Authorities upon payment of dues. Institutional members have voting privileges at the Association’s Annual Meeting. An institutional member shall designate one member of its current governing board to vote on behalf of that institution on any matter to which a member is entitled to vote, and shall notify the association of the name and address of its designee. Individual Current board members of a governing body that holds institutional membership are automatically individual members without payment of dues. Associate Open to all former Board members and other persons who support the goals of ANCBH upon payment of dues. Director Emeritus Open to duly qualified former members of the ANCBH Board of Directors who are elected to this honorary status by a vote of the Board of Directors. The Director Emeritus is an honor that is bestowed only on those leaders in public health who have served on the ANCBH Board of Directors. Director Emeriti are entitled to: Be represented on the current Board of Directors Attend all Board of Director meetings and functions Click here to download the current list of Emeriti Members. BOARD OF DIRECTORS NOMINATION FORM WHY HDs NEED TO SUPPORT AND JOIN ANCBH

Local Boards of Health and Public Health Authority Boards A local board of health is the policy-making, rule-making, and adjudicatory body for public health in the county or counties in its jurisdiction. State statutes give boards of health specific powers and duties. Every type of local board may make local public health rules that apply throughout the board’s jurisdiction. Each board has limited authority to set fees for public health services. Each board also influences the day-to-day administration of the local public health agency. Public health authority boards have expanded powers and duties compared to county and district boards of health. Consolidated human services boards have all of the powers of county and district boards of health, except a consolidated human services board may not appoint the agency director (who is appointed instead by the county manager, with the advice and consent of the board). A consolidated human services board also plays a more active role in the development of the agency’s budget, and has additional powers and duties related to its oversight of other human services programs. North Carolina General Statutes defines both the responsibilities and the composition of local boards of health. The local board of health is charged with being “the policy-making, rule-making and adjudicatory body for a county health department.” And, with few exceptions, the typical board is composed of eleven members: one physician one dentist one optometrist one veterinarian one registered nurse one pharmacist one county commissioner one engineer four general public representatives The exceptions to the 11-member board include boards for a district health department, public health authority, and a consolidated human service agency or public hospital. S.L. 2012-126 (H 438) extends to all counties and creates new options to allow a board of county commissioners to assume the powers and duties of certain boards, create a consolidated human services agency, or take both actions. The options are: Assume direct control of certain boards by adopting a resolution abolishing the board(s) and transferring their powers and duties to the board of county commissioners; Create a consolidated human services agency (CHSA) governed by a consolidated human services board appointed by the county commissioners; or Create a CHSA governed directly by the county commissioners and appoint a health advisory committee. For a comparison of powers and duties by type of board, refer to the attached pdf from this UNC School of Government website: https://www.sog.unc.edu/resources/faqs/what-does-local-board-health-do DOWNLOAD COMPARISON OF BOH POWERS

Public Health "Every Where, Every Day, Every Body" The Three Core Functions of Public Health: The Job of the Local Board of Health In 1988, the Institute of Medicine issued The Future of Public Health report which stated that America’s public health system was in disarray. The Institute’s panel recommended new governmental functions at federal, state and local levels to strengthen our nation’s public health system. Localities, they said, should reestablish boards of health or “public health councils” to assess public health needs, develop public health policy, and assure that public health services are available. It is these three core functions – assess, address, and assure – that constitute the job of the local board of health. Assess: To scan, weigh and balance community needs, resources, statistics and politics. Address: To determine a course of action; to set targets, to allocate resources, to make policy and assign responsibility. Assure: To make certain that progress is made Adapted from Assess, Address, Assure: Manual for North Carolina’s Local Health Boards. Copyright 1993 – Association of North Carolina Boards of Health. The Ten Essential Public Health Services The 10 Essential Public Health Services provide a framework for public health to protect and promote the health of all people in all communities. To achieve equity, the Essential Public Health Services actively promote policies, systems, and overall community conditions that enable optimal health for all and seek to remove systemic and structural barriers that have resulted in health inequities. Such barriers include poverty, racism, gender discrimination, ableism, and other forms of oppression. Everyone should have a fair and just opportunity to achieve optimal health and well-being. Assess and monitor population health status, factors that influence health, and community needs and assets Investigate, diagnose, and address health problems and hazards affecting the population Communicate effectively to inform and educate people about health, factors that influence it, and how to improve it Strengthen, support, and mobilize communities and partnerships to improve health Create, champion, and implement policies, plans, and laws that impact health Utilize legal and regulatory actions designed to improve and protect the public’s health Assure an effective system that enables equitable access to the individual services and care needed to be healthy Build and support a diverse and skilled public health workforce Improve and innovate public health functions through ongoing evaluation, research, and continuous quality improvement Build and maintain a strong organizational infrastructure for public health References: 1. Website of Department of Health and Human Services – Centers for Disease Control and Prevention - https://www.cdc.gov/publichealthgateway/publichealthservices/essentialhealthservices.html 2. National Association of Local Boards of Health: Being an Effective Local Board of Health Member Ten Essential Public Health Services and How They Can Include Addressing Social Determinants of Health Inequities Conditions in the places where people live, learn, work, and play affect a wide range of health risks and outcomes. These social determinants of health and actions to address the resulting health inequities can be incorporated throughout all aspects of public health work. Learn more. History of Public Health in North Carolina The State Archives of North Carolina preserves and provides public access to historically significant archival materials related to North Carolina. Archived files trace the history of the Department of Health and Human Services beginning with a reference to “an act of the 1755 Assembly ordering quarantine on vessels" and concluding with the 1990s. As referenced in the The Eighteenth Biennial Report of the North Carolina State Board of Health : "In the seventies Dr. Thomas Fanning Wood of Wilmington, caught the vision of the possibilities of public health work to North Carolina. How fully he grasped the far-reaching consequences of his idea, how clearly he saw the ever-growing hosts of lives saved as a result of his vision and inspiration, we shall never know. We do know that the vision never left him, and that under its sway he worked, through the Medical Journal which he edited and through the North Carolina State Medical Society, until his influence reached the people of the State in their General Assembly of 1877, with the effect that on February 12, 1877, the North Carolina State Board of Health was born. Ours was the twelfth State board of health to be established". The county boards of health were composed of the affiliated county medical societies and were under the direction of the State Board of Health. The intent was to create a uniform system of health and sanitation throughout the state. But “the General Assembly appropriated only one hundred dollars to establish this health system; and the existence of the State Board of Health was nominal.” Additional excerpts from this history: “In 1899 the General Assembly passed additional legislation to protect public water supplies from contamination, and the State Board of Health was charged with instructing local health boards and water company inspectors on the procedures for sampling and inspection.” “… in 1911 the General Assembly recognized the State Board of Health as the state's medical adviser …. The state board was also required to issue bulletins statewide in the event of a dangerous outbreak of disease.” “In 1917 the General Assembly also charged the state board with responsibility for the sanitary conditions and the hygienic care of prisoners in state prisons, local jails, county prison camps, and all other places of confinement…. .” “In 1931 the dental care program was established as a separate Division of Oral Hygiene and expanded its efforts to educate the public preventive dental care. In the early 1930s the Division of Preventive Medicine took responsibility for school health services, health education and information, and maternal and child health services. Later in the decade, they initiated a nutrition program offering consultation services to local health departments, schools, and other institutions requesting services.” “… in 1945, the General Assembly instructed the state board to initiate a program related to the prevention and cure of cancer, with emphasis on the early detection and treatment of cancers. Under terms of the law, the board was to provide a system of financial aid for low-income cancer patients; establish minimum standards for cancer clinics or departments in general hospitals; collect information on cancer and sponsor an educational program for citizens; and compile and preserve statistical, clinical, and other records relating to cancer prevention and cure. … “In 1949 the last remaining county established a full-time health department." “In 1963 the General Assembly created a new Department of Mental Health, transferring to that department the services previously performed by the Division of Local Health and its Mental Health Section. Other laws during the same period significantly increased the state board's responsibilities. In 1961 the legislature provided for the licensing of nursing homes by the State Board of Health rather than by the Medical Care Commission and the State Board of Public Welfare. The 1963 General Assembly gave the state board responsibility for a program of air pollution control, although they failed to fund it. In 1965 Governor Dan K. Moore designated the State Board of Health as the official state agency to administer Title XVIII of U.S. Public Law 89-97, commonly referred to as Medicare. The Office of Chief Medical Examiner and a Division of Medical Examiner were created in 1967 …." “Under the 1973 act, the Commission for Health Services was granted the power and duty to adopt rules and regulations for the conduct of the state's public health programs, to protect and promote public health, and to control diseases and other health impairments. … Furthermore, the law stipulated that local health departments, when directed by the DHR, would enforce rules established by the Commission for Health Services and that DHR would supervise the local health departments." “New programs in place by the early 1990s included the Office of Chief Nurse, charged with coordinating public health nursing services with local health departments and statewide programs; the Office of Health Education, charged with providing various services and developing teaching strategies for environmental, community, and personal health programs; and the Office of Legislative Affairs to represent the department in the General Assembly and to monitor proposed legislation and the work of the legislative study and research committees." As it relates to Public Health, the State Archives collection includes links to a large searchable collection of digitized original documents , dated 1879 – 1973, including the Bulletin of the North Carolina Board of Health and Biennial Reports of the North Carolina State Board of Health. View the First Bulletin of the North Carolina Board of Health [1886-1887 : v.1, 1-12 plus Supplements] View the First Biennial Report of the North Carolina Board of Health [1879-1880] DOWNLOAD SELECT PUBLIC HEALTH STATUTES

ANCBH Public Health Nursing Conference May 2, 2025 Concord, NC Program and Speaker Bios Presentations Speakers and Attendees 1/1

Resources This section offers educational resources of various types as they become available, in the form of documents to download and useful links. Hurricane Helene: Emergency Resources ANCBH Newsletters CDC Newsroom Directory of Local Health Departments and Directors Interactive Maps – Organization and Governance of NC Human Services Agencies Health Directors Job Description Accreditation Information Continuing Education Information Vaccine Confidence This website has tools and resources for building vaccine confidence in patients and communities Health-Related Web Sites Health Equity and Behavioral Health Integration This resource from AHRQ provides an overview of the role of behavioral health integration in reducing disparities in health and healthcare, and shares practical strategies and resources for ensuring integrated practices are advancing health equity. Restaurant Inspection Scores Covid funding inadequate for NC Public Health Read the Raleigh N&O analysis. ANCBH Meeting Minutes: BOD (restricted access)