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Karen Powell, FHD Director: Duties and Powers of Enforcement for Covid-19

May 21,2020

In my on-going informational series about Foothills Health District today I want to focus on who our health director is and what her duties are, as well as answer a few questions that had been sent to me concerning the recent incident in Spindale with Carolina Cafe.  To do this I referenced NC Legislative General Statute 130A as well as contacted NCDHHS (North Carolina Department of Human and Health Services).

Each type of local public health agency must have a director, who serves as the administrative head of the agency and exercises legal powers and duties prescribed by law. The director of our district health department must meet minimum education and experience requirements that are set out in state law. In general, the director must have education and experience in medicine, public health, or public administration related to health. (G.S. 130A-40)

Karen Powell

The appointment of the local health director for a district health department is done by the district board of health after consultation with all applicable boards of County Commissioners. Although the board of health must consult with the Commissioners, the statute does not require the Commissioners to consent to or approve the appointment. (G.S. 130A-40 ) Foothills Health District Board and the Director function under the direction of North Carolina Department of Human and Health Services (NCDHHS)

Karen Powell is the Public Health Director for Foothills Health District. She has worked in Public Health for 11 years as Health Choice Coordinator, Child Care Health Consultant, Preparedness Coordinator and as Health Director. She holds a bachelor’s degree from Greensboro College in Sociology and a Master’s Degree from Webster University in Health Care Management. Karen currently serves as the NC Region 2 Health Director representative.

All local health directors have powers and duties that come from multiple sources of law. (G.S. 130A-41)  A Health Directors powers and duties generally fall into these five categories:

1)  Administration: The local health director administers programs under the direction of the board of health and serves as secretary to them, and explains the department’s activities to the board, local officials, and the public.

2)  Remedies: The local health director is responsible for enforcing public health laws within their jurisdiction and may employ a number of legal remedies when public health laws are violated. The director may:

  • Initiate civil or criminal proceedings against a public health law violator (G.S. 130A-18)
  • Abate public health nuisances or imminent hazards (G.S. 130A-19); (130A-20)
  • Impose administrative penalties (fines) for violations of state or local laws regulating smoking in public places. (G.S. 130A-22)(h1)
  • Embargo food or drink in some circumstances (G.S. 130A-21)
  • Impose administrative penalties for violations of local on-site wastewater rules, or conditions imposed on permits issued under such rules (G.S. 130A-22)(h).

The local health director may also play a role in actions taken by local public health employees to suspend or revoke permits, such as a permit to operate a restaurant. (G.S. 130A-23)

Communicable disease control: The local health director must investigate cases and outbreaks of communicable diseases and ensure that communicable disease control measures are given. (G.S. 130A-144) The director may order isolation or quarantine if the legal conditions for exercising the isolation or quarantine authority are met. (G.S. 130A-145)  The local health director also has the duty to enforce the North Carolina laws requiring the immunization of children. (G.S. 130A-41)(b)(7).

Other disease control: The local health director must examine, investigate and control rabies in accordance with state public health laws. (G.S. 130A-41)(b)(10). The director must also investigate the causes of other diseases in the jurisdiction, whether or not they are communicable. (G.S. 130A-41)(b)(3).

Educate and advise: The local health director must disseminate public health information, promote the benefits of good health, and advise local officials about public health matters. (G.S. 130A-41)(b).

As you can see this is a position that carries a lot of responsibility concerning the public’s health in many different areas. When you add a pandemic to the mix with daily and ongoing changes that require the Director to take point and lead, it becomes even more stressful. It is not unreasonable that some lines would be crossed in the performance of their duties.

I did reach out to NCDHHS to clarify some items of confusion that have recently occurred here in Rutherford County concerning Governor Cooper’s Executive order and enforcement of such by Ms. Powell. My questions were answered by Kelly Haight Connor, Communications Manager, Office of Communications NCDHHS as stated below:

1) Has NCDHHS mandated that health directors pull certificates of health on businesses that do not comply with the Governor’s Executive Orders?

Answer: Local health department cannot enforce provisions of the Executive Order nor can they take permit action (e.g., suspending a permit) for violations of provisions in the Executive Order. However, a local health department can take action when there is evidence that the establishment poses a threat to the public’s health or safety.

2) Are all Health Department Directors in NC official members of The Covid-19 Task Force and represent the Governor as such in these situations?

Answer: All 85 health directors are not members of the Governor’s COVID-19 Task Force.

With the recent discrepancies of how Spindale’s Carolina Cafe’s and Vale’s Mitchem’s Kitchen’s compliance issues were handled, it was a concern to many as to why our local business was threatened with having their health certificate pulled and Vale’s business was issued a fine and allowed to continue to operate in violation of the Governor’s Executive Order. “Posing a threat to the public’s health or safety” is a subjective observation but when a business is conforming with all previously established rules that had been set forth to be “in compliance” as soon as the Executive Order was changed it is hard to justify that as a reason to pull a business’s certificate of health if it in fact it was not specific to the Executive Order itself.

I appreciate all the hard work that Ms. Powell and Foothills Health District does on an everyday basis as well as trying to take point for the local current Covid-19 crises. It is and will be an on-going process. Hopefully we can all work together to better understand each other and our roles during this time. Communication, transparency and respect will be the key to make this happen.

If you have any questions specific to Foothills Health District or NCDHHS please send me an email to the address below and I will attempt to get them answered for you.

If you have any information or questions about a Covid-19 situation at a business or institution that you would like investigated please contact me at 

(all communications are confidential)

*This article contains personal observations which do not reflect the position of RC Catalyst in any way.