2003-11-05 RM Exhibits
e New Hanover County Health Deparbnent Revenue and Expenditure Summaries for September 2003 Cumulative 25 00 Month 3 of 12 Revenues Current Year Prior Year Type of Budgeted Revenue Balance
Budgeted Revenue Balance Revenue Amount Earned Remalnln Amount Earned Remalnln Federal State 1 662 620 619 793 1 042 827 143 953 1 561 255 8 44 Imel Control 570 161 152 376 417 785 138
743 449 201 23 60 Medicaid 1 044 080 82 425 951 655 179 572 855 814 17 34 Medicaid Max 273 333 0 00 EH Fees 300 212 21 93 Heafth Fees 113 850 40 67 Other 2 282 095 21 97 Expenditures
e ypeol Ex ndlture Budgeted Amount Expended Amount Balance Remalnl Budgeted Amount Expended Amount Balance Remalnln 1 878 760 405 523 Summary Budgeted Actual F0Y403 FY 034 Expenditures
Salaries Fringe 9 917 317 1 910 845 Operating Expenses 1 465 775 306 067 Capital Outlay 340 363 17 326 Total Expenditures 11 723 455 2 234 238 19 06 Revenue 6 246 351 1 359 600 21 77
Net County 5 477 104 874 638 16 00 e Revenue and Expenditure Summary For the Month of September 2003 11
Date BOH Grant R9Quested Pending Recelvecl Denied 10 112003 No activity to report for October 2003 New Hanover County Safe Schools Uniting for Youth U4Youth funding will be received
over a 93l2oo3 3 year 9rant period 49 000 4g ooo Safe Kids Coalltlon Fire Prevention Please note this grant was pulled coslltion not eble to meet deadline for request 2 500 2 500 8612003
NC DHHS OPH Preparedness and Response 82 350 31 950 50 400 Smart Start Partnership for Children Grant 7312003 Increase for Part Time Nurse Position 5 523 5 523 Cape Fear Memorial Foundation
Diabetes Today twoyear request 42 740 annually Received 25 00 year 1 and 20 000 yeer 2 85 480 45 000 40 480 Duke University Nicholas School of the EGnevolrgornampehnict Information Systems
Grant Env Health 10 000 10 000 Safe Kids Coalition Safe KIds Mobile Car Seat Check up Van 50 000 50 000 Safe Kids Coalltlon Risk Watch Champion 6 412003 Team 10 000 12 500 Smart Start
Partnership for Children Child 51712003 Care Nursing Program Preliminary Approval 171 977 172 500 Smart Start Partnership for Children Heallh Check Preliminary Approval 41 035 41 747
UCNHC Child Care Health Consultant 82 849 84495 Cape Fear Memorial Foundation through PartnershlD for Chlldrenl Navigator Proaram 176 707 180 000 41312003 No activity to report for April
2003 3512003 No activity to report for March 2003 2512003 No activity to report for February 2003 11612003 NC DHHS OPH Preparedness and Response 115 950 33 600 82 350 12412002 No activity
to report for December 2002 NC Health and Wellness Trust Fund Teen Tobacco Use Prevention Cessation Program 111612002 100 000 per year for 3 years 100 000 100 000 Safe Klda Buckle Up
PNroogrrathm Carolina 101212002 Safe KIds 5 000 5 000 Developing Geographic Information Systams GIS Capacity In Local Health Department In Eastern North COaurokllnea University Nicholes
School of the Environment and Earth Sciences NSEES 18 000 18 000 NO acuv ty 10 repo lor lSl0ep0le2mbe NO acuv ty to report or August zuuz NO 8CUVtIY 10 report lor JulY ZUUZ Totals 988
371 99 000 614 792 281 253 NHCHD BOARD OF HEALTH APPROVED GRANT APPUCATiON STATUS FY 10134 eee 10 02 As 011012212003 NOTE Notification raceived since lest report 62 20 28 48 12
NHCHD BOARD OF HEALTH APPROVED GRANT APPLICATION STATUS FY 034 Pendlno Grants 2 13 Funded Tolel Reauest 8 50 Partisllv Funded 3 19 Denied Totel Request 3 19 Numbers of Grants Applied
For 16 100 eee 13 As of 1012212003 NOTE Notification received since last report
ti eee NEW HANOVER COUNTY BOARD OF COMMISSIONERS Request for Board Action Agenda D Consent Meeting Date 117 03 Agenda Department Health Presenter David Rice Contact Janet McCumbee Subject
Request for Approval of funds from Cape Fear Memorial Foundation Brief Summary Health Department has requested 3 000 from Cape Fear Memorial Foundation for dental care for low income
children with no Medicaid or dental insurance A mini grant has been requested to pay local dentists for restorative dental care for children on free or reduced lunch when school nurses
identify an immediate need for dental care This has been previously funded by the C HI P Program which no longer exists The Health Dept plans to apply for additional CFMF funding in
their next regular funding cycle This grant would meet immediate needs to fill the present gap RecomIriended Motion and Requested Actions NHCHD to accept 3 000 from Cape Fear Memorial
Foundation to pay for dental services for needy children These funds will be used to serve children referred by school nurses without any source of payment for dental services also to
approve the related budget amendment if a contract is received I Funding Source Cape Fear Memorial Foundation Will above action result in New Position 0 Number ofPosition s DPosition
s Modification or change o Change in Position s I Explanation I Attachments Memo 14
NEW HANOVER COUNTY HEALm DEPARTMENT 2029 SOUTH 17m STREET WILMINGTON NC 28401 4946 TELEPHONE 910 343 6500 FAX 910 341 4146 October 15 2003 Mr Garry Garris President Cape Fear Memorial
Foundation 2508 Independence Blvd Ste 200 Wilmington NC 28412 Dear Mr Garris There is a significant need in this community for provision of pediatric dental services for children with
no dental insurance or Medicaid benefits These children are experiencing acute dental problems requiring immediate attention but no funding is currently available to satisfy their needs
e The New Hanover County Health Department intends to submit a grant funding request to the Foundation to provide these services through dentists in the community with whom we currently
have active contractual agreements To qualify for these services children must have no Medicaid or third party dental insurance and must meet eligibility requirements for free or reduced
price lunches Unfortunately while we are awaiting the next funding cycle there remains a tremendous need for gap funding to provide dental care for a growing number of children Please
consider our request for interim funding in the amount of 3 000 which we believe would satisfy the majority of services needed until our grant submission is reviewed and decided Thank
you 4 David M Rice Health Director kI IW Janet McCumbee Director Personal Health Services e 15 Healthy People Healthy Environment Healthy Community
Iee NEW HANOVER COUNTY BOARD OF COMMISSIONERS Request for Board Action Agenda D Consent Meeting Date 1117 03 Agenda Department Health Presenter David Rice Contact Janet McCumbee I 1
1 Subject Request for Approval of funds from the Medical Society through Good Shepard Ministries Brief Summary Health Department will receive 25 000 for one year to provide preventive
nursing services at the Good Shepard clinical site for 10 hours per week In addition the Community Services Physician Extender will provide limited services and oversight of nurse screenings
and education to the homeless population as needed Staff from the Health Department will work cooperatively with Good Shepard and other community agencies to assess client needs and
make appropriate referrals funds will provide some testing and medications and assist this population with health needs on a limited basis Recommended Motion and Requested Actions NHCHD
to accept 25 000 from Good Shepard Ministries which they will receive from Medical Society to provide nursing services to the population frequenting the shelter These funds will be added
to the budget to be used for temporary salaries and operating expenses incurred by the Community Health staff to approve the related budget amendment when the contract is received I
Funding Source Good Shepard MinistrieslMedical Society Will above action result in ew Position 1 temporary no benefits Number ofPosition s DPosition s Modification or change DNo Change
in Position s Explanation The funds are to be used to provide 10 hours per week of nursing services to assist Community staff with services at the Good Shepard clinical site I Attachments
BOH memo 16
jjeee NEW HANOVER COUNTY HEALTH DEPARTMENT Good Shepherd Ministries of Wilmington Inc Medical Society Grant Budget Proposal Goal To provide professional health screening for early identification
of disease and illness health education and anticipatory guidance basic medical first aid limited episodic acute care and referral for follow up to the indigent underserved and uninsured
population at the Good Shepherd Ministries of Wilmington in New Hanover County Objective Identification of health problems and behaviors common to high risk populations in particular
the homeless and medically underserved clients in order to promote positive health and social outcomes Strategy Staff medical clinic at the Good Shepherd Ministries for a miniri1um of
ten 10 hours per week with a public health nurse Physician Extender will provide clinic oversight under Medical Consultant protocols PROPOSED LINE BUDGET I Salaries Public Health Nurse
14 700 Temporary no benefits 25 00 Ihr x 10 hrsIwk x 52 weeks plus FICA Medical Consultant 2 079 3 hrsmo x 57 75 Ihr x 12 mo Salaries Total 16 779 II Operating Contract Services 3 900
Laboratory medical referrals and radiology services Departmental Supplies 4 021 Medications phannacy supplies and outreachtesting supplies refrigerator for medslvaccinestests Employee
Reimbursements 300 70 milesmo x 12 mo x 036 mile Operating Total 8 221 Total Budget 25 000 17
eee NEW HANOVER COUNTY BOARD OF COMMISSIONERS Request for Board Action Agenda Meeting Date 1117 03 De artment Health Contact Janet McCumbee David Rice Sub ect Re uest for A roval of
Tuberculosis TB Funds from Duke Universi BriefSurnmary Health Department will receive 10 388 for 03 04 FY to continue participating in a Duke University TB Treatment Research Project
NHC Health Dept has been assisting Duke with a research project for a new TB treatment protocol since fall of2001 Duke would like to provide funds as an incentive for allowing staff
to work with the Duke project and the TB patients enrolled The funds will be used in the TB program for su lies and tem or staffm to assist with outreach Recommended Motion and Requested
Actions NHCHD to accept 10 388 from Duke University to be added to the TB budget for temporary salaries and operating expenses incurred by the TB staff to approve the related budget
amendment when the contract is received I Funding Source Duke University Will above action result in ew Position 1 temporary no benefits Number ofPosition s DPosition s Modification
or change o C e in Position s Explanation The funds are to be used to provide 10 hours per week of nursing services to assist TB staff with outreach for TB patients receiving therapy
from the health department This has been done in the past with other temporary monies and was helpful to the ro I Attachments BOH memo 18
NEW HANOVER COUNTY HEALTH DEPARTMENT 2029 SOUTH 17111 STREET WILMINGTON NC 248944061 TELEPHONE 910 343 6500 FAX 910 341 4146 To Board of Health From Janet McCumbee RN Personal Health
Services Director Date 10 20 03 Subj Request to Accept Funds For Duke TB Study FY 034 e The Community Health Services Team requests consideration of acceptance of the following Duke
University Research Project TB Control Program Funds Effective 7 103 2597 per quarter through 6 30 04 10 388 History We have participated in the Duke University TB research project since
the fall of 2001 For the first time we will receive funds to assist with time staff is spending with the project Duke has paid for continuing education for TB staff however this year
they have some additional funds to provide us We have enrolled approximately 40 patients since the beginning presently following about 8 These patients are being treated with a new medication
for TB Our staff does the directly observed therapy and monthly assessments Duke would like for for the NHCHD to bill them each quarter for 2597 to offset any cost we incur as part of
the TB research Project We will continue to participate over the 034 FY and would like to budget the funds for use in the TB program Proposed Budget for 03 04 Duke TB Funds Temporary
Salary RN temp position no benefits To assist with TB outreach 25 00 hr X 10 hrslwk x 26 pay periods 6 500 OO FICA 7 000 4210 Departmental Supplies Pharmacy supplies nutrition and medication
supplements outreach activities office supplies 2 807 5100 Employee Reimbursements 780 miles x 0 36 mile 281 e 5200 Training Travel Total TB program updates and related training 300
10 388 19 Healthy People Healthy Environment Healthy Community
eee Betsy Summey 07 31200304 37 PM To Page Dunn NHC@NHC Janet McCumbee NHC@NHC cc bcc archive Subject Duke University Offer As you know the TB Control Program has been participating
in studies conducted by Duke University for about two years Last year they included us in a grant proposal to the CDC with the idea of obtaining funds to increase Lee Ann Cook s salary
from 75 to 100 time That proposal was turned down Thankfully Lee Ann s position has been increased to 100 by our own county budget Now at the year end Duke has found it has money left
in their budget which they want to give to us to ensure that the studies can be continued here They have been able to gather participants from this area in numbers that are very important
to the validity of their study The money is not grant dependent Basically these are the components of a formal agreement which is forthcoming 1 That we participate in tuberculosis research
studies by assisting with screening and following patients according to the study protocols 2 That we report to the study team and document adverse experiences and side effects in study
patients according to theprotocols definitions 3 That we conduct studies according to Good Clinical Practices and in compliance with existing federal policies concerning use of investigational
agents and protection of human subjects 4 That we invoice Duke University 2597 on a quarterly basis with July 1 2003 the start date of the first quarter That sum represents what would
have been 25 of LeeAnn s salary plus benefits I am making sure of some of the expected duties and the amount of Lee Ann s time especially in view of our limited staff I hope the extra
money will be considered for someone on a very limited basis who may be able to do outreach work i e DOPTs DOTs At any rate look this over and let me know any questions concerns you
may have before I get the final document from Duke which we will sent to the BOH for approval Thanks Betsy 20
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feee NEW HANOVER COUNTY BOARD OF COMMISSIONERS Request for Board Aetion Agenda D Consent Meeting Date 1117 03 Agenda Department Health Health Promotion Presenter Carrie Snell Tobacco
Prevention Health Educator Contact Carrie Snell 343 6548 Elisabeth Constandy 343 6658 Sr Health Educator Sub ect Vision 2010 Tobacco Prevention and Control Grant Brief Snmmary The NC
Tobacco Prevention and Control Branch has received funding from the Centers for Disease Control and Prevention to continue the tobacco prevention movement across the state NHCHD has
received this funding for 10 years to fund the Project ASSIST Coalition ofNew Hanover and Brunswick Counties Current funding will end 6 30 04 The monies are now competetive and the local
coalition has expanded to include Pender County on the application for continuation funding Focus areas for the grant remain the same and include Preventing Youth Initiation Promoting
Cessation Reducin Ex osure to Secondhand Smoke and Eliminatin Dis arities Recommended Motion and Requested Actions Approve Vision 2010 Tobacco Prevention and Control Grant application
for 100 000 and associated budget amendment if funding is received I FundingSource North Carolina Tobacco Prevention and Control Branch ofDHHS Will above action result in ONew Position
Number ofPosition s DPosition s Modification or change o Chan e in Position s Explanation Funding will allow continuation of Tobacco Prevention Health Educator sition and related ro
Currentl 100 ant funded throu 6 30 04 I Attachments Brief RFA Description Budget Explanation 23
eee Vision 2010 Local Leadership Coalitions in Tobacco Prevention and Control Request for Applications Purpose This Request for Applications RFA issued by the North Carolina Department
of Health and Human Services NCDHHS through the Tobacco Prevention and Control Branch TPCB seeks proposals from local health departments and their coalition partners to carry out evidence
based tobacco prevention and control policies and interventions in collaboration with the Tobacco Prevention and Control Branch with funding from the Centers for Disease Control and
Prevention CDC The proposed funding period for the local RFA covers four years but requires annual approval from TPCB The proposals must demonstrate local plans to carry out the TPCB
s plan approved by the CDC for development and implementation of strategic evidence based tobacco prevention and control programs in one or more North Carolina counties Research and
recent experience have shown that well funded staffed community based programs are critical to evidence based tobacco prevention programs they educate the public build credibility influence
local decision makers and impact attitudes policies and systems change These programs must focus limited resources on evidence based policy and programs in order to achieve the maximum
impact Background North Carolina is at a crossroads Centuries old social economic and political traditions in the nation s leading tobacco producing state are giving way to the knowledge
gained in recent decades about the health effects of tobacco use and widening state and local support for the policies and interventions known to be effective While barriers remain the
tobacco prevention and control movement in North Carolina has made strides in the last twelve years that indicate a change in norms and position North Carolina s tobacco control program
as a leader among tobacco producing states Accomplishments and indicators of change include the historic allocation of 18 6 million over three years by the NC Health and Wellness Trust
Fund Commission HWTFC which provided the first ever NC state funds dedicated for tobacco prevention and control a smoking ban on the floor of the NC House of Representatives a rapid
acceleration in school districts adopting 100 tobacco free school policies the percentage of workers in NC protected by nonsmoking policies exceeding the national average the development
of a statewide plan to eliminate tobacco related health disparities and the serious consideration of a considerable increase in cigarette excise tax TPCB has a broad comprehensive mission
to reduce deaths and health problems in all ages and populations due to tobacco use and secondhand smoke TPCB programs build capacity of diverse organizations and communities to carry
out effective culturally appropriate strategies towards CDC s four goals 1 prevent initiation of tobacco use among young people 2 promote cessation for adults and youth 3 eliminate exposure
to secondhand smoke and 4 identify and eliminate tobacco related health disparities in specific populations 24
eee Vision 2010 Local Leadership Coalitions in Tobacco Prevention and Control Budget Form 200405 Health Department Applicant New Hanover County Name of Contact Person for Budget Cynthia
Hewett Business Manager Phone 910 6354030 Fax 910 4314416 E mail chewett@nhcgov com 2004 05 Amount offunding requested 100 000 Projected Grant Expenses Total CDC Grant In Kind Line Items
Funds Contributions Prooosed Salary or Wages 10 FTEHealth Educator 37 265 Fringe Benefits 21842 Travel 7 000 Supplies 12 053 Contracts 10 000 Other 2 900 Furniture and Eauioment 3000
Limit 0 Indirect Charees 9 000 Media 7 500 Total 100 000 25
eee Vision 2010 Local Leadership Coalitions in Tobacco Prevention and Control Budget Explanation Salary and Wages Projected for existing employee including 5 MeritlMarket adjustment
for FY 04 05 Travel 2 000 1500 1500 1500 500 7 000 00 Local employee reimbursement to include travel within NBC Brunswick and Pender Counties Mandatory In State meetings 2 statewide
4 regional per year In State travel for training National Conference one per year Coalition volunteer mileage reimbursement Total Supplies Incentives for program initiatives marketing
health fairs in 3 county area educational materials including props brochures posters and videos office supplies for coordinator Contracts The Coalition will disseminate 4 mini grants
of2 500 to non profit agencies in the 3 county area to expand or enhance tobacco awareness cessation and prevention campaigns Other Postage 400 Printing 2500 locally generated brochures
Indirect Charges 9 of total grant request to cover management support andor supervision for the Health Educator position Media 3000 2000 2500 7 500 00 Radio spots 6 at 500 per spot Billboard
at Sharks Baseball Park including game sponsorship Roadside billboards to promote campaigns 2 at 1250 each Total 26
eee NEW HANOVER COUNTY BOARD OF COMMISSIONERS Request for Board Action Agenda Consent Meeting Date 11 17 2003 A enda i8J De artment Public Health Presenter Cind Hewett Business Mgr Contact
Cind Hewett Business Mana er ext 6680 Subject 42895 48 reimbursements received for purchase of Jail Health Pharmaceuticals BriefSurnmary As of July 1 2003 the NHC Jail Health Program
was contracted to Prison Health Services As a result of this several pharmaceutical items were returned to Cardinal Health for reimbursement 2 570 17 others were purchased by a local
pharmacy Tom s Drug Company 10 809 03 while others were purchased for use in the Jail by Prison Health Services 16 106 28 The Health Department is requesting to budget these funds to
cover the cost of Temporary Staff working on the Jail Medical Records Project Additionally any funds remaining from this would be used to support needed expenditures for the Health Department
Clinic area as a result of the Department s reoreanization and mieration towards aoen Access Access Clinic Recommended Motion and Requested Actions To approve the 42895 48 receipts from
Jail Health Pharmaceuticals and any associated budget amendment These funds will be used to cover the cost of Temporary Contracted Staff working on the Jail Medical Records Project as
well as using any remaining funds to support needed exoenditures for the Health Deoartment Clinics I Funding Source Cardinal Health Tom s Drug Company and Prison Health Services Will
above action result in DNew Position Number ofPosition s DPosition s Modification or change i8JNo Chan e in Position s Ex lanation Tem or Contracted Staff will be aid from Contracted
Services I Attachments Budget amendment 27
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Jee Access III of the Lower Cape Fear Inc 201 North Front Street Suite M 108 Wilmington NC 28401 Phone 910 763 0200 Fax 9107630222 Ai ACCESS III I d L nVIiIl CAfJE I E J Non profit partnership
with primary care physicians hospitals health departments and departments of social services J Contracted with the State to provide case management services to Carolina Access patients
J Serves Carolina Access patients in southeastern N C Bladen Brunswick Columbus New Hanover and Pender counties J Provides disease and case management services to impact cost and quality
of health care J Provider driven partnership with doctors identifying problem diseases and adopting best practices J Extensive State database system to assist with identifying patients
with special needs related to our 5 initiatives Asthma disease management in accordance with National Institute of Health NIH guidelines Diabetes disease management in accordance with
American Diabetes Association ADA guidelines High costhigh risk disease case management Reducing unnecessary use of Emergency Department Better utilization of prescribed medications
by using PAL Prescription Advantage list J Case management services can help you Identify patients with special needs Educate patients on disease management and self care link patients
to support services Provide feedback on patient progress J Your practice can work with us to Identify patients that will benefit from these services Make referrals to Access III of the
lower Cape Fear Have charts available for case managers to gather information Discuss specific patient needs with case managers
4eIe ASTHMA DISEASE MANAGEMENT PROGRAM WHY IS MANAGING ASTHMA IMPORTANT Approximately 15 percent of the Medicaid population has a diagnosis of asthma Asthma is the primary and secondary
reason for hospital admissions and emergency room visits for patients under age 21 Proper asthma management prevents missed school and work days allows patients to lead normal active
lives reduces hospitilizations and ED visits reduces unnecessary health complications CORE ELEMENTS OF THE ASTHMA DISEASE MANAGEMENT PROGRAM Adopting National Institute of Health NIH
guidelines http www nih gov Staging asthmatic patients Stage I II III IV Using asthma action plan in medical record at home and in school Implementing a process assuring that a system
for asthma care takes place such as recording changes on asthma action plan and providing education on use of peak flow meters and spacers Educating medical personnel regarding proper
use of anti inflammatory medications Using case managers to coordinate care educate families and assess home environments Reporting outcomes and process measures to providers and staff
regularly Gathering data to assess performance and encourage improvement PERFORMANCE AND PROCESS MEASURES Proportion of asthma patients staged Stage I II III IV Proportion of asthma
patients staged II III IV on corticosteroids Proportion of asthma patients with Asthma ManagementAction Plan Percent of asthma patients receiving Annual Influenza Vaccine EXPECTED OUTCOMES
Improved knowledge of asthma Improved self care Decreased hospitalizations Decreased emergency department visits ACCESS III OF THE LOWER CAPE FEAR
DIABETES DISEASE MANAGEMENT PROGRAM WHY IS MANAGING DIABETES IcMPORTlAT e Diabetes is the 7th leading cause of death
in NC and in the nation North Carolinians with diabetes have an 80 percent greater rate of death from stroke more than twice the rate of death from coronary heart disease and three times
the rate of death from hypertensive heart disease than those without diabetes The prevalence of diabetes in North Carolina is higher than the national average A high percentage of diabetics
have inpatient admissions and emergency department visits Proper management of diabetes can prevent unnecessary complications including blindness and amputations DIABETES DISEASE MANAGEMENT
Providers and case managers use diabetes disease management guidelines developed by I the American Diabetes Association ADA http www diabetes org PERFORMANCE AND PROCESS MEASURES FOR
AUDITS FOR PERIODIC CHART o Jr REVIEWS Diabetic Flow Sheet in the Medical Record Continued care visits at least twice a year Blood pressure at every continuing care visit Referral for
dilated eye exam every year with report of exam on file Foot exam every year Comprehensive foot exam with monofilament annually Glycosylated Hemoglobin HbAlc twice a year Annual lipid
panel Annual flu vaccine Pneumococcal vaccine given once repeat IF first dose was given at 65 yrs old AND pt is now 65 AND first dose was given 5 yrs ago e HEALTH CARE PROVIDERS CAN
HELP BY FOLLOWING THESE GUIDELINES FOR CHILDREN Ie Diabetic Flow Sheet in the Medical Record Continued care visits twice year Blood pressure at every continuing care visit Annual dilated
eye exam for pts 10 years old within 3 5 yrs after diagnosis Glycosylated Hemoglobin HbAlc twice a year Annual lipid profile after 2 years old if values are low risk and no family history
repeat every 5 years Annual screen for microalbuminuria beginning 5 years after initial diabetes diagnosis or at onset of puberty which ever comes first Annual Flu vaccine after age
6 months Pneumococcal vaccine Foot exam twice a year beginning 5 years after initial diabetes diagnosis or at onset of puberty whichever comes first ACCESS III OF THE LOWER CAPE FEAR
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4ee PHARMACY INITIATIVE WHY IS MANAGING PHARMACY IMPORTANT Pharmacy costs show the greatest increase in expenditures for Medicaid and for Access networks There are a high number of Medicaid
enrollees on 8 or more prescribed drugs The pharmacy initiative provides an opportunity to improve quality and reduce cost ABOUT THE PRESCRIPTION ADVANTAGE LIST PAL Developed by Access
II and III Clinical Directors and other physicians with the aim being cost control VOLUNTARYway for providers to reduce Medicaid drug expenditures Ranks drugs within different therapeutic
categories according to cost with Tier 3 being the least expensive and Tier 3 being the most expensive When therapeutic benefit is equal providers are encouraged to prescribe Tier 1
medications North Carolina Physicians Advisory Group has updated the current list with tentative release date being November 2003 PAL list will continue to be updated quarterly Pocket
guides and office charts will be available Visit http www epocrates com to view or download the PAL onto palm device for free ACCESS III OF THE LOWER CAPE FEAR
ee EMERGENCY DEPARTMENT UTILIZATION INITIATIVE WHY IS iMAGAINLG EMERGENCY DEPARTMENTUTILIZATION IMPORTANT ED utilization has been increasing on an average of30 or more for the past couple
of years Pharmaceutical and ED costs are increasing the most per year in the Medicaid system Many of the ED visits in the Medicaid system are for non emergent care and could be prevented
There is a tremendous opportunity for cost savings if non urgent care can be redirected to the primary care provider s office CASE MANAGERS Utilize patient database and real time ED
data to identify patients making unnecessary visits to the ED Contact the enrollee by phone and mail to remind them of the PCP s location telephone number and hours of operation Provide
recipients with education related to handling non urgent problems at home Follow up with a home visit as needed to provide more intensive education and community resource planning HEALTHCARE
PROVIDERS CAN HELP BY Providing access to medical advice and care for enrolled recipients 24 hours a day 7 days per week Providing various methods of communicating hours of operation
and medical advice to enrollees such as educating them during check incheck out having written hours of operations on all patient materials displaying hours and office number poster
size in patient waiting areas offering an after hours message that gives clear instructions on how to access medical advice Notifying Case Manager of inappropriate use ofED and report
repeat offenders Providing educational information to the recipient on handling non urgent problems at home ACCESS III OF THE LOWER CAPE FEAR
FROM Eand c Dr Oolr a Iooplry koClIlr uWIIIs hrdM iuA IIIIcIIolIeo cun 1 VIIJIoia 10 taN n llr PHONE NO 910 397 2868 Nov B4 2003 02 26PM P2 Good Shepherd Ministries of Wilmington Inc
811 M rtiD Street WilmiDgton NC 28401 Phone 9104746234 Fas 9107637394 November 3 2003 Dr David E Rice Hea11h tDoimr New Hanover Health Dept 2029 South 1iStreet Wilmington NC 28401 Dear
Dr Rice Good Shepherd Ministries is in receipt oCtile Budset Propuooal for the agreemem between Good Shephad Mlnbtriea IIIId tile New Hanover CouInf Hea11h Depa buout to slIfaamedica1
olinic lit 811 Martin S1roet for a minimum of 10 hoursIweek plusdqhutJsupplies This total budget of25 000 will be paid for wi1h JDOQjesrcce vedofmia lgIIlIt fiom the Norlh CaroIiDa Medical
FoUDdatiOll A total aWlU d 4o6f ooo was receiwd om1hc grant a ponion orthe DIODe behJa lII1Dd for oonstructIon of the clinic and the rmrWndAr foroDpegrat the cIiDic We woukllib to start
1hls program In JlIIlIIlI1Y 2004 the last siJl moD1hs ofour fiscal year 8IId voulc1 anticipate renewing this proposal for the ItIell fiscal year July 2004 Tllnc 2005 The BoeM of Directors
is aware ofthe plans for this f3d1ity however I would need their endorsemeot before we wou1d be able to sian the proposal They will adchss 1his11at 1he Deltt board meetIns on November
20 2003 Good Shepherd is eagerly awaltllli the openiDg of1his much needed olinic 8IId is thaukfid for the SllypOtt oftbc New HaDova Couuty Health Depanment ExeCutive Dlrector ne pJlIII
oIGeoll SIlepllonl MIDIsIries or IVIIIbI IDe lie 1op 1Id aD llUId soclII tile or tile 11 jGIIIID I Ity e A IIDM 1985
t0 1 Ln1 NEW HANOVER COUNTY HEALTH DEPARTMENT Animal Control Services 180 Division Drive Wilmington NC 28401 TELEPHONE 910 341 4197 FAX 910 341 4349 Right Of Refusal New Hanover County
Animal Control Services NHCACS reserves the right to refuse adoption of an animal for good cause Reasons for refusal may include but are not limited to the following prior citations
being issued to potential adoptee by NHCACS history of animal abuse or neglect prior seizure of an animal from adoptee s possession history of involvement in dog fighting or any other
offense which would negatively reflect on the potential adoptee s ability to care for the animal in the opinion ofNHCACS staff
e Iif f North Carolina Department ofHeahh and HumanServices Division of public Health Section of Epidemiology State LaboratotyofPublic Health Tel 919 7337544 Fax 9197157700 MSC 1918
PO Box 28047 Raleigh NC 27611 8047 Michael F Ea ley Governor October 28 2003 Memornndum To North Carolina Arboviral Surveillance Network Carmen Hooker Odorn Secretary From 1 Todd McPherson
Manager Virology Serology Unit Subject NC 2003 Arboviral Surveillance Data thru CDC Week Number 43 ending 10 25 03 The NC State Laboratory of Public Health in Raleigh has continued to
monitor for West Nile virus and other arboviral activity within the state throughout calendar year 2003 This year the surveillance indicators and tests employed for arboviral activity
testing at the SLPH include 1 sentinel chickens IFA serology 2 dead bird testing ie corvids raptors and cardinals WNV real time RT PCR 3 mosquito pools WNV andor EEE real time RT PCR
and culture if needed 4 equine necropsy material testing by Vero cell culture andor WNVIEEE real time RT PCR and 5 testing of human clinical specimens IFA HI andor EIA IgM serology Vero
cell culture and real time RT PCR as appropriate The following numerator data identifies specimens that have been determined to yield either presumptive evidence of recent infection
or are laboratory confirmed cases of arboviral infection In some cases the county designation has been changed to reflect more accurate follow uo data Also due to the rapidly changing
number of arboviral cases in equines particularly there may be some differences between the day to day reporting by NCDA etc and the weekly reporting via this update Cases in bold print
represent cases not previously reported I NUMERATOR DATA reoresents SLPH data olus data from other additional sources Human Arboviral Surveillance Positive for LAC bv County Totals 23
LaCrosse Positives tJ County DescriDtion bv Lab test tyoe virus Week of Onset IY Bertie SLPH 04008 3167 2618 male child seroconversion to LAC on S1 S2 41 tJtc Buncombe SLPH 13011 1465
1466 2505 male child seroconversion to LAC on SI S2 32 SLPH 08011 1083 1084 2257 male child seroconversion to LAC on S1S2 CSF 30 SLPH 04011 2619 female child JgG JgM seropositive to
LAC on SI 38 SLPH 0401l 2951 2952 female child JgG JgM seropositive to LAC on SI 40 SLPH 03011 2953 2954 male child JgG JgM seropositive to LAC on SI 40 SLPH 11 011 2678 2679 2687 male
child JgG JgM seropositive to LAC on S 1 S2 38 SLPH 10011 3127 3126 female child IgG IgM seroDositive to LAC on SI CSF 41 Caldwell SLPH 14014 2261 male child serooositive to LAC on SI
36 Columbus SLPH 05024 0868 869 male child seropositive to LAC in CSF SI 28 Durham SLPH 18032 2157 teenage male seropositive to LAC on SI 36 Graham SLPH 1l01l 1390 1391 2471 male child
seroconversion to LAC on SI S2 32 Havwood SLPH 45044 1176 1177 1402 adult female seropositive to LAC 31 SLPH 14045 1674 1675 2151 male child seroconversion to LAC on SIS2 CSF 34
Descriotion by Lab test tvoe virus SLPH 13011 1467 1468 female child IgG IgM seropositive to LAC on SI SLPH 11050 1231 655 female child seroconversion to LAC on S S2 SLPH 4050 9144 945
2642 male child seropositive to LAC on S I S2 0S8L0P6H0 501 898 female child seroconversion to LAC SLPH 09060 2 81 2182 male child seropositive to LAC SLPH 04088 2618 3167 male child
seroconversion to LAC on SI S2 SLPH 13011 2616 2617 male child IgG IgM seropositive to LAC on SI SLPH 080 1 2795 2796 female child IgG IgM seropositive to LAC on S 1 SLPH 08011 lnl 1922
male child IIG seroDositive to LAC on SI CSF continued Week of Onset 32 32 36 33 35 38 38 39 34 Human Arboviral Surveillance Positive for LAC by countv 1 Human Arboviral Surveillance
Positive for WNV by County Totals 24 WNV positives ftqfy tvi County Descriotion by Lab test tvoe virus Week ofOnset ftCJ Beaufort SLPH 13007 2109 2 0 female child seroconfirmation to
WNV on SI CSF 36 Carteret SLPH 760l6 2107 2108 adult male serooositive to WNV on S1 S2 CSF 36 Clay SLPH 55022 1806 adult female serooositive to WNV on S 31 Columbus SLPH 27024 2358 2359
29 9 adult male seroconfirmed to WNV on S1S2 CSF 36 Craven SLPH 33025 2590 2818 adult male IgG IgM seropositive on SI S2 to WNV 37 Cumberland SLPH 65026 820 1821 adult male confirmed
WNV IgG IgM on SI CSF 34 SLPH 67026 26498 2650 adult male seropositive for WNV on SI 37 SLPH 47026 2880 adult female seropositive forWNV IgG IgM on SI 35 Dare VA Lab male child PanBio
IgM and CSF PCR reactive for WNV 35 Davie SLPH 63030 1157 1158 1213 adult male IgG 12M to WNV on S1 S2 CSF 30 Durham SLPH 26032 3174 adult female IIG IIM seropositive to WNV on SI 43
Franklin SLPH 55035 2536 2252 2596 2597 adult female seroconfirmation on S1S2 CSF 37 Harnett SLPH 18043 2002 adult female seropositive for WNV on S I 34 Iredell SLPH 33049 1746 2007
adult male seroconfirmation to WNV on SI S2 33 SLPH 23049 2790 2791 seroconfirmation to WNV on S S2 37 Jackson SLPH 74050 3093 3094 adult male IIG IIM seropositive to WNV on SI 41 Lenoir
SLPH 56054 1917 956 2002 adult male confirmed positive WNV IgG IgM on CSF 35 Mecklenburl SLPH 37060 744 adult female seropositive to WNV on SI 30 SLPH 48060 2136 2137 2 83 2 84 adult
male seroconfirmed to WNV on S12 CSFs 35 SLPH 76060 2578 3066 adult female seroconfirmation to WNV on S S2 38 SLPH 53092 1596 943 adult male IgG 12M seropositive to WNV on SI S2 34 SLPH
31092 1 187 1703 adult female confirmed seroconversion to WNV Co 31 SLPH 30092 2425 2426 3040 adult male seroconfirmation to WNVon SI 2 CSF CO 38 Eastern Nc SLPH 45048 1 84 13 2 1599
adult male IgG IgM seropositive to WNV on S I 30 County Jackson Mecklenburl Transylvania Georrlia Wake Listinls in italics revresent human cases acauired out side NC other state noted
bv Human Arboviral Surveillance Positive for EEE by County County Descriotion by Lab test tvoe virus Scotland SLPH 08083 1493 f1e6m5al2e child IgG IgM seroconversion to EEE Totals 1
EEE positive rJ Week of Onset rJ 1 33 Page 2 e
fI e NC Totals 119 WNV positives Week Collected jltJJil 41 lJ fV 40 30 30 38 28 34 36 38 38 29 41 41 36 38 33 33 40 38 38 27 38 35 33 33 35 34 34 34 35 35 36 36 35 37 37 38 40 336 35
35 36 39 39 30 40 35 34 37 42 34 39 32 Equine Surveillance Positive for WNV bv Countv County Descriotion bv Eouine lab number test tvoe Alexander Alr 114 Rollins 43377 Tested at NVSL
Beaufort Agr 107 Rollins 42722Tested at NVSL Bladen Rollins 32774 EIA IgM at NVSL Rollins 33383 EIA IgM at NVSL Rollins 40813 EIA IgM at NVSL Brunswick NVSL 264176 EIA IgM vet direct
submittal Rollins 36346 EIA IgM at NVSL Rollins 38587 EIA IgM at NVSL Rollins 41330 EIA IgM at NVSL Buncombe NVSL 274847 EIA IgM vet direct submittal Clibarrus VR 2568 Griffin Lab 3130
NAAT Caldwell Alr 112 Rollins 43379 Tested at NVSL Alr 115 Rollins 43829 Tested at NVSL Caswell Rollins 39104 EIA IgM at NVSL Rollins 40957 EIA IgM at NVSL Catawba Univ ofFL 106939 via
serology vet direct submittal Univ of FL 107106 via serology vet direct submittal Chatham Agr 109 Rollins 42575 Tested at NVSL Clav Rollins 420 4 EIA IgM at NVSL Cleveland NVSL 275428
via serology vet direct submittal Columbus Rollins 30294 EIA IgM at NVSL Rollins 4 669 EIA IgM at NVSL Craven NVSL 272585 via serology vet direct submittal Cumberland Rollins 35244 EIA
IgM at NVSL Rollins 35245 EIA IgM at NVSL VR 3223 Rollins 36625 NAAT NVSL EIA IgM Rollins 35659 EIA IgM at NVSL Rollins 35660 EIA IgM at NVSL Rollins 36521 EIA IgM at NVSL VR 3221 Rollins
36573 NAAT EIA IgM at NVSL Rollins 37405 EIA IgM at NVSL Rollins 38296 EIA IgM at NVSL Rollins 38523 EIA IgM at NVSL Rollins 38883 EIA IgM at NVSL Rollins 39443 EIA IgM at NVSL NVSL
274528 EIA IgM vet direct submittal Rollins 41166 EIA IgM at NVSL Agr 0 Rollins 43124 Tested at NVSL Currituck VADA CS 18 18 EIA IgM at Ivor Lab in VA Rollins 39446 EIA IgM at NVSL Davidson
VR 3282 Rollins 36976 NAAT VR 3313 Rollins 37223 NAAT Rollins 38086 EIA IgM at NVSL Texas A M C032660200 vet direct submittal Texas A M C032670283 vet direct submittal Davie VR 2602
Rollins 31498 culture Agr 04Tested at NVSL Duplin Rollins 38746 EIA IgM at NVSL Forsvth VR 3222 Rollins 35578 NAAT positive NVSL 270645 EIA IgM vet sent direct NVSL 274250 EIA IgM vet
direct submittal Alr 117 NVSL 279050 vet direct submittal Tested at NVSL Franklin Rollins 36341 EIA IgM at NVSL Rollins 41709 EIA IgM at NVSL Gaston Rollins 35655 EIA IgM at NVSL Page
3
Equine Surveillance Positive for WNV bv Countv Continued Countv Descriotion bv Eouine lab number test tvoe Week Collected Gates VADA CS 17835 EIA IgM at Ivor Lab in VA 31 VADA CS 18723
EIA IgM at Ivor Lab in VA 33 Rollins 37201 EIA IgM at NVSL 35 Rollins 37406 EIA IgM at NVSL 35 Granville SLPH VO 829 HI serology from NCSU 28 Greene Rollins 41943 EIA IgM at NVSL 39
Agr 103 Rollins 42345 Tested at NVSL 40 Guilford Rollins 40218 EIA IgM at NVSL also EEE pos 38 Univ Missouri 20731 03 EIA 111M 40 Halifax Rollins 41768 EIA IgM at NVSL 39 Agr 105 Tested
at Ivor Lab in VA 38 Harnett Rollins 36742 EIA IgM at NVSL 35 Rollins 39586 EIA IgM at NVSL 37 Henderson NVSL 276675 EIA IgM at NVSL vet direct submittal 39 Hoke Rollins 38084 EIA IgM
at NVSL 36 Rollins 38087 EIA IgM at NVSL 36 Rollins 38295 EIA IgM at NVSL 36 Iredell NVSL 268266 EIA IgM vet direct submittal 30 Rollins 34565 EIA IgM at NVSL 32 Rollins 36132 EIA IgM
at NVSL 34 NVSL 271 96 EIA IgM vet direct submittal 35 Johnston VR 3531 Rollins 39232 NAAT 37 VR 3546 3546 Rollins 39703 NAAT 37 Jones NVSL 270704 EIA IgM vet direct submittal 34 Lenoir
Rollins 34091 EIA IgM at NVSL 32 Lincoln Univ ofFL 106941 via serology vet direct submittal 34 Rollins 37832 EIA IgM at NVSL 35 Martin Rollins 31556 EIA IgM at NVSL 29 Mitchell Agr 102
tested at Kord Animal Disease Lab in TN 40 Moore NVSL 274230 EIA IgM vet direct submittal 37 Alr 118 Rollins 44266 Tested at NVSL 42 Onslow Alr 113 NVSL 278572 sent from NCSU CVM Tested
at NVSL 41 Pasquotank Rollins 33659 EIA IgM at NVSL 31 Perouimans VADA CS 18727 EIA IgM at IvorLab in VA 33 Person Alr 116 NVSL 278880 sent from NCSU CVM Tested at NVSL 41 Randolph Rollins
37896 EIA IgM at NVSL 35 Rollins 38300 EIA IgM at NVSL 35 Rollins 39445 EIA IgM at NVSL 37 Rollins 40219 EIA IgM at NVSL 37 Rollins 41668 EIA IgM at NVSL 38 Alr 119 NVSL 279171 vet direct
submittal Tested at NVSL 42 Robeson VR 3489 Rollins 38782 NAAT positive EIA IgM at NVSL 37 Rollins 39583 EIA IgM at NVSL 37 Rollins 40996 EIA IgM at NVSL 38 Rollins 41392 EIA IgM at
NVSL 39 Agr 108 Rollins 42871 Tested at NVSL 40 Rockinlham Rollins 39028 EIA IgM at NVSL 36 Rollins 39804 EIA IgM at NVSL 37 e Page 4
Eauine Surveillance Positive for WNV bv Countv Continued 1 County DescriDtion bv Equine lab number test tvDe Week Collected Sampson Rollins 35661 EIA leM at NVSL 33 fI Rollins 36792
EIA IeM at NVSL for WNV and EEE 35 NVSL EIA leM via NCSU CVM 06774 34 Rollins 38310 EIA leM at NVSL 35 Rollins 40005 EIA IeM at NVSL 38 Rollins 418 1 EIA IgM at NVSL 37 Agr 111 Rollins
42576 Tested at NVSL 40 Stokes NVSL 273840 EIA 12M vet direct submittal 37 Rollins 39587 EIA leM at NVSL 37 Tvrell NVSL 271402 EIA leM vet direct submittal 33 Union VR 3052 Griffin 35226
culture neeative NAAT positive 33 Vance Rollins 4 578 EIA leM at NVSL 38 Wake Rollins 35474 EIA leM at NVSL 33 Warren Rollins 33876 EIA leM at NVSL 32 Wilkes Aer 106 VR 3813 Rollins
4263 NAAT positive 40 Wilson Rollins 37598 EIA IeM at NVSL 35 54 NC counties e Totals 2 WNV 1 EEE Week Collected33 35 41 Eauines Positive for WNV or EEE with Non North Carolina Residence
State Description bv Eauine lab number test tvpe Virlinia VR 3050 NCSU OOlOlculture negative and NAAT positive for WNV Vin inia VR 3394 Rollins 37768 NAAT positive for EEE Virlinia Rollins
43869 Tested at NVSL Positive for WNV Eauine Surveillance Positive for EEE bv Countv County Anson Beaufort Totals 112 Positive EEE tlt Week Collecte J 36 P 3 vr 28 lIte 29 rv 31 30 34
24 29 31 26 27 30 29 28 24 26 27 29 30 35 DescriDtion bv Equine lab number test tvDe VR 3163 Rollins 36116 culture Rollins 34289 EIA I M at NVSL Rollins 38 70 EIA I M at NVSL VR 3103
Rollins 35621 culture negative and NAAT positive Rollins 29821 EIA IgM at NVSL Rollins 32354 EIA IgM at NVSL Rollins 33384 EIA IgM at NVSL Rollins 33383 EIA IgM at NVSL Rollins 36798
EIA IgM at NVSL SLPH 827 HI serologv via NCSU NVSL 266137 EIA IeM Rollins 33476 EIA IgM at NVSL Rollins 28316 EIA IeM at NVSL EIA IgM at Texas A M Diae Lab vet direct submittal Rollins
33855 EIA IgM at NVSL Rollins 30296 EIA IeM at NVSL NVSL 265273 positive via EIA IgM vet direct submittal VR 1846 Rollins 26336 culture NAAT VR 2103 Rollins 27997 culture VR 2265 Rollins
29163 culture VR 2526 Rollins 310 0 culture Rollins 32201 EIA IgM at NVSL VR 3300 Rollins 37 67 NAAT Rollins 37005 EIA IgM at NVSL Bertie Bladen Brunswick Camden Columbus Craven Cumberland
Page 5
Equine Surveillance Positive for EEE bv Countv County Descriotion by Equine lab number test tvoe Currituck Rollins 35669 EIA IlM at NVSL Dare VR 2673 Rollins 32193 culture negative and
NAAT Dositive Davidson VR 2948 Rollins 34693 culture VR 3030 via LHD culture VR 3049 Rollins 35696 culture negative and NAAT Dositive VR 3074 Rollins 35697 culture negative and NAAT
Dositive NVSL 272973 EIA IgM at NVSL Vet direct submittal DUDlin Rollins 31319 EIA IgM at NVSL VR 2874 Rollins 33652 culture VR 3334 Rose Hill 4789 Rollins 375403 NAAT Edlecombe VR 3243
Rollins 36638 NAAT Franklin VR 2525 Rollins 30941 culture VR 3063 Rollins 35293 culture VR 3547 Rollins 39704 NAAT VR 3504 Rollins 38918 NAAT Gaston VR 2441 Griffin Lab 30272 culture
Gates RT PCR at Ivor Animal Lab in VA VR 2684 Rollins 32320 culture Rollins 34282 EIA IgM at NVSL Granville VR 2420 NCSU CVM 00038 culture VR 3204 Rollins 36510 NAAT Green Rollins 35475
EIA Igm at NVSL Guilford Rollins 40218 EIA IlM at NVSL also WNV DOS Harnett VR 2498 Rollins 30839 culture VR 2614 Rollins 31683 culture Rollins 34132 EIA IgM at NVSL VR 3075 Rollins
35410 culture VR 3244 Rollins 36739 NAAT VR 3342 Rollins 37570 NAAT Rollins 39585 EIA IgM at NVSL Rollins 40694 EIA IgM at NVSL Henderson VR 2731 Western Diag Lab 32454 culture Hertford
Rollins 32588 EIA IgM at NVSL Hoke VR 2502 Rollins 30920 culture Rollins 30643 EIA IgM at NVSL Johnston VR 2842 Rollins 33300 culture VR 2934 Rollins 34237 culture Rollins 33853 EIA
IgM at NVSL VR 3561 Rollins 39850 NAAT Jones VR 2458 Rollins 30384 culture Rollins 31549 EIA IgM at NVSL NVSL 269278 EIA IgM vet direct submittal Lee VR 2998 Rollins 34778 culture Rollins
36800 EIA IgM at NVSL Lenoir Rollins 34869 EIA IgM at NVSL Rollins 35677 EIA IgM at NVSL Nash Rollins 36525 EIA IgM at NVSL New Hanover VR 2023 Rose Hill 27637 culture NortbamDton Rollins
33159 EIA IgM at NVSL Onslow VR 1924 Rollins 26687 culture NAAT VR 1987 Rollins 27283 culture NAAT NVSL 267892 EIA IgM vet direct submittal Page 6 Continued Week Collected 33 30 33 33
33 33 36 29 32 35 35 29 33 37 38 29 28 30 32 29 35 33 38 29 30 32 34 35 35 38 37 30 30 29 29 31 32 32 38 29 30 32 33 34 33 33 34 26 32 25 25 31 e
e Eauine Surveillance Positive for EEE bv County Countv Descriotion bv Equine lab number test tvoe Oranle Rollins 35909 EIA IgM at NVSL Pender VR 1936 NCSU 1320 culture NAAT VR 2409
Rose Hill 30092 culture VR 2627 RoseHill R4o0l3lin8s 31909 culture Randolph Rollins 34214 EIA IgM at NVSL Richmond NVSL 269182 EIA IgM vet direct submittal NVSL 276858 EIA IgM at NVSL
vet direct submittal Robeson VR 2195 Rollins 2843 culture Rollins 27906 EIA IgM at NVSL Rollins 30536 EIA IgM at NVSL Rollins 30537 EIA IgM at NVSL VR 2527 NCSU 00056 culture negative
and NAAT positive VR 2672 Rollins 32 5 culture NVSL EIA IgM Rollins 31552 EIA IgM at NVSL Rollins 30789 EIA IgM at NVSL Rollins 33045 EIA IgM at NVSL VR 2782 Rollins 331 5 culture negative
and NAAT positive Rollins 37901 EIA IgM at NVSL NVSL 266175 EIA IgM vet direct submittal Rollins 31813 EIA IgM at NVSL Rollins 318 4 EIA IgM at NVSL VR 2746 Rollins 32708 culture VR
3013 Rose Hill 4446 culture Rollins 36792 EIA IgM at NVSL for WNV and EEE Rollins 31878 EIA IgM at NVSL Rollins 370 9 EIA IgM at NVSL VR 3463 Rollins 38475 NAAT VR 2875 Rollins 33635
culture VR 2877 Rollins 33662 culture negative and NAAT positive Texas A M Laboratory vet direct submittal VR 3193 Rollins 36500 culture VR 2876 Rollins 33642 culture negative decomoosed
but NAAT positive VR 3440 Rollins 38418 NAAT VR 2325 NCSU 00025 culture VR 3252 Rollins Rose Hill 36979 NAAT VR 33 4 Rollins 37289 NAAT Rollins 38085 EIA IgM at NVSL VR 2291 Rollins
29167 culture Continued Week Collected 34 25 28 30 32 32 39 27 26 28 29 29 30 30 29 31 31 35 28 30 30 31 33 35 29 35 37 32 32 32 34 32 36 28 35 35 36 28 Sampson Scotland Stanlev Union
Wake Wavne Yadkin 44 counties Dead Bird Surveillance Positive for WNV bv Countv Totals 135 positive for WNV Coun Descri tion PHPM ID Number Week First Positive Alamance 1 crow 206 29
Alexander I crow 336 33 Allelhanv I crow 335 33 VV Anson I crow 409 37 Ashe 1 crow 105 216 Bladen 2 blue iavs 194 252 2 crows 201 235 I cardinal 210 g b Brunswick I crow 191 Buncomhe
2 crows 138 170 27 Page 7
Dead Bird Surveillance Positive for WNV bv Countv Continued County Description PHPM ID Number Week First Positive Burke I crow 151 28 Cabarrus 2 crows 323 325 33 Caldwell I blue iav
212 30 Camden I crow 200 29 Carteret I crow 125 28 Catawha I blue iav 213 I crow 257 29 Cherokee I crow 316 32 Chowan I crow 242 31 Cleveland 3 crows SLPH 361 362 372 33 Columbus I crow
345 34 Craven 6 blue iavs 198 241 266 238 265 311 I cardinal 240 I crow 263 29 Cumberland I crow 205 3 blue iavs 204 293 294 29 Currituck I crow 148 28 Dare I blue iav 214 I crow 268
30 Davidson I crow 363 34 Davie I cardinal 347 34 Duolin I crow 338 33 Durham I crow 115 26 Forsvth 3 crow 231 233 230 I blue iav 232 29 Gaston I crow 039 24 Gates lcrow 159 28 Guilford
I blue iav 028 23 Harnett 2 blue iavs 357 358 and I crow 354 34 Henderson 2 crow 208 264 29 Hertford I crow 379 35 Hoke I blue iav 403 37 Iredell I blueiav 274 2 crows 273 308 I cardinal
317 I hawk 275 31 Jones 2 crows 331 374 33 Lincoln I crow 270 31 Macon I crow 015 22 Madison I hawk 306 and I crow 334 32 McDowell 2 crows 366 390 35 Mecklenburl 10 crows 8 blue iavs
tested at USGS Lab 26 Moore 2 crows 334 359 1 Great Homed Owl via NVSL 33 Nash 2 crows 410 446 38 New Hanover I blue iav 245 31 Northamoton I blue iav 302 32 Onslow I blue iav 182 29
Oranle I crow 405 36 Pamlico I blue iav 352 34 Pasauotank I crow 237 I blue iav 224 30 Pender 2 crow 329 333 33 Perauimans I crow 269 31 Person I crow 380 35 Polk I crow 099 26 Randoloh
I CooDer s Hawk seroDositive at NVSL 33 Richmond I crow 227 31 Robeson I blue iav 243 30 Rockinlham I blue iav 188 I crow 267 29 Rowan I crow 400 37 Rutherford 2 crow 260 223 31 Samoson
2 crows 158 211 28 Stanlev I crow 431 38 Stokes I crow 328 33 Page 8
It e DescriDtion PHPM ID Number 2 crows 425 423 Dlus I blue iav 424 I crow 429 I crow 397 I blue iav 396 I crow 435 I blue iay 434 I cardinal 433 3 crows 220 297 341 Dlus I blue iay
310 I crow 404 I crow 377 I crow 303 2 crows 373 408 I blue iay 391 Continued Week First Positive 34 38 36 38 30 37 35 33 35 35 Dead Bird Surveillance Positive for WNV bv Countv Countv
Surrv Swain Transvlvania Union Wake Warren Washinlton Wataula Wilkes Wilson 72 counties I Mosquito Surveillance of NAAT Positive SDecies bv Countv Totals I WNV and 9 EEE positives Week
Collected 30 33 30 27 27 26 28 28 28 31 wt1 Countv Columbus Henderson Jones Mecklenburl New Hanover Pender Robeson Pool Number SDecies Virus DescriDtion 118 Cs melanura EEE 0005 Cx restuans
WNV 34 Cx erraticus EEE NC070 Culex DiDiens comDlex WNV tested at SC State Lab 9 Cx salinarius EEE 17 Cs melanura EEE 20 Cs melanura EEE 16 Ae yexans EEE 20 Cs melanura EEE 21 Cs melanura
EEE 59 Cs melanura EEE 7 counties Other Veterinarv Surveillance Positive for EEE by County Countv DescriDtion bv SDecimen lab number test tvDe Craven Emu VC 3106 3111 Rollins 32475 culture
Craven Llama VR 3298 Rollins 37177 NAAT Jones Emu VC 3381 3382 yia Rollins 35196 culture 2 counties Totals 3 positive for EEE Week Collected31 35 33 Countv Beaufort Sentinel Chicken
Seroconversion Surveillance by County Totals 2 WNV 34 EEE 15 HJ positives Chicken Number Virus DescriDtion 796 EEE 798 EEE 799 EEE 800 EEE Cross Reactions 12 EEE Hn Week Collected41
41 41 41 Page 9
Sentinel Chicken Seroconversion Surveillance by County County Chicken Number Virus Descril1tion Bladen 766 EEE 767 EEE 768 EEE HJ 769 EEE 770 EEE 772 EEE 774 HJ 775 EEE Brunswick 957
WNV Carteret 826 HJ 827 EEE HJ 828 EEE 829 HJ EEE 830 HJ 698 EEE 841 n WNV 762 EEE 811 HJ 812 HJ 813 EEE 814 EEE 815 EEE HJ 816 EEE HJ 817 HJ EEE 818 HJ 819 HJ 820 HJ 821 EEE 825 EEE
HJ 792 EEE 793 EEE 794 EEE 791 HJ 795 EEE 879 EEE 717 EEE HJ 723 EEE 861 EEE New Hanover 751 HJ 752 HJ EEE 754 HJ 755 HJ 696 HJ 697 EEE HJ 806 EEE HJ 807 EEE 808 EEE 809 EEE HT 810 EEE
858 EEE 860 HJ 721 EEE 722 EEE Continued Week Collected27 27 Ail 29 29 29 31 37 39 01 37 29 33 31 37 33 43 29 36 30 28 28 40 28 30 30 34 34 30 34 27 29 27 31 31 35 28 34 IjL 36 VI 36
tPi 36 36 V rJItV 37 31 27 29 41 29 28 30 34 34 Columbus Craven Currituck Jones Pamlico Pender Page 10
e Sentinel Chicken Seroconversion Surveillance bv Countv Countv Chicken Number Virus Descrivtion PerQuimans 783 EEE 781 EEE 782 EEE 784 EEE 785 EEE Wavne 833 HJ 12 counties Continued
Week Collected31 33 33 33 41 33 11 DENOMINATOR DATA testinl at the SLPH onlv Human Surveillance Serology Specimens 1981 66 2047 Culture Specimens 133 CSF s on 133 patients Veterinary
Surveillance Serology Specimens 4 on 4 individuals Culture andor NAAT Specimens Total 467 on 161 individuals Equine 422 on 146 individuals Bovine 3 on 1 individual Sheep 4 on 2 individuals
Goat 6 on 2 individuals Llama 12 on 4 individuals Alpaca 2 on 1 individual Emu 10 on 2 individuals Dog 2 on 1 individual
Deer 3 on 1 individual Bear 3 on 1 individual Dead Bird Surveillance Number of birds tested 389 Birds are tested for WNV via real time RT PCR discontinued testing 9 30 03 Sentinel Chicken
Surveillance specimens tested 731 20 flocks of 5 birds per flock and each is tested for a minimum of 4 arboviruses every two weeks via IFA Mosquito Pools Tested 1286 tested Most of these
mosquito pools were tested for both EEE and WNV using real time RT PCR Filename NeArboviral Report thru Week 43 Page 11
II SANITATION TIPS FOR FOOD WORKERS FAU 2003 Also in this issue What to do with leftovers Page 2 Safe food to go Page 2 Training and certification r Page 3 ServSafe manager training
now online Page 3 Test yourself on food safetyPage 4 During the blackout I just hope the chef could see the expiration dates Copyright 2003 Pike Fischer Ine 1 800 255 8131 Power Blackout
Unked to Foodborne Illness Although the food industry reported only minor losses from the power blackout that hit the mid west and north east of the United States and parts of Canada
in August some areas reported an increase in foodborne illness after the outage The New York City Health Department issued an advisory Augustl saying that its surveillance system had
detectlOd a higher than usual number of visits for diarrheal illness at emergency rooms in the city The citys Health Commissioner Thomas Frieden said the spike in illness was possibly
caused by spoiled food What You Can Do The New York City Health Department issued the folllowing advice advice to restaurants and other food establishments during the blackout o Perishable
refrigerated foods that have been without refrigeration and at more than 40 degrees Fahrenheit for more than two hours should be discarded Refriger ated foods that should be discarded
include meat red meat chicken seafood hot dogs bacon pizza open canned meats soft cheeses milk yogurt eggs or egg dishes fresh cut fruits open mayonaisse Worcestershire sauce creamy
salad dressings opened tomato sauces biscuits rolls cookie dough cooked pasta pasta salads cheesecake cream filled pastries cooked vegetables baked potatoes and potato salad o Any perishable
food that has thawed for more than two hours and is above 40 degrees F whether from the refrigerator or the freezer should be discarded o Food items that can be kept for a limited time
without refrigeration include hard processed cheese such as cheddar Swiss parmesan provolone Romano butter margarine opened fruit juices opened canned fruits peanut butter jellies and
mus tards opened vinegar based dressings breads rolls cakes muffins breads waffles pancakes bagels pies fruit herbs spices and raw vegetables o Any food item discarded should be disposed
of in double bagged plastic gar bage bags and should be well tied and or in sealed plastic containers or sealed for example zipper locked plastic bags The advice about doublebagging
seemed an extreme measure to some food safety experts Ed o After the power returned it was okay to refreeze frozen foods that still con tained ice crystals and felt cold These include
beef veal poultry and ground meats fish shellfish seafood products egg products soft and hard cheese casseroles juices fruits vegetables cakes pies pastries flours cornmeal and frozen
meals o As a general rule a well functioning freezer that was unopened and at least half full will have kept foods cold for about 24 hours o Do not taste things to see if theyre bad
o Use common sense and evaluate each item separately o If in doubt throw it out
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FOOD TALK FAU 2003 Test Yourself on Food Safety J 1 The number one factor leading to foodborne illness 5 Which of the following is not considered a potentially in food establishments
is hazardous food group a improper cooling of foods a Red meats b cross contamination b Fish and shellfish c poor personal hygiene c Poultry and eggs d inadequate cooking of foods d
Dried grains and spices 2 Food handler exposure to which of the following illnesses must be reported to the manager a Hepatitis A b E coli 0157 H7 c Shigella d all of the above 3 Bacteria
grow within a temperature range called the danger zone which is between a 00 and 2200F b 00 and 1400F c 410 and 1400F d 410 and 2200F 4 Which of the following bacteria produce a toxin
that is most likely to cause death if consumed a Campylobader jejuni b Clostridium botulinum c E coli 0157 H7 d Listeria monocytogenes Source Essentials of Food Safety Sanitation Prentice
Hall 6 Foodborne illness can be caused by a poor personal hygiene b cross contamination c temperature abuse d all orthe aoove 7 The most effective way to control the growth of bacteria
in a food establishment is by controlling a time and temperature b pH and oxygen conditions c temperature and water activity d time and food availability 8 Bacteria are the most common
cause of foodborm disease in a food establishment because a under ideal conditions they grow very rapidly b bacteria are found naturally in many foods c bacteria can be easily transferred
from one source to another d all of the above P Il e L p 9 p s q 17 J p l e L SfJilMSU JjWUjlp JdO qllPJH 1J0Pl O qllPJH J P PO vlooo IOt8Z IN NOI9NIWlIM ums HlL I HInOS 6Z0Z NOISIAIO
HI1 3H 1 IN3WNOHIAN3 IN3WIHltd30 HImH AlNnOl UAON H M3N
National Association ofLocal Boards ofHealth I United We lSnti f PublishedJor Members ojLocal Boards oJHealth August 2003 President s Message Connie Tatton President I want to thank
all those who took the time and effort to attend present or display at our annual conference in Baltimore in July I wish all of you could have been there It was an outstanding conference
We began with a harbor dinner cruise which was relaxing and provided a great opportunity to enjoy each others company Our opening keynote speaker was Hugh Tilson MD DrPH currently of
the UNC School of Public Health An excellent speaker he gave a dynamic presentation of the new Institute of Medicine Report The Future of Public Health in the 21 Century which should
be currently available When he gave his presentation it wasn t off the press yet so we were privileged to receive a great preview Peter Beilenson MD MPH Commissioner of Health for Baltimore
City Health Department gave a report of the challenges facing his department Aside from his regular demanding duties he has been a player with other area stakeholders in formulating
a health insurance plan for the under insured and he describe what role his department has played in this endeavor We were also extremely happy to have Ed Thompson MD MPH Deputy Director
for Public Health Services CDC give a presentation on Infectious Diseases past and present how we dealt with diseases a hundred years ago what we have learned and how we deal with new
diseases today Rounding out our plenary keynote speakers was Jerome Hauer MPH Acting Assistant Secretary for the Office of Public Health Emergency Preparedness Department of Health and
Human Services Continued on Page 2 Wasatch County UT Health Department Sponsors Wasatch High School Traffic Safety Program Submitted by Jonelle Fitzgerald 85 CHES Wasatch County Health
Department If you were walking down the hallway at Wasatch High School 850 students this past April you would have seen students dressed in black with faces painted representing the
23 of all fatal fatal crashes that are related to alcohol in Utah You would have heard sirens and a medical helicopter flying into the High School football field supposing there had
been a major disaster Upon arriving on the scene you could find a Mock DUI Crash Crashed cars were placed on the football field High School students were released from classes to go
out to the field The Wasatch County Sheriffs Department provided a dispatcher who dispatched a crash and law enforcement EMS and fire department responded and worked as if the crash
were real We were fortunate to have the Air Med helicopter from the University of Utah Hospital come to pick up one of the crash victims Heber City Police completed sobriety tests on
the drunk driver then handcuffed him and hauled him to jail Continued on Page 2
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