SUBCHAPTER 48D - LOCAL HEALTH DEPARTMENT ACCREDITATION - STANDARDS

SECTION .0100 - GENERAL PROVISIONS

10A NCAC 48D .0101      ACCREDITATION REQUIREMENTS

(a)  The completion of each activity in Section .0200 of this subchapter shall be scored based on the self-assessment and site visit as follows:

(1)           two points shall be awarded when all of an activity is completed;

(2)           one point shall be awarded when part of an activity is completed; and

(3)           zero points shall be awarded when no part of an activity is completed.

(b)  The Board shall assign an LHD an accreditation status of accredited if the LHD earns at least four points in each standard set out in rules .0201 through .0211 of this Subchapter and at least 81 points overall.

(c)  If an LHD does not meet the criteria set out in Paragraph (b) of this Rule, the Board shall assign an accreditation status of conditionally accredited or unaccredited in accordance with G.S. 130A-34.1.

History Note:        Authority G.S. 130A-34.1;

Eff. June 1, 2026.

SECTION .0200 – STANDARDS and ACTIVITIES

10A NCAC 48D .0201      STANDARD A: ASSESSMENT and SURVEILLANCE

To satisfy the assessment and surveillance accreditation standard, a local health department shall complete the following activities:

(1)           conduct a community health assessment;

(2)           collect and use a minimum of two sources of data to document the health of the population and identify communities with barriers accessing health care;

(3)           collect and use a minimum of two sources of data to guide LHD programs and services;

(4)           provide, contract for the provision of, or assure the availability of laboratory services for disease detection in the jurisdiction; and

(5)           monitor emerging health issues and threats and report communicable diseases in accordance with 10A NCAC 41A .0103.

History Note:        Authority G.S. 130A-34.1;

Eff. June 1, 2026.

10A NCAC 48D .0202      STANDARD B: COMMUNITY PARTNERSHIP DEVELOPMENT

To satisfy the community partnership and development standard, a local health department shall complete the following activities:

(1)           consult with representatives of communities with barriers accessing health care in developing and implementing LHD programs and services;

(2)           develop and maintain relationships with community partners and government entities to improve LHD programs and services; and

(3)           consult community partners in the development of the community health improvement plan.

History Note:        Authority G.S. 130A-34.1;

Eff. June 1, 2026.

10A NCAC 48D .0203      STANDARD C: COMMUNICATIONS

To satisfy the communications standard, a local health department shall complete the following activities:

(1)           develop a plan for communicating public health information to the population and demonstrate using the plan;

(2)           tailor communications to reach communities and distribute the communications to those communities;

(3)           share data about the health of the population with the public and community partners;

(4)           develop partnerships with the media and promote public health messages through those partnerships; and

(5)           develop and implement a plan to educate the population on public health topics.

History Note:        Authority G.S. 130A-34.1;

Eff. June 1, 2026.

10A NCAC 48D .0204      STANDARD D: EMERGENCY PREPAREDNESS AND RESPONSE

To satisfy the emergency preparedness and response standard, a local health department shall complete the following activities:

(1)           maintain emergency preparedness and response plans and train LHD staff on those plans;

(2)           provide LHD personnel and communications systems to implement preparedness and response plans, in the event of a state of emergency declaration under G.S. 166A-19.3(19), a disaster declaration under G.S. 166A-19.3(3), or a disaster declaration under 44 C.F.R. Part 206, Subpart B in coordination with government entities and community partners;

(3)           maintain LHD continuity of operations in the event of a declared emergency or disaster, as set out in Paragraph (2) of this Rule;

(4)           exercise the powers and duties of the local health director pursuant to G.S. 130A-41; and

(5)           maintain a written plan that describes how to reach the LHD by phone, email, or other form of communication 24 hours per day, seven days per week.

History Note:        Authority G.S. 130A-34.1;

Eff. June 1, 2026.

10A NCAC 48D .0205      STANDARD E: STRUCTURAL AND SOCIAL DETERMINANTS OF HEALTH

To satisfy the structural and social determinants of health standard, a local health department shall complete the following activities:

(1)           develop a plan that addresses structural or social determinants of health in the population;

(2)           provide training to the LHD's workforce on structural or social determinants of health; and

(3)           implement the plan to address structural or social determinants of health in the LHD's programs and services.

History Note:        Authority G.S. 130A-34.1;

Eff. June 1, 2026.

10A NCAC 48D .0206      STANDARD F: ORGANIZATIONAL WORKFORCE DEVELOPMENT

To satisfy the organizational workforce development standard, a local health department shall complete the following activities:

(1)           comply with applicable state and local human resource laws and policies related to local health department employee grievances, performance reviews, and job qualifications, including to have, or be recruiting, a local health director who meets the qualifications of G.S. 130A-40;

(2)           develop and implement a workforce development plan to recruit and retain employes who meet LHD job qualifications;

(3)           review the workforce development plan to identify and implement improvements to the plan; and

(4)           provide professional development to members of the LHD's workforce, including opportunities for on-the-job training and continuing education.

History Note:        Authority G.S. 130A-34.1;

Eff. June 1, 2026.

10A NCAC 48D .0207      STANDARD G: ORGANIZATIONAL LEADERSHIP, GOVERNANCE, AND LEGAL SERVICES

To satisfy the organizational leadership, governance, and legal services standard, a local health department shall complete the following activities:

(1)           share public health updates with elected officials and community partners;

(2)           develop and maintain a strategic plan that sets out the LHD's priorities for the LHD's services, programs, and initiatives;

(3)           educate members of the LHD's Board of Health on their roles, responsibilities, and legal authority;

(4)           access and use legal services; and

(5)           develop and implement a plan to include community partners on public health boards, councils, or groups.

History Note:        Authority G.S. 130A-34.1;

Eff. June 1, 2026.

10A NCAC 48D .0208      STANDARD H: ORGANIZATIONAL FACILITIES

To satisfy the organizational facilities standard, a local health department shall complete the following activities:

(1)           maintain facilities used for LHD programs and services;

(2)           develop and maintain written protocols for the security of LHD facilities;

(3)           develop and maintain clinical and environmental health equipment in accordance with manufacturers' requirements; and

(4)           implement tobacco-free policies in LHD facilities.

History Note:        Authority G.S. 130A-34.1;

Eff. June 1, 2026.

10A NCAC 48D .0209      STANDARD I: ORGANIZATIONAL FINANCE AND INFORMATION TECHNOLOGY

To satisfy the organizational finance and information technology standard, a local health department shall complete the following activities:

(1)           develop and maintain a budgeting, auditing, billing, and financial policy;

(2)           evaluate the LHD's finances and identify opportunities to secure additional funding to support LHD programs and services; and

(3)           maintain policies and procedures that comply with the privacy and security standards required by the Health Insurance Portability and Accountability Act of 1996, P.L. 104-191, as amended, and its implementing regulations, as applicable.

History Note:        Authority G.S. 130A-34.1;

Eff. June 1, 2026.

10A NCAC 48D .0210      STANDARD J: ACCOUNTABILITY AND PERFORMANCE MANAGEMENT

To satisfy the accountability and performance management standard, a local health department shall complete the following activities:

(1)           develop and maintain written policies and procedures for the administration of the LHD;

(2)           comply with state and local laws and rules relating to programs and services offered by the LHD;

(3)           maintain a procedure for monitoring and improving the performance of LHD programs and services;

(4)           identify and use evidence-informed practices to improve LHD programs and services; and

(5)           use quality improvement practices to improve LHD services and programs.

History Note:        Authority G.S. 130A-34.1;

Eff. June 1, 2026.

10A NCAC 48D .0211      STANDARD K: POLICY DEVELOPMENT AND SUPPORT

To satisfy the policy development and support standard, a local health department shall complete the following activities:

(1)           enforce public health laws and rules in accordance with G.S. Chapter 130A-4;

(2)           make recommendations to the LHD's Board of Health on local rules or policies to improve the health of the population; and

(3)           make recommendations to legislators or regulators regarding state laws or rules impacting public health.

History Note:        Authority G.S. 130A-34.1;

Eff. June 1, 2026.