11/01/2006
NHCHD BOARD OF HEALTH APPROVED GRANT APPLICATION STATUS FY 05-06
Date(BOH) Grant Requested Pending Received Denied
10/4/2006
• March of Dimes - Maternity Care
Coordination expenditures for Baby Love
Program Baby Boutique and Learning Center $3,000 $3,000
91612007 No Activity for September 2006
81212006 No Activi for Au ust 2006
7/512006 I ervlce oor Inatton am y
Counseling Program (Cape Fear Memorial
Foundation) - Funding for Licensed Clinical
Social Worker for 3 ears $260,000 $75,000 $185,000
Eat Smart Move ore - Community Grant
(NC Dept of Public Health Physical Activity
and Nutrition Branch $16,495 $12,416 $4,079
6/712006 Living Well (Cape Fear Memorial
Foundation) Ratify grant received to produce
Living Well publication $0 $12,000
Landfall Foundation - Purchase CPR
supplies and instruction manuals for school
nurses $2,300 $2,300
5/312006 Diabetic Supplies (Cape Fear Memorial
Foundation $21,000 $21,000
NHCDHHS - Division of Medical Assistance
- Health Check Coordination Funding $33,873 $33,873
4/5/2006
NC Pandemic Influenza Planning Funds -
Pandemic Influenza planning. Ratification of
• grant application submitted for 3/2/06 deadline
Note: Full funding expected per State
notification; currently partial funding
confirmed with additional award to follow. $49,030 $49,030
31112006 No Activi for March 2006
Child Care Nursing (Smart Start)
Continuation funding for existing grant
2/1/2006 program $166,600 $160,000 $26,600
Health Check Coord. (Smart Start)
Continuation funding for existing grant
pro ram $45,800 $12,000 $33,800
Family ssessment Coor . (Smart StartContinuation funding for FAC portion of
Navigator program 'NOTE: May receive
$44,000 in 2nd phase if funds avail. $113,000 $44,000 $69,000
NC Institute for Public Health - Accreditation
- assistance with improvement in areas
(policies/procedures & continuing ed training
log). $17,034 $4,150 $12,884
Tabled by BOH Pediatric Primary Care (United
not approved Way/NHRMC) Start-up funds to support new
for submission primary care program for pediatric patients $30,000 $0
Cape Fear Memorial Foundation- Obesity
1/4/2006 Grant (3 year period $300,000 $225,000 $75,000
Cape Fear United Way- Panorex Grant $38,000 $38,000
• NC Office of Minority Health 8 Health
Disparities- Interpreter Grant $20,000 $20,000
NACCHO Grant-Addressing Disability in
Local Public Health. Collaboration with
12/7/2005 UNCW. $25,000 $25,000
As of 10111/2006 $
NOTE: Notification received since last report.
" Program did not apply for grant.
NHCHD BOARD OF HEALTH APPROVED GRANT APPLICATION STATUS FY 05.06
Date(BOH) Grant Requested Pending Received Denied
Office of Research, Demonstrations and •
11/2/2005 Rural Health- Pediatric Prima Care Grant $50,000 $50,000
Health Carolinians- Contract Coordinator $5,000 $5,000
1011212005 - 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- • Graniwas
to be used for educational and $e•ooo from approved by noed
purposes existing PA NHC-CC by RWJ
by RWJ
media campaigns only. budget 9119105 Foundation
71612005 No activity for July 2005.
NC Dept of Insurance- Office of State Fire
6/1/2005 Marshall- Risk Watch Continuation Grant $ 25,000 $ 25,000
HUD (partnership with City of Wilmington)
Lead Outreach and Education Program (3
year funding) $ 275,000 $275,000
Ministering Circle- Good Shepherd
Ministries Clinic supply & Equipment $ 15,000 $ 15,000 $ -
No activity for May 2005.
Cape Fear Memorial Foundation- Living
4/6/2005 Well Program $ 20,000 $ 20,000 $
National Safe Kids Coalition-Mobile Van for -
3/2/2005 Car Seat Checks $ 49,500 $ 49,500 $ -
Smart Start- Child Care Nursing Program $ 239,000 $ 170,000 $ 69,000 •
Smart Start- Health Check Coordination
Program $ 43,800 $ 43,800
Smart Start- Navigator Program $ 155,000 $ 44,000 $111,000
2!2/2005 No activity for February 2005.
Champion McDowell Davis Charitable
1/5/2005 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 $
10/6/2004 No activity to report for October 2004.
91112004 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 $2,202,832 $3,000 $1,165,469 $966,363
0.14% 52.91% 43.87%
Pending Grants 1 3%
Funded Total Request 16 52%
Partial/ Funded 9 29% •
Denied Total Request 6 19%
Numbers of Grants Applied For 31 100%
As of 10111/2006
NOTE: Notification received since last report.
Program did not apply for grant.
• New Hanover County Health Department
Revenue and Expenditure Summaries for September 2006
Cumulative: 25% Month 3 of 12
Revenues
Current Year Prior Year
Type of Budgeted Revenue Balance % Budgeted Revenue Balance %
Revenue Amount Earned Remaining Amount Earned Remaining
Federal & State $ 1,902,273 $ 672,060 $ 1,230,213 35.33% $ 1,816,791 $ 574,191 $ 1,242,600 31.60%
AC Fees $ 611,161 $ 162,966 $ 448,195 26.66% $ 659,496 $ 180,222 $ 479,274 27.33%
Medicaid $ 1,546,994 $ 193,202 $ 1,353,792 12.49% $ 1,500,300 $ 324,019 $ 1,176,281 21.60%
Medicaid Max $ 310,000 $ - $ 310,000 0.00% $ - $ - $
EH Fees $ 310,000 $ 51,945 $ 258,055 16.76% $ 300,212 $ 55,996 $ 244,216 18.65%
Health Fees $ 250,200 $ 62,259 $ 187,941 24.88% $ 128,000 $ 51,985 $ 76,015 40.61%
Health Choice $ 35,125 $ 2,445 $ 32,680 6.96% $ . - $ - $ -
Other $ 2,676,206 $ 455,438 $ 211,220,768 17.02°h $ 3,072,186 $ 512,392 $ 2,559,794 16.68%
Totals $ 7,641,959 $ 1,600,314 $ 6,041,645 20.94°k $ 7,476,985 $ 1,698,804 $ 5,778,181 22.72%
Expenditures
Current Year Prior Year
• Type of Budgeted Expended Balance % Budgeted Expended Balance %
Expenditure Amount Amount Remaining Amount Amount Remaining
Salary & Fringe $ 12,095,529 $ 2,099,440 $ 9,996,089 17.36% $ 11,315,151 $ 2,002,450 $ 9,312,701 17.70%
Operating $ 2,198,416 $ 461,577 $ 1,736,839 21.00% $ 1,868,430 $ 376,951 $ 1,491,479 20.17%
Capital Outlay $ 88,585 $ 30,940 $ 57,645 34.939% $ 679,225 $ 9,815 $ 669,410 1.45%
Totals $ 14,382,530 $ 2,591,957 $ 11,790,573 18.02% $ 13,862,806 $ 2,389,215 $ 11,473,591 17.23°
Summary
Budgeted Actual %
FY 06-07 FY 06-07
Expenditures:
Salaries & Fringe $ 12,095,529 $ 2,099,440
Operating $ 2,198,416 $ 461,577
Capital Outlay $ 88,585 $ 30,940
Total Expenditures $ 14,382,530 $ 2,591,957 18.02%
Revenue: $ 7,641,959 $ 1,600,314 20.94%
Net County $ 6,740,571 $ 991,643 14.71%
Revenue and Expenditure Summary
For the Month of September 2006
10
• NEW HANOVER COUNTY BOARD OF COMMISSIONERS
Request for Board Action
Agenda: Consent Meeting Date: 11/13//2006
A enda: ? BOH Mt g. 11/01//06
Department: Health Presenter: David E. Rice, Health Director
Contact: David Rice 798-6591
Subject: Reconsideration of the Resolution to Support Legislation Authorizing Counties
to Set Fees for Local Environmental Health Food and Lodging Services
Brief Summary: The North Carolina Association of Local Health Directors, at its
meeting on September 21, 2006, requested local boards of health and county boards of
commissioners to adopt a resolution to support legislation authorizing counties to set fees
for local environmental health food and lodging services. North Carolina Department of
Environment and Natural Resources mandates sanitation inspections and permitting of
food and lodging facilities to be performed by local public health department personnel,
acting as Agents of the State. The State currently charges an annual fee ($50) to all
permitted food and lodging facilities and disburses a portion of the fees collected to local
health departments. Current fees are not adequate to conduct the mandated services. State
support for the food and lodging services in New Hanover County is less than 2.4
percent. The cost associated with the permitting and inspections is bome almost
• exclusively by the county as an unfunded ma date by the State.
(94. Zft)x496 ,urCM
At its meeting on October 16, 2006, the New Hanover County Board of Commissioners
tabled the NHCBH's resolution and requested the Health Director revise the resolution to
provide greater discretion at the County level to establish and administer programs
related to the inspection of food and lodging facilities.
Recommended Motion and Requested Actions: To reconsider the New Hanover County
Board of Health Resolution to Support Legislation Authorizing Counties to Set Fees for
Local Environmental Health Food and Lodging Services and submit the revised
resolution to the New Hanover Count Commissioners for their consideration.
Fundin Source:
Will above action result in:
?New Position Number of Position(s)
?Position(s) Modification or change
®No Chan a in Position(s)
Explanation:
•
11
f
Attachments: 1. NHC Board of Commissioners Draft Resolution •
2. Letter to the North Carolina Association of County Commissioners
3. NHC Board of Health Resolution to Support Legislation Authorizing Counties to Set Fees for
Local Environmental Health Food and Lodging Services.
•
•
12
DRAFT
NEW HANOVER COUNTY BOARD OF COMMISSIONERS
RESOLUTION
WHEREAS, Environmental Health Specialists employed by New Hanover County Health
Department serve as regulatory agents of the North Carolina Department of Environment and
Natural Resources, Division of Environmental Health, to assure compliance with established
environmental/public health standards; and
WHEREAS, Environmental Health Specialists evaluate food service and lodging facilities to
identify risks in operations or practices that may jeopardize the public's health and safety; and
WHEREAS, North Carolina general statutes mandate at least quarterly inspections of all
restaurants and other similar types of food service establishments; and
WHEREAS, New Hanover County Health Department will receive $24,000 as its State's
portion during fiscal year 2006-07; and the costs for providing these services during Fiscal Year
2006-07 will be $1,012,150, with the primary source of revenue being New Hanover County ad
valorem taxes; and
• WHEREAS, the New Hanover County Board of Health and the New Hanover County Board of
Commissioners believe that the user fees for food and lodging facilities would be more equitable
than asking county residents to bear the cost of this State mandated service through the use of ad
valorem taxes;
NOW, THEREFORE, BE IT RESOLVED, that the New Hanover County Board of
Commissioners does hereby request the General Assembly to review the General Statutes on
Regulations of Food and Lodging Facilities to allow the collection of county imposed inspection
fees and allow counties more flexibility in the frequency of inspections of food and lodging
facilities.
ADOPTED the 13th day of November 2006.
Robert G. Greer, Chairman
Attest:
• Sheila L. Schuh, Clerk to the Board
13
*OCT-18-2006-WED 08:46 AM NHC COMMISSIONERS FAX No.910 798 7145 P, 001
r W
(office of ivy
Robert G. Greer
Chairmen 39Darb of ltommio!YI.DTIU
William A. Caster q Ja
Vlae-Chairman ,*EtA A?anober QGDUntp
Tea Caws Jr. 320 cbeginut otreet, 3&06111 $05 New[
Commissioner Vilmington, ff0rtb Carolina 28401-4093 Wanda rh Copley
William A. Kopp, Jr. Zfl;e ge ane (910) 798 -7149 CountyAttorney
Commisalonar ,jFax (910) 798-7145 Bruce T. Shell
Nancy H. Pritchett www.nhogov.com County Manager
Commmaloner Shelia L. Schutt
Clerk to the Board
September 19, 2006.
Jim Blackburn, General Counsel
NCACC
P.O Box 1488
Raleigh, NC 27602-1488
Dear Mr. lAW15um: 9(rl/n
The New HanovUer County Commissioners met on September 18, 2006 and adopfed .
the following goals for consideration by the steering committee to be incorporated into the
NCACC legislative agenda to be presented to the General Assembly.
Tax Relief - Support legislation to provide greater flexibility to individual counties in
providing tax relief. Counties in North Carolina do not currently have the authority to
create tax exemptions.
Schools - Support legislation to reinstate state funding for local school system utility costs.
i
Medicaid Relief- Support legislation to permanently end county participation in Medicaid
Funding.'
Revenue Options - Support legislation to allow all counties to enact any or all of several
j revenue options from among those that have already been authorized for any other county.
Gang Prevention, Intervention, and Suppression - Support legislation to adequately fund
gang prevention, intervention, and suppression activities.
Adult Care Homes - Support legislation to enhance the enforcement of regulations
governing Adult Care Homes by enacting mandatory time and quality standards for the
North Carolina Division of Facility Services to respond to the findings and
i recommendations of the local Departments of Social Services.
i
I
14
.OCT-18-2006-WED 08:46 AM NHC COMMISSIONERS FAX No,910 798 7145 P.002
J Page two
Jim Blackburn, General Counsel
NCACC
September 19, 2006
Food and Lodging Inspections - Support legislation to review the general statues that
relate to inspections of food and lodging facilities to provide greater discretion at the
County level to establish and administer programs related to the inspection of food and
lodging facilities.
Mental Health - Support legislation to ensure that Mental Health, Developmental
Disability, and Substance Abuse services are available, accessible, and affordable to all
citizens.
Please do notliesitate to call if you have any questions or need any additional information.
Sincerely,
Robert G.
Chairman
C: Senator Julia Boseman
•
Representative Carolyn Justice
Representative Danny McComas
Representative Thomas Wright
County Commissioners
County Manager Bruce Shell
Budget Director Cam Griffin
15
NEW HANOVER COUNTY
HEALTH DEPARTMENT
• 2029 SOUTH 17TH STREET
WILKWGTON,PIC 28401-4946 "'""""°•°'°°°"^"°"O
TELEPHONE (910) 798-6500 FAX (910) 772-7805
NEW HANOVER COUNTY BOARD OF HEALTH RESOLUTION
TO SUPPORT LEGISLATION AUTHORIZING COUNTIES TO SET FEES FOR
.-LOCAL-ENVIRONMENTAL-HEALTH.FOOD_AND_LODGINGSERVICES-.--
WHEREAS, Environmental Health Specialists employed by New Hanover County Health Department
serve as regulatory agents of the North Carolina Department of Environment and Natural Resources,
Division of Environmental Health to assure compliance with established environmental/public health
standards; and
WHEREAS, Environmental Health Specialists evaluate food service and lodging facilities to identify risks
in operations or practices that may jeopardize the public's health and safety; and
WHEREAS, North Carolina general statutes mandate at least quartedy inspections of all restaurants and
other similar types of food service establishments; and
WHEREAS, New Hanover County Health Department will receive $24,000 as its State's portion during
fiscal year 2006-07; and the costs for providing these services during Fiscal Year 2006-07 will be
$1,012,150, with the primary source of revenue being property taxes; and
WHEREAS, local health departments are allowed to charge fees to support the on-site sewage program
• in their counties; and
WHEREAS, the practice of local food and lodging fees is currently utilized in other states; and
WHEREAS, legislative action is required to allow local health departments to charge fees for food and
lodging activity.
WHEREAS, local health departments fully support holding the Division of Environmental Health harmless
for the funding to develop and maintain the environmental health data system; and
WHEREAS, the New Hanover County Board of Health believes user fees for food and lodging facilities
would be more equitable than asking county residents to bear the cost of this State mandated service
through the use of local taxes; now
THEREFORE, the New Hanover County Board of Health hereby requests the General Assembly to enact
legislation to expand General Staatute130A-39 (g) to include food and lodging fees.
Adopted the day of LefB Pe", 2006.
(Seal) Donald P. Blake, Chairman
New Hanover County Board of Health
• r ' -
Attest: >
> t C~~i~ [ 7
David E. Rice
Secretary to the Board of Health
,',,,,~f f, rN ; n uN~~%0% .16
• NEW HANOVER COUNTY BOARD OF COMMISSIONERS
Request for Board Action
Agenda: Consent Meeting Date: 11/13/06
Agenda: ® BOH - November 1, 2006
Department: Health Department Presenter: Kim Roane, Business Manager
Contact: Kim Roane, 798-6522
Subject: Budget Ammendment in the amount of $19,732 for Family Planning
Contraceptive Funds in the Women's Preventive Health Program.
Brief Summary: The New Hanover County Health Department has received notification
from the Division of Public Health that an additional $19,732 has been awarded to be
used to purchase contraceptives for women served by our Family Planning program.
This amount represents an increase of $16,331 in Title X funds to support the purchase of
oral contraceptives for low-income women and an increase of $3,401 in Women's Health
Service Funds to support the purchase of contraceptives for women not eligible for
Medicaid.
• Recommended Motion and Requested Actions: To accept and approve the $19,732
additional State funds to be used to support the purchase of contraceptives for the New
Hanover County Health Department Women's Preventive Health Family Planning
Program.
Funding Source: State Department of Health and Human Services, Division of Public
Health Women's and Children's Health Section. No County match is required for receipt
of these funds.
Will above action result in:
?New Position Number of Position(s)
?Position(s) Modification or change
®No Change in Position(s)
Ex lanation:
Attachments: Division of Public Health Budgetary Estimates 2
•
17
N.C. Division of Public Health Budgetary Estimate to Local Health Departments; SFY 06-07
Original Activity# 151 Activity Name: Family Planning
vision#_2_
TBIe X
ROW 1 FmM CCIPRC FL dMCC1RrC Fen41I=ffRC FuMI cc"c FunMICCIFRC
1511.592A-FP Totel of All
Paymerd Period
Pa ent Period - 711106 -6130107 P em Period - P em Period - P em Period -
Service Period
Service period - 6101116- 6131107 Service Period - Service Period - Service Period -
Sources
COUNTY
$14,296.00 514,296.00
01 .ALAMANCE 520088.00
202 ALBEMARLE REG $20,086.00
$2,179.00 52,179.00
02 ALEXANDER 53108.00
D4 ANSON $310B.Do
E9 886.00 59,666.00
201 APPALACHIAN 58780.00
07. BEAUFORT 58780.00
29 BADEN 53188.00 S9 488.00
55901.00
10 BRUNSWICK $5901,00 .
$19083.00 519 083.00
11 BUNCOMBE 358311.00
12 BURKE 55.830.00
$12 006.00 312,006.00
13 CABARRUS ~57,959.00
14 CALDWELL $7953.00
E3 827.00 E3 827.00
78 CARTERET 53230.00
17 CASWELL $3,230.00
523,089.00
S23.089.00
18 CATAWBA 55858.00
19 CHATHAM SS 858.00
52 728.00 - S2 728.00
20 CHEROKEE $1 977.00
22 CLAY 51377.00
.$11 332.00 511,332.00
23 CLEVELAND $8 930.00
24 COLUMBUS $6 930.00
$7,953.00 37.953.00
25 CRAVEN 528.238.00
26 CUMBERLAND $26236.00
28 $4,795.00 54,795.00
DARE 511,940.00
29 DAVIDSON S1 1 940.00
$2,931.00
30 DAVIE 32,931.00
' .55,484.00 55,464.00
31 DUPLIN
32 DURHAM 519,373.00
$19,373.00
$7449.00
33 EDGECOMBE - 57,449.00
$13,254.00 $13,284.00
35 34 F FRANKLIN $4.861.00 $4,881.00
521 469.00 521.489.00
36 G $1,058.00
38 GRAHAM $7,058.00 $7.583.00
203 GRAN-VANCE $7,583.00
$4109.00 $4,109.00
40 GREENE $48,818.00
41 GUILFORD $49,616.00
$5 917.00
42 HALIFAX $5,917.00
EB,301.00 58,301.00
43 HARNETT $7
44 HAYWOOD $7,383.00
57,621.00 37,621.00
45 HENDERSON 51,576.00
46 HERTFORD $1,576.00
53,009.00
,009.00
47 HOKE $3
- 5862.00
5862.00
48 HYDE - $6,493.00
49 1REDEI I $6,493.00
•
18
w
N.C. Division otPublic Health Budgetary Estimate to Local Health Departments, SFY 06-07.
Original Activity # 151 Activity Name: Family Planning
RevisioD# 2 •
- TiOe X
ROW 1 Fun41RCCIFRC FuM CGFRC FuMI1t=FRC pwidMCCIFRC FuedRCCIFRc
1511-592A-FP ToW Of All
Payment Period
Pe ant Period - 711106 - 6130107 Pe ant Period - P act Peril - P erd Pertod -
Service Period
Service Period - 6101106.6131107 Service P__- • SarviCe Period - Service Period -
- - Solncaa .
COUNTY 54,182. -
50 -JACKSON _541192.00.
$10,392.00 $10,392.00
51 JOHNSTON
52 JONES STON $788'00 -
E ,
53 LEE $5 958.00 $5956.00
$5945.00 - $5945.00
54 LENOIR 53705.00
55 LINCOLN $3705.00
$4 336.00' " -
58 MACON
$1 963,00 ;1983.00
57 MADISON $7112.00
205 MAR-TYR-WASH $7112.00
80 MECKLENBURG $37 606.00 $37806.00
$4,015.00
62 MONTGOMERY $4015.00.
00
63 MOOR; E9 368.D0 $9,36B..
84 NASH 272881.00 ;12,884.00
2 218 391.00 .
85 NEW HANOVER 18 331.00 - S2 803.00 -
66 NORTHAMPTON $2903.00
164.00 59184.00
87 ONSLOW 59 - - 57088.00
68 ORANGE $7,088.00
$1 748.00 51 748.00
89 PAMLICO ;5851.00
- -
71 PENDER $5851-00
24 529.00 54.629.00 •
73 PERSON 517,105.00
74 PITT 517105.00
58 827.00 $9,827.00
78 RANDOLPH 53248.00
T7 RICHMOND 53,246.00
570,209.00 ;10,208.00
78 ROBESON ;8,793.00
79 ROCKINGHAM $8783.00 '
58,528.00
$6 526.00
80 ROWAN 511,000.00
207 R-P-M 511 000.00
57,311.00 57 311.00
82 SAMPSON ;8788
83 SCOTLAND $6786'00
$2 461.00 52481.00
84 STANLV 53,335.00
85 STOKES $3335.00
SQ542.00 $8,542.00
66 SURRY 51,189.00
87 SWAIN 51189.00 .
S6 177.00 $6,177.00
' 206 TOE RIVER
.00 ;4,424.00
88 TRANSYLVANIA $4,424 =1457200
90 UNION $14,572.00
92 WAKE $49911.00 549,911.00
S3 458.00
S3.456.00
93 WARREN
516,802.00
$16,602,00
96 WAYNE' $4,115.00
97 WILKES 54?15.00
58,074.00 58,074.00
98 WILSON 52,804.00
99 YADKIN $2,804.00
TOTALS BY CENTER 5757,997.00 $0.00 EO.OD 20.00 5757,997.00
$757,997.00
CHECK GRAND TOTAL
Sign a ntl Date - DPH Program Administrator Signature tl Date- Div talon of Public Health Budget Offker 10
16
Signature and Date - DPH Section Chief 19
N.C. Division of Public Health Budgetary Estimate to Local Health Departments, FY 0607
# 151 Activity Name: Family Planning
Original Activity
Revision# _4_ Furq CGFRC Fun44IcemRC
Fun41RCCIFRC Fun49tCCIFRC T0181 O7 All
ROW 1 151115151lfA
. 1511 41017 -FR Payment Period -
Peymerd Periotl payment Period payment PeHotl -
8101106-06170107 810110646130107
Service Period Servlee Period
0710`110 1107 0710IMS-05131107 Service Period - Service Periotl • SourOes
COUNTY
318,519.00
31,885.00 $14,624.00 S32 0$7,00
01 ALAMANCE $12744.00 $19943.00
$4,62B.00
202 ALBEMARLE REG $2,026.00 $2,602.00
02 ALEXANDER E%ANDER $7144.00
04 ANSON $1,895.00 $5,249.00 $9,356.00
2001 1 APPALACHIAN 35415.00 $3 941 .00 $8,989.00
$0.00 $6,989.00 39.643'.00
07 BEAUFORT
59,916.00
08 BLADEN $3583.00 $6,050.00
10 BRUNSWICK $1,895.00 $8,021.00 $20,924.00
520,382.00
11 BUNCOMBE $542.00 $10,641.00
$1189.00 $9,452.00 $14,241.00
12 BURKE
13 CABARRUS 51,895.00 $12,346.00 $10,858.00
$1711.00 $9,145.00 $0.00
14 CALDWELL $0.00
16 CARTERET $0.00 $3.832.00
$1354.00 $2278.00 $16705.00
17 CATAWB 31,895.00 $14,810.00
$5,848.00
$2,870.00
1189 C CHATHAM ATHAM $1,354.00 $4494,00
20 CHEROKEE $1,354.00 S1,61B.D0 $1,517.00 22 CLAY $1,117.00 3 ,00.00 $15,488.00
23 CLEVELAND $1,354.00 $14,132.00 $12,163.00 24 COLUMBUS $1,895.00 $10,268.00 $12880.00
$303.00 $12,377.00 347.708.00
• 25 CRAVEN
53,417.00
26 CUMBERLAND $0.00 $47,708.00
$1,354.00 52,083.00 323,471.00
28 DARE 515
29 DAVIDSON $7,907.00 53,389.00
$1,218.00 $2 ,584 ,171 .00 .00 510,282.00
30 DAVIE SB,928.00
$1,354.00 535,223.00
32 31 DU DURHAM $1.895.00 $33,328.00
$17,256.00 33 EDGECOMBE $1,354.00 $15,902.00 $43,778.00
$1,354.00 542.422.00 S6 531.00
34 F $542.00 $5,989.00
35 FRANKLIN $27,249.00
$1,354.00 S25.895.00 $2,983.00
3 38 8 GR GRAHAM AHA $2,398.00 3585.00
90 4 00 $15,885.00 $17$3,899.00
,930.00
203 GR CE $1 $2818.00
40 GREENS EENS $1,112.00 $80406.00
$$.132.00 $52,274.00 $14938-00
41 GUILFORD $12,684.00
$2.254.00 $$6555..00
42 HALIFAX $72 161 .00 555
$542.00 .00
43 HA $3,694.00
44 HAYWOO WOOD 52.861.00 50022.00
$1,895.00 $8127.00 55,53500
45 HE $3488.00
46 HERTFORD N TFORD $2,047'00 $10.784.00
$4,041.00 $6,743.00 51,338.00
47 HOKE .00
$814.00 5724
575,814.00
48 HYDE 513,946.00
49 IREDELL 81,868.00
20
N.C. Division of Public Health Budgetary Estimate to Local Health Departments, FY 06-07
Original _ Activity # 151 Activity Name: Family Planning _ i
Revision# 4_ Fun4atCCIFRC
ROW 1 Fun i1RC(WRC FunM1CCIFRC F.Mlcc"c _ Total of All
1611-0017-FR 7 IRA -
Payment Period Payment Period payment Period - Payment Period
8101106-06130107 8101106-06130107
Service Period Service Part
otl Service Penotl
07101106-05131107 07101106-05131107 Service Period - Sources
COUNT' 52,894.00 55,558.00
50 JACKSON $2,665.00 575,055.00
1.00 $7,541.00
51 JOHNSTON- 51,354.00 513,70093.00
.
52 JONES ¢ 14 8 00 51, $8,885.00
5542.00
53 LEE $8,343.00 $14,275.00
54 LENOIR 51652.00 $12623.00
55 LINCOLN $677.00 $8,312.00 $8,988.00 58 MACON 53,757.00
$1,895.00 $1,862.00
$3126.00
57 MADISON 51895.00 $1,231.00
$13,402.00
$4.874.00 $8,528.00 $85,120
60 205 M M ECKLE BURG $0.00 $85,120.00
$3,805.00 $4,840.00 $8,4 $10;100.00
62 MONTGOMERY RG $7,895.00 54..00
63 MOORE 00
64 NASH 554 $8,205.00
64 NASH 2.00 $13,501.00 514,043.00 65 NEW HANOVER 221,228.00
66 NORTHAMPTON $3.401.00 $856.00 $17,827.00 25,181.00
$4,325.00
517,459.00
$1,895.00 $15,564.00
87 OANGE $0.00 $7,650.00
68 ORANGE 57,850.00
57,278.00
69 PAMLICO $0.00 $1.278.00
71 PENDER $6,388.00
$1,895.00 54,494.00
56888.00
73 PERSON $2,217.00 $4,449.00
524078.00
74 PITT $3,249.00 $20829.00
$14,970.00
52.609.00 $12,301.00
7 R $10114.00 -510,828.00 • -
77 7 RICHMOND CHMOND $072.00 538,270.00
78 ROBESON $6,525.00 $31,745.00 513,908.00
511,484.00 221,7 87.00
79 ROCKINGHAM 82,424.00
515,857.00
80 ROWAN - 55.330.00 $20.040.00
$7,108.00 $12
02 SAMPSON $1,895.00 ,932.00 211208.00 .
207 R-P-M $8,314.00
214,1 8fi.00
83 SCOTLAND $4,903.00 $9,283.00
$7.957.00
84 STANLY $1,783.00 $6174.00
53,502.00
85 STOKES 5406.00 $3186.00
57,728.00
88 SORRY $1,354.00 $6,374.00 24,007.00
22,340.00
87 SWAIN $1,667.00 - 26,273.00
55,686.00 $2,587.00 24,774.00
206 TOE SrVER
YLVANIA $2436.00 $2,278.00
88
90 UNION NION $1,354.00 $12,115.00 $13,469.00
258,010.00
92 WAKE $1.895.00 254.115.00 22,894.00
$0.00 $2,894.00
93 WARREN
96 W $16549.00 $17,903.00
97 WILKEES $1954.00 -
$0.00 25,834.00 $5.834.00
LK -$16.595.00
99 WILSON $1,895.00 $14,700.00 YADKIN 00 $5,783.00
98
$2,785.53,018.00
$0.00 51,1 ,
TOTALS BY CENTER $183,384.00 $0.00 B3 384 .00
Et,000 000.00 $1,783.384.00
COCK GRAND Tg3AL -
o~
Date - DP Program Administrator Signature and ate -0 P H Budget Officer
Sig.
ignature and Date - DPH Section Chief
21
• NEW HANOVER COUNTY BOARD OF COMMISSIONERS
Request for Board Action
Agenda: I Consent Meeting Date: BOH Mtg.
A ends: ? November 1, 2006
-Department: Board of Health Presenter: David Rice
Contact:David Rice
Subject: The Board of Health Rulemaking Authority: A Primer for Local Boards of
Health
Brief Summary: Rulemaking is an essential function of boards of health. The NCIPH has
adapted a web-based module called "The Board of Health Rulemaking Authority: A
Primer for Local Boards of Health" to support volunteers who serve on local boards of
health.
This training can be viewed by the entire board together as a group or by board members
individually. For more information please refer to our on-line brochure at
-http://w-ww.sph.une.edu/content/view/2801/2851/
• Recommended Motion and Requested Actions: Discuss process for New Hanover
Count Board of Health Members
Fund in Source: N/A
Will above action result in:
?New Position Number of Position(s)
?Position(s) Modification or change
®No Change in Position(s)
Explanation:
Attachments: Overview --The Board of Health Rulemaking Authority: A Primer for Local
Boards of Health
•
22
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SKILLS TE.
I
THE UNIVERSITY OF NORTH CAROLINA AT CHAPEL MILL
Skills Test Instructions
i
Welcome to the UNC-CH Customizable Online Skills Test!
This skills test will check if you have the basic system requirements,
• plug-ins, and skills to take an online course at UNC. Don't worry, you
can go through the test as many times as you like, and we will offer a
good number of links to help along the way.
The test you are seeing has been assembled for you by the professor or
program contact who provided you with this url. Each section of the
test is represented by a button in the left button bar. Please go through
each test, starting with the first button under "Instructions" (this
section) and moving down to the "Finish" button. Make sure that you
successfully complete each section before moving to the next. You will
see directions in blue text at the bottom of each page, telling you how to
get to the next test.
The last button you see is marked "Finish." This button allows you to
print out a certificate verifying that you have taken this skills test.
Good luck! If you have any questions along the way, please use the
help links provided.
Please continue to the first button under " histructions" in the left button
bar.
http://cf.unc.edu/skillstest/takeJbanner.htm 10/18/2006
30
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•
•
Vrrik:tl vi wuuuucug nuuv uvu-i`cgrbuauvu rdgv r vi a
Board of Health Rulemaking Authority Online Module Registration (HCE6630107)
IMPORTANT NOTICE:
When you submit this form it will generate an UNSECURE email to oce@unc.edu. If you prefer, you may call us to register
(919-966-1032).
Instructions: To register for the Board of Health Rulemaking Authority module, please enter the information requested below. When yc
have finished, click the "Submit' button. If you want to erase everything and start over, click the "Erase" button.
Items marked with an are required.
'First Name
Middle Name - -
'Last Name -
'Gender Female Male
'Birthdate !Why do we ask for your birthdate?
'Mailing address
i
This is my home business address.
• 'City
`State - -
'Zip code
'E-mail Address
Home phone
Area code + number
Work phone Area code + number
Fax
_ iArea code +number
'County or district board of - -
health - - !
Term appointment and -
expiration dates
`Term number -
*Mich ofthefollowing ? Chairperson ? Nurse
describes your board
position/profession? ? Vice-chair ? Optometrist
(chairperson and vice-chair ? Commissioner ? Pharmacist
must check two.)
? Dentist ? Physician
? Engineer ? Veterinarian
? General public ? Not a board member
If you answered "not a board
• member' in the previous
question, please explain your
interest in this training.
I
https://www2.sph.unc.edu/oce/f`ormstbohrule reg.cfm 10/18/2006
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Submit Erase Form
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We ask that you provide your birthdate with the understanding that it will be used only as identification for internal record keeping an
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32
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• Slide 1 _ Welcome to Board of Health
Rulemaking Authority, A Primer for
Section 1: What is a Board of North Carolina Boards of Health.
Health (BOH) Rule? This is a short course designed to
bolster your knowledge about the
rulemaking responsibility,
boundaries and procedures for local
nNOPH board of health members.
Slide 2 ..Board of Health Rulemaking..;- Hello, my name is Aimee Wall. I am
o nha ry ~4, a faculty member at the UNC
Aimee Wall Institute of Government in Chapel
•Insfituteof Hill. The Institute is part of the UNC
Government School of Government.
• UNC School of y'
Government
At the Institute, I work with citizens,
nNCIPH students and state and local
governments on issues related to
North Carolina's public health laws.
• In recent years, I have spent a good
• bit of time learning about North
Carolina's boards of health, with a
particular focus on their rulemaking
authority. That is what I would like
to talk with you about today.
Slide 3 7o tcs During this tutorial, we are going to
P k answer some fundamental questions
o°H)rule? Board of Health
about board of health rules.
• What kinds of rules may a
BOH adopt? First, what is a BOH rule?
• General rulemoking Second, what kinds of
authority
• Special Authority rules may a BOH adopt?
• What special pr«eduml
requirements apply to We will address the
mlemaking?
MCIPH = board's general authority
to make rules as well as
the limitations on this
authority
Finally, we will briefly review a few
• of the procedural requirements that
North Carolina law imposes on the
rulemaking process.
While these questions seem quite •
basic, you will be surprised to see
how complicated the answers have
become over the years.
Slide 4 Section 1, What is a board of health
- 4 r rule?
Section 1: What is a Board of
Health (BOH) Rule? This section will focus on the
definition of a board of health rule
and explain how a rule differs from a
county ordinance or a policy.
61NC.1PH
Slide 5 North Carolina has a state law that
what l:;o!soH tile2 _a says local boards of health have the
• "A [BOH] shall have the authority to adopt rules necessary to
responsibility to protect and protect and promote the public •
promote the public health. The
board shall have the authority to health.
adopt rules necessary for that
purpose."
Gs. 13M29
MNICIPH
Slide 6 __Whatisthelegal effedofa.BOH..,,,... So, a BOH has the authority to adopt
°tile2 rules, but...
• Prohibit citizens m
from doing What are these "rules" and, more
something or
•Requirecitizens - specifically, "what is the legal effect
to do of a BOH rule?"
something:
nNCIPH A board of health rule is basically a
directive that is adopted by a local
board of health.
A rule can prohibit citizens from
doing something or require citizens
to do something. For example, a •
board of health rule can prohibit
• smoking inside the county health
department. Or a board of health
rule can require a citizen to follow a
certain procedure if she wants to
install a new septic system on her
property.
Slide 7 What.is Are these rules actually "laws"? Yes,
a:BOH Rule2„.
indeed they are. If a BOH rule is
Is a board of health rule a properly adopted, it has the same
law? i"
•Yes force as any other applicable law.
• Rules are laws adopted Individuals within the board's
by administrative bodies -
•Enforceable jurisdiction are required to comply
- with that law. If they don't comply,
mwarH they can be charged with a Class 1
misdemeanor - a criminal offense.
The county attorney may also want
to go to court to get an injunction -
which would likely result in the court
telling the individual to comply with
the rule. In some limited situations,
people can also be fined. For
example, if the BOH has adopted
local rules governing private wells,
the health director has the authority
to assess fines for violations of those
rules.
Slide 8 Let's take a moment to talk about
whar fs asOH Rule? ' terminology. We call laws adopted
• Rules = Regulations by boards of health "rules" but we
-Delegated authority could easily use the term
• Develop laws to protect the public "regulation" instead. These terms
health are basically interchangeable. Rules
• Oversee the health department
and regulations are, in short, laws
mwcirn adopted by an administrative body -
such as a federal, state or local
agency.
• Most health departments are
agencies of the county, which are, in
turn, a part of the state. Other types
of health departments, such as •
district health departments and
public health authorities are also
agencies. The boards of health have
been delegated authority by the
state to develop administrative laws
necessary to protect the public
health and to oversee the health
department in general.
Slide 9 eoMRu6,.ConlyOrdinnnce So, how is a BOH rule different from
ftr. diffw" Gcm en anlinence2y a county ordinance? Both are
-Scope of authority considered laws but there are three
-BOH limited to health; county basic differences to keep in mind.
is not
-Elected vs. appointed
-Elected officials have more First, a Board of Health rule is
expansive authority limited to. rules related to health. A
tav:w county ordinance, which is adopted
by the board of county
commissioners, can encompass any
variety of issues affecting a county, •
including health-related issues.
Second, a fundamental difference
between the board of commissioners
and a board of health is that the
commissioners are elected, whereas
the board of health members are
appointed. As an elected, legislative
body, the commissioners are able to
make some decisions and adopt
some laws that boards of health may
not be able to. This concept - the
difference in authority between an
a elected and an appointed body - will
come up again later during this
tutorial.
• Slide 10 IOHRule n;County Ordinance _ The final noteworthy difference,
ilow.u Rrlil(erentlmm an ordMnncez between a BOH rule and a county
• BOH rules apply to ordinance is that a BOH rule will
entire county apply throughout the entire county,
•Ordinances do not including municipalities. In general ,
apply to
municipalities )unless an ordinance will not govern
municipality so chooses) municipalities (unless, of course, the
"NICIP+ o municipality chooses to be governed
by it).
Slide 11 ;-Rule vs,-policy How is a BOH rule different from a
'Misi.leii,Ale diiferenflromcpolic policy? Basically, a BOH rule is a,
•9oH rule is a law law and a policy is not. This seems
• policy is noto law
• A rule is simple, but this distinction tends to
enforceable confuse people a good bit in
against the general
public practice. Boards of health may
adopt policies governing just about
,,,,r„N„ anything at the health department
• and the policies may be enforceable
against the department's employees
but policies do not have the force of
law. A person could not be charged
with a misdemeanor for violating a
BOH policy. If an employee violates
a BOH policy, it is possible that the
health director could take action
against the employee.
Some boards of health have tried to
adopt "policies" in areas where they
don't have the legal authority to
adopt a "rule." I strongly advise
them against doing this - it is simply
wrong to ignore the limits on the
boards rulemaking authority by
adopting a policy instead.
For example, boards of health have
limited authority to regulate smoking
• in county buildings. Some boards of
health have tried to adopt policies
that prohibit smoking in a building,
knowing full well that it could not •
adopt a valid rule prohibiting
smoking in that building.
We'll talk more about the scope of
BOH authority in the time that
follows.
Slide 12 Here are a few discussion questions
"Drscusswn.Queshons
- to consider.
• What are some of the political issues
that might come into play when -
deciding whether to adopt a rule First, what are some of the political
rather than an ordinance?
• Do you have any BOH rules in your issues. that might come into play
jurisdiction? when deciding whether to adopt a
• What is an example of a BOH policy rule rather than an ordinance?
in your jurisdiction?
MNCU'H = Second, do you have any BOH rules
in your jurisdiction?
Third, what is an example of a BOH
policy in your jurisdiction?
•
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• Slide 1 Welcome to Section 2 of our :BOH
Rulemaking tutorial. In Section 2,
Section 2: Rules That a Board of we are going to examine the kind of
Health May Adopt rules a board of health may adopt.
Pan 1: Authority to Make Rules
In Part 1, we will focus on the
general authority of a board to make
nNCiPH rules.
In Part 2, we will examine the
special limitations that are applied to
specific areas of rulemaking.
Slide 2 As we discussed in Section 1, state
";General Auihonty
law directs boards of health to
•May adopt rules necessary to protect and promote the public
protect and promote the public health and authorizes them to adopt
health rules in order to do so. The
-Have the
pr responsibility public health protect
and promote the public health language in this law is quite strong -
(G.3. 130A-39(o)-(b)) it actually says that boards have the
ONCIPH responsibility to do this. That is a
• pretty important mandate and it
could be intimidating to a new board
member.
Slide 3 But boards of health are not acting
,__General Authonty
- - r alone in trying to protect the public
• Other go.erameat rulemokmg health in this state. The federal
bodies share responsibility
-Federal government is involved in many
-CDC and EPA -s
• Stale public health issues, primarily
-Commission far Heath through agencies such as the
Services
-EmironmentalManagement Centers for Disease Control (CDC)
MNCIPH Commission 3 and the Environmental Protection
Agency (EPA). Their laws apply
throughout the country.
The state government is also
involved. The General Assembly
regularly enacts legislation that
affect health. These laws often
• delegate rulemaking responsibility to
one of two state rulemaking bodies:
the Commission for Health Services
and the Environmental Management •
Commission. These rulemaking
bodies are comparable to boards of
health because they are appointed .
bodies authorized to adopt rules for
certain purposes. They adopt many,
many rules that affect local health
departments - such as rules
governing:
e what services must be
provided by health
departments
• How a health department
should respond when it
identifies a person who has a
communicable disease and the
requirements that apply to
restaurant inspections.
With limited exceptions, state
statutes and regulations apply
across the entire state and therefore
are important partners in your job to •
protect and promote the public's
health.
Slide 4 z. GeneraMuthority, _ What happens if the board of health
Anreraiifio 'VAt other state roles = - wants to adopt a rule about
• BOH rule may be m r stringent
than the Environments something and there is already a
Management Commission (EMC) rule in place adopted by one of these
or Commission (or Health Services
Is rule where "a more stringent other state rulemaking bodies?
rule is required to protect the public
health" Well, state law specifically allows
a.s.,3a,-=9=)(b) local boards to adopt rules that are
MNCIPH more stringent than a state rule.
That means that the board of health
can adopt a rule that goes above
and beyond any state rule that is in
place.
For example, imagine the state had
a rule requiring all homeowners to
get their drinking water tested for •
arsenic. The BOH could not adopt a
rule saying homeowners are not
• required to have their water tested.
That would be less stringent. They
may, however, be able to adopt a
rule that requires homeowners to
get additional water testing in some
situations. Such a provision may be
considered more stringent.
We have had two court cases in
recent years that have challenged
BOH general rulemaking authority.
Board members should be aware of
these cases and understand the
limitations that they place on the
board's general authority. The first
case we'll address speaks directly to
the issue of adopting a rule that is
more stringent than a state rule.
Slide 5 There was a case out of Chatham
~GeneralAuthony y County that was decided by the NC
• BON must esploin why more sM,ent roles needed
'a respond to local haolth need Supreme Court, in 2002. Several
• BON hog farm rules imolideted
•'Did not include any rationale years earlier, the board of
or basis in C'onh Chath making commissioners adopted a hog farm
mfln tngo am County 9
Plica "oa'ndf.H.ad ordinance and the board of health
"thetest ofthestnte.' adopted hog farm rules. The two
Craig .Countyal CIamna. 356 N.C. 40 f2 MI
Yes NOPM 5 local laws were identical.
The court invalidated both of them,
but for different reasons. The court
essentially said that the county
commissioners could not adopt an
ordinance on this issue because the
state had already regulated this field
completely. In other words, the
state had established a "complete
and integrated scheme" for
regulating hog farms.
The court invalidated the board of
health rules for a different reason.
• They recognized that the board has
the authority to adopt more
stringent local rules even when the
state has established a complete and •
integrated scheme of regulation.
The court said, however, that they
could only do it if they explain that
local rules are needed to respond to
a local health concern. In other .
words, the board has to justify why
more stringent rules are necessary
in its jurisdiction as compared to all
of the other areas of the state. If
the board had included such a
justification, the rules may have
been upheld by the court.
It is important to note that this need
for local justification is probably an
issue only when the board is
considering adopting a rule in a field
that is already heavily regulated by
the state.
Slide 6 General Authority The second case that imposed some •
Five-part ta forBOH tiles limitations on board of health
1. Are related to the promotion rulemaking authority arose in Halifax
or protection of health County. It had to do with BOH rules
2. Are reasonable in light of the
health risk addressed regulating smoking in public places.
3. Do not violate any low or We will talk in more depth later
constitutional provision about the BOH authority to regulate
NNOPH smoking. For now, I would like to
focus on the general principles that
came out of this case.
The court outlined a five-part test
that BOH rules must satisfy in order
to be considered valid. The first
three parts of the test are good
common-sense..
First, the rules must be related to
the promotion or protection of
health. This is consistent with the
state law we looked at a moment •
ago outlining the scope of the
board's general authority - boards
• have the authority to "protect and
promote" health
Second, the rules must be
reasonable in light of the health risk
addressed. This "reasonableness"
requirement applies to basically all
administrative rules. The court is
just cautioning boards - "Don't go
overboard"
Third, the rules must not violate any
law or constitutional provision. For
example, a state law prohibits
boards of health from regulating
restaurant inspections. Therefore,.
boards may not regulate restaurant
inspections.
Slide 7 General Authority Now we'll talk about the last two
• Five-part testfor'BOKrules - parts of the test. They are a little
4. Are not discriminatory more complex.
5. Do not make distinctions based
upon policy concerns traditionally
reserved for legislative bodies The fourth one is that the rules must
City of RoonokeRapids v.Peedle,124N.C. not be discriminatory. I believe
App 578(1996) what the court meant with this step
to aPH is that, the rule must not discriminate
between two people who are
similarly situated. In other words, if
one person is regulated and another
person in a similar position is not,
there must be a good reason for
treating them differently.
The fifth and final part of the test is
that the rules must not make
distinctions based upon policy
concerns traditionally reserved for
legislative bodies.
Slide 8 GenetnlAuthonty Court invalidated rules : The court in the Halifax County -case
.ba>edor,a'ands relied primarily on the fourth and
• The mles discriminated fifth parts of the test to invalidate
inappropriately because they
protected the health of employees in the Halifax County BOH smoking
some restaurants and not others rules.
-Regulations varied based on
-Size of restaurant
-whether it had a bar With respect to the fourth part of the
ntrclpH a test, the court discussed the fact
that the rules treated restaurants
differently depending on things such
as the size of the restaurant and
whether the restaurant had a bar.
Because the rules made these kinds
of distinctions, the court concluded
that the rules discriminated
inappropriately. Basically, if the
rules are intended to protect the
health of the employees in the
restaurants, the rules cannot
discriminate between employees in
different types of restaurants •
without a good reason for doing so.
The rules must protect them all in
the same way.
Slide 9 ; General Authority: Court invalidated , Looking at the fifth part of the test,
:;~ralesbtiaedzon J andf5 the court concluded that the rules
meBoard mode ndiey allom`ng made policy distinctions reserved for
legislativee bodies w whhen they allowed smoking
in wine restaurants and not others legislative bodies when they allowed
• Court inferred that the board made
distinctions based on reasons unrelated to smoking in some restaurants and
public health (such as economic hardship)
• BOHmust only consider healthunless a not others.
legblaeve body directs it otherwise
nvCIPH In distinguishing between
restaurants with and without bars,
for example, the court inferred that
the board of health was making a
decision based on economic
considerations. The court surmised
that the BOH allowed smoking in
restaurants with bars because the
board concluded that smoking was •
considered essential to the bar's
business. The court also inferred
• that the board of health made
decisions based upon the difficulty of
enforcing the rules in some settings.
The court explained that legislative
bodies - such as the General
Assembly or the board of county
commissioners - should be the ones
to develop policies that balance the
relative importance of protecting
health against the economic
interests of business owners.
Slide 10 We have just covered the board of
Discusstor'Quesbo T health's general authority to adopt 11 i~ll .ABOHhasthemyonsibilitytoprotect the rules and the general limitations
public's health. Rulemaking is one way to g
do so. What are other ways that the BOH
can act to protect the public's health? placed on that authority. Before we
• Does it make sense that the low allows move on consider a couple of
legislotire bodies (such as the board of on,
county commissioners( more freedom to
make new ws than appointed discussion questions about this
la
of health)? Uve bodies (such as the board
o general authority.
i~urlFt
• First, a BOH has the responsibility to
protect the public's health.
Rulemaking is one way to do so.
What are other ways that the BOH
can act to protect the public's
health?
Second, does it make sense that the
law allows legislative bodies (such as
boards of county commissioners)
more freedom to make new laws
than appointed administrative bodies
(such as the board of health)?
•
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• Slide 1 w
Section 2: Rules That a Board of
Health May Adopt
Part 2: Special Limitations on
Rulemoking
FINCIPH
Slide 2 SpecialLimitations On;Rulemaking~_ _ I would next like to discuss four
vnuthority , r special situations where boards'
sp~ial and `om ' "
• rulemaking authority is also
• Food and lodging C mit'i-
• wells `°"m limited: food and lodging/ wells
• D~NR~mDepi~ r
• On-sde NomAl Rew.n• septic systems, or on-site
wastewatel NCK: Na C., i-
syVenns Co"
Mn:•nkuk..nd
sepliceptic s systems) wastewater systems
• GS: ae~^I Co"
• Smoking smoking.
{\NCIPH Before we begin this next portion,
I want to clarify some of the
acronyms that I am using:
EMC refers to the Environmental
• Management Commission - which
is one of the two state public
health rulemaking bodies in North
Carolina. The other rulemaking
body, as we discussed earlier, is
the Commission for Health
Services. Most public health
rules come out of the
Commission for Health Services.
DENR refers to the Department of
Environment and Natural
Resources, which is the agency
that is responsible for various
programs affecting public health,
including food and lodging, wells
and septic systems.
NCAC refers to the NC
Administrative Code -which is
where all of the rules or
• regulations of the Health Services
Commission and Environmental
Management Commission are
published. •
Finally, GS refers to the General
Statutes - which is where the
laws passed by the state General
Assembly are published.
Slide 3 Okay, now for the special
Sped°ILmdafiom:.Food °nd LodAtng limitations on rulemaking
• Slak ho°a compeh°mim authority.
pt°m in plan for load ad lodging sanitation
• BOH moy_pgl adopt rvlm
fln'^~a We'll start with food and lodging,
food and lodging in this area the state has a
p3°t0 comprehensive system in place
GS. 13otiAlgl
(AVQPH 3 regarding the grading and
permitting of restaurants and.
lodging facilities, such as hotels.
Local environmental health
specialists (or sanitarians) are
charged with enforcing these
state laws. They technically act •
as "agents of the state" even
though they are county or district
employees.
Local boards of health are not
allowed to adopt any rules in this
area - even rules that are more
stringent than the state rules.
Please take a moment to note the
citation at the bottom of the
slide. This is the reference to the
law where this limitation is found.
I have tried to include these
references throughout the tutorial
so that you can consult the laws
directly if you have questions.
•
Slide 4 With respect to wells, the
Special ~mdahom:Wills
situation is slightly different.
• eOH may adopt local well The state has rules regulating
rules
• Must adopt EMC well rules some types of wells, but there
by reference and adopt more
stringent rules "when are gaps in those rules. The state
-
necessary to prated the is in the process of considering
public health." legislation in 2006 that would _
G5.81.96: IS• K< M(E6 Ms)
nNCIPH expand state regulation of wells
but in the meantime the burden
falls primarily on local boards of
health to fill those gaps if they
choose to do so.
So, boards of health may have
local well rules - and many do -
but they should only do so if they
adopt the state rules by reference
and then add any more stringent
provisions that they decide are
necessary to protect the public
health.
• Slide 5 What does it mean to "adopt the
Spe'dal Lmdahomi .Walla
state rules by reference"?
-"Adopting by reference' Basically, it means that the state
-The state rules become local rules as they are written become
rules and then the BOH local rules and then the board of
supplements the rules health adds more requirements
G.S. 87.96; 15A NCAC 02C (EMC rvb•) or restrictions to supplement the
MVC1PH 6 state rules. The local board of
health may not make the local
rules less stringent than the state
rules.
Slide 6 _ The third type of special
Special ijmdohone:.On site Wastewater„
limitation on rulemaking authority
• BOH may adopt local on relates to local rules governing
site rules
• BOH rules must odopl on-site wastewater systems, also
state rules by reference
. and incorporate more known as septic systems.
stringent provisions as
necessary to protect public
• health Local rules governing on-site
GS. tsw.xrol:ISOAasSIa-(m
systems are allowed. Local
boards, however, must adopt the
state on-site. rules by reference
(just like wells) and incorporate
any more stringent provisions
that they deem necessary.
Slide 7 Once a local board of health has
:SpecaWmMhonsiOnsiteWaafewater decided upon local on-site rules,
• BOH rules must be approved it must submit the rules to the.
by DENR Department of Environment and
•DENR may revoke approval Natural Resources for approval.
MA DENR has the authority to revoke
MNCPH NCDENR approval of any local rules in
three situations:
• First, if the local rules are
not as stringent as the
state rules,
• Second, if the local rules
are not sufficient and
necessary to safeguard the
public health, or
• Third, if DENR learns that
the local rules are not being
enforced.
I'm only aware of two North
Carolina counties that have
adopted local on-site rules (Wake
County and Orange County).
There is one major reason why
local governments are shying
away from local rules in this area.
Local rules mean more potential
liability and expense for the
county. Let me explain.
When local environmental health
specialists (or sanitarians) are
enforcing the state's on-site
rules, they are acting as "agents
of the state."
Therefore, if the specialist or the
county is sued based on the
• specialist's actions, the state will
(in most cases) step in and help
out. A lawyer from the attorney
general's office may represent
the specialist and the state will
likely pay some or all of the
judgment.
While there are some exceptions
that may apply, it is still an
excellent safety net for the
county and the specialist.
If the board of health adopts local
rules, this safety net goes away.
The county, the specialist, or the
county's insurance company
would be responsible for
providing an attorney and paying
the judgment.
• Slide 8 Okay, now for the tricky
. Special Umlfatiomi3molang
- limitation -regulation of
• Local regulation of smoking. State law in this area
smoking is quite
limited under state has severely limited the ability of
law local government lawmakers -
• Limitations apply
to rules adopted including boards of health to
after October
1993 regulate smoking in public places.
LIVCIPM •
To try to simplify things a bit, I
have broken the state law
limitations down into several
categories.
Before describing these
categories, it is important to note
that these special limitations on
rulemaking authority I am about
to discuss apply only to rules
proposed or adopted after
October 15, 1993. If your board
• of health had a rule in place prior
to October 1993, the rules will
probably be okay as long as they
are consistent with the limitations •
placed on the board's general
rulemaking authority discussed
earlier in this tutorial
Slide 9 >Special Limitations: Smoking The first category we will talk
=bcategcnabout includes
-smoking - Category 1 . Buildings owned, leased or
-Buildings owned, leased or occupied by local
occupied by local government
-Public meetings ' t government - such as
rr: courthouses and office
a.5.143-595euq. buildings - as well as Public
ONCiPn meetings
Now let's discuss what local
governments - including boards
of health - may do to regulate
buildings and spaces in this
Category.
Slide 10 Special Limitations: Smoking, Local governments are allowed - •
Gategoryl'=' but not required - to establish a
May establish nonsmoking areas nonsmoking area in any Category
-20%ofinterior space ofequal
1 facility. The law does not
quality must be smoking unless
physically impracticable specify how much of the property
-If 20% is physically impracticable, or space is required to be
20"k be as near as possible to nonsmoking but, as a general
nNaPn 9 rule, the local law must reserve
20% of the facility's interior
space for smoking. The law
specifies that the quality of the
smoking space must be "equal"
to that of the nonsmoking space.
So while the law does not say
that the lobby or any other
particular area must be
designated for smoking, it would
be unwise to send smokers to a
closet in the basement because
that space would likely not be
considered to be of "equal •
quality" to the nonsmoking area.
There is an important exception
• to this 20% requirement. If the
local government body concludes
that designating 20% of the
space as smoking would be
"physically impracticable," it can
designate a smaller area for
smoking. According to the law,
that smaller area must be as near
as possible to 20% of the interior
space.
We do not know what the term
"physically impracticable" means
in this context. Dictionary
definitions of the term suggest
that the task must be impossible.
That seems to be a fairly high
threshold to meet. But many
local governments in the state
have put forward arguments in
order to avail themselves of the
• exception. Some have argued
this to an extreme. For example,
some assert that it is
"impracticable" for a building to
have any smoking indoors at all
because the ventilation system
will recirculate the smoky air and
affect the health of non-smokers.
It is unclear how North Carolina's
courts would respond to such a
rationale.
•
Slide 11 $pedal Lmitations:5molang Let's now discuss the second •
'~.C?bga0'2 - category of smoking regulation
• Local limitations. This buildingsngs housing category
ddepartments
a a r a . includes many different types of
social services , facilities but, perhaps most
-In cludes grounds ,
surrounding the importantly, it includes local
building (opto
50 linear hhet government buildings housin
SO li) 9
M4CIPtt health departments and
departments of social services.
This includes the grounds
surrounding the building up to
fifty linear feet.
Slide 12 speclalLimxahons:Smoking categoryr In addition to buildings housing
-2 local health departments and
Al. includes departments of social services,
• child care centers
• Libraries and museums open to the public this category also includes:
• Public transportation owned or leased by . Child care centers
local government
• Indoororenas sealing 0 Libraries and museums
more than 23,000 people
•Certain other lociliti. open to the public
RNaPH • Public transportation owned •
or leased by local
government
• Indoor arenas seating more
than 23,000 people
• And certain other facilities
such as hospitals, nursing
and rest homes, mental
health facilities, and
enclosed elevators
Boards of health typically do not
get involved in regulating these
types of facilities, however,
because other laws already
prohibits smoking.
The large arenas were added to
category 2 in 2005. It is my
understanding that the only
arena that can take advantage of •
this provision is in Greensboro.
• Slide 13 speaalLmbhoas smakos With respect to all of those
spaces identified in Category 2,
•May regulate/prohibit smoking local governments are allowed to
• Not subject to 20% requirement adopt any restrictions that they
• With respect to health departments
• BOH has authority to prohibit smoking think are necessary - unless, of
in and around a building housing any course, a different law says
part of the local health department /
• Commissioners also have this outhority otherwise.
nNOPH 1s
Note that local regulation of
smoking in these spaces is not
subiect to the 20% requirement
applicable to Category 1.
This regulatory authority is useful
for regulating smoking in those
county buildings that house
health departments and
departments of social services.
The law is drafted in such a way
that the entire building housing
• any component of the named
departments may be regulated
without regard to the 20%0
requirement. The law was
changed to provide local
governments with this broad
authority in 2005.
Slide 14 Options: Smoking Next, we will talk about Category
3. (Which is quite limited. It
Includesindoor spaces of only applies to auditoriums,
• Auditoriums
• Arens (eaept>23,000) arenas and coliseums, and
• Coliseums -
•Buildings oppurtenoNto appurtenant buildings such as
these three types of buildings
May regulate smoking conference space attached to a
• Not subject to 20% requirement must coliseum.
dso,note a smoking space in to
61NCIPH
Local governments may regulate
smoking in those facilities but
they must reserve an area in the
lobby for smoking. The lobby
• area does not, however, have to
equal 20% of the space.
Remember that arenas that seat •
more than 23,000 are in
Category 2.
Slide 15 Speb!aWmttaAons:Smoking e The fourth category covers
'rtc6fegary•.4 5ehoclara , » t~ u schools, school property, school
Includes events and school buses. -
•Shools
• School prope State law was amended in 2003
property,
events or buses to prohibit smoking in school
State law prohibits
smoking in n school - buildings during school hours.
buildings during _
school hours
R c,Pn This change in the law was
necessary to bring state law in
line with federal law requiring
such spaces to be smoke free.
The law was also changed at that
time to provide local boards of
education with broad authority to
regulate smoking on school
property and at school events.
•
Slide 16 Special Limitations: Smoking, w.' Local boards of education have
=`s«rexpansive authority to regulate
• Local boards of education have smoking within Category 4. They
expansive authority
are not subject to any of the
~ to o regulate smoking
within Category 4 restrictions or limitations that
•Not subject to apply to other categories.
20% requirement
tavcia-- 16 In general, boards of education,
rather than boards of health, .
have played the central role in
regulating smoking in and around
schools.
• Slide 17 $pecial lmta ons:Smolang - The final category includes all
rv Cgtegory S: Otkor:pab is placesr other public places, including
•Other public places
(including restaurants and bars.
restaurants and barn Lo
cal governments *Since October 15 1993 state law
have no authority to / /
regulate has expressly prohibited local
governments from adopting local
nN IPH V laws regulating smoking in these
places.
If your board of health had a rule
in place before that date, the rule
may still be enforceable. If it
hasn't already done so, the board
should consult with an attorney
to determine whether the rule
violates any of the restrictions
placed on rulemaking as a result
of the 1996 court decision from
Halifax county that we discussed
earlier.
• Slide 18 We are at the end of Section 2 of
DISCU5510n`QL estl
x G this tutorial. We have covered
• What are the pros and cons of having
local on-site wastewater BOH rule.? several special limitations on your
• Is smoking allowed in your local health board's rulemaking authority.
department? Is it allowed in other county
buildings? Now take a minute to think about
• What do you see as the BOH's
and discuss these limitations
responsibility with respect to to use of
tobacco products in public places, more specifically.
including govemment buildings?
M\ CIPH - re
What are the pros and cons of
having local on-site wastewater
BOH rules?
Is smoking allowed in your health
department? Is it allowed in
other county buildings?
What do you see as the BOH's
responsibility with respect to the
use of tobacco products in public
• places, including government
buildings?
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• Slide 1 We are now at the third and final
u section of this tutorial. In this
Section 3: Procedural section, we will.focus on the
Requirements for Rulemaking procedural requirements for
Part 1: Rulemaking Checklist rulemaking. First, we will walk.
through a rulemaking checklist that I
put together for you. Second, we
1\NCIPH will briefly review some legal issues
related to the rulemaking process.
Slide 2 First let's walk you through our
JOH Ruleriialung Checldtsl rtr m checklist.
?Is the rule within the BOH's general
authority?
?Is it necessary to protect and When considering a new board of
promote the public health?
?is it reasonable in light or the health health rule, board members should
risk addressed? determine whether the proposed
-'Does it treat similarly situated
persons equally? action falls: within the board's
nNr_PM general rulemaking authority. Start
• by asking the following questions:
• Is the rule necessary to
protect and promote the public
health - as we discussed, this
is the basic authority provided,
to boards. If the answer is
yes, you can then ask:
Is the rule reasonable in light
of the health risk addressed?
If it is also reasonable then
you can ask:
• Does the rule treat similarly
situated persons equally? As
the court explained in the
Halifax county case, the BOH
rule must not discriminate.
•
Slide 3 If your answers to the first three
BOM:Rulemalung_Clieddtst
~'WT questions were yes, you should ask •
?Is the rule within the BOH's general whether the rule balances factors
authority?
?Does H balance factors other than other than health? Such as
health?
?If so, does the BOH howe specific economic factors? If it does, board
authority to do so?
./Are there state rules on the. some subject? members must investigate whether
?lf so, is there a local health reason for
making local rules more stringent? the board has specific authority from
nNCIPH an elected body to do so - such as
in the form of a statute or
ordinance. If no specific authority
exists, the rule would be beyond the
scope of the board's authority. If
the board does have specific
authority, it then ask:
• If there are state rules on the
same subject - such as hog
farms, you should ask whether
there is a local health reason
for making local rules more
stringent than those followed
by the rest of the state?
Slide 4 If the answer to that question is also
$O R°k "9 eCid' - yes, then the board only. has to
?Dospeciollimitationson determine whether any of the
rulemaking authority
apply? special limitations on rulemaking
? Food and lodging authority apply, such as those for
? Wells
? On-site wastewater food and lodging, wells, septic
? Smoking systems and smoking.
nNCIPH '
I hope this explanation of the
board's rulemaking authority was
clear. It is a complicated subject
that is continuing to evolve
throughout the state.
Before we wrap up, let's take a few
minutes to review some of the legal
issues related to the process of
rulemaking.
•
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• Slide 1
Section 3: Procedural
Requirements for Rulemaking
Part 2: Rulemaking Process
nNCIPH
Slide 2 RuiemakingProcess Since the details of the rulemaking
alc%capt, t. U ,r9., F. process may vary from jurisdiction
to jurisdiction, I want to briefly
•Open meetings mention two key procedural issues
-Public notice that apply, throughout the state.
• Every board may have a different
nvaPn Y approach to the details of the
rulemaking process. But there are
two key procedural issues that
should be uniform throughout the
state. Those are compliance with
our Open Meetings Law and the legal
requirements related to public
notice.
Slide 3 Rulemaking Process First of all, the board's activities
=SubiedtoQpen Meefings;L~w - - related to rulemaking are subject to
• David Lawrence, Open Meetings the state's open meetings laws. I
and Local Governments
in North Carolina: Some am not going to address the details
Questions and Answers, of those laws in this tutorial but
available at would encourage Board members
https://iogpubs iog.unc edu/
or 919-966-4119 and health directors to learn about
MNCIPH them. My colleague, David
Lawrence, has published a book that
describes those laws in great detail.
• It is available from the Institute of
Government's publications division.
Slide 4 Rulemakinge ess-_ The second procedural piece I am •
nwKw,e _ going to mention requires the board
• Ten days before proposed action (or the secretary to the board) to
• Place a copy of the mle in each clerk's office in
jurisdiction provide the public with notice that
• Publish o notice in a paper of general
circulation stating the board is about to adopt, amend
• Salatance of proposed rule or a desanpnon of
subpm coot lss. in drod or repeal a rule. There are two basic
• Piapaua effective date
• TM1at copies of the roposed mb am a.aibbkat notice requirements and both must
the health depanmem
nNOPH be done ten days before you are
about to take action on a rule.
First, you must place a copy of the
rule in the county clerk's office at
least 10 days before the rule is to be
adopted, amended or repealed. A
copy must be placed in the clerk's
office of every county within the
board's jurisdiction. For district
health departments, and public
health authorities, this means
multiple copies may need to be
provided.
Second, the board must publish a •
notice in the paper at least 10 days
before the proposed action. The
notice must state:
• The substance of the proposed
rule or a description of the
subjects and issues involved;
The proposed effective date;
and also
That copies of the rule are
available at the health
department.
The law says that the notice must be
published in a paper of general
circulation within the jurisdiction.
This means that boards serving
multiple jurisdictions may have to
publish more than one notice,
depending on the papers available.in
the area. •
One final parting thought given
• that you are telling the world in this
notice that copies will be available at
the health department, please make
sure that copies are actually there!
Slide 5 We have reached the end of our
;;Public Healfh Law Contacts tutorial.
hS: f -pi. l4.,
Institute of Government
UNC School of Government I want to thank the North Carolina
-Aimee Wall: (919) 843-4957 or Institute for Public Health for
"rail@sog.unc.edu allowing me to participate in this
•>Jill Moore: (919) 966-4442 or
moore@sog.unc.edu program, particularly Teme Levbarg,
Bill Browder, Steve Hicks and John
Graham.
I am available at the Institute of
Government to answer questions
regarding any of these board of
health issues, as well as other public
• health law concerns that you might
have. I have one other colleague
who also works exclusively on public
health issues. Her name is Jill
Moore. Please do not hesitate to
contact us. Thank you.
Slide 6 Congratulations, you have now
f2equest Ce tificate yrr
completed the Board of Health
• Congratulations, you have now Rulemaking Authority: A Primer for
completed the Board of Health
Rulemaking Authority: A Primer for Local Boards of Health module!
Local Boards of Health modulel _
• Please click the link below to request Please visit the url below to request
your certificate
your certificate:
https://www.sph.unc.edu/oce/forms
/bohrule_cert.cfm
•
FLU VACCINE UPDATE
Private stock only
As of 11-1-06 8:00 a.m.
Vaccine received from vendors: 3,580 doses
Vaccine received locally: 1 000
Total received: 4,580 doses
Vaccines given: (3,534) doses administered to the public
Vaccine available in house: 1,046 doses (currently available for immunizations)
Vaccine to be delivered: 2,920 doses
Vaccine to repay locally: (1,000) Net vaccine to be available: 2,966 doses to be given
a9~b
~ sba
State-supplied vaccine
6 months thru 35 months: 85 doses given 115 doses remaining to give ao6
36 months and older: 179 doses given 321 doses remaining to give S D o
7,~00
• New Hanover County Child Fatality Team 2005 Summary
The New Hanover County Child Fatality Prevention Team (NHC CFPT) is a group comprised
of community representatives from diverse agencies and disciplines. Our team currently has 17 members
which are either appointed by their agency board, per the state addendum, or are appointed by New
Hanover County Board of Commissioners. Our team currently has two openings. The mission of the
NHC CFPT is to promote the development of a community wide approach to understanding the causes of
childhood fatalities, identify the deficiencies in public agencies to deliver services to children and
families, and to make and carry out recommendations for change in system delivery to prevent future
childhood deaths. The NHC CFPT meets on a quarterly basis with meetings in February, May, August
and November. Several team members attended 2 state fatality reviews in 2005. A state review is
conducted when the family is involved with DSS at the time of death. The attendance this year has
averaged 7 community members and 2 Health Department staff members per meeting.
The team reviews deaths that occurred in the previous year. During 2005 the team reviewed the
deaths of 17 children. Of these deaths 5 were due to extreme prematurity and complications associated
with this. Four deaths were due to congenital abnormalities. Two children died due to existing medical
conditions. Two deaths involved motor vehicles. There were two child deaths due to SIDS and one
shooting victim. No trends were identified this year in New Hanover County.
• The New Hanover Child Fatality Prevention Team receives funds annually from DHHS via the
Child Health Contract Addendum. This year funds were used to purchase car seats and combination
smoke detectors/carbon monoxide detectors. These were distributed to low income families. The New
Hanover County Health Department Health Promotion Team educated the families receiving the car seats
on the child safety seat laws and proper use and installation. The Wilmington Fire Department distributes
the smoke detectors/carbon monoxide detectors with referrals from the Health Department. A small
amount was spent on refreshments. This money was in the fiscal budget `04-`05.
The New Hanover County Child Fatality Team continues to work to improve participation of its
members and invite persons related to investigations of child deaths to be a part of the review process.
Attendance has been steady and members share agency information with the coordinator prior to the
reviews when they are unable to attend. The team has worked diligently to obtain and review needed
records and work collaboratively in the process of the actual review of each child death.
Respectfully Submitted,
IY~
Joy ~e Hatem, CSW
CFPT Review Coordinator
c: attachment
N.C Child Fatality Task Force
1928 Mail Service Center • Raleigh, NC 2 7 699-19 28 • phone: 919-707-5626 • fax: 919-870-4882
Co-Chairs: Jennifer Tolle Whiteside, Tom Vitaglione Executive Director: Selena Barrier •
Embargoed Until September 18, 2006
Child Death Rate Decreases in 2005
September 18, 2006 (Raleigh, NC) - In 2005, North Carolina's child death rate decreased slightly according to the NC
Child Fatality Task Force, a legislative study commission.
"Though the decrease is less than one percent, it marks a return to an overall downward trend in child fatality rates for our
state" said a statement released today by Jennifer Tolle Whiteside and Tom Vitaglione, Co-Chairs of the NC Child Fatality
Task Force. The death rate had increased in 2004 after a decade of steady decline.
Official figures gathered by the State Center for Health Statistics show a 2005 rate of 76.9 deaths per 100,000 children less
than 18 years of age. This represents a slight decrease from 2004, but is a remarkable 28% lower than the rate in 1991,
when the NC Child Fatality Task Force was established. "Although there is some relief that the rate is continuing the
downward trend that began in the early 1990s, our state still needs to be concerned for its youngest citizens," said Selena
Berrier, Executive Director of the Task Force.
The release of these data begins the annual study cycle of the NC Child Fatality Task Force. "The data present us with
questions about why and how children die. We work to find answers to these questions and make recommendations that
will lead to a reduction in child deaths," said Berrien
Highlights of the data include:
• The death rate remained the same for infants, but decreased slightly in all other age categories. •
• Motor vehicle-related deaths decreased in 2005 by almost 20%, but remain the primary cause of death for 15-17
year olds. "In recent years, the Task Force has sponsored the adoption of the graduated driver's license system,
including a new restriction on cell phone use by teen drivers which will go into effect in December 2006. Other
efforts include stricter requirements for booster seats, and safety requirements for all-terrain vehicles," said
Vitaglione, who is a Senior Fellow with Action for Children NC. "We have been successful in protecting many
children, but there is more work to be done."
• The number of deaths due to Sudden Infant Death Syndrome (SIDS) increased slightly in 2005, and Task Force
leaders plan to continue efforts to support SIDS reduction campaigns as well as other efforts to reduce infant deaths
associated with sleep positioning.
• Compared to 2004, deaths due to unintentional injuries declined overall, while homicide and suicide numbers
increased. Child abuse homicides typically increase when overall homicides rates increase. Data from the Office
of the Chief Medical Examiner will be released in conjunction with Prevent Child Abuse North Carolina on
September 20, 2006.
• There were 61 deaths due to firearms in 2005, up from 39 in 2004. "This alarming increase will make gun safety a
Task Force focus in the next year", said Berrien
The NC Child Fatality Task Force also released the number of child deaths for each county by cause and age. Because the
numbers for each county are relatively small, rates are not computed. State and county data can be found online at
www.ncehild.oriz/content/view/280/165/
In 1991, the NC General Assembly adopted a child fatality prevention initiative. This initiative established the NC Child
Fatality Task Force, which was charged with studying the incidence and causes of child deaths. Since its inception, the NC
Child Fatality Task Force has made numerous recommendations for changes to legislation, rules, and policies likely to
prevent deaths and promote the well-being of children.
Our Children, Our Future, Our RESPONSIBILITY
NC Child Fatality Task Force Page - 2
• more information contact: Selena Berrier, 919-707-5626
Jennifer Tolle Whiteside, 919-829-8009
Tom Vitaglione, 919-834-6623 ext. 235
•
•
2005 CHILD DEATHS IN NORTH CAROLINA
Trend in Rate of Child Deaths 1990-2005'
Ages Birth through 17 Years
125
T105.2 100.5 96.0
9.100 107.0 88.4 86.4
77.7
p 98.8 81.0. 73.8
u 87.0 87.0
c 75 810 76.4 73.3 76.9
0
° 50
m
a
m 25
C
0 -i
1990 1991 1992 1993 1994 1995 1996 1997 1998 1999 2000 2001 2002 2003 2004 2005
Child Deaths by Cause in North Carolina
Ages Birth through 17 Years
Average Annual % change
Number Number Number from last
Cause of Death 2001-2005 in 2004 in 2005 year
Birth defects 209 219 208 -5%
Other birth-related conditions 553 575 580 1%
Sudden infant death syndrome 98 103 105 2% •
Illnesses 286 286 293 2%
Unintentional injuries 279 313 273 -13%
motor vehicle injuries 170 192 155 -19%
bicycle injuries 7 6 7 17%
injuries caused by fire 16 19 13 -32%
drowning 22 13 21 62%
falls 3 4 3 -25%
poisoning 13 17 18 6%
other unintentional injuries 48 62 56 -10%
Homicide 52 51 78 53%
Suicide 24 23 29 26%
All other 49 37 1 48 30%
TOTAL 1551 1607 1614-T- 0.4%
Child Deaths by Age NC Population
Average Number Number % change Total Under 18
2001-2005 in 2004 in 2005 2004 to 2005 2004 18541263 2069515
Infant 1011 1050 1077 3% 2005 8682066 2097943
1-4 138 140 141 1% % change 1.6% 1.4%
5-9 89 90 86 4%
10-14 120 117 111 -5%
15-17 193 210 199 -50A
Data reflect state residents. •
Please see Technical Notes at http:/tw .Schs.state.nc.us/SCHS/healthstats/deaths/odtech2005.html
Child death rates for 1990.1999 are not the same as published in some previous reports due to revised population estimates.
Produced by the N.C. Division of Public Health -Women's and Children's Health Section In conjunction with the State Center
for Health Statistics.
• New Hanover County Child Fatality Team 2005 Summary
The New Hanover County Child Fatality Prevention Team (NHC CFPT) is a group comprised
of community representatives from diverse agencies and disciplines. Our team currently has 17. members
which are either appointed by their agency board, per the state addendum, or are appointed by New
Hanover County Board of Commissioners. Our team currently has two openings. The mission of the
NHC CFPT is to promote the development of a community wide approach to understanding the causes of
childhood fatalities, identify the deficiencies in public agencies to deliver services to children and
families, and to make and carry out recommendations for change in system delivery to prevent future
childhood deaths. The NHC CFPT meets on a quarterly basis with meetings in February, May, August
and November. Several team members attended 2 state fatality reviews in 2005. A state review is
conducted when the family is involved with DSS at the time of death. The attendance this year has
averaged 7 community members and 2 Health Department staff members per meeting.
The team reviews deaths that occurred in the previous year. During 2005 the team reviewed the
deaths of 17 children. Of these deaths 5 were due to extreme prematurity and complications associated
with this. Four deaths were due to congenital abnormalities. Two children died due to existing medical
conditions. Two deaths involved motor vehicles. There were two child deaths due to SIDS and one
shooting victim. No trends were identified this year in New Hanover County.
• The New Hanover Child Fatality Prevention Team receives funds annually from DHHS via the
Child Health Contract Addendum. This year funds were used to purchase car seats and combination
smoke detectors/carbon monoxide detectors. These were distributed to low income families. The New
Hanover County Health Department Health Promotion Team educated the families receiving the car seats
on the child safety seat laws and proper use and installation. The Wilmington Fire Department distributes
the smoke detectors/carbon monoxide detectors with referrals from the Health Department. A small
amount was spent on refreshments. This money was in the fiscal budget `04-`05.
The New Hanover County Child Fatality Team continues to work to improve participation of its
members and invite persons related to investigations of child deaths to be a part of the review process.
Attendance has been steady and members share agency information with the coordinator prior to the
reviews when they are unable to attend. The team has worked diligently to obtain and review needed
records and work collaboratively in the process of the actual review of each child death.
Respectfully Submitted,
fl-4*At~
, CSW
JoYCe
CFPT Review Coordinator
• c: attachment
N.C. Child Fatality Task Force
1928 Mail Service Center • Raleigh, NC 27699-1928 • phone: 919-707-5626 • fax: 919-870-4882
Co-Chairs: Jennifer Tolle Whiteside, Tom Vitaglione Executive Director: Selena Berrier •
Embargoed Until September 18, 2006
Child Death Rate Decreases in 2005
September 18, 2006 (Raleigh, NC) In 2005, North Carolina's child death rate decreased slightly according to the NC
Child Fatality Task Force, a legislative study commission.
"Though the decrease is less than one percent, it marks a return to an overall downward trend in child fatality rates for our
state" said a statement released today by Jennifer Tolle Whiteside and Tom Vitaglione, Co-Chairs of the NC Child Fatality
Task Force. The death rate had increased in 2004 after a decade of steady decline.
Official figures gathered by the State Center for Health Statistics show a 2005 rate of 76.9 deaths per 100,000 children less
than 18 years of age. This represents a slight decrease from 2004, but is a remarkable 28% lower than the rate in 1991,
when the NC Child Fatality Task Force was established. "Although there is some relief that the rate is continuing the
downward trend that began in the early 1990s, our state still needs to be concerned for its youngest citizens," said Selena
Berrier, Executive Director of the Task Force.
The release of these data begins the annual study cycle of the NC Child Fatality Task Force. "The data present us with
questions about why and how children die. We work to find answers to these questions and make recommendations that
will lead to a reduction in child deaths," said Berrier.
Highlights of the data include:
• The death rate remained the same for infants, but decreased slightly in all other age categories. •
• Motor vehicle-related deaths decreased in 2005 by almost 20%, but remain the primary cause of death for 15-17
year olds. "In recent years, the Task Force has sponsored the adoption of the graduated driver's license system,
including a new restriction on cell phone use by teen drivers which will go into effect in December 2006. Other
efforts include stricter requirements for booster seats, and safety requirements for all-terrain vehicles," said
Vitaglione, who is a Senior Fellow with Action for Children NC. "We have been successful in protecting many
children, but there is more work to be done."
• The number of deaths due to Sudden Infant Death Syndrome (SIDS) increased slightly in 2005, and Task Force
leaders plan to continue efforts to support SIDS reduction campaigns as well as other efforts to reduce infant deaths
associated with sleep positioning.
• Compared to 2004, deaths due to unintentional injuries declined overall, while homicide and suicide numbers
increased. Child abuse homicides typically increase when overall homicides rates increase. Data from the Office
of the Chief Medical Examiner will be released in conjunction with Prevent Child Abuse North Carolina on
September 20, 2006.
• There were 61 deaths due to firearms in 2005, up from 39 in 2004. "This alarming increase will make gun safety a
Task Force focus in the next year", said Berrien
The NC Child Fatality Task Force also released the number of child deaths for each county by cause and age. Because the
numbers for each county are relatively small, rates are not computed. State and county data can be found online at
www.ncchild.or2leontent/view/280/165/
In 1991, the NC General Assembly adopted a child fatality prevention initiative. This initiative established the NC Child
Fatality Task Force, which was charged with studying the incidence and causes of child deaths. Since its inception, the NC
Child Fatality Task Force has made numerous recommendations for changes to legislation, rules, and policies likely to
prevent deaths and promote the well-being of children.
Our Children, Our Future, Our RESPONSIBILITY
NC Child Fatality Task Force Page-2
~r more information contact: Selena Berrier, 919-707-5626
Jennifer Tolle Whiteside, 919-829-8009
Tom Vitaglione, 919-834-6623 ext. 235
•
•
2005 CHILD DEATHS IN NORTH CAROLINA
Trend in Rate of Child Deaths 1990-2005,
Ages Birth through 17 Years •
125
105.2 100.5
c 96.0
v 100 107.0 - 88.4 86.4 81.0 77.7
t 98.8 73.8 -
l:_ - _
- 87.0 -97.0.
C 75 63.0 76.4 73.3 -
c 76.9
0
° 50
d
a
° 25
m
lY
0
1990 1991.1992 1993 1994 1995 1996 1997 1998 1999 2000 2001 2002 2003 2004 2005
Child Deaths by Cause in North Carolina
Ages Birth through 17 Years
Average Annual % change
Number Number Number from last
Cause of Death 2001-2005 in 2004 in 2005 year
Birth defects 209 219 208 -5%
Other birth-related conditions 553 575 580 1% •
Sudden infant deaths ndrome 98 103 105 2%
Illnesses 286 286 29 2%
Unintentional injuries 279 313 273 -13%
motor vehicle injuries 170 192 155 -19%
bicycle injuries _ 7 6 7 - 17%
injuries caused by tire 16 19 13 -32%
drowning 22 13 21 62%
falls 3 4 3 -25%
poisoning 13 17 18 6%
other unintentional injuries 48 62 56 -10%
Homicide 52 51 78 53%
Suicide 24 23 29 26 0
All other 49 37 48 30%
TOTAL 1551 lbU( 0.4%
Child Deaths by Age NC Population
Average Number Number % change Total Under 18
2001-2005 it 2004 in 2005 2004 to 2005 2004 8541263 2069515
Infant 1011 1050 1077 3% 2005 8682066 2097943
14 138 140 141 1% %change 11.4%
5-9 89 90 86 -4%
10-14 120 117 111 -5%
15-17 193 210 199 5%
Data reflect state residents. •
Please see Technical Notes at http:/twww.schs.state.nc.us/SCHS/healthstats/deaths/odtech2005.htmi
Child death rates for 1890-1999 are not the same as published in some previous reports due to revised population estimates.
Produced by the N.C. Division of Public Health - Women's and Children's Health Section in conjunction with the State Center
for Health Statistics.
New Hanover County Child Fatality Team 2005 Summary
The New Hanover County Child Fatality Prevention Team (NHC CFPT) is a group comprised
of community representatives from-diverse-agencies and disciplines. Our team currently has 1,7 members
which are either appointed by their agency board, per the state addendum, or are appointed by New
Hanover County Board of Commissioners. Our team currently has two openings. The mission of the
NHC CFPT is to promote the development of a community wide approach to understanding the causes of.
childhood fatalities, identify the deficiencies in public agencies to deliver services to children and
families, and to make and carry out recommendations for change in system delivery to prevent future
childhood deaths. The NHC CFPT meets on a quarterly basis with meetings in February, May, August
and November. Several team members attended 2 state fatality reviews in 2005. A state review is
conducted when the family is involved with DSS at the time of death. The attendance this year has
averaged 7 community members and 2 Health Department staff members per meeting.
The team reviews deaths that occurred in the previous year. During 2005 the team reviewed the
deaths of 17 children. Of these deaths 5 were due to extreme prematurity and complications associated
with this. Four deaths were due to congenital abnormalities. Two children died due to existing medical
conditions. Two deaths involved motor vehicles. There were two child deaths due to SIDS and one
shooting victim. No trends were identified this year in New Hanover County.
The New Hanover Child Fatality Prevention Team receives funds annually from DHHS via the
• Child Health Contract Addendum. This year funds were used to purchase car seats and combination
smoke detectors/carbon monoxide detectors. These were distributed to low income families. The New
Hanover County Health Department Health Promotion Team educated the families receiving the car seats
on the child safety seat laws and proper use and installation. The Wilmington Fire Department distributes
the smoke detectors/carbon monoxide detectors with referrals from the Health Department. A small
amount was spent on refreshments. This money was in the fiscal budget `04-`05.
The New Hanover County Child Fatality Team continues to work to improve participation of its
members and invite persons related to investigations of child deaths to be a part of the review process.
Attendance has been steady and members share agency information with the coordinator prior to the
reviews when they are unable to attend. The team has worked diligently to obtain and review needed
records and work collaboratively in the process of the actual review of each child death.
Respectfully Submitted,
Jo e Hatem, CSW
CFPT Review Coordinator
• c: attachment
N.C. Child Fatality Task Force
1928 Mail Service Center • Raleigh, NC 27699-1928 • phone: 919-707-5626 • fax: 919-870-4882
Co-Chairs: Jennifer Tolle Whiteside, Tom Vitaglione Executive Director: Selena Berner
Embargoed Until September 18, 2006
Child Death Rate Decreases in 2005
:..p - - -
Se tember 18, 2006 (Raleigh, V - C) - In 2005 North Carolina's child death rate decreased slightly according to the NC
Child Fatality Task Force, a legislative study commission.
"Though the decrease is less than one percent, it marks a return to an overall downward trend in child fatality rates for our
state said a statement released today by Jennifer Tolle Whiteside and Tom Vitaglione, Co-Chairs of the NC Child Fatality
Task Force. The death rate had increased in 2004 after a decade of steady decline.
Official figures gathered by the State Center for Health Statistics show a 2005 rate of 76.9 deaths per 100,000 children less
than 18 years of age. This represents a slight decrease from 2004, but is a remarkable 28% lower than the rate in 1991,
when the NC Child Fatality Task Force was established. "Although there is some relief that the rate is continuing the
downward trend that began in the early 1990s, our state still needs to be concerned for its youngest citizens," said Selena
Berrier, Executive Director of the Task Force.
The release of these data begins the annual study cycle of the NC Child Fatality Task Force. "The data present us with
questions about why and how children die. We work to find answers to these questions and make recommendations that
will lead to a reduction in child deaths," said Berrien
Highlights of the data include:
• The death rate remained the same for infants, but decreased slightly in all other age categories.. •
• Motor vehicle-related deaths decreased in 2005 by almost 20%, but remain the primary cause of death for 15-17
year olds. "In recent years, the Task Force has sponsored the adoption of the graduated driver's license system,
including a new restriction on cell phone use by teen drivers which will go into effect in December 2006. Other
efforts include stricter requirements for booster seats, and safety requirements for all-terrain vehicles," said
Vitaglione, who is a Senior Fellow with Action for Children NC. "We have been successful in protecting many
children, but there is more work to be done."
• The number of deaths due to Sudden Infant Death Syndrome (SIDS) increased slightly in 2005, and Task Force
leaders plan to continue efforts to support SIDS reduction campaigns as well as other efforts to reduce infant deaths
associated with sleep positioning.
• Compared to 2004, deaths due to unintentional injuries declined overall, while homicide and suicide numbers
increased. Child abuse homicides typically increase when overall homicides rates increase. Data from the Office
of the Chief Medical Examiner will be released in conjunction with Prevent Child Abuse North Carolina on
September 20, 2006.
• There were 61 deaths due to firearms in 2005, up from 39 in 2004. "This alarming increase will make gun safety a
Task Force focus in the next year", said Berrier.
The NC Child Fatality Task Force also released the number of child deaths for each county by cause and age. Because the
numbers for each county are relatively small, rates are not computed. State and county data can be found online at
www.nechild.org/content/view/280/165/
In 1991, the NC General Assembly adopted a child fatality prevention initiative. This initiative established the NC Child
Fatality Task Force, which was charged with studying the incidence and causes of child deaths. Since its inception, the NC
Child Fatality Task Force has made numerous recommendations for changes to legislation, rules, and policies likely to
prevent deaths and promote the well-being of children. •
Our Children, Our Future, Our RESPONSIBILITY
NC Child Fatality Task Force Page - 2,
r more information contact: Selena Berrier, 919-707-5626
10 Jennifer Tolle Whiteside, 919-829-8009
Tom Vitaglione, 919-834-6623 ext. 235
•
2005 CHILD DEATHS IN NORTH CAROLINA
Trend in Rate of Child Deaths 1990-2005'
Ages Birth through 17 Years
125
105.2 .100.5 96.0
00 107.0 88.4 86.4
c 1 -
98.8 81.0 77.7 '
t- 73.8
0 75 87.0-_ --87.0 83.0 -
$ 76.4 73.3 76.9
° 50
m
n
25
tY
0
1990 1991 1992 1993 1994 1995 1996 1997 1998 1999 2000 2001 2002 2003 2004 2005
Child Deaths by Cause in North Carolina
Ages Birth through 17 Years
Average Annual % change
Number Number Number from last
Cause of Death 2001-2005 in 2004 in 2005 year
Birth defects 209 219 208 -5%
Other birth-related conditions 553 575 580 1%
Sudden infant death syndrome 98 103 105 2% •
Illnesses 286 286 293 2%
Unintentional injuries 279 313 273 -13%
motor vehicle injuries 170 192 155 -19%
bicycle injuries 7 6 7 17%
injuries caused by fire 16 19 13 -32%
drowning 22 13 21 62%
falls 3 4 3 -25%
poisoning 13 17 18 6%
other unintentional injuries 48 62 56 -10%
Homicide 52 51 78 53%
Suicide 24 23 29 26%
All other 49 37 48 30%
TOTAL 1551 1607 1614 0.4%
Child Deaths by Age NC Population
Average Number Number % change Total Under 18
2001-2005 in 2004 in 2005 2004 to 2005 2004 8541263 2069515
Infant F120 1050 1077 3% 2005 8682066, 2097943
1-4 140 141 1% %change 1.6% 1.4%
5-9 90 86 -4%
10-14 117 111 -5%
15-17 210 199 -5%
Data reflect state residents. - •
Please see Technical Notes at http:liw .Schs.state.nc.us/SCHS/healthstats/deaths/cdtech2005.html
Child death rates for 1990-1999 are not the same as published in some previous reports due to revised population estimates.
Produced by the N.C. Division of Public Health - Women's and Children's Health section in conjunction with the State Center
for Health statistics.
€A.5
:You - - e - •
Z
Health
• u Health Department
•`§z.?
4k- F
a,~v October 2006
NEW.HANOVER COUNTY HEAT-1t
~
Hours of Operation for Main Office: ~A T E STInOcNAS~AN D r
Office Hours: Monday-Friday, .8:00a.m,=5p.m. A SWERS ABOUT FLU:
Clinic Hours: Monday - Friday, 8:00 a.m - 4:30 p.m.
Extended Clinic Hours: Tuesday evening until 7 p.m.
Se Habla Espanol " There is no pandemic flu in the world today. them, leading to rapid disease spread from per-
Servicio de Interprete Gratis No one knows when or where a pandemic son to person. THERE IS CURRENTLY NO
may begin or how severe it will be. But, PANDEMIC FLU.
North Carolina must be ready. The North What is the state of North Carolina doing to
New Hanover County Carolina Division of Public Health and local prepare for a pandemic flu?
Health'Department health departments are leading those prepa-
ration efforts. Now is the time to prepare North Carolina public health has a history of
for pandemic flu. This preparation will help responding to emergency situations. Public
Wilmington, NC 28401 you cope with other emergencies, like hur- health helps communities respond to and re-
phOrie 91.0.798:6500 ricanes or ice storms. cover from natural disasters like hurricanes and
ice storms as well as to new diseases. Public
fax ,,910.341.4146 Are you confused about the difference be- health professionals are working now to ensure
www.nhchd.org tween seasonal, bird and pandemic flu? that the state is prepared for a pandemic flu.
SEASONAL FLU: THEY
: Offsite locations: This is the yearly flu. North Carolina's flu • Use technology to detect unusual illnesses at
season runs from October through April. hospital emergency departments across North
fillilYlQl COlrtt/Ol The seasonal flu is a respiratory virus that Carolina.
Services is spread person to person. This wintertime • Educate health care workers to be on the alert
180 Division Drive respiratory illness is marked by a fever and for signs of unusual illness.
Wilmington, NC 28401 symptoms like coughing and sneezing. Peo- • Prepare to distribute vaccines and antiviral
910-798-7500 ple usually have some immunity against the medications in the event of a pandemic.
seasonal flu. There is also a vaccine avail- • Work with education, business, community
Environmental able to prevent the seasonal flu. This vac- and faith groups to help everyone prepare for
Health Services cine must be given every year, beginning in a pandemic.
230 Marketplace Drive the fall months. The New Hanover County
Wilmington, NO 28403 Health Department is offering seasonal flu For more information about what your
910-798-6667 vaccine. Please call 798-6646 to schedule community is doing to prepare for a pan-
(located in County Annex at an appointment. demic flu, contact your local
Market Place Mall) health department or the De-
BIRD FLU: partment of Health and Hu-
NEW HANOVER COUNTY Bird flu is just that - a flu that affects birds. man Services' CARE-LINE
HEALTH DEPARTMENT There has been a lot of attention focused on at 1-800-662-7030.
a bird flu outbreak that began in Asia in the
BOARD MEMBERS late 1990s. That strain of flu, which is called State of North Carolina
Donald P. Blake, Chairman, Public Member H5N1, is highly contagious among birds. A Department of Health r
small number of people have been infected and Human Services
Edward Weaver, Jr, OD, Vice Chairman, Optometrist V
with the virus through very close contact Division of Public Health
Marvin E. Freeman, Sr, Public Member with birds, or very close contact with anoth- www.ncdhhs.gov
James R. Hickmon, RPh, Pharmacist er person with this strain of bird flu.u
Cheryl Lofgren, RN, Nurse
Sandra L. Miles, DDS, Dentist PANDEMIC FLU:
Nancy H. Pritchett, County Commissioner A pandemic flu occurs when a new flu vi-
Robert M. Shakar Jc, MD, Pbysician rus appears in humans, spreads easily from `
John S. Tunstall PE, Engineer person-to-person, causes serious illness, and
y
moves across the globe. Flu pandemics are
Stanley G. Wardrip, Public Member caused by new flu viruses. Because they are
G. Robert Weedon, DVM, MPH Veterinarian new, humans have little or no immunity to ,
JanelleA. Rhyne, MD, Medical Consultant
fi i
ewly Diagnosed HN, AIDS, and Syphilis Case j
in New Hanover County
THE REAL COST 100 s
OF HIV/AIDS y~ ~d egg r kt6 ~a
80 ~ ^ r ~ fi x= w ~r
60,.~ AIDS
_x
Sucora Anderson, Board Chair. ; t HIV
Coastal Carolina Care Consortium 40 Syphilis
Cynthia Withrow, RN 20
:4
Public Health Nurse o a
PEN
New Hanover County Health Department 2001102 2002103 2003104 2004105 2005106
What is the real cost of living with HIV/AIDS?
Most of us are familiar with the staggering cost For every diagnosed case of many sexually transmitted infections, it is estimated that there are
as many as three or four undiagnosed cases in the community. Many"people are unaware of
of primary health care including medications their risks or of their infection status.
and long term care. However, the other side of
the coin that most of us never see is the human
side of the epidemic. The day to day struggles lation is undiagnosed and unaware of their in-
for some who are living with HIV/AIDS can fection. The Centers for Disease Control and often be more far reaching and complex than Prevention (CDC) estimates that approximate-
the disease it self. ly 40,000 new HIV infections occur each year
in the United States. HYPERLINK "http:H
Behind the numbers and statistics we periodi- www.cdc.gov/hiv/resources/factsheets/At-A-
cally hear about in media reports, are the many Glance.htm" www.cdc.gov/hiv/resources/fact-
faces and stories behind the epidemic. For sheets/At-A-Glance.htm
example, the mother grappling with who will
care for her children on the days when she is New Hanover County Health Department of-
too sick to do so, and who is going to care for fers HIV testing. It is free and confidential.
them someday if she is no longer around. Or Appointments can be made by calling 798-
the father who is unable to work due to the pro- 6500. Both pre-test and post-test counseling
longed effects of HIV, and is struggling with are provided.
how to provide for his family. Or maybe the.'
teenager who just found out he/she is positive JF E
and is not sure of how to tell their parents, or
the parents coping with the realization that they
now might outlive their child who is positive or ! dentist
fo the who ! e f a m i ly
possibly having to provide long term care.
Perhaps the emotional cost of the epidemic { with emphasis on patient comfort,
will begin to change when we realize that be- using the latest technologies, and also
hind every infection represented as a number, ` maintaining the highest quality of
there is also a face and a story that as humans, continued education for our staff
we can all relate. Learning to reach out with k rl Y*
compassion to those living with HIV/AIDS, li
to stop judging them and being afraid of the New Patients Welcome!
illness. Finally accepting that this disease is r;
not "somebody else's problem." As a loci- ;A
andra
ety when one person is infected, we are all
ultimately affected. s7 8150811
Vausat
iYd} rtes
wwwsardramikcan
. At the end of 2003, it was estimated that as
many as 1,185,000 people were living with DENTISTRY
1
HIV or AIDS in the United States. It is also
estimated that as many as 24-27% of this popu- `
Sandra L. Miles, DDS, PA 1 North 16th Street on the corner of Market & 16th
E s
(
U"
T -MYEAR IN REVIEW •
FROMYOUR HEALTH
DEPARTMENT
This annual report is the result of much thought and dental program serves children ages 3-18 years old $13,005,257. The Health Department's budget
deliberation by the members of the New Hanover with Medicaid, Health Choice, and those without was composed of 33 individual programs. Division
County Board of Health and the staff of the New dental insurance. A sliding scale fee schedule is Managers submitted a line item budget for each pro-
Hanover County Health Department. During fiscal available for the uninsured Our dental team con- grain within their respective divisions. The Health
year 2005-06 the Health Department experienced sists of a contract dentist, two dental assistants and Director and Business Manager reviewed all bud-
many challenges and opportunities, including: one administrative support technician. Services get requests. Budget hearings were conducted and a
provided on the unit include screening, oral exami- Budget Workbook including all programs with line
nations, x-rays, sealants, extractions, fillings and item narrative justifications was prepared and sub-
basic dental care. The mobile unit will be parked mitted to the Board of Health for approval.
at various schools in New Hanover and Brunswick
r, Counties. Sponsors include Kate B. Reynolds The Health Department's Business Manager was re
Foundation, Cape Fear Memorial Foundation, Cape sponsible for preparing expenditure reports that en-
Fear Area United Way, and Brunswick County sured billing and receipt of the Health Department's
' Health Department state grant funds. The Health Department complied
a ' with New Hanover County Financial Policies and
WIC PROGRAM EXCEEDS STATE Procedures, which included. an annual audit
REQUIREMENTS:
When WIC (Women Infants and Children) Nutrition
Programs meet and exceed the state assigned case-
ANIMAL CONTROL SERVICES: load for their county, there are additional funds pro-
The year for Animal Control Services (ACS) began vided. The caseload requirement is then increased. Total Actual Expenditures for FY 2995-2008
with a major search and seizure operation, which re- Our WIC program did just that this past fiscal year,
Opera": (:apitai Outlay:
sulted in the impoundment of 137 Dachshunds from and exceeded their new assigned caseload We have $,,694,955 $7+9,M
a single residential address in the county. Resolution been able to staff a part time, temporary Nutritionist 13% 6%
of the case resulted quickly, thanks to diligent work to keep the caseload up.
'
by staff and the District Attorney's office. -Over 100 4"sakuy
of the animals became the property of ACS, which ADDITIONAL INTERPRETERS 8
led to a month long season of neutering and adopt- NEEDED: ~$1 .5,r
ing. On day one, close to 200 interested parties ar- Clinical services had a total of 3755 client visits with 81%
rived on-site for a chance to take home only a hand- Spanish Interpreters. Eight percent of all clinical pa-
ful of available dogs. Adoption dates continued over fients were Hispanic and 76% of those needed an as sue:
the next several weeks, until all had been relocated interpreter at each visit Our department applied for :''M'~ "P° wmma
to new homes. and received funds from the state to supplement a
new interpreter position. In addition, our Women In- I
MOBILE DENTAL UNIT ARRIVES: fants and Children Nutrition Program served 1179 Hx
The mobile dental unit "Miles of Smiles" arrived in Hispanics (unduplicated number of clients) this year. $3n,= New Hanover County on Friday, June 9, 2006 (the This has continuously increased from fiscal year 99-~
last day of traditional school) and saw the first pa- 00, when, they served 181.
dent on Monday, June 12, 2006. The first to benefit
from this exciting and much needed prograiri were FINANCIAL MANAGEMENT:
Freeman Elementary School students and children The New Hanover County , HealtliDepartment
in that local neighborhood. When the mobile den- Amended Expenditure Budget (Adopted' Budget
tal unit arrived there was approximately 40 children plus any amendments that wereprocessed during
with signed parental consent for'treatment. During the fiscal year) for FY 2005-2006 was $14,104,293.
11 work days in June, 44 children were seen. The Actual expenditures for FY 2005-2006 were
R:
~V
_ P O'E~_ T
4SSFST
taof New Hanover
Brunswick and
Fender Counties
LIST OF NON-SMOKING RESTARAUNTS IN
WILMINGTON & SURROUNDING AREAS
CAROLINA BEACH
Cottage D & U Diner NoFo Cafe Hole-In-One at Goose Bay Bo Sue's
Courtyard By Maniot Dairy Queen Opus Jade Garden- Leland Corianders
Frank's Pizza David's Deli and Restaurant Orange Julius Joseph's Italian Bistro Crabby Mike's
Generations Deli Downtown Pita Delite KFC Dairy Queen
Granny's Country Kitchen Dick's Dogs and Burgers Pizza Pan Kohl's Domino's
Hazdees Dog House Portland Grille Kopp's Quick Stop I & II Hardee's
Kate's Breakfast and Lunch Dunkin Donuts Quizno's Subs ; MCDonalds,.. Lanier's Campground
Mama Mia's Echo Farms Country Club.:. _ Ray's Restaurant New'China Max's Pizza
Michaelangel% Pizza Everyday Gourmet Rudino's- ' ' Papa'John's Pizza ' Mollie's Restaurant
Subway Fire Bowl Sazk6 Japan Phil's Sandwich Shop New York Corner Deli .
Top Wok Firehouse Subs' ''Sawmill Port City Java Subway
Flaming Amy's Sbarro Pizza Pharmacy Restaurant
CASTLE HAYNE Folk's Cafe South College Sandwich The Picrh use Restaurant
Hazdees of HWY 117 French's Classic Burgers Spiro's Breakfast and Lunch Subway
Frontier Food to`Go Steak Escape Sugar Sha `
KURE BEACH Genk Japanese, Restaurant . Subway
Freddie's Restaurante Golden China Taco Bell ENDE UNTY
WILMINGTON Golden Dragon Tailwind Deli News and Gifts Burgaw
Good Goody House Target Food Avenue AB Grdlea d Ice Cream
A Southern Thyme Onnby's Pizza Temezzo And i ' •
A Taste of Italy Han=dee Hugo Tidal Creek Co-op China mg
Andy's Cheesesteaks Hazdees The Woods at Holly Tree Restaurant
Anntony's Caribbean Cafe, Hibachi Express Tokyo Deli eei ~g
Antonios Pizzeria Hollywood East Cinema Grill Two Guys Grille D minor
Arab Shrine Club ' Honey Baked Ham Company UNCW Cafeterias Holland's She ter Greek urant Ono 1
Arby's I Love NY Pizza Verizon Wirefes`s Cafeteria Maria's Court
yard i?~
Artisan Market and Cafe Indochine Restaurant Wendy s - McDonald's
Atlanta Bread Company Inuista What's Cookin' Scotchman '
Bagel Basket Jackson's Big Oak BJi tonsaIIouse SkaBagel Oven Cafe Jellybeans t i~n on F e sROom , -Barnes and Noble Caf e Jersey Mikes s n
Bayan Jesters Java U Ci`"
Bear Rock Cafe Jeters at the Mall '.ZetxTt~ Your Co vettience
Bellas Sweets and Spirits " Jeters Hot Dogs Bento Box Joe Muggs WRIGHTSVILLE BEACH' HAMPSTEAD
Blimpies Subs -Jones Seafood House Mercer's Restaurant Andy's A
Bojangles Jungle Rapids Verandah Cafe-Holiday Inn China Garden
Bon Appetit K's Cafe Vito's Pizzeria Domino's,,
,
Boodles Ken''Bagels and Deli King's Table i
Brasserie Du Soleil Kohl's Frozen Custard BRUNSWICK COUNTY Old Point CountryClub Grill
Brigade Boys and Girls Club Krazy pizza Andy's- Shallotte Panda Chinese Restaurant' _
Brightmore KS Cafe and Catering Archibald's Deli Pizza's 2 U
Brooklyn Pizza Company Lake Shore Commons Bart's BBQ Player's Cafe
Burger King Le Catalan ` Beck's Port City Java
Cafe at Temptations Lovey's Namial Foods Bella Cucina Scotchman
Cameron Art Museum Lucky Staz BHI Clubhouse Subway
Carolina BBQ Lupita's Bakery ' - Billy Bass Seafood The Bagel Bakery
CFCC Food Court Manhattan Bagel Bojangle's- Shallotte Topsail Greens Snack Bar
Charlotte's Uptown Eatery Marc's on Market Burger King- Shallotte XYZ Pizza
Checkers Marriott Courtyard Calabash Deli
Chick fil A Mayfaire Cinemas Captain Nance"s Seafood R0C:KY_-POINT
China Garden McDonald's Captain Pete's Freshway
China King Merin's Burger House Cinelli's at Ocean Isle Beach Grand Oak Driving Range
China One Minch Sushi Cook's Nook Hardee's
China Star Ming Tree Derbster's Dining Paul's Place
China Wok Moe's Southwest Grill Double Eagle Grill Wendy's
Chopstix.Express Montego Bay Ella's
Chuck E Cheese Nagila Great Wall SURF CITY
Cici's Pizza Nikki's Fresh Gourmet Hazdees Andy's
-,City Club Cubbies Nino's Pizza.and Pasta Holden 'Beach Pier and Grill Batson's Gallery