After months of discussion, the Macon County Board of Commissioners unanimously voted to combine Public Health and Animal Services into a single Consolidated Human Services Agency.
The decision was made at the commissioners’ Nov. 13 meeting after the Macon County Board of Health recommended the action. The resolution enacting the change states it would “improve administrative efficiency, enhance services and strengthen oversight.”
The resolution would organize both the county’s Public Health and Animal Services departments under a CHSA Board comprised of the current health board’s 11 members and four other “consumers of human services.” The current health board’s members will select the other four nominees and could begin the process of evaluating applications as early as its next meeting. Instead of a health director selected by the health board, the CHSA would be governed by a CHSA director appointed by the county manager with the commissioners’ advice and consent. The director would report directly to the county manager and serve as the director of both the health department and the CHSA.
County Manager Warren Cabe is directed by the resolution to develop a transition plan “to ensure continuity of services, proper integration of departments and communication with affected staff and stakeholders.” Cabe said the most significant change would be removing Health Department employees from the jurisdiction of the N.C. Human Resources Act and placing them within the county’s H.R. department.
Commissioners John Shearl and Barry Breeden have each said they receive frequent complaints about the department’s work environment and have lamented the county manager holds insufficient power to reconcile complaints.
“That’s probably the only major change,” Cabe said. “They would fall under the county personnel policies, which are essentially identical to the state policies. All our policies will be the same standards. Services will be the same.” Cabe stressed the county was not interested in removing personnel or eliminating positions, and administrative changes will be few. Public Health Employees are currently already on a county pay structure, Cabe said.
Public concerns
At the Board of Commissioners’ Sept. 9 meeting, a public hearing on consolidation saw members of the public oppose the board’s initial July suggestion of taking over the Health Department; people expressed concern the takeover would place commissioners’ politics over sound health policy. Speakers at the meeting said the health board’s makeup of health care professionals (eight professionals with three members of the general public) brought experience that centered science and patient care. Under a CHSA Board, those same healthcare professionals would continue to hold policymaking power.
Some commenters also expressed a desire to be a part of a decision to consolidate as a formal proposal developed. While no public hearing was advertised for November’s consolidation vote, Cabe said September’s public hearing gave members of the public a chance to comment and citizens would be free to comment at future Board of Commissioners and Board of Health meetings.
A few commenters urged commissioners to wait before making a big administrative change and give the Health Department and health board a chance to draft and implement new policy to meet the concerns of department employees.
Since July 23, when multiple Public Health employees brought workplace complaints forward to the health board during its regular public comment period, the board has been revisiting its policies to make raising and resolving complaints easier for public health employees. These efforts included revised employee complaint and grievance policies, which were both finalized at the board’s Oct. 28 meeting.
Cabe stressed that because Animal Services and Public Health were already combined under the Health Department, not much administrative change would happen.