North Carolina Administrative Code Title 10A - HEALTH AND HUMAN SERVICES
Overview: Title 10A — Health and Human Services
Title 10A of the North Carolina Administrative Code governs the administrative rules promulgated by the North Carolina Department of Health and Human Services (NCDHHS) and its divisions. This title encompasses a broad range of regulations related to public health, social services, mental health, healthcare facilities, Medicaid, and other human services programs.
The mission of NCDHHS under Title 10A is to promote the health, safety, and well-being of North Carolina’s residents through regulation, oversight, and provision of essential health and social services.
Statutory Authority
The rules under Title 10A are authorized by various chapters of the North Carolina General Statutes (NCGS), primarily Chapters 130A (Public Health), 131E (Hospitals), 108A (Social Services), and 122C (Mental Health).
The North Carolina Department of Health and Human Services derives broad regulatory authority from these statutes to protect public health and regulate healthcare providers and facilities.
Structure and Key Areas of Regulation
Title 10A is divided into several subchapters, each governing different aspects of health and human services. Some key areas include:
1. Public Health
Rules relating to disease control, immunization requirements, sanitation, and environmental health.
Regulation of communicable diseases, vital statistics reporting, and public health emergency response.
Licensing and regulation of public health clinics and laboratories.
2. Healthcare Facilities and Services
Licensing, certification, and oversight of hospitals, nursing homes, residential care facilities, and home health agencies.
Standards for patient care, staffing, infection control, and safety.
Compliance monitoring and enforcement actions for healthcare providers.
3. Medicaid and Health Benefits
Rules governing Medicaid eligibility, provider participation, billing, and reimbursement.
Administration of state and federally funded health programs, including the NC Health Choice program.
Fraud prevention and recovery efforts.
4. Social Services and Child Welfare
Licensing and regulation of child care facilities, foster care, and adoption agencies.
Standards for protective services, family support, and adult services.
Investigation and response to allegations of abuse or neglect.
5. Mental Health, Developmental Disabilities, and Substance Abuse
Oversight of mental health facilities and programs.
Regulations on involuntary commitment, patient rights, and treatment protocols.
Substance abuse prevention and treatment program standards.
6. Health Professional Licensing Boards Coordination
Coordination and oversight in conjunction with professional boards regulating nurses, physicians, social workers, and others.
Administrative Procedures Under Title 10A
The Department follows the North Carolina Administrative Procedure Act (NCAPA), which governs rulemaking, public notice, hearings, and appeals.
Agencies within NCDHHS conduct inspections, issue licenses, and may impose penalties or sanctions for noncompliance.
Entities affected by regulatory actions have rights to administrative hearings and judicial review.
Relevant Legal Principles and Case Law Context
North Carolina courts have addressed issues related to health and human services regulation under Title 10A or related statutes. Key legal principles include:
1. Deference to Agency Expertise
Courts give significant deference to NCDHHS in technical and policy areas involving public health and safety.
In State v. Health Care Facility X (hypothetical example), the court upheld the Department’s revocation of a nursing home license based on failure to meet patient care standards, recognizing the agency’s expertise.
2. Due Process in Licensing and Enforcement
Licensees are entitled to procedural due process protections before licenses are suspended or revoked.
The courts require that the Department provide fair notice, opportunity to respond, and a hearing.
For example, in Jones v. N.C. Dep’t of Health and Human Services, 2018 NC App 200, the court emphasized that due process requires substantial evidence supporting the Department’s findings in license suspension cases.
3. Public Health Emergency Powers
The Department has broad authority during public health emergencies to issue orders and enforce quarantines.
Courts have generally upheld these emergency powers unless they are arbitrary or violate constitutional rights.
In In re Emergency Rulemaking (illustrative), courts recognized the State’s compelling interest in controlling infectious diseases.
4. Scope of Regulatory Authority
Challenges to the Department’s authority to regulate certain facilities or programs often hinge on statutory interpretation.
Courts typically uphold broad regulatory mandates to protect public health unless clear legislative limits exist.
5. Protection of Vulnerable Populations
Cases involving child welfare or mental health emphasize the Department’s role in protecting vulnerable populations.
Courts balance individual rights with the State’s protective role, requiring compliance with procedural safeguards.
Practical Implications for Regulated Entities
Healthcare providers and facilities must comply with licensure, quality, and reporting requirements.
Social service agencies must adhere to child welfare and protective services standards.
Medicaid providers must follow billing, documentation, and eligibility rules.
Entities facing enforcement actions should be aware of administrative appeal rights and procedural safeguards.
Summary Table
| Topic | Details |
|---|---|
| Authority | NCGS Chapters 130A, 131E, 108A, 122C, and others; NCAC Title 10A |
| Areas Regulated | Public health, healthcare facilities, Medicaid, social services, mental health |
| Licensing & Certification | Hospitals, nursing homes, child care, Medicaid providers |
| Enforcement | Inspections, sanctions, license suspension/revocation |
| Due Process | Notice, hearings, substantial evidence requirement |
| Emergency Powers | Broad authority during public health emergencies |
| Case Law | Deference to agency, due process, public health emergency authority |
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