GENERAL ASSEMBLY OF NORTH CAROLINA

SESSION 1993

S	1 

SENATE BILL 69*

Short Title:  Public Health Study.	(Public)
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Sponsors: Senators Cooper; Walker, Ward, Forrester, and Seymour.
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Referred to:  Rules and Operation of the Senate.
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February 4, 1993

A BILL TO BE ENTITLED
AN ACT TO ESTABLISH THE PUBLIC HEALTH STUDY COMMISSION.
Whereas, recent data on the health status of North Carolina citizens suggest that the State and local public health systems are not operating at maximum efficiency and effectiveness; and
Whereas, demands on financial resources to support State and local public health have increased dramatically, while the State's percentage of financial support to local public health efforts has decreased; and
Whereas, a strong county-based public health system has been the entry point for the delivery of public health and primary care services to the citizens of North Carolina; and
Whereas, prevention, surveillance, assessment, and education are major tasks and strengths of the public health system; and
Whereas, the public health system must be incorporated into health care reform and cost control strategies; and
	Whereas, the structure, financing, accessibility, and accountability of the public health system need close and continued scrutiny to ensure that the system keeps pace with the needs of society and with current health care reform efforts; Now, therefore,
The General Assembly of North Carolina enacts:
Section 1.  Chapter 120 of the General Statutes is amended by adding the following new Article to read:
"ARTICLE 22.
"The Public Health Study Commission.
"§ 120-195.  Commission created; purpose.
There is established the Public Health Study Commission.  The Commission shall examine the public health system to determine its effectiveness and efficiency in assuring the delivery of public health services to the citizens of North Carolina.
"§ 120-196.  Commission duties.
The Commission shall study the availability and accessibility of public health services to all citizens throughout the State.  In conducting the study the Commission shall:
(1)	Evaluate whether the current organizational structure of the public health system is effective in meeting public health needs and the likelihood that such structure will be able to achieve the State's public health mandate in the future;
(2)	Determine whether the public health services currently available in each county or district health department conform to the mission and essential services established under G.S. 130A-1.1;
(3)	Study the workforce needs of each county or district health department, including salary levels, professional credentials, and continuing education requirements, and determine the impact that shortages of public health professional personnel have on the delivery of public health services in county and district health departments;
(4)	Review the status and needs of local health departments relative to facilities, and the need for the development of minimum standards governing the provision and maintenance of these facilities;
(5)	Propose a long-range plan for funding the public health system, which plan shall include a review and evaluation of the current structure and financing of public health in North Carolina and any other recommendations the Commission deems appropriate based on its study activities;
(6)	Study and make recommendations on the role of the public health system in health care reform efforts; and
(7)	Conduct any other studies or evaluations the Commission considers necessary to effectuate its purpose.
"§ 120-197.  Commission membership; vacancies; terms.
(a)	The Commission shall consist of 17 members, one of whom shall be the State Health Director.  The Speaker of the House of Representatives shall appoint seven members, two of whom shall be selected from among the following: the UNC School of Public Health, the North Carolina Primary Care Association, the North Carolina Home Care Association, the North Carolina Pediatric Society, and the North Carolina Citizens for Public Health. Five of the Speaker's appointees shall be persons who are members of the House of Representatives at the time of their appointment, one of the five being the Representative who chairs the House standing committee related to health matters. The President Pro Tempore of the Senate shall appoint seven members, two of whom shall be selected from among the following: the North Carolina Health Directors' Association, the North Carolina Public Health Association, the Association of Public Health Nurses, the North Carolina Environmental Health Supervisors' Association, and the North Carolina Association of Public Health Educators.  Five of the President Pro Tempore's appointees shall be persons who are members of the Senate at the time of their appointment, one of the five being the Senator who chairs the Senate standing committee related to health matters.  The Governor shall appoint one member from either the North Carolina Medical Society or the North Carolina Hospital Association. The Lieutenant Governor shall appoint one member from either the North Carolina Association of County Commissioners or the Association of North Carolina Boards of Health.
(b)	Vacancies shall be filled by the official who made the initial appointment using the same criteria as provided by this section. All initial appointments shall be made within one calendar month from the effective date of this Article.
(c)	Legislative members appointed by the Speaker and the President Pro Tempore shall serve two-year terms.  The public members initially appointed by the Speaker and the President Pro Tempore shall each serve a three-year term.  The members initially appointed by the Governor and the Lieutenant Governor shall each serve a one-year term.  Thereafter, the terms of all Commission members shall be for two years.
"§ 120-198.  Commission meetings.
The Commission shall have its first meeting not later than 60 days after adjournment of the 1993 General Assembly, first session, at the call of the President Pro Tempore of the Senate and the Speaker of the House of Representatives.  The President Pro Tempore of the Senate and the Speaker of the House of Representatives shall each appoint one legislative member of the Commission to serve as cochair. The Commission shall meet upon the call of the cochairs.
"§ 120-199.  Commission reimbursement.
The Commission members shall receive no salary as a result of serving on the Commission but shall receive necessary subsistence and travel expenses in accordance with the provisions of G.S. 120-3.1, 138-5, and 138-6, as applicable.
"§ 120-200.  Commission subcommittees; non-Commission membership.
The Commission cochairs may establish subcommittees for the purpose of making special studies pursuant to its duties, and may appoint non-Commission members to serve on each subcommittee as resource persons.  Such resource persons shall be voting members of the subcommittee and shall receive subsistence and travel expenses in accordance with G.S. 138-5 and G.S. 138-6.
"§ 120-201.  Commission authority.
The Commission has the authority to obtain information and data from all State officers, agents, agencies, and departments, while in discharge of its duties, pursuant to the provisions of G.S. 120-19, as if it were a committee of the General Assembly.  The Commission shall also have the authority to call witnesses, compel testimony relevant to any matter properly before the Commission, and subpoena records and documents, provided that any patient record shall have patient identifying information removed.  The provisions of G.S. 120-19.1 through G.S. 120-19.4 shall apply to the proceedings of the Commission as if it were a joint committee of the General Assembly.  In addition to the other signatures required for the issuance of a subpoena under this section, the subpoena shall also be signed by the cochairs of the Commission.  Any cost of providing information to the Commission not covered by G.S. 120-19.3 may be reimbursed by the Commission from funds appropriated to it for its continuing study.
"§ 120-202.  Commission reports.
The Commission shall report to the General Assembly, the Governor, and the Lieutenant Governor the results of its study and recommendations.  The Commission shall submit its written report not later than 30 days after the convening of each biennial session of the General Assembly.
"§ 120-203.  Commission staff; meeting place.
The Commission may contract for clerical and professional staff or for any other services it may require in the course of its ongoing study.
The Commission may, with the approval of the Legislative Services Commission, meet in the State Legislative Building or the Legislative Office Building."
Sec. 2.  There is appropriated from the General Fund to the Legislative Services Commission the sum of ninety-two thousand sixteen dollars ($92,016) for the 1993-94 fiscal year and the sum of one hundred three thousand nine hundred four dollars ($103,904) for the 1994-95 fiscal year to fund the first two years of the Commission's study established by this act.
Sec. 3.  This act becomes effective July 1, 1993.