The North Carolina Department of Health and Human Services (DHHS) is responsible for the welfare of all North Carolina residents, including children, the elderly, the economically impoverished, and the physically and developmentally disabled. By the early 2000s it was the state's largest government agency, with a 2005 operating budget of over $11 billion-more than 20 percent of the state's total budget.
The modern DHHS is an amalgamation of many previously existing state agencies and departments, including the Department of Public Welfare, Department of Public Health, and Department of Mental Health. In 1971 the General Assembly created the Department of Human Resources, which combined government agencies and free-standing departments performing similar functions. This umbrella organization continued to expand with the addition of the Division of Vocational Rehabilitation in 1973, Office of Rural Health in 1974, and Division of Aging in 1977. The administration of the Medicaid program was reassigned from the Division of Social Services to the newly created Division of Medical Assistance in 1978. In 1989 a Division for the Deaf and Hard of Hearing was formed, and the Division of Public Health was transferred to the Department of Environment, Health, and Natural Resources. In 1997 the Department of Human Resources reacquired the Public Health Division and was renamed the Department of Health and Human Services.
The three largest modern-day DHHS divisions are the Division of Medical Assistance (which accounts for over half of the department's budget), Division of Social Services, and Division of Mental Health, Developmental Disabilities, and Substance Abuse Services. Other DHHS branches include the Division of Child Development (created in 1993) and the Early Intervention and Education Division (established in 1999 and renamed the Office of Education Services in 2001).
The Department of Health and Human Services is the second largest agency in the state, with over 19,000 employees. The North Carolina Department of Public Safety formed in 2012. It merged the Departments of Correction, Crime Control and Public Safety, and Juvenile Justice and Delinquency into one, making it the only agency larger than the Department of Health and Human Services.