12/05/2005
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NEW HANOVER COUNTY BOARD OF HEALTH
New Hanover County Health Department
Dr. Thomas Fanning Wood Memorial Conference Room
2029 S. 17`s Street
Wilmington, North Carolina 28401
Wednesday, December 7, 2005
AGENDA
Date: December 7, 2005
Time: 8:00 A.M.
Place: Dr. Thomas Fanning Wood Memorial Conference Room
New Hanover County Health Department
Presiding: Mr. Donald P. Blake, Chairman
Invocation: Dr. Edward Weaver, Jr.
Minutes: November 2, 2005
Recognitions: Mr. Donald P. Blake
Personnel
New Emplovee(s)
Darlene Hobson, Public Health Nurse, Clinic Health, PHS
Joseph Nick Meir, Vector Control Officer, Vector Control, ACS
Five Years
David Glenn Jenkins, Environmental Health Program Specialist Senior,
Vector Control, EHS
Ten (10) Year Service Award
Nancy A. Ryan, Shelter Supervisor, Animal Control Services
Anthony Williams, Animal Control Officer, Animal Control Services
Carol C. Bottoms, Dietition, Nutrition, Personal Health Services
Other Recognitions
Super Staff Award - January 2006
Teresa Y. Stanley, Public Health Nurse, School Health, Personal Health Services
• Departmental Focal:
Health Programs Administration - Pediatric Dental Unit Mr. Scott Harrelson
Assistant Health Director
BOH Agenda
December 7, 2005
Page 2
Monthly Financial Report: October 2005 Ms. Cindy W. Hewett
9 (Includes Grant Update) Business Manager
Committee Reports:
Executive Committee Mr. Donald P. Blake
New Business: Mr. Donald P. Blake
NHC Health Department Fee Policy Changes - PHS -
Laboratory Procedure Codes and Fees
~a a Grant Application - National Association of County and City
Health Officials (NACCHO) - Health Programs Administration - $25,000
aC} _a Training - Customer Service Program - Health Programs Administration
a9.30 Resolution - Influenza Vaccine Supply /
~J NHC Board of Health Meetings for 2006 FD{ ~t?
Election - Board of Health Officers for 2006
Comments:
C~ut~hcce on SS~s
Board of Health Members Mr. Donald P B ake
• ~ar~SrP: FLU ?~t'i~ ~i//~y~
Health Director , OVAx7z05klk/'
Mr. David E. Rice
Health Director
1. Social Security Account Numbers
2. East Carolina University - MPH Program Advisory Board
3. NCALHD Regi n 8 Representative - 2006-97
Other Business: F1 ~J Mr. Donald P. Blake
Adiourn: - Mr. Donald P. Blake
Mr. Donald P. Blake, Chairman called the regular business meeting of the New Hanover County
Board of Health (NHCBH) to order at 8:00 a.m. on Wednesday, November 2, 2005 in the
Thomas Fanning Wood Conference Room of the New Hanover County Health Department
located at 2029 S. 17'h Street, Wilmington, North Carolina.
Members Present:
Donald P. Blake, Chairman
Edward Weaver, Jr., OD, Vice-Chairman
James R. Hickmon, RPh
Marvin E. Freeman, Sr.
Cheryl Lofgren, RN
Sandra L. Miles, DDS
Nancy Pritchett, County Commissioner
Robert M. Shakar, MD
Stanley G. Wardrip, Jr.
G. Robert Weedon, DVM, MPH
Members Absent:
John S. Tunstall, PE
Others Present:
Kelly Haggerty, Administrative Support Technician, Animal Control Services
Brenda Rivenburgh, Animal Control Officer, Animal Control Services
Rebecca Balthazar, Public Health Nurse, Maternal Health, Personal Health Services
Kelly Johnson, Public Health Nurse, School Health, Personal Health Services
Thurman Grady, Vector Control Operator, Vector Control, Environmental Health Services
Cindy Hewett, Business Manager
Elisabeth Constandy, Health Promotions Supervisor, Health Programs Administration
Dr. Jean McNeil, Animal Control Services Manager
Janet McCumbee, Personal Health Services Manager
Dianne Harvell, Environmental Health Services Manager, Environmental Health Services
Betty Jo McCorkle, PHN, Clinic Supervisor, Personal Health Services
Scott Harrelson, Assistant Health Director
David E. Rice, Health Director
Marilyn Roberts, Recording Secretary
Invocation:
Mr. Donald P. Blake gave the invocation.
Minutes:
The minutes of the September October 12, 2005 Board of Health Meeting were approved as
submitted.
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Recognitions:
Personnel •
New Employee(s)
Kelly Haggerty, Administrative Support Technician, Animal Control Services
Brenda Rivenburgh, Animal Control Officer, Animal Control Services
Five (5) Year Service Award
Rebecca Balthazar, Public Health Nurse, Maternal Health, Personal Health Services
Kelly Johnson, Public Health Nurse, School Health, Personal Health Services
Fifteen (15) Year Service Award
Thurman Grady, Vector Control Operator, Vector Control, Environmental Health Services
Mr. David E. Rice, Health Director and Mr. Blake congratulated staff.
Other Recognitions
None
School Physical Screenings Meeting - October 31, 2005
Mr. Rice, Ms. Janet McCumbee, Personal Health Services Manager and Mr. Scott Harrelson,
Assistant Health Director attended the School Physical Screenings Meeting held on Octoberl3l,
2005. Dr. Robert M. Shakar along with Dr. Esposito, Dr. Spicer, Mr. Jim Strickland and Ms.
Bonnie Brown of the New Hanover - Pender County Medical Society also were in attendance.
Dr. Shakar reported that New Hanover Regional Medical Center would no longer,¢e sponsor ing
the athletic screenings so the committee is looking for sponsorship from the New Hanover
County Health Department as well as the facility to be the site for services. Dr. Shakar stated that
there was a tour of the facility and the auditorium could be used for the sports physicals that
would involve two (2) evenings - the boys on one evening and the girls on the next. Athletic
physical exams are only good for one year. This request will come before the Board of Healtti at
a later date.
Department Focal: Response to Waste Water Spills. Environmental Health Services
Ms. Dianne Harvell, Environmental Health Services Manager gave a brief power point
presentation on Wastewater Spill Response along with handouts. Highlights of the presentation
included:
New Hanover County NPDES Permits
• National Pollutant Discharge Elimination System (NPDES)
• 33 wastewater collection, treatment & disposal systems actively permitted
• Municipal/county, industrial, rest home, schools, subdivisions & Sweeney Water
Treatment Plant
• Operator or entity must periodically seek renewal of their permit from NC DENR/EPA
standards
• Public hearings/notices
Reporting Spills S
• 1999 enactment NC General Statute 143-2151C 33
• Discharge of 1,000 gallons or more of untreated wastewater to the surface waters of the
State
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• Issue press release to all print & electronic news media within 48 hours after the owner or
operator has determined discharge has reached the surface waters of the State
• • Retain a copy of the press release and a list of the news media to which it-was distributed
for at least one year
• NCDENR informally mandates operator or entity sample surface waters until number
upstream/down stream colonies equalize
Wastewater Spill Notification Protocol
• Dedicated phone line will call forward 24-7 to on-call Team Leader
• Team Leader receiving notice will first assimilate as much information as possible
. relative to the event
• Team Leader will notify EHS Manager & determine if a site visit is necessary
• Team Leader will communicate with on-site DENR representative & reach a consensus
decision regarding the necessity of posting signs & particulars that may warrant
alternative or supplemental actions
Marginal/Unacceptable Actions
• Internet
• National Weather Service Emergency Alert System
• NPA Systems
• Radio - outside normal work hours
• Reverse 911
Ms. Harvell then presented an example of the Collection System Sanitary Sewer Overflow
Reporting Form (Form CS-SSO) that should be submitted to the appropriate DWQ Regional
Office within five days of the first knowledge of the sanitary sewer overflow (SSO),
• Following a brief question and answer session, Mr. Blake thanked Ms. Harvell for her
presentation.
Monthly Financial Report - September 2005 (Includine Grant Status Report)
Ms. Cindy W. Hewett, Business Manager presented the September Revenue and Expenditure
Summary Report that reflects an earned revenue total of $1,698,804 with a remaining revenue
budget of $5,778,181 and an expenditure total of $2,389,215 with a remaining budget of
$11,473,591. Fiscal is still working with the county finance office in the process of changing
over to the new finance system. A summary of the financial report is below:
Budgeted Actual %
FY 05-06 FY 05-06
Expenditures:
Salaries & Fringe $11,315,151 $2,002,450
Operating Expenses $1,868,430 $376,951
Capital Outlay $679,225 $9,815
Total Expenditures $13,862,806 $2,389,215 17.23%
Revenue: $7,476,985 1,698,804 22.72%
Net Count $6,385,821 $690,411 11.00%
Ms. Hewett reported the Health Department Grant Status. Totals for grants requested $986,700
. received $451,700 and denied $205,000. Two pending grants: Wolfe-NC Public Health
Association Prenatal Grant for FY 05-06 and FY 06-07 for $5,000 and HUD (partnership with
City of Wilmington) - Lead Outreach and Education Program (3 year funding) for $275,000. No
updates for the past couple of months.
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Sleepy Time Puppy I
Mr. Blake requested that Dr. Jean McNeil, Animal Control Services Manager explain to the
Board of Health why she was holding a "stuffed puppy". Dr. McNeil displayed the "Sleepy
Time" puppy and explained that proceeds would go to a group in Wilmington called "Care".I
This group was established after Hurricane Katrina to aid the animal victims. After the event,
puppies/money will be sent to the children of this disaster.
New Business:
Grant Application - Healthy Carolinians - Health Programs Administration - $5.000
Our local Healthy Carolinians Task Force, Cape Fear Healthy Carolinians has the opportunity to
apply for $5,000 from the state office of Healthy Carolinians. This money can be used for
various reasons outlined in the application, including staff. Our local Task Force is currently
restructuring to include Brunswick County. We have gone through strategic planning and chosen
four areas to concentrate on which are all high priority areas in each of the four recent community
assessments done for our area. The four focus areas are: Access to Care, Obesity, Childhood
Injury and Domestic Violence.
The plans that we are establishing now will dictate the work of the entire task force for at least) the
next three years. Many local Task Forces have full time coordinators, ours does not. We dolnot
feel that the current workload would justify a full time employee. We do feel that a part-time
contract coordinator would be most beneficial. The deliverables for this coordinator would
.involve working with each subcommittee to develop goals that tie in with the national Health
People 2010 objectives, to complete the action plans for each of the focus areas and to complete
the task force certification and present it to the entire task force and submit to the state for
certification by May 2006. 1I
Motion: Mr. Blake recommended from the Executive Committee for the Board of Health to
accept and approve the request to contract with a local professional to gain certification for the
Cape Fear Healthy Carolinians as presented and to approve any associated budget amendment if
funding is awarded and submit to the New Hanover County Commissioners for their
consideration. Upon vote, the MOTION CARRIED UNANIMOUSLY.
Primary Care Proiect Grant Application
The New Hanover County Health Department has been notified by the Division of Medical
Assistance, Carolina Access of the Lower Cape Fear, New Hanover County Department of Social
Services and representatives of local pediatric groups to alert us of the need for additional
providers for low income and indigent children in New Hanover County. Currently in New
Hanover County there are 14,167 children on Medicaid, 2,168 on North Carolina Health Choice
and approximately 4,234 with no insurance coverage. When you combine all three groups there
are 20,569 children in this target population and the number is growing. Currently in New
Hanover County there are no pediatricians accepting Medicaid clients without restrictions.
Clinical services provided at the New Hanover County Health Department (NHCHD) currently •
include: Adult and childhood immunizations, TB screening, physician ordered injections,
pregnancy testing, birth control methods, vasectomy counseling, physical exams for adults and
children, the Breast and Cervical Cancer Control Program (BCCCP) and screening and treatment
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for sexually transmitted diseases. The additional services that are put forth in this business plan
are primary care services'for children. These services would include sick treatment visits such as
• those found at local general practice physician offices in the area. However, this would not
include specialty care.
These services would be provided on a daily basis from 8:00 a.m. - 5:00 p.m. at the main health
department facility. Recent changes made in our clinic model to accommodate open access
scheduling make our clinics more conductive to providing primary care. The services would be
provided by a team of qualified professionals including one full time nurse practitioner, one full
time physician's assistant, one part time contract physician, nurses and certified nursing
assistants.
This information is timely. We have received a request for proposal from the Office of Research,
Demonstrations and Rural Health for which we can apply for funding to create new or expand
existing services provided to uninsured and medically indigent patients including medical
services. This would also tie in to one of our priority areas from our strategic plan - Access to
Care.
There was lengthy discussion and numerous questions from the Board of Health regarding
Primary Care Project involving positions, clinic being self sufficient, target population, and the
number of children that could be seen.
Motion: Mr. Stanley G. Wardrip moved to accept and Dr. Sandra L. Miles seconded. Motion
passed from the Board of Health to accept and approve the Grant Application for the Primary
Care Project of $50,000 (to establish a pediatric primary care clinic geared toward low income
• and indigent children) and approve any associated budget amendment if funding is awarded and
submit to the New Hanover County Commissioners for their consideration. Upon vote,. the
MOTION CARRIED UNANIMOUSLY.
Committee Reports:
Board of Health Nominating Committee 2005
Dr. Sandra Miles, Chairman of the Nominating Committee for 2005 reported:
Members: Marvin E. Freeman, Sr.
Cheryl Lofgren, RN
Sandra Miles, DDS
Recommendations:
We have consulted with MR. Blake and Dr. Weaver and they have agreed to serve
another term as chair and vice chair, consecutively
The three members of the Nominating Committee believe these two will represent the
board members well for this next year, just as they have done during this year.
Further recommendations may be made by other board members and brought to the
December meeting at which time we will do the final voting.
Health Director's Job Performance Anoraisal
Mr. Blake reported that he received ten (10) performance evaluations for Mr. David E. Rice and
. the average of the performance ratings was "exceptional." It was agreed that Mr. Rice should be
recommended for the County's merit pay increase. Mr. Blake thanked Mr. Rice for his dedication
and hard work and stated he is doing a very good job.
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Motion: Mr. Blake moved from the Executive Committee for the Board of Health to approve the
performance evaluation and a merit increase of five (5) percent for Mr. Rice, Health Director.
Upon vote, the MOTION CARRIED UNANIMOUSLY.
Old Business:
None
Comments:
Mr. Stanley G. Wardrip expressed concern regarding the high-powered cellular tower that will be
constructed at 1540 Murray Farms Road (Murrayville area) and possible health hazards as a
result. Reference was made to a Health Study and AHEC will be contacted to do research.) Mr.
Wardrip requested that the Board of Health write a letter to the New Hanover County
Commissioners regarding this issue. Mr. Blake ask Mr. Rice to investigate and get back to, Ms. V
Nancy Pritchett, County Commissioner as soon as possible because Mr. Pritchett needs a reason
to table this at the next County Commissioner's Meeting.
Mr. Freeman reminded the Board of Health regarding the "doggie donations".
Commissioner Pritchett reminded Board of Health of Household Hazardous Waste Collection
Day to be held on Saturday, November 5th from 9:00-5:00 pm in the Old Cinema Parking Lot on
College Road.
Health Director
New Hanover County Newspaper Wrap •
Mr. Rice presented the New Hanover County Health Department's newspaper wrap that was a
part of the Wilmington Star News in November 2005.
Court Case Resolved
Mr. Rice presented a letter re: Satorre et al. v. New Hanover County et aL; 02 CVS 1017, New
Hanover County Superior Court stating the case had been resolved.
Flu Clinic
Mr. Rice presented Board of Health with complimentary letters regarding flu shot clinic services.
Mr. Rice stated that all staff has assisted in flu shot clinic in some capacity and this has been a
great effort.
Holiday Celebration
Mr. Rice announced that the Holiday Celebration would be held on December 8'h from 11:30 a.m.
- 2:00 p.m. and theme for this year is "Holiday Expressions".
New Hanover County Manager
Mr. Rice announced that Mr. Bruce Shell, former New Hanover County Finance Director has
accepted the position of New Hanover County Manager. He will take his new office on •
November 22, 2005.
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Performance Appraisals and Work Plans
• Mr. Rice stated that all Job Performance Appraisals with work plans have been completed with
Management Team.
Adiournment•
Mr. Blake adjourned the regular business meeting of the Board of Health at 9:17 a.m.
Mr. Donald P. Blake, Chairman
New Hanover County Board of Health
David E. Rice, M.P.H., M.A., Health Director
New Hanover County Health Department
Approved:
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New Hanover County Health Department
Revenue and Expenditure Summaries for October 2005
Cumulative: 33.33% Month 4 of 12
Revenues
Current Year Prior Year '
Type of Budgeted Revenue Balance % Budgeted Revenue Balance %
Revenue Amount Earned Remaining Amount Earned Remaining
Federal & State $ 1,816,791 $ 1,072,043 $ 744,748 59.01% $1,862,627 $ 827,614 $ 1,035,013 44.43%
C Fees $ 659,496 $ 224,829 $ 434,667 34.09% $ 580,161 $ 202,350 $ 377,811 34.88%
Medicaid $ 1,500,300 $ 414,765 $ 1,085,535 27.65% $1,138,039 $ 238,740 $ 899,299 20.98%
Medicaid Max $ - $ - - $ 151,600 $ - $ 151,600
EH Fees $ 300,212 $ 74,317 $ 225,895 24.75% $ 300,212 $ 80,100 $ 220,112 26.68% t..
Health Fees $ 128,000 $ 64,377 $ 63,623 50.29% $ 113,545 $ 53,092 $ 60,453 4636%
Other $ 3,097,186 $ 768,417 $ 2,328,769 24.81% $2,440,135 $ 708,434 1$1,731,70 1 29.03%
$ 4,883,238 34.91% $6,586,319 1$2,110,33 0 $ 4,475,989 32.04%
otals $ 7,501,985 1$12,161118,174711
Expenditures
Current Year Prior Year
• Type of Budgeted Expended Balance % { Budgeted Expended Balance %
Expenditure Amount Amount Remaining Amount Amount Remaining
Salary & Fringe $ 11,315,151 $2,835,374 $ 8,479,777 25.06% $10,435,430 $2,722,350 $7,713,080 26.09%
Operating $ 1,893,430 $ 445,904 $ 1,447,526 23.55% $ 1,595,318 $ 475,444 $1,119,874 29.80%
Capital Outlay $ 679,225 $ 166,395 $ 512,830 24.50%11 $ 206,841 $ 15,858 $ 190,983 7.67%
Totals $ 13,887,808 $3,447,673 $ 10,440,133 24.83%j $ 12,237,589 $ 3,213,652 $9,023,937 26.26%
Summary
Budgeted Actual %
FY 05-06 FY 05-06
Expenditures:
Salaries & Fringe $11,315,151 $2,835,374
Operating Expenses $1,893,430 $445,904
Capital Outlay $679,225 $166,395
Total Expenditures $13,887,806 $3,447,673 24.830
Revenue: $7,501,985 $2,618,747 34.910/(
Net County $6,385,821 $828,926 12.980/c
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Revenue and Expenditure Summary
For the Month of October 2005 8
NHCHD BOARD OF HEALTH APPROVED GRANT APPLICATION STATUS FY 05.06
Date (BOH Grant Requested Pending Received Denied
Office of Research, Demonstrations and
• 11/2/2005 Rural Health- Pediatric Prima Care Grant $50,000 $50,000
Health Carolinians-Contract Coordinator $5,000 $5,000
10/12/2005 No activity for October 2005.
9/712005 No activity for September 2005.
Wolfe-NC Public Health Association
Prenatal Grant for FY 05-06 and FY 06-07-
8/3/2005 assistance for diabetic prenatal patients. $5,000 $5,000
• allocating
North Carolina Alliance(NCAH) for $5,000 from -
Secondhand Smoke- Local Control existing PA
Initiative-if approved and awarded PA funds ' 0fro budget- • crept was
to be used for educational and $5,,00000 from approved by not approved
purposes existing PA NHC-CC by RWJ
media campaigns only. budget 9/19/05 Foundation
7/6/2005 No activity for Jul 2005.
NC Dept of Insurance- Office of State Fire
6/1/2005 Marshall- Risk Watch Continuation Grant $ 25,000 $ 25,000
HUD (partnership with City of Wilmington)
Lead Outreach and Education Program (3
year funding) $ 275,000 $275,000
Ministering Circle- Good Shepherd
Ministries Clinic supply & Equipment $ 15,000 $ 15,000 $ .
No activity for May 2005.
Cape Fear Memorial Foundation- Living
4/6/2005 Well Program $ 20,000 $ 20,000 $
National Safe Kids Coalition- Mobile Van for .
• 3/2/2005 Car Seat Checks $ 49,500 $ 49,500 $ -
Smart Start- Child Care Nursing Program $ 239,000 $ 170,000 $ 69,000
Smart Start- Health Check Coordination
Program $ 43,800 $ 43,800
Smart Start- Navigator Program $ 155,000 $ 44,000 $111,000
2/2/2005 No activity for February 2005.
Champion McDowell Davis Charitable
1/52005 Foundation - Good Shepherd Clinic $ 56,400 $ 56,400
12/1/2004 No activity for December 2004. -
March of Dimes- Maternity Care Coordination
Program educational supplies and incentives
11/712004 for pregnant women. $ 3,000 $ 3,000 $
1016/2004 No activity to report for October 2004.
9/1/2004 No activi tore ort r September 2004.
Office of the State Fifore Marshal- NC
Department of Insurance- Risk Watch
8/4/2004 continuation funding (3 ears) $ 25,000 $ 25,000
NC Physical Activity and Nutrition Branch-
Eat Smart Move More North Carolina $ 20,000 $ 20,000
NC March of Dimes Community Grant
717/2004 Program- Smoking Cessation- $ 50,000 $ - $ - $
Wolfe-NCPHA Prenatal Grant- Diabetic
Supplies for Prenatal Patients $ 5,000 $ 5,000
Totals $1,041,700 $55,000 $451,700 $485,000
5.28% ' 43.36% 46.56%
Pending Grants 2 12%
• Funded Total Request 8 47%
Partial) Funded 2 12%
Denied Total Request 5 29%
Numbers of Grants Applied For 17 100%
9.
As of 11/15/2005
NOTE: Notification received since last report.
- Program did not apply for grant.
NEW HANOVER COUNTY BOARD OF COMMISSIONERS
Request for Board Action
Agenda: Consent Meeting Date: 12/19/2005
Agenda: M :1
Department: Health Presenter: Cindy Hewett, Business Mgr
Contact: Cindy Hewett, Business Manager, ext 6680
Subject: Changes in the New Hanover County Health Department Fee Policy-
Laboratory Procedure Codes and Fees
Brief Summary: The New Hanover County Health Department is requesting to change
its current Fee Policy as it pertains to Laboratory procedure codes and fees. We are
requesting to add new procedure codes and associated fees, as well as re-implementing
use of previously assigned fees to existing procedures. We have recently learned that we
are now able to bill for referred lab services that are not included as part of a mandated
service.
Recommended Motion and Requested Actions: To accept and approve changes to the
New Hanover County Health Department Fee Policy as presented and to submit to the
New Hanover County Commissioners for consideration.
Funding Source: Private ay patients, Medicaid, Private. Insurance Com ames
• Will above action result in:
?New Position . Number of Position(s)
?Position(s) Modification or change
®No Change in Position(s
Explanation: Please see attachment for detailed information. Although the overall
impact to our budget is expected to be minimal, we are anticipating a decrease in cost and
an increase in revenue.
Attachments: Laboratory Fee and Code Information
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Attachments: 1. NACCHO RFP 2. Abstract proposal drafted b UNCW incl budget •
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• National Association of County and City Health Officials
Request for Proposal: Addressing Disability in Local Public Health
Project PAL Promoting Active Lifestyles
New Hanover County, NC Health Department
ABSTRACT
Health promotion activities are critical for people with disabilities for a number of reasons, one being their proneness to
have a sedentary lifestyle (Kailes, ham://wvnv ncpad ora%wellness/fret sheet php•>sheet=106§ion=804 According to
the U.S. Department of Health and Human Services, physical activity is one of the ten leading indicators of health
(httl2://xvww.liealtiivpeople.pov/LHI/Ihiwliat.htm Unfortunately, people with disabilities compared to people without
disabilities are less likely to engage in physical activity and are more likely to be obese
(hLtp://www.cdc.govlncbdddldhMplhidata.htm Becker (p. 236) noted that physical exercise and social support are
important for every one, but they are actually more critical for people with disabilities who sometimes have been described
as having "thinner margin of health". Therefore, the purpose of Project PAL is to increase the health and wellness of
individuals with birth defects and developmental disabilities in New Hanover County North Carolina by facilitating their
engagement in active lifestyles. Current estimates indicate there are over 28,000 individuals in New Hanover County with
disabilities, 3,169 of which are served by the school system, thus Project PAL.has the potential to effect the health and
wellness of many individuals.
In order to accomplish this, Project PAL proposes a four-pronged approach: (1) develop and disseminate information, (2)
conduct trainings, (3) create community partnerships, and (4) support existing and new active recreation programs.
1. Develop and disseminate information-poster, brochures, flyers and a website containing information about
• opportunities for inclusive and special active recreation for people with disabilities in New Hanover County will
be developed and distributed through The University of North Carolina at Wilmington, the New Hanover County
Health Department, and other health and human service agencies in New Hanover County. In addition, the health
department will promote public health services through screening and education at recreation events where
individuals with disabilities are likely to be participating.
2. Conduct trainings-health department, parks and recreation department, and school personnel are often unaware
of the benefits of active recreation pursuits for individuals with disabilities or of their potential to participate.
Therefore, in-service trainings on active recreation opportunities and accommodations will be developed and
delivered to these audiences, as well as to disability advocacy groups. In addition, fitness centers in the county will
be provided training on how to make their facilities accessible and usable by people with disabilities.
3. Create community partnerships-in New Hanover County has a number of groups who work independently to
provide active recreation opportunities for people with disabilities (e.g., Wilmington Parks and Recreation
Department, Special Olympics, the YMCA, Wilmington Disabled Athletic Association [WDAA]), and a number
of special events are held annually by other groups (e.g., Accessible Recreation Day sponsored by UNCW and
Adapted Water Sport Clinic sponsored by Vocational Rehabilitation). However, these groups rarely communicate
with each other and do not share resources. They often find it difficult to get participants and fund their programs.
Thus, Project PAL will create a community partnership among such agencies and groups as the parks and
recreation department, Special Olympics, the school system, United Cerebral Palsy, WDAA, YMCA, disability
advocacy groups, and the health department to share resources and information to increase participation in active
recreation. I .
4. Support existing and new programs-each of the programs identified above operate on very small budgets thus
can do very little marketing or outreach. Project PAL will assist existing and new programs by providing them
with financial resources to use for advertising their programs and recruiting participants and their families.
Project PAL clearly fits within at least three of New Hanover County Health Department's strategic planning priorities for
2005-reducing obesity, reducing health disparities, and increasing access to health care. In accordance with the
department's health promotion agenda to provide educational services to promote healthy lifestyles, New Hanover County
• Health Department will partner with health and recreation therapy faculty from the University of North Carolina
Wilmington to implement and evaluate Project PAL.
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Project PAL •
PRELIMINARY BUDGET
A. Contract Services/ Salary
a. Personnel Total $11,250
B. Equipment
a.. None Total -
C. Supplies
a. . General office supplies Total $500
D. Travel I
a. Local travel Total $500
E. Other
a. Website design and maintenance Total $ 550
b. Brochure design, printing, and duplication Total $1000 t`
c. Poster design, printing, and duplication Total $1000
d. $400 x 8 programs for promotion Total $3200
e. Trainings Total $1000
L Evaluation Total $6000
Grand Total Requested $25,000 l
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• NACCHO 1100 17th Street, NW
Second Floor
Washington, DC 20036
Phone: (202) 783-5550
Fax: (202) 783-1583
REQUEST FOR PROPOSAL
Addressing Disability in Local Public Health
***Applications must be received by December 9, 2005***
BACKGROUND
In the past 30 years, definitions of disability continue to evolve. During the 1970s, the concept of
disability referred to an underlying physical or mental condition. Today, disability is seen as a
complex interaction between an individual and his or her environment.' "According to the U.S.
Census Bureau, there are nearly 50 million Americans with some type of disability, including
• long-term physical disability, such as those associated with spinal cord injury, cerebral palsy, or
spina bifida; sensory disabilities such as hearing loss and visual impairment; and cognitive
conditions like intellectual disability."2
Serious challenges confront persons with disabilities, such as limited access to the range of
activities, programs, and services that promote healthy living. In fact, "research shows that
people with disabilities often have more problems accessing social and recreational activities,
employment, and health care than people without disabilities."' Furthermore, individuals with
disabilities are more susceptible to developing secondary conditions, which are additional health
problems either directly related to, or worsened by a primary condition. Such secondary
conditions include, but are not limited to, pain, fatigue, obesity, isolation, and depression.
In January 2005, the National Association of County and City Health Officials (NACCHO)
conducted a series of key informant interviews. The purpose of the interviews was two-fold: (1)
to explore the role that local health departments play in providing services to individuals and
their families affected by birth defects and/or developmental disabilities, and (2) to help shape
priorities and develop resources to support local health departments in their work.
Relative to other priorities, most respondents considered health promotion for people with
disabilities a high priority. Despite the importance, however, most also reported a limited ability
• ' U.S. Census Bureau. littol!%~~w.aen.,us.i,,ov.hhesl%k~Av/disabilitN/o%,erview.html. Downloaded. October 26, 2005.
2 Centers for Disease Control and Prevention. National Center on Birth Defects and Developmental Disabilities. Disability and
Health: Promoting the Health and Well-Being of People with Disabilities, 2004.
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to address the issues, due to insufficient funding and staffing and the health department's ~
emphasis on other priorities (e.g., bioterrorism/emergency preparedness). .
NACCHO, with guidance and funding from the National Center on Birth Defects and
Developmental Disabilities of the Centers for Disease Control and Prevention (CDC), is
undertaking a project to improve the capacities of local health departments in addressing th
health and well-being of individuals with disabilities. The purpose of this project is to: (1) 1
provide funding to local health departments that demonstrate the need for supplemental resources
to improve support systems for health promotion of individuals with disabilities; and (2) offer
local health departments guidance and support for health promotion of persons with disabilities
through models and strategies developed as a result from this project. NACCHO will provide
funding to local health departments through a competitive grant process.
AVAILABILITY OF FUNDS
NACCHO plans to award approximately $70,000 to local health departments to: 1) plan andl
implement an innovative means by which to address health promotion of persons with
disabilities, and 2) collect preliminary performance and evaluation data on the intervention. The
project duration will be 12 months (with a possibility of a no-cost extension to finish project
implementation) and the total award per grantee will range in size with a maximum award of
$25,000. NACCHO plans to announce the selected local health department(s) in January 2006. •
The proposed budget amount must include both direct and indirect costs. Funding estimates for
the overall program and for the individual project may change.
APPLICATION REQUIREMENTS
I
A. Eligibility
To be eligible for this project, the applicant must:
• Be a local health department;
Work collaboratively with NACCHO, the National Center on Birth Defects and
Developmental Disabilities (CDC), and established partners;
• Agree to fulfill expectations for participation.
B. Application Procedure
I
Applicants must submit to NACCHO the Application Form, a statement of intent with regard
to the Criteria for Selection, a proposed budget request, and an evaluation plan. Applicants
must clearly demonstrate a desire and ability to incorporate and enhance health promotion1for
people with disabilities within their jurisdiction.
NACCHO strongly encourages.projects that focus on coalition building between public anld
private stakeholders. All applicants should indicate how this project will be evaluated and
how the essential public health services will be addressed (see Appendix A).
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Applications are due December 9, 2005. Applications received after the deadline will not
be considered for funding. Letters of support are not required.
C. Budget
Submit a complete line-item budget request and a detailed justification consistent with the
purpose and objectives of the project. Items that may be included in the request for funds are
staff salary and fringe benefits, phone/facsimile, postage, field equipment, travel, and
contractual fees. For a sample budget, see Appendix B.
Project funds can support the purchase of field equipment, if the purchase meets the needs
outlined in the application and will help to achieve replicable knowledge. Funds cannot be e'
used for the purchase or upkeep of office equipment. Additionally, project funds cannot be
used to purchase food or beverages.
CRITERIA FOR SELECTION
NACCHO will use the following criteria to review the applications. Please note that the criteria
will be weighted according to the percentages given below.
• The rationale or problem statement that explains a) the need for developing or enhancing
health promotion for people with disabilities within the community; b) the anticipated
impact of the proposed activities, and c) the target population to be served (30%).
? What is the public health issue the project addresses?
? How does the project address the issue?
? What process was used to determine the public health issue's relevancy to the
community?
? Who is the target population or audience? What is the number or percentage of
the population to be reached?
? What are the goals and objectives of the project?
• A project description that includes a timeline and innovative method(s) or innovative
applications of proven methods for addressing the problem statement (20%).
• Specification of resources (e.g., training, staff, and technical assistance) needed to
conduct this project (15%).
Distinguish which resources are available to contribute to the project and those that you
would need to acquire. Also describe any relevant experience your department has in
addressing the focus area.
• A plan for assuring a collaborative approach in addressing the health and well-being of
individuals with disabilities (15%).
•
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The local health department should have a role in the project's development and •
implementation. Additionally, the project should demonstrate broad-based involvement
and participation of community partners (e.g., healthcare professionals, governmental
partners, local residents, the business sector, educational institutions, etc.). If relevant,
the project should also demonstrate cooperation and participation within the department
(i.e. other department staffi.
> What is the local health department's role in this practice?
> What is the role of stakeholders/partners in the planning and implementation of
the practice?
How will the LHD foster collaboration with community stakeholders? Describe
the relationshipls and how it furthers the practice's goals.
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• Applicability of the proposed project to other public health programs and practices I
nationwide (10%).
How will your project benefit other local health departments in addressing disability? Is
it feasible for other local health departments to replicate the project?
• An evaluation component to measure the effectiveness of the proposed project. Briefly
describe how the project will address the essential public health services. All ten essential
services do not need to be addressed. (see Appendix A) (10%).
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Evaluation assesses the value of the practice and its potential worth to other local health •
departments and the populations they serve. It is also an effective means to assess the
credibility of the practice. Evaluation helps public health departments maintain
standards and improve the practice.
In addition, applicants are encouraged to address the following elements in their application:
sustainability of the project and demonstration of leadership in the field of disability.
PROCESS FOR SELECTION
All proposals will be carefully reviewed by a NACCHO peer review panel for the extent to
which they meet the criteria defined above and rated based on the following:
• Completeness (includes application form, written proposal, and budget);
• Evidence of health department capacity in working on health promotion of persons with
disabilities;
• Demonstrated partnerships and collaborations;
• Demonstrated need;
• Innovation within the community;
• Realistic work plan (e.g., time line, goallobjectives)
• Reasonable outcomes;
¦ Realistic and appropriate evaluation plan; and
• Realistic and appropriate budget.
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• EXPECTATIONS
The participating local health department(s) will be responsible for completing the activities
described in its proposal. The health department(s) will also work closely with community
residents, other state and local agencies, peer advisors, and NACCHO, as necessary, in
conducting the project work. The selected health department(s) must complete the following
activities or submit the following documents to NACCHO;
• A semi-annual report describing the implementation of the project;
• An expense report for the project;
• An evaluation of project activities; and
• A final report including a compilation of findings and lessons learned for distribution to
local health departments as appropriate (e.g., through the development of written
materials, conference presentations, site visits to peer communities, etc.).
SUPPORT FROM NACCHO
NACCHO makes a commitment to provide the following support to the chosen health
department(s):
• Overall multi-site project coordination which may entail periodic conference calls or
• meetings;
¦ Consultation as needed in the design, implementation, and evaluation of activities;
• Financial support (per a contractual agreement process); and
• Access to peer advisors to support and assist the project.
WHAT TO INCLUDE IN APPLICATION PACKAGE SUBMITTED TO NACCHO
• A completed application form.
• A written proposal that addresses the Criteria for Selection. Limit the proposal to five
pages in length (12-point font/single-spaced), excluding attachments.
• A proposed budget and timeline. For a sample budget, see Appendix B.
• Please send your application package via:
o E-mail: jlinaccho.org (preferred) OR
o Mail: Hard copies of application packages are also welcome. Please include one
original application package and three additional copies, and mail to:
Jennifer Li, Program Manager
NACCHO
1100 17th Street, NW
2nd Floor
Washington, DC 20036
• Applications are due December 9, 2005.
•
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WHERE TO OBTAIN ADDITIONAL INFORMATION
For further information about the application procedures and program technical assistance,
contact Jennifer Li at (202) 783-5550, Ext. 234 or jli(a?naccho.org. ;
For additional information on disability data and resources:
2004 Disability Status Reports (
http://ww",.ilr.cornell.edu/ped/disabilitvstatistics/index cfm?n=1)
American Fact Finder (htW-.//factfinder.cen-,us.gov)
Christopher and Dana Reeve Paralysis Resource Center
(www.paralysis.org) or (800) 539-7309
Cornell University (http://NnAnA,.ilr.cornell.edu/ped/disabilitystatistics/about cf n#content) k
'Healthy Athletes Program (http:/hvww specialolvm ip es org)
National Center on Birth Defects and Developmental Disabilities, CDC
http://www.cdc.L2,ov/ncbddd
)
National Center on Physical Activity and Disability (http://wW~i.ncpad.ora)
National Limb Loss Information Center
(http://w'ww.amputee-coalition.ora/nllic about.html)
• U.S. Census Bureau (http:/hvww,census.aov)
1
21
NEW HANOVER COUNTY BOARD OF COMMISSIONERS
Request for Board Action
Agenda: Consent Meeting Date: 12/07/05
Agenda:
Department: Health Presenter: Scott Harrelson
Contact: Scott Harrelson 343-6592
Subject: Customer Service Program
Brief Summary: During the past year the Health Department's Quality Assurance Team
has assessed the need for a continuous customer service program for the entire
department. This has also been addressed as a point of interest for the county through the t
county's customer service group made up of employees from various departments.
We wanted to find a program that offered front line techniques as well as supervisory and
managerial training. We have found a reputable group which offers training for medical
and non-medical personnel and line staff as well as upper management. The first year of
the program would involve TCA Companies in assisting us to develop service standards
for our department and providing a 2 day program for up to 36 managers and supervisors
which would include the cost of the facilitator and all materials. The premise of the
• program is to train our staff to be trainers and then to have our staff carry out the sessions
for the entire department. The entire program would take approximately 3 years to
implement. Most of the expense would be incurred during the first two years, During
year one the cost would be $8,000.
Recommended Motion and Requested Actions: BOH to accept and approve allocation of
$8000 to develop service standards and provide the "Leading Empowered Teams" in
Service Quality Excellence training to 30 of our management and su ervisor staff.
Funding Source: AHEC Training fund $3000, Local BT funds $2500, Medicaid
Maximization funds $2500
Will above action result in:
QNew Position Number of Position(s)
QPosition(s) Modification or change
®No Change in Position(s)
Explanation: NHCHD staff will administer programs once properly trained.
Attachments: 1) Proposed Contract 2) Building Customer Service Standards 3) Reference
letter from previous user 4 Presentation handout for a similar, but not exact program
•
22
7, e.,4 eanjBaalea August 3, 2005
With PROPOSAL FOR:
sand) Philips ossociotes
Mr. Scott Harrelson
Director of Health Programs Administration
New Hanover County Health Department
2029 South 17'e Street
Wilmington, NC 28401
New Hanover County Health Department's Service Excellence Initiative
PHASE I (Year 1) July 1, 2005 / June 30, 2006
Management Team and Supervisor Training
"Leading Empowered Teams" in Service Quality Excellence
• A 2-day program for up to 30 Managers
Includes Facilitator and all materials $8,000.00
Year 1 total investment $8,000.00
Agreement, Contract, and Invoice
This agreement supercedes all other proposals and agreements between the two parties.
The New Hanover County Health Department may add quantities to this agreement at the stated cost at any time.
Invoice amount above is due upon signing this agreement or 60 days prior to the first scheduled activity.
Note: All investment is plus travel and lodging
AGREED TO BY BOTH PARTIES AS STATED BELOW
New Hanover Health Department Date
TCA Companies and Sandi Philips Associates Date
•7.eA &.A44iea. P.O.'S'ax1250. ;D=d..Ire273. 1-fff-773-0459-- 919-542-6602-- 57.919-542-51F0
ta[.u.~yteaee. cewr. - 9kaY as GFe wad : tcaan. co.+23
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NEW HANOVER COUNTY HEALTH DEPARTMENT
BUILDING CUSTOMER SERVICE STANDARDS
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T Establish a small committee
(A) Have representatives from each department that will utilize the
standards.
(B) Establish meeting dates and date for completion of project.
2 First Committee Meeting
(A) Review standards of other organizations and other recommended
standard customer service standards.
Select a model and scope and customize it to the needs of the Health
Department. •
(B) What departments and leaders will implement standards?
(C) How will the standards be implemented? i
(D) How and when will associates be reviewed, compared to the standards.
I
3 Publish recommended standards and get reviews from all departments
prior to finalizing standards.
(A) Receive feedback, adjust standards as desired.
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4 Finalize standards and implement.
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(A) Set up associate review.date or dates.
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WD,
O3 4 .
2
;,#tx Arthur R. Kamm, Ph.D.
PresidendCEO
January 16, 2002
Mr. Jess Spiller
TCA Companies
P.O. Box 1250
Pittsboro, NC 27312
3500 Repwy Pmkmy - ~ .
s we a Dear Jess:
c-7, nc Now that my company has completed 2.5 years of training, I'd like to share with
27517 you some of the benefits we have derived from your programs. It is clear to me
that the training must be continuous; I found reinforcement to be important in
growing a customer service culture as well as indoctrinating new employees into
that culture.
Phone (919) 460-0801
•
Pas (919) 460.6026 The People Principle" concept, a people building process, has produced positive
results not only on the corporate level, but on the personal level for our employees
miwae,henun.cem as well. Enhanced productivity and the ability to provide exceptional customer
service does begin with the basic concept that people must feel good about
themselves. The response to the training has been great both from management
and the team. By combining training in the areas of Customer Service, Team
Building, Communications and Management Skills we have achieved results
beyond what I anticipated including:
1. Employee turn-over rate has dropped to near zero;
2. Enhanced enthusiasm and team play; and,
3. A significant Increase in profitability over the past year.
I look forward to our continued relationship.
Sincerely,
Arthur R. Kamm, Ph.D.
President
• AR Kamm Associates, Inc.
25
Who Gets To Decide
if the service you deliver Is
"Partners in Caring" Poor, Satisfactory, or Outstanding ?
Delivering Exceptional Healthcare l e 4pk
Customer Focused Service L'
A Strategic, Plan For
New Hanover County Health Department
"'We do"
Enhanced Customer Your Internal Customers, "Who are we?"
Your External Customers, "Who are we?"
Focused Service ,
WHY PEOPLE ABANDON "Partners in Caring"
HEALTHCARE PROVIDERS The Customer Service Driva,HeamrcareCulture.
The Blue Anew represents a Cultural Change aver fine.
• 64% Due to personal treatment The Red Arrows represard what happens without M Fix aunt
(Customer service)
r '
• 23% Due to time issues j=F~
• 20% Due to quality of medical care 3 I. a amq
2
Tams • 3% No reason given • Ca,OY~IeJJwYYaq u+.alldnsY '
r
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Year One "Partners in Caring"
• Planning and Assessments The Customer Service Driven Healthcare Culture.
Do we have a plan in lace for improving The eta` Arrow "p'°""' a eaMUral eh"Ipe oeer ema.
P The Red Arrows mpraaerdwhat happ"mwHhaat mhmarDsulart.
healthcare customer service?
Do we have a system in place to be sure we hire •aN•a
only people who can be good customer service
providers? Y«r2 I °
• Leading Empowered Teams in Healthcare 6 FbWH.rtle:.r Vidwuerary
Service Excellence. I x.
Directors and Managers must not only buy into Yrrl , s oeea d.. c.aq,.ga _
the concept of exceptional healthcare customer 3 la°Me6~;
service they must "walk the talk°I 2 moo. afa
• The Essence of Caring a classic training ° asap aapaa•r•a Hr"om e. eMh"a.Twm.
program for everyone in The Organization PI mini "W A~
preceded by two days of facilitator training. ° a `
e I .
"Partners in Caring"
Year Two The Customer Service Driven Heardr CuNum.
Blue Arrow npresan~ a CW Wral a~arq. w" tlma.
The
Attaining Excellence in Healthcare Customer Service The Red Ar Wepms"dwhrthapoemwunart
A training program for all Directors & Managers.
Adds to the skills of LETI
Good Idea CamPai9n Y.er3 6 6 H.. R.Nm.
co"e.vbg.cmq,.ya
30 day Award Program that gets everyone creating T ra..ao.aormp RArwMr
new ways to improve customer service! Ways you Ywr3\ 6 9.rvkeFlr.aHWtlramvwoub.ry
haven't even thought of! \ 6 Been u.. ce"ntpn
Yrrl -•d"ba6.o~l~'°la H•°Itl'c•m CU"omw 6•rvia
. Service First Healthcare Video Library .wro. afirbg
A library of 12 video sessions allowing Directors, H.drhe•m a.Mc. 6•wa Teeme
Managers, and Team Leaders to select the topic and Awewiwrb
they want to reinforce! 4r<
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"Partners in Caring"
Year Three The Cudmoer service Dduen Healeheara CUlahra.
The Blue /urun represanls a Cultural Change wer dean.
• Essence of Caring The Red Arrows rsprasadwlul bappeswRAau MORL
A Customer Service refresher training program soe~a=_
for all employees!
Trra a• b°••o°
• Cost Savings Campaign L5 A 30 day award program involving everyone, looking for cost savings, reducing waste, yam" at HeeMean vhaeo U1xv y
preventing errors, and improve efficiencies! y~rh 1, a bn t.
NMMUn QMawr MMp
• Good Idea Campaign Is Back
_ ~3
A 30 day award program that again involves wens .fie ee aseeg.K. r..o. .
everyone as they look for ways to continuously °"""'g •"^~y
improve customer service! r«h..e
a arh.. m
•
•
28
NEW HANOVER COUNTY BOARD OF COMMISSIONERS
Request for Board Action
Agenda: Consent Meeting Date: December
Agenda: ® 19, 2005
Department: Health Presenter: David E. Rice, Health Director
Contact:David E. Rice
Subject: Influenza Vaccine Supply Resolution
Brief Summary: The North Carolina Association of Local Health Directors, at its
meeting on November 17, 2005, requested local boards of health and county boards of
commissioners to adopt a resolution regarding the supply of influenza vaccine. The
resolution is requesting support by local boards to address sufficient federal funding of
adult vaccine infrastructure, including influenza as a primary component. The resolution
also requests guaranteed government prices for influenza vaccine and bulk purchase for
public health. During the past few years, New Hanover County Health Department has
been challenged in its ordering of enough influenza vaccine to meet the demand.
Recommended Motion and Requested Actions: To recommend approval of the Influenza
• Vaccine Supply Resolution to the New Hanover County Board of Health and submit to
the New Hanover Count Commissioners for their consideration.
Funding Source: N/A
Will above action result in:
?New Position Number of Position(s)
?Position(s) Modification or change
®No Change in Position(s)
Ex lanation:
Attachments: Influenza Vaccine Supply Resolution
•
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Influenza Vaccine Supply Resolution
New Hanover County Board of Health
New Hanover County Board of County Commissioners
New Hanover County, North Carolina
Whereas each year, a substantial proportion of vaccine-preventable diseases occur among adults, despite
the availability of safe and effective vaccines; and
Whereas, adult immunization levels continue to lag far behind childhood rates, and adult morbidity and
mortality from vaccine-preventable diseases remain distressingly high; and
Whereas, adults form the core infrastructure needed to respond to any emergent public safety and health
need; and
Whereas, the burden of and responsibility for vaccinating high-risk and vulnerable populations often falls
upon public health departments and their public partners; and
Whereas, public health is often unable to serve the high-risk and vulnerable populations within a
community because of a lack of timely distribution of vaccine, especially influenza vaccine; and
Whereas, commercial vaccinators make early bulk purchases of influenza vaccine and are able tol offer
mass flu campaigns before public health can vaccinate high-risk populations; and
Whereas, the federal government and local medical providers look to the public health infrastructure to •
be prepared to respond to and coordinate the response of any communicable disease outbreak, including
an influenza pandemic; and
Whereas, the federal government has provided support for the childhood immunization program
nationally that has resulted in dramatic reductions in childhood vaccine preventable diseases; and
Whereas, an adult immunization infrastructure is needed prior to implementation of a national universal
influenza vaccine recommendation; now
Therefore, in recognition of this compelling public health challenge, the New Hanover County Health
Department and the New Hanover County Commissioners request that:
• Sufficient federal funding be identified to support a robust adult vaccine preventable disease
vaccination infrastructure and program that would include influenza as a primary component;
• Guaranteed government prices for influenza vaccine be offered as an incentive for vaccine
production to meet the demand;
• Federal government bulk purchase a base number of doses for public health;
• Regulations be created to guarantee distribution to public agencies first; and
• Enforcement rules be developed for providers who disregard high-risk vaccination criteria-
I
Adopted this day of 12005
Donald P. Blake, Chairman Robert G. Greer, Chairman .
New Hanover County Board of Health New Hanover County Board of Commissioners
• I
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FT
X9 odb~
New Hanover County Board of Health
2006 Meeting Dates
A
• January 4, 2006
• February 1, 2006
• March 1, 2006
• April 5, 2006
• April 13, 2006 - Staff Appreciation Luncheon
• May 3, 2006
• June 7, 2006
• July 5, 2006
• August 2, 2006
• September 6, 2006
• October 4, 2006
• November 1, 2006
• December 6, 2006
• December 14, 2006 - Holiday Celebration
•
31
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NEW HANOVER COUNTY
HEALTH DEPARTMENT
2029 SOUTH 17TH STREET
WILMINGTON, NC 284014946 "'N"""°
TELEPHONE (910) 343-6500 FAX (910) 3414146
December 1, 2005
Gary Gams
Cape Fear Memorial Foundation
2508 Independence Blvd, Suite 200
Wilmington, NC 28412
Mr. Gams:
Thank you for the opportunity to submit a letter of interest on behalf of Cape Fear
Healthy Carolinians (CFHC) to combat the growing obesity problems of New Hanover
County.
As we discussed the Obesity Sub-Committee of CFHC has been growing a community
• coalition of concerned parties including representatives from virtually every sector of our
community in strong support of a coordinated effort to this health crisis. Background .
research has supported our belief that the only way to successful intervene is through a
systemic approach to impact the lack of physical activity and increasingly poor eating
habits.
The committee has been diligent in its efforts to review available research regarding
what approaches to community based interventions seem to have the greatest promise,
not just of participation in programs, but in actual improvements in health status. In
reviewing the resources that are currently available in the community and evaluating
what interventions would be appropriate for implementation, this coalition has
developed a plan that encompasses the following: 1. changes in policy (e.g. school
nutrition and physical education requirements, open space policy, etc.); 2. Changes in
the physical structure of the community (e.g. walking trails, increased access to safe
public environments, etc.) 3. Organizational programs (e.g. within the schools, church
programs, business based wellness programs, etc.) and 4. interventions targeting
individuals and groups (e.g. information and referral program, diabetes mail walks,
neighborhood trails program, etc.). These programs would be introduced in the context
of a coordinated community wide multimedia education and awareness campaign.
The Obesity Sub-Committee envisions a program that will last from three to five years
as we create increased awareness and implement infrastructure that we expect would
• become self sustaining. This effort would be a coordinated effort from the organizations
listed in the attachment as well as other organizations that may join the coalition as it
unfolds and expands. We are anticipating that Kate B Reynolds Charitable Trust will be
partnering with us in this endeavor. Additionally, we will be collaborating with the City of
Wilmington in applying for a small ($30,000) grant to the Fit Communities program of the
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NC Health and Wellness Trust Fund request under Mayor Broadhurst's leaders lip... `
We are requesting $300,000 over three years to establish the necessary infrast I cture •
to coordinate the community efforts, assist in the implementation of the multiple ~
programs, direct the community educational campaign, establish additional funding
sources and provide technical assistance to various partner organizations. These funds
would be utilized to contract with a coordinator, pay for administrative support, ai d
cover basic start up expenses.
As we discussed, the coordinator's role would be to supplant rather than replace the
efforts of the community partners. The process of integrating the many community
partners, organizing the various programs and providing the necessary technical,
assistance and professional expertise will require more resources than Healthy i
Carolinians currently has available. It is the clear consensus of the Obesity. Sub
Committee that a systemic community approach is the only way that we, can make a
significant and sustainable difference. In order to accomplish that, the initial priority
established unanimously by the Obesity Sub-Committee was to contract a coordinator
with a background in health, community development, grant writing who would lead the
coalition and bring the necessary time and expertise to this ambitious undertaking. It is
not the expectation of the CFHC that we would establish a new agency or organization,
but rather add time-limited resources into the current efforts of increasing awareness of
the issue of obesity in New Hanover County.
Certain portions of the target population fall outside the target population of Wilmington
Health Access For Teens. Therefore another member of the CFHC is needed to Abe the
fiscal agent. In considering which of the CFHC partners would be the, most logical fiscal
agent for this grant request we identified the New Hanover County Health Department
to be the fiscal agent.
Our proposal, pending formal approval by the New Hanover Board of Health and the
New Hanover County Commissioners, would be to have the Coordinator be contracted
through the New Hanover County Health Department. In the spirit of community and
interagency cooperation, UNCW Division for Public Service and Continuing Studies has
agreed to donate in-kind space and additional resources to support the Obesity Sub-
Committee's efforts in this endeavor.
We would appreciate your consideration of this program.
I
Respectfully,
rg Figueroa, M.D. David Rice, Director
Chair, Cape Fear Healthy Carolinians New Hanover County Health Department
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To: Local Health Directors
From: Chris Hoke, NC Division of Public Health
Jill Moore, UNC Institute of Government
Subject: New Guidance on Local Health Departments' Collection and Use of Social
Security Numbers
Date: November 30, 2005
We have attached new guidance on your collection and use of SSNs. This replaces all
previous guidance on this issue. Please discard the earlier information you received from
us. The most significant changes from previous guidance are:
• We have chanited our position on when local health departments may collect
SSNs from their clinical clients. We have received additional information from
state and local public health agencies that have made clear that the public health
system must be able to uniquely identify individuals statewide to carry out a
number of legally'prescribed duties and responsibilities. For this reason we
believe you should continue to collect SSNs from all patients who have them and
are willing to provide them to you. Our reasoning is explained in much greater
detail in the attached Q&A document under question 3.
• Although we now believe you can continue to collect SSNs, the new law requires
you to segregate them from the rest of the record. We consulted with Joy Reed on
how to do this. Our detailed recommendations are under question 6. In brief they
are:
o Paper records: Record the SSN only on the Personal Data Sheet. Stop
using the SSN on every page of the patient chart. Use your locally devised
chart number instead.
o Electronic records: Record the SSN on HSIS's patient master. HSIS will
make the changes necessary to prevent the number from displaying on
other screens.
• The new law requires you to document your need to collect and use SSNs. We
have developed a new sample document for this purpose. See also question 8.
• The new law also requires you to develop a statement of the purposes for which
you collect and use SSNs to provide to patients upon request. Other laws require
you to provide some additional information. We have developed a new sample
statement of purpose that you may use. See also question 9.
This guidance is limited to collection of SSNs from LHD clinical patients. It does not.
address collection of SSNs from employees, vendors, or others. Furthermore, the
guidance focuses on requirements of the new law that are effective 12/1/05. There are .
additional requirements that will be effective 7/1/07. We will provide guidance on those
early in 2006.
S.L, 2005-414 (S 1048) Identity Theft Protection Act:
Background Information'& Preliminary Gi idance
Revised 11/30/05
Chris Hoke,.N.C. Division of Public Health
Jill Moore, UNC Institute of Government
Note: This replaces all earlier versions of this document Please
discard any version with an earlier dale.
1. What does S 1048 do?
S 1048 restricts government agencies' collection and use of social security numbers. The
restrictions that are of most immediate concern to local health departments are those that
require compliance by December 1. 2005. As of that date:
• State and local government agencies may not collect SSNs from individuals
unless:
o The agency is specifically authorized bylaw to collect the SSN, or
o Collection of the SSN is imperative for the performance of the agency's
® legally prescribed duties and responsibilities
• An agency that is permitted to collect SSNs under one of the above standards
must clearly document that it is permitted to collect SSNs.
• An agency must provide individuals whose SSNs are collected with the following
information: (1) whether provision of the SSN is voluntary or mandatory, (2) the
statutory or other authority that allows the agency to ask for the SSN, and (3) the
uses that will be made of the SSN. Upon request, the agency must provide the
individual a written statement of the purpose(s) for which the SSN is collected
and used., Agencies must not use SSNs for any purpose other than the purpose(s)
stated.'
• An agency that collects SSNs on or after December 1; 2005 must segregate the
SSN from the rest' of its records, by keeping it on a separate page or otherwise
separating it from the rest of the information so that, it can be redacted if the
record is disclosed.
S 1048 requires agencies to provide the written statement of the purposes for which the SSN is collected
and used to individuals upon request. However, local government agencies must also comply with the
Federal Privacy Act of 1974 and North Carolina's State Privacy Act (GS 143-64.60). Those laws require
® government agencies to inform an individual from whom an SSN is requested whether the provision of the
SSN is voluntary or mandatory, the statutory or other authority that allows the agency to ask for the SSN,
and the uses that will be made of the SSN.
Hoke & Moore/November 30, 2005 I
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2. May local health departments continue to collect SSNs after December 1, 20059I
Yes, if(1) the local health department (LHD) is specifically authorized by lawto collect
the SSN, or (2) collection of the SSN is imperative for the performance of the local health
department's legally prescribed duties and responsibilities. f
This document addresses the collection of SSNs from LHD clinical clients only. LHDs I
may also collect SSNs from employees, vendors, and others. LHDs should consult with
their local government's administration regarding the collection of SSNs for those
purposes.
n.
3. May LHDs collect SSNs from all clinical clients?
We believe the answer is yes.
To reach this conclusion, we have had to consider what it means for collection of SSNs to
be "imperative" for the performance of the LHD's legally prescribed duties and
responsibilities. S 1048 does not define what it means by "imperative," but it seems clear
that SSNs may not be collected merely for administrative convenience - the SSN must beI
needed for some purpose that cannot be served by any alternative.
Until there is an alternative "em for creating unique identifiers for every resident of
North Carolina we believe collection of SSNs will be imperative to the performance of
several of the local health department's legally prescribed duties
North Carolina's public health system must be able to identify specific individuals in
order to carry out its duties related to disease surveillance, investigation, and control.
Unique identifiers are required to de-duplicate statewide data used for public health
surveillance. Furthermore, there are public health programs or operations that must be j
able to accurately identify individuals. In a state with a population of more than 8 million,
this cannot be done without unique identifiers for individuals.
At this time, the SSN is the only unique identifier that is available to the public health
system. HSIS has the capability to produce alternative identifiers that are unique within a
local health department's jurisdiction, but it is not capable of producing altemative
identifiers that are unique statewide. Within the next couple of years, it is expected that a
new system will replace HSIS that will be capable of assigning unique identifiers that are
not SSNs. In the meantime, collection of SSNs from patients will be imperative to the
performance of several legally prescribed duties, including: j
• Public health surveillance
• Communicable disease control j
• Investigation and control of public health threats during a bioterrorist incident or
other public health emergency
• Submission of specimens to the state public health laboratory
• Newborn screening program
• Identification of individuals in the NC Immunization Registry
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Hoke & Moore/November 39, 2005 2
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• Purchase of medical care programs, such as the AIDS Drug Assistance Program
• Breast and cervical cancer screening program
In addition;-the SSN is presently the only unique identifier available to local health
departments for the following administrative activities that are necessary for the LHD to
carry out its legally prescribed patient care duties:
• Locating the medical record of a patient whose chart cannot otherwise be
specifically identified. (Identifiers such as name and date of birth are not always
sufficient to this purpose, since they may not be unique.)
• Accessing or billing third-party insurance systems that still fely on SSNs as
unique identifiers.
4. Are there otl er purposes for which LHDs may collect SSNs from clinical clients?
Yes. Local health departments may collect SSNs when they are specifically authorized by-
law to do so. As of 11/30/05, we have determined that LHDs are authorized bylaw to
collect SSNs from clients in the following circumstances:
i To participate inthe debt set-off program. GS 105A-3. (Note that this only
applies to LHDs that participate in that program)
• To make presumptive eligibility Medicaid determinations. GS 108A-25(b);
l0A NCAC 22K0102.
® Note: The presumptive eligibility Medicaid form (DMA-5032) provides a
space for the pregnant woman's SSN and the form instructions-direct
providers to enter the number. The Division of Medical Assistance has
advised us that LHDs must ask for this number from their pregnant clients
for whoIn they are determining presumptive eligibility. However, if the
woman does not have a SSN or refuses to provide it, the LHD may leave
the space blank and the woman may still be certified as presumptively'
eligible.
There may be other circumstances in which LHDs are authorized or required by other
laws to collect SSNs from their clients. For example, we are still reviewing programs that
require LHDs to verify clinical clients' financial eligibility. Whether the SSN may be
collected to carry out that purpose may vary by program. -We will provide further
guidance on this issue when we have' it.
5. What must LHDs do.to comply with S 1048 with respect to the SSNs they collect
from clinical'clients on or after 12/1/05?
Local health departments must:
• Develop and maintain an internal document explaining why the LHD is
authorized to collect SSNs from clinical clients: (Sample attached.)
• Develop a statement of the purposes for which the SSN is collected and used to
give clients upon request. The'statement must explain that provision of the SSN is
Hoke & Moore/November 30, 2005 3
voluntary, the authority by which the SSN is collected, and the purposes, for
which it will be used. (Sample attached.) I
• Segregate the SSN from the remainder of the record This will require most LHDs
to change some of their current practices. See the next question.
6. How should the LIID segregate the SSN from the remainder of the record?
Paper records: The SSN may be entered on the patient Personal Data Sheet (Form DHHS
2800 in the Problem Oriented Health Record) under "Social Security No." It is our
understanding that the current practice is for the patient's SSN to appear on every page of
the patient's chart. This Practice must change. It is also our understanding that local
health departments have their. own systems for assigning "chart numbers" that are distinct
from the patient ID number. Beginning December 1. 2005, local health departments
should use the locally devised chart number rather than the SSN on each nape of newly
created charts and on new pages added to existing charts The forms in the state Problem
Oriented Health Record that currently provide a space for "Patient number" or "Social
Security Number" will be changed Until the forms are changed, put the chart number
rather than the SSN on any POHR form that requests a patient number or SSN except the
Personal. Data Sheet (put the SSN on that one only).
HSIS: The SSN may be entered into HSIS on the Patient Master under "ID Number." At
present, the patient ID number is visible on every screen to some users. However, HSIS is
planning to make a change that will prevent the display of SSNs on pages other than thel
patient master. - '
7. What about the SSNs that LHDs already have in their records that are not
segregated from the rest of the chart? Does the new law require local health
departments to remove those numbers from every place they appear in the old
charts?
Effective December 1, local health departments should be segregating SSNs as described
in question 6 above, but we do not believe you have an immediate duty to go back into
old charts and remove SSNs that appear elsewhere in the chart. S 1048 has other
provisions that government agencies must comply, with by July 1, 2007, which may affect
health departments' use of SSNs you already have in the system. Those will be addressed
in a later guidance document.
8. How should a LHD document its collection and use of SSNs from clinical clients?
The LHD must clearly document that it is permitted to collect SSNs. It appears that this
document can be internal. There is no requirement that this document be filed anywhere
other than in the local health department, but the department should be prepared to I
produce it upon request. We have provided a sample document that a LHD may use. The
sample should be modified as needed to reflect the LHD's actual collection and uses of
SSNs. For example, a LHD that does not participate in the debt set-off program should
not document that it will collect and use SSNs for that purpose.
Hoke @ Moore/November 30, 2005 1
9. What must be included in the information given to patients regarding collection
and use of SSNs?
The LHD must provide individuals whose SSNs are collected with the following
information:
• The purpose(s) for which the SSN is collected.
• Whether the individual's provision of the SSN is voluntary or mandatory.
• The use(s) that will be made of the SSN.
This information may be provided orally at the time the SSN is collected, but a written
statement must be provided to the patient on request. A sample is attached
Some of these requirements come from S 1048, but others come from the Federal Privacy
Act of 1974 and the State Privacy Act (G.S. 143-64.60). The requirement that you tell the
individual whether provision of the SSN is voluntary or mandatory comes from the .
federal and state privacy acts, not S 1048. Local health departments may not require
individuals to provide SSNs under the privacy acts, so a LHD's collection of SSNs must
be identified as voluntary.
The LHD must not use SSNs for any purpose other than the purpose(s) in the statement.
® 10. What should a LHD do if a patient does not have or refuses to provide a SSN?
The LHD should use HSIS's alternative formula for assigning a patient identifier. This
will not provide a unique identifier that can be used statewide, but since provision of the
SSN is voluntary under the Federal Privacy Act, this is the best the LED can do until
there is a new system that provides an alternative unique identifier.
11. What should local health departments do right away to comply with S 1048?
Local health departments should immediately focus on the following key activities:
1. Chauee the LHD's policy about where SSNs are recorded in LHD records. In
the paper record, the SSN should appear only on the patient Personal Data Sheet,
under "Social Security Number." Stop using the SSN on each page of the
patient's chart. Use the chart number instead. On the electronic record, record the
SSN under' ID number" on the patient master. HSIS will make the changes
required to segregate this number electronically.
2. Document the circumstances under which the health department will still be
permitted to collect SSNs.
3. Develop a statement as described in question 9, ensure that the information
described in question 9 is provided at the time the SSN is collected, and be
prepared to provide a copy of the written statement to patients upon request.
Hoke & Moore/November 30, 2005 5
SAMPLE
STATEMENT:
COLLECTION AND USE OF SOCIAL SECURITY NUMBERS BY
HEALTH DEPARTMENT
Pu se
S.L. 2005414 (S 1048), section 4, prohibits government agencies from collecting a social
security number (SSN) from an individual unless the collection of the SSN is authorized
by law or otherwise imperative for the performance of the.agency's duties and
responsibilities as prescribed by law. It also provides that SSNs shall not be collected
until and unless the need for SSNs has been clearly documented. This statement
documents Health Department's need to collect SSNs from some individuals.
Collection of Social Security Numbers by Health Department
1. Collection and use as a unique identifier
Health-Department ("the.Department") collects social security numbers
from all clinical patients for use as a unique identifier. This is imperative to the
performance of many of the Department's legally prescribed duties. North Carolina's
public health system must be able to identify specific individuals in order to carry out its
duties related to disease surveillance, investigation, and control. Unique identifiers are
required to de-duplicate data used for public health surveillance. In addition, there are
public health programs or operations that must be able to accurately identify individuals.
In a state, with a population of more than 8 million, this cannot be done without unique .
identifiers for individuals.
At this time, the SSN is the only unique identifier that is available to the public health
system The statewide public health billing and data collection system, HSIS, is incapable
of producing alternative identifiers that are unique statewide. The North Carolina
Department of Health and Human Services is developing a new data system to replace
HSIS that is expected to be capable of assigning unique identifiers that are not SSNs.
Until such a system is in place, collection of SSNs from patients will be imperative to the
performance of the following duties and responsibilities as prescribed by G.S. Chapter
130A:
• Public health surveillance
• Communicable disease control
• Investigation and control of public health threats during a bioterrorist incident or
other public health emergency
• Submission of specimens to the state public health laboratory
. • Newborn screening program
Draft/November 2005
i
• Identification of individuals in the North Carolina Immunization Registry
• Breast and cervical cancer screening program
• Purchase of medical care programs
In addition, the SSN is presently the only unique identifier available to Health
Department for the following administrative activities that are necessary for the
Department to carry out its legally prescribed patient care duties:
• Locating the medical record of a patient whose chart cannot otherwise be
specifically identified. Identifiers such as name and date of birth are not always
sufficient to This purpose, since they may not be unique.
• Accessing or billing third-party insurance systems.
2. Collection and use forpresumptive eligibility Medicaid determindtions
The Department is a health care provider that is qualified to make presumptive
determinations of Medicaid eligibility for pregnant women. As a qualified provider, the
Department must agree to make presumptive eligibility determinations based on the
procedures and guidelines issued by the North Carolina Division of Medical Assistance
(DMA). 10A N.C.A.C. 22K0102. Since October 2005, DMA has required providers who
are qualified to make presumptive eligibility determinations to request the social security
numbers of pregnant women who are determined to be presumptively eligible for
Medicaid. See Form DMA-5032 and the accompanying Instructions for Providers. This
requirement constitutes legal authority for the Department to collect SSNs for this
purpose.
3. Collection and use of SSNs for the debt set-offprogram
The Department participates in the debt set-off program created by G.S. Chapter 105A
Agencies that participate in this program are legally authorized to collect SSNs by G. S.
105A-3(c).
[Name], Health Director
Date
Draft/November 2005
SAMPLE
STATEMENT FOR PATIENTS:
COLLECTION AND USE OF SOCIAL SECURITY NUMBERS BY
HEALTH DEPARTMENT
Health Department asks all patients to provide social security numbers, so
that we have a means to uniquely identify each patient. Provision of your social security
number is voluntary. Your social security number will be kept confidential in accordance
with state and federal laws that protect the privacy of health information.
Health Department is legally authorized to collect and use patient social
security numbers for the following purposes:
• Determining whether patients are presumptively eligible for Medicaid (10A
NCAC 22K.0102)
• Participating in the local government debt set-off program (G. S. 105A-3)
• The following activities, which require a unique identifier and are imperative to
the performance of Health Department's legally prescribed duties and
responsibilities (G.S. 132-1.10):
o Uniquely identifying medical records
o Accessing or billing third-party insurance systems
o Submission of specimens to the state public health laboratory
o Newborn screening program
o Investigation and control of communicable diseases and other public
threats
o North Carolina immunization registry
o Breast and cervical cancer screening programs
o Arranging patients' participation in "purchase of care" programs, which
help pay for health care
o Public health surveillance
Draft/November 2005
NEW HANOVER MEDICAL GROUP, P.A.
Family HealthCare
WnUL OFFICE
1960 SOUTH SDITEEN7'H STREET
WILMI G-MN, NC 28401 -
TEL(910)343-9991
FAX (910) 343-8448 .
QIAR1 RC M. ALMOND, MD. November 2, 2005
FAMILY PRACTICE
DEWEYR BRIDGER, BI, MD.
FAMILY PRACTICE
1. WILL." EAKINS. M.D.
INTERNAL MEDICNE President George Washington Bush
CHARLES B. HERRING MD White House _
INTERNAL MEDICINE 1600 Pennsylvania Avenue
CLIFFORD T. LEWIS, MM. Washington, DC 20500
INTERNAL MEDICINE
DEBORAH A. STENGEL, M.D. Dear President -Bush:
FAMILY PRACTICE
THOMAS A WEICINEIMER. MD. - I am writing to you to: request your investigation into
INTERNALMEDICNE - the unacceptable, incomprehensible situation that exists
RICHARD DRBETTT.MD.,RA.CR. In Wilmington; North Carolina, over distribution of
influenza vaccine.
ERIC 1. CARTER, PAL
FAMILYPRACIICE
ELIZABETH C. WARD, PAt I am ,a famxl-,, physician in North Carolina., and o e of
FAMILY PRACICE the senior partners of an eighteen ,physician provider
ArroREAIL(,o)wBlm9s group `that -1n61 des wo ph~+sacaan assistants W 'li the,N=,
MATSTRATOR large'st pt..p lam- a a.c .ic ~ i a NMI
C: _
In we acl n e '3v 3,~Qi)a^s~ 'suo~~°a73NMI
GROVE OFFICE encou ers:'s7eY5a~s'~e~, _'"`,OOItTe papur'
5145s~GTOON NC P8Ra1OZ~ path s a a .c ~ c Z ,o1~ - ~,ba!„;!AAPms~ el .~a~a I'.
IM(910)792-1144 on t 'e s_ S ent-repreneu - hip. .Muy,-~# roICQr
FAX(910)7W-0160 stores and ,.pharmacies---lave already receive3 'lcienza
vaccine, but we_are:<curreritly unable to get influenza
SIA P. DRAIN ~MD. vaccine delivered to us despite ordering from three
DEAN H. ICARRAS, MD. different suppliers.
.
INTERNAL MEDICINE _
I do not know what the distribution formula is, or how
SHONA R MARTIN, MD.
NTFRNALMFDICINE it has been established. I think it is incredulous that
SHEA E. M.MANUS. M.D. DrimarY care Dhysi.ci_a.ns who trP?,t; "sick" patience daily .
BT,ERNALMEDICNE are not able to receive influenza vaccine for
NEIL H. MUSSEI-WIITE, MD. administration to our patients, when other parties, i.e. ,
FAMILY PRACTICE grocery stores and pharmacies, are able to do so.
JEFFREY L. WARHAFTIG. MD.
INTERNAL MEDICINE We ordered our flu vaccine this year from three
different suppliers so as to not "put all of our eggs in
O20GDDERNOOFIC~E one basket". To date we have received 10 vials, or 100
74 wLMTNGTON,NC28411 doses of-influenza vaccine. We usually. give about 8,000
TU(910)6862525 doses annually.
FAX(910)686-1606 JOHN D. BOLDIZAR. MD. _
FAMILY PRACTICE
.
BRY ].H. BROADBENT M.D.
YFRACDCE
Y PALE GA, MD.
N7FRNAL MEDICINE
IAMCE F. DICKERRSON. M.D.
FAMILY PRACTICE
November 2, 2005
Page two of two •
Something urgently needs to be done about this desperate situation
because our patients' lives are at risk. The number one cause of
death in hospitals today is pneumonia. The number one complicating,
illness prior to developing pneumonia in older people' is influenza.
I ask for your immediate attention to this matter.
A
Cordially, with fondest regards,
Neill H. Musselwhite, M.D., F.A.A.F.P.
NHM/kn
cc: Governor Mike Easley
The Honorable Richard Burr
The Honorable Elizabeth Dole •
The Honorable Mike McIntyre
The Honorable Julia Boseman
The Honorable Carolyn H. Justice
The Honorable Daniel F. McComas
The Honorable Thomas E. Wright
The Academy of Family Practice
North Carolina Medical Society
American Medical Association
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• North Carolina Department of Health and Human Services
Division of Public Health - Women's & Children's Health Section
1917 Mail Service Center • Raleigh, North Carolina 27699-1917
Tel 919-707-5550 • Fax 919-870-4824
Michael F. Easley, Governor Carmen Hooker Odom, Secretary
November 22, 2005
Neill H. Musselwhite, M.D.
New Hanover Medical Group
5145 South College Road
Wilmington, North Carolina 28412
Dear Dr. Musselwhite:
Your recent letter to Representative Carolyn Justice was referred to the Immunization
Branch for a response. I hope the following information will provide some clarification
for you on the current flu vaccine situation.
According to the Centers for Disease Control and Prevention (CDC), there will be an
• adequate amount of flu vaccine available this year. However; because of the lengthy
manufacturing process for flu vaccine, distribution of vaccine supplies has been staggered
through out the fall months this year. Though influenza vaccine distribution is-a primarily
private sector enterprise, the CDC does try and influence the distribution of the vaccine
through recommendations, guidelines and extensive collaborations with vaccine
manufacturers. The North Carolina Immunization Branch provides feedback to the CDC
regarding distribution issues in our state, and will continue to advocate for a distribution
system that insures vaccine supplies are readily available for those persons in priority risk
groups.
Immunization Branch staff spoke with Janet McCumbee, Director of Nursing at the New
Hanover County Health Department yesterday regarding your flu vaccine situation. I
understand that Ms. McCumbee spoke with a member of your staff, and that an
agreement has been made to share 2,000-3,000 doses of state-supplied flu vaccine with
your practice. The health department will provide you with the vaccine as well as all
necessary information regarding billing restrictions, accountability, and storage and
handling of this vaccine. I hope this will help you to provide adequate flu vaccination
coverage for your patients, particularly those at high risk.
For some of your patient population, you may also want to consider purchasing FluMist
nasal flu vaccine for use in persons 5-49 years of age who are healthy. It may be an
option for healthcare workers and persons who are close contacts of those at high risk for
• flu. Though higher in cost than inactivated flu vaccine, it is usually available in adequate
supply.
® Location: 5601 Six Forks Road • Raleigh, N.C. 27601 An Equal Opportunity Employer
A
Dr. Musselwhite •
Page 2
November 22, 2005
We do appreciate and share your concerns about the supply and distribution system for
flu vaccine. Please be assured we will continue to advocate for revisions to the system
that will allow for improved availability of vaccine for patients in priority risk groups
Sincerely,
Beth Rowe-West, RN, BSN, Head,
Immunization Branch
Women's and Children's Health Section
North Carolina Division of Public Health
Cc: The Honorable Carolyn H. Justice
Dr. Leah Devlin, State Health Director •
Janet McCumbee, New Hanover County Health Department
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'United-We Stand
A-
1,,!'LNe nef
wsB
Riblished for Members of Local Boards of Health Third Quarter, 2005
What"s
I began my assistance as a member of FEMA's Rapid
Needs Assessment Team for Alabama and Mississippi. I
departed home early Saturday morning on Aug 27th
(seems like months ago) for Fort Walton Beach,
3 Report Florida. This would be close enough to get to my
' Washington assessment work. We rode out the storm which hit
early Monday morning, Aug 29. I was evacuated from
Board ' Directors my hotel in Destin on Sunday as local emergency
management officals feared flooding of parts of
Destin and Fort Walton Beach along coastal route 90.
NALBOH News So we moved to higher ground. The roads did flood
over but I avoided being stranded. We operated out
Application 5 Membership of the Northwest Florida Fairgrounds. We had fairly
high gusts of winds. On Tuesday, we began to plan
our assessments. A team flew by helicopter to
Jackson, Mississippi. My team remained to assist in the
Call for Conference Source: <www.noaa.gov>
coastal areas of Alabama. After flying to Clanton,
Presentations Alabama to meet with the Alabama State Emergency Management folks, we were informed
that they were able to handle their assessments in Mobile and other areas.
' Annual Conference Our Public Health and Medical Needs Assessment Team departed by ground transportation to
Awardees
Gulfport to begin working in
Mississippi.
We met up with the Mississippi Department of Health's (DOH) Incident Team at the base for
1 Tobacco-Free
operations of the local Emergency Management Systems (EMS) provider, American Medical
Response (they also help to serve in the Metro Atlanta area in Georgia). They had a wonderful
operation established. They were handling all of the emergency transports as well as staging
State Association ambulances at shelters and other locactions as the 911 system was inoperable for some time.
We began working along with our counterparts of the Mississippi DOH assessing the immediate
health and medical needs all along the Mississippi coast, which included the counties of Jackson,
Environmental Harrison, Hancock, then northward to The Pearl River, Stone and George counties. Ground Zero
Emergency Preparedne3s
was in the county of Hancock. The towns of Bay Saint Louis and Waveland suffered very heavy
destruction. I saw housing units and subdivisions completely gone, leaving nothing but con-
Crete slabs. I flew by helicoper to witness Katrina's fury all along the Mississippi coast. Old
Needs 14 NALBOH ' ancestrial homes were all but completely destroyed. Trees, cars, railcars and tractor trailers were
' Interest ' uplifted by the 150+ mph winds and storm surge and strewn hundreds of feet. It was a very
disturbing view as I found my eyes at times tearing and turning away from land into the waters
of the Gulf of Mexico.
15Calendar of Events I have been to many storms. This is by far the most devastating with the physical destruction
of property, compounded by severe disruption and loss of the basic human needs of shelter,
Coined on Page 2
TWC Ss P.. National Association of Local Boards of Health
C' PUBLIC XF 1111
1840 East Gypsy Lane
N A L B O H Bowling Green, OH 43402
Phone: (419) 353-7714; Fax: (419) 352-6278
Email: <nalboh@nalboh.org>
Website: <www.nalboh.org>
Page 2 NALBOH NewsBrief Third Quarter 2005
President's Message (continued)
food, water, health and medical care. So many people were displaced from their homes.
My function here is the United States Department of Health and Human Services liaison to the Mississippi DOH Coastal Plains District
Unified Command Center in Gulfport.
Some of my activities have been assisting in the Mississippi DOH with the coordination of:
• Injury and Illness Surveillance System to track the various conditions of patients seen at the area hospitals and the
National Disaster Medical Assistance Teams (DMATs) which are federal teams made up of volunteers from communities who
become federalized to assist with medical care in times of disasters. There are also Veterinary Medical Teams (VMATS)
helping with the animals and the Disaster Mortuary Operational Response Teams (DMORTs) helping the State Medical
Examiner's office with identification.
• Environmental Health Teams going out, assessing; helping with food, water, hygiene and sanitation at the shelters; assisting
distribution sites with food, water, ice and other supplies needs.
• Mosquito Control Surveillance to locate standing water areas near the population and treat these areas with larvicide control
as well as to monitor the different species and number of mosquitos that could interfer with emergency work or
carry viruses such as West Nile.
Joining the hard working Mississippi DOH staff are many employees of the US Dept of Health and Human Services including CDC and
other state and local health officials from other states like Florida, who have lots of hurricane response experience.
One nice story I heard was of a puppy who obviously survived the storm. It wandered into one of the DMAT medical facilities. The
staff is caring for the puppy and rightly named her Katrina.
Although the state of Mississippi does not have local boards of health, its district and local county health departments are doing a
fantastic job keeping everyone healthy by their continual assessments, surveillance and preventive interventions and healthy
public messages throughout the impacted areas. Our NALBOH friend from CDC, Dr. Ed Thompson (the former Mississippi health
officer) visited Dr. Amy, the current state health officer, along with CDC director Dr. Julie Gerberding, to offer assistance. This
response clearly demonstrates a great public health system in action with a local state and federal partnership to make a strong
Mississippi health and medical response. The Mississippi DOH is operating out of a very functional Unified Command System at the
WIC Warehouse in Gulfport to manage the entire response within their Coastal Plains District Health Department.
I am coping very well here but I must admit that it is rough. I have slept on many floors in different buildings as well as in my car.
I am proud to be a part of this massive response to help the great state of Mississippi. It is very, very rewarding. I am so proud of
our public health and medical care system. Alabama, Mississippi and Louisiana will come back stronger because of public health.
I hope this gives you a taste of my experiences here. Given recent developments (Hurricane Rita), I am not sure when I'll be
home.
God Bless America and please include those affected in your prayers.
Best regards from Gulfport,
Ronal C. Burger
President
National Public Health Performance Standards:
Helping You Learn About Your Health Department and Jurisdiction
At NALBOH's annual conference, we had a lively session on performance standards. If you were unable to attend, here's a brief
summary. What is the National Public Health Performance Standards Program (NPHPSP)? The NPHPSP is an effort to
improve the performance of public health systems. The program is based on the ten essential services, focuses on the overall public
health system, describes an optimal level of performance, and supports continuous systems improvement. There is a state, local,
and governance performance assessment instrument. The governance instrument assesses the performance of the governing
body for the purpose of improvement. Why should your local board of health take interest? The NPHPSP governanc
instrument will help your local board of health identify its role in the public health system, and learn more about your health
department and jurisdiction. The instrument emphasizes the governing body's responsibility - providing oversight of the health
agency's and community's disease prevention and health promotion services. How do you get started? The instrument is
available on NALBOH's web site. There is also a link to CDC's web site where you can access the instrument, the User's Guide, and
list of frequently asked questions. For more information or help getting started, contact Tiffany Hinton by telephone at
(202) 223-4034 or e-mail <tiffany@nalboh.org>. ?
Third Quarler2005 NALBOH News Brief Page 3
From 2Waay Hmrrarr, DC L~ om
As I write here in Washington, we are awaiting the passage of the Labor-Health and
Human Services-Education (L-HHS-Education) Appropriations bill for fiscal year 2006.
So far, there are some reasons to remain hopeful. The Prevention Block Grant that
allows a state or locality to address its own public health priority needs, although
there is no federal funding or limited funds, has been restored - at millions less than
last year, but still restored. Additionally, the L-HHS-Education appropriation
increases funds for community health centers.
rm The downside are the cuts and freezes in programs over the last few years are
i r I1L1 resulting in significant funding decreases for federal programs that address the
training of health professionals in rural and medically underserved areas, the
prevention of chronic diseases such as cancer and diabetes and the prevention and
treatment of infectious diseases such as HIV/AIDS.
In the midst of this budget process, a new report on the public health workforce has been released by HRSA's Bureau of Health
Professions. The report focuses on workers in state and local governmental public health agencies, particularly public health
physicians, nurses, and other workers with formal public health training. The report is based on case studies representing the four
relationships between state and local public health agencies: centralized - a state operated public health system; decentralized
a public health system operated by local government; shared - a public health system jointly operated by state and local
government; and mixed - a public health system with differing levels of state and local involvement.
Findings from the study indicate that governmental public health agencies have difficulty recruiting for a variety of occupations
including nursing, health education, social work, epidemiology, nutrition and laboratory support. The single biggest barrier to
adequate staffing of governmental public health agencies is budget constraints. Beyond budget constraints, recruitment
difficulties were attributed to general shortages of workers within an occupation, non-competitive salaries, and lengthy processing
time for new hires.
The study highlights the need for increased public health funding if we seek a well-trained workforce ready to respond to
emergencies, investigate and intervene in acute and chronic disease outbreaks, and help prevent morbidity and mortality in our
communities.
Public health funding is essential. NALBOH will continue to support efforts to increase public health funding, and we hope you will
too. Is your community prepared for an outbreak? Do you have an increased number of youth with diabetes? Do you have
enough workers to keep your food and water systems safe? Letters to legislators and to the editors of your local newspaper can
help make a difference - make a prepared and healthy community a priority.
If you need my assistance, please do not hesitate to call the NALBOH office in Washington, DC at (202) 223-4034. O
Board of Directors & Staff
Board of Directors Staff
President President-Elect Executive Director
Ronald Burger (GA) Lee Kyle Allen (NC) Marie M. Fallon, MHSA
Secretary/Treasurer Past President DC Director Liaison
Gladys Curley (MD) Connie Tatton (UT) Tiffany Hinton, MPH
Ex-Officio Project Director-Environmental Health & Emergency
Ned E. Baker (OH) Preparedness
Marie M. Fallon (OH) Jeff Neistadt, MS, RS
Anthony Santarsiero (GA) Grants Manager
Jennifer O'Brien, MPH, MA
East Great Lakes Region Mid Atlantic Region Membership Coordinator/Publications Manager
Alice Davis (OH) Walter Stein (NJ) Grace Serrato
Midwest Region New England Region NewsBrief Editor
Larry Hudkins (NE) Shepard Cohen (MA) Fleming Fallon, MD, DrPH
Southeast Region West Region
Rachel Stevens (NC) Carolyn Meline (ID)
West Great Lakes Region
Sharon Hampson (WI)
State Affiliates
John Gwinn (OH)
Donna Rozar (WI)
m
Page 4 NALBOH NewsBrhef Third Quarter 2005
70H's the Ten Essential Pu blic Health Services, and Nashville-
NAL13th Annual the National Public Health Performance
erence Standards Program. Later, a lively mock Board More Than A Tale of
SubmitteBurger, NALBOH President of Health meeting was performed by some TWO Cities
of NALBOH's Board Members in order for
Our 131" Annual Conference and meeting the participants to discuss certain board -
is now history. We look f0rvaard to our duties. The participants were then required Dr. Stephanie Bailey, Director of the
adolescent years as we begin to plan. If to attend a certain number of the breakout Metro Public Health Nashville and Davidson
you attended, wow, wasn't it a terrific way sessions and complete a short, multiple County welcomed NALBOH members and
to celebrate public health? If you did not choice question test in order to receive their guests to their thirteenth annual meeting
have the opportunity to attend, you will certificate of participation. with a splendid description of the Nashville
have another chance in July 26-29, 2006 area community and health status.
as we partner with NACCHO in San The NALBOH Board is pursuing funds in
Antonio. order to use the feedback from the ACCP She characterized Nashville as a "Tale of Two
to develop a certification and credentialing Cities" and described the disparities that
We witnessed the breathtaking feats program. Stay tuned for more exciting news exist between Music City USA, the Health
performed by the Peking Acrobats on the about board member education and Care Capitol of the World, and the Athens
paddlewheel riverboat General Jackson. training. of the South and the health disparities that
We discovered Nashville and historic exist among the community's diverse
Tennessee. We thoroughly enjoyed Prior to our conference, NALBOH's board population groups and the families and
ourselves in Music City USA as we took the members and staff held a strategic planning children living in and around Nashville.
advice of Metro Public Health Nashville and session led by Eastern Kentucky University's
Davidson County Health Officer, Dr. Environmental Health Professor and expert The inaugural "Board Member Orientation"
Stephanie Bailey, to spend money. On strategic planning facilitator Joe Beck. The was a huge success evidenced by the
Friday night, we were surrounded by the purpose was to allow our Board to take a dialogue of Board members between
opening of the 2005 Promise Keepers look into the future at NALBOH's vision, sessions. Plans are to offer it as a part of
Conference and the home opener of the mission, values and broad objectives. Our annual meetings in the future. We held
Tennessee Titans football game. Board and staff are all very excited about again this year was a "Town Hall Meeting"
However, many of us still had a chance to the future of NALBOH. where board members could interact
visit the museums, the Grand Ole Opry, directly with other board members on their
and other attractions on Friday night. Our annual membership business meeting successes and/or challenges. QuestionslIV
was also held during the conference. were asked about implementing
We listened to outstanding plenary NALBOH finances and revised bylaws were programming to address obesity in
sessions by Dr. Stephanie Bailey, Metro Public reviewed and approved. Our Board communities.
Health Nashville and Davidson County Health Development Committee also provided
Officer; Richard Hamburg, Government members with an outstanding slate of The annual meeting was structured with
Liaison for the Trust for,America's Health; officers for our ballot for 2006. There was four tracks available to attendees. Board
Richard Barnes, Federal-State Program one nominee from the floor for the State Governance, Community Health,
l Relations Director for the Food and Drug Affiliate spot. Look for the ballot coming to Environmental Health and Preparedness.
Administration; Dr. John Maupin, President your board's mailing address soon. Please The sessions under each track provided
of Nashville's Meharry Medical College; and talk with your board and vote. valuable information for both new and
Dr. William McDaniel, Board Chair, current board members.
Lexington-Fayette County Kentucky Health This is a good opportunity to think about
Department. We had a chance to update getting involved with NALBOH by signing Did you know.....
ourselves on all kinds of activities, projects, up for one of our committees. Either
best practices, and innovative* ideas. Our complete the form on page 15 of this • Local health departments conduct over
learning opportunities centered on our four News Brief or call the office. We need 2.5 million inspections each year of
conference tracks: Board Governance committee members. Get involved with retail food operations? There are
Community Health, Environmental Health, your State Association of Local Boards of 878,000 licensed facilities. Over 28,000
and Preparedness. Health (SALBOH) if you have one in your sanitarians conduct these inspections.
state or call to get assistance to start one. • Only 31 cases of waterborne disease
We also had over 60 board members take NALBOH, SALBOH, and you! What a great outbreaks were reported in the
advantage of our 2005 Annual Conference partnership in local public health. United States 2003. Do you believe
Certification Program (ACCP) pilot test. This the number?
program was developed by NALBOH's Thanks again for all your cooperation and • The National Public Health Performance
Education and Training Committee support of NALBOH and thanks for coming Standards can be used to build
members. Participation in the program to Music City USA. If you could not, plan on capacity in your local health
increased knowledge in becoming a more San Antonio in 2006 and Anchorage in 2007. department? \
effective board member. The program Remember, boards of health are public • The National Voluntary Accreditatio
began Wednesday afternoon just prior to health's democracy and boards of health System for local health departments is
our conference kickoff social with a three connect people to public health. Be safe being studied by a national steering
hour Board Member Basics Session. This and stay healthy through prevention. O committee?
session focused on discussion about public
health core functions, board governance, Continued on pages
Third Quarter2005 NALBOH NewsBrief Page 5
• TB has accounted for 2-3 million deaths in this country and
Mad Cow Disease has resulted in the death of 2 cows. 2006 NALBOH Membership
- • Your staff can take a bioterrorism course online FREE from
the FDA. Its called an introduction to Food Security
Awareness at <www.fda.gov>. 7membership me to consider your 2006 NALBOH membership. A
in NALBOH provides an opportunity for you and your
This was a small sampling of the information from the annual ard of health to:
meeting. As board members we are all challenged and charged Have an input into national health policy;
with staying current on not only local, but state and national Receive copies of the NALBOH NewsBrief for each board
issues that affect our communities. member;
• Receive discounts for NALBOH educational materials; and
Plan on attending next year's annual meeting in San Antonio, Participate in NALBOH's exceptional Annual Conference at
Texas! O a member rate.
NACCHO Operational Definition The 2005 annual conference was the biggest and best yet. The
2006 annual conference is planned for San Antonio, Texas, July
26-29, 2006. Join NALBOH and b2 part of this great conference
A landmark project to develop an operational definition of local designed specifically for those serving on boards of health. It will
public health agencies is seeking input from government public be co-located with the National Association of County and City
health officials and organizations. Health Officials. I
Using the Ten Essential Public Health Services as a framework, Join NALBOH now by sending in the membership application
the National Association of County and City Health below or return the invoice that was mailed to you in October,
Officials (NACCHO) has drafted a listing of the specific along with payment to: NALBOH, 1840 East Gypsy Lane Road,
functions under each to be performed by county, municipal, and Bowling Green, OH 43402. Call the office (419) 353-7714 if you
other local governmental public health agencies. The NACCHO need a replacement invoice. O
draft reflects views expressed by scores of public health
professionals and representatives of national associations in Application for Membership
multiple rounds of comments.
NACCHO is now entering the last rounds of feedback on the Date:
operational definition. The association is soliciting feedback to Membership Year: 2006 (January 1 - December 31, 2006)
make sure that the definition accurately reflects the public health
field's shared opinions about how local public health
Board of Health/OrganizaOONName of LidiNeual
agencies serve their communities.
Each essential public health service is divided into two to five Mailing Address
components. The breadth and depth of the definition reflects city scare zip code
the multi-disciplinary nature of local governmental public health,
as well as its relationships with other entities in the amine Eax Email
local public health system (media, private providers, academia,
and others).
Contact Person and Title
To respond to NACCHO's solicitation for comments, using an Check type of desired membership:
online feedback tool, see <naccho.org/topics/infrastructure/ D Institutional ($120)
operational_definition.cfm>. View the draft definition, then click Any local board of health or other governing body
on "Tell us what you think." that oversees local public health services or programs or
($95) a local board of health whose state association is
To offer suggestions of ways to share information about the an affiliate member of NALBOH (GA, ID, IL, MA, NC, NE, NJ,
project, or t obtain additional OH, UT WI)
operational definition ,
0 Affiliate ($300)
information, contact Grace GorenFlo at ( (202) 783-5550 x222, State associations of local boards of health SALBOH
<ggorenflo@naccho.org>. ( )
o Associate ($60)
The project is funded by the Robert Wood Johnson Foundation Any individual committed to NALBOH's goals and objectives
and CDC. O 0 Retired ($12)
Any former member of a board of health, state board of
health, local governing body, state, territorial or tribal board
The NALBOH NewsBrief is published by the of health
National Association of Local Boards of Health O Sponsor ($60)
1840 East Gypsy Lane Road, Bowling Green, OH 43402 A non-profit organization, agency or corporation committed
Phone: (419) 353-7714; Fax: (419) 352-6278 to NALBOH's goals and objectives or
Email: <nalboh@nalboh.org>; Website: <www.nalboh.org> ($300) a for-profit organization, agency or corporation
The production and distribution of this publication is supported by committed to NALBOH's goals and objectives
funds from the Centers for Disease Control and Prevention. O Student ($20)
Reproduction or use of any contents enclosed must be Any full time student committed to NALBOH's goals and
requested in writing to the NALBOB office. O objectives
i
i
en I
Page 6 NALBOH NewsBrief Third Quarter 2005
Call for Presentations
National Association of Local Boards of Health
1411 Annual Conference - San Antonio, Texas, July 26 - 29, 2006
Submission Deadline: December 9, 2005
About the Call for Presentations
The National Association of Local Boards of Health (NALBOH) is accepting applications for presentations for its 140 annual
conference, which will be held July 26 - 29, 2006 in San Antonio, Texas. Applications must be received by December 9,
2005. The goal of NALBOH's annual conference is to provide current public health information and training to board of health
members from across the United States.
The application form and submission guidelines are available online at <www.nalboh.org>. Frequently Asked Questions (FAQ)
about the conference and the Call for Presentation is also available online.
Because NALBOH will be co-located in San Antonio with the National Association of County & City Health Officials (NACCHO),
NALBOH encourages submissions that address interactions between local boards and health officers or that include a local
board member as a presenter or panelist.
The criteria for acceptance are listed below. All applications will be reviewed by NALBOH's Program Committee.
Abstract Selection Criteria
The goal of NALBOH's annual conference is to provide current public health information and training to board of health
members from across the United States. In 2006, NALBOH and the National Association of County & City Health Officials
(NACCHO) will be co-located in San Antonio. Therefore, NALBOH will give preference to submissions that:
• Are submitted from local board of health members
• Are submitted from health officers
• Include local board of health members
• Present topics related to public health governance or address specific local board of health responsibilities in relation to
the topic
The NALBOH program committee will review all applications and make its selections based on the criteria above. Applicants
will be notified of the status of their submission by March 10, 2006. All accepted presentations will be part of a NALBOH
certification program for local board of health members. Presenters will be required to submit presentation materials and five
to ten test questions related to the content by June 30, 2006.
For more information or questions, please contact Jennifer O'Brien by phone at 419-353-7714 or via email
at <jennifer@nalboh.org>
Requests for Articles and Meeting Announcements
NALBOH publishes articles about the successes, challenges, and accomplishments of local boards of health as well as
upcoming conference announcements and meeting dates. To submit an article or announcement, please contact the
NALBOH office at 1840 East Gypsy Lane Road, Bowling Green, OH 43402, fax to (419) 352-6278, or email us at <nalboh@nalboh.org>.
A NewsBrief submission form is available online at <www.nalboh.org/newsbrief/newsbrief.htm>. 73
ThirdQuarter2005 NALBOH New.sBrief Page 7
Presentation Submission Form
mAIBON~
NALBOH Ie Annual Conference - July 26 - 29
1. Presentation Title:
2. Presentation Length:
3. Conference Track: ? Board ? Community ? Environmental ? Emergency
(pnaesemaa~mgIPPW Governance Health Health Preparedness
4. Presenters: (Please note that all correspondence will be addressed to the primary presenter)
Primary Presenter
First Name: Last flame: Credentials:
Title: - Organization:
Address:
City: State: Zip:
Telephone: Fax:
Email-
Primary
Presenter Bio
(20B wmdlBBlt)
Additional or Co-Presenters:
First [lame: Last Name: Credentials:
Title: Organization:
Email:
Co-Presenter
Bic
(I00 ward lvolq
First flame: Last Name: Credentials:
Title: Organization:
Email:
Co-Presenter
Bic
(2W wmdtwn)
5. Please provide a summary (150 words limit) of yur presentation.
6. List the three major objectires of this session (100 word limit).
7. How is this presentation relevant to public health governance and local boards of health (150 word limit)?
8. Please provide a short abstract (50 - 75 words maxbnum) to be used in NALBOH's conference Literature.
Please send your completed form by December 9, 2005 using one of the foLLowing methods:
US Postal Mail HALBOH, 1840 East Gypsy Lane Road, Bovding Green, OH 43402
Facsimile 419-352-6278
E-mail with attachments Jennifer O'Brien - jennifer@naLboh_org
For more information or questions, please contact. Jennifer O'Brien at 419-353-7714 w jennif"nalboh.org
m
not~
Page 8 NALBOH NewsBrief Third Quarter 2005
i
1
~I
East Great Lakes Regional Director Award New England Regional Director Award
presented to Vivian McCullough (OH) presented to Carolyn Wysocki (CT)
by Alice Davis (OH) by Shepard Cohen (MA)
c
Southeast Regional, Director Award presented West Great Lakes Regional Director Award
to Dennis Harrington (NC) presented to Reverend Annie Clark (IL)
by Rachel Stevens (NC) by Sharon Hampson (WI)
P t
r
t
i
Mid Atlantic Regional Director Award Health Officer of the Year Award presented
presented to Miriam Cohen (NJ) to Kenneth Pearce (OH)
by Walter Stein (NJ) by Ron Burger (GA) and Alice Davis (OH)
Third Quarter2005 NALBOH NewsBrief page g
2005 Conference Awardees (continued) Silent Auction Results
This is NALBOH's first ever silent auction and we are pleased
to have had a great response, both from our contributors and
bidders. All auction proceeds will benefit the MacNeal
Scholarship Fund. We are glad to announce $1,000 was
raised.
The Winning Bid Goes To:
" • Pillow
Barbara Ann Hughes (NC)
r • North Carolina Light House Lap Cover
Fleming Fallon (OH)
• Garden Sculpture
Donna Rozar (WI)
• Pedometer with CDC Logo
Phil Lyons (UT) `
• Book, History of CDC
2005 MacNeal Scholarship Award presented Marie Fallon (OH)
to Chris Tofteberg (AK) by NALBOH • Shirt with CDC Logo
Ed Schneider (NE)
• Country Music Hall of Fame T-Shirt
Congratulations to the followin Bill Gardner (OH)
9 Donna Rozar (WI)
Award Recipients: • Swiss Cheese Wheel
Dave Radford (ID)
Midwest Regional Director Award • Lighted Framed Picture
was awarded to Gilbert Savery (NE). Grace Duncan (O
Award was accepted by Ed Schneider (NE) • North Carolina Gift Pack
on behalf of Gilbert Savery. Marcia Stanhope
~ Dave Radford (ID)
West Regional Director Award • Carved Frog
was awarded to lean Curtiss (MT). Janice McMichael (GA)
Award was accepted by Carolyn Meline • Throw
on behalf of Jean Curtiss. Judy Reimer (NE)
• Stock Yard Restaurant Gift Certificate
Rodia England
President's Award (UT)
was awarded to Dr. Julie Gerberding and • Lincoln Library & Vermillion County Health
Centers for Disease Control and Prevention (CDC) and Department Gift Set
Staff (GA). Award was accepted by Anthony Brooke Passey (ID)
• Framed Artwork
Santarsiero on behalf of the CDC. Bill Bailey (GA)
• James r
LLB 2005 Rev. Everett L. Hageman Award
Gift Basket
was awarded to Dr. Michael Kretz (WI) Nashvillle le Aquarium
Carol Chang (NJ)
• UNC T-Shirt & Coasters
Claudia Richardson (NC)
IF Legislator of the Year Award Marcia Stanhope (KY)
was awarded to Senator Mike DeWine (OH) • re-vigorate Massage Gift Certificate
Dave Radford (ID)
• New Jersey Gift Package
2AUAnnueConference Winners Brooke Passey
• Autographed Titan Football
Thank you to all of those who turned in their conference Carol Remington (OH)
evaluations. Two Winners were randomly selected from • Nashville Zoo Admission
the evaluations returned, Carol Chang (NJ)
• First Aid Kit & Portfolio
AND THE WINNERS ARE Grace Duncan
• Wisconsin Gift Basket
2006 Waived Registration Fee: Dave Radford (ID) Judy McDonald (IL)
• Nebraska Goodies Gift Package
2006 Conference Hotel Stay: Vivian McCullough (OH) Ed Schneider (NE)
• Pottery Soup Bow/Cup
Thank you again and we hope to see you in 2006 in Pat Libbey (DC)
San Antonio, Texas! Marie Fallon (OH)
Ed Miller OH O
j
o i
Page 10 NALBOH News6rief Third Quarter 2005
Framework Convention on Updated Cigarette Taxes
Tobacco Control (FCTC) Information
Campaign for Tobacco Free Kids
The Campaign for Tobacco Free Kids
The Campaign for Tobacco Free Kids has updated its
The Framework Convention on Tobacco Control (FCTC), the information regarding cigarette taxes. According to the data,
first global public health treaty, came into force with 57 increasing cigarette taxes is a threefold win for states - a
countries committing to its provisions. The treaty represents health win that reduces smoking and saves lives, a fiscal win
the first coordinated global effort to reduce tobacco use, the that raises revenue and reduces health care costs, and a
world's leading preventable cause of death. political win that is popular with the public. To view the
information, please visit <http://tobaccofreekids.org/reports/
Provisions of the FCTC prices/>. O
The objective of the FCTC is "to protect present and future
generations from the devastating health, social,
environmental and economic consequences of tobacco Tobacco Industry's Campaign
consumption and exposure to tobacco smoke" The treaty
commits countries to: Contributions
The Campaign for Tobacco Free Kids
• Ban all tobacco advertising, promotion and sponsorship
(with an exception for nations with constitutional In May 2005, the Campaign for Tobacco Free Kids updated its
constraints). 2004 report Campaign Contributions by Tobacco Interests.
The report provides data by state as well as summary charts
• Place large, graphic health warnings on cigarette packs. and tables. According to the data, over $2 million was spent
on federal candidates during the 2003 - 2004 election year.
• Implement measures to protect non-smokers from In addition, the data show that since the report began in
secondhand smoke. 1997, total contributions have amounted to $9.4 million
dollars. Of the $9.4 million contributed, 75% of it (or $7
• Increase the price of tobacco products, which reduces million) was donated to Republican candidates and $2.3
smoking among both youth and adults. million to Democratic candidates. For more information about
the amount of money spent by the tobacco industry in
• Combat cigarette smuggling. federal elections, please visit <http://tobaccofreeaction.org/
contributions/>. ?
• Regulate the content of tobacco products.
How to Further the Work of the FCTC Finding Data and Resources for
In order to support the development of a strong FCTC and
combat tobacco industry disinformation, an alliance of Your Smokefree Activities
non-governmental organizations from around the world has
been formed. Now comprising more than 200 groups from The Centers for Disease Control and Prevention (CDC)
more than 90 countries, the Framework Convention Alliance Office on Smoking and Health has a webpage devoted to
(FCA) is playing a key role in educating policymakers and providing data and research links for those interested in
strengthening cooperation across borders. quitting, learning about the health consequences and other
information. The webpage <www.cdc.gov/tobacco/news/
To encourage the President to ratify the treaty, please visit HealthConsequences.htm> is a valuable resource to access
the FCA's website at, iwww.fctc.org/countrydata/ reliable data and information.
contact2.php?countryID=183> or visit Tobacco Treaty Now
<tobaccotreatynow.org/> to send a preprinted letter to your Other national organizations with data and information include
representative or President Bush. ? the:
• American Cancer Society <www.cancer.org>
How Does Your State Rate with • American Legacy Foundation <www.americanlegacy.org>
• American Lung Association <www.lungusa.org>
Tobacco Control Laws? • Americans for Nonsmokers' Rights Foundation
American Lung Association <http://no-smoke.org/>
• Campaign for Tobacco Free Kids
In its 2004 report, State of Tobacco Control 2004, The <www.tobaccofreekids.org>
American Lung Association has given the federal government • National Association of Local Boards of Health
and states grades regarding how well their laws control <www.nalboh.org/tobacco/control.htm>
tobacco. The report summarizes data in each of the four • Tobacco Technical Assistance Consortium
categories of tobacco prevention and control: spending, <www.ttac.org>
smokefree air, cigarette excise tax and youth access. To
access the report, please visit <http://Iungaction.org/reports/ For additional links, please visit <www.nalboh.org/webhealth/
tobacco-contro104.html>. ? tobacco.htm>. ?
ThirdQuarter2005 NALBOH News Brief page 11
Association of Illinois Massachusetts Association of
Boards of Health (IBOH) Health Boards (MAHB)
Survey Report Submitted by Marcia Benes
Submitted by Jan Attala Allen, President-Elect MAHB has launched a web
In January 2005, the Membership based el-earning Center
Committee of IBOH sent a survey, via the offering a broad curriculum
Illinois Department of Health (IDPH) of web-based courses
Director's Office, to all 95 Health relating to Emergency
Department Administrators in both Preparedness, Environ-
electronic and letter form to distribute to mental Health, Communi-
.
~
each Department's Board of Health (BOH) ty Health , Management
and Governance.
Members. All members of the IBOH serve
voluntarily, and the organization does not have paid staff to This is the first major expansion of the MAHB's role in providing
conduct any business to date. The Association is a section with- education and training since the round breaking Certification
in the Illinois Public Health Association. Program began in 1996. This comprehensive training system for
The purposes of the survey were to assess needs and to learn local boards of health utilizes the same system employed by
Harvard
the opinions of board members in order to be more effective in University, MIT and the Army. MAHB now has the
meeting the goals of IBOH, namely, to support local boards of as real potential to time offer multimedia presse entations ar demand as well
health in their roles in local and state public health governance, meetings, and large online seminars.
and to provide a state perspective in promoting and enhancing The eLearning Center will not replace the three on-site MAHB
public health in the broadest sense. This survey was also Fall Certification Programs, but
is, intended to encourage participation in IBOH. intended to expand
Certification and other training opportunities ies to to those who are
The Instrument contained 10 items, with an opportunity to unable attend these popular sessions. The first pilot courses will
add comments, and took about five minutes to complete. leavailable this fall. For more information, visit <www.mahb.org
learningcenter.htm>.
Responses were faxed to the Chair of the Membership MAHB 2005 Certification Program will be held in three locations
Committee by BOH members from 30 of the 95 counties. this fall with three concurrent daylong sessions covering the
Results revealed that: following topics:
67% of respondents were aware that they were IBOH Governance
members, by having paid annual dues; and reported having • Inspections and Tort Law
received The Bugle Call, the quarterly publication (local, • Liability and Mutual Aid Agreements
state and national PH updates), o • Brainstorming Staffing Issues
81% had computer access, but only 42% were agreeable
to receive e-mail information; Environmental & Community Health
> 36% knew IBOH's networking opportunities, and 26% were • DEP and Boards of Health: areas of mLtual concern
aware of the IBOH Orientation Manual availability [via • Tattooing - Implantation, hot tubs, oxygen bars, colonic
University of Illinois Mid-America Regional Public Health cleansing
Leadership Center, School of Public Health]; • Housing Condemnation
72% were aware of public policy influence, but only 23% • Role of the Public Health Nurse
had attended IPHA meetings;
> 54% knew about the IBOH Section of IPHA; and Emergency Preparedness
9 48% expressed interest in attending future meetings. • Risk Communication Primer
Added comments were summarized in the following four • Flu Pandemic: Update on planning
categories; meeting logistics, educational content, networking, • Emergency Preparedness and Animals
and general. Each category contained useful suggestions and • Introduction to the Health Alert Network
included a "kudos" for IBOH's newsletter, The Bugle Call. plus an Orientation Session for new board members
Follow-up action is planned to address the Survey's results by 2005 Edition Guidebook for Massachusetts Boards of Health CD,
the Executive Council of the IBOH at their regular meeting in including all Certification Program Presentations and Handouts
October 2005. As many BOH members reported not receiving will be provided at sign-in. For more information go to
the survey via their health department administrators, improved <www.mahb.org/Certification/`certification.htm>. O
channels of communication will also be examined.
i\ mplications of this survey, based on the data, should lead to
relevant and effective recommendations to better meet the
needs of board of health members across Illinois. Since this
Survey, an Affiliation Agreement has been signed with NALBOH
that we anticipate will further assist all Local BOH members
through our Illinois Association of Boards of Health. O
j
Page 12 NALBOH Newsfirief' Third Quarter 2005
111[911111 L41111 _ _ • ' • . •
Critical Findings when nation's environmental health Local boards of health must think pro-
infrastructure inadequately prepared to actively to properly address the
Assessing the effectively manage the myriad of existing environmental health workforce concern.
Environmental Health and emerging environmental health Local boards may have to think outside
challenges. the box in order to successfully recruit
Workforce Capacity and retain qualified environmental
The Seventh Report to the President and health professionals. Please share
An adequate supply of qualified public Congress on the Status of Health your innovative ideas or success stories.
health iscriticaltothenation's Personnel in the United States (1988) Please email
professionals your experiences to
environment and is the first line of defense illustrated the urgent need to address the <jeff@nalboh.org>. O
in an intentional or unintentional health national shortage in the environmental
emergency. Today, health agencies are health workforce. The report calculated
facing shortages of these critical personnel that 137,000 additional environmental Flu Pandemic: Are We
and have been concerned for more than a health professionals are needed
decade. The Bureau of Health Professions throughout the country. Estimates of the Prepared?
(Department of Health and Human existing number of environmental health
Services Health Resources and Services practitioners vary widely, but an Over the past few years, there has been
Administration) issued a report entitled the additional 137,000 represents at least a lot of attention given to the influenza
Public Health Work Force Enumeration 2000 twice as many as are currently in the field. virus. With the shortage of flu vaccine
that stated that the ratio of state public Accredited undergraduate environmental and the introduction of avian flu into.our
health workers to population had dropped health programs graduate fewer than 400 vocabulary, are we really prepared any
from 219 per 100,000 in 1980 to 158 per students each year, far too few to fulfill better today than we were just a few
100,000 in 2000. A survey of this need. Enrollment in the nation's short years ago? According to a report
thirty-seven state health departments in accredited environmental health programs issued by the Trust for America's Health,
2003 by the Council of State Governments, has declined from 2657 in 1994 to 1078
the answer to the question is a simple no.
the National Association of State in 2002 which is a 60% decrease in eight
Personnel Executives, and the Association Years. According to the report, even a
of State Territorial Health Officials revealed moderately severe strain of pandemic flu
critical public health workforce issues The National Environmental Health Science could kill up to half a million Americans with
including: and Protection Accreditation Council is over two million in the hospital with
successfully addressing some of the serious complications. Unfortunately, there
• High Vacancy Rates - high vacancy above-mentioned issues by introducing are less than one million staffed hospital
rates are one sign of workforce interventions to increase enrollment,
I~! beds in the U.S. so many people will not
shortages, and the average vacancy diversity, and programs that teach receive the care needed to fight off the
rates in state public health agencies environmental health. Student
e o loess.
averaged 11% (rangy 1/o to 21%) in recruitment grants to increase enrollment
2002. and diversity as well as efforts to recruit According to the World Health
new environmental health programs have Organization (WHO) a flu pandemic
• High Turnover Rates - the average had direct impact on current enrollment involving the H5N1 avian virus could kill over
annual employee turnover rate was and diversity. Most grant recipients saw seven million worldwide primarily because
12% (range 1% to 21%) in 2002. an increase in enrollment; from 2003 to people lack immunity to the virus. The
2005, enrollments have increased more U.S. is currently stockpiling antiviral drugs,
• Aging Work Force - the average than 5% and graduation rates have specifically oseltamivir, to help combat the
age of public health employees is increased 18%. Additionally, three potential flu pandemic. This drug does
almost 47 which points to the Association of Environmental Health not cure influenza but it can prevent
predominance of "baby boomers" in Academic Programs members have infection or reduce its severity if taken
the work force. become newly accredited. early enough.
• Retirement Eligibility - on average, There is no profession that more clearly Boards of health should be taking the
about 25% (range 6% to 450%) of the affects the public than the environmen- necessary precautions at this time in
public health work force is eligible for tal health professional. Whether in the preparing for a possible flu pandemic.
retirement. air we breathe, the food and water we Boards of health must ensure their local
consume, or the homes in which we live, public health agency and community have
Environmental health professionals are best the public's health is ensured by environ- emergency plans in place to address the
known for their efforts to ensure safe food, mental health professionals. An possibility of pandemic flu. Some issues
water, air, and sanitation, but the understaffed or ill-trained workforce can to consider in the planning process are
emergence of new disease threats such ultimately result in higher rates of disease, health care system surge capacity,
as West Nile Virus, SARS, and pandemic death, or costly clean up of env
ironmen- communication and coordination between
influenza identifies the ever-increasing need tal hazards. The workforce must be highly public and private sectors, and placing
for a strong environmental health trained to anticipate, recognize, evaluate, limitations on the movement of the
workforce. The continuing declines in the and effectively control disease and public. O
size and capabilities of the environmental environmental threats. Working
health workforce have possibly left the together we can accomplish these goals.
Third Quarter2005 NALBOH Newsbirief page 13
Environmental Health & Emergency Preparedness (continued)
41Boards of Health Infection Control and
Role in Disasters Emergency Shelters
Such as Hurricane
Katrina Community shelters provide temporary
housing for individuals who are displaced
from their homes following natural
What can you do as a board of disasters like Hurricane Katrina.
health member in times of Community shelters may offer more
public health emergencies such than just temporary housing though.
as Hurricane Katrina which K Without proper screening and infection
devastated the gulf coast control procedures, community shelters
recently? ~i could potentially offer an opportunity
j + for displacpci individuals to contract an
First, boards and their local ii infectious disease. Boards of health must
public health agency need to be be aware of the many dangers associated
prepared. Make sure there is a with temporary shelters and ensure
plan of action using the incident proper infection control procedures are
command system or unified practiced by the temporary residents.
command system. Whether it
only involves your health Source: <www.noaa.gov> General Infection Control Procedures
agency or other health agencies assisting include:
(unified) this command system, it helps to During the response, LBOH members may
organize the emergency response by be able to volunteer to assist in many • Proper Hand Hygiene:
establishing a chain of command and ways. You need to discuss in advance how After an emergency, potable water
giving a focus to various parts of the you can help your LPHA. may not be available. If potable
organized response such as operations, water is not available, alcohol-based
logistics, administration, and finance. Local Our core public health functions and the products may be used until potable
boards of health (LBOH) must assure the Ten Essential Services are very much a water and hand washing facilities are
level of preparedness. part of emergency response. Our role in available. Once the facilities are
governance is critical to having a well available for use, public health officials
LBOH members need to assure that their prepared LPHA to be able to respond must ensure the residents and shelter
Local Public Health Agency (LPHA) effectively to any intentional or staff are properly washing their hands.
practices by having drills among unintentional event that affects the
themselves to test their response public's health. • Clean Living Environment:
capabilities as well as with the local Maintaining clean surfaces and
Emergency Management Agency. They LBOH are the hub of the public health providing proper trash removal help
need to practice establishing an incident system. LBOH represent public health's to reduce the seread of infections to
command or management system. LBOH democracy by connecting people to residents and staff.
should know when these drills occur, public health.
attend them and possibly participate. • Good Personal Hygiene:
Public health demonstrated its Practicing good personal hygiene is as
Boards of health need to look at the Ten effectiveness greatly in its response to the important for shelter staff as it is to
Essential Public Health Services and relate aftermath of Hurricane Katrina by making the residents. Good hygiene
them to a response to an emergency or a effective public health interventions practices include such things as
disaster which effects the public's health. through prevention. Our public health proper hand washing, bathing on a
The LPHA uses every one of those ten system is strong and getting stronger by regular basis, and not sharing personal
services and LBOH need to assure that having effective governance through toilet items like toothbrushes.
those services are met during a disaster LBOH. O
especially by having an adequate staff to Boards of health must also ensure that
carry out those services. LBOH can help to What Happens After the Dirty Bomb residents are properly screened by medical
assure that there is a surge capacity by Explodes? Radiological Population personnel upon entering the shelter and
helping to sponsor a Medical Reserve Corps Monitoring isolated from the general population if found
and to have mutual aid agreements to brin Centers for Disease Control and
g Prevention Public Health Training ill. Some conditions that may constitute
in staff from neighboring counties or g isolating individuals include: fever, cough,
districts or even from other states through Network Satellite Broadcast & Webcast. skin rashes or lesions, vomiting, and
4 the states' Emergency Management SAVE THE DATE: diarrhea. O
Assistance Compact (EMAC). EMAC March 9, 2006
authorizes states to provide assistance. 1:00-3:00 PM ET
States such as Florida and North Carolina Questions may be e-mailed in advance of
have deployed public health staff into the the broadcast to <rsb@cdc.gov> For more
area impacted by Katrina to assist. information visit <www.phppo.cdc.gov/
phtn. 0
Page 14 NALBOH News Brief Third Quarter 2005
Share Your Experiences With NALBOH
NALBOH relies onboard members and other volunteers to guide its work. Committees meet monthly via conference calls.
Members have an active role in reviewing, recommending and directing NALBOH activities and products. Complete the form by
checking the box(es) of the committees on which you are interested and provide your contact information. Submit to NALBOH
via fax at (419) 352-6278 or mail to NALBOH, 1840 East Gypsy Lane Road, Bowling Green, OH 43402 no later than
November 30, 2005. Thank you for your support.
?Awards Committee ? Emeritus Committee
Directs search for award nominations. Reviews Assists at the annual conference; works with the
nominees and selects award recipients. Coordinates Membership and State Association Committees; works
awards and their presentation at the annual conference. with Board of Directors in requested capacity.
Must be a farmer NALBOH Board of Director or
?Board Development Committee officer to volunteer for this committee.
Oversees the election process of NALBOH's Board ? Finance Committee
of Director positions. Facilitates new board member Oversees the development and implementation of
orientation and the annual self-evaluation of the board. financial policies and procedures. Explores additional
income opportunities. Reviews financial statements the
? By-Laws Committee annual budget .
Annually reviews NALBOH By-laws and submits draft
and proposed amendments. Presents revisions to the ? Legislative Committee
Board of Directors and the association membership for Develops procedures for proposing legislation and
vote at the annual conference. programs to keep national legislators informed on public
health issues. Encourages legislative efforts at the state
? Education & Training Committee level to promote local public health advocacy efforts.
Coordinates and reviews all education efforts between ? Membership Committee
the subcommittees; works with the Program Committee
in planning the annual conference; and develops Plans and organizes the annual membership drive and
educational resources and training materials to strengthen all follow-up activities. Establishes targeted
boards of health. membership drives and explores joint membership
ventures. Reviews dues dtructure and membership
? Environmental Health Subcommittee benefits.
Develops environmental health educational
resources and training materials; oversees related
grant activities. 0 program Committee
.
Plans, organizes, and implements the annual conference;
? Preparedness/Workforce Subcommittee reviews past evaluations; presents draft conference
Develops preparedness and workforce development schedules to the Board of Directors for approval.
educational resources and training materials;
oversees related grant activities. ? State Association Development
? Tobacco Control and Prevention Subcommittee Committee
Guides the development of NALBOH's tobacco (SALBOH Committee)
control policies and advocacy efforts; promotes Identifies states with state associations of local boards
anti-tobacco efforts; oversees related grant of health; provides or identifies resources to organize
activities. state associations; helps develop and establish state
associations. Must be a president or executive director
of a SALBOH to volunteer for this committee.
NAME BOARD OF HEALTH/AFFILIATION
ADDRESS PHONE
FAX EMAIL ADDRESS
7hird Qaarter2005 NALBOH NewsBrief page 15
;1
The Grass III
r ~ I I
October 2005
3rd International Conference on Safe Water
Safe Water, Water for Life, Water for All People
October 20-21, 2005
Hilton San Diego Resort, San Diego, California
Sponsored by Safe Water 2005
For more information visit <www.safewater2005.com>
Massachusetts Association of Health Boards Certification Program
October 22, 2005
8:00 a.m. - 4:00 p.m.
Clarion Hotel, Northampton, Massachusetts
Sponsored by Massachusetts Association of Health Boards
For more information visit <http://www.mahb.org/Certification/certification.htm>
3rd National Prevention Summit
Innovations in Community Prevention
October 24-25, 2005
Hyatt Regency Washington on Capitol Hill, Washington, DC
Sponsored by Steps to a Healthier US Initiative
For more information visit <www.healthierus.gov/steps/summit.html>
Wyoming Through the Chew's 2nd Annual Spit Tobacco Summit
Working Together to Save Lives
October 24-26, 2005
Parkway Plaza Hotel, Casper, Wyoming
Sponsored by Wyoming Through the Chew
For more information visit <http://www.throughwithchew.com/twc/ss.asp?nbid=16>
November 2005
Massachusetts Association of Health Boards Certification Program
November 12, 2005
8:00 a.m. - 4:00 p.m.
Holiday Inn Taunton, Taunton, Massachusetts
Sponsored by Massachusetts Association of Health Boards
For more information visit <http://www.mahb.org/Certification/certification.htm>
American Cancer Society's Great American Smokeout
November 17, 2005
Sponsored by American Cancer Society
For more information visit <http://www.cancer.org>
December 2005
American Public Health Association's 133rd Annual Meeting and Exposition
December 10-14, 2005
Philadelphia, Pennsylvania
Sponsored by American Public Health Association
For more information visit <http://www.apha.org>
Save the Date - 2006
7th Annual Ned E. Baker Lecture in Public Health
Friday, April 7, 2006
Sponsored by National Association of Local Boards of Health
For more information, visit <www.nalboh.org>
National Association of Local Boards of Health
National Association of County & City Health Officials
Co-located Annual Conference
July 26 - 29, 2006
Sheaton®Gunter Hotel`
205 Fist Hfn st e , sen AnmNo, TOM 78205 Tel"hore: (210) 227.3241 Far (210) 7273299
Tdl F~'ree se,vetl (588) 999.2089
~y
The Sheraton Gunter Hotel is a historical San Antonio riverwalk hotel near the San Antonio convention center,
riverwalk restaurants, the alamo, theater district, and downtown San Antonio attractions.
For more information on the Sheraton Gunter Hotel visit <www.gunterhotel.com/gunterhome.html>.
For more information on NALBOH's 14th Annual Conference, visit our website at <www.nalboh.org>.
National Association of Local Boards of Health NON PROFIT ORG.
1840 East Gypsy Lane Road U.S. Postage
N A L B O H Bowling Green, OH 43402 PAID
Bowling Green, OH
E-mail: <nalboh @ nalboh.org> Permit No. 47
Website: <www.nalboh.org>