A BILL TO BE ENTITLED
AN ACT to REQUIRE the Department of Health and Human Services to establish a local health department VOLUNTARY accreditation program and to establish the Local Health department accreditation board; and to appropriate funds to implement this act.
The General Assembly of North Carolina enacts:
SECTION 1.(a)  G.S. 130A‑2 is amended by adding the following new subdivision in alphabetical order to read:
"§ 130A‑2.  Definitions.
The following definition shall apply throughout this Chapter unless otherwise specified:
…
(01)	"Accreditation board" or "Board" means the Local Health Department Accreditation Board."
SECTION 1.(b)  Part 1 of Article 2 of Chapter 130A of the General Statutes is amended by adding a new section to read:
"§ 130A‑34.1. Accreditation of local health departments; board established.
(a)	All local health departments may obtain and maintain accreditation in accordance with this section and with rules adopted by the Commission.
(b)	The Local Health Department Accreditation Board is established. The Board is established within the Department of Health and Human Services for budgetary purposes only. The Board shall be composed of 15 members appointed as follows:
(1)	Eight appointed by the General Assembly, four upon recommendation of the President Pro Tempore of the Senate, and two by each of the Speakers of the House of Representatives.
a.	Of the members recommended by the President Pro Tempore of the Senate, two shall be county commissioners recommended by the North Carolina Association of County Commissioners, and two shall be members of a local board of health as recommended by the North Carolina Association of Local Boards of Health.
b.	Of the members recommended by each of the Speakers of the House of Representatives, one shall be a county commissioner recommended by the North Carolina Association of County Commissioners, and one shall be a member of a local board of health as recommended by the North Carolina Association of Local Boards of Health.
(2)	Six by the Secretary of Health and Human Services, as follows:
a.	Two local health directors.
b.	One staff member from the Division of Public Health.
c.	Three members at large.
(3)	One by the Secretary of Environment and Natural Resources, from the Division of Environmental Health.
(c)	Any appointment to fill a vacancy on the Board created by the resignation, dismissal, ineligibility, death, or disability of any member shall be made by the original appointing authority and shall be for the balance of the unexpired term. The chairman shall be elected by the Board and shall designate the times and places at which the Board shall meet. The Board shall meet as often as necessary to carry out its duty to develop and review periodically accreditation standards, to engage in activities necessary to assign accreditation status to local health departments, and to engage in other activities necessary to implement this section.
(d)	Members of the Board who are not officers or employees of the State shall receive reimbursement for travel and subsistence expenses at the rates specified in G.S. 138‑5. Members of the Board who are officers or employees of the State shall receive reimbursement for travel and subsistence at the rate set out in G.S. 138‑6.
(e)	The Board shall assign an accreditation status to each local health department that applies for initial accreditation, reaccreditation, or relief from conditional accreditation. The Board shall assign the appropriate accreditation status, as follows:
(1)	Accredited, which means that the local health department has satisfied the accreditation standards adopted by the Board and applicable rules adopted by the Commission.
(2)	Conditionally accredited, which means that the local health department has failed to meet one or more accreditation standards and has therefore been granted short‑term accreditation subject to conditions specified by the Board.
(3)	Unaccredited, which means that the local health department has continued to fail to meet one or more accreditation standards after a period of conditional accreditation.
(f)	The Commission shall, after reviewing standards developed by and consulting with the Board, adopt rules establishing accreditation standards for local health departments. The accreditation standards shall include at least all of the following:
(1)	An accreditation process that consists of the following components:
a.	A self‑assessment conducted by the local health department seeking accreditation. The self‑assessment shall measure the local health department's capacity to and performance of the following essential services:
1.	Monitoring health status to identify community health problems.
2.	Diagnosing and investigating health hazards in the community.
3.	Informing, educating, and empowering people about health issues.
4.	Mobilizing community partnerships to identify and solve health problems.
5.	Developing policies and plans that support individual and community health efforts.
6.	Enforcing laws and regulations that protect health and ensure safety.
7.	Linking people to needed personal health care services and assuring the provision of health care when otherwise unavailable.
8.	Assuring a competent public health workforce and personal health care workforce.
9.	Evaluating effectiveness, accessibility, and quality of personal and population‑based health services.
b.	A site visit by a team of experts to clarify, verify, and amplify the information in the self‑assessment.
c.	Final action by the Board on the local health department's accreditation status.
(2)	The local health department's capacity to provide the essential public health services as defined by the Centers for Disease Control and Prevention.
(3)	The local health department's facilities and administration. The review shall address, at a minimum:
a.	Adequacy of facilities for services provided.
b.	Hours of operation that are adequate for access to essential services.
c.	Mechanisms for assessing quality of services.
(4)	The local health department's staff competencies and training procedures or programs.  The review shall address, at a minimum:
a.	Licensing, certification, and registration requirements.
b.	Continuing education.
c.	Orientation.
(5)	The local health department's governance.  The review shall address, at a minimum, policies on:
a.	Budgeting, accounting, fee-setting, and purchasing.
b.	Other financial management activities that assure accountability for funds. 
(g)	The Board shall assign the following accreditation status, as applicable:
(1)	"Accredited" to a local health department that satisfies the accreditation standards and rules adopted by the Commission. The initial period of accreditation shall expire four calendar years after initial accreditation is granted. 
(2)	"Conditionally accredited" to a local health department that, in its initial accreditation application, fails to satisfy the accreditation standards and rules adopted by the Commission. The period of conditional accreditation shall expire two calendar years after conditional accreditation is granted. The Board shall provide to the local health department a written statement of the conditions that must be satisfied in order for the local health department to be accredited. At any time during the two-year period, the local health department may request that its status be reviewed and changed from "conditionally accredited" to "accredited."  If the Board finds that the conditions have been met, the Board shall change the local health department's status to "accredited" with the accreditation period to expire four calendar years after the conditional accreditation was initially granted. If the Board finds that the conditions have not been satisfied, the local health department shall continue under its grant of conditional accreditation.
(3)	"Unaccredited" to the local health department if, at the end of the conditional accreditation period, the department fails to meet the accreditation standards at that time.
(h)	Each accredited local health department shall apply for reaccreditation before the initial period of accreditation expires. If a local health department fails to apply for reaccreditation in a timely manner, the Board shall change the local health department's status to "unaccredited."
(i)	When the Board assigns the status "unaccredited" to a local health department, the Board shall send written notification of that status to the local health department and to the Secretary.
(j)	The Commission shall adopt rules to implement this act."
SECTION 2.  There is appropriated from the General Fund to the Department of Health and Human Services the sum of two hundred fifty-five thousand five hundred ninety-seven dollars ($255,597) for the 2004‑2005 fiscal year.  These funds shall be allocated for administrative costs and for activities of the Accreditation Board for the accreditation of six or fewer local health departments.  The Department may provide for the accreditation of additional local health departments if non-State funds are obtained for this purpose.
SECTION 3.  This act becomes effective July 1, 2004.