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06/04/2008 mvwwwnwwwwnm~ New Hanover County Health Department Revenue and Expenditure Summaries for April FY 2007-2008 Cumulative: 83.33% Month 10 of 12 Revenues Current Year Prior Year Type of Budgeted Revenue Balance % Budgeted Revenue Balance % Revenue Amount Earned Remaining Amount Earned Remaining Federal & State 2,116,715 1,803,012 $ 313,703 85.18% 1,981,895 1,747,648 $ 234,247 88.18% AC Fees 640,161 590,193 $ 49,968 92.19% 613,661 586,345 $ 27,316 95.55% Medicaid 1,569,058 881,484 $ 687,574 56.18% 1,455,867 926,816 $ 529,051 63.66% Medicaid Max 309,128 0 $ 309,128 0.00% 310,000 0 $ 310,000 0.00% EH Fees 310,000 244,757 $ 65,243 78.95% 310,000 221,609 $ 88,391 71.49% Health Fees 359,700 386,499 $ (26,799) 107.45% 301,200 341,254 $ (40,054) 113.30% Health Choice 35,125 22,547 $ 12,578 64.19% 35,125 15,109 $ 20,016 43.01% Other 3,778,707 3,061,176 $ 717,531 81.01% 2,556,213 2,195,781 $ 360,431 85.90% EM -1 1 1 Totals $ 9,118,594 $ 6,989,668 $ 2,128,926 76.65% $ 7,563,961 $ 6,034,562 $ 1,529,399 79.782j" Expenditures Current Year Prior Year Type of Budgeted Expended Balance % Budgeted Expended Balance % Expenditure Amount Amount Remaining Amount Amount Remaining Salary & Fringe 13,198,325.00 10,243,069.20 $ 2,955,256 77.61% 12,012,062.00 8,681,294.32 $ 3,330,768 72.27% Operating 2,619,391.83 1,565,934.48 $ 1,053,457 59.78% 2,167,221.00 1,224,063.05 $ 943,158 56.48% Capital outlay 67,029.00 49,835.73 $ 17,193 74.35% 108,494.00 68,223.38 $ 40,271 62.88% Totals $ 15,884,746 11,858,839 $ 4,025,906 74.66% $ 14,287,777 $ 9,973,581 $ 4,314,196 69.80% Summary Budgeted Actual % FY 07-08 FY 07-08 Expenditures: Salaries & Fringe $ 13,198,325 $ 10,243,069 Operating $ 2,619,392 $ 1,565,934 Capital outlay $ 67,029 $ 49,836 Total Expenditures $ 15,884,746 $ 11,858,839 74.66% Revenue: $ 9,118,594 $ 6,989,668 76.65% Net County $ 6,766,152 $ 4,869,172 71.96% Revenue and Expenditure Summary For the Month of April 2008 7 N HGHU BOARD OF HEALTH APPROVED GRANT APPLICATION STATI.IS FY 07-08 and FY 06-07 Data B H Grant Ra uestacl Pendin Received Denied 1-171.... TICK Control Demonstration Project: North Carolina Department of Environment and . Natural Resources (N CD EN R) - possible 3 year funding for Environmental Health Vector Control ro ram $15,000 $15,000 Ministering ircla donation o funds for ch,lestG,,h labo-to a ui -t S-1.300 $9,300 4/212008 e 9 sa year un ng - en er or Health Promotion and Disease Prevention at UNC-Chapel Hill; weight loss program for low income women .0_40 and 64. $2-4.755 $24 755 _ 3/5/2008 attar o ntant nly: ape ear Mem oriel Foundation -Men's Preventive Health - 3 ears, 5232,000 216/2008 Community Waste Reduction Recycling to secure low cost Community Animal Neuterin $26 000 $25,000 91212006 mart Start - ew Ha~O- County Partnerehip for Children - Child Cara Nursin Pro ram $196.000 $16-9.0,421 $35.458 Maternity Cara Coordination - North Carolina Department of Health and Human Services funds to provide Maternity Care Coordination services to non-Medicaid eligible clients 597,680 597 580 921512007 HIV/STD Prevention Ouiraach - North Id Carolina HIV/STD Prevention and Care Branch - total of multi-year funding th ru M.Y. 2010 5975 000 $175,000 Family Counseling Services - Cape Fear Memorial Foundation continuation funding for 1 ear (of a Possible 3 ears $S3.000 $50,000 [$3:000 11/712007 Living Wall - Additional funds added to original grant to complete winter edition of newsletter - C. p. Fear Memorial Foundation $650 $650 Asthma Program - North Carolina Dept. of Health and Human Services Division of Public Health Asthma Pro ram 518 000 $15,000 $3,000 1013/2007 Healthy Carolinians - Request for funds from the North Carolina Division of Public Health, Office of Healthy Carolinians, for support of the local task force. $12,048 $12,048 ACHIEVE Grant - Canters for Disease Control/YMCA - Workplace Wellness Services 540,000 $40,000 91512007 No Activi for Se tam bar 2007 81112007 No Activi for Au uat 2007 719112007 WIC Mini-grant - Request to rati application _ renovations to i.. for mini-grant funds for T. ~lnr the WIC registration workstations to improve customer service. $18,000 $98,000 8 As of 5/21/200H NHCHn BOARD OF HEALTH APPROVED GRANT AP PLiCAT1ON STATUS FY 07-08 and FY 06-07 Oat- BOH) Grant Re uastad Pendin Racalvad O-ni-d 6/6/2007 Landfall Foundation - Request for funds to = purchase 16 wheelchairs for the NHCHO School Health Nursin Pro ram. $2,700 $2.700 5/2/2007 Living WBIF Received notification from Capa Fear Memorial Foundation of continuation funding for the publication of the Living Well news a er insert. $0 $92.000 4/412007 Ministering Circl- (CO1p.... py funding) - Raquast for $12,000 start-up funds from Ministering Circle for purchase of Colposcopy egcipM--t. Also plan to r-qu-.t additional funds from other grant sources such as Capa Fear Memorial Foundation for expansion of program to include a second Colposcopy unit and additional training, supplies and contract services. $12.000 $12.000 , Capa Fear Memorial Foundation - , Colposcopy Program - Warn- Preventative , Health. $25,000 for start up cost for physician and interprater contracted services, equipment, supplies, and training. $25,000 $25,000 317/2007 Closing The Gap - Raqu Ost for $225,000 ($75,000 par year for 3 years) from North Carolina Offic- of Minority Health and Health Oisparitias for a Health Educator to fgcus on prevention of HIV and attar sexually transmitted disease in the Latino and Afro- American population._ $225,000 $225,000 rpl/ 217/2007 CA -MRSAc Funding from UNC-Chapel Hill School of Medicine to assist with rasearcM1 related to the prevalence of community associated m-thiciilin resistant st.phylococus aureus $92,600 $12,000 113/2007 mart tart - aw anovar aunty Partnarshlp for Children - Child Cara Nursin Program $178,500 $170,000 $8,500 12/6/2006 Ouk- Endowment Funds, NHRMC - Dental Unit - Personal Health Services. $25,000 for indigent dental care and $15,000 for sedation equi ment $40,000 $20,000 $20,000 99/9/2006 No Activity for Nov-mbar 2006 10/4/2006 March of Dimas - Maternity Care Coordination axpanditures for Baby Lova Program Baby Boutiqua and Learning Center $3,000 $3,000 916/2006 No Activi for Se tambar 2006 8/2/2006 No Activi for Au ust 2006- 7/6/2006 ervtce oar na ton Family Counseling Program (Capa Faar Mamorlal Foundation) - Funding for Licansad Clinical Social WorKer for 3 ears $260,000 $75,000 $985,000 Ea[ mart ova ore - ommun ty rant (NC Dept of Public H-a1LM1 Physical Activity , and Nutrition Bra ncM1 $16,495 $12,416 $4,079 Totals $1.372,128 $57,335 $775,056 $55-1,737 4. 18 % 56.499/. 40.219/6 9 As of 5/21/2008 r NHCHD BOARD OF HEALTH APPROVED GRANT APPLICATION STATUS FY 07-08 and FY 06-07 Date (BOH) Grant Requested Pending Received Denied Pending Grants 3 13% Funded Total Request 10 42% Partial) Funded 7 29% Denied Total Request 4 17% Numbers of Grants Applied For 24 100% I 10 As of 5/21/2008 NEW HANOVER COUNTY BOARD OF COMMISSIONERS Request for Board Action Agenda-_ Consent Meeting Date: A ends: 1301-1: 06/04/08 Department: Health I Presenter: Jean P- McNeil, Animal Control Services Mara er Contact Jean P- McNeil 798-7505 Subject: Animal Control Services (ACS) Advisory Committee - Appointment of Member Brief Summary: This is a request to fill the vacant member-at-large position of the Animal Control Services Advisory Committee with Mr- Larry Schramm. Mr. Schramm contacted and visited our facility to learn about what he could do to help the animals o£ the area- He is a guest writer for the Star News and this is where he gained knowledge of our shelter- His plans are to increase education in the schools through community volunteers and to institute a donation program of animal items for new pet owners- He has always enjoyed working with animals, so his background should be helpful in rovidin support to the existing committee mambers. Rcoended Motion and Requested Actions: rest appointment of Mr- Larry Schramm to fill the vacant member-at-large on the Anim al Control Services Adviso Committee- Fundirn Source: N/A Will above action result in: QNew Position Number of Position(s) Position(s) Modification cr change ®No Chan a in Position s) Ex lanation- Attachments. A lication fora ointment to NHC ACS Adviso Committee 1 1 NEW HANOVER COUNTY HEALTH DEPARTMENT W Animal Control Services , I 180 Division Drive NEW HANOVER COUNTY NEP Wilmington, NC 28401 TELEPHONE (910) 798-7500 FAX (910) 341-4349 Application for Appointment New Hanover County Animal Control Services Advisory Committee (Please print legibly) Category Interest: Advisory Committee - Animal Control Services Name: Larry Schramm Address: 8903 Mahogany Run City: Wilmington, NC 28411 Phone (Home) 910-319-3169 (Cell) 404-281-6702 Why do you wish to serve on the Animal Control Services Advisory Committee? Enjoy being with and working with animals -I've had dogs, cats, alligators, turtles, raised canaries and fish - should have been a vet. I believe with my background I may be able to provide some positive input to the Committee. What areas of concern would you like to see the Committee address? Nancy mentioned to me that New Hanover County now has a mandatory spay/neuter ordinance, so we should examine the possibilities of sponsoring a county-wide low cost spay/neuter program. Other concerns would be how to best bring attention to adoptable animals with mobile pet adoption sites, and perhaps to go along with that, rabies vaccination clinics. Another possibility is to have community volunteers undergo training and then present education programs for schools, covering topics like leaving pets in hot cars, cold weather concerns for pets left outside, dangers of letting dogs stick their heads out of a moving vehicle, seeing eye dogs and other companion dogs, and so on. Also, people throw away a lot of items, so we could institute a donation program where folks could donate dog and cat toys, brushes, litter pans, cat or dog magazines or books that visitors could read or take with them when they leave. Date: April 17, 2008 Signature: Larry chramm 12 NEW HANOVER COUNTY BOARD OF COMMISSIONERS Request for Board Action Agenda: Consent Meeting Date: A ends: ® BOH: 6/4/08 Department: Health Presenter: Dianne Harwell, Environmental Health Services Mana ar Contacts Dianne Harwell 798-6665 Subject: Repeal New Hanover County Board Of Health Rules Governing Water Supply Wells Brief Surizinary: The NC Environmental Management Con~rxiission and Commission for Public Health have adopted regulations governing the petaiittirng, inspection, sampling and testing of water supply wells which become effective July 1, 2008_ At present it appears, these standards will adequately protect the public's health and our groundwater resources- We, therefore, propose to repeal the New Hanover County Board of Health Rules Governin Water Supply Wells- or cmended Motion and Requested Actions: Repeal New Hanover County Board of Health Rules Governin Water Su 1 Wells_ Furndin Source: Will above action result in: QNew Position Number of Position(s) OPosition~s) Modification or change ®No Chan a in Position s Ex lanatiorx: Attachments: Fre -tl Asked Questions: Local Regulation of Private Drinkin Water Wells 1 3 Frequently Asked Questions: Local Regulation of Private Drinking Water Wells Aimee Wall UNC School of Government In 2006, the General Assembly enacted legislation directing the Environmental Management Commission (EMC) to adopt rules "governing the permitting and inspection by local health departments of private drinking water wells...."' In addition, the legislation directed the Commission for Public Health to adopt rules governing the sampling and testing of water from private wells? The EMC and the Commission for Public Health finalized the rules and they-are expected to go into effect July 1, 2008 s Before the legislation was enacted, approximately 35 counties had local board of health rules or ordinances in place that governed private drinking water wells.4 After the legislation was enacted, the remaining counties adopted local laws governing private drinking water wells primal ly because they were offered a financial incentive to begin getting local well programs in place. Once the state regulations go into effect iti July, they will be applicable statewide. Environmental ~4w health specialists in local health departments will be responsible for enforcing the state's requirements in their respective jurisdictions. One critical decision that each county will need to make is whether it wants to adopt a local well rule or ordinance that supplements the state regulations. In a question and answer format, this bulletin will review the scope of the new state regulations and the authority of local governments to adopt more stringent local laws. Q1. To what types of wells do the new state regulations apply? Chapter 87 of the North Carolina General Statutes imposes standards on the construction, operation, maintenance and abandonment of all types of wells. A "well" is defined as "any excavation that is cored, bored, drilled, jetted, dug, or otherwise constructed: I S.L. 2006-202, sec. 2 (adding a new subsection (7) to G.S. 87-87). 2 S.L. 2006-202, sec. 4 (adding new G.S. 87-97(i)) 7 22 N.C. Register 1691-94 (Apr. 1, 2008) (amending 15A NCAC 2C). 4 Pat Stith, Clean Wells Le) to Chance, News Observer (Mar. 26, 2006) ("Thirty-five counties have some sort of construction oversight or well-testing program, but only 14 require even minimal tests. In the other 65 counties, well drillers are on the honor system when it comes to construction standards."). s The incentive money was included in the 2006 and 2007 appropriations acts. See S.L. 2006-66 (providing over $800,000 to the Department of Environment and Natural Resources for distribution to counties "for technical support and enforcement assistance as [counties] enforce statewide private water supply well construction standar(&"); S.L. 2007-323 (providing an additional $300,000 for distribution to county well programs). 1 - 4/14/2-008 [DRAFT] 14 • For the purpose of locating, testing or withdrawing groundwater or for evaluating, `y testing, developing, draining or recharging any groundwater reservoirs or aquifer, or • Tklat rnay6 control, divert, or otherwise cause the movement of water from c r to any aquifer.- 'T'his definition is broad enough to encompass many types of wells that are used in the state, including dririlcing water supply wells, monitoring wells, and injection wells- The 2006 legislation and the new regulations require Iocal health departments to manage the inspection and permitting process for a subset of wells, "private dri-eking water wells," which are defined as "any excavation that is cored, bored, drilled, jetted, dug, or otherwise constructed to obtain groundrvaterfor human consumption" and that serves or is proposed to serve • 14 or fewer service connections or • 24 or fewer individuals. The terra also includes any "well that supplies drinking water to a transient noncorrttnunity water system as defined in 40 Code of Federal Regulations § 141.2 <July 1, 2003 Edition)," which encompasses wells at locations such as campgrounds and rest areas. Q2_ Wbat state laws applied to private drinking water wells before the new leglslation? The state laws in Article 7 of Chapter 87, which have been in place for many years, govern the construction, operation, repair, and abandonment of wells. The EMC has also adopted detailed regulations implementing the statutory requirements found in Chapter 87, often referrod to as the "2C rules" because they are found in Title 1 SA, Chapter 2C of the North Carolina Administrative - (---de -7 A smaller subset of wells-those serving certain establishments regulated under state law such as restaurants, hotels, summer camps and local jails'-are subject to additional regulations adopted by the Commission for Public Health-9 While all cf these laws were in p] ace regulating how wells should be constructed, operated, repaired and abandoned, state Iaw required only a few categories of wells to be inspected and pemzitted by state or local officials- Wells associated with regulated establishments, such as restaurants, were inspected in conjunction with the issuance o£the establishment's operations permit. In addition, the EMC is authorized to issue permits for a small subset of wells: (1) those with a designed capacity <>f 'l 00,000 gallons per day or greater and (2) those in certain geographical areas identified by the EMC.1O G.S. 87-85- 7 15A NCAC 02C. s Establishments regulated pursuant to 15A NC--AC 18A. - ' 15A NCAC 18C; 15A NCAC 18A _9700_ 1O The EMC is authorized to hold public hearings to identify geographical areas where requiring prior penaYission For well construction is `Yeasonably necessary to protect the groundwater resources and the public wel rare, -FYty and health-.-." G.S. 87-88(a)_ To date, the EMC has not identified any geographical areas requiring permits pursuant t- 2- is provision. 4/14/200.8 [DRAFT] 1 5 Q3. Did local governments previously have authority to adopt local laws governing private drinking water wells? Yes. Some local governments concluded that more oversight of well construction, operation, repair, and abandonment was necessary and therefore adopted local well ordinances or board of health rules. These local laws typically established local permitting systems and imposed additional substantive requirements or restrictions on the well construction process. Cities and counties may adopt ordinances governing private drinking water wells because the state has delegated local governments the general authority to adopt ordinances necessary to protect the "health, safety, or welfare of its citizens and the peace and dignity" of the city or county.l Local boards of health may cite to two sources of authority for the adoption of local public health rules governing private drinking water wells. First, the public health chapter of the North Carolina General Statutes (Chapter 130A) grants boards of health the general authority to adopt rules necessary to protect the public's health. The law provides that a local board may even adopt rules that are more stringent than those adopted by the Commission for Public Health or the Environmental Management Commission when, in the board's opinion, a more stringent rule is required to protect the public health. 12 Second, boards of health have specific authority in the Article 7 of chapter 87, which governs well construction, to "adopt by reference rules adopted by the Environmental Management Commission pursuant to3this Article and may adopt more stringent rules when necessary to protect the public health. Q4. May a local government continue to enforce its local well ordinance or board of health rule or adopt a new ordinance or rule after the state regulations governing private drinking water wells go into effect? The existence of a state law can sometimes preempt - or override - the auth sntate law of local governments to adopt local laws in the same substantive field. For example, expressly prohibit local laws, such as the prohibition on local board of health rules related to the grading, operating, and permitting of food and lodging facilities. 14 State law can also impliedly preempt local law if the state has created a regulatory scheme that is so "complete and integrated" that there is no room left for additional regulation.15 Fleming 160A-1 74 G.S. 153 GovERNMnEN9' IN, NORTH CARCOLiNASat 2,lUNC School oBGovernmenit (2007 ~ in COUNTY AND MUNICIPAL is G.S. 130A-39 (a)-(b). `s G.S. 87-96(c). 14 G.S. 130A39(b). The enactment and operation of a " Craig v. Chatham, 356 N.C. 40, 44-46, 565 S.E.2d 172, 175-76 (2002) C' lion general, statewide law does not necessarily prevent a county from regulating in the same field. However, pTeemp issues arise when it is shown that the legislature intended to implement statewide regulation in the area, to the 141„r exclusion of local regulation.") 3 - 4/14/2008 [DRAFT] 16 But, in the case of well construction, the state has expressly recognized and allowed for local laws to coexist with the state laws. Two provisions in Article 7 of Chapter 87, in particular, indicate that the legislature anticipated and condoned local action in this area: • '`T1ae provisions of any law, rule, or local ordinance which establish standards affording greater protection to groundwater resources or public health, safety, or welfare shall prevail within the jurisdiction to which they apply, over the provisions of this Article and rules adopted pursuant to this Article."I6 "A local board of health may adopt by reference rules adopted by the Environmental Management Commission pursuant to this Article, and may adopt more stringent rules when necessary to protect the public health."1 7 17-ius, it appears that local governments may regulate the same subjects governed by the private drinking water well rules adopted by the Environmental Management Commission if the local laws are "more stringent" than the state rules or afford "greater protection to groundwater resources or public health, safety, or welfare." $ut before assuming that a local well ordinance or rule can continue to be enforced, the local goverrunent must carefully examine the new state regulations and evaluate which local provisions are more stringent- Under the law, the testing rules adopted by the Commission for Public Health are treated somewhat differently. While the Environmental Management Commission's rules establish a floor upon which more stringent protections may be built, the Commission for Public Health's rules establish a ceiling. -1-be law states that "rules relating to public health, wells, or groundwater adopted by the Commission for Public Health shall prevail over this Article, rules adopted pursuant to this Article, and rules adopted by a local board o£health.___"18 Thus, a local board of health may not adopt more stringent testing rules.l9 QS_ When is a local provision "more stringent" than n provision in the EMC raffles? While the clauses "more stringent" and "provide greater protection" are not expressly defined in the state _law, a common sense interpretation would suggest tliat the local provision build upon or increase the regulatory requirements already imposed by the state laws. In the context of ordinances, state statutes also refer to local autliority to adopt ordinances that require "a higher standard of conduct or condition."20 16 G_S_ 87-96(a)_ 19 li however, a local government had an ordinance or rule in place prior to July 1, 1989 that is efFectively more stringent than the Commission's new testing rules, the pre-1989 law would remain enforceable. Id_ 2O Phis language is taken from G.S. 160^-174(7o)("The fact that a State or federal law, standing alone, makes a given act, omission, or condition unlawful shall not preclude city ordinances requiring a higher standard of conduct or condition.")_ This law addresses the authority of cities to adopt ordinances. The courts have extended 4 - 4/14/2008 [DRAFT'] V 1 7 For example, the state regulations governing well construction require the water supply source for most wells to be at least 20 feet below land surface 21 Under certain circumstances, the state regulations would permit wells to draw on water supplies that are less than 20 feet below the surface and in other situations, the state-regulations require wells to draw on water supplies that are at least 35 feet below the surface. 2 A county may conclude that, based upon characteristics specific to the county or region, all wells should be required to draw on water supplies that are at least 35 feet below the surface. This type of local law would likely be considered "more stringent" than the state regulations. Another example could be a local law that proposes to modify the timeline for local health department staff to conduct a grout inspection. Under the state regulations, before the well contractor grouts a new well, he must contact the health department and schedule a time for a health department representative to inspect the grouting. If the local health department representative is unable to conduct the inspection within one hour of the scheduled time, the , contractor is allowed to move forward with grouting the well without the inspection 23 If a health department in a particularly large county wanted more time to arrive at the grouting site to complete the inspection, it might consider extending the window of time from one to two hours. It is not entirely clear whether such a provision would be considered "more stringent." The argument in favor of such a conclusion is that allowing the health department more time to attend and inspect the grout before it is conducted increases the likelihood that the grouting will be done in compliance with the law. The opposing argument would be that such a provision is not necessary to protect the-public health because it does not increase the standard or level of protection to the groundwater or public health;, it simply increases the amount of time the contractor must wait at a well site. 24 4 When considering a local ordinance or rule provision, local governments will need to evaluate the provision carefully, compare it to the state law, and decide whether it considers the provision to be "more stringent" or provide greater protection to groundwater or public health than the state law. For each local provision adopted, it would be wise to prepare a clear explanation of the local law that includes an explanation as to why the provision is more stringent or provides greater protection. Q6. What is the difference between adopting a local well ordinance and a board of health rule? Ordinances are adopted by local elected officials, such as boards of county commissioners and they can local allbe enforcedlth. city councils. Board of health d board of healthbrulespare bodies City and county ordinances an - - 21 15A NCAC 02C .0107. iz 15A NCAC 02C.01 16 (less than 20 feet); 02C.01 17 (35 feet or more). " 15A NCAC 02C .0305. 24 There may be some situations in which leaving a well open for a longer period of time could be detrimental to public health or the environment. For example, in some types of soils, it may be difficult to keep the space needed for the grouting open for a long period of time. Before proceeding with a local rule extending the period of time for a grouting inspection, local lawmakers should consider all relevant information and make an independent determination as to whether an extended inspection period is appropriate. 5 - 4/14/2008 [DRAFT] 18 through the imposition of civil and criminal penalties- But when deciding what form a local well `r law should take, officials should be aware o£ a few key differences betwcern these types of local laws. Jurisdiction= A board o£health rule applies throughout its ji-Isdicticn,25 including within all municipalities.-6 The jurisdiction o{ city and county ordinances, on the other hand, is generally more limited- With some exceptions, a county ordinance typically governs only the - unincorpornted areas of n county27 A municipality within that county may, bowever, adopt a resolution empowering the county to enforce its ordinance within the rrtunicipality.28 A city ordinance will govern within the city limits and may also extend to city property and rights-of- way outside the city limits-29 Scope of"QUthority: Cities and counties have the relatively expansive authority to adopt ordinances necessary to protect and promote the "health, safety; and welfare o£ its citizens and the peace and dignity of the [city/county], and may define and abate nuisances.-3' Local boards of health, by comparison, are charged with "the responsibility to protect and promote the public health rand] have the authority to adopt rules necessary for that purpose--" In addition, the state well laws specifically authorize local boards of health to "adopt by reference rules adopted by the Environmental Management Commission pursuant to this Article, and may adopt more stringent ruleswhert necessary to protect the public health." 32 Thus, the authority of boards of health is more narrowly confined to protecting the public health. This limitation presents a challenge for local boards that attempt to draft rules that address ,~,y concerns other than health. For example, a board o£ health rule should not include exceptions -.goo that are based on economic factors rather than health factors_33 "Local health ne¢d": In a 2002 case, the North Carolina Supreme Court stated that, in a field of law heavily regulated by the state, a local board of health lacked the authority to "superi mpose additional regulations without specific reasons clearly applicable to a local health need."' The court went on further to explain that the board of health failed to "provide any rationale or basis for making the restrictions in Chatham County more rigorous than those applicable to and followed by the rest of the state.-35 Based on the language in this decision, a board of health may need to consider adopting private drinking water well rules only if the talcs address "local health needs-" -,A board ofhealth may govern a single county or multiple counties- z' G.S. 130A-39(c)_ zs Jd 29 G_S. 160A-176. 3O G.S. 153A-121 (..-ties); 160A-774 (cities). 32 zo S¢¢ Roanoke Rapids v_ Peedin, 724 N.C_App_ 579,478 S_E.2d 528 (1996); see also Aimee N_ Wall, Tfv¢ Rv!¢molcing Authority of North Carolina Locn! Boards ofH¢a!tls, Health I_aw Bulletin No_ 81 (Nov. 2003), ovailob!¢ ar www.ncphlaw_unc_cdu_ - " Craig v- County of Chatham, 356 N_C_ 40, 51-52, 565 S_E_ 2.1 172, 179 (2002) as Jd 6 - 4/14/2008 [I Ik AF7-] 1 9 Enforcement: There are three options available to enforce an ordinance: civil monetary fines, criminal penalties, and equitable relief such all an injunction 36 Only two options are available to enforce a board of health rule: criminal penalties and equitable relief 37 The board is not authorized to impose -civil fines for violations of board of health rules- Q7_ What process shonld n board of health 1.'OIIOw if it -uDts to retain or adopt local we11 roles? Once the state rules go into effect in July, there is the potential for tremendous confusion in those jurisdictions that have a local well rule or ordinance- Do the state rules apply? Are some or all of the provisions of the local laws still in effect because they are more stringent? Which laws will govern the construction of a new well? -rhe public, the drillers and the EHS's charged with enforcing the law will likely all have similar questions and concerns- '1"he burden is on the local government to minimize the confusion. In those jurisdictions chat have local well rules, the board of health will need to take some action in order to harmonize the state and local laws. For example, a board of health has several options available: - A local board of health may adopt a "sunset provision" that repeals local rules upon the effective date of the state rules. 13y doing so, the board of health makes it clear that only the state rules apply within the board's jurisdiction. • A local board of health may take action to repeal local rules effective July 1- 137 doing so, the board of health makes it clear that only the state rules apply within the board's jurisdiction. - • A local board of health may adopt a new rule or amend a rule with an effective date on or after July 1. The new or amended rule should adopt the state rules by reference and incorporate "more stringent" requirements deemed necessary to protect the public health. Such n rule would provide clear guidance regarding the law applicable within the jurisdiction- ]For any -of the above actions, the board cf health will need to follow the general rulemaking _ procedures outlined in C-3-S. 130A-39. Specifically, not less than 10 days before the adoption, amendment or repeal of the local rule, a copy of the proposal must be made available at the off-Ice of each county clerk within the board's jurisdiction and a notice must be published in a newspaper having general circulation within the jurisdiction. The notice must provide a general description ofthe subjects and issues involved, the proposed effective date, and a statement explaining that copies of the proposal are available at the local health department- - When a board of health passes a local rule that adopts the state rules by reference, reading the two laws together may be challenging. To assist the public and others trying to understand the law, the board or staff members could develop "guidelines" that bring together both the state 14-4 (criminal remedies); 153A-123 <other remedies available to counties); 16OA-175 (other remedies available to cities)- ' G.S_ 13oA-]8 (injunctions); 130A-25 <misdemeanorj_ 7 - 4/14/2008 [DRAFT] 2 O rules and the local rules in one document- While the guidelines would not have the force of law, they could help improve understanding of the law applicable within the jurisdiction. Q8_-If a local government adopts a local board of ltealtlt rule and is subsequently sued by a property owner or other individual, will the state provide for legal representation and pay settlements and judgments? In some f gilds of public health,. local health department staff mctabers that are enforcing state rules are considered authorized agents of the state.38 For example, if an enviror rital health specialist (EHS) employed by a county complies with specific [raining requirements and passes a certain test, 39 he or she may be "authorized" to enforce statewide sanitation regulations governing restaurants. 1'h4_/ authorized agent (i_e_, local EHS) is allowed to enforce the state rules, which includes inspecting rcstatirar,ts, issuing, suspending or revoking a restaurant's permit, and issuing a sanitation grade to a restaurant. 4o - If a restaurant owner challenges an action taken by the EHS either by filing an appeal with the Office of Administrative Hearings or by suing the EMS, the county or others, the state will typically be involved in providing representation and paying all or some of any settlement or judgment. State law provides: Any local health department sanitarian enforcing rules of the Commission for Public Health or of the Environmental Management Commission under the supervision of the Department of Environment and Natural Resources pursuant to G.S. 1 30A-4 shall be defended by the Attorney General, subject to the provisions of G_S_ 143-300.4, and shall be protected from liability in accordance with the provisions of this Article in any civil or criminal action or proceeding brougbt against the sanitarian in his official or individual capacity, or both, on account of an act done or omission made in the scope and course of enforcing the rulAes ~o.f the Commission for Public Health or of the Environmental Management Corxizission 41 If, instead of enforcing a state law, an EHS is enforcing a local law or policy or is acting outside the scope of his or her agency, it is highly unlikely that the state will provide representation or pay ally part of a civil judgment_42 - Controversy surrounding state and local responsibility for litigation-related costs typically arises in the context of enforcing laws related to on-site wastewater (i.e., septic systems) permitting and inspection programs. State 1aw sets out detailed requirements governing the permitting of on-site 130A-4(d)~ C"r"hc local health department shall utilize local staff authorized by the Department of Environment and Natr~ral Resources to enforces" the rules of the Commission For Public Health and -rhe Environmental Management Commission. 39 75A NCAC 010- 0100 et seq_ 15A NCAC 18A _2600 et seq_ G.S. 143-300.8. S- Cates V. P4 -C- Dept_ of Justice, 346 N_C_ 781 (1997DP (holding that a specialist who conducted a preliminary soil evaluation was not entitled to representation by the Auorney General because the evaluation was not provided for in the state ruled- 8 - 4/14/2008 2 1 ? wastewater systems.43 State law also specifically authorizes local boards of health to adopt local rules governing permitting and inspection of on-site wastewater systems. In such cases, the local board of health must. • Adopt the state rules by reference "with any more stringent modifications or additions deemed necessary by the local board of health to protect the public health; 44 and • Ask the Department of Environment and Natural Resources (DENR) to review its proposed rules.as DENR may approve of the local rules if it finds that the local rules are "at least as stringent" as the state rules and "sufficient and necessary to safeguard the public health .s46 DENR retains the authority to revoke its approval of local rules if it later concludes that they are "not as stringent as [the state rules, are not sufficient and necessary to safeguard the public health, or are not being enforced.'07 When a local board of health decides to adopt local rules and follows through with the process outlined above '48 the state's position has histo6cally been that the entire body of rules - including those state rules that are adopted by reference - are considered local rules. In such cases, the state's position is that the EHS is not acting as an "authorized agent of the state" with respect to any of the rules, even those that are "adopted by reference" from the state. Therefore, when those local rules are challenged, the state does not provide legal representation and does not pay any portion of the settlement or judgment. rr At this time, it appears that the state will take the same approach with respect to local well rules. Thus, if a jurisdiction wishes to enforce more stringent local well rules, it should adopt the state rules by reference and add provisions it considers necessary to protect the public health. Once the local rules are in place, the EHS will not be acting as an agent of the state, the Attorney General's office will not provide representation in legal challenges based on the rules and the state will not pay any judgment or settlement that arises from such litigation. Given the potential liability exposure, a local board of health should consult with the county or health department attorney prior to moving forward with local rules. 43 G.S.130A, Article 15A NCAC 18A .1900 et seq. M G.S.130A-335(c)(2). `s G.S.130A-335(c)(1). "G.S. 130A-335(cX3). 0 G.S. 130A-335(d). 08 Only three counties, Guilford, Orange and Wake, currently enforce local on-site wastewater rules. 9 - 4/14/2008 [DRAFT] 22 - 4/1512008 1 vnc seed a co.........++. ce the state rules after 7/a Locals authority to have local laws 7[- cnt ust be more sfrino Bc>" eed to respond Co a local LHOS 777 If suedlocal laws,SCatay claim and not represent ^LOCaI health departments shall enforce the minimum well-~ ~ con ru ~On, Permitting ~w n _~LIn9 G.-f C= pe an e re wre men s set out In this Article _ and ru es adopted pursuant tot s A~ ,yn,, A"Cie_ G_5. 87-9Ka) 2 3 4115/2008 ...rte nforce total well laws v_ BOH rail on , auThortty y not address lectors other <ban health e most be ~necosary to pro<ect <h< pobltc hea1M~ alth need" ent - 7 77777 a If the local provision p vides BIG More protection to the ubilc More protection for public health More protection for groundwater/envSronm¢n[ a Example ^ Local provision allows EHS two hours [rather than - one)to conduct grout inspection More SLrInrJ¢n[7 a Local body should carefully review state rules What "more siringenC° provisions desired? a Take action to address exi sling local rules Sunset provision or repeal . Adopt state rules by reference + new local rules .24 4/15/2008 Local rule or ordinance • Adopt state rules by reference and add more stringent provisions ¦ Entire body of rules become local rules • No tort claims protection (STCA) • NoAG representation 25 § 87-96_ Co~nilict with other laws(a) The provisions of any law, rule, or local ordinance which establish standards affording greater protection to groundwater resources or public health, safety, or welfare shall prevail, within the jurisdiction t0 which they apply, over the provisions o£ this Article and rules adopted pursuant to this Article. (b) Rules relating to public health, wells, or groundwater adopted by the Corxnmissic a for Public Health shall prevail over this Article, rules adopted pursuant to this Article, and rules adopted by a local board o£ health pursuant to subsection (c) of this section- This Article shall not be construed to repeal any law or rule in effect as of July 1, 1989. (c) A local board of health may adopt by reference rules adopted by the Environmental Management Cotarnission pursuant to this Article, and may adopt more stringent rules when necessary to protect the public health. (1967, c- 1157, s_ 14; 1973, c. 476, s. 128; 1989, c- 727, s. 17; 1991, c. 650, s_ 1; 2007-182, s- 2.) § 130A-39_ Powers mad duties of a local board oT health- A local board of health shall have the responsibility to protect and promote the public health. The board shall have the authority to adopt rules necessary for that purpose. (b) A Ioeal board o£ health may adopt a more stringent rule is as area regulated by the Corrytaissioa for Public Health or the Environmental Management Coraaaissioa where, in the opinion o£ the local board of health, a more stringent rule is required to protect the public health; otherwise, the rules of the Comtaissioa for Public Health or the rules of the Environmental Management Comntissioa shall prevail over local board of health rules. However, a local board of health may not adopt a rule eoacerniag the grading, operating, and permitting of food and lodging facilities as listed is Part- 6 of Article 8 ofthis Chapter and as defaced in C--.S- 130A-247(1), and a local board ofhealth may adopt rules concerning wastewater collection, treatment and disposal systems which are not designed to discharge effluent to the land surface or surface waters only in accordance with G.S- 130A-335(c)- (c) -The rules c f a local board of health shall apply to all municipalities witlzia the local board's jurisdiction- (d) Not less than 10 days before the adoption, amendment or repeal of any local board of health rule, the proposed rule shall be made available at the office of each county cleric within the board's jurisdiction, and a notice shall be published in a newspaper having general circulation within the area of the board's jurisdiction- The notice shall contain n statement of the substance of the proposed rule or a description of the subjects and issues involved, the proposed effective date of the rule and a statement that copies of the proposed rule are available at the local health deparCmeat_ A local board of health rule shall become effective upon adoption unless a later effective date is specified is the rule- (e) Copies of all rules shall be filed with the secretary of the local board of health- General statutes Page 1 2 6 (f) A local board o£ health may, in its rules, adopt by reference any code, staadard, rule or regulation which has been adopted by any agency of this State, another state, aay agency of the iTaited States or by a generally recognized association_ Copies of any material adopted by reference shall be filed with the rules. (g) A local board of health may impose a fee for services to be rendered by a local healtla depATtx3a=nt, except where the imposition of a fee is prohibited by statute or ?vbere an employee of the local health departmeat is performing the services as an agent o£ the State- Notwithstanding any other provisions of law, a local board of I-Itb may impose cost-related fees for services perforracd piu'sLrt to Article 1 1 of this Chapter, "Wastewater Systems," for services performed pursuant to Part 10, Article 8 0£ this Cbapter, "Public Swimming Pools", for services performed pursuant to Part 11, Article 8 of this Chapter, "Tattooing", and for services performed pursuant to G_S_ 87-97_ Fees sball be based upon a play recommended by the local health director and approved by the local board o£ bealth and the appropriate county board or boards c f cornmissioners_ T'he fees collected' under the authority of tbis subsection are to be dcposiied to the account o£ the local bealth departiaent so that they may be expended for public health purposes in accordance with the provisions of the Local Govemmeat Budget and Fiscal Control Act_ (1901, c_ 245, s_ 3; Rev_, s_ 4444; 1911, c. 62, s_ 9; C_S., s_ 7065; 1957, c_ 1357, s_ 1; 1959, c_ 1024, s_ 1; 1963, c. 1087; 1973, c_ 476, s_ 128; c_ 508; 1977, 4--_ 857, s_ 2; 1981, c_ 130, s_ 2; c. 281; c_ 949, s_ 4; 1983, c. 891, s_ 2; 1985, c_ 175, s_ 1; 1989, c_ 577, s. 2; 1991 (Reg- Sass, 1992), c_ 944, s. 10; 1993 (Rag_ Sess_, 1994), c_ 670, s_ 2; 1995, c_ 507, s_ 26.8(c); 2006-202, s_ 6; 2007-182, s_ 2_) N_C. General Statutes Page 2 2 7 Roberts, Marilyn ~-"gym: Neilson, Rob t: Monday, May 12, 2008 8.43 AM o: Harvell, E)ianne; Roberts, Marilyn Cc: Roane, Kim; Standfest, Maria Subject: [=-HS Public Notice Attachments: REPEAL Well Rules - Public Notice"doc Diane and Marilyn, I wanted to let you know that the attached public notice is scheduled to run in the Star News on Sunday May 25t, and Sunday June 1't. Thank you, Rob Robert Neilson Business Officer Na- Hanover County Health department (910) 798-5680 - office (910) 341-4146 - fax fneilsonCcDnhGOOV" corn 2 8 PUBLIC NOTICE The New Hanover County Board Of Health at their scheduled June 4, 2008 monthly meeting will consider repeal of existing RULES GOVERNING WATER SUPPLY WELLS IN NEW HANOVER COUNTY NORTH CAROLINA which were enacted on April 5, 1995. The North Carolina Commission For Public Health and Environmental Management Commission have adopted more protective regulations governing water supply wells which become effective July 1, 2008. The repeal of RULES GOVERNING WATER SUPPLY WELLS IN NEW HANOVER COUNTY NORTH CAROLINA is proposed to become effective July 1, 2008. Copies of both standards are available for inspection at the New Hanover County Health Department, 2029 South 17th Street and the Environmental Health Services office, 230 Government Center Drive, Suite 140. 2!9 Nof-t CalrolirEa Public Healtls Commcmaratirsg Local PYbfiC "4mwftft AW4m"=V A==reditation Dear New Hanover County Board of Health: Congratulations on achieving accreditation from the NC Local Health Department ACCredltation Board. The accomplishment of accreditation means your organization complies with the highest established standards for public health capaclty In North Carolina. We at the NC State Health Director's Office join with you as you commemorate and promote this outstanding achievement Fn continuous quality. improvement. We know that NC Local Public Health Department Accreditation requires a slgnificant commitment, and the achievement of accreditation is worthy In many ways. AchievFng Full Accreditation status from the NC Local Health Department Accreditation Board makes a strong statement to your community about your desire to provide serv[ces of the highest quality. It also contributes to the collective goal of assuring that every person in North Carolina has access to a core set of essential public health services. We In the Division of Public Health extend our thanks and appreciation to you as a Local Public Health Agency. Our thanks also for your willingness to accept the challenge of accreditation and for the hard work of your agency in accomplishing your goal. Sl~nceraelly, Leah M. Devlin, DOS, MPH NC State Health Director 6/2/2008 MST Colposcopy except lot- t lie highest grade pap test result Began seekinggrant funding for start-up costs/training Volunteer to perform Colposcopy procedure (Dr. Henry] emple) O *11STOn"AlL, O Board of I lealth Approval W-4/07) Grant received ($12,000) from rainisteringcircle L(ILlipment and Supplies ordered (5/07) Chnic profile set up (weekly Colposcopy C11111c) Additional funding received 10/15/07 Cape Fear Foundation WHAT IS ® P® ® P® Use of magnification to better viev., cervix Piovided by health care provider View cervix through instrument called a Colposcope Collect a biopsy (tissue sarnple) From anyabnormal areas (as needed) Tissue Sample sent to Lab foi- further testing 1 6/2/2008 REASONS FOR 1 1, abnormal cells on a pap test Rule out cervical cancer M 1`6 decide if further treatment is needed Prevention of cervical cancer f-11"V (HUMAN PAPILLOMA VIRUS) 95(!'i) Of Stl'aiuS Cause no problems Afte(ts genital ai ea and shows lip ()jj pap test Passed by close physical contact Is a sexually transmitted disease Other types cause warts on hands, feet, face MOST FREQUENT REASON FOR 1 1 1 1 Can take weeks/months/years to surface after exposure with a sexual partner Can cause cell changes on the cervix High risk types can sometimes lead to cervical cancer if left untreated Gardasil (H ' available 2 6/2/2008 Began 1/10/2oo8 Detects High Risk HPV Scheduled for Colposcopy 43.5% w Tested w Positive Percentage Positive 1 1 1 1 Abnormal pap tests reviewed (Nurse) High risk pap tests reviewed (Dr. Temple) Previous Colposcopy findings reviewed ~i and recommended plan/care (Dr. Temple) Very high risk referred to NHRMC 3 6/2/Zoos ~kw DECREASE! Over t lie past several decades: Decrease in the nuinber of invasive cervical cancer cases Decrease in deaths Due to: Early detection (pap tests) Screening (Colposcopy) NUMBERS: NEW ffANOVEH COUNTY JULY 2007 - APIRIL Vii. Abnori-rial pap tests percent 16% (up one percent from 2oo6/2007) r Abnormal • • repeat tests needing pap 5%) BENEFIT , PATIENT Scheduled Notification after Proredure Pmcedure F n m vM b zoo?/zooB 3-S Mon[hsy [-;Weeks .a MonthsY P eek New Hanover New Hanover Coastal OBlG n Coasral06/G n County Health County I{ealN Clinic pep rtrnent Clinic De rmient 4 6/2/2008 r O O_...m) Total ¦zoo6/zoos ?zoo~/zoo8 5 r INTERNAL REVENUE SERVICE DEPARTMENT OF THE TREASURY P. O. BOX 2508 CINCINNATI, OH 45201 Employer Identification Number: Date: MAY 0 6 2908 65-1317627 DLN: 17053299309047 PUBLIC HEALTH FOUNDATION OF NEW Contact Person: HANOVER COUNTY INC JACK D NEITZEL ID# 95127 C/O DAVID E RICE Contact Telephone Number: 2029 S 17TH ST .(877) 829-5500 WILMINGTON, NC 28401 Accounting Period Ending: June 30 Public Charity Status: 170 (b) (1) (A) (vi) Form 990 Required: Yes Effective Date of Exemption: October 23, 2007 Contribution Deductibility: Yes Advance Ruling Ending Date: June 30, 2012 Addendum Applies: No Dear Applicant: We are pleased to inform you that upon review of your application for tax exempt status we have determined that you are exempt from Federal income tax under section 501(c)(3) of the Internal Revenue Code. Contributions to you are deductible under section 170 of the Code. You are also qualified to receive tax deductible bequests, devises, transfers or gifts under section 2055, 2106 or 2522 of the Code. Because this letter could help resolve any questions regarding your exempt status, you should keep it in your permanent records. Organizations exempt under section 501(c)(3) of the Code are further classified as either public charities or private foundations. During your advance ruling period, you will be treated as a public charity. Your advance ruling period begins with the effective date of your exemption and ends with advance ruling ending date shown in the heading of the letter. Shortly before the end of your advance ruling period, we will send you Form 8734, Support Schedule for Advance Ruling Period. You will have 90 days after the end of your advance ruling period to return the completed form. We will then notify you, in writing, about your public charity status. Please see enclosed Publication 4221-PC, Compliance Guide for 501(c)(3) Public Charities, for some helpful information about your responsibilities as an exempt organization. Letter 1045 (DO/CG) -2- PLTB L= C HEALTH FOUNDAT=ON OF NEW Sincere 1y , Robert Choi D i rector , Exempt Organizations Rulings and Agreements Enclosures v Pub1 icat ion 4 2 2 1- PC Statute Extension V Let ter 1 O 4 5 (DO / CG) Form 1023 (Rev. 6-2006) Name: Public Health Foundation of New Hanover County, Inc. EIN: 65 _ 1317627 Page 11 Public Charity Status (Continued) e 509(a)(4)-an organization organized and operated exclusively for testing for public safety. ? f 509(a)(1) and 170(b)(1)(A)(iv)-an organization operated for the benefit of a college or university that is owned or ? operated by a governmental unit. g 509(a)(1) and 170(b)(1)(A)(vi)-an organization that receives a substantial part of its financial support in the form ? of contributions from publicly supported organizations, from a governmental unit, or from the general public. h 509(a)(2) -an organization that normally receives not more than one-third of its financial support from gross ? investment income and receives more than one-third of its financial support from contributions, membership fees, and gross receipts from activities related to its exempt functions (subject to certain exceptions). i A publicly supported organization, but unsure if it is described in 5g or 5h. The organization would like the IRS to ? decide the correct status. 6 If you checked box g, h, or i in question 5 above, you must request either an advance or a definitive ruling by selecting one of the boxes below. Refer to the instructions to determine which type of ruling you are eligible to receive. a Request for Advance Ruling: By checking this box and signing the consent, pursuant to section 6501(c)(4) of the Code you request an advance ruling and agree to extend the statute of limitations on the assessment of excise tax under section 4940 of the Code. The tax will apply only if you do not establish public support status at the end of the 5-year advance ruling period. The assessment period will be extended for the 5 advance ruling years to 8 years, 4 months, and 15 days beyond the end of the first year. You have the right to refuse or limit the extension to a mutually agreed-upon period of time or issue(s). Publication 1035, Extending the Tax Assessment Period, provides a more detailed explanation of your rights and the consequences of the choices you make. You may obtain Publication 1035 free of charge from the IRS web site at www.irs.gov or by calling toll-free 1-800-829-3676. Signing this consent will not deprive you of any appeal rights to which you would otherwise be entitled. If you decide not to extend the statute of limitations, you are not eligible for an advance ruling. Consent Fixing Period of Limitations Upon Assessment of Tax Under Section 4940 of the Internal Revenue Code For Organization ' u Edward Weaver- Jr,.,--Q..1) ---1QI.Q4/2QQ7. - (Signature of Officer, Director, Trustee, or other (Type or print name of signer) (Date) authorized official) Boa>=d.cf _.}3ealth,_.Cha_iz.......... (Ttit e out oT`y of ,sjgne ~~'~d/? ~~~!/'i~W?•~! Ld u -r~'~jj IvtlG. For IRS Use Only / MA"i,...O . Q.1 ,08 IRS Director, Exempt Organizations (Date) b Request for Definitive Ruling: Check this.box if you have completed one tax year of at least 8 full months and ? you are requesting a definitive ruling. To confirm your public support status, answer line 6b(i) if you checked box g in line 5 above. Answer line 6b(ii) if you checked box h in line 5 above. If you checked box i in line 5 above, answer both lines 6b(i) and (ii). (1) (a) Enter 2% of line 8, column (e) on Part IX-A. Statement of Revenues and Expenses. (b) Attach a list showing the name and amount contributed by each person, company, or organization whose ? gifts totaled more than the 2% amount. If the answer is "None," check this box. (ii) (a) For each year amounts are included on lines 1, 2, and 9 of Part IX-A. Statement of Revenues and Expenses, attach a list showing the name of and amount received from each disqualified person. If the answer is "None," check this box. ? (b) For each year amounts are included on line 9 of Part IX-A. Statement of Revenues and Expenses, attach a list showing the name of and amount received from each payer, other than a disqualified person, whose payments were more than the larger of (1) 1% of line 10, Part IX-A. Statement of Revenues and Expenses, or (2) $5,000. If the answer is "None," check this box. ? 7 Did you receive any unusual grants during any of the years shown on Part IX-A. Statement of ? Yes No Revenues and Expenses? If "Yes," attach a list including the name of the contributor, the date and amount of the grant, a brief description of the grant, and explain why it is unusual. Form 1023 (Rev. 6-2006) Rice, David E_ From= Rice, David a. ent: Monday, May 19, 2008 11: 30 AM o_ Jenkins, Paula Cc: Roane, Kim; Neilson, Rob Subject: RE: Recommendation Approved. David E. Rice, MPH, MA Health Director New Hanover County Health Department 2029 South 17th Street Wilmington, NC 28401 910-798-6591 driceCcanhcaov.com htto://www_nhrhd.orc _ From: Jenkins, Paula Sent: Monday, May 19, 2008 11:10 AM To: Rice, David E_ Cc: Roane, Kim; Neilson, Rob Subject: FRecommendation Mr. Rice, The F.A.C.T_ meeting held on May 14, 2008 resulted in the following recommendation: ,acrease fees for pre-exposure rabies vaccine to $175.00 (previously $150.00) for private patients and to $165.00 (previously $115.00) for HD employees. The increases are needed to offset the cost of purchasing/administering the vaccine. The cost of the vaccine is now $146.65 per dose, an increase from $139.11. The increases in fees will not generate revenue in excess of $5,000 in one year. Request approval of recommendation. Thank you. Paula S_ Jenkins Fiscal Support Supervisor Billing Unit New Hanover County Health Department 2029 South 17th Street Wilmington, NC 28401 (910) 798-6501 i • - • a • _...~.-•Y ~.o~~P4 May 2008 NEW MANavER COUNTY HEAL-ZN New Hanover County Health Department Hours of Operation for Maiin OfRc¢: OtFice Hours- Monday-Friday, 8:00 a.m. - 5 p_rti. Awarded State Re-AccreditatioII Clinic Hours= Monday - Friday, 8:00 a_m. - 4:30 p_m_ Extended Clinic Hours: Tuesday evening until 7 p.m_ T ocal health departments in North Carolina are required to Se Habla Espanol L wFc" --V" CA(-~ become accredited by the North Carolina Local Health Servicio de Interprete Gratis Y Department Accreditation 73oard_ Accreditation is given N¢w Hanover CDIIII w health departments that meet or exceed standardized tY Accredited benchmarks reflecting successful program evaluation and Health Departlment Health operation. The New Hanover County Health Department 2029 South 17th Street a nt was among the first health departments in the state to Wilmington, NC 28401 become accredited four years ago- Now the department is phone 910.798.6500 p~ one ofthe first to be re-accredited_ fax 910.341-4146 - 2008-201 2 ~.a. Following a three-day site visit by representatives from the www.nhchd_org :a~'L'j'I')ent P~'~'~~ State of North Carolina Health Department Accreditation Board, the New Hanover Coamty Health Department was Offsite 1OC9ti0IIs: designated as an accredited health department. "ITtc site visit report Animal Control _tea that- ServsCes • Staff seem very caring p¢tientfocused and team oriented 7 80 Division Drive Collaborative arrangements exist with many organiZOtions and agencies Wilmington, NC 28401 910-798-7500 including the hospit¢I churches, schools and the medical community to resourcefully address public health priorities- The Ze¢dership and Environmentttl cooperation even extend to neighboring couuties_ Health Services 230 Marketplace Drive The award winning Board o_fHealth is highly invested and engaged in Wilmington, NC 28403 public health issues_ 910-798-6667 (located in County Annex at The agency has been proactive with no smoking policies for facilities and Market Place Mall) vehicles since first implemented in 1987_ NEW HANOVER COUNTY "Earning this distinction gives assurance that our health department meets national standards HEALTH DEPARTMENT ofpublic health practice- The health department staff and Board of Health are pleased to o,M-v BOARD MEMBERS this level of competence to the citizens of our community," said David Rice, Health Director. VER CC:PUNTY i"tE~a..Tt"'f EyCrl~r•ii r wra saaara L_ M11e•, DDS, chair, nentiat NEW H^HC G_ Robert Wectlov, DVM, MPH, Vice Chalr Veterinariav ~'"RVir-eivta W_ Aaams, PhD, Nurac Dovald P. Bia!<e, Public Member v^~{ T"~~=_ _ - Michael E. Goivs, OD, Optometrist . a i James R Ricittttov, RPb, Phamactst r ~ ~ y~'.'4 ls, Robert E_ Lewis, Public Member !a~i¢~'.t,~, t ~ a Navcy H. Pritchett, Covvty Commassioncr ~t i\tw Robert M_ Shaicar Jr_, MD, Physician ' ti,,- ~ ~ t' ~ ~ ~Y C_ Bevjamiv Spratliey, Pubhc Member ~ _ John N_ "Ibnstali, PE, Engineer _ ~l.•. ~i~ ¦¦gg~~~~'~~~~ 4 Free Sports Screening Exams for NEW NRNOVER COUNTY NFti4SYO New Hanover County Athletes and Cheerleaders N(-\\ I lanover M111 " Sk-110 r15 Each year, all North Carolina students who plan to participate in athletics or cheerleading must undergo a state-mandated screening examination. Physicians in the New Hanover - Pender County Medical Society, in concert with New Hanover County Health Department and the School System, are offering free screenings to New Hanover County athletes and cheerleaders at designated times and places. Exams for the boys will be on'I'ht€r,da , Jt!nk~ I:_, -'_008'. Girls'exams will be 1I 3,rs. . Iwn 10- 2,I'?. All exams will be at the Health Department, 2029 South 1711 Street. These will be the ONLY free screening dates for 2008-2009 school sports. Students from the schools listed below should report to the New Hanover County Health Department at the following times: June 12, 2008- Boys June 19, 2008- Girls June 12, 2008- Boys June 19, 2008- Girls 6:30pm 6:15pm 7:00pm 6:45pm Ashley HS Ashley HS Roland Grise MS Roland Grise MS WCA, CFA, MGC, CCHS WCA, CFA, MGC, CCHS Myrtle Grove MS Myrtle Grove MS Trask MS Trask MS New Hanover HS New Hanover HS Laney HS Laney HS Virgo MS Virgo MS Noble MS Noble MS Williston MS Williston MS Murray MS Murray MS Hoggard HS Hoggard HS Pop Warner and Special Olympics cheerleaders and teams should arrive at six on the appropriate date for boys or girls The waiting area for students is the Health Department's parking lot, near the Auditorium entrance. The students from each school will be called in, as a group, in the order listed. THERE IS NO NEED TO ARRIVE MORE THAN 15 MINUTES EARLY - except as noted, above, for Pop Warner and Special Olympics students. Before beginning an examination, physicians are required to see the new Medical History, Emergency Information, and Parental Permission Forms (total of 2 pages) which are available in the schools, the Board of Education and at www.nhcs.kI2.nc.us Departments > Athletics > Parent Information). These forms must be completed and signed by a parent or guardian before the exam is begun. A parent may add his/her initials in the proper space and secure the Tdap vaccine for a student Rising ninth graders should list the high school that they will attend in the, falla „ 01-N n, v 1H n~~d fo _.,c., , r0rn +5 _ n 14..., t~. 11 ;r,n t . 4. }„t<e<~~ If there are questions, call the student's school, the Medical Society office (790-5800), or Jim Strickland, ATC/LAT (251-6100 ext. 270). Please do not call the Health Department for information. Parents should be advised that the exams are a screening for athletics and not a complete physical examination. It is important that health concerns be addressed, promptly, by the child's personal physician. The New Hanover County Health Department and our physicians, staffs and administrations are happy to be able to donate their time, expertise, and facilities to serve the community's children. Your help in disseminating the pertinent information so that students an parents can benefit, is greatly appreciated. What's New for Schools This Fall? Students entering kindergarten in New Hanover County in Fall 2008 will be required to have a Kindergarten Health Assessment. The form has changed slightly from last year's form. The most important change is the addition of a stereopsis.(binocular vision) screening. This is done during the vision screening part of the assessment. All blanks on the form must be completed in order for it to be considered a complete kindergarten health assessment. Parents should also plan to provide the school with a copy of the child's immunization record. Attention all rising sixth graders! The State of North Carolina has passed a law that requires rising sixth graders to receive a Tdap (Tetanus, Diptheria, and Pertussis) booster vaccination for entry into the sixth grade, if the student has not had a tetanus shot within the last five years. Parents should plan to submit a completed immunization record to the school. This booster can be obtained at the New Hanover County Health Department or your physician's office. MEN'S HEALTH FAIR COMING THIS SEPTEMBER New Hanover County Health Department, New Hanover Regional Medical Center and local medical professionals are teaming up to provide FREE health screenings to men without health insurance. We are offering hundreds of dollars of medical screenings for FREE. Screenings include: vascular screenings, fasting cholesterol panel, blood sugar, blood pressure and prostate exam. Look for more information to come in August. w Hurricane Preparedness Week May 25th May 31st • e Are You Prepared? ~a 0 NEW HANOVER COUNTY NEA Before, during, and after a hurricane, injuries can occur. To prevent injury, stay cautious, use common sense, read instructions for equipment, wear sturdy clothing exposing as little skin as possible, and wear sturdy shoes or boots until all clean-up is completed. Before a hurricane, be prepared! Being well prepared prevents you from taking risks such as travel, eating / drinking contaminated food, or operating equipment unsafely. Make plans to take care of people, pets, property, and belongings. Use a checklist to prepare, make sure everyone in your household knows the plan, and assign specific duties to everyone. Some things to do for human and pet safety are: • Know evacuation routes and shelter locations / policies • Take a first aid and/or CPR course • Have working fire extinguishers, smoke detectors, carbon monoxide detectors • Practice your household escape routes (2 minimum) • Monitor electricity, gas, chemical, and structural hazards • Inform local authorities of special needs such as elderly, n disabled family and neighbors • Pre-pack supplies for evacuation or loss of utilities: these can include food, bottled water, toiletries, bedding, medicines, etc. (have pre-prepared baby formula or bottled water on hand, do not use treated tap water with powder formula for babies) • Clean all sinks & tubs, and fill with water for use after storm • Leave pets with your animal shelter preferably, or leave in a secure room with plenty of food and water. Family Disaster Plan: • Discuss the type of hazards that could affect your family. Know your home's vulnerability to storm surge, flooding and wind. • Locate a safe room or the safest areas in your home for each hurricane hazard. In certain circumstances the safest areas may not be your home but within your community. • Have an out-of-state friend as a family contact, so all your family members have a single point of contact. • Make a plan now for what to do with your pets if you need to evacuate. • Post emergency telephone numbers by your phones and make sure your children know how and when to call 911 • Check your insurance coverage - flood damage is not usually covered by homeowners insurance. • Stock non-perishable emergency supplies and a Disaster Supply Kit. • Use a NOAA weather radio. Remember to replace its battery every 6 months, as you do with your smoke detectors. i Some things to do for property and belongings: • Know location of important papers to take quickly if leaving • Secure or dispose of chemicals, pesticides, solvents • Secure outside items, and shutter or tape windows • Lock up when leaving • Bring automobiles into cover if possible During a storm, stay put! Flying debris outside and through windows causes a great portion of injuries during hurricanes. When you must move about, use battery powered flashlights or lanterns, AVOID USE OF CANDLES. WHEN CANDLES MUST BE USED, NEVER LEAVE THEM UNATTENDED AND NEVER PLACE NEAR FLAMMABLE ITEMS!! After the hurricane, proceed with caution! • Use a radio or TV (battery powered if no electricity) to get local information about utilities, flooding, water contamination, closed off areas, curfews, and other information. • Inspect and use all equipment such as chainsaws, pumps, and blowers carefully and according to instructions. • Wear eye protection and gloves! • Be cautious about debris in the road when returning home, and return during daylight • Use stored or bottled water until authorities announce the drinking supply is safe - do not use well water until it is tested • Proceed around your house and property with great caution, some injury hazards include: • Debris such as glass, wood, metal, falling branches • Pets / wild animals afraid and confused • Gas leaks, electrical wiring damage, chemicals • Bees, wasps, hornets, ants, snakes, mosquitoes • Flood waters moving swiftly and/or contaminated with debris, bacteria, parasites, etc. GENERATORS CAN BE DANGEROUS! They can cause severe injury or death to those in the home or utility line workers when used incorrectly or at the wrong time! • Use a generator only with an APPROVED AUTOMATIC INTERRUPT DEVICE! The generator can cause severe injury or death due to shock, fires, or explosions. Since one never knows exactly when utility power will be restored, the generator must automatically shut off when power comes back to the house through the utility lines. For more information on Hurricane Preparedness Week please access the following website: hap://www.nhc.noan.gov/HAW2/engHsb/intro.shtM Miles of Smiles Continues... The mobile Dental Unit is moving to Johnson Elementary School, located at 1100 McRae Street, Wilmington NC 28401 . 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 Eligible? How Do I Schedule • Children 3-18 years of age an Appointment? • Children with Medicaid or NC Health Choice Insurance • Children with no dental insurances i • Children in need of low-cost dental care Call 910-512-3113 • Children who are unable to travel to a local dental office to schedule an appointment New Hanover County Health Department g' e Phone: 910.798.6500 NfY. N•NOMf COJNiv •Ul'lrP• • . • • s ,uN,N 4- NIN N.N6NIi CD ' M- - D i n i n ASSIST China One KS Cafe and Catering Water Street Restaurant China King China Star La Costa Restaurant Wendy's D&B Restaurant t China Wok Lake Shore Commons What's Cookin' Dee's Drug r Chopstix Express Le Catalan Wilmington Ice House Domino's - Chuck E Cheese L'Oven Cafe Wilmington Tea Room Holland's Shelter Creek CAROLINA BEACH Cici's Pizza Lovey's Natural Foods Wilmingtonian/Percy's Restaurant Bowman's Seafood City Club Cubbies Lucky Star Wrightsville Cafd Maria's Courtyard Courtyard By Marriot Connection Internet Cafd Lupita's Bakery Zaxby's McDonald's Frank's Pizza Courthouse Cafd Macaroni Grill Zero's Scotchman Hazdees Cubbie's Manhattan Bagel Skat's Kate's Breakfast and Lunch D & U Diner Marc's on Market WRIGHTSVILLE BEACH Subway Mama Mia's Dairy Queen Marriott Courtyard Airlie Seafood Company Szechuan Pavilion Michaelangelos Pizza David's Deli and Restaurant Mason Bistro The Bridge Tender U Wash and Dry Grill Subway Deli Downtown Mayfaire Cinemas Mercer's Restaurant Your Convenience ~ The Oceanic Top Wok Dick's Dogs and Burgers McDonald's Verandah Cafe-Holiday Inn HAMPSTEAD Tuscan Grill Dog House Meritt's Burger House V Verandah Pizzeria Andy's Double Happiness Midtown Deli and Grill China Garden KURE BEACH Dunkin Donuts Minch Sushi BRUNSWICK COUNTY Freddie's Restaurante Echo Farms Country Club Ming Tree Domino's Andy's- Shallotte Jolly Roger Ed's City Grill i Moe's Southwest Grill Archibald's Deli WILMINGTON King's Table A Southern Thyme El Guajiro Restaurant Montego Bay Bart's BBQ Old Point Country Club Everyday Gourmet Nagila Beck's A Taste of Italy Grill Fire Bowl New Hanover Regional Bella Cucina Andy's Cheesesteaks Panda Chinese Restaurant Firehouse Stubs Medical Center Cafd BHI Clubhouse Anntony's Caribbean Cafd Pizza's 2 U Flaming Amy's Nicola's Bill Bass Seafood Antonios Pizzeria Y Player's Cafd Flip's BBQ Nikki's Fresh Gourmet Arab Shrine Club Bojangle's- Shallotte Port City Java Arby's Folk's Cafd Nino's Pizza and Pasta Burger King- Shallotte Scotchman Fratelli's Italian Buffet NoFo Cafd Calabash Deli Artisan Market and Cafd Subway French's Classic Burgers Opus Captain Nance's Seafood Atlanta Bread Company Frontier Food to Go Orange Julius The Bagel Bakery Bagel Basket Captain Pete's Topsail Greens Snack Bar Bames and Noble Cafd Genki Japanese Restaurant Papa Bellas Cinelli's at Ocean Isle Beach XYZ Pizza Bayan Golden China Pita Delite Cook's Ndok Bear Rock Cafd Golden Dragon Pizza Pan Wilmington Derbster's Dining ROCKY POI NT Bellas Sweets and Spirits Good Goody House Pop's Incredible Pizza Double Eagle Grill Freshway Bento Box Gumby's Pizza Portland Grille Ella's Grand Oak Driving Range Blimpies Subs Gyro Place Quizno's Subs Great Wall Hardee's Bojangles Han-dee Hugo Ray's Restaurant Hazdees Paul's Place Bon Appetit Hazdees Rudino's Holden Beach Pier and Grill Wendy's Boodles Henry's Sammy's @ UNCW Hole-In-One at Goose Bay Bottega Art Gallery Hibachi Express Sarku Japan Jade Garden- Leland SURF CITY Brasserie Du Soleil Hollywood East Cinema Grill Sawmill Joseph's Italian Bistro Andy's Brightmore Honey Baked Ham Company Sbarro Pizza KFC Batson's Gallery Brooklyn Pizza Company I.H.O.P. Schlotzsky's Kohl's Bo Sue's Burger King I Love NY Pizza Seascape Internet Cafd Kopp's Quick Stop I & II Corianders Cafd at Temptations Indochme Restaurant 7 Region's Inc. McDonalds Crabby Mike's Cameron Art Museum Invista 17" Street Deli New China Dairy Queen Carolina BBQ Jackson's Big Oak BBQ South College Sandwich Domino's Papa John's Pizza Catch Jellybeans Spiro's Breakfast and Lunch Phil's Sandwich Shop Hardee's CFCC Food Court Jersey Mikes Subway Port City Java Lanier's Campground ' Chazley's Grilled Subs Jesters Java Taco Bell Pharmacy Restaurant Max's Pizza Charlotte's Uptown Eatery Jeters Hot Dogs Tailwind Deli News and Gifts Mollie's Restaurant The Pierhouse Restaurant Checkers Joe Muggs Target Food Avenue Subway New York Comer Deli Cheeze Pleaze Cheesecake Jones Seafood House Terrazzo Sugar Shack Subway House Jungle Rapids Tidal Creek Co-op TK Diner Chelsea's K's Cafd The Woods at Holly Tree Chick fil A Ken's Bagels and Deli Tokyo Deli PEN DER CO U N T`Y China Garden Kohl's Frozen Custard Two Guys Grille B U RGAW China King Kona Coast C66 at NHRMC UNCW Cafeterias A B Grille and Ice Cream Krazy Pizza Verizon Wireless Cafeteria Andy's New Hanover County Health Department Look for this logo on the NHCHD website for the most current list of area smoke-free dining 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! Nrw xMloval wuNx q.:~