04/02/2008
New Hanover County Health Department
Revenue and Expenditure Summaries for February FY 2007-2008
Cumulative: 66.67% Month 8 of 12
Revenues
Current Year Prior Year
Type of Budgeted Revenue Balance % Budgeted Revenue Balance %
Revenue Amount Earned Remaining Amount Earned Remaining
Federal 8 State $ 1,986,215 $ 1,509,513 $ 476,702 76.00% $ 1,948,525 $ 1,522,068 $ 426,457 78.11%
AC Fees $ 642,661 $ 460,865 $ 181,796 71.71% $ 611,161 $ 443,090 $ 168,071 72.50%
Medicaid $ 1,569,058 $ 657,477 $ 911,581 41.90% $ 1,580,867 $ 704,704 $ 876,163 44.58%
Medicaid Max $ 309,128 $ - $ 309,128 0.00% $ 310,000 $ - $ 310,000 0.00%
EH Fees $ 310,000 $ 142,849 $ 167,151 46.08% $ 310,000 $ 123,100 $ 186,900 39.71%
Health Fees $ 359,700 $ 327,413 $ 32,287 91.02% $ 334,200 $ 289,354 $ 44,846 86.58%
Health Choice $ 35,125 $ 19,124 $ 16,001 54.45% $ 35,125 $ 10,913 $ 24,212 31.07
Other $ 3,762,812 $ 2,315,130 $ 1,447,682, 61.53% $ 2,625,988 $ 1,750,816 $ 875,172 66.67%
Totals is 8,974,699 $ 5,432,370 $ 3,542,329 60.53% $ 7,755,866 $ 4,844,046 $ 2,911,820 62.46%
Expenditures
Current Year Prior Year
Type of Budgeted Expended Balance % Budgeted Expended Balance %
Expenditure Amount Amount Remaining Amount Amount Remaining
Salary & Fringe $ 13,222,225 $ 7,702,279 $ 5,519,946 58.25% $ 12,114,229 $ 6,909,242 $ 5,204,987 57.03%
Operating $ 2,456,262 $ 1,240,615 $ 1,215,647 50.51% $ 2,268,968 $ 986,002 $ 1,282,966 43.46%
Capital Outlay $ 65,364 $ 11,505 $ 53,859 17.60% $ 96,485 $ 53,611 $ 42,874 55.56%
Totals $ 15,743,851 $ 8,954,399 $ 6,789,451 56.88%0$ 14,479,682 $ 7,948,855 $ 6,530,827 54.90%
Summary
Budgeted Actual %
FY 07-08 FY 07-08
Expenditures:
Salaries 8 Fringe $ 13,222,225 $ 7,702,279
Operating $ 2,456,262 $ 1,240,615
Capital Outlay $ 65,364 $ 11,505
Total Expenditures $ 15,743,851 $ 8,954,399 56.88%
Revenue: $ 8,974,699 $ 5,432,370 60.53%
Net County $ 6,769,152 $ 3,522,029 52.03%
Revenue and Expenditure Summary
For the Month of February 2008
7
NHCHU BOARD OF HEALTH APPROVED GRANT APPLICATION STATUS FY 07-08 and FY 06-07
Uate BOH Grant Re uestad P-"din Received Denied
3/5/2008 (Letter o nta nt nly= ape Fear em oria
Foundation -Men's Prava ntive Health - 3
V-.-, $232,000
21612008 Community Waste Reduction S Recycling
to secure low cost Community Animal
Neut.rin $25,000 $25,000
1/2/2008 Smart Start -New Hanover ounty _..f) .y
Partnership for Children - Ch11d Cara
(0 6
Nursin Pro ram $196,500 $-196.600
Maternity Care Coordination - North
Carolina yep-tment of Health and Human
Services funds to provide Maternity Care
Coordination services to non-Medicaid eligible
clients $17,580 $17,580
12/512007 HIV/STS Prevention Outreach - North
Carolina HIV/STO Prevention and Cara
Branch - total of multi-year funding thru May,
2010 $175,000 $175,000
Family Counseling Services - Cap- F-ar
Memorial Foundatiof~n continuation funding For D 17B Q
1 ear of a oss iblY 3 ears) $53,000 $53,000
1117/2007
Living Wall - Additional funds add-d to
original grant to complete wint-r edition of
newsletter -Cape Fear Memorial Foundation $6SO $6SO
Asthma Program - North Carolina IJapt. of
Health and Human Services Division of Public
Y Health Asthma Pr.:,
o ram $18,000 $15,000 $3,000
10/3/2007 H--thy Carolinians - R-quest for funds from
the North Carolina Division of Public Health,
Office of Healthy Carolinians, for support of
the local task force. $-12.0-48 $12,048
ACHIEVE Grant - Cent-ra for Oisaas-
Control/YMCA - Workplace W-ilness
Services $40,000 $40,000
915/2007 No A\.tivi for September 2007
8/112007 No Activi for Au ust 2007
711112007 WIC Mini-grant -Request to ratify application
for mini-grant funds for minor renovations to
the WIC registration workstations to improv-
customer service. $18,000 $18,000
6/6/2007 Landfall Foundation - RGqu-st for funds to
purchase 16 wheelchairs for the NHCHO
School Health Nursin Pro ram. $2,700 $2,700
5/212007 Living Wall_ Received notification from Cap-
Fear Memorial Foundation of continuation
funding for the publication of the Living Well
4 newspaper insert. $O $12,000
30
As o1 3/1 H/2006
NHCH~ BOARD OF HEALTH APPROVED GRANT APPLICATION STATUS FY 07-08 and FY 06-07
E3ate (BOH Grant Re nested Pendin Received Uaniad
4/4/2007 Ministering Carole (Colposcopy funding) -
Raquast for $12,000 start-up funds from
Ministering Circle for purchase of Colposcopy
equipment- Al- plan to request additional `r
funds from other grant sources such as Cape
Fear Memorial Foundation for expansion of
program to include a second Colposcopy unit
and additional training, supplies and contract
services.
$'12,000 $12,000
Cape Fear Memorial Foundation -
Colpo.copy program - Woman. Preventative
Health.$25,000 for start up cost for physician
and interpratar contracted services, -
aquipment, supplies, and training. $25,000 $25,000
3/712007 Closing -re Gap - Request for $225,000
($75,000 per year for 3 years) from North
Carolina Office of Minority Health and Health
I7i.paritias for a Health Educator to focus on
prevention of HIV and other sexually
transmittal disease in the Latino and Afro-
American population- $225,000 $225,000
21712007 CA -MRSA= Funding from UNC-Chapel Hill
School of Medicine to assist with research
related to the prevalence of community
associated mathicillin resistant staphylococus
auraus $12,600 $12,600
11312007 Smart Start - New Hanover County
Partnership for Children - Child Care
Nursin Pro ram $178,500 $170,000 $8,500
1216/2006 E3uka Endowment Funds, NHRMC - Dental
Unit - Personal Health Services. $25,000 for
indigent dental ca ra and $15,000 for sedation
equipment $40,000 $20,000 $20,000
11/112006 No Activi for November 2006
10/4/2006
Marorl of mimes - Maternity Care
Coordination expenditures for Baby Love
Program Baby Boutique and Learning Center $3,000 $3,000
9/6/2006 No Activi for Se tem ber 2006
8/212006 No Activi for Au ust 2006
715/2006 I erv oe oor Inatlon '.-fly
Counseling Program (Cape Fear Memorial
Foundation) - Funding for Licensed Clinical
Social Worker for 3 ears $260,000 $75,000 $185,000
at Smart Move ore - Commun ty rant
(NC Uept of Public Health Physical Activlty
and Nutrition Branch $16,495 $12,416 $4,079
Totals $1,331,073 $292,080 $562,71-4 $488 279
21 .94 1 4228-1. 36.68%
Re!-ding;rants 4 19%
Funded Total Re uest 9 43
Pa rtiall Funded 5 24
Daniel Total Re nest 3 14%
Numbers of Grants A lietl For 21 100
3 1
AS of 3H 8/2O0H
NEW HANOVER COUNTY BOARD OF COMMISSIONERS
r Request for Board Action
Agenda: Consent Meeting Date:
Agenda: ® BOH Mtg. 04/02/08
CC Mtg. 4/21/08
Department: Health Presenter: Jean P. McNeil,
Animal Control Services Manager
Contact: Jean P. McNeil 798-7505
Subject: Animal Control Services Onsite Spay/Neuter Facility - "Thank You"
Presentation
Brief Summary:
In June 2002, the Board of Health approved construction of an on-site spay/neuter facility
and adoption play area as an addition to the existing Animal Control Services structure at
180 Division Drive. On August 19, 2002, the County Commissioners also approved this
project, which was erected by June 2004.
The first surgery completed was performed by Dr. G. Robert Weedon, current
veterinarian on the Board of Health. Since that date, over 2500 animals have been
surgically altered at the clinic, which continues to have a direct impact in reducing pet
W overpopulation in our area.
On behalf of the citizens of New Hanover County, the Board of Health, the entire Health
Department, and the Animal Control Services staff, please accept our heartfelt thanks and
appreciation for allowing us this opportunity to save so many lives of companion animals
in our community. We extend to you this small token of gratitude for all that you have
made possible for us.
Recommended Motion and Requested Actions: N/A
Fundin Source: N/A
Will above action result in:
ONew Position Number of Position(s)
?Position(s) Modification or change
®No Change in Position(s)
Ex lanation: N/A
Attachments: Framed collage to be resented at time of meeting.
32
NEW HANOVER COUNTY BOARD OF COMMISSIONERS
y~ R¢quest for Board Actioa
Agenda- Consent Meeting Date:
Agenda: ® BOH: 4/2/08
CC : 4/21/08
Department: Health Presenter: Janet McCumbee, Personal
Health Services Mana er
Contact: Janet McCumbec 798-6559
Subject: Grant A lication - Wei ht-Wise Pro ram- $24,755 over 3 ears
Brief Summary: The Center For Health Promotion and Disease Prevention at the
University of North Carolina - Chapel Hill is soliciting applications from local health
departments to implement a weight loss program with low income women between ages
40 and 64- This program, called Weight-Wise has successfully been piloted across North .
Carolina, and tbey would like to replicate it in health departments over the next 3 years.
Our main target population would be overweigbt female health department clients who
qualify by income and age. Funds will be awarded over a three year period: $3,250 for
study related expenses (year one - $1,600, year two - $1,395, year three - $255), and
$21,505 for salary support (year one - $3,512, year two - $15,796, year three - $2,197)-
The three year award will total $24,755. Salary can be used £or the staff identified as tl-ie
interventionist and assistant- The grant will require at least 8 hours per week of staff time-
Recommended Motion and Requested Actions: To approve the UNC-CH Weight-Wise
Program Grant Application for $24,755 (over 3 years; to implement a weight loss
program for low income women between ages 40 and 64 and any budget amendment that
would result from acceptance of the funds, if awarded and to submit to the New Hanover
Count Commissioners for their consideration.
Fundiri Source: UNC Center of Health Promotion and Disease Prevention
Will above action result in:
®New Position Number of Position(s) - 1
~Position(s~ Modification or change
QNo Change in Position(s)
Explanation: Use salary funds to hire temporary part time qualified staff to implement
the program. QualiFed staff, per grant can be a nurse, health educator, or dietician- May
be able to use current staff temporary and part time- No matching county funds needed-
An new Position created would end when rant funds are exbausted-
Attachments: Letter from iJNC; Descri ti- of ro rarm
ADMOO1 NHCBOH Request for Board Action
1 1 /07
33
i
- Ill uNC
I CENTER FOA HEALTH rH BHVNxv ~.as:rv
` P AOM OTION AND aj N R"tH cwazo LaNA
DZSEASE PAE VENTION ax c AFEL HILL
March 18, 2008 i']oo MARTIN LC1TH£R KING JR. 13LV D. T 9ag.966.6080
CA MPLSS BOX ')qm6 F 9~9966.6m 64
CHAPEL H1LL_ NC m9599-Ogm6 www.Fapd(,. u,a c.edv
Dear Director of Nursing,
The Center for Health Promotion and Disease Prevention at LJNC-Chapel Hill has been funded by the
Centers for Disease Control and Prevention to conduct a 3-year study that seeks to translate the
success of one research-tested weight loss program into many successful programs across the state-
The North Carolina WISEWOMAN Weight Control Pilot Program (known as the Weight-Wise
Program) was evaluated at the New Hanover Community Health Center in Wilmington, NC,
and resulted in meaningful weight loss (of about 9 lbs_) that was associated with improved blood
pressure and cholesterol values among low-income, midli£a women. Given the success of this
program, we now want to see if it can be implemented in "real-world" settings (i_e_, in health
departments, using existing staff and resources). To do so, we will test the intervention at six
health departments, and we hope that your health department will consider participating in this
project_
We are currently recruiting county health departments within 200 miles of U7V4'_ to apply for
participation in the project_ In May 2008, we will randomly select six health departments from the
applicants to implement the project_ Enclosed is a brochure that provides an overview of the project-
We have sent your Health Director the complete application packet, and wa request that you (or other
appropriate staff) work with your Health Director to complete the brief application_ The application
Yom, packet includes the following four documents:
1 _ An informational packet, which provides an overview of the program, eligibility
requirements, and compensati-ilbenefits For health departments and study participants
2_ Health Department Contact Information Form
3_ Health Department Application Form (which includes selecting an Interventionist and
Assistant)
4_ Memorandum of Agreement (MOA)
If your health department is eligible and interested in applying, please fill out and return the
Health Department Contact Inforxrlation Form, Health Department Application Form, and the
MOA to our office by April 15, 2008- Even if you do not wish to Darticxz-te -Z/or your health
department zs not eZZ~2zble (see informational packet for eIigiZ iZzty eauzremersts) we ask that you MI
out and return the Health Dena tment Applzcatzon Form to our office- (A stamped, self-addressed
envelope is included)
Again, we thank you for your interest in this exciting project_ If you have any questions, please
contact Ms_ Beverly Garcia, Project Director, at 919-966-6088 or Dr_ John Graham, Research Co-
Investigator, at 919-966-8450. We look forward to receiving your response!
Sincerely,
`x.. Carmen Samuel-Hodge, PhD, MPH, I2D
Principal Investigator
Center for Health Promotion and Disease Prevention
University of North Carolina at Chapel Hill 34
Weight-Wise Program Summary A 1~
Purpose
To help low-income, midlifa women lose weight safely and keep it off by improving their eating and
physical activity habits-
To learn how to implement successful weight loss programs, using existing staff and resources in
county health departments in North Carolina-
Background
From 2005-07, UNC researchers tested a 16-week behavioral weight loss program called "Weight-
Wise" for low-income, midlifo women, based in a community health center setting to Wilmington, NC_
Weight-Wise was adapted from two very effective interventions--the Diabetes Prevention Program
and PREMIER Program--to fit the needs of lower income, midlife women participating in the
WISEWOMAN Program- - - - -
The Weight-Wise program was successfulI Participants lost on average S_4 Ibs,. lowered their systolic
and diastolic blood pressure by 7.5 mmHg and 5 mmHg, respectively, and increased their HDL-
cholesterol by 1.1 mg/d L_ Half of the participants were also successful at keeping off at least 10 tbs.
after a 1-year maintenance program. -
The UNC Center for Health Promotion and -Disease Prevention has been awarded a grant from the
Centers for Disease Control and Prevention (CDC) to assess if the Weight-Wise program can be
Overview of Weight-W isa
- Six health departments that meet the eligibility criteria (see Program Details) will be randomly
selected to participate in the Weight-Wise program. Health departments must be within a 200-mile
radius of Chapel Hill, NC.
- The Weight-Wise. intervention is a 16-week, group-based weight loss program that focuses on
changing lifestyle behaviors to promote weight loss- Weight-Wise builds on theories of behavior
change that emphasize setting achievable goals, building self-efficacy or confidence, and providing
opportunities for problem-solving and group social support- Each group session focuses more on
changing behaviors than on providing information or advice to participants.
In each health department, 40 low-income, overweight women ages 40-64 years will be enrolled in
the program- Twenty women will be randomly selected to participate in the program first
(intervention group), while the other 20 women (control group) will wait to begin the program- When
the first group of women finishes the program, the second group of women (control group) will
participate in a shorter version of the weight loss program-
, Wo will collect some personal and health information from all study participants at enrollment and at
specified follow-up intervals (see Program Details for more information).
3 5
Program l3etails (see study flow diagram)
Health Department 1--vo 7
Health Oapartments are eligible to apply if they are within about 200 miles of Chapel Hill and have:
• existing services or programs for women aged 40-64 years
• a patient population with enough low-income and English-speaking women to enroll 40
participants
• at least 1 staff person (or 1 FTE) who is a registered dietitian (RD), a health educator (CHES
credential or MPH degree), or a registered nurse (RN) assigned to patient education roles
• meeting space on-site or access to space off-site that could accommodate a group size of 20
The health director and/or other designated staff will be expected to work with the UNC research
team to:
• Identify a registered dietitian, masters-trained or certified health educator, registered nurse -
assigned to patient education roles, or other qualified staff arson to work as the
interventionist for the program 1 be needed throughout
the study's duration, including t ragnIng sessions)
• Identify an assistant to work with the interventionist - -
• Enroll 40 low-income, overweight women ages 40-64 years into the study
• Provide a suitable space for weekly group sessions and other visits to the health department
by program participants
Complete short surveys and/or interviews about the health department characteristics,
resources, partnerships, and experience with weight loss program delivery
If the health department decides to participate in the Weight-Wise program, the Health Director
will sign a Memorandum of Agreement (see attached)-
Interventionist S. Assistant
Research funds allow UNC to provide each health department with some salary support for one
interventionist and one assistant- The interventionist and assistant will be expected to:
• consent to be in a research study
• participate in all Weight-Wise training activities, which include four 5-hour sessions over four
weeks at a location convenient to the 6 sites, plus 4-6 hours of on-line instruction, and 2 hours/
week of homework for 4 weeks (in total, 32-34 hours of training)
• work with the research team to coordinate study activities, including participant recruitment
and data collection
• implement the 16-week weight management program with 20 eligible woman; then deliver a
10-week adaptation of the program for the 20 women who will receive the delayed intervention
(i_e_, control group) each group session lasts two hours and will be offered two times per week
• participate in. structured interviews, agree to be videotaped/audio-recorded during selected
intervention sessions, and answer brief survey questions
a G
Important Characteristics of the Weight-Wise Staff
r"he key to any successful weight management program is choosing a group facilitator or leader who has a
good relationship or builds good rapport with program participants. We need your help in identifying the
"right" people to lead your site's Weight-Wise Program. Below is a list of some of the important
characteristics we think the staff you select should have:
The Weight-Wise Interventionist and Assistant should be:
? Passionate about leading this group of women to healthier lives through modest weight loss
? Someone who has a reputation for building good rapport with clients
? Empathetic to the daily struggles women face and have a good understanding of their day-to-day
lives and the resources in the community
? A good listener
? Willing to enhance or learn new skills in changing lifestyle behaviors
We expect that the staff selected to lead this program will already have some knowledge of nutrition and
physical activity. The training we provide will serve to enhance this existing knowledge base.
Participants
Women can participate in Weight-Wise if they meet the following eligibility criteria:
• Are 40-64 years of age
• Are overweight with a BMI greater than 27.5
r • Willing to lose 5% or more of their body weight and follow recommendations for healthy dietary and
physical activity patterns
Have a household income at or below 250%'of the federal poverty level
Willing and able to provide informed consent
Have a home phone or easy access to a phone
• Are English-speaking
Eligible participants will be expected to do the following at the beginning of the program and at 2-3
additional specified intervals, depending on which group they are assigned to:
• Give information by telephone interview on eating and physical activity habits, psychosocial factors
such as social support, barriers to losing weight, health history, and demographics (age, employment,
etc.)
• Provide measures of blood pressure, weight, and height
• Wear a physical activity monitor for 7 days, at the beginning of the program, and at one follow-up
assessment
• Attend scheduled weekly 2-hour group sessions at the health department or designated site
Participants interested in Weight-Wise will NOT be required to:
• See their regular primary health care provider more often than usual. (Participants will be encouraged
to see their provider if there is a change in health status or medical regimen.)
• Provide the research staff with access to their medical record. The research staff will only contact the
participant's primary health care provider at the beginning of the program to obtain a
recommendation for the level of physical activity appropriate for the participant. 37
Flow niagram
Taking Part in the Weight-Wise Prograrn
The Weight-Wise Program is designed to help low-income, overweight women ages 40-64 years lose weight
safely, as well as to help UNC researchers learn how to develop successful weight loss programs in clinical
settings- Here is what will happen if your health department is selected to participate in Weight-Wise:
Phase 1: Health Uepartrrlent Application
and Selection Proc¢ss
Marc" 20 Applications mailed to eligible health departments
April 15 Application packets due to UNC
_ May Health nir-tors notified of the 6 health
departments randomly selected for the study
Phase 2:_ Study PrePslll?Ad As7F4?mcn
June-July UWC res4arCF?aT3 .r7sCet oiy-' ad><I-'si!'attFM
depmrwt f'i
Aug_-Sept. tlaalEh deparl[tnsst?S #rld anterY'-ws...
3
..,?a x M-`.Vt s
3 8
Compensation 8c Other Benefits
~rWa recognize that health departments and participants taking part in Weight-Wise will need to devote some
time and resources to the program- To help compensate for this, we have outlined below the payments to
health departments and study participants- We have also identified a number of other benefits that health
departments can expect from participation in this project.
Payments to the Health E>epartment
Health departments will be compensated for time and effort directed toward administrative aspects of the
program and for measurement expenses (!_e_, providing space for group sessions and data collection visits).
Health departments will receive the following compensation:
Year 1: $1,000 for administrative expenses and $600 for measurement expenses
Year 2: $1,395 for measurement expenses
- Year 3: $255 for measurement expenses
In total, each health department will be paid $3,250 to help offset study-related expenses-
In addition, each health department will receive some salary support for the interventionist and assistant
positions, to compensate for time spent training, completing surveys, enrolling participants, and
implementing the intervention- Salary support for the interventionist and assistant:
- Year 1: $3,512
Year 2: $15,796
• Year 3: $2,197
f*.,,Payments to Study Participants
In addition to the health benefits that women may receive from participating in this program, we have
provided compensation for study components that involve data collection-
UNC will reimburse participants:
$10 for data collection visits
• $20 for wearing the physical activity monitor
- $10 for phone interviews _
Some small incentives may be given during the intervention as well.
Other Benefits to the Health Department
Here are some other ways your health department may benefit from participation in this project:
Providing evidence-based services to clients who are at high risk
_ Improving the health of low-income women at high risk for cardiovascular disease-
Training and salary support of existing staff to implement a weight management program with proven
effectiveness
_ Continuing education credits may be available for nurses, health educators, and registered dietitians
who complete the training program
QUeStiOnS~
Thank you for your interest in this project! Please direct any questions to Beverly Garcia, Project Director
919_966_6088; beverly_garcia@unc_edu or John Graham, Research Co-Investigator 919.966.8450;
jwgraham@email.unc.edu.
3 9
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Mar 101.08 04:19p College Rd f9nimal Hospita 9103923126 p.l
a
National Animal Control Association
Awards Committee
SERVING GOVERNMENTS & NONPROFITS SINCE 1978
To: G. Robert Weedon, DVM, MPH
From: Debbie Dawson, Awards Committee Chairperson
NACA Board of Directors
Date: March 4, 2008
Subject: Bill Lehman Memorial Award
Dr. Weedon, it is my pleasure to announce that you have been selected as the recipient
of the 2007 NACA Bill Lehman Memorial Award. Your nomination was considered
along with other nominees from across the United States and selected as the person
that met the highest standards for someone not directly employed in the animal control
field. The caliber of applicants made this year's selection extremely difficult for the
Awards Committee. You are to be commended for achieving this level of recognition.
As part of the award, you receive a complimentary conference registration for you and a
guest to our conference in Spokane, Washington. Please let us know if there are any
accommodations that you will need. It is NACA's hope that you will be able to attend
and accept this award. Each award winner will be given several minutes at the award
luncheon for prepared or extemporaneous remarks. Winners will be recognized and
promoted during the balance of the conference as resources for other agencies to look
to for guidance.
Please send me a high quality digital picture of yourself by April 15, 2008. You will need
to complete a -registration form and mail or fax -it to our Corpofate Office.. Should you
have guests attending the awards luncheon, please contact Executive Director John
Mays at 913-768-1319 ext. 6 or nacaO-nacanet.ora at your convenience. Again,
congratulations!
Debbie Dawson
Board of Directors
250 5 h Ave N
Edmonds, WA 98020 425-771-0205 dawson(M-ci.edmonds.wa.us
-
NA--A Award Nomination
Bi11 Lehman Memorial Award
G_ Robert Weedon, nVM, MPH (recent photo)
4140 S_ College Road
Wilmington, NC 28409
910-395-6555 W 910-297-2771 H _
rweedon~bell south. net
._rd
Submitted by= Jean P_ McNeil, AVM
New Hanover County
Animal Control Services Manager
180 Division Drive
Wilmington, NC 28401
910-798-7505 W 910-791-4934 H
m4--"4a D""c--ciov.com
4w -44~
NACA Award Nomination
Bill Lehman Memorial Award
Nomination for G. Robert Weedon, DVM, MPH
4140 S. College Road
Wilmington, NC 28409
910-395-6555 W 910-297-2771 H
rweedonO-bel Isouth. net
Dr. Weedon is both a long time personal friend and a professional colleague. We
began our journey together as my becoming one of his many employees at the
animal hospital he started and continues in as a senior partner. One of his
greatest loves has always been to teach anyone who would listen. This began
with his co-workers and has expanded today to include a position as adjunct
professor at the University of North Carolina at Wilmington (UNCW).
I left his hospital in 1990, to take a job with New Hanover County Animal Control
Services. I am currently the director there. Dr. Weedon first reached out to
partner with us as the primary animal hospital source to collect licensing fees for
the pets in our county. As always, the main reason that animal control agencies
fail to succeed is a minimal revenue source. Pet licensing is a ready means of
attaining this goal. We are a success story in this area, primarily because he was
willing to take the risk of believing in us to collect the fees. Other veterinarians in
the community soon followed his example, and we have developed a great system
through this process. We have exceeded $700,000 of revenue in a single fiscal
year, which is close to our being self-supporting as a division.
Approximately ten years ago, Dr. Bob decided that training his staff was not
sufficient to meet the "teacher bug" needs in his system. He solicited the
leadership of our local university to be allowed to present a self-made course
called Animals in Society. The class was and is designed to inform our future
community leaders about the importance of proper animal care, various animal-
related issues, and methods to improve the human animal bond. One of the first
connections with my agency was to allow me to share in this teaching experience
by giving the students the animal control viewpoint about our companion animals.
Since many were considering veterinary medicine as their chosen career, 1 was
especially pleased to fill their minds with ideas that I personally had no knowledge
of until I had become connected to this profession. Three of his early students
developed and published a volunteer manual specific to our animal control
division, which we are still able to utilize today.
Early in my tenure as director, my boss requested my participation in a learning
experience called the Management Academy of Public Health (MAPH). Our animal
control resides under the jurisdiction of the health department as one of its
divisions. Community partners were a requirement of the nine month training, so
(of course) I considered Dr. Weedon. He agreed, which began another phase of
our continued partnership. Our project was to do a business plan involving some
aspect of public health. Since pet overpopulation is long recognized as a major
method to decrease potential rabies vectors, we channeled our focus on building
- an on-site spay/neuter facility and adoption play area. The first surgery was done
on Sapt@rrabgr 22, 2004, by I:3,r. Wesdon_
Or. Weedon's experience in the MAPH program ignited his desire to Furth@r his
own education- H@ completed a master's of public health (MPH) in 2005, joining
an eiitg group of less than 200 veterinarians nationwide who also hold the clegnse
of MPH- nuring the latter portion of finishing his degree, h@ began as six year taorm
as the veterinarian on the board of health- Hs remains as vocal and p@rsuasive
advocate for every animal issue presented to our elBCtad ofncials, including (but
not limited to) a recent battle to maintain our antiOtethering law- We are the only
county in North Carolina that has been able to pass this ordinance-
=r_ Bob began coming to our surgery suite to perform volunteer spay/neuters for
animals at our shelter. Ha has come hers n@arly every otthBr Friday morning for,
since the clinic portion opened. Included during this time, ha has pulled in
multiple pr@-veterinary students to assist them in preparation for veterinary
school- We also rec@ive many hours of free labor from veterinary students that
visit his hospital on senior class sxtgmships_
This past year, I was again approached about participation on a year-long public
health training course. The Southsastam Public H@alth Leadership Institute
(SEPHLI) was completed just last month (osc@mb@r 2007)_ nr_ Bob was my
project partner, which was titled, Rabies Awareness and Corrirnun/!y Education_
As the title implies, we spent this past year developing as sustalnabls program for
- reaching community partners with the ever important rabies informatfon_ was
focused on several areas, where wa believed w@ could achieve the greatBSt impact _
on our community: public heath forums to reach the area vet@rinarians,
elementary school education, and increased rabies vaccination compliance- We
clevelopacl as plan to reach our goals by increasing the mentoring role we had
already developed with the Pre-Veterinary Medical Association (PUMA) at UNCW,
hosting multiplB no cost rabies clinics in and around the surrounding area, and
reaching out to the veterinary community-
Ths success of the year-long endeavor was recognized by top honors for best
leadership project being awarded at the graduation ceremony- For us, the
highlight of the year occurred on S@ptamber 8, 2007, when we partnered with the
PVMA to do an on-campus rabies clinic in conjunction with the Cent@rs for
~iseasa Control's inaugural World Rabies Awareness "ay_ We vaccinated nearly
400 dogs, cats, and ferrets in at two hour period that clay- In addition to this event,
we also conduct@d four different public health forums, two additional rabies
clinics (ons in partnership with our neighboring Brunswick County Animal
Services), and elerrsentary school rabies education presantecl by PVMA students.
It was at whirlwind of a year, but all worthwhile due to the massive community
impact.
These accomplishments and future endeavors have all been made possible by Ur_
Bob Wesclon, who is a mentor, friend, and colleague to our animal control ag@ncy_
H@ is a true model for other veterinarians to follow in developing at means of
- positive community partn@ring to batter that lives of companion animals
' d
The Newsletter of New Hanover County Animal Control Services
II
Barks and
Meows
Rabies Clinics
April 2008 Volume 1, Issue 1
• Animal Control Services
April 19, 2008 Rabies Awareness
• UNCW (Sponsored by Rabies is a uniform) fatal dis- or
the Pre-veterinary Medi- Y potentially rabid, animal, for a period of ten days. This
cal Association) Sep- ease that can be spread from the law states that it should is because it is a known fact
tember 27, 2008 animals to people. It is extraor- receive a booster vaccination that if the animal is shedding
dinarily preventable and the within 72 hours. If this is not virus in the saliva, it will show
• Inner City Rabies Clinic single most effective way to done, or the vaccine is not signs of rabies within that 10
November, 2008
prevent it is to have your pets current, it must, ' day period.
vaccinated against it. In New be quarantined
It is important to
Hanover County, since 1996, for a period of
remember what
there have been 90 cases of six months. The
constitutes rabies
Do you know how many rabies; 6 cats, I dog , and the rationale for
'exposure. Ac-
people die worldwide every rest wild animals. Both North that is that since
cording to the
year from rabies.? Carolina law and New Hanover the rabies virus
Centers for Dis-
County ordinance require that travels in the Dr. Robert Weedon
(Answer on page 2) your pet be immunized against nervous system, and Stephen Watson ease Control and
(ACS employee) at the Prevention, rabies
rabies. Your veterinarian can it can take six
do this for you as part of an months for signs UNCW Rabies Clinic. can be spread
overall vaccination protocol, or to develop. That is reason through a bite that
you can have it done at one of enough to ensure that your breaks the skin, salivary con-
Inside
this issue: the county-sponsored clinics animals stay current on their tact with an open wound, or
salivary contact with mucous
(see inset). rabies vaccines. membranes
• (eyes, nose,
Awareness If your animal is currently vacci- If your pet were to bite a mouth). Protect yourself and
Hated and is exposed to a rabid, human it must be quarantined your pets-vaccinate.
Rabies Clinics Pet Overpopulation
Pet Do you know the number one according to the Humane population problem (see inset
Overpopulation reason that animals die in our Society of the United States, page 2). Another thing you
country? It is from euthanasia. 6-8 million animals enter can do is adopt your next pet
According to the American shelters every year in our from Animal Control Ser-
• Society for the Prevention of country. How do we prevent vices. By doing these things,
Partners Cruelty to Animals, five out of this from happening? The you will cut down on the
ten dogs in shelters and seven simplest solution is to have number of animals entering
out of ten cats in shelters are your pet spayed or neutered. our shelter, and help find a
destroyed simply because there That way he or she does not loving home for one (or
L is no one to adopt them. And, contribute to the pet over- more) that is already there.
r j
Barks and Meows-The Newsletter of New Hanover County Animal Control Services
New Hanover County
Animal Control Services Our Mission
180 Division Drive
Wilmington, NC 28401
To protect the community from the threat of rabies virus exposure
Phone: 910-798-7500
Fax: 910-341-4349 and to ensure proper animal care through prevention, public per-
Hours of Operation
8:00AM-4:45 PM Monday- CeptlOn, and education.
Friday
I O:OOAM - 1:45PM Saturday
Your Pet Our Priority'
.
Adoption and Redemption
12:00 PM - 4:45 PM Monday -
Friday
I O:OOAM - 1:45PM Saturday
Community Partners
New Hanover County Animal I ferent veterinary schools
Control Services is very fortu- s` around the country. This is
nate to have many community the essence of the university-
partners to work with. The community partnership. Not
local veterinary community only do the students get tre-
provides emergency care to mendous experiential training,
injured stray animals and sev- but the county saves thousands
eral veterinarians volunteer at Former UNCW student Erin of dollars in salaries that would
What is the the onsite spay/neuter facility. Siltamaki doing surgery at have to be paid if the students
ACS. Erin is now in veteri-
An additional partnership with nary school at Purdue Univer- did not provide volunteer la-
potential of one the veterinary community is sity. bor.
female animal, and the service, offered by most of
her offspring in her The Animal Control Services
the veterinary hospitals in the vices Manager, and Dr. Robert
Advisory Committee is made
lifetime? area, of collecting the county Weedon, Veterinarian on the up of citizens from New Hano-
license as a service to their New Hanover County Board ver County and they advise
Answer next issue clients. That saves them the of Health are both Adjunct ACS on policies and proce-
trouble of having to go out to Faculty at UNCW and are dures as well as develop ordi-
ACS to license their pets. PUMA Faculty Advisors. Stu- nances (both new and revised)
Another tremendous commu- dents gain experience volun- to send to the Board of Health
nity partner is the Pre- teering at the onsite spay/ for their approval. Ultimately
Answer to the question on page 1:
Veterinary Medical Association neuter facility as they prepare ordinances must be approved t~ 55,000 people die annually worldwide at the University of North to by the County Commissioners,
~1rr Carolina Wilmington. Dr. jean erinary apply for admission to vet- college. Several of the but it all begins with the work
from rabies. McNeil students have gone on to dif-
, Animal Control Ser- of our community partners.
FY 2008 North Carolina Local Health Department Accreditation New Hanover
County Site Visit Report
i
North Carolina Local Health Department Accreditation
Site Visitors' Report Form
HEALTH DEPARTMENT: New Hanover County Health Department
COUNTY (or COUNTIES): New Hanover
HEALTH DIRECTOR: David Rice
BOARD OF HEALTH CHAIR: Dr. Sandra Miles
DATE HDSAI COMPLETED: December 10,2007
DATE of SITE VISIT: March 4-6, 2008
RECOMMENDED ACCREDITATION STATUS:
X Accreditation Conditional Accreditation
SUMMARY of FINDINGS:
Site Visit Team Composition
Tim Green, Administration Site Visitor (Lead)
Lynn Lathan, Environmental Health Site Visitor
Doris Lane, Nursing Site Visitor
Sylvia Chapman, Board of Health Site Visitor
Region Served by the Health Department
New Hanover, a coastal county in southeastern North Carolina, is the second smallest geographically
but one of the most densely populated in North Carolina with 183,000 people. The racial composition is
80% White, 16% African American, 3% Hispanic and approximately 1 % American Indian with Asian
combined. Wilmington a port city is strong in historical significance and is generally viewed as the
cultural, medical, educational and economic center for the southeastern region of the state. The
unemployment rate at the end of 2006 was 3.7% compared to the state's average of 4.5%. In 2006,
88% of people 25 years and older had at least a high school education and 35% had a bachelor's
degree or higher.
Local Health Department Services/Programs
Two hundred and seven positions are funded through the health department's $13 million budget
(2006) which includes the following services: Environmental Health, Vector Control, Animal Control,
Women, Infants and Children (WIC), Community Health, Child Health and Child Service Coordination,
Communicable Disease, Women's Health, Family Planning and Health Promotion. The Dental program,
"Miles of Smiles" uses a mobile dental unit and began June, 2006. The health department hosts the
State Public Health Regional Surveillance Team 2.
Findings
The following are a reflection of the many positive comments and observations made by the Site Visit
Team:
• Staff seem very caring, patient focused and team oriented. They also seem open and receptive
to change. Staff in several key positions have many years of experience.
1
FY 2008 North Carf~olina Local Health Department Accreditation New Hanover
County Site Visit R4Port
• The facility housing the health department is safe and well maintained. Access to clinical areas
is controlled by badge scanning. Plans for a new facility are supported by county administration. -
• An effective Vector Control Program works closely with the Corps of Engineers.
• The health department has a strong, cooperative working relationship with the local mental
health agency. Collaborative arrangements exist with many organizations and agencies
including the hospital, churches, schools and the medical community to resourcefully address
public health priorities- The leadership and cooperation even extend to neighboring counties.
• The award winning Board of Health is highly invested and engaged in public health issues.
• The agency has been proactive with no smoking policies for facilities and vehicles since first
implemented in 1987.
The Site Visit Team extends a special thank you to David Rice, Health Director, Scott Harrelson,
Agency Accreditation Coordinator and Eunice Inman, State Nursing Consultant and to all staff and
Board of Health members for their strong contributions to a successful site visit.
The New Hanover County staff are to be highly commended for the well organized manner in which the
benchmarks and the corresponding evidence were presented. Staff were very responsive to the Site
Visit Team's (S\/-V) requests for clarification and additional information. The health department is one of
the oldest in the state operating for more than 1 25 years. It was one of the first six local health
departments accredited. The health director and management team members are very experienced
and they enjoy the confidence and support of a very active Board of Health. The health director
provides strong leadership and he is very proud of the department's history. The Environmental Health
Services are co-located with other related county services for a "one-stop-shop" approach. There has
been a major county emphasis on customer service and this is very evident in the health department.
The animal control facility and animal adoption services are impressive. The board of health orientation
is comprehensive, well documented and could probably serve as a model- Staff seem very enthusiastic -000
and service oriented.
The following benchmarks and activities were "Not Met":
• Benchmark 7 and Activity 7.3 which states "The local health department shall investigate and
respond to environmental health complaints or referrals... complaint/referral tog should include...
documentation of timely and appropriate action-" On September 11, 2007 Environmental Health
received an anonymous complaint that a particular spa facility's pool water was very cloudy to
the point "you can't see your hand 2 feet in." During the morning of September 13, 2007 a
named complainant called Environmental Health regarding the same facility stating "the pool
has been cloudy all week, staff ok'd swimmers its safe to swim would clear up by Thursday"
(September 13, 2007). On September 14, 2007 Environmental Health staff called the facility and
spoke with its representative who acknowledged "the pool water is cloudy". On September 17,
2007 the Environmental Health staff visited the facility and noted conditions of "many wall, floor,
deck, tiles worn etc, to the written complaint record; however, there was no mention whatsoever
as to the cloudy pool water conditions previously acknowledged and confirmed by the facility
representative- The SVT deemed the agency's response time as not timely given the severity of
the reported and confirmed cloudy water conditions- Also there was no indication as to the
status of the cloudy condition or action to be taken- The State Administrative Code water quality
standards section for a public swimming pool states the clarity of the water shall be maintained
such that the main drain grate is visible from the pool deck at all times. Cloudy conditions would
warrant immediate suspension of a public swimming pool operation permit.
• Benchmark 30 and Activity 30.3 states "The local health department shall have examination
rooms and direct client service areas that are configured in a way that protects client privacy.
Written clinical protocols addressing privacy and agency floor plan/layout conducive to privacy,
2
FY 2008 North Carolina Local Health Department Accreditation New Hanover
County Site Visit Report
to be verified through observation by site visitors." The agency offered as evidence/explanation
the following: HIPAA Policy, HIPAA Policy-Programs must maintain confidentiality, NHCHD
Confidentiality Policy and Agency Floor Plan. When the SVT asked the agency if there were
written clinical protocols addressing privacy, the response was HIPAA covers all area(s) of the
health department and see Confidentiality Policy and Procedures. No written clinical protocols
were provided. These protocols would delineate specific steps and measures that would be
taken by staff to protect client privacy in exam rooms and direct client service areas. For
example, amongst other points, exam tables would be positioned such that when the exam
room door is opened the patient would be afforded maximum privacy or a curtain would be
drawn once the room is occupied. Exam room doors with glass sections must be covered in a
manner to preclude see through and protect privacy. The protocol could address the use of
draping sheets and chaperones.
Accreditation Recommendations:
The Accreditation Site Visit Team recommends New Hanover County Health Department for
accreditation status.
Other Suggestions for Performance Enhancement/Quality Improvement:
• Activity 15.1 - The SVT suggests that the agency strategic plan clearly include in its narrative
the following: A review and analysis of factors influencing the health department's ability to
improve the community's health, delineates how the agency uses local health data and
information to set goals and objectives and how the agency uses community input where
applicable. Specific target dates would help to measure performance relative to goal attainment.
• Activity 22.1 - The agency has an arrangement by which direct patient care for prenatal services
is provided by the regional hospital in New Hanover County. The agency provides some
resources to support these services. There is currently an eight week wait for this service. The
SVT suggests that the agency develop a plan with community leaders and providers to address
the unmet prenatal care needs of indigent and medicaid patients.
• Activity 30.2 - The SVT suggests additional signage in Spanish at the Environmental Health
section and the mobile dental unit. Braille signage was observed in the health department in
very limited use and some exam rooms did not appear to be handicap accessible.
• Activity 31.4 - The SVT viewed Position Description Questionnaires, work plans and job
specifications for various positions. The SVT suggests that a position description clearly
identified as such be written for each position and include specific duties and responsibilities.
The position description should be current, signed and dated by the employee, supervisor and
health director.
• Activities 23.2, 24.3, 31.4 and 31.5 - Based on a limited sample of employee records they
currently contain information that is loosely housed in a file folder. The SVT suggests that a
more organized record system including multiple distinct sections be utilized to secure and
maintain certain documents by category and some order as to chronology.
• Activity 39.3 - The SVT suggests that Environmental Health fees for lot evaluations, septic
system permits and well permits be reviewed as these fees have remained the same for the
past six years.
3
FY 2008 North Carolina Local Health department Accreditation New Hanover County Site Visit Report
FY 2008 NOrtn Carolina Local Healt11 nepartment Accreditation - HnSAI Summary Cl,tecKllst
NEW HANOVER COUNTY HEALTH DEPARTMENT
CFB.E$ crams f€ . CFSES
M NM M 'Nlp/ M NM MOH' NM•e.
Aaarasmsnt ~fcy }3FiuI?ange . .{Mileio
1 x 9 x 16 x 27 x 34 x
1.1 x 9.1 x 16.1 x 27.1 x 34.1 x
1.2 x 9.2 x 16.2 x 27.2 x 34.2 x
1.3 x 9.3 x 16.3 x 27.3 x 34.3 x
9.4 x 34.4 x
2 x 9.5 x 17 x 28 x
2.1 x 9.6 x 17.1 x 28.1 x 35 x
2.2 x 17.2 x 35.1 x
29 x
2.4 x 10.1 x 17.4 29.1 x 36 x
10.2 x 29.2 x 36.1 x
2.3 x 10 x 17.3 rxx.x
3 x 10.3 x 18 36.2 3.1
1 0.4 3.2 18.2 37 11 18.3 37.1 4 11.1 18.4 30 37.2 41 11.2 30.1 37.3 4.2 19 30.2 x 37.4 x
4.3 12 x 191 30.3 x 37.5 x
12.1 x 19.2 x 30.4 x
5.1 12.3 20 30.6 38.1 x
5.2 20.1 30.7 x 38.2 x
5 K--Xx 1.2 x 30.5 x 38 x
5.3 13 202 30.8 x 38.3 131 309 6 21 x 3010 39 x
6.1 14 211 x 391 62 14.1 x 21.2 x 31 x 39.2 x
6.3 x 14.2 x 21.3 x 31.1 x 39.3 x
14.3 x 21.4 x 31.2 x 39.4 x
7 x 14.4 x 31.3 x
7.1 x 22 x 31.4 x 40 x
7.2 x 15 x 22.1 x 31.5 x 40.1 x
7.3 x 15.1 x 22.2 x 31.6 x 40.2 x
7.4 x 15.2 x 22.3 x
x
7.5 x 15.3 x 32 x Al
7.6 x 15.4 x 23 x 32.1 x 41.1 x
7.7 x 15.5 x 23.1 x 32.2 x 41.2 x
15.6 x 23.2 x 32.3 x 41.3 x
8 x 23.3 x 32.4 x
8.1 x
8.2 x 24 x 33 x
8.3 x 24.1 x 33.1 x
8.4 x 24.2 x 33.2 x
24.3 x 33.3 x
33.4 x
25 x 33.5 x
25.1 x 33.6 x
25.2 x 33.7 x
26 x J
26.1 x
26.2 x
26.3 x
4
2
FY 2008 North Carolina Local Health Department Accreditation New Hanover County Site Visit Report
SITE VISITORS:
Tim Green, Date Lynn Lathan, Date
Administration Site Visitor (Lead) Environmental Health Site Visitor
Doris Lane, Date Sylvia Chapman, . Date
Nursing Site Visitor Board of Health Site Visitor
ACCREDITATION ADMINISTRATOR:
David Stone, Date
Accreditation Administrator
5
NEW HANOVER COUNTY
j HEALTH DEPARTMENT
1 s~ 2029 S_ 17tl' Street -
~r.. Wilmiagtoa. NC 28401
TELEPHONE (910) 798-6500 FAX (910) 341-4146
March :31, 2008
University of North Carolina at Chapel Hill
Attn: Betty Alexander, Accreditation Board Chair
Campus Box 8165
Chapel Hill, NC 27599-8165
Ms. Alexander:
The New Hanover County Health department (NHCHE),) recently completed our site visit for re-
accreditation. We found the process to be very beneficial for our agency and we are
convinced that accreditation will improve our public health system.
We would like to take this opportunity to respond to the two bench marks listed as "Not Met" as
well as the areas that were listed under the other suggestions for performanca enhanoemant
and quality improvement- We have listed the comments of our site visit team along with our
responses below=
~r "Not Met" Frindinos of Site Visit Team
BenCi,rnamrk 7 and Activity 7_3 - "The local health department shall investigate and
respond to environmental health complaints or referrals- _ _ complaint/referral log should
include--- documentation of timely and appropriate action-" On September 11, 2007
Environmental Health received an anonymous complaint that a particular spa facility's
pool water was very cloudy to the point "you can't see your hand 2 feet in_° During the
moming c f September 13, 2007 a named complainant called Environmental Health
regarding the same facility stating "the pool has been cloudy all week, staff ok'd
swimmers its safe to swim would clear up by Thursday" (September 13, 2007)_ On
September 14, 2007 Environmental Health staff called the facility and spoke with its
representative who acknowledged "the pool water is cloudy-- On September 17, 2007
the Environmental Health staff visited the facility and noted conditions of -many wall,
floor, deck, tiles worn etc, to the written complaint record; however, there was no
mention whatsoever as to the cloudy pool water conditions previously acknowledged
and confirmed by the facility representative- The SVT deemed the agency's response
time as not timely given the severity of the reported and confirmed cloudy water
conditions- Also there was no indication as to the status of the cloudy condition or action
to be taken- The State Administrative Code water quality standards section for a public
swimming pool states the clarity of the water shall be maintained such that the main
drain grate is visible from the pool deck at all times- Cloudy conditions would warrant
immediate suspension of a public swimming pool operation permit-
' NHCHV Response We provided our complaint tracking procedure and complaint logs
as documentation for this activity- We believe that our procedures and complaint logs
do show that we have a system in place which provides the nature of the complaint,
whether or not it was a justified complaint, when the complaint was received, what the ,
response was and when the complaint was abated- It is not uncommon for our
Environmental Health staff to receive in excess of 30 pool complaints during the course --+-10'
of a year- Should the perceived shortcomings of one complaint investigation warrant a
"Not Met- designation for the entire activity when the process and documentation of the
system is clearly present?
We do not delineate a precise time line for every circumstance that could be reported as
at complaint because staff is trained through their knowledge of discipline standards as
well as the scientific foundations of environmental/public health practice to prioritize
their response- If given contact information, then staff promptly attempt to speak
directly with the complainant- By doing so, they are better able to assess risk and
appropriately prioritize their response- In this case, the first complainant did not provide
contact information, while the 2?-a complainant did and was contacted so as to obtain a
better understanding of the conditions experienced- Though users may consider pool or
spa water `cloudy', this does not implicitly mean that the main drain grate is not visible,
and conditions warrant enforcement action. The investigating Environmental Health
Specialist reported that through her inspection on September 17, she documented the
complaint as invalid (no violation was recorded on the inspection form), and believed it
probably a result of her communication with the operator who took action to correct the
problem- It is our practice to conduct meticulous pool and spa facility inspections prior
to issuing an operation permit (required annually)- By doing so, the assigned
Environmental Health Specialist can assure facilities begin the permit period in 1001i6
compliance with standards as well as gain a sense of potential operation and
maintenance problems- It also exceeds requirements set forth in the North Carolina
general statutes and administrative code- From an environmental/public health
perspective, this proactively mitigates potential risks, and reduces the number of
complaints received over a permit period- In most cases, it creates and supports a
collaborative effort, and shared goals between the health department, owner and
operator of the facility-
BencFirrmark 30 and Activity 30_3 - "The local health department shall have
examination rooms and direct client service areas that are configured in a way that
protects client privacy- Written clinical protocols addressing privacy and agency floor
plan/layout conducive to privacy, to be verified through observation by site visitors-' The
agency offered as evidence/explanation the following= HIPAA Policy, HIPLIA Policy-
Programs must maintain confidentiality, NHCH1:> Confidentiality Policy and Agency Floor
Plan- When the S%/-r asked the agency if there were written clinical protocols addressing
privacy, the response was HIPAA covers all area(s) of the health department and see
Confidentiality Policy and Procedures. No written clinical protocols were provided-
These protocols would delineate specific steps and measures that would be taken by
staff to protect client privacy in exam rooms and direct client service areas- For
example, amongst other points, exam tables would be positioned such that when the
exam room door is opened the patient would be afforded maximum privacy or a curtain
would be drawn once the room is occupied. Exam room doors with glass sections must
be covered in a manner to preclude see through and protect privacy- The protocol could
address the use of draping sheets and chaperones- -„yI
NHCHIo Resoonsme Our HIPAA and patient confidentiality policies apply to all staff and
speak specifically to our clinic staff since they deal directly with personal health
information. These policies are to cover our clinic staff as well. We have undergone
very clinically focused Women's health audits and STD audits and we have never been
asked to provide a clinic privacy protocol above and beyond the policies that we
provided for documentation for this activity. Our nurse consultant referenced four other
health departments that were not asked to produce any documentation above and
beyond what we provided for this activity. No violations were pointed out by the site
visit team during their walk through and observation of our clinical areas.
We believe the statement provided by the site visit team would be more appropriate
under the Other Suggestions for Performance Enhancement/Quality Improvement
section and not as a basis for a "Not Met" designation for activity 30.3.
Other Suggestions for Performance Enhancement/Quality Improvement:
• Activity 15.1 - The SVT suggests that the agency strategic plan clearly include in
its narrative the following: A review and analysis of factors influencing the health
department's ability to improve the community's health, delineates how the
agency uses local health data and information to set goals and objectives and
how the agency uses community input where applicable. Specific target dates
would help to measure performance relative to goal attainment.
NHCHD Response: We plan to pursue a new vendor to facilitate our strategic
planning retreat and we will include these factors in the deliverables for a final
report from the vendor.
• Activity 22.1 - The agency has an arrangement by which direct patient care for
prenatal services is provided by the regional hospital in New Hanover County.
The agency provides some resources to support these services. There is
currently an eight week wait for this service. The SVT suggests that the agency
develop a plan with community leaders and providers to address the unmet
prenatal care needs of indigent and Medicaid patients.
NHCHD Response: We had an initial meeting of a local prenatal task force to
address this situation on November 16, 2007. We have a plan of action and
many of the objectives have been met. The 8 week wait time has already been
cut to less than 4 weeks. Once all objectives have been met the wait time should
be further reduced.
• Activity 30.2 - The SVT suggests additional signage in Spanish at the Environmental
Health section and the mobile dental unit. Braille signage was observed in the health
department in very limited use and some exam rooms did not appear to be handicap
accessible.
NHCHD Response: We will address these issues and improve upon them in our main
facility. Environmental Health Services is located in the New Hanover County
Government Center as a component of a 'One Stop Permit' process. While no other
agency in this facility has Spanish signage, we have added directional Spanish signage
and agency name Spanish signage for Environmental Health Services. Beyond this
effort which included bringing the need to the attention of county administrators, we are
not in a position to further influence signage_
• Activity 31.4 - The SVT viewed Position E)escription Questionnaires, work plans and
job specifications for various positions- The SVT suggests that a position description
clearly identified as such be written for each position and include specific duties and
responsibilities- The position description should be current, signed and dated by the
employee, supervisor and health director-
NHCH~ Rgsaonse: New Hanover County is substantially equivalent- Our county has
determined that our position description questionnaire (PE>Q) will be used as our job
description- In addition to the 1°E>Q we also have job classification sheets for all
positions, detailed individual work plans that are performance management based and
program performance standards for additional guidance for staff assigned to those
particular programs-
• Activities 23.2. 24.3. 31 _4 arrd 31 _S - Based on m limited sample of employee records
they currently contain information that is loosely housed in a file folder- The SVT
suggests that a more organized record system including multiple distinct sections be
utilized to secure and maintain certain documents by category and some order as to
chronology-
IVHCHO Response: We will work to purge unnecessary information and improve. our
personnel records for easier review-
s Actlylty 39.3 - The SVT suggests that Environmental Health fees for Iot evaluations,
septic system permits and well permits be reviewed as these fees have remained the
same for the past six years-
NHCHn Response: For many years our fees have been some of the highest in
the state- With our current operating system it is difficult to determine our true
costs- We are establishing m new operating system called 00ecade which will
give us a true account of our actual costs- Once we have that information we will
take the necessary actions to increase our fees if warranted-
'Ir
Veryi~/2~
s,
Mavid E_ Rice, MPH, MA
Health Director
w: David Stone, Accreditation Administrator
Public Health Grand Rounds
Y Ir"blic Health Grand Rounds
Real people, Real communities. Real issues.
Future Programs Archived Programs • • `
Highlights Public Health Grand Rounds is a series of satellite
broadcasts and webcasts presenting real-world case
Cutting Edge Legal
studies on public health issues ranging from obesity to
Preparedness for Chronic
bioterrorism, from SARS to food safety.
Disease Prevention (continuing
legal education credits
available)
Public Health Is Global Health_ Marl( Your Calendars for 2008
An Innovative Approach to
Fighting Disease in Uganda Public Health Grand Rounds
4
will be broadcast via
Coordinated Approach to Child webcast and satellite on
Health: From Research to
Practice May 29 and Sept 25, 2:00-
Healthy Places Leading to 3:00 PM ET.
Healthy People: Community
Engagement Improves Health Watch this space for details
for All. coming soon!
UNC
Public Health Grand Rounds is Q.
sponsored by:
University of North
Centers for Disease Control Carolina
and Prevention School of Public Health
See Our Other Partners
A collaboration between the Centers for Disease Control and Prevention
Public Health and the University of North Carolina at Chapel Hill School of Public Health
GRAND
ROUNDS North Carolina Institute for Public Health
Campus Box 8165 1 UNC-CH I Chapel Hill, NC 27599-8165
grandrounds@unc.edu
Phone 919.843.9261 1 Fax 919.966.5692
RINCIPH
http://www.publichealthgrandrounds.unc.edu/ 3/27/2008
i
Public Health Grand Rounds -00
Standards, Accreditation, and ImprovemerIt Rair.1"a the Bar of Pulblic Health
Perfo rm ar+ce
Webcast and Satellite Broadcast
Thursday, May 29, 2008,
2:00-3:00 pm ET
www oublichealthorandrounds unc edu
Program Overview
What is the relationship between public health agency performance and health status? How
does a local or state jurisdiction assess its current services and activities and achieve better
health outcomes for the public it serves? Why is there so much attention to quality
improvement and accreditation in public health these days and does it really matter?
How do these efforts connect with other longstanding efforts such as the CDC National
Public Health Performance Standards Program (NPHPSP)? To answer these and other
questions, this program will provide information about national and state efforts in
accreditation and improvement as well as provide some on-the-ground insight into what it
~eany means for a local health department.
Groundbreaking work is occurring to develop a voluntary national accreditation program for
state and local public health agencies- The national accreditation model,. which was
developed through a practice-driven model and was heavily endorsed by the field, has led to
the creation of the new Public Health Accreditation Board (PHAi3). The national
accreditation program, slated to be launched in 2011, is particularly intended to catalyze
quality improvement in public health practice.
North Carolina is among the handful of states that have led the way in quality improvement
and accreditation. In 2002, the North Carolina Division of Public Health and the North
Carolina Association of Local Health Directors undertook the initiative to develop a
mandatory, standards-based system for accrediting local public health departments
throughout the state. The focus of North Carolina's Local Health Department Accreditation
(NCLH DA) is on the capacity of the local health department to perform at a prescribed, basic
level of quality as defined by the same ten essential services used in the CDC NPHPS
Program- Using the same principles, the state health department also has piloted an -
accreditation process - the only state in the nation to do so.
Our case study at the New Hanover County Health Department in coastal North Carolina
looks at the entire process improvement initiative-the successes, pitfalls, lessons learned,
and plans for the future. Tha case study describes:
- The department self assessment, including benchmarks and activities
- The three-day visit by a multidisciplinary team of peer volunteers
- The accreditation process by the North Carolina Local Health Department
Accreditation Board
Our distinguished faculty and nationally recognized panel of experts will discuss the specifics
of the case and how the processes, tools and resources from the North Carolina experience,
and other states, can be applied across the nation to improve health for all. The panel alsot
will reflect on the relationship with current national initiatives such as the NPHPSP_
1
Goals of the Program
The principal goals of this program are: 1) to increase awareness and understanding of
state and national efforts to implement accreditation for state and local public health
agencies in a way that that promotes quality improvement; 2) to promote a national
dialogue on the importance of strengthening the governmental public health and public
health systems; and 3) to create a stronger understanding of how efforts to strengthen
public health are interrelated.
Learning Objectives
• Identify the similarities and distinctions between the National Public Health
Performance Standards (NPHPS) Program and accreditation.
• Describe the tools and resources available for support quality improvement in state
and local health departments.
• State the benefits of achieving accreditation.
Audience
This Public Health Grand Rounds program focuses directly on the priorities of many public
health policy makers and practitioners, at all levels, including:
• Executive directors, medical directors, and program directors and managers in local,
state, tribal, and provincial health departments
• Elected and appointed public health policy makers (e.g., city council members,
county commissioners, state legislators, and members of local and state boards of
health)
• Leaders of community-based and faith-based organizations working for better
community health.
Faculty
Edward L. Baker, MD, MPH (Co-Moderator)
Director, North Carolina Institute for Public Health
UNC School of Public Health
Stephanie B. Coursey Bailey, MD, MSHSA (Co-Moderator)
Chief of Public Health Practice, CDC
Panelists
TBD
Selected Resources will soon be available at
www.12ublichealtharandrounds.unc.com
2
Page 1 of 1
Rice, David E.
From: Rice, David E.
Sent: Friday, March 14, 2008 3:47 PM
To: Roane, Kim
Subject: RE: Recommendations from March F.A.C.T. Meeting
Approved.
David E. Rice, MPH, MA
Health Director
New Hanover County Health Department
2029 South 17th Street
Wilmington, NC 28401
910-798-6591
drice@nhcgov.com
http://www.nhchd.or-q
From: Roane, Kim
Sent: Friday, March 14, 2008 3:47 PM
To: Rice, David E.
Subject: Recommendations from March F.A.C.T. Meeting
Dave,
The F.A.C.T. meeting held on March 12, 2008 resulted in the recommendation to add the following to the Fee
Policy:
FCZ150 Fluconazole with a fee of $2.00 and an employee fee of $2.00. Effective date March 17, 2008.
This is a new treatment offered as an alternative to miconazole.
Annual change in revenues is expected to be less than $1,000, so approval may be granted by the Health
Director.
Thank you for your consideration,
Kim
3/14/2008
0,314TY, o New Hanover County
Health Department
z o
az 2029 South 17"' Street
k"'v
NEW HANOVER TY HEA'•F~'181151150~•
April 1, 2008
The Honorable Mike McIntyre
House of Representatives
2437 Rayburn House Office Building
Washington, DC 20515-3307
Re: HR 5613, Protecting the Medicaid Safety Net Act of 2008
Dear Congressman McIntyre:
As New Hanover County Health Director, I write to ask that you please considering
signing on as a co-sponsor to HR 5613: Protecting the Medicaid Safety Net Act of
2008. HR 5613 would delay the implementation of seven Medicaid regulations that
adversely affect the ill, developmentally disabled, or mentally ill children and adults in
New Hanover County and the district you represent at large, which rely on Medicaid for
a variety of health services.
The Congressional Budget Office estimates that states and local governments stand to
lose $20 billion of federal Medicaid funding over the next five years. The current state of
America's economy exacerbates the problems New Hanover County would face if
these moratoria are not put in place.
As you know, the State of North Carolina already faces difficult challenges as a result
from mental health reform. Specifically, implanting the proposed rules would cripple an
already aligning statewide mental health system.
Again, I ask that you please agree to co-sponsor and vote yes on HR 5613. New
Hanover County needs your support on this important legislation.
Sincerely,
David E. Rice
Health Director
cc: New Hanover County Board of Health
•
ILI,
n--
March 2008
0
NEW HANOVER CO.- HEA -
Hours of Operation for MalD Officeo
Oft'ice Hours: Monday-Friday, 8=00 a.m. - 5 p.m.
Clinic Hours: Monday -Friday, 8:00 a_m_ - 4:30 p.m.
Extended Clinic Hours: Tuesday evening until 7 p.m. Q
Se Habla Espanol ci
Servicio de Interprets Gratis L3pe I=e:ir
New Hanover couHty IS YOUR CHILD RIDING SAFELY?
PROBABLY NOT!
Healtll De artment you know that
P Did over 80% o
(child safety seats are installed incorrectly?
2029 South 1 7th Street contact your local permanent checking station r,r a s-ee chile sar ty seat :nspect;on pet-formes by
Wilmington, NC 28401 Nationally cemfied clt:ld Passenger safety -recut-,ic:an
phone 910.798.6500 New Hanover County Fire Services
fax 910.341.4146 std Kon #51 std KOn st6 std Knn #41
WWW_nhChd.Org 3805 US H18b ay 421 North Ogden Fire Departrnent Castle Hayne Fire Services
(910) 772-7900 7375 Market SL 5311 Castle Hayne Rd
(910) 686-7420 (910)6'15-0237
OffSite locatzons7 s[ation # 31 staKon # 93 staKon #6z
Animal Control Myrtle ~rot,e Fare se.-..ices Federal Point Fare Porter's Neck Fire ser.•:ces
S'6T1rZCeS 5636 Carolina Beach Rd 9815 River Ad 907 Porter's Neck Rd
1 80 Division Drive (930) 791-5000 (930) 796-7203 (930) 686-6377
Wilmi
9ngton, NC 28401 Ci of Wilmin ton Fire Stations
70-798-7500 ty g
Statlov #1 StaKOn #9
Environmental Fire Depa[Yrrtent Headquarters 1201 Maifary Cutotr Rd
Health Services 801 Market S_- (910)342-2750
230 Marketplace Drive (910) 341-7846
Wilmington, NC 28403 Emergency onse takes priority over a c at i s ection. T"ltaxtk
91 0-798-6667 n P you for understand;ng.
Or contact: Safe Kids Cape Fear
(located in County Annex at resp
Market Place Maly 00,10.) 798-6636
ww,1 saf -6.6org
NEW HANOVER COUNTY Helpful information for having your child's car seat inspected
HEALTH DEPARTMENT The following ar recommended or required for a certified technic;an to best teach your Family to install your seat
BOARD MEMBERS correeay. Bring:~ .your Child (Recommended]
Sandra L_ Miles, DDS, Cbaiy Dentist In their current car seat (Required)
G_ Robert Weedoq DVM, MPH, Vice Chair, Veterinarian ~ Your most used vehicle (Required
Virginia W. Adsms, PhD, Nurse
Car
Public Seat Tips to Help You At Home
Douala P. Blske, Member
Michael E. Goina, OD, Optometrist - A Properly installed car seat will m e less than 1 inch s:de to side at the seat belt path.
James R Hielcrvon, RPb, Phamacist - Children under l y_ must be rear-facing in the car. The .Attterican Academy of Pediatrics recommends that
children remain rear Facing as long as possible. Most convertible seats can be used rear facing up [0 30-35 pounds.
Robert E. Lewis, Public Member - Eff ct:ve January 1, 2005: NC Law states a child less than 8 years old and less than 80 pounds shall be
Nancy H_ PritebeK, County Commssioner properly secured in eight appropriate child passenger rastramt system (child safety seat or booster seat)
Robert M. Sbalcaty Jr_, MD, Physician - Children 12 and under should NE VEA ride in front o£an airbag.
C_ Benjamin Sprsdley, Public Member -Car seats that w e during a motor vehicle crash may need to be replaced. Please check with a NaGOnally
John N_'I\tns[all, PE, Engineer Certified Child Passenger Safety Technician to see :f your seat is safe.
- NEVER purchase a use second hand seats. They may have been in a motor vehic lecrash previously, be m~ssmg
nans_ be over 6 veers old, or be under recall.
J
Qp
o~
NEW HANOVER COUNTY HEACt~
HEALTHY CAROLINIANS
Cape Fear Healthy Carolinians of Brunswick and New Hanover Counties is a collaborative,
community based network dedicated to improving the quality of life for all of our residents.
Cape Fear Healthy Carolinians has identified three health priorities which are represented
in the three following committees:
• Access to Care Committee to improve the access for affordable Join us to learn how you
medical care can help your faith community
• Obesity Prevention Committee to reduce overweight and become healthier in 2008!
obesity • Violence Prevention Committee to develop violence prevention
programs Date: March 25, 2008
To learn more about Cape Fear Healthy Carolinians, explore our web site Time: 5:307:30 PM
www.caiefearhealthycarolinians.or. Location: New Hanover County
Highlighting the Obesity Prevention Committee Health Department Auditorium
Overweight and obesity rates among children and adults continue to increase. Recent data
from the North Carolina Behavior Risk Factor Surveillance System shows North Carolinians
are among some of the heaviest in the United States. More than 60 percent of adults in New Sessions on:
Hanover County and 63 percent of Brunswick County adults are overweight or obese.
Implementing Wellness Programs
To counter the ongoing rise of this obesity epidemic, the Obesity Prevention Committee Protecting and Promoting Breastfeeding
conducts educational programs and promotes health and environmental policies conducive
to improving health behaviors among the adults and children in New Hanover and Brunswick
counties. Specific programs include walking programs, and wellness programs throughout Refreshments will be served
schools, worksites, and faith communities.
Door prizes will be awarded
By focusing on promoting wellness programs in faith based organizations, policies to
combat the obesity epidemic can be promoted throughout large gatherings of residents. On
March 25, a Healthy Faith Based Communities event will take place at the New Hanover
County Health Department auditorium from 5:30 until 7:30 to encourage the establishment
of wellness programs within area faith based organizations.
If you have any questions regarding this event or would like more information on the Obesity Prevention Committee, please feel free to contact Amy Cook at 910-798-6548 or
Ruthie McHugh at 910-253-2583.
• ~w
NEW HANOVER COUNTY To"HEA0International Travel Clinic
r
t 3a t'
r +d ~ i j Vaccinations are recommended,
h} 3 x - ~ i 1*.
isj s 3 i f t but a few, like yellow fever or
meningococcal, are required'
w , , ; {1st ! s to travel to certain areas of
the world. We provide all
- At
! }ti r vaccinations that are currently
t
it "t~u t F!y;
required for travel, including:
i _11 41
Yellow fever
Typhoid
i r x .t. Polio
x
Ad" Japanese encephalitis
Hepatitis A
Hepatitis B
Td or Tdap
Pre-exposure rabies information is provided to travelers based
Measles, mumps, and rubella on their individual travel itinerary.
The New Hanover County international Clinic. This change emphasizes travel to Vsricella Our nurses have received many compliments
and cards thanking them for their time,
Travel Clinic has been a huge success with specific countries and not simply travel to Meningococcal information, and caring attitudes. The travel
the public's demand for vaccinations and a foreign area. We provide much more than Distributing anti-malarial medications is clinic has been a very positive experience
anti-malarial medications to meet their travel vaccinations in our travel clinic - such as another way of providing protection to for our staff and community.
needs at a reasonable cost. We are a one- recommended vaccinations, anti-malarial travelers. Not all areas of the world require International Travel services are provided
stop shop! In addition, we provide general medications and a broad overview of the malaria prophylaxis, but we can provie our by appointment only. A consultation fee
travel information based on individual individual's trip. customers with it through our pharmacy. is included with the medication/vaccine
travel itineraries. Our clients have been We provide a great deal of information, The three medications we provide are fees. For more information or to make an
both pleased and grateful that we have taken including: screening our patients before Chloroquine, Doxycycline, and Malarone. appointment, call the International Travel
such an interest in their travel needs and administering vaccinations or anti- We also provide information to our future Line @ 798-6611.
their general health while traveling. malarials for any possible contradications, travelers through our web-based travel
We began offering travel clinic services on providing the proper documentation on the program which is updated almost daily with
International Certificate of Vaccination card,
March 2, 2007 as the Foreign Travel Clinic, the latest travel news, including disease
Since then, we have adopted and changed and providing information to help travelers outbreaks and even countries that are
the name to the International Travel better prepare for a safe. unsafe for travel at the current time. This
Miles of Smiles Continues...
The mobile Dental Unit has relocated to the Supply Elementary School campus. Children do not need to
be students at this school in order to be seen and receive services. Children from both New Hanover and
Brunswick counties may be seen.
Who is How Do I Schedule
Eligible? an Appointment?
• Children 3-18 years of age Call 910-512-3113
• Children with Medicaid or NC Health Choice Insurance to schedule an appointment
• Children with no dental insurance
• Children in need of low-cost dental care
L.~
• Children who are unable to travel to a local dental office
.s .
mi. New Hanover County Health Department a~r
, PIA
Phone: 910.798.6500
• • •
NFW NANOV(! COUNTY NEA.1v'~F
~J Dining
° T
SJ T China King F Krazy Pizza Two Guys Grille PEN DER COUNTY
a,NNN;(, Nb
China One KS Cafd and Caterin UNCW Cafeterias Bur aw
nay. c g g
China Star La Costa Restaurant Verizon Wireless Cafeteria A B Grille and Ice Cream
China Wok Lake Shore Commons Water Street Restaurant Andy's
Chopstix Express Le Catalan Wendy's China King
CAROLINA BEACH Chuck E Cheese L'Oven Caf6 What's Cookin' D&B Restaurant
Bowman's Seafood Cici's Pizza Lovey's Natural Foods Wilmington Ice House Dee's Drug
Courtyard By Marriot City Club Cubbies Lucky Star Wilmington Tea Room Domino's
Frank's Pizza Connection Internet Cafd Lupita's Bakery Wilmingtonian/Percy's Holland's Shelter Creek
Hazdees Courthouse Cafd Macaroni Grill WOW Cafd and Wingery Restaurant
Kate's Breakfast and Lunch Cubbie's Manhattan Bagel Wrightsville Cafd Maria's Courtyard
Manta Mia's D & U Diner Marc's on Market Zaxby's McDonald's
Michaelangelos Pizza Dairy Queen Marriott Courtyard Zero's Scotchman
Subway David's Deli and Restaurant Mason Bistro Skat's
Top Wok Deli Downtown Mayfaire Cinemas WRIGHTSVI LLE BEACH Subway
Tuscan Grill Dick's Dogs and Burgers McDonald's Airlie Seafood Company Szechuan Pavilion
Dog House Meritt's Burger House Big Daddy's U Wash and Dry Grill
KU RE BEACH Double Happiness Midtown Deli and Grill The Bridge Tender Your Convenience
Freddie's Restaurante Dunkin Donuts Minch Sushi Mercer's Restaurant
WILMINGTON Echo Farms Country Club Ming Tree South Beach Grill HAMPSTEAD
A Southern Thyme Ed's City Grill Moe's Southwest Grill Verandah Cafd-Holiday Inn Andy's
A Taste of Italy EI Guajiro Restaurant Montego Bay Vito's Pizzeria China Garden
Everyday Gourmet Nagila Domino's
Andy's 's Car bbean BRUNSWICK COUNTY Jolly Roger
Annton s Caribbean Cafd Fire Bowl New Hanover Regional pnd s- Shallotte
Y Firehouse Subs Medical Center Cafd y King's Table
Antonios Pizzeria Archibald's Deli Old Point Country Club
Arab Shrine Club Flaming Amy's Nicola's Bart's BBQ Grill
Arby's Flip's BBQ Nikki's Fresh Gourmet Beck's
Folk's Cafd Nino's Pizza and Pasta Panda Chinese Restaurant
Artisan Market and Cafd Bella Cucina pizza's 2 U
Atlanta Bread Com an Fratelli's Italian Buffet NoFo Cafd
P Y BHI Clubhouse Player's Cafe
French's Classic Burgers Opus
Bagel Basket Billy Bass Seafood Port City Java
Frontier Food to Go Orange Julius
Barnes and Noble Cafd Bojangle's- Shallotte Scotchman
Genki Japanese Restaurant Papa Bellas
Bayan Burger King- Shaliotte Subwa
Golden China Pita Delite y
Bear Rock Cafd Calabash Deli The Bagel Bakery
Golden Dragon Pizza Pan Wilmington
Bellas Sweets and Spirits Captain Nance's Seafood Topsail Greens Snack Bar
Good Goody House Pop's Incredible Pizza
Bento Box Captain Pete's Xl'Z Pizza
Blimpies Subs Gumby's Pizza Portland Grille Cinelli's at Ocean Isle Beach
Bojangles Gyro Place Quizno's Subs Cook's Nook ROCKY POINT
Boleros Cafe Han-dee Hugo Ray's Restaurant Derbster's Dining Freshway
Bon Appetit Hazdees Rudino's Double Eagle Grill Grand Oak Driving Range
Boodles Henry's Saltworks Ella's Hardee's
Brasserie Du Soleil Hibachi Express Saltworks II Great Wall Paul's Place
Brigade Boys and Girls Club Hollywood East Cinema Grill Sammy's @ UNCW Hazdees Wendy's
Honey Baked Ham Company Sarku Japan
Brightmore Holden Beach Pier and Grill
I.H.O.P. Sawmill SURF CITY
Brooklyn Pizza Company Hole-In-One at Goose Bay
I Love NY Pizza Sbarro Pizza Andy's
Burger King Jade Garden- Leland
Indochine Restaurant Schlotzsky's Batson's Gallery
Cafd at Temptations Joseph's Italian Bistro
Invista Seascape Internet Cafd Bo Sue's
Cameron Art Museum KFC
Carolina BBQ Jackson's Big Oak BBQ 7 Regione's Inc. Kohl's Corianders
Catch Jellybeans 17'h Street Deli Kopp's Quick Stop I & H Crabby Mike's
CFCC Food Court Jersey Mikes South College Sandwich McDonalds Dairy Queen
Jesters Java Spiro's Breakfast and Lunch Domino's
Chazley's Grilled Subs New China
Jeters Hot Dogs Subway Hardee's
Charlotte's Uptown Eatery Papa John's Pizza
Joe Muggs Taco Bell Lanier's Campground
Checkers Phil's Sandwich Shop
Cheeze Pleaze Cheesecake Jones Seafood House Tailwind Deli News and Gifts port City Java Max's Pizza
Jungle Rapids Target Food Avenue Mollie's Restaurant
House Pharmacy Restaurant
K's Cafe Terrazzo New York Comer Deli
Chelsea's The Pierhouse Restaurant
Ken's Bagels and Deli Tidal Creek Co-op Subway
Chick fil A Subway
China Garden Kohl's Frozen Cutstazd The Woods at Holly Tree Sugar Shack
Kona Coast Cafd at NHRMC Tokyo Deli TI{ Diner
New Hanover County Health Department Look for this logo on the NHCHD website for the most current list of area smoke-free dining
s establishments. If your favorite smoke-free restaurant is not on the list, please call Project ASSIST '
Phone: 910.798.6500 at 910-798-6548 and let us know!
N~..- WNOYR COYlNTV NEN~~~~