01/04/2006
i
' NEW HANOVER COUNTY BOARD OF HEALTH
New Hanover County Health Department
Dr. Thomas Fanning Wood Memorial Conference Room
2029S.17 1h Street
Wilmington, North Carolina 28401
Wednesday, January 4, 2006
AGENDA
Date: January 4, 2006
Time: 8:00 A.M.
Place: Dr. Thomas Fanning Wood Memorial Conference Room
n~ • ' New Hanover County Health Department
Y/ll9?G/ Presiding: Mr. Donald P. Blake, Chairman
Invocation:
Minutes: December 7, 2005
UU Recognitions: - Mr. Donald P. Blake
Personnel
New Employee(s)
Arlene DeShields, Environmental Health Specialist, Environmental Health Services
Tyler McKeithan, Environmental Health Specialist, Vector Control, EHS
n,/~~i1uo~•• /arm 5a~ - /tom
Ten (10) Year Service ward
Alicia E. Pickett, Environmental Health Program Specialist, EHS
Twenty (20) Year Service Award
Janet McCumbee, Personal Health Services Manager, Personal Health Services
Other Recognitions
Oath of Office
Board of Health Members
General Public Representative: Donald P. Blake
Dentist Representative: Dr. Sandra L. Miles
Engineer Representative: John S. Tunstall
BOH Agenda
January 4, 2006
' Page 2
Departmental Focal:
New Hanover County Health Department Website Mr. David E. Rice
Health Director
q Monthly Financial Report: November 2005 Ms. Cindy W. Hewett
(Includes Grant Update) Business Manager
Committee Reports:
Executive Committee Mr. Donald P. Blake
New Business: Mr. Donald P. Blake
Cape Fear Memorial Foundation (CFMF) - Letter of Intent -
T Obesity - Health Programs Administration
Interpreter Grant - Personal Health Services - $20,000 14
Cape Fear United Way Grant - Dental Unit - $38,00
oZ3 I Orientation for Local Boards of Health
1630,-3 Revised NHCHD Organizational Char 0
NHCHD Board of Health 2006 om ' tee Assignments
iler&ase i/ Ole tJ
Comments:
Board of Health Members Mr. Donald P. Blake
Health Director
Mr. David E. Rice
Health Director
1. Business Manager Vacancy
2. NHCHD Policy and Procedures
3. Invocation Schedule for 2006
Other Business: - 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, December 7, 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
John S. Tunstall, PE
Stanley G. Wardrip, Jr.
G. Robert Weedon, DVM, MPH
Members Absent:
Others Present:
Cheryl Welch, Star New Reporter
Darlene Hobson, Public Health Nurse, Clinic Team, Personal Health Services
Joseph Nick Meier, Vector Control Officer, Vector Control, EHS
David Glenn Jenkins, Environmental Health Program Specialist Senior, Vector Control, EHS
Nancy A. Ryan, Shelter Supervisor, Animal Control Services
Anthony Williams, Animal Control Officer, Animal Control Services
Larry Grimsley, Public Health Nurse, Clinic Team, Personal Health Services
Teresa Y. Stanley, Public Health Nurse, School Health Team II, Personal Health Services
Frankie Mincey, Public Health Nurse, School Health Team 11, Personal Health Services
Evelyn Bowden, Public Health Nurse, School Health Team II Supervisor, PHS
Carol C. Bottoms, Dietitian, Nutrition, WIC, Personal Health Services
Cindy Hewett, Business Manager
Elisabeth Constandy, Health Promotion Supervisor, Health Programs Administration
Dr. Jean McNeil, Animal Control Services Manager
Betty Jo McCorkle, PHN, Clinic Supervisor, Personal Health Services
Scott Harrelson, Assistant Health Director
David E. Rice, Health Director
Marilyn Roberts, Recording Secretary
Invocation:
Dr. Edward Weaver, Jr. gave the invocation.
Minutes:
The minutes of the November 2, 2005 Board of Health Meeting were approved as submitted.
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Recognitions:
Mr. Blake recognized and reminded everyone of Pearl Harbor Day- December 7m.
Personnel
New Employee(s)
Darlene Hobson, Public Health Nurse, Clinic Team, Personal Health Services
Joseph Nick Meier, Vector Control Officer, Vector Control, Environmental Health Services
Five (5) Year Service Award
David Glenn Jenkins, Environmental Health Program Specialist Senior, Vector Control, EHS
Ten (10) Year Serv ice Award
Nancy A. Ryan, Shelter Supervisor, Animal Control Services
Anthony Williams, Animal Control Officer, Animal Control Services
Carol'C. Bottoms, Dietitian, WIC, Personal Health Services.
Mr. Don Blake and Mr. Rice welcomed new employees and congratulated staff on their tenure
with the Health Department.
Other Recognitions
Super Staff Award - January 2006
Teresa Y. Stanley, Public Health Nurse, School Health Team 11, Personal Health Services was
recognized as Super Staffer for January 2006.
Department Focal: Health Programs Administration - Pediatric Dental Unit
Mr. Scott, Harrelson, Assistant Health Director gave a brief update on the Pediatric Dental Unit
(Brunswick and New Hanover County). Highlights of the presentation included:
Target Audience
• Medicaid Children 18,000
• NC Health Choice 3,000
• Uninsured 6,290
Total 27,290
Free and Reduced lunch for children is much higher with each of these schools; average stay for unit will
be about two months.
School Sites
• Freeman Elementary
• Johnson Elementary
• Williston Middle/Gregory Elementary
• Sunset Park Elementary
• Lincoln Elementary (Brunswick)
• Supply Elementary (Brunswick)
Scheduling
• 8-2:30 On-Site
• One year round school, Johnson
• Boys and Girls Clubs •
• Brunswick Head Start
• Referrals from partner agencies
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Care Path
• interest survey
• Income verification
• Payment (if necessary) -
• Consent for Treatment
• Child retrieved from class
• Initial Visit, cleaning and x-ray
• Develop the care plan
• Consent to administer care plan
• Treat the child
Impact
• 3000 new customers
• Recurring source of free care
• Sliding fee scale dental clinic
• Reduced school absences
Progress
• Obtained grant funding
• Signed a dentist
• Completed bid process
• Application to United Way
• Support from Healthy Carolinians
• Surveys for Williston
• Construction of the unit began in December 2005
• Delivery for April 2006
Ms. Pritchett, County Commissioner expressed concern as to the inclusion of all Preschoolers.
Following a brief question and answer session, Mr. Blake thanked Mr. Harrelson for his
presentation.
Monthly Financial Report - October 2005 (Including Grant Status Report)
Ms. Cindy W. Hewett, Business Manager presented the October Revenue and Expenditure
Summary Report that reflects an earned revenue total of $2,618,747 with a remaining revenue
budget of $4,883,238 and an expenditure total of $3,447,673 with a remaining budget of
$10,440,133. Ms. Hewett commented that Animal Control Services are doing a good job with
collections. Revenues are up and Expenditures are down. A summary of the financial report is
below:
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 24.83%
Revenue: $7,501,985 2,618,747 34.91%
Net County $6,385,821 $828,926 12.98%
Ms. Hewett reported the Health Department Grant Status. Totals for grants requested $1,041,700
received $451,700 and denied $485,000. Two pending grants: Office of Research,
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Demonstrations and Rural Health - Pediatric Primary Care Grant for $50,000 and Healthy
Carolinians - Contract Coordinator for $5,000.
Committee Reports:
None
New Business
Mr. Blake reported that the Executive Committee met on November 291h and made several
recommendations for the Board.
NHC Health Department Fee Policy Changes - Personal Health Services - Laboratory.
Procedure Codes and Fees
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 not able to bill for referred lab services that are
not included as part of a mandated service. I
Motion: Mr. Blake moved from the Executive Committee for the Board of Health 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. Upon vote, the MOTION
CARRIED UNANIMOUSLY.
National Association of County and City Health Officials (NACCHO) Grant - Address a g
Disability in Local Public Health
Mr. Scott Harrelson, Assistant Health Director presented information - The National Association
of County and City Health Officials (NACCHO) has released a proposal for local health
departments to address serving clients with developmental disabilities (autism spectrum
disorders, mental retardation, cerebral palsy, ADHD, hearingNisual disorders, etc.) The
University of North Carolina at Wilmington has identified a gap in identification of resources for
this population, and has requested to partner with New Hanover County Health Department
(NHCHD) to develop a resource network for these agencies and the families/clients that they. .
serve. UNCW is primarily interested in the physical health benefits that could be enhanced
through increased awareness of services in the area, as the developmentally disabled are at Ia
higher risk for lifestyle related illness (obesity, sedentary lifestyle). NHCHD would include this
physical enhancement as part of the department's Health Promotion plan to increase activity, and
could potentially increase service to a population that is currently underserved for health services.
UNCW will utilize the majority of funding to assess use of local services, hire a graduate
assistant or fund existing faculty time to coordinate initiative, and pay for cost of post-initiative
evaluation of use of services. NHCHD Health Promotion will coordinate presence of NHCHD
staff members to participate in provider in-services, resource sharing events, and other events to
promote NHCHD services.
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Motion: Mr. Blake moved from the Executive Committee for the Board of Health to accept and
approve the Grant Application - National Association of County and City Health Officials
(NACCHO) through Health Promotions for $25,000 and associated budget amendment if funding
is received and submit to the New Hanover County Commissioners for consideration. Upon
vote, the MOTION CARRIED UNANIMOUSLY.
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Training - Customer Service Program - Health Programs Administration
• Mr. Scott Harrelson explained that during the past year the Health Department's Quality
Assurance Team has assessed the need for a continuous customer service program for the Health
Department. This has also been addressed as a point of interest for the county through the
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 that 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 30 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. The cost would be $8,000 for the first year.
There was discussion among the Board of Health members. Ms. Nancy Pritchett, County
Commissioner inquired as to the outside consultant. Mr. Rice stated that Mr. Bruce Shell, the
new. County Manager would tag on to this concept because the county is interested in our process.
Motion: Mr. Blake moved from the Executive Committee for the Board of Health to accept and
approve the allocation of $8,000 to develop service standards and provide the "Leading
Empowered Teams" in Service Quality Excellence training and to submit to the New Hanover
County Commissioners for consideration. Upon vote, the MOTION CARRIED
UNANIMOUSLY.
Resolution - Influenza Vaccine Supply
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
purchase for public health. During the past few years, New Hanover County Health Department
has been challenged in ordering enough influenza vaccine to meet the demand.
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
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Whereas, commercial vaccinators make early bulk purchases of influenza vaccine and are able to offer _
mass flu campaigns before public health can vaccinate high-risk populations; and O
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 nati Inally
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 uni lersal
influenza vaccine recommendation; now
Therefore, in recognition of this compelling public health challenge, the New Hanover County Hialth
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 are developed for providers who disregard high-risk vaccination criteria.
Adopted this day of 2005
Donald P. Blake, Chairman Robert G. Greer, Chairman •
New Hanover County Board of Health New Hanover County Board of Commissioners
Motion: Mr. Blake moved from the Executive Committee for the Board of Health to accept and
approve the Resolution and to submit to the New Hanover County Commissioners for
consideration. Upon vote, the MOTION CARRIED UNANIMOUSLY.
Board of Health Meeting Dates for 2006
Mr. David E. Rice presented the Board of Health members with the Board of. Health Meeting
dates for 2006. The meetings will continue to be held on the first Wednesday of each month at
8:00 a.m.
Motion: Motion passed from the Executive Committee to recommend to the Board of Health to
accept and approve the Board of Health Meeting Dates for 2006. Upon vote, the MOTION
CARRIED UNANIMOUSLY FOR THE ACCEPTANCE OF THE BOARD OF :HEALTH
MEETING DATES FOR 2006.
Election - Board of Health Officers for 2006
Dr. Sandra L. Miles, Chairman of the Nominating Committee, presented the following Board of
Health members nominated by the Nominating Committee for 2006 Chairman and Vice-
Chairman of the New Hanover County Board of Health.
Mr. Donald P. Blake, Chairman
Dr. Edward Weaver, Jr., Vice-Chairman
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There were no further nominations from the floor. A motion was made to close nominations.
Upon vote, the MOTION CARRIED UNANIMOUSLY. Mr. David E. Rice, Health Director,
• received the completed ballots and the vote was unanimous for Mr. Blake and Dr. Weaver.
Comments
Board of Health Members:
Ms. Pritchett, County Commissioner distributed flyers from the New Hanover County Gang
Intervention and Education Team.
Ms. Cheryl Lofgren inquired as to the status of the Food and Lodging Fees collections from the
state. Mr. Rice is to make contact with Mr. Terry Pierce regarding this issue.
Ms. Lofgren also expressed interest in the statistics of the pediatric flu shots given.
Health Director:
Accredited Health Departments
Mr. Rice distributed a map of the geographic locations of the 2006 Participating Health
Departments for Accreditation.
Dr. Weaver expressed interest in the smaller counties versus the larger counties to be accredited.
Flu Vaccine Concern
Mr. Rice presented copies of a letter from a local Wilmington doctor to President Bush in regards
to receiving flu vaccine.
Mr. Blake expressed concern as to the flu coverage. There was discussion among Board of
Health members as to the status of our flu shot clinic, the suppliers and the number of patients
that continue to come in for flu shots.
Social Security Account Numbers
Mr. Rice presented a letter from Mr. Chris Hoke, NC Division of Public Health and Ms. Jill
Moore, UNC Institute of Government regarding the new guidance on Local Health Departments'
Collection and Use of Social Security Numbers.
East Carolina University - MPH Program Advisory Board
Mr. Rice announced that he would be serving on the East Carolina University - MPH Program
Advisory Board.
North Carolina Association of Local Health Directors (NCALHD) Region 8 Representative
Mr. Rice announced that he has been appointed as the North Carolina Association of Local
Health Directors (NCALHD) Region 8 Representative for 2006-07.
•
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Letter of Intent to Cane Fear Memorial Foundation
Mr. Rice presented a copy of a Letter of Intent to the Cape Fear Memorial Foundation from the
Cape Fear Healthy Carolinians and the New Hanover County Health Department regarding
Obesity Grant Application. Mr. Rice stated that we are taking our Strategic Planning goals very
seriously and there will be more information to come.
County Manager to attend January Board of Health Meeting
Mr. Rice announced that he has invited Mr. Bruce Shell, the new County Manager to attend the
January 4, 2006 Board of Health Meeting.
Holiday Celebration
Mr. Rice reminded the Board of Health members to attend the Holiday Celebration to be held on
December 8`h.
Adjournment:
Mr. Blake adjourned the regular business meeting of the Board of Health at 9:45 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:
8
New Hanover County Health Department
Revenue and Expenditure Summaries for November 2005
Cumulative: 41.67% Month 5 of 12
•
Revenues
Current Year Prior Year
Type of Budgeted Revenue Balance % Budgeted Revenue Balance %
Revenue Amount Earned Remaining Amount Earned Remaining
Federal 8 State $ 1,816,791 $ 1,225,161 $ 591,630 67.44%;;. $1,999,741 $ 849,702 $ 1,150,039 42.49%
C Fees $ 659,496 $ 281,142 $ 378,354 42.63%z $ 580,161 $ 248,885 $ 331,276 42.90%
Medicaid $ 1,500,300 $ 414,765 $ 1,085,535 27.65%. $1,138,039 $ 309,038 $ 829,001 27.16%
Medicaid Max $ - $ - - $ 151,600 $ - $ 151,600
EH Fees $ 300,212 $ 91,483 $ 208,729 30.47%.i_4. $ 300,212 $ 107,752 $ 192,460 35.89%
Health Fees $ 128,000 $ 110,118 $ 17,882 86.03%';. $ 113,545 $ 64,244 $ 49,301 56.58%
Other $ 3,097,186$ 1,004,622 $ 2,092,564 32.44%r,. $2,440,135 $ 729,096 $ 117111039 29.88%
TolalS $ 7,501,985 $ 3,127,291 $4,374,694 41.69% $6,723,433 $ 2,308,716 $ 4,414,717 34.34%
Expenditures
Current Year Prior Year
Type of Budgeted Expended Balance % Budgeted Expended Balance %
Expenditure Amount Amount Remainin Amount Amount Remaining
Salary & Fringe $ 11,315,151 $4,104,390 $ 7,210,761 36.27% $10,420,730 $3,531,406 $6,889,324 33.89%
Operating $ 1,893,430 $ 647,141 $ 1,246,289 34.18%" $ 1,680,360 $ 646,670 $1,033,690 38.48%
Capital Outla $ 679,225 $ 166,395 $ 512,830 24.50%L' $ 216,841 $ 17,593 $199,248 8.11%
Totals 5 13,ee7,806 $4,917,926 $ 8,969,880 35.41%s 12,317,931 $ 4,195,668 $8,122,263 34.06%
Summary
Budgeted Actual %
FY 05-06 FY 05-06
Expenditures:
Salaries & Fringe $11,315,151 $4,104,390
Operating Expenses $1,893,430 $647,141
Capital Outlay $679,225 $166,395
Total Expenditures $13,887,806 $4,917,926 35.41%
Revenue: $7,501,985 $3,127,291 41.69%
• Net County $6,385,821 $1,790,635 28.04%
Revenue and Expenditure Summary
For the Month of November 2005
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NHCHD BOARD OF HEALTH APPROVED GRANT APPLICATION STATUS FY 05-06
Date BOH Grant Requested Pending Received Denied
NACCHO Grant-Addressing Disability in
Local Public Health. Collaboration with
• 12/7/2005 UNCW. $25,000 $25,000
Office of Research, Demonstrations and _
11/2/2005 Rural Health- Pediatric Prima Care Grant $50,000 $50,000 O 600
Health Carolinians- Contract Coordinator $5,000 $5,000 S COD
10112/2005 No activity for October 2005.
9/7/2005 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 ' allocating budget- ' Grant was
$5,000 from approved by not approved
to be used for educational purposes and existing PA NHC-CC by RWJ
media campaigns only. budget 9119105 Foundation
7/612005 No activity for Jul 2005.
NC Dept of Insurance- Office of State Fire
6/112005 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
1/5/2005 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
1117/2004 for pregnant women. $ 3,000 $ 3,000 $
10/612004 No activity to report for October 2004.
9/1/2004 No activity to report for September 2004.
Office of the State Fire Marshal- NC
Department of Insurance- Risk Watch
8/4/2004 continuation funding (3years) $ 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
7/7/2004 Program- Smoking Cessation- $ 50,000 $ - $ - $ -
Wolfe-NCPHA Prenatal Grant- Diabetic
Supplies for Prenatal Patients $ 5,000 $ 5,000
Totals $1,066,700 $80,000 $451,700 $485,000
7.50% 42.35% 45.47%
• Pending Grants 3 17%
Funded Total Request 8 44%
Partial) Funded 2 11%
Denied Total Request 5 28%
Numbers of Grants Applied For 18 100%
As of 12/5/2005
` NOTE: Notification received since last report. 10
" Program did not apply for grant.
NEW HANOVER COUNTY BOARD OF COMMISSIONERS
Request for Board Action
Agenda: Consent Meeting Date: 01/09/06
Agenda:
Department: Health Presenter: Scott Harrelson, Assistant
Health Director
Contact: Scott Harrelson, Assistant Health Director
Subject: Cape Fear Healthy Carolinians (CFHC) - Grant Application - Letter of Intent -
Obesity
Brief Summary: The Obesity Sub-Committee of Cape Fear Healthy Carolinians (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 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. We are
requesting $300,000 over three years to establish the necessary infrastructure 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, and cover basic
start up expenses. No County matching funds are required Space for the two temporary
employees will be provided via in-kind contribution from UNCW.
The grant application will be completed by members of the Obesity Sub-Committee.
Cape Fear Memorial Foundation requested that the funding be routed through the New.
Hanover County Health Department. Considering that Obesity was among our top
initiatives for the department we would like to offer our support to assist this project.
Recommended Motion and Requested Actions: To approve the Letter of Intent for Grant
Application requesting $300,000 from Cape Fear Memorial Foundation over three years,
to accept the funds if awarded, and approve an associated budget ammendment.
Funding Source: Cape Fear Memorial Foundation
Will above action result in:
?New Position Number of Position(s)
?Position(s) Modification or change
?No Change in Position(s)
• Explanation: No new permanent positions. Temporary Program Coordinator and
Temporary Administrative Support Technician - no benefits.
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Attachments: Letter of Intent for Grant Application
•
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NEW HANOVER COUNTY
'HEALTH DEPARTMENT
e 2029 SOUTH 17TH STREET
WH.D'HNGTON, NC 28401-4946 NlAM NOY[l COVN YX!
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 concemed 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 mall 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'leadership...
We are requesting $300,000 over three years to. establish the necessary infrastructure
to coordinate the community efforts, assist in the implementation of the multiple 1
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, and
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 x.
Carolinians currently has available. It is the cleat 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 si 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 Wilm ngton .
Health Access For Teens. Therefore another member of the CFHC is needed tolbe the
fiscal agent.. In considering which of the CFHC partners would be the most logicial fiscal
agent for this grant request we identified the New Hanover County Health DepartFnent
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.
Respectfully,
? I~EC O j
rg Figueroa, .D. David Rice, Director
Chair, Cape Fear Healthy Carolinians New Hanover County Health Department
14
® NEW HANOVER COUNTY BOARD OF COMMISSIONERS
Request for Board Action
Agenda: Consent Meeting Date: 01/09/06
Agenda:
Department: Health Presenter: Janet McCumbee, PHS
Manager
Contact: Janet McCumbee, PHS Manager
Subject: Grant Application-Spanish Interpreter Position Funds- $20,000
Brief Summary: The NC General Assembly has appropriated funds for the hiring of
interpreters, and has notified local health departments they may apply for funding in the
amount of $20,000/year to hire interpreters to enhance our capacity to serve Limited
English Proficiency (LEP) clients. NHCHD currently has a temporary, part-time Spanish
interpreter serving our WIC/Nutrition clients and our Child Service Coordination (CSC)
families. However, the demand for interpreting services is not being met. Our need is to
increase this temporary, part-time position to a full-time interpreter position, and this
funding, if awarded, will allow us to accomplish this. Our Hispanic population has
grown tremendously over the past 5 years, as evidenced by the WIC Hispanic caseload
(1999-2000 FY total=181 clients; 2004-2005 FY total=869). If funded, NHCHD would
receive $20,000 from the state for salary and fringe to support a full time position. A
local County match is required, which already exists in our currently budgeted temporary
salary supported by federal WIC funds and CSC Medicaid revenue. The current cost for
the part-time position is $25,650/year. The County match required to fund this increase
to a full-time position would be $24,000, which is slightly less than the current amount
funded through WIC and CSC budgets. No additional County funds would be required to
implement. Space is available for this position (currently occupied by temporary
interpreter this position will replace). If awarded, funds will be available January 1,
2006. There is potential for 3 years of funding. Sustainability: Position will be sustained
as long as funding continues.
Recommended Motion and Requested Actions: To approve the application for the
$20,000 state grant and, if awarded, the associated budget amendment related to the
recei t of rant funds in the health dept. 05-06 6 months and 06-07 6 months budget.
Funding Source: NC Office of Minority Health and Health Disparities, Division of
Public Health-$20,000; WIC and CSC revenue as matching funds (already included in
current bud et .
Will above action result in:
FjNew Position Number of Position(s)
®Position(s) Modification or change
?No Change in Position(s)
Ex lanation: Change art-time, temporary, position to FT position with benefits.
15
Attachments: WIC Spanish Caseload chart, Budget O
16
• HISPANIC CASELOAD TRENDS
Month/Year Total WIC Total Hispanic % WIC Hispanic
Participation WIC Participation Participation
December 2001 2824 233 8.3
March 2002 2783 255 6.7
June 2002 2940 281 9.6
September 2002 2976 286 9.6
December 2002 2885 279 9.7
March 2003 2843 303 10.7
June 2003 2901 332 11.4
September 2003 2930 360 12.3
December 2003 2813 373 13.3
March 2004 3034 442 14.6
June 2004 3115 473 15.2
September 2004 3082 530 17.2
December 2004 3056 549 18.0
March 2005 3130 626 20.0
June 2005 3175 639 20.1
September 2005 3107 641 20.6
Unduplicated Spanish clients using interpreter services for WIC:
FY 1999-2000: 181
FY 2000-2001: 273
FY 2001-02: 348
FY 2002-03: 418
FY 03-04: 590;
FY 04-05: 869
Total unduplicated for FY 2005-06 to date is 851 clients, only 14 away from the
entire last fiscal year.
17
NEW HANOVER COUNTY HEALTH DEPARTMENT
Budget for 4/1/04-3/31/05
NC Office of Minority Health
and Health Disparities Total Budget Grant Request NHCHD
Interpreter Grant
EXPENDITURES:
Personnel 12 months 1/1/06-12/31/06
Interpreter (Full Time Salaries / Wages* $28,650.00 $20,000.00 $8,650.00
Taxes $2,190.00 $0.00 $2,190.00
Benefits $12,360.00 $0.00 $12,360.00
Total Personnel $43,200.00 $20,000.00 $23,200.00
Non-Personnel Expenses
Office Supplies $500.00 $0.00 $500.00
Training/Travel $300.00 $0.00 $300.00
Total Non-Personnel Expenses $800.00 $0.00 $800.00
• * includes 5% merit/market
TOTAL EXPENSE BUDGET REQUEST $44,000.00 $20,000.001$24,000.001
12/14/2005 kr
18
Personnel: Program Assistant CR03 O
Hours / Week 40
Weeks / Year 52
Sala $27,290, 5% merit/market $1,365)
Taxes $2,192
Medical / Dental $12,500
Other: Describe: Retirement $1,418
19
• CSC Interpreting Need
The need for additional hours to equal a full time position has been documented by the
supervisors in the respective programs, as indicated below.
CSC
New Hispanic Clients Referred to CSC Program since January 2005 = 59
Current caseload of Hispanic children= 38
Frequency of contacts- one visit per month per family
New client visit with interpreter= 2 hours
Subsequent visits= 1 1h hours
Many services are delayed because of unavailability of interpreters
Examples:
• Standards not always be met for time from first referral received to first home
visit (2 weeks)
• 11 different CSC program staff use the interpreters, so this complicates the
scheduling, and visits must often be rescheduled
• One of the frustrations is just getting an interpreter to be available to sit with a
CSC to make phone calls
• Postpartum/Newborn home visits for Hispanic Moms/Babies are not currently
being done because of lack of interpreter time
• Child Find and outreach cannot be offered to Hispanic families in the community
• More translation is needed of forms and letters, many times these are unique or
short notes to a family, not a routine form already available in Spanish
20
NEW HANOVER COUNTY BOARD OF COMMISSIONERS
Request for Board Action
Agenda: Consent Meeting Date: 1/9/06
Agenda:
Department: Health Presenter: Scott Harrelson, Assistant
Health Director
Contact: Scott Harrelson, Assistant Health Director
Subject: Cape Fear United Way Grant
Brief Summary: The Cape Fear United Way has graciously agreed to provide NHCHD
with a grant of $38,000 for the purchase of a Panorex imaging machine for the mobile
dental unit. This piece of equipment would allow us a greater capability for discovering
dental abnormalities than routine x-rays. This would allow us to perform reimbursable
services from the mobile unit which could uncover dangerous abnormalities and better
treat the dental customers. This is a one-time grant, for the purchase of this equipment,
with no County match required. Grant will end once equipment is purchased. Space for
the equipment is available in the Mobile Dental Unit.
• Recommended Motion and Requested Actions: Approval for acceptance of Cape Fear
United Way Grant for the amount of $38,000 to purchase a Panorex imaging machine,
and associated budget ammendment for FY 05-06 related to the receipt of rant funds.
Funding Source: Cape Fear United Way
Will above action result in:
?New Position Number of Position(s)
?Position(s) Modification or change
®No Change in Position(s)
Explanation:
Attachments:
•
21
Cape Fear Area United Way
613 Shipyard Boulevard
Suite 100
P.O. Box 1503
Wilmington, NC 28402-1503
tel 910.798.3900
fax. 910.798.3917
Ryl
www.cfauw.org 416011
Memo
To: David Rice, Director
New Hanover County Health Department
From: Lynn Pharr, President
Cape Fear Area United Way
Date: December 15, 2005
Re: Mobile Dental Unit
Earlier today, our Board of Directors approved $38,000 for a Panorex Machine for the Mobile Dental
Unit. The United Way is actively seeking solutions to our community's most pressing needs and we
feel that this program will do just that. We are honored to partner with you in this most important
venture.
•
r k
22
Orientation for Local Boards of Health
An Instructional Module
M y
M ~~9 WT
g:~ f
Leaders Guide
N-S E i L.i E FOR UN 3C. H3„,F"2L H
23
Table of Contents
Introduction ................................................................................................................................1
Orientation Module CD Contents ...............................................:.........:......................................2
Module Packet Checklist .............................................................................................................3
Instructional Options I 5
Frequently Asked Questions 8
Technical Information 8
Appendix A-Planning Table .....................................................................................................10
Appendix B-Discussion Questions ............................................................................................12
Appendix C-Review Questions .................................................................................................14
i
24
Introduction
This Leader's Guide provides an overview to the "Orientation for Local Boards of Health" module. It also
includes guidance and recommendations for health directors on how to use module materials to lead your
board members through the orientation instruction as a group.
Since 2002, The North Carolina Institute for Public Health (NCIPH) has partnered with the North
Carolina Division of Public Health and the Association of North Carolina Boards of Health to provide
orientation for local boards of health in North Carolina. The NCIPH also works closely with the UNC
Institute of Government for legal guidance and consultation. As part of a Consolidated Agreement
between the NCIPH and the N. C. Department of Health and Human Services, N. C. Division of Public
Health, orientation training for new board members is required.
Beginning in 2002, Dr. Teme Levbarg, a Continuing Education Specialist at the NCIPH has traveled
throughout North Carolina, teaching a course designed to familiarize new board members with the
practice of public health and the issues with which public health is concerned. The course also introduces
them to their roles, responsibilities and the sources of law that pertain to public health, and reviews the
guidelines and expectations for participation as a local board of health member. As you know, the
volunteers who serve on local boards of health do not necessarily come from a background in public
health, yet, as board members, they are responsible for rule making, adjudicating disputes about public
health issues, as well as policy development and administration in public health. In this context,
orientation training is crucial
• In order to make the orientation training more accessible and convenient to those who need it, the NCIPH
has adapted the traditional instructor-led course into this CD-based module, which can be used in a
variety of ways to help you educate your board and support them in becoming an effective working
group. While this module could be completed independently by each of your board members, using the
CDs, they will get more out of the materials if you lead them as a group through the module. Ideally, all
board members will complete the orientation as a group, and participate in discussions using the questions
provided in each section of the module. Such an approach will maximize the benefits of the training for
your board as a whole, ensuring that everyone on your board is working from the same basic foundation.
We thank you in advance for being willing to take on a leadership role in implementing and guiding this
orientation training for your board members. The remaining sections of this Leader's Guide will provide
you with more details on the components of the module and suggestions on options for accomplishing the
orientation training. As group leader for those completing this module, we recommend that you first go
through the module yourself in order to become familiar with it. It is also recommended that you read
through the Leader's Guide, before beginning the module yourself.
Finally, you will be able to contact Dr. Teme Levbarg by either phone or email, should you need her
assistance or involvement in guiding your board members through this module. (Please see page 8 of this
guide for details on reaching Dr. Levbarg.)
Again, many thanks for your participation and leadership during the orientation process using this
module!
•
1
25
Orientationi Module 1 O
The Orientation for Local Boards of Health CD is a self-contained teaching tool for you to use
with your board during orientation training. The handout materials in your module pac et
support the presentations on the CD and are also integral to this training.
The Orientation CD covers the following topics:
Please note that Sections 2 and 3 are each composed of tiro parts.
Section 1 Ten Great Public Health Achievements of the 2e Centu
Section 2: Understanding the Work of a Board of Health:
Part 1 The Core Functions of Public Health
Section 2: Understanding the Work of a Board of Health:
Part 2 Ten Essential Services of Public Health
Section 3: Legal Responsibilities and Authority:
Part 1 Structure
Section 3: Legal Responsibilities and Authority:
Part 2 Roles and Responsibilities
Section 4 Guidelines and Expectations for Board Members
Each section or part on the CD includes the following core components:
? Introduction: A brief overview of the section/part, along with the objectives,
estimated time and materials needed to complete that section/part.
? Presentation and questions: A short audio and slide presentation that serves as the
"lecture" for the section/part. Each presentation includes a set of discussion
questions designed to help apply the material to your local board ofhealth and
prepare for group discussion.
? Discussion questions: The list of discussion questions from the presentation.
4- Review: A short, self-graded set of review questions covering the main pozpts of
that section/part.
? Resources: A list of websites and publications that may be helpful in learni g
more about the content in that section/part.
The CD also contains a glossary of public health terms and acronyms and their defuutions. The
glossary can be accessed from any section/part. .
2
26
Module
• In addition to this Leader's Guide, your packet of module materials should contain the following
items:
For Use by the Leader
l One Orientation for Local Boards of Health CD
ET Selected North Carolina Public Health Statutes (booklet)
I~ One copy of The Suggested Rules of Procedure for Small Local Government Boards (book)
I1 CJ One copy of The Rulemaking Authority of North Carolina Boards of Health (article)
d One copy of all PowerPoint slides from the CD, with script (to be reproduced for any
participant who is hearing impaired)
Provided for every Board Member
d Orientation for Local Boards of Health CD
E Selected North Carolina Public Health Statutes (booklet)
l~ The Rulemaking Authority of North Carolina Boards of Health (article)
10 Essential Services of Public Health (color handout)
d NCIPH fact sheet
Mf One copy of all PowerPoint slides from the CD (6 slides per page, no script)
Reproducible Masters of Additional Handouts
The following handouts should be reproduced for each participant. Note: Many of these masters
have been copied double-sided, for economy.
Registration form
E° Evaluation form
E Association of North Carolina Board of Health contact list
E1 Local Health Services Section, N.C. Division of Public Health
1I9 Public Health Across NC fact sheet
d institute of Government fact sheet
d Healthy Carolinians - Information about the North Carolina Community Health Assessment
d Healthy Carolinians - North Carolina 2010 Health Goals
19 Office of Minority Health - Racial and Ethnic Health Disparities in North Carolina Report
Card 2003
3
27
.
lJ Institute of Government publications:
? Health and Social Services Agencies' Legal Duties to Clients with Limite O
English Proficiency: New Federal Guidance
? Responding to Biological Threats: The Public Health System's Communi able
Disease Control Authority
These readings were chosen because they offer new board members a quick means of learning
about public health in North Carolina. Each article or fact sheet is concise and focused. ~or
example, the reading Racial and Ethnic Health Disparities in North Carolina Report Carld 2003
offers a quick reference to what the health issues are in North Carolina and the disparities~ that
exist by race and ethnic origin. The Institute of Government article, The Rulemaking Authority of
North Carolina Local Boards of Health is an instructive and compelling description of w a
happened in two different counties where local boards of health set about to make new rules and
were not successful.
These readings also clarify a number of acronyms and technical terms and introduce read s to a
broad range of public health topics, allowing board members to feel more confident and
comfortable about serving on a local board of health.
4
28
Inst!ructionall Options
This module was created in order to make crucial orientation training available to members of
local boards of health. The design for the module is somewhat flexible allowing you, as leader,
some choices in how it is delivered. You may choose to follow all the suggestions of this guide,
or, you may come up with your own ideas on what may make this training more effective for
your board. Whatever approach you use, if each of your board members completes the module
CD, including the review questions, takes time to think about the discussion questions provided,
and reads the additional handouts, he or she will obtain the basic foundation needed to be an
effective local board of health member.
Beyond this basic use, the orientation module will be most effective if you provide and facilitate
time for board discussion and interaction using the discussion questions in the PowerPoint
presentations on the module CD. This will enable members to learn the policies and practices of.
your board of health, as well as apply the knowledge they gain as they cover the material on the
CD. Providing discussion and interaction could be accomplished in at least two ways.
Group Learning by Section - Recommended model
The recommended approach would be to cover the module as a group, in a series of board
meetings, setting aside time to cover each section and part of the training. The PowerPoint
"lecture" presentations on the CD would be projected and viewed as a group at these meetings
• and discussion would occur as the discussion questions are encountered in the presentations. In
this format you might consider the possibility of inviting staff or other guests during appropriate
sections. For example, you might invite local health department staff for discussion of Section 3,
Part 2, which looks at the essential services provided by the health department. You would also
use copies made from the reproducible masters in the module packet to support the presentations
on the CD and enhance discussion.
Self-study and Group Discussion
This instructional option would involve allowing each of your board members to complete the
module CD and read the handouts individually. You would facilitate group discussions on the
material, based upon the provided discussion questions, at your regular board meetings, covering
one section or part per meeting. As in the option above, guests could be invited appropriately
depending on the topic and copies from the reproducible masters in the module packet would be
distributed to all board members to support the presentations on the CD and enhance discussion.
Remember that, whichever instructional option you choose, you should complete the module CD
yourself, before beginning training with your board.
Whichever way you choose to enhance the materials with group interaction and discussion, the
Checklist for Orientation Training that follows and the Planning Table (Appendix A) will be
helpful to you in planning your orientation training.
•
5
29
Checklist for Orientation Training
A checklist of suggested steps for coordinating your orientation training follows: O
Before the training
? Check the contents of your module packet and review the regis lith ation
and evaluation information provided.
? Complete the module CD yourself in order to become familiar it.
Pay special attention to the discussion questions, considering in advance
how you might facilitate such a discussion.
? Decide whether to complete this orientation training with all members of
the board, or use it only to train new members. (It is recommended that
all board members complete the orientation training together. This will
ensure that everyone on your board is working from the same basic
foundation. Also, experienced board members can contribute Ieatly
during group discussions.)
? Decide upon an instructional option. (See page 5.)
? Complete and send in a registration form for each participant.
? CHOOSE ONE OF THREE WAYS TO REGISTER:
1. Fax your registration forms to 919-966-5692
2. Register by phone by calling 919-966-4032
3. Mail your completed registration forms to:
Registrar, Office of Continuing Education
UNC-CH School of Public Health
Campus Box 8165
Chapel Hill, North Carolina 2759978165
? Develop a schedule for the training and provide it to participants.
? Distribute the materials to each participant.
? If participants are completing the module CD independently, encourage
them to complete the review questions and consider the discussion
questions in advance of the group meeting.
? Invite any guests who might add appropriately to group discussions.
During the training
? Encourage participation when viewing the presentations on the C~ as a
group.
? If participants are completing the module CD independently, pro de
support and direction, as needed.
? Provide reminders to participants concerning when group discussions
will take place and what content will be covered in each discussion.
6
30
` ? Brief yourself in advance for group discussions by reviewing the
. discussion questions and course objectives (Appendix B), and review
questions (Appendix C) on the module CD.
? Use the Planning Table (Appendix A) to ensure appropriate materials
are available during group meetings.
? Provide reminders to any guests you have invited to be present for group
discussions.
After the training
? Complete and return the evaluation forms to:
Maura O'Donoghue
Office of Continuing Education
UNC-CH School of Public Health
Campus Box 8165
Chapel Hill, North Carolina 27599-8165
? Upon receipt of the evaluations, a certificate stating that your board has
completed the orientation program for the current year will be sent to
you. Also, your county will then be included in the. quarterly report that
is provided to the State, as part of the Consolidated Agreement,
concerning the completion of board training.
7
31
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35
NEW HANOVER COUNTY BOARD OF COMMISSIONERS
Request for Board Action
Agenda: Consent Meeting Date: 01/23/06
A :0 1
Department: Health Presenter: Cindy Hewett , Business Mgr
Contact: Cindy Hewett, ext 6680
Subject: Increase in Women, Infants and Children WIC Funding
Brief Summary: New Hanover County Health Department WIC Program has received
notification they are receiving an additional $12,522 funding to be used to support our
local WIC Program. Funds received were based on an increase in each local agency cost
per participant for State Contract Year 2005, an increase in base caseload for local
agencies serving above caseload and an increase in local Nutrition Services and
Administration funds for agencies receiving an increase in base caseload. Funds will be
deposited in the WIC Budget Revenue line item and WIC Budget Contracted Services
Expenditure line item.
Recommended Motion and Requested Actions: To accept and approve receipt of
additional WIC funds and associated budget amendment.
Funding Source: NC Department of Health and Human Services, Division of Public
Health, Women's and Children's Health Section, Nutrition Services Branch.
Will above action result in:
?New Position Number of Position(s)
?Position(s) Modification or change
®No Change in Position(s)
[Explanation: See attachments for further details.
Attachments: Letter from Alice Lenihan, Branch Head Nutrition Services and Budgetary
Estimate.
•
North Carolina Department of Health and Human Services
Division of Public Health - Women's & Children's Health Section
1914 Mail Service Center • Raleigh, North Carolina 27699-1914
Tel 919-707-5800 9 Fax 919-870-4818
Michael F. Easley, Governor Carmen Hooker Odom, Secretary
December 21, 2005
TO: Local Health Directors
ATTENTION: Local WIC Directors
FROM: Alice Lenihan, MPH, RD, LDN
Branch Head, Nutrition Services
The purpose of this memo is to notify you of:
• Increase in each local agency cost per participant allocation for State Contract Year 2005,
• Increase in base caseload for local agencies serving above the case caseload; and
• Increase in local Nutrition Services and Administration (NSA) funds for agencies receiving
an increase in base caseload.
The additional funds and caseload have been increased through the remainder of the State Contract
Year 2005-2006. The revised caseload will be used for the WIC Budget Guidance for State
Contract Year 2006-2007.
Each agency has received an increase in their cost per participant of $0.25 for their base caseload
for six months. This increase brings the cost per participant up to $12.00 per participant per month.
Agencies whose active participation was above the base caseload received an increase. The
accompanying NSA funds at the rate of $12.00 per additional participant for six months.
The increased funds have already been placed in local agency budgets (20 % of the NSA increase
was budgeted in Nutrition Education-5404; the remainder was budgeted in Client Services 5403).
Attached is a spread sheet which illustrates the increases.
I want to thank each of you and your staff for continuing to serve the growing WIC participation in
North Carolina.
Please contact your Regional Nutrition Consultant if you have any questions.
CC. NSB Staff
• Regional Nutrition Consultants
Regional Administrative Consultants
Attachment
® Location: 5601 Six Forks Road • Raleigh, N.C. 27609 An Equal Opportunity Employer
N.C. Division of Public Health Budgetary Estimate to Local Health Departments, SFY 05-06
Original Activity # 403 Activity Name: WIC
Revision#_6_
ROW 1 Fund/RCC/FRC FundIRCC/FRC Fund/RCC/FR Fund/RCC/FR Fund/RCC/FR Fund/RCCIFR Fund/RCC/FR Fune/RCC/FR Total
1540-64034F 15405403-GG 1540-5404GF 1540-5404GG 1540.5405-GF 1540.5405-GG 1540-5409-GF 1540-5409-GG of All
Payment Payment Payment Payment Payment Payment Payment Payment
Period Period Period Period Period Period Period Period
07105.10105 12105-06/06 07/05-10105 12/05-06/06 07105-10/05 11/05-06106 07/05-10/05 11105-06/06
Service ervlce erv ce Serv ce erv ce erv ce Service
Service Period Period Period Period Period Period Period Period
06105-9105 11/05-05/06 06105-9/05 11105-05/06 06105-9/05 10105-05/06 06/05-9105 10105-05106
Sources
UUUNIY 01 ALAMANCE $ 12,582 K$2008 $15,728
553
214 ALBEMARLE REG $ 4,442 ill $5553
02 ALEXANDER $ 8,030 $10038
04 ANSON $ 1 060 $1,325
204 APPALACHIAN $ 4,402 $5 502
07 BEAUFORT $ 2,934 09 BLADEN $ 1 453 $1,817
10 BRUNSWICK k$22 $ 1256 $6279
11 BUNCOMBE $ 4,585 $22,928
12 BURKE $ 625 $3123
13 CABARRUS $ 5 695 $28 476
14 CALDWELL $ 663 $3317
16 CARTERET $ 365 $1,827
17 CASWELL $ 647 $3,233
18 CATAWBA $ 3,313 $16866
19 CHATHAM $0
20 CHEROKEE $ 1,418 $ 355 $1.773
22 CLAY $ 295 $ 74 $369
23 CLEVELAND $ 9,712 $ 2,428 $12140
24 COLUMBUS $ 2,542 $ 635 $3,177
25 CRAVEN $ 3.827 $ 957 $4 784
26 CUMBERLAND $ 14,534 $ 3,634 $18168
28 DARE $ 775 $ 194 $969
29 DAVIDSON $ 4116 $ 1,029 $5145
30 DAVIE $ 2 918 $ 730 $3.6481
31 DUPLIN $0
32 DURHAM $0
33 EDGECOMBE $ 3 190 $ 797 $3,987
34 FORSYTH $ 12 845 $ 3,211 $16,056
35 FRANKLIN $ 5 596 $ 1.399 $6995
36 GASTON $ 5 081 $ 1.270 $6,351
37 GATES $0
38 GRAHAM $ 2.714 $ 678 $3,392
221 GRAN-VANCE $ 7,836 $ 1,959 $9795
40 GREENE $ 1,154 $ 288 $1442
41 GUILFORD $ 45,117 $ 11,279 $56396
42 HALIFAX $0
43 HARNETT $ 5,191 $ 1,298 $6.489
44 HAYWOOD $ 1,389 $ 347 $1738
45 HENDERSON $ 2,911 $ 728 $3639
46 HERTFORD $ 1,739 $ 435 $2174
47 HOKE $ 5,520 $ 1,380 $6.90(
48 HYDE $ 518 $ 129 $647
49 IREDELL $ 14,888 $ 3,671 $18,357
N.C. Division of Public Health Budgetary Estimate to Local Health Departments, SFY 05-06
• Original Activity # 403 Activity Name: WIC
Revision#_6_
ROW 1 Fund/RCC/FRC Fund/RCC/FRC Fund/RCC/FR Fund/RCC/FR Fund/RCC/FR FundIRCC/FR Fund/RCCIFR Fund/RCC/FR Total
1540-5403-GF 1540-5403-GG 1640.5404-GF 1540-5404-GG 1540.6405-GF 1540-5405-GG 1540.5409-GF 1540-5409-GG of All
Payment Payment Payment Payment Payment Payment Payment Payment
Period Period Period Period Period Period Period Period
07105.10105 12105-06106 07/05-10105 12/05-06106 07/05-10105 11105-06106 07105-10105 11105-06106
Service Serv ce Service Serv ce erv ce Serv ce Serv ce
Service Period Period Period Period Period Period Period Period
06105-9105 11105-05106 06105-9105 11/05-05106 06/05-9/05 10105-05106 06105-9/05 10105-05/06
COUNTY Sources
50 JACKSON $ 2,858 $ 715 $3,573
51 JOHNSTON $ 9,844 $ 2,461 $12,305
52 JONES $ 455 $ 114 $569
53 LEE $ 4 730 $ 1.183 $5913
54 LENOIR $ 3,966 $ 992 $4958
55 LINCOLN $ 4,075 $ 1,019 $5,094
56 MACON $ 1,578 $ 395 1,973
57 MADISON $ 725 $ 181 $906
218 MAR-TYR-WASH K$21492 $ 1,128 $5,642
60 MECKLENBURG $ 5373 $26,865
62 MONTGOMERY $ 539 $2,697
63 MOORE $ 1568 $7841
64 NASH $ 847 $4235
65 NEW HANOVER $ 2 504 $12 522
66 NORTHAMPTON $ 235 $1,173
67 ONSLOW $ 2,137 $10683
68 ORANGE $0
69 PAMLICO $ 446 $ 111 $557
71 PENDER $ 3,487 $ 872 $4,359
73 PERSON $ 4,272 $ 1,068 $5 340
74 PITT $ 5,459 $ 1,365 $6,824
76 RANDOLPH $ 5,637 $ 1,409 $7,046
77 RICHMOND $ 2528 $ 632 $3158
78 ROBESON $ 6,206 $ 1 551 $7,757
79 ROCKINGHAM $ 3041 $ 760 $3,801
80 ROWAN E 8,025 $ 2006 $10031
216 R-P-M $0
82 SAMPSON $ 2.071 $ 518 $2.589
83 SCOTLAND $ 1,977 $ 494 $2,471
94 STANLY 5 1,778 $ 445 $2,223
85 STOKES $ 1,09g $ 275 $1,374
86 SURRY $ 2,371 $ 593 $2,964
87 SWAIN $ 470 $ 117 $587
205 TOE RIVER $ 2,352 $ 588 $2940
68 TRANSYLVANIA $ 787 $ 197 $984
90 UNION $ 4138 $ 1 034 $5172
92 WAKE $ 48,859 $ 12215 $61,074
93 WARREN $ 945 $ 236 $1181
96 WAYNE $ 4 819 $ 1 205 $6,024
97 WILKES $0
98 WILSON $ 4,835 $ 1,209 $6 ,044
99 YADKIN $ 4,250 $ 1,063 $5313
9
TOTALS BY CENTER $0 $464,773 $0 $116,1961 $0 $0 $0 $0 $580,96
CHECK GRAND TOTAL $580969
• Signature and Data - DPH Program Administrator Signature and Date- Division of Public Health Budget Officer
Signature and Date - DPH Section Chief
I,
David E Rice/NHC To "Stanley Wardrip" <Stanley.Wardrip@nhhn.org>
01/03/2006 02:14 PM cc bcaster@nhcgov.com, bgreer@nhcgov.com,
bkopp@nhcgov.com, clofgren@charter.net,
donblake@aol.com, eweaver@ec.rr.com,
bcc
Subject Re: NEW HANOVER COUNTY: CELL PHONE ON THE
ROAD
Stanley,
Based on your attached report, I have researched past NHCBH discussions and actions
on the use of cell phones and driver distractions. 'I have attached three PDF files:
1. August 2, 2000 NHCBH Meeting: Public Comment - Proposed Regulation for the Use
of Mobile Telephones While Operating a Motor Vehicle,
2. August 29, 2000 NHCBH Executive Committee Meeting: Proposed Regulation for the
Use of Mobile Telephones While Operating a Motor Vehicle, and
3. April 4, 2001 NHCBH Meeting: Resolution in Support of Programming and Actions to
Reduce Motor Vehicle Crashes Related to Driver Distraction.
R abe Rabe Rohe
August 2, 2000.PDF August 29, 2000PDF Apra 4, 2001.PDF
Hopefully, these three attachments will assist the Board of Health in its discussion
tomorrow. I will place copies of your report and these attachments in the Board's folders.
. Thanks,
David E. Rice, Health Director
New Hanover County Health Department
2029 South 17th Street
Wilmington, NC 28401
Phone: 910-343-6591 Fax: 910-341-4146
ddce@nhcgov.com
http://www.nhchd.org
"Stanley Wardrip" <Stanley.Wardrip@nhhn.org>
"Stanley Wardrip"
<Stanley.Wardrip@n To donblake@aol.com, hickmonj@bellsouth.net,
hhnnorg> rweedon@bellsouth.net, iamsmiles@bizec.rr.com,
12/30/2005 06:47 PM clofgren@charter.net, eweaver@ec.rr.com,
ncenbty@gmail.com, bcaster@nhcgov.com,
bgreer@nhcgov.com, bkopp@nhcgov.com,
ddce@nhcgov.com, npritchett@nhcgov.com,
pmelvin@nhogov.com, SUoyd@nhcgov.com,
tdavis@nhcgov.com, "Stanley Wardrip"
<Stanley.Wardrip@nhhn.org>, jstunstall@nkteng.com,
freemanm@wrightcorp.com
cc
Subject. NEW HANOVER COUNTY: CELL PHONE ON THE ROAD
• For the sixth year in a row studies by the AAA has shown New
Hanover County as one of the worst places to drive in North
Carolina. Accident rates has increased in this community every
year for the past five years, and our insurance rates has risen
between two and seven percent in the past two years. New Hanover
County has rank number one for "best chance of being in an
accident" and "best change of being injured". By requiring drivers
to put down their cell phones and pay attention to the road, this
new law will help make our roads safer and save lives.
Attached is a copy of the report that I plan to give to the New
Hanover County Board Of Health meeting on January 09, 2006. Please
let help make the roads of New Hanover county safe. By requiring
drivers to put down thier cell phones and pay attention to the
road, this law will help make our roads safer and save lives!
Thank you for your time,
Stanley G. Wardrip Jr, EMT-P/AAS
New Hanover Co. BOH Public Member
Eastern Carolina's EMS Association Chairman
SWardrip@NHHN.Org
(910)619-7902
cegphone3.doc
. NEW HANOVER COUNTY: CELL PHONE ON THE ROAD
December 30, 2005
Stanley Wardrip Jr, EMT-P/AAS
BOH Public Member
For the sixth year in a row studies by the AAA has shown New Hanover County as one of
the worst places to drive in North Carolina. Accident rates has increased in this
community every year for the past five years, and our insurance rates has risen between
two and seven percent in the past two years. New Hanover County has rank number one
for "best chance of being in an accident" and "best change of being injured".
Since the invention of the car, driver awareness -or lack thereof- has been a safety
concern. Hundreds of things inside and outside the car can divert a driver's attention from
the road. Each year, more than 42,000 people are killed and more than 3 million are injured
in more than 6 million motor vehicle crashes on the nation's roads. The National Highway
Traffic Safety Administration (NHTSA) estimates that driver distraction is a contributing
cause of 20 percent to 30 percent of all motor vehicle crashes-or 1.2 million accidents.
One researcher has estimated that driver inattention may cause as many as 10,000 deaths
each year and approximately $40 billion in damages.
A government study released in June 2005 indicates that the distraction of cell phones
and other wireless devices was far more likely to lead to crashes than other distractions
faced by drivers. Researchers for the Virginia Tech Transportation Institute and the
National Highway Traffic Safety Administration (NHTSA) tracked 100 cars and their drivers
for a year and concluded that talking on cell phones caused far more crashes, near-
crashes and other incidents than other distractions. According to a study by the Insurance
Institute for Highway Safety, drivers that uses cell phones while driving are four times
more likely to get into crashes serious enough to injure themselves,
By requiring drivers to put down their cell phones and pay attention to the road, this new
law will help make our roads safer and save lives.
RECENT STUDIES:
A study from the University of Utah published in the winter 2004/2005 issue of Human
Factors, the quarterly journal of the Human Factors and Ergonomics Society, found that
motorists who talked on cell phones were 18 percent slower in braking and took 17
percent longer to regain the speed they lost when they braked. An earlier University of
Utah study by the same researchers found that drivers talking on cell phones were less
likely to recall seeing pedestrians, billboards or other roadside features.
A study funded by the North Carolina Governor's Highway Safety Program (2004}
founded:
- An estimated 58.8 percent of the state's licensed drivers have used a cell phone while
driving.
- The average reported time per day spent talking on a cell phone while driving was 24.5
minutes; while the median reported time was much lower at 5.0 minutes. Talk time
decreased with increasing age, and was higher for males than for females.
- Users generally perceived talking on cell phones while driving to be less distracting and O
less of a safety concern than did non-users. Users were also less likely than non-users
to support legislation that would prohibit anything other than hand-held phone use,land
were less likely to support stricter penalties for cell phone users involved in crashe§.
- Cell phone crashes were nearly twice as likely to involve rear-end collisions (45.1 %
versus 25.6%)
- Cell phone crashes were somewhat more likely to occur during the midday or
afternoon hours. They were also more likely to occur in urban areas, on local streets
and at roadway locations with "no special feature." They were not found to be
overrepresented at intersection locations.
-Compared to non-users, drivers who were using their cell phone at the time of their rash
were more likely to be male, under the age of 55, and driving a sport utility vehicle. I
- The most commonly identified driver violations for cell phone users involved in crashes
were failure to reduce speed (23.5%), traffic signal violation (9.6%), speeding (4.9%),
following too closely (3.5%) and failure to yield (3.5%).
A study done by the National Public Services Research Institute for AAA in 1991, "Thel
Effect of Cellular Phone Use Upon Driver Attention", used a driving simulator to test
reaction responses while tuning a car radio, having a simple conversation on a cellula
phone, dialing a cellular phone and having a complex conversation on a cellular
phone. The conclusions were:
All forms of cellular phone usage lead to significant increases in response tires or n n-
response to highway traffic situations.
- Intense or complex conversation leads to the greatest increases in overlooking
significant highway traffic conditions and the time to respond to them.
The distracting effect of cellular phone use among drivers over age 50 is two to three
times as great as that of younger drivers and encompasses all three aspects of cellular
phone use - placing calls and carrying on simple and complex conversation. The effect is
to increase non-response by 33 - 38%.
Prior experience with cellular phones appears to bear no relationship to the distracting
effect of cellular phone use.
Association Between Cellular-Telephone Calls and Motor Vehicle Collisions
• The results of a recent studies conducted by researchers from the University of
Toronto, "Association Between Cellular-Telephone Calls and Motor Vehicle
Collisions", were published in the New England Journal of Medicine in February of
1997. Studies were made of 699 drivers who had cellular phones and were involved in
traffic crashes resulting in substantial property damage but no personal injury. Each
motorists cellular phone bills were analyzed for the day of the crash and the week
prior to the crash.
The results of the study showed that the risk of collision when using a cellular phone
was four times higher that the risk when the cellular phone was not being used. Calls
close to the time of the collision (i.e., within 5 minutes) presented a greater risk than
calls placed 15 minutes or more prior to the crash. The risk was similar for drivers who
differed in personal characteristics, such as age and driving experience. The study
also found that cellular units allowing hands-free operation offered no safety
advantage over hand-held units.
The researchers cautioned that "data do not indicate the drivers were at fault in the
collisions; it may be that cellular telephones merely decrease a driver's ability to avoid
a collision caused by someone else."
Thirty-nine percent of the drivers called emergency services after the collision, which
suggests that having a cellular telephone may have had advantages in the aftermath of
an event.
The authors noted that motor vehicles are a leading cause of death in North America
and the most frequent cause of death for children and young adults. They also point
out that driver error contributes to over 90% of collisions.
State and Federal Laws:
The number of state legislatures debating measures that address the problem of cell-
phone use while driving and other driver distractions continues to rise. According to the
National Conference of State Legislatures, over two-thirds of states looked at bills that
would restrict the use of cell phones while driving in the first part of 2005. Four states -
Colorado, Delaware, Maryland and Tennessee - banned their use by young drivers in
2005. In May, the city of Chicago banned the use of hand held cell phones while driving;
imposing penalties of $50 or $200 (the latter if the driver is involved in an accident).
In October 2005 a Connecticut law banning the use of hand-held cell phones while driving
went into effect. The measure goes further than some similar laws in other states and
municipalities. Drivers in Connecticut can be fined $100 not only for using a cell phone,
but those pulled over for speeding or other moving violations can be fined for other
driving distractions such as putting on makeup or turning to discipline children in the
back seat. In January 2004 New Jersey passed a bill prohibiting the use of cell phones
while driving and in April of that year the District of Columbia (DC) followed suit. In New
Jersey fines range between $100 and $250; in DC fines are $100. New York was the first
state to enact such legislation in 2001. Drivers there face fines of $100 for the first
violation, $200 for the second and $500 thereafter.
• {3}
1
States with cell phone legislations: Arizona, Arkansas, California, Connecticut, Dale are,
District of Columbia, Illinois, Maryland, Massachusetts, Minnesota {eff 1/06}, New O
Hampshire, New Jersey, New Mexico, New York, Ohio, Pennsylvania, Rhode Island,
Tennessee, and Texas.
Countries that restrict or prohibit hand-held cell phones in cars
I Australia Gteece Portugal Sweden
Austria Ireland Philippines Switzerland
Britain Israel Romania Taiwan
Brazil Italy Singapore Turkey
Chile Japan Slovenia
Denmark Norway S. Africa
Germany Poland Spain
Local Action:
Many counties, cities, towns and municipalities across the United States have considered
restrictions on cell phone use while driving. More than two dozen local communities-in
Florida, Massachusetts, New Jersey, New Mexico, New York, Ohio, Pennsylvania and Utah-
-have passed ordinances that prohibit the use of hand-held phones while driving.
These include: Miami-Dade County, Fla., Pembroke Pines, Fla., Westin, Fla., Brooklin
Mass., Bloomfield, N.J., Carteret, N.J., Hazlet, N.J., Irvington, N.J., Marlboro, N.J., Nutlr?y,
N.J., Westchester County, N.Y., Brooklyn, Ohio, North Olmstead, Ohio, Walton Hills, Ohio,
Lower Chichester, Pa., Conshocken, Pa.,, Lebanon, Pa., York, Pa., and Sandy, Utah.
Local debate over the use of cell phones and other interactive communication devices
while driving has had a significant effect on debate at both the state and national level . In
states where local communities have passed restrictions, the legislature may feel pressure
to address the issue to avoid a piecemeal approach where the boundaries of the law m y
not always be clear to motorists. In New York, for example, the Legislature passed its
statewide ban of hand-held phone use while driving after three large counties enacted
similar prohibitions. In Florida, the Legislature preempted local laws after several
communities, including Miami-Dade County, banned handheld phones.
• TABLE 2.6 Support for Possible Legislation Regarding Self Phone Use'While Driving
• cell Cell
Cell Phone Legislation Phone Phone P-value*
Users Nou-L"sers.
(n=500) (n=1S0)
Illegal to talk on hand-held phone % For 70.6 76.7
except in emergency. talking ruing % Against 25.5 20.7 N.S.
hands-free device O.K. % Unknown 3.6 2.7
Illegal to talk on any type cell phone % For 26.5 63.3 -
(hand-held or hands-free) except in % Against 69.5 32.7 p<.001
case of emergency. %Unknown 3.4 4.0
Drivers in accidents white talking on :6 For 53.5 78.0
phone automatically cited for careless % Against 39.5 15.3 p<.001
and reckless driving and heavily %Unknowu 6.4 6.7
penalized on insurance prenutuns.
For cell ohoue use status. based on regression models iucoroora tuts age and gender. K.S -Non-signif.
ONE-WEEK CRACKDOWN ON DRIVING AND CELL PHONE USE: 1,331 TICKETS:
{Westchester County NY): Copied from Westchester Current News 03/31/04
If you were driving while talking on a hand-held cell phone last week, you may have been among the 1,331 people
ticketed by police. If you were guilty of this infraction and weren't caught this time, look out.
County Executive Andy Spann said that the combined effort of the Westchester County Department of Public
Safety and 31 local police departments got the word out the hard way to drivers: It's against the law to talk on a
hand-held cell phone while you drive.
"This was about the safety of the driving public, including the people who naurd the state cell phone law," said
Spann. "During one week, county and local police issued a remarkable 1,331 summonses, compared to 8,000 In
all of 2003. We hope those people who were ticketed - as well as those who escaped this time - will now change
their behavior. All It takes is a split-second distraction for there to be an accident."
For one week, beginning Monday, March 18, the various police departments teamed up to focus attention on the
issue of driver distraction caused by using a hand-held cell phone while driving.
Spann said the initiative was so successful that it will be don again - but the next time there will be no advance
notice to the public." The public should remember that if they are going to use a cell phone while they drive it
must be a hands-free device. Using a hand-held phone Is illegal next week and the weeks thereafter, even if we
don't have a 'sting' going on at a given moment."
In April 2001, Westchester County became one of the first municipalities in the country to enact a law to regulate
cell phone use while driving. This law was superseded later that year by a state-wide ban, which provides for
fines of up to $100 for a first offense, $200 for a second offense and $600 for subsequent offenses.
According to the county's department of Public Safety, there were 226 cell phone summonses written In 2001;
6,868 in 2002; and 8,384 in 2003.
County Public Safety Commissioner Thomas Beffiore said, "1 am appreciative of the attention given to this
important matter by the county police departments. Their outstanding enforcement efforts helped educate the
public and enhanced safety on the roads we patrol."
Chief Robert D'Angelo of North Castle, president of the Westchester Chiefs of Police Association, said, N am
proud of the contribution In this effort of my own department - and all the departments that participated."
County Legislator Louis Mosiello, the author of the original Westchester cell phone and driving law, said, "The
reason we passed our law - and that the state then passed a state-wide ban - was to save lives. But too many
people don't take this law seriously enough." Mosiello has asked the state to consider increasing the penalty for
violations so that offenders face points on their driver's license.
i {5}
a
Legal Liability: O
As legislatures have debated the merits of restrictions on cell phone use while drivi g, a
second battleground over driver cell phone use has emerged in the courts. With
increasing frequency, legal cases are testing whether drivers-or, in some instances he
driver's employer-should be held civilly or criminally responsible for crashes cause by
the driver's use of a cell phone.
Employer and Manufacturer Liability: Although only a handful of high-profile cases have
gone to court, employers are still concerned that they might be held liable for accide
caused by their employees while driving and conducting work-related conversations on
cell phones. Under the doctrine of vicarious responsibility, employers may be held le ally
accountable for the negligent acts of employees committed in the course of employment.
Employers may also be found negligent if they fail to put in place a policy for the safe use
of cell phones. In response, many companies have established cell phone usage polities.
Some allow employees to conduct business over the phone as long as they pull overlto
the side of the road or into a parking lot. Others have completely banned the use of a~I
wireless devices.
In December 2004 a civil case involving a car crash caused by a driver using a cell phone
for business reasons was dismissed when the driver's employer, Beers Skanska Inc.,
agreed to pay the plaintiff $5 million. The plaintiff in the case being heard in Georgia's
Fulton County Superior Court was severely injured in the crash. The suit is among th
most recent of several cases where an employer has been held liable for an accident
caused by a driver using a cell phone. See background section on Employer and
Manufacturer Liability.
In mid-October 2004 in the case of Yoon v. Wagner a Virginia jury awarded $2 million in
damages to the family of a young girl who was killed by a driver using a cell phone at the
time of the accident. The plaintiff also filed a suit against the driver's employer, after it
became clear through an examination of phone records that the driver had been talkin~ to
a client when she hit the girl.
In an article published in the June 2003 edition of the North Dakota Law Review, attorney
Jordan Michael proposed a theory of cell phone manufacturer liability for auto accidents if
they fail to warn users of the dangers of driving and talking on the phone at the same time.
The theory holds that maker liability would be similar to the liability of employers who
encourage or demand cell phone use on the road. Holding manufacturers liable would
cover all persons who drive and use cell phones for personal calls. Michael notes that
some car rental agencies have already placed warnings on embedded cell phones in their
cars.
o -a
•
Conclusion:
Increased reliance on cell phones has led to a rise in the number of people who use the
devices while driving. There are two dangers associated with driving and cell phone use.
First, drivers must take their eyes off the road while dialing. Second, people can become
so absorbed in their conversations that their ability to concentrate on the act of driving is
severely impaired, jeopardizing the safety of vehicle occupants and pedestrians. Since the
first law was passed in New York in 2001 banning hand-held cell phone use while driving,
there has been debate as to the exact nature and degree of hazard. The number of cell or
mobile phone users in the United States has grown from fewer than 100,000 in January,
1985 to an estimated 300million in July, 2005. With the explosion in ownership has come
increased use of cell phones while driving. Data collected by the National Highway Traffic
Safety Administration (NHTSA) as part of its Fall 2004 National Occupant Protection Use
Survey revealed that an estimated 12.9% of passenger car drivers are using cell phones at
any time while driving.
Driving while using a cell phone is by far the most immediate hazard to both the cell phone
user and everyone in their immediate vicinity. You must consider the consequences and
the lives that are in your hands when you choose to take your mind off the roadl In today's
fast paced/high tech world all too many people have forgotten that driving is a huge
responsibility and is responsible for way too many deathsl Simply because you hold the
keys to not only your life but the lives and futures of others as well. The most important
aspect to remember is that it's not only your live endangers anymore, distractions in the
wrong place, at the wrong time, have proven deadly time and time again.
Make safety your top priorityl By requiring drivers to put down their cell phones and pay
attention to the road, this new law will help make our roads safer and save lives." - Gov.
George Pataki, New York
"Cell Phone Safety Is Your Most Important Call!!
National Association of Local Boards of Health
United'We Stand
q
NeWSBJP,ief
Published for Members of Local Boards of Health Fourth Quarter, 2005
What's i
7Allen. s fellow NALBOHians as I bring you my final President's message.
r has gone by so quickly for me and for NALBOH. Folks such as
Katrina, Rita, and Wilma took some of my quality time from
, but I was represented very well by our President-Elect Lee Kyle
am talking about another extreme hurricane season. The 2005
Board , Directors season, as you may know, broke the record as it exhausted the regular
storm names of 21 forcing the use of the Greek alphabet with named
storms Alpha and Beta. Public health was at its best as local, state, and
Report , federal public health agencies
, , responded to help provide essential
community services and to help keep those impacted healthy and safe.
National Public Health Performance Standards During 2005, NALBOH made several strides in helping to strengthen and prepare local boards of
health enabling them to protect and promote the health of their communities through
education, technical assistance and advocacy. Here are just some of our accomplishments.
• Presented another successful annual conference which included our Annual Conference
Certification Program
6 Pandemic Influenza
Preparedness • Partnered with our sister organizations on workgroups such as:
4 Profile of Local Public Health Agencies
4 Sustainable Mosquito Control Programs for Communities
7 CDC Launches Online 4 Operational Definition of Local Public Health
Training Course 4 Presidents' Council for Food Defense and Security
4 Exploring Accreditation of Local Public Health Agencies
4 Methamphetamine's Impact on Local Government
Tobacco-Free 4 Workforce Development
• Developed a Food Safety Guide for Local Boards of Health
' • i
Emergency Preparedness • Developed a On-Site Waste Water Management Guide for Local Boards of Health
• Secured additional funding to help educate local boards of health about recreational water
1 SALBOH disease prevention
Membership Application • Secured additional funding to help educate local boards of health about emergency
preparedness and responses
• of Events • Began work on revising our strategic plan which will help guide NALBOH into the future
• Worked more closely with our State Associations of Local Boards of Health or SALBOH's and
developed a Memorandum of Understanding that delineates the division of labor as to what .
Continued on Page 2
TMe wssPms National Association of Local Boards of Health
6 PUBLIC XERLTN
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 Fourth Quarter 2005
President's Message (continued) =
NALBOH can do.for a SALBOH and what a SALBOH can VISION: NALBOH represents the grassroots foundation
do for NALBOH; this will serve to strengthen us all of public health in America. The organization is anchored
by serving and empowering boards of health. We
Finally, looking toward the future, we are still working on our actively engage and represent the public in public health.
ultimate accomplishment for NALBOH. This is the We are recognized and valued as a partner in the public
development of a Leadership Institute for Boards of Health. health system. As a partner, NALBOH influences public
Such an Institute could be university based and used to health policy, resource allocation, and education. We
provide education and training for Board of Health leaders are a self-sustaining, responsive, accountable, and
across the country. We also continue to work on a program pro-active organization. NALBOH serves boards of
that can serve to accredit individual board members as well as health, and provides a national voice for our members.
boards. This certainly will be necessary if local public health MISSION: To prepare and strengthen boards of health,
agencies begin an accreditation process. However, this takes empowering them to promote and protect the health
additional funding. We are reaching out in order to secure of their communities.
this funding so that the ultimate accomplishment can be
realized.
Board of Directors
We are also actively seeking funding sources so that we can President President-Elect
continue to provide education and training for local boards of Ronald Burger (GA) Lee Kyle Allen (NC)
health in the field of emergency preparedness for both Secretary/Treasurer Past President
unintentional and intentional events that might impact their Gladys Curley (MD) Connie Tatton (UT)
communities. We will try to prepare local boards of health for
that ever so dangerous•pandemic influenza. East Great Lakes Region Mid Atlantic Region
I have been so proud to help represent and further the Alice Davis (OH) Walter Stein (NJ)
success of NALBOH as your President. However, you are the Midwest Region New England Region
driving force of NALBOH and your local public health system. Larry Hudkins (NE) Shepard Cohen (MA)
I continue to encourage you to get involved with both Southeast Region West Region
NALBOH and your SALBOH. If you don't have a SALBOH, try Rachel Stevens (NC) Carolyn Meline (ID)
to get one started in your state. West Great Lakes Region
Sharon Hampson (WI) Ex-Officio
Remember, we represent public health democracy by State Affiliates Ned E. Baker (OH)
connecting people to public health. Thank you for helping to John Gwinn (OH) Marie M. Fallon (OH)
create the conditions in all of our communities so that people Donna Rozar (WI) Anthony Santarsiero (GA)
can live, work, play, learn, and worship in a healthy and safe
manner. Staff
Executive Director
Marie M. Fallon, MHSA
Be safe and stay healthy through prevention.
DC Director Liaison
Best regards for another successful year in public health. Tiffany Hinton, MPH
Project Director-Environmental Health & Emergency
Preparedness
C Jeff Neistadt, MS, RS
Grants Manager
Ronald C. Burger Jennifer O'Brien, MPH, MA
President ? Membership Coordinator/ Publications Manager
Grace Serrato
NewsBrief Editor
Fleming Fallon, MD, DrPH
The NALBOH NewsBrief is published by the
National Association of Local Boards of Health Requests for Articles and
1840 East Gypsy Lane Road, Bowling Green, OH 43402 Meeting Announcements
Phone: (419) 353-7714; Fax: (419) 352-6278
Email: <nalboh@nalboh.org>; Website: <www.nalboh.org> NALBOH publishes articles about the successes, challenges,
and accomplishments of local boards of health as well as
The production and distribution of this publication is upcoming conference announcements and meeting dates.
supported by funds from the To submit an article or announcement, please contact the
Centers for Disease Control and Prevention. NALBOH office at 1840 East Gypsy Lane Road, Bowling
Green, OH 43402, fax to (419) 352-6278, or email us at
Reproduction or use of any contents enclosed must <nalboh@nalboh.org>. A NewsBrief submission form is
be requested in writing to the NALBOH office. ? available online at <www.nalboh.org/newsbrief/
newsbrief.htm>. ?
Fourth Quarter 2005 NALBOH News Brief Page 3
From Tiffany Hinton, DC Liaison
I am hearing a lot about health disparities these days. To start, in August the
Society for Public Health Education sponsored a summit to identify new research
w rs e ,r `;,fit T needs related to racial and ethnic health disparities. After a multitude of plenary
and panel presentations, summit participants identified some key issues to be
addressed such as community design and planning, health literacy, and cultural
competency. Participants also agreed that more community-based research,
t5 r M partnerships and funds are needed to tackle the problems of racial and ethnic
health disparities.
A little while later, a report titled Closing the Gap: Solutions to Race-Based Health
Disparities, was released by the Northwest Federation of Community Organizations.
The report documents best practices in addressing health care disparities. Its key
recommendations include: eliminating disparities. in access to health insurance, developing health care institutions that are
welcoming and respectful to people of different races and ethnicities, tracking racial disparities in health care provision, providing
medical interpretation services for all clinical encounters, and improving access to traditional and non-Western treatments.
Additionally, the Health Policy Institute of the Joint Center for Political and Economic Studies held a briefing to announce its new
initiative, Place Matters: Addressing the Root Causes of Health Disparities. The objective of this initiative is to provide strategies
and tools that enable local officials to track and accelerate progress in addressing social and environmental factors that lead to poor
health. Place Matters focuses on 100 counties in the U.S. including Wayne County in Michigan, Franklin and Cuyahoga Counties in
Ohio, Milwaukee County in Wisconsin, Durham and Robeson Counties in North Carolina, and several counties in Georgia. Place
Matters is supported by the National Association of Counties and the National Association of City and County Health Officials.
The short story - some emphasis is being placed on the social and built environment to improve a community's health. What does
this mean for local boards of health? I'll use the words of Connie Tatter, NALBOH's Past President and new Mayor of Midway, UT,
"The American environment needs to change drastically if we are going to maintain and create a healthy lifestyle for our children
and grandchildren. Board of Health members must be elements of that change."
To end, here's some good news in regards to the right of local communities to enact smoke-free air laws. Illinois has become the
second state (after Delaware) to completely repeal preemption. The law goes into effect on January 1, 2006.
Congratulations, Illinois!
If you need my assistance, please do not hesitate to call the NALBOH office in Washington, DC at (202) 223-4034. O
Local Boards of Health Using Assessment Tool to Improve Health:
Tool Helps Spell Out Roles, Responsibilities
Submitted by Michele Late, Executive Editor
The Nation's Health, American Public Health Association
Local boards of health around the country are using a performance assessment program to improve the health of their
communities, and in the process are learning more about their own roles and responsibilities.
Launched in 2002, the National Public Health Performance Standards Program encourages public health stakeholders to take a
close look at the services provided through their state or local health systems. The program includes a public health
governance assessment instrument that is aimed specifically at local boards of health and the services they oversee.
Since the inception of the performance standards program, several hundred local boards of health have used the governance
instrument, and the number of participants is growing, according to Tiffany Hinton, MPH, liaison director at the National
Association of Local Boards of Health. With about 3,000 local boards of health nationwide, organizers are hoping that use of the
governance instrument will become more widespread, especially because of recent positive results.
While the instrument has a goal of improving community health, it has also served as a learning tool for local board of health
members by educating them about their responsibilities. "Such an effort is vital because of the important role local boards of health
play;" Hinton noted.
In general, local boards of health oversee local health departments and serve as a link between the departments, elected officials
and residents. However, board members are more likely to be community volunteers than full-time health
professionals, which means they may not be familiar with the essential services that are expected to be provided via public health
systems.
_ Continued on page4
Page 4 NALBOH NewsUrief Fourth Quarter 2005
Local Boards of Health continued from page 3
training on the role of local boards of health adopted, Wysocki told The Nation's Health.
"If they have a better sense of their in the state, he said the meetings were an Now, when new members join the board,
responsibilities, that, in turn, benefits the eye-opening experience for many they receive an orientation manual, a
community;" said Hinton, also an APHA attendees. welcome letter, a video on public health
member. and other materials.
"We believe that this is a wonderful
Based on the essential services of public educational opportunity for local board The instruments helped clarify the role the
health - such as surveillance, regulation members who don't fully understand the Connecticut local board of health was
enforcement and health promotion - the broader scope of their responsibilities and expected to play, with board members
26-page governance instrument asks may not have ever been made aware of discovering that they "had more
users to rank their health systems' ability them;" Roman told The Nation's Health. "I responsibilities, more authority than we
to offer public health services. For would encourage every other state to take started out thinking we had;" said
example, local boards of health using the this on as a project" Wysocki, who is an APHA member.
instrument are asked whether they have
a mission statement, if they advocate for Researchers at Rutgers University, which is Because of the board's positive experience
laws that protect public health, whether assisting in the New Jersey effort, were with the governance instrument, Wysocki
they monitor progress toward health expected to present a report on the said she would recommend its use by
objectives and if they ensure that their assessments at a statewide meeting in other local boards of health.
communities have up-to-date public health September.
emergency response plans. "I would encourage them to use it both as
While officials in New Jersey found that a self-assessment of their work and to
Boards of health rank hew well they think conducting the assessments on a statewide identify their responsibilities;" she said.
they are doing on each of the basis was key to their success, other local
responsibilities that are outlined in the boards of health have used the governance APHA is one of six national partners
instrument and then send their data to instrument on their own. working on the National Public Health
the Public Health Foundation, which Performance Standards Program with CDC,
generates a report with performance In Ohio, the city of Kent's local board of which is leading the effort. The other
scores, charts and suggestions on how to health saw the governance instrument as partners are the Association of State and
use the results for quality improvement. "a way to find out what is really going on in Territorial Health Officials, National
the city and the health department," Association of County and City Health
'Local boards of health are important to according to board member John Gwinn, Officials, NALBOH, National Network of
the health of the nation;' said Karlene PhD, MPH. The city board of health began Public Health Institutes and Public Health
Baddy, MEd, director of the Public Health using the governance instrument in April Foundation.
Innovations Project at APHA. "The better 2003, spending time at each of its regular
they are able to do their work, the more meetings to answer its questions. For more information on the National
we benefit" Public Health Performance Standards
Board members found the instrument "very Program or to download the governance
While the governance instrument has been educational, especially in terms of the instrument, visit <www.phppo.cdc.gov>,
used in multiple states, it has been used information that came to light on the roles <www.nalboh.org> or <www.apha.org/
most widely in New Jersey, which of the board and the breadth of public health ppp/phipmain.htm>.
coordinated a statewide governance activities being conducted in Kent;" said
assessment effort. Through a grant from Gwinn, who is an APHA member and Local boards of health that are interested
CDC, the New Jersey Local Boards of NALBOH Director. "The board worked with in using the governance instrument and
Health Association coordinated 20 the city's health officer when conducting are looking for guidance should contact
meetings with members of local boards of the assessment, which was particularly Hinton at <tiffany@nalboh.org> or
health from around the state beginning helpful;" Gwinn said. (202) 223-4034.
last October.
In central Connecticut, local board of health source: The Nation's Health, October 2005.
As a result, more than 160 governance members found the governance instrument used with permission. ?
assessments have been conducted to date so beneficial that they have used it twice.
in New Jersey, and organizers are The seven-member District Board of Health
expecting that number to rise to more for Berlin, Rocky Hill and Wethersfield used
than 200, according to APHA member Paul the instrument in 2002 and again this year, i
Roman, President of the New Jersey Local according to board chair Carolyn Wysocki,
Boards of Health Association. MA, MHSA. I
I
While some local board of health members The board was able to identify its strengths
initially came to the New Jersey meetings and weaknesses through the assessment,
with trepidation, they left with a "sense and was so impressed with the results that
of accomplishment;" said Roman, who is they were used to shape the district's
also President of the Shrewsbury, N.J., Lo- strategic plan and take action. For example,
cal Board of Health and of the Monmouth after the assessment showed that the
County, N.J., Regional Health Commission. board was lacking an orientation manual, a
Because there has not been much document and set of procedures was
I
Fourth Quarter 1005 NALBOH NewsBrief Page 5.
The Medical Reserve
so both a student of public health and Corps (MRC) Holds
someone currently working in the public
health field, my biggest takeaway from the First Training
n NALBOH conference was the value of and Conference in
need for assessing the performance of public
health programs. Success stories were Manalapan Township,
shared and existing assessment tools were
all presented for the benefit of the group. New Jersey
At some point, it becomes necessary to
step back from the daily grind and ask, "Why The Manalapan Township Board of Health
NALBOH's 13th Annual are we doing this? Are we making any hosted the first ever Educational
headway?" I think it is time for such a Conference for the U.S. Public Health
Conference reinvention in the public health world. Service (PHS) Region II Medical Reserve
Submitted by Chris Tofteberg We've been working with the same ideals Corps (MlZd) on October 22, 2005. Over
University of Alaska, anchorage and regulations created decades ago and 220 medical professionals and laypeople from
1005 MacNeal Scholarship Awardee the world has changed immensely in that throughout New Yor)C State and New
period. It's time for us to catch up with Jersey converged on our Middle School on
Going to a conference can be an the rest of the world. a rainy Saturday for this event in the
intimidating affair when you're unfamiliar Northeast. Participants even drove over 300
with the content. Even more so, when While the sessions were certainly hundred miles from Buffalo, N.Y. to attend
the attendees and target audience are of educational and informative,I must say that the Conference.
a much different background than the networking and discussions between
yourself. I must say that I was a bit sessions were worth their weight in gold. The MRC Conference included introductions
apprehensive about attending the NALBOH Every conference should have as many by New Jersey's Commissioner of Health,
conference because of this. I've had very opportunities to just sit down and talk about Dr. Fred Jacobs, and the Director of the
little experience working with a board of the issues! The wealth of knowledge in this National MRC, Commander Robert Tosatto
health, so I thought the topics and group was amazing, and their willingness to of the PHS. Dr. Bruce Marganoff,
attendees would be somewhat different answer my questions was helpful to say the Coordinator of the Region II MRC,
than the usual faire for me. And I was least. Attendees made this outsider feel at programmed the event.
apprehensive about Nashville. Not because home and I quite honestly haven't met a
I had heard anything bad about Nashville, nicer group of people. Fitting in was never Presenters included Sergeant Jae Geletta
in fact quite the opposite. But it was an issue; everyone made me feel right at of the N.J. State Police on the National
August, after all, and I anticipated that it home, even though home was four Incident Management System; Dr. Anand
would be hot. Uncomfortably hot. thousand miles away. It seems the only Pandya of New York University on the
apprehension I had about attending the psychological response to disasters;
I tend to select tracks or sessions that are conference that was in any way validated Commander Patricia Pettis of the PHS on
outside my area of expertise when I was the heat! principles of mass distribution of medications
attend conferences. Not because I am so and Kim Silverstein; RN, on the creation of
confident in what I know, but more My sincere thanks to NALBOH and all its family emergency plans.
because I realize my opportunities to learn members for making this opportunity
topics outside my normal range are few. available to me. This was something that The Manalapan MRC, first in the nation
My current coursework (hopefully leading would not normally be available to me, and created by a local board of health, was
to a thesis and graduation!) as a student I will certainly benefit in my academic and proud to be the first in our region to
at the University of Alaska Anchorage career pursuits. ? sponsor an educational gathering. Next
assessing the need for a board of health in year's will be probably be held in New York
Alaska was a nice tie-in. So at the State. Once MRCS are firmly established in
NALBOH conference, I mainly stayed 2005 NALBOH Puerto Rico and the U.S. Virgin Islands, both
within the Board Governance track since Official Results part of Region II, a future conference may
this was certainly unfamiliar soil for me. be held there.
President-Elect:
But then again, it wasn't. When you get John Gwinn (OH) Our MRC actively participated in the
right down to the nuts and bolts of it, national preparedness exercise TOPOFF 3
we're all facing the same challenges in our Secretary/Treasurer: last spring, during which drug distribution
communities. Poor communication Gladys Curley (MD) to the entire New Jersey population was
between agencies. Funding problems. Lack simulated, following an aerosol "plague"
of a clear vision of where we are in our First State Affiliate Director attack on the public highways. This
respective public health missions. Politics. Southeast Regional Director December 411, our MRC will run its own Point
Everyone has to deal with each of these Results of First State Affiliate and of Distribution exercise at our county library,
issues daily. The nodding heads in the Southeast Regional Directors simulating distribution of medications to the
audience at the sessions made it abundantly will be available after the 34,000 residents of Manalapan Township.
clear that these are universal issues and tie-breaker votes have been counted We have over 150 members in the
are not restricted to any particular county in January 2006. Manalapan MRC and we are proud that we
or community. are ready to "take care of our own." ?
4
Page 6 NALBOH NewsBrief Fourth Quarter 2005
Wisconsin Pandemic • Decide when the pandemic plan is to distribute information passed on from
be implemented and assure local DPH to appropriate local health
Influenza Preparedness emergency plans are implemented department staff
Plan during the influenza pandemic 0
• Determine the feasibility of
• Develop and implement a local mass establishing a local information hotline
Following are relevant issues that provide a vaccination plan based on the and a plan to staff the call center
basis for preparedness activities pertaining template provided by the Division of
to pandemic influenza: Public Health • Conduct daily briefings with
spokespersons and clinic leaders to
• An influenza pandemic is inevitable. • Using Flu-Aid software from the CDC, determine new information to be
develop the local estimated impact of relayed to public; this information
• To some extent, everyone will be an influenza pandemic should also be relayed to State DPH
affected by the influenza pandemic. for state communications
• Develop a plan to close and re-open
• The first wave of the pandemic may schools, businesses and other public • Develop a method to post current
last from 1-3 months, while the entire events, if necessary information on LHD or municipal
pandemic may last for 2-3 years. website
• Develop a plan to educate the public
• Liability protection for vaccine prior to the onset of the pandemic • Develop plans for communicating with
manufacturers and persons who special populations in the local area
administer influenza vaccine will likely Surveillance (Hmong, Hispanic, Amish etc.)
be made available through • Support state surveillance activites
congressional legislation. including Sentinel Clinician Surveillance • Designate spokespeople for local
• Although antiviral agents are available and Laboratory Surveillance and any media; local health department
enhanced surveillance activities officers should identify a primary
that can theoretically be used for both
spokesperson and backups in
treatment and prophylaxis during the • Monitor local death rates conjunction with local emergency
next pandemic, these agents will likely management, HIRSA recommen-
be available only for limited distribution. • (If determined feasible) monitor local dations and local elected officials
hospital census \
The Wisconsin Influenza Pandemic • It may be decided that the county
Preparedness document was developed • (If determined feasible) monitor emergency management director
using the CDC Planning Guide for State and absentee rates in schools should be the primary spokesperson,
Local Officials (Draft 2.1). The document is with health information provided by the
divided into six sections: Command and • Keep the DPH informed of all surveill- local public health department
Control, Surveillance, Communication, ance activities
Vaccine, Emergency Response-Maintenance • Keep in mind that local elected officials
of Essential Health and Medeal Services and • Monitor influenza activity among may want to take on the spokes-
Other Essential Services, and Antiviral different population groups person role; in that case, a local
Medications. Each section contains a brief
public health official should be with the
overview, followed by the role of the DPH Communications elected official at all media briefings in
and the role of local health departments • Develop a communication plan in order to answer health-related
Roles of local public health should be conjunction with local emergency questions
collaborated with those of local emergency management coordinators and
management. The document must be hospitals in their area • In addition, if a local health department
considered a "Work in Progress;" that will is short-staffed and can't designate
be updated when new information and • Determine if a local Joint Information multiple spokespeople, a local physician
guidelines from the WHO or CDC are Center will be opened at the local can serve as a local spokesperson
available. At any time during the stages, Emergency Operations Center. If so,
the activities may be changed or cancelled then media relations can occur at the Vaccine
by the Division.of Public Health (DPH). local Joint Information Center • Develop, practice and implement a
mass-vaccination plan
Command and Control • Coordinate communication plans with pp
• Identify who will be administrative and HRSA recommendations; the public • Continue to emphasize annual d
medical decision makers during the (and the media) will be contacting influenza vaccine and the use of
pandemic healthcare providers and hospitals for pneumococcal vaccine during the Y
• Develop a local pandemic influenza medical information preparation phases of the pandemic
preparedness plan that corresponds to • Develop a 24/7 contact list for staff • Coordinate activities with bordering ~l
existing emergency plans jurisdictions
• Develop a list of local media contact
• Meet with local stakeholders and names, numbers and methodology to • Identify priority groups for vaccination
review major elements of the local quickly send them information specific to pandemic influenza
pandemic influenza plan
0 Develop an internal plan on how to cnntinuotl on paged
Fourth Quarter 2005 NALBOH NewsBrief Page 7
Wl PantlemiclnHuema...Continued from page 6 Internal Flu Pandemic CDC Launches New
• Develop a system to estimate the Planning Online Training Course
number of persons in priority groups
for vaccination in Public Health
In addition to ensuring the local public
• Develop standing orders for influenza health agency is well prepared for a Emergency Law
community flu pandemic, boards of health
p vaccination must take the appropriate steps to ensure CDC's Public Health Law Program and CDC's
• Improve current influenza and there is an adequate amount of agency Coordinating Office for Terrorism
pn prove coal vaccination programs staff available to respond to a potential Preparedness and Emergency Response is
outbreak. Boards should begin to take the offering a new online training course that
• Assure the security of influenza appropriate steps below: is beneficial to local board of health
vaccine during storage and delivery members. "Public Health Emergency Law"
• Understand how a flu pandemic could includes six PowerPoint presentations that
when available affect the local public health agency's may be used by local board of health
staff. Pandemics sometimes occur in members, no -legal professionals in health
• Support state stockpiles and the a series of waves, so local boards of departments emergency management
delivery of antivirals to priority groups health should be prepared to combat agencies, and other active organizations
Emergency Response: Maintenance of a flu pandemic without all of the involved in emergency preparedness. The
Essential Health and Medical Services health agency staff. If a pandemic online training course covers legal
and Other Essential Services does occur, local boards should be principles in the following areas:
prepared for absenteeism rates of
• Develop and maintain an inventory of approximately 25 to 60%. • Implementing basic concepts (e.g.,
voluntary emergency medical plans under which public health and
personnel and supplies • Meet with the health officer and emergency, management work
• Local health departments, in appropriate management staff to together)
develop with local emergency internal plans. A local
should develop a local public health agency must be able to • Detecting and declaring emergencies
managers,
Emergency Operations Plan (EDP) survive the emergency and continue
including plans for pandemic influenza to function. Boards must work with • Protecting persons (e.g., quarantine
the health officer to identify core and isolation)
• Development of a mass fatality functions, personnel and skills that will
be needed during the pandemic. • Managing property
disaster plan Strategize how to manage and plan
• Participate, if requested, in mass for absences by key personnel. • Mobilizing professional resources
fatality disaster exercises • Develop an internal system for • Reviewing advanced topics (e.g.,
• Assure that local registrars have communication. Ensure that contact legal implications of public communi-
issuing lists are updated and have all cations during emergencies)
developed plans for filing and
death certificates in li mass fatality communication options evaluated to
keep personnel informed of ongoing This course also provides an interactive case
situation events. study following the presentations.
• Assure that a hospital public health • Increase the cleaning schedules of the For more information on the online
emergency plan is implemented health agency. As
public health training opportunity or to order copies of
• In conjunction with the Division of professionals, we understand the the CD-ROM containing all of the
Public Health, receive updates, no less importance of clean and disinfected course components, please contact the
work spaces. Ensure the health Public Health Emergency Law field
than weekly, from public health regional
offices agency is being properly cleaned and coordinators at (770) 220-0608. You can
common areas disinfected on a daily also reach them via e-mail at
• Identify essential services within the basis. <wbradford@mcking.com> or
<w ru s h i n g@ m c k i n g. co m>. O
jurisdiction and develop a local plan to By applying these simple steps, boards of
minimize interruption of these ,
R• health can help ensure the local public
services; services may include local health agency is ready to respond to a
1 agriculture and farms, home healthcare potential flu pandemic. O
` and delivery of food to those in need
Antiviral Medications
Support state stockpiles and the
delivery of antiviral medication
For more information, visit
<www.cdc.gov>. 0
Page 8 NALBOH NewsBrief Fourth Quarter 2005
New Resource Refuting contained Fact Sheet: Clean Indoor Air <www.13thwctoh.org>. Other inform
the Constitutional discussed the number of states with clean tion about the conference (e.g., schol 1
indoor air laws for specified locations. ships, registration, hotels, travel, etc.) is also
Right to Smoke According to the Fact Sheet, forty-nine available online. ?
states have clean indoor air laws
The Tobacco affecting public schools, while Give Spit Tobacco the
Control Legal only sixteen states have laws
Consortium that apply to private schools. Boot
recently pub- , Government worksites in By: "Cowboy Ted"Hallisey
lished There is forty-three states and private <www.cowboyted.com>
No Constitu- is worksites in thirty states are
tiona/ iRight to protected. It is time to join forces to Give Tobacco
Smoke order the Boot in rural areas of the United States
to refute the The SCLD Update also had a and at traditional rural events. A number of
otion that Fact Sheet on Youth Access organizations and individuals have enjoyed
nsmoking is that to Tobacco. In the Fact limited success in the fight against tobacco
constitutionally Sheet, readers learn that in rural areas. Now it is time to join forces
protected right. legislation restricting the sale and let the world know that tobacco is
The brief, user- of tobacco products to minors unacceptable in all forms in rural and
friendly law has been enacted in all fifty frontier towns.
synopsis explains states and the District of
why smoking is not a specially protected Columbia. To enforce the The Buck Tobacco program in California and
liberty or privacy right under the US laws, twenty-six states are able to the Threw With Chew program in
Constition's Due Process Clause or Equal suspend or revoke a tobacco retailer's Wyoming have made great strides to alert
Protection Clause. The synopsis details that license while thirty-seven states require the public to the dangers of spit tobacco.
indeed the Constitution leaves the door inspection of tobacco retailers. Gruen Von Behrens and Cowboy Ted
wide open for smoke free laws and other Hallisey have personally been visiting with a
For more information about the State number of students across the country to
tobacco-related laws that are rationally
/1
related to a legitimate government goal. Cancer Legislative Database Program or encourage them to live a tobacco -fire
The synopsis also highlights two types of download copies of the newsletter or fact ct lifestyle.
state laws that may create a limited right sheets, please visit <www.scld-nci.net>.
to smoke, and in the absence of a ? A host of programs across the country have
been carrying the torch individually in their
constitutionally protected right to smoke, it
advocates can seek to amend or repeal 13th World Conference respective geographic areas and now it is
these laws, thus taking away any safeguards time to unify as one and form a collaborative
the laws afford to smokers. on Tobacco OR Health effort to fight spit tobacco.
This synopsis is particularly useful to local The Preliminary Program and Call for We are seeing a number of local success
board of health members because it Abstracts are now available for the stories with spit tobacco education and
131h World Conference on Tobacco OR prevention programs. Lets combine forces
describes how laws that create a limited
right to smoke Health. The Conference will be held July and take it to a national audience. Andrea
so that they do o not t impede amended or repealed local tobacco 12-15, 2006 in Washington, DC. The Craig-Dodge is the coordinator for the Buck
control efforts. To download the PDF American Cancer Society (ACS) is the Tobacco program and has encouraged other
version of the synopsis, please go to official host and invites all to attend the programs to integrate and use the Buck
<http://www.wrnitchell.edu/tobaccolaw/ meeting in Washington, DC. Tobacco resources for their programs and
resourcesTCLC.html>. The Tobacco outreach efforts.
Control Legal Consortium's website also The conference features the latest
contains useful links to sample ordinances, research on the science of tobacco and its Together, we can gain strength and
legislation and litigation, studies and reports, effects, and presenters will share relevant experience in tobacco awareness, tobacco
Tracking Tobacco Laws, and other legal new data on topics including addiction, education, media relations, and lobbying
information. Visit the Consortium online at cessation, public policy, secondhand smoke, efforts with elected officials to bring
<www.wmitchell.edu/tobaccolaw/ and smokeless tobacco. The conference awareness to the issues of spit tobacco. It
also allows attendees to examine the is time to give spit tobacco the boot in
ndex.html>. ? impact of the Framework Convention on rural and frontier towns.
Tobacco Control and to discuss ways
Resources for State developing countries may use it to promote Please use my experience with kids and
Legislation their tobacco control efforts and how it media, along with the sport of rode
The National Cancer Institute hosts a State may reinforce tobacco control in developed and tobacco education as a resource t
Cancer Legislative Database (SCLD) that countries. apply to your program. Contact me at
<www.cowboyted.com>. C3
provides information about state The Preliminary Program and
cancer-related legislation in a variety of Call for Abstracts (due December 15,
areas. The State Cancer Legislative 2005) information is online at
Database (SCLD) Update Summer 2005
Fourth Quarter 2005 NALBOH NewsBrief Page 9
Flu Season is Here:
Are you Prepared
As the influenza season nears, boards of health must ensure that their communities are
properly prepared for a worst case scenario. Over the past several years, the media has
brought much well deserved attention to the possibility of an influenza pandemic. Boards of
health, now more than ever, have to ensure that their local public health agency has a plan to
'1 I!
effectively respond to an influenza epidemic.
Each year in the United States, an average of 30,000 - 50,000 individuals die from the 4
influenza virus. Worldwide, the fatalities are about 20 to 30 times as high as the death toll in a 3 9
this country. Over the past 300 years, there have been 10 documented pandemics of the a
influenza A virus. Why are we not adequately prepared for this possibility? Did we rely too
much on a vaccine even though we all knew as public health professionals that the vaccine
itself is not perfect? These questions could probably be debated for the entire flu season.
Now is not the time to ask questions or lay blame but to prepare for the inevitable. Below are
steps that board of health members should be taking:
1. Ensure that the local public health agency has an influenza preparedness and response plan and that plan is integrated with
plans from other local response agencies, health care delivery systems, and managed care organizations. Boards of health
should also consider working with other community organizations as well as school boards and others who may be
invaluable during an influenza crisis. Countermeasures, surge capacity, temporary hospitals, and staffing are just a few of the
issues that must be addressed in the influenza planning.
2. Educate the community. Education is crucial to any public health program but it is especially important that the public
understands basic infection control guidelines as well as what to do if they suspect they have the influenza virus. Some simple
education can pay big dividends in the event of a pandemic.
nsuring that these steps are taken can greatly improve the community response to an influenza epidemic. Boards must
continuously work with community leaders to ensure there are ongoing efforts at the local level in preparing for an emergency, no
matter what that might be. O
NALBOH's All Hazards Recreational Water Survey
Preparedness Guide
!t Effective pool and spa inspections/assessments are
Now Available' . 180 ILI ,,'an important component of environmental health
activities in local public health agencies. Recently,
NALBOH is proud to offer a new JLLL~~~!!! NALBOH partnered with the National Swimming
educational training guide for local board Pool Foundation to conduct research and
of health members. The guide titled "Emer- education for local board of health members on recreational water programs. The
gency Preparedness Including Bioterronsm: ultimate goal of the partnership is to:
An All Hazards Approach for Local Boards
of Health;" specifically addresses the role • Promote aquatic activities to local communities. Aquatic activities have
of local board of health members in many documented health benefits. Local boards of health must be educated on
community preparedness. the many different health benefits so they can ensure that their local public health
agencies are promoting and encouraging aquatic recreation within their individual
Local boards of health are responsible for communities.
assuring adequate public health services are • Educate board of health members on the importance of aquatic recreation,
provided in their communities, including aquatic safety and recreational water illnesses.
protecting the community from the risks • Make boards of health aware of the lack of uniformed training among public health
associated with man-made or natural professionals and the pool/spa industry and offer solutions to the problem (i.e.,
` disasters. The information provided in the NSPF CPO course). Training must be consistent in order to fully prevent
I guide will enable board members to make recreational water illnesses.
more informed decisions regarding their • Create new community partnerships that encourage aquatic recreation to combat
public health agency's emergency the current obesity epidemic.
reparedness efforts.
In the near future, boards of health will be receiving a survey to determine their
To obtain your board's copy of the overall knowledge of the local public health agency's recreational water programs.
educational guide, please call the NALBOH The survey will also be available through NALBOH's website. Please fill out the
office at (419) 353-7714 or visit us online survey so NALBOH can better serve its members. Results of the survey will be used to
at <www.nalboh.org>. O develop an educational guide on recreational water programs and the roles and re-
sponsibilities of the local board of health. O
Page 10 NALBOH NewsBrief Fourth Quarter 2005
SALB • 11- .41011
2006 NALBOH Membership
BOARD OF HEALTH It is time to consider your 2006 NALBOH membership. A
SELF-EVALUATION membership in NALBOH provides an opportunity for you and your
Excerpts from the Ohio Association of board of health to:
Boards of Health Have an input into national health policy;
Board of Health Member Guide to Roles Receive copies of the NALBOH NewsBrief for each board
and Responsibilities member;
• Receive discounts for NALBOH educational materials; and
• Participate in NALBOH's exceptional Annual Conference at
a member rate.
The 2005 annual conference was the biggest and best yet. The
ARE YOU AN EFFECTIVE BOARD MEMBER? 2006 annual conference is planned for San Antonio, Texas, July
26-29, 2006. Join NALBOH and be part of this great conference
Are you: designed specifically for those serving on boards of health. It will
be co-located with the National Association of County and City
Committed - Dedicated to the work of the agency and its Health Officials.
vision for the future.
Join NALBOH now by sending in the membership application
Involved - Attend tneetings, work in partnership with staff, below or return the invoice that was mailed to you in November,
lend skills, expertise and talents through committee along with payment to: NALBOH, 1840 East Gypsy Lane Road,
participation. Bowling Green, OH 43402. Call the office (419) 353-7714 if you
need a replacement invoice. ?
Informed - Educated about policies, procedures and
budgets. Application for Membership
Challenged - Seek to learn new skills. Date:
Trained - Take advantage of orientation programs, attend Membership Year: 2006 (January 1 - December 31, 2006)
conferences.
Accountable -Honor your commitment to serving on the Board of Health/Organization/Name of Individual
board of health.
Mailing Address
DO YOU HAVE AN EFFECTIVE BOARD? city stare zip code
Yes, if your board: Fhone Fax email
• Has no single person who dominates the board coofaa Person and rde
• Works with the health officer Check type of desired membership:
• Makes collective decisions ? Institutional ($120)
• Learns job duties Any local board of health or other governing body
• Problem-solves
• Develops a unifying pupose that oversees local public health services programs or
• Is open-minded ($95) a local board of health whose state association is
• Develops a sense of camaraderie an affiliate member of NALBOH (GA, ID, IL, MA, NC, NE, NJ,
• Is willing to compromise OH, UT, WI)
• Accepts personal sacrifices ? Affiliate ($300)
• Has cdfnmunity interest State associations of local boards of health (SALBOH)
• Constantly looks for ways to improve 71 Associate ($60)
• Build relationships Any individual committed to NALBOH's goals and objectives
• Does all things with integrity 73 Retired ($12)
• Is receptive to public input Any former member of a board of health, state board of
• Is careful of bias health, local governing body, state, territorial or tribal board
• Focuses on long-range planning of health
• Makes decisions based on facts ? Sponsor ($60)
• Pledges to become educated ? Anon-profit organization, agency or corporation committ
to NALBOH's goals and objectives or
($300) a for-profit organization, agency or corporation
committed to NALBOH's goals and objectives
? Student ($20)
Any full time student committed to NALBOH's goals and
objectives
l
i
Fourth Quarter 2005 NALBOH NewsBrief Page 11
NAIBON-
S Grass Hoots
t t T.'~ 01PUblit Nealth
December 2005
65th Annual Meeting
Association of Schools of Public Health
December 10-14, 2005
Ritz-Carlton, Philadelphia, Pennsylvania
Sponsored by Association of Schools of Public Health
For more information visit <http://www.asph.org/>
American Pulic Health Association's
133rd Annual Meeting and Exposition
Evidence-Based Policy and Practice
December 10-14, 2005
Philadelphia, Pennsylvania
Sponsored by American Public Health Association
For more information visit <http://www.apha.org>
February 2006
ul Speak: Plain Talk About Health Literacy
nd the Physician-Patient Partnership
February 8-11, 2006
Snake River Lodge & Spa, Jackson Hole Wyoming
Sponsored by University of Tennessee Graduate School of Medicine
For more information visit <http://gsm.utmck.edu>
Future Events 2006
7th Annual Ned E. Baker Lecture in Public Health
April 7, 2006
Featured Speaker: Dr. David Matthews, President of the Kettering Foundation, Former Cabinet Secretary
Sponsored by National Association of Local Boards of Health and Bowling Green State University
For more information visit <http://www.nalboh.org>
Community-Campus Partnerships for Health
9th Conference
Walking the Talk: Achieving the Promise of Authentic Partnerships
May 31-June 3, 2006
Hyatt Regency Minneapolis, Minneapolis, Minnesota
Sponsored by Community-Campus Partnerships for Health
For more information visit <http://www.ccph.info/>
IgOALBOH's 14th Annual Conference
my 26-29,2006
Sheraton Gunter Hotel, San Antonio, Texas
Sponsored by National Association of Local Boards of Health
Co-located with the National Association of City & County Health Officials
For more information visit <http://www.nalboh.org>
1
National Association of Local Boards of Health
&
National Association of County & City Health Officials
Co-located Annual Conference
July 26 - 29, 2006
Sheraton Gunter Hotel
205 East H;`ston Street Sen Antonio, Tuxes 78205 Telephone: (210) 227.3241 Fax: (210) 227J299
Tod Free` d X888) 899-2089
r -
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 O Bowling Green, OH
E-mail: <nalboh @ nalboh.org> Permit No. 47
Website: <www.nalboh.org>
PPP7
Mr. William T. Steuer, Chairman, called the regular business meeting of the New Hanover County
Board of Health to order at 8:00 a.m. on Wednesday, August 2, 2000.
Members Present:
William T. Steuer, Chairman Gela M. Hunter, RN
Wilson O'Kelly Jewell, DDS, Vice-Chairman Mr. Robert G. Greer
Henry V. Estep, R14U Anne Braswell Rowe
Michael E. Goins, OD Estelle G. Whitted, RN
Members Absent:
W. Edwin Link, Jr., RPH
Philip P. Smith, Sr., MD
Melody C. Speck, DVM
Others Present:
Mr. David E. Rice
Frances De Vane, Recording Secretary
Invocation:
Dr. Wilson Jewell gave the invocation.
Minutes:
Mr. Steuer asked for corrections to the minutes of the July 12, 2000 New Hanover County Board of
Health meeting. The Board of Health approved the minutes of the July 12, 2000 Board of Health
meeting.
Public Comment:
Proposed Regulation for the Use of Mobile Telephones While Operating a Motor Vehicle
Dr. Joseph Hooper, former Board of Health Chair and New Hanover County Commissioner, thanked the
Board of Health for the opportunity to appear before the Board to present a proposed regulation to
prohibit the use of hand-held cell phones while driving an automobile. He expressed hand-held mobile
phones are a threat to the safety, cause injuries and automobile accidents, and are a health hazard to
New Hanover County citizens. Dr. Hooper advised other states have pending mobile phone usage
regulation and some municipalities and other countries have banned the use of cell phones. He chose to
submit the Proposed Regulation for the Use of Mobile Telephones While Operating a Motor Vehicle to
the Board of Health, because under North Carolina General Statue 130-A-1.1 the Board has the authority
to promote and make public health and safety regulations.
Ms. Rowe asked if the proposed cell phone regulation would infringe on individual rights. Dr. Hooper
responded cell phones need to be regulated for safety reasons, and the proposed regulation has nothing to
do with the freedom of speech. Mr. Steuer asked if the Board should wait for the state or federal
13
governments to restrict cell phone usage while driving a motor vehicle. Dr. Hooper encouraged the
Board of Health to consider the recommendation as presented.
•
Mr. Steuer thanked Dr. Hooper for presentation to the Board. The Proposed Regulation for the Use of
Mobile Telephones While Operating a Motor Vehicle will be presented to the Executive Committee of
the Board of Health for their consideration.
Recognitions:
Service Awards
Susan O'Brien - 25 Years
Mr. Rice recognized and congratulated Ms. Susan O'Brien, Laboratory Director, as a recipient of a New
Hanover County Service Award. He acknowledged Ms. O'Brien is a cornerstone of the Health
Department, and he commended her for 25 years of dedicated public health service.
Personnel
New Employees
Joan Hulette, Clerical Specialist I, Communicable Disease
Maureen Lamphere, Public Health Nurse I, Communicable Disease
Lenora Kay Lunceford, Clerical Specialist I, Communicable Disease
Harvey Eugene Young, Environmental Health Specialist, Environmental Health e
• Department Focal: °
WIC Outreach
Ms. Nancy Nail, Nutrition Director, presented a department focal on WIC Outreach. She explained the
New Hanover County Health Department received a WIC Outreach Grant ($10,000) that provided an
outreach worker from mid-May through June. The objective of the WIC Outreach Grant was to recover
the caseload lost as a result of Hurricane Floyd. Outreach campaigns included storefront set-ups, radio
spots and public service announcements, newspaper articles, and community visits. WIC informational
booths were set up at Wal-Mart, K-Mart, and Roses from 10:00 a.m. to 4:00 p.m. on high volume
shopping days. Public service announcements were aired in English and Spanish on WAAV I&
WMYT/WDVV. An article entitled Women, Infants, and Children Program Improves Health of Low-
Income Children was featured in the Wilmington Journal. To reach the target population outreach
workers were made to doctor's office, WIC vendors, Childcare Centers, housing authorities, churches,
and Headstart Center to encourage new and former clients to participate in the WIC Program. As a
result of these efforts, 17 additional appointments were scheduled for new WIC participants.
Mr. Steuer thanked Ms. Nail for her presentation.
Monthly Financial Report - June 2000:
• Ms. Cindy Hewett, Business Officer, presented the June Health Department Financial Summary Monthly •
Revenue and Expenditure Report that reflects an earned revenue remaining balance of $224,914
(94.74%), an expenditure remaining balance $974,896 (89.95%), and a cumulative percent of 100%I
14~
Proposed Regulation for the Use of Mobile Telephones While Operating a Motor Vehicle
Mr. Steuer presented Dr. Joseph W. Hooper's proposed regulation to prohibit the Use of Mobile Telephones
While Operating a Motor Vehicle to the Executive Committee. Dr. Hooper, former Board of Health
Chair and New Hanover County Commissioner, presented the regulation to the Board of Health at their
August 2, 2000 meeting. The issue was referred to the Personal Health Committee for study.
Mr. Rice contacted Ms. Jill D. Moore, Attorney, Institute of Government, UNC at Chapel Hill, to get
information regarding whether a local board of health has the authority to regulate the use of mobile
telephones by drivers operating motor vehicles on public highways. Mr. Rice concluded it is unclear
under existing law whether the Board of Health has this authority. He stated public health risky
behavior is viewed as a cause of injury and could be addressed to increase public awareness level either
by education or regulation.
Ms. Rowe emphasized this issue needs to be addressed. It is a public health issue. It is not safe to drive
with one hand on the wheel with conversation distracting the motor vehicle driver. Mr. Steuer expressed
this issue is not restricted to New Hanover County.
Mr. Rice introduced Mr. David Howard, Injury Prevention Health Education, Women's Preventive Health
Services. Mr. Howard advised the usage of cell phones and the proposed regulation is not a simple issue
to address. He reported according to a Lexis-Nexis article from the Coastal Area Health Education
Center, 30 states had introduced legislation on this matter but none have passed.
Mr. Howard reported the use of mobile phones is highly prevalent on New Hanover County roadways.
The perception of many is that the use of mobile phones while driving causes less than optimal driving
performance. This perception is backed by opinion and study evidence by the National Highway Traffic
Safety Administration (NHTSA). The study concluded cellular telephones do increase the risk of crash.
Recommendations of the report include in-vehicle systems should be made more compatible with safe
driving, improved data collection, improved consumer education, evaluation of technology and
crashworthiness, and the monitoring of the Emergency Medical Services for overload of 911 system.
This NHTSA report stated states do enforce existing reckless and/or inattentive driving laws.
Mr. Howard addressed the issue of driver inattention, distraction, and proper driving skills. The NHTSA
report disclosed it's not just the phone, it's everything and anything taking a driver's attention from
driving their vehicle safely and according to highway rules. The report recommends stronger
enforcement of existing State laws governing reckless and inattentive driving. Mr. Howard distributed
copes of the N.C. Statutes addressing reckless and/or inattentive driving provided by the Wilmington
Highway Patrol. He advised that according to the N.C. League of Municipalities no other municipalities
in North Carolina have legislation addressing this issue.
Mr. Howard concluded the preemption by State traffic laws must be looked at before addressing a local
regulation. Mr. Rice reiterated public health does not stop at jurisdiction boundaries; however, all issues
should be studied. Mr. Estep stated the enforcement of the proposed regulation would be monumental.
After speaking with Ms. Moore of the Institute of Government, Mr. Burpeau advised the Board's main
challenges of the proposed regulation appear to be jurisdiction issues, that the regulation doesn't address
the traffic issue, and if the Board has the authority to pass the regulation. He informed as the Board of
Health makes its decision regarding the regulation, each exception should have a health basis with no
exemption. The regulation could be. challenged by vendors, realtors, homebuilders, citizens, and
businesses. Mr. Burpeau contacted the Attorney General's office and the question is would state law
4
keep the Board of Health from pursuing the regulation. He stated if the Board decides this is a health
issue, he will assist the Board of Health with legal issues.
• Mr. Steuer reiterated the issue is not solely a local issue and would be highly contested by groups. He suggl sted the
Board support public awareness and educational programs on safe driving addressing cell phones and other) driving
distractions. Mr. Howard will confer with the Governor's Highway Safety Program to address this issue on
a state level.
Motion: Motion passed to refer the issue of the Proposed Regulation for the Use of Mobile Telephones
While Operating a Motor Vehicle to the Personal Health Committee for further study and to provide
preventive education to raise public awareness of in-vehicle technology including the safety of theluse of
mobile telephones as well as other driving distractions including behavior, eating, and diverse
conversation.
Mr. Estep suggested preparing a Department Focal on the Proposed Regulation for the Use of Mobile
Telephones While Operating a Motor Vehicle to cover in-vehicle technology and legal aspects of the
issue. Mr. Link emphasized the use of mobile phones while driving will promote public awareness to
other driving distractions, rules, and skills.
Strategic Planning Process
Mr. Rice reminded the Board to mark their calendars for the Strategic Planing Retreat on October 6 and 7,
2000. Mr. William T. Herzog, MSPH, School of Public Health, UNC@ Chapel Hill, is to serve as
facilitator of the retreat to be held at the Marriott Courtyard. He reported he has received approximately
two-thirds of the retreat responses from the Board of Health and retreat participants. Mr. Rice is
preparing a pre-packet retreat to be distributed two weeks prior to the Strategic Planning Retreat. Ili will
include the Health Department Organizational Capacity Indicators - 1998-99 from the AEIOU Surveys.
• Revision of Health Director's Evaluation Form I
Upon the request of the Board of Health, Mr. Rice presented a Revision of the Health Director s
Evaluation Form. He stated the performance rating form was clarified to make it simpler and more
accurate. The Board of Health completes the form on an annual basis. Mr. Steuer explained the form is
improved and eliminates the complicated numerical totals.
Motion: Motion passed to recommend to the Board of Health the approval of the Revision of the Health
Director's Evaluation From.
Ad iou rnment
Mr. Steuer adjourned the Executive Committee meeting of the Board'of Health at 8:00 p.m.
David E. Rice, Health Director I
New Hanover County Health Department
5
DRAFT
A REGULATION
OF THE
NEW HANOVER COUNTY
BOARD OF HEALTH
WHEREAS, the New Hanover County Board of Health is charged pursuant to North
Carolina General Statute 130A-1.1 with promoting and contributing. to the public health of the
citizens of New Hanover County; and
WHEREAS, the Board of Health believes that the operation of a motor vehicle on the
public roadways while using a telephone may cause the operator to maintain less than full
attention to the operation of said motor vehicle; and
WHEREAS, the Board of Health finds that the regulation of the use of mobile telephone
while operating a motor vehicle in the County will enhance the safety of those persons operating
motor vehicles and other persons using the roadways;
NOW, THEREFORE, BE IT ORDAINED BY THE NEW HANOVER COUNTY
BOARD OF HEALTH that a regulation be adopted to read as follows:
Section 1.0 Definitions:
As used in this Ordinance:
(1) "Mobile Telephone" means, including but not limited to cellular, analog,
wireless and digital telephones.
(2) "Use" means to use a mobile telephone in:
(A) Dialing
(B) Answering
(C) Talking
(D) Listening
(3) "Park" means for an automatic transmission vehicle that the vehicle is in
the Park gear; for a standard transmission vehicle that the vehicle is in the
neutral gear and the brake is being utilized or otherwise stationary.
Section 1.1 Use; Restrictions:
(1) No person shall operate a motor vehicle on any street or highway while
engaging in any conduct defined as the "Use" of a mobile telephone unless
the operator maintains both hands on the applicable steering device.
(2) Division (1) of this section does not apply to a person who is using the
mobile telephone:
(a) To contact public safety forces, or
(b) While maintaining the vehicle in the Park position either on public
52
or private property, or
(c) With a "hands free device" which allows the operator to maintain
• both hands on the vehicle while using the mobile telephone. •
Section 2.1 Penalties
(A) Whoever violates any of the provisions of this regulation shall be guilty of
a misdemeanor, subject to a fine of Fifty ($50.00) Dollars.
(B) All fines imposed pursuant to this regulation shall inure to the benefit of
the New Hanover County Board of Education.
This regulation shall be effective
ADOPTED THIS DAY OF 2000.
53
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• Facsimile Cover Sheet
INSTITUTE OF GOVERNMENT
CB # 3330, Knapp Building
UNC-Chapel Hill.
Chapel Hill, NC 27599-3330
To: David Rice
Agency: New Hanover County Health Department
Fax: 910-341-4146
From: Jill Moore
Phone: 919/966-4442
Fax: 919/962-0654
Email: moor ognail.iop unc edu
• Date: August 23, 2000
Pages including this cover page: 3
Comments: Original being sent via us mail.
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08/23/2000 10:12 9199622706 INST OF GOVT PAGE 02/03
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_ INSTITUTE Of GOVERNMENT
August 23, 2000
David Rice, Health Director
New Hanover County Health Department
2029 South 17'x' Street
Wilmington, North Carolina 28401
Dear Dr. Rice:
You asked me whether a local board of health has the authority to regulate the use of
mobile telephones by drivers operating motor vehicles on the public highways. I have
completed my research and I conclude that it is unclear under existing law whether a rule
on this issue would be within the local board of health's authority. This letter summarizes
the law that would govern the issue if the rule were adopted and subsequently challenged.
® Local boards of health "have the responsibility to protect and promote the public health
[and] the authority to adopt rules necessary for that purpose." G.S. 13OA-39(a).
There is nothing in the statutes that further explains the meaning of terms such as "protect
and promote" or "necessary for that purpose." However, the North Carolina Court of
Appeals in a 1996 case provided a five-part test for determining when a local board of
health rule is within its authority:
[A) board of health acts within its rule making powers when it enacts a regulation
which (1) is related to the promotion or protection of health, (2) is reasonable in
light of the health risk addressed, (3) is not violative of any law or constitutional
provision, (4) is not discriminatory, and (5) does not make distinctions based upon
policy concerns traditionally reserved for legislative bodies.
City ojRoanoke Rapids v Peedin, 124 N.C. App. 578, 587, 478 S.E.2d 528 (1996).
In the Peedin case, the Court of Appeals struck down a smoking control rule adopted by
the Halifax County Board of Health. The Court concluded that the Halifax Board's rule
failed part (5) of the above test. According to the Court, the rule failed because it applied
different standards to different types of restaurants (e.g., large versus small-capacity
restaurants) when it lacked a health-specific rationale for doing so. The Court stated that
The University of North Carolina at Chapel Hill
CUtl 3330 Knapp Building • Chapel Hill, NC 27599.3330
919 966.5381 • 919 162.0054 1rax1
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l Dr. Rice
August 23, 2000
Page Two •
the distinctions had "no foundation in consideration of public health" but were instead
made out of concerns for economic hardship and difficulty of enforcement-matters that
a board of health lacks authority to consider in adopting a rule. The Court concluded,
"the statutes cannot be held to permit the Board to consider factors other than health in
promulgating its rules."
As you consider the development of your rule, I would advise you to consider carefully
each of the five factors enunciated in Peen and, when appropriate, include findings in
the rule that address the factors. For example, I would recommend that you specifically
make note of the studies you told me about that demonstrate an increased risk of injury
associated with the use of phones in vehicles. Unfortunately, the Peen Court did not
offer guidance as to how the first four factors in the five-part test would be applied; thus,
I am not able to predict whether your proposed rule would satisfy those factors.
Another issue I considered is whether a board of health would be precluded from making
a rule that affects the operation of motor vehicles, since that matter is usually regulated
by the North Carolina General Assembly. I consulted with two of my colleagues who
specialize in motor vehicle law, Jim Drennan and Ben Loeb. They told me that there is
nothing in North Carolina's motor vehicle law that expressly prohibits a local
government unit from acting in this area, but there is also nothing in the law that
expressly authorizes it. Most local actions that affect motor vehicle law have specific
facilitating language in the statute or a local act of the General Assembly supporting
them.
I hope this information is useful to you and your Board. Please call me if I may be of any
further assistance.
Sincerely,
Jill D. Moore
Assist= Professor
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Mr. David Howard, Health Educator, advised the New Hanover County Safe Communities/Safe Kids
Coalition is requesting this specially equipped trailer to conduct Child Safety Seat Check events; for
trauma coordination of the Southeastern Regional Advisory Committee; for Child Passenger Safety
media coverage; and for training purposes, traveling resource, and for events, fairs, etc. It is a
partnership effort between the New Hanover County Sheriff's Department and the Health Department.
The Sheriff's Department is to provide insurance on the trailer, tow, and store the trailer at their facility.
Motion: Dr. Speck moved and Dr. Goins seconded for the Board of Health to accept and approve the
Safe Kids Trailer Grant Application for $8,740 from Safe Communities, North Carolina Governor's
Highway Safety, to purchase a child passenger safety trailer and equipment and to approve submission of
the associated budget request to the New Hanover County Commissioners. Upon vote, the MOTION
CARRIED UNANIMOUSLY.
Resolution in Support of Programming and Actions to Reduce Motor Vehicle Crashes Related to
Driver Distraction
Dr. Jewell recommended the Board of Health to accept and approve a New Hanover County Board of
Health and Sheriff's Department Resolution in Support of Programming and Actions to Reduce Motor
Vehicle Crashes Related to Driver Distraction and/or Poor Driving Behavior as submitted by the
Personal Health Committee of the New Hanover County Board of Health.
Mr. Rice informed Assistant County'Attorney Kemp Burpeau and Sheriff Joseph W. Lanier reviewed
® and support the resolution. Policy pertaining to road safety must be passed by the state.
Motion: Mr. Steuer moved and Mr. Link seconded for the Board of Health to accept and approve a New
Hanover County Board of Health and Sheriff's Department Resolution in Support of Programming and
Actions to Reduce Motor Vehicle Crashes Related to Driver Distraction and/or Poor Driving Behavior as
submitted by Personal Health Committee of the New Hanover County Board of Health. Upon vote, the
MOTION CARRIED UNANIMOUSLY.
Comments:
Board of Health
Dr. Speck presented an article entitled Dashboard Dining Cited as Road Safety Threat from the American
Automobile Association's Foundation for Traffic Safety that analyzed 26,145 automobile crashes from
1995-1998 in the United States. It concluded dashboard diners (19%) are a greater threat to driver
distraction than vehicular phones. Other driver distractions included attention to something outside
vehicles (20%), i.e. billboards/signs/other people and crashes; use of CD players and radios (11%); and
other occupants (9.4%) i.e. children. Ms: Rowe advised 35 states are addressing the vehicular phone
issue and the Resolution to Reduce Motor Vehicle Crashes Related to Driver Distraction passed by the
® Board is a good step forward.
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NEW HANOVER COUNTY BOARD OF HEALTH AND SHERIFF'S DEPARTMENT
RESOLUTION IN SUPPORT OF PROGRAMMING AND ACTIONS TO REDUCE MOTOR VEHICLE
CRASHES RELATED TO DRIVER DISTRACTION AND/OR POOR DRIVING BEHAVIOR
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WHEREAS, According to the North Carolina Department of Transportation 1999 data, New
Hanover County ranks first among North Carolina counties in total crash rate, non-fatal injury
crash rate, crash injuries per 1000 people; third in crashes per 1000 registered vehicles; Isustains
a crash-related injury every two hours; and has a monetary crash cost per hour of $22,962, and
WHEREAS, In North Carolina motor vehicle crashes are the leading cause of injury-relateld deaths
for all ages, and the leading cause of death for persons up to 34 years of age. Motor vehicle
crashes are also a leading cause of non-fatal injury to persons up to age 34, and the leading cause
of traumatic brain and/or spinal cord injury, both of which can cause life-long disability for the
victims with great cost to family, friends, and communities, and
WHEREAS, A year 2000 study by the United States National Highway Traffic Safety Administration
found higher risk of crashes due to mobile phone use distraction; also concluded many
distractions have the potential to cause crashes at similar magnitude, and
WHEREAS, The North Carolina Governor's Task Force for Healthy Carolinians lists the reduction
of motor vehicle Injuries as one of it's priorities, and
WHEREAS, The New Hanover County Board of Health and Sheriff's Department recognize motor
vehicle crashes as a major Impediment to community health and safety, and
WHEREAS, The New Hanover County Board of Health and Sheriff's Department recognize driver
distraction, inattention, and poor driving behaviors as significant contributors to crash linjuries
and deaths.
THEREFORE BE IT RESOLVED, The New Hanover County Board of Health and Sheriff's
Department support programming and actions by government, private business, community
groups, schools, individuals, and others to reduce motor vehicle crashes related to driver
distraction, inattention, and/or poor driving behaviors.
Adopted the _ day of 2001.
Wilson O'Kelly Jewell, DDS, Chairman
New Hanover County Board of Health
(Seal)
Joseph W. Lanier, Sheriff
New Hanover County
Attest:
Secretary to the Board of Health •
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