A BILL TO BE ENTITLED
AN ACT to improve the public health infrastructure by establishing an accreditation system for local health departments, as recommended by the public health task force 2004, AND TO APPROPRIATE FUNDS T0 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)	The Local Health Department Accreditation Board is established within the North Carolina Institute for Public Health. The Board shall be composed of 17 members appointed by the Secretary of the Department of Health and Human Services as follows:
(1)	Four shall be county commissioners recommended by the North Carolina Association of County Commissioners, and four shall be members of a local board of health as recommended by the Association of North Carolina Boards of Health.
(2)	Three local health directors.
(3)	Two staff members from the Division of Public Health, Department of Health and Human Services.
(4)	One staff member from the Division of Environmental Health, recommended by the Secretary of Environment and Natural Resources.
(5)	Three at large.
 (b)	Members shall serve four‑year terms except that initial terms shall be staggered such that three members are appointed for one year, four members are appointed for two years, four members are appointed for three years, and six members are appointed for four years. An appointment to fill a vacancy on the Board created by the resignation, dismissal, ineligibility, death, or disability of any member shall be made for the balance of the unexpired term. The Secretary may remove any member for misfeasance, malfeasance, or nonfeasance. The chair shall be designated by the Secretary  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.
(c)	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.
(d)	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.
(e)	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.
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 follows:
a.	Monitoring health status to identify community health problems.
b.	Diagnosing and investigating health hazards in the community.
c.	Informing, educating, and empowering people about health issues.
d.	Mobilizing community partnerships to identify and solve health problems.
e.	Developing policies and plans that support individual and community health efforts.
f.	Enforcing laws and regulations that protect health and ensure safety.
g.	Linking people to needed personal health care services and assuring the provision of health care when otherwise unavailable.
h.	Assuring a competent public health workforce and personal health care workforce.
i.	Evaluating effectiveness, accessibility, and quality of personal and population‑based health services.
j.	Conducting research.	
(3)	The local health department's facilities and administration.
(4)	The local health department's staff competencies and training procedures or programs. 
(5)	The local health department's governance and fiscal management; and
(6)	Informal procedures for reviewing Board decisions.
(f)	All local health departments shall obtain and maintain accreditation in accordance with this section. The Board shall implement accreditation over a period of eight years, beginning January 1, 2006. The Board shall establish a schedule specifying when each local health department shall apply for initial accreditation and ensuring that all local health departments have applied for initial accreditation by December 1, 2014.
(g)	The Board shall assign the following accreditation status, as applicable:
(1)	"Accredited" to a local health department that satisfies the accreditation standards. 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. 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. During the conditional accreditation period, the local health department may apply again for accreditation in accordance with rules adopted by the Commission.
(h)	Each accredited local health department shall apply for reaccreditation in accordance with rules adopted by the Commission.
(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 section."
SECTION 2.  There is appropriated from the General Fund to the Department of Health and Human Services the sum of one million two hundred fifty thousand dollars ($1,250,000) for the 2005‑2006 fiscal year.  These funds shall be allocated to the Local Health Department Accreditation Board to carry out the purposes of this act.
SECTION 3.  Section 1 of this act becomes effective October 1, 2005.  The remainder of this act becomes effective July 1, 2005.