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07/09/2008 New Hanover County Hea1tFT E>epartment Revenue and Expenditure Summaries for May FY 2007-2008 Cumulative: 91.671% Month 11 of 12 Rev¢nues Currant Year Prior Yaar Types of Budgeted Raven ua Balance % Budgeted Revanua Balance Raven ua Amount Earned Remaining Amount Earned Ramaining FY6 era1 Slate $ 2,116,715 $ 1.927,122 $ 189,593 91.04% $ 1.981,895 $ 1.847,363 $ 134,532 93.21% AC Fees $ 640.161 $ 643,369 $ (3.208) 100.50% $ 613,661 $ 663,912 $ (50.251) 108.19% Medicaid $ 1.403,558 $ 884,600 $ 518,958 63.03% $ 1,455,867 $ 1.037.443 $ 418.424 71.26% Medicaid Max $ 309,128 $ - $ 309,128 0.00% $ 310.000 $ - $ 310,000 0.00% EH Fe- s/\ $ 310,000 $ 261,514 $ 48,486 84.36% $ 310.000 $ 239,440 $ 70,560 77.249 Health Paas $ 357.200 $ 409,671 $ (52,471) 114.69% $ 301.200 $ 370,989 $ (69,789) 123.179 Health Choice $ 35,125 $ 25,206 $ 9.919 71.76% $ 35,125 $ 16,511 $ 18.614 47.01% Other $ 3.647,007 $ 3,380,999 $ 266.008 92.71% $ 2,580,213 $ 2,402,216 $ 177.996 93.10% Totals $ 8,818,894 $ 7,532,481 $ 1.286,413 85.41% $ 7.587,961 is 6.577,875 $ 1,010,086 86.69% Expenditures Currant Year Prior Year Types of Budgeted Expanded Balance % Btdgeted Expended Balance Expandlture Amount Amount Ramaining Amount Amount Ramaln ing Salary & Fringe $ 12,968,603 $ 11,213.455 $ 1.755,148 86 47% $ 11,988,062 $ 9,947,981 $ 2.040.081 82.98% OparaTi ng $ 2,553.929 $ 1.832,724 $ 721,204 71.76% $ 2,193,756 $ 1,470,572 $ 723,184 67.03% Capital Outlay $ 62.514 $ 49,836 $ 12.678 79-72% $ 121.959 $ 81.633 $ 40.326 66.93% Totals $ 15,585,046 $ 13,096.015 $ 2,489,031 84.03% $ 14,303,777 $ 11.500,186 $ 2,803,591 80.40% Summary Budgeted Actual % FY 07-08 FY 07-08 Expenditures= Salaries 8 Fringe $ 12,968,603 $ 11.213.455 Operating $ 2,553,929 $ 1,832,724 Capital Outlay $ 62.514 $ 49,836 Total Expenditures $ 15.585,046 $ 13.096,015 84.03% Revanua_ $ 8,818,894 $ 7,532.481 85.41% Net County $ 6,766.152 $ 5.563,534 82.23% A¢Y enu¢ and Expen ditu r¢ Summary For ti- Mouth of May 2008 7 NHCHl7 BOARD OF HEALTH APPROVED GRANT APPLICATION STATUS FY 07-08 and FY 06-07 data (BO") Grant Re u¢sted Pendin Received Denied 6/612008 No Activi Tor June 2008 ~i 51712008 Tick Control Cemonsiration Proj-t= North Carolina Department of Environment and Natural Resou rtes (NClDENR) - possible 3 year funding for Environmental Health Vector $15,000 $15,000 Control ro ram Ministering Circle donation of funds for cholestech laborato equipment $1,300 $1,300 Is¢ year un Ing - an ar or 4/2/2008 "0 Health Promotion and Disease Prevention at - UNC-Chapel Hill-, weight loss program for I- $24.756 income woman ages 40 no 64. $24,755 3/5/2008 ( ¢tter o I-f-nt On y: ape ear Memorlal Foundation - Man's Preventive Health - 3 ears, $232,000 2/6/2008 Community Wastes Reduction Q Recycling to secure low cost Community Animal $25,000 Neuterin $25,000 1/2/2008 Smart Start -New Hanover ounty Parma rs hip for Children -Child Care Nursin Pro ram $196,500 $161,042 $35,458 a erns are oor na Ion - o Carolina ~epartmanf of Health and Human - Servioes funds-to provide Maternity Care Coordination services to non-Me~4dicaid eiigibla clients note= awarded 3 yeaf V___1 at year prorated for 11 months_ Next 2 years at $17,580 $-16,115 $17,580/ ear. 12/512007 HIV /STS Pr-._tl0n Outreach - North Carolina HIV/STD Preve n[ion and Care Branch - total of multi-year funding thru May. 2010 $175000 $175,000 Family Counseling Services -Cape Fear Memorial Foundation continuation funding for 1 ear (of a ossible 3 years $53 000 $50,000 $3,000 1-1/712007 Living Wail - Additional funds added to original grant to complete winter edition of $650 newsletter - Cape Fear Memorial Foundation $650 Asthma Program -North Carolina Dept. of Health and Humn Services Division of Public Health Asthma Paro ram $18,000 $15000 $3,000 m 101312007 Healthy Carolinians - Request for Divis fu the North Caolina ion of Pubic elfthro, Off ce of Healthy Carolinians, for support of $12,048 7612 048 the local task force. ACHIEVE Grant - Cen[e rs for Disease C -t-l/-YMCA - Workplace Wellness $40,000 Services $40,000 9/5/2007 No Activi for Se t¢m b¢r 2007 81112007 No Activi for Au ust 2007 8 Aa of B/11/2O0H NHCHn BOARD OF HEALTH AP PROV EO GRANT APPLICATION STATUS FY 07-08 and VV 06-07 f Oat. (BO") Grant Requested Pendin RG..I-a M.ni.d 7/1112007 WIC Mini-grant - Request to ratify application for mini-grant funds for minor renovations to the WIC registration workstations to improve customer service. $18,000 $18,000 ,y 6/612007 Landfall FOU -lotion - Request for funds to purchase 16 wheelchairs for the NHCHI7 School Health Nursin Pro ram. $2,700 $2,700 512/2007 Living Well: R eceived•notification from Cape Fear Memorial Foundation of continuation funding for the publication of the Living Well newspaper insert. $O $12,000 414/2007 Ministering Circle (Colposcopy funding) - Request for $12,000 start-up funds from Ministering Circle for purchase of Colposcopy equipment. Also plan to request additional 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 Cap¢ Fear Memorial Foundation - Colposcopy Program - Womens Preventative Health. $25,000 for start up cost for physician and interpreter contracted services, equipment, supplies, and training- $25,000 $25 000 3/712007 Closing Th. Gap - Request for $225,000 ($75,000 per year for 3 years) from North Carolina Office Of Minority Health and Health Disparities fora Health Educator t0 focus on prevention of HIV and other sexually transmitted disease in the Latino and Afro- American o ulations. $225 000 $225,000 2/712007 CA -MRSA: Funding from UNC-Chapel Hill School of Medicine to assist with research related to the prevalence of community associated methicillin resistant staphyl-U. .U-U. $1 2, 600 $1 2,600 11312007 mart Start - F4.- Hanover ovnty Partn.rship for Children -Child Care Nursin Pro ram $178,500 $170,000 $8,500 1121117106 nuk. Endowment Funds, NHRMC - mental Unit - Personal Health Services. $25,000 for indigent dental care and $15,000 for sedation - equi ment $40,000 $20 000 $20,000 11/1/2006 No Aotivi for M--l- 2006 - 1 0/4/2006 March of Oim¢s - Maternity Care Coordination expenditures for Baby l_ v Program Baby Boutiqand Learning Center $3,000 $3,000 M- bar 2006 916/2006 Aotivi for Se PT-u-- 81212006 No A.ti vi for Au uat 2006 715/2006 I .rv c¢ U r Ina Ion am y Cou ns.ling Program (Cap. Fear M.morlal Foundation) - Funding for Licensed Clinical Social Worker for 3 ears $260 000 $75 000 1$185.000 9 As of 6/1112008 NHCHD BOARD OF HEALTH APPROVED GRANT APPLICATION STATUS FY 07-08 and FY 06-07 Pending Received Denied Date (BOH) Grant =Gran~ Eat Smart Move M=Health (NC Dept of Public 1 and Nutrition Bran$12,416 $4,079 576,492 $15,000 $791,171 $ 1.09% 57.66% 42.01% Pending Grants 1 4% Funded Total Request 11 46% Partial) Funded 7 29% Denied Total Request 5 21% Numbers of Grants Applied For 24 100% 10 As of 6/11/2008 _ - NEW HANOVER COUNTY BOARD OF COMMISSIONERS Request for Board Action Agenda- Consent Meeting Date: Agenda: ® BOH: 7/9/08 C: 7/21C/09 Department-. Presenter: Janet McCumbee, Personal Health Services Marna er Contact: Janet McCurrmbea 798-6559 Subject: Subject: Grant Application - Cape Fear Memorial Foundation Grant - Men's Preventive Healtli - Personal Health Services - $232,000 (over 3 ears Brief Si Y"ury: The Health Department has been invited to apply for funds from Cape Fear Memorial Foundation to begin a men's preventive health program. The intent to apply for funding was recommended and approved by the Board of Health in March 2008. The program will address the leading causes of morbidity and mortality in New Hanover County-heart disease, stroke, and cancer. Men's health fairs would be held at community sites for the target population of low income, uninsured and underinsured men _ The customers will receive health risks assessments, screenings, and lab tests for hypertension, heart disease, diabetes, stroke, and prostate cancer. The men's health program would require additional supplies, contracted services and staff, hours for the health department- Partnerships are already in place with other community service providers to carry out this program of men's health fairs and provide follow up for this target o elation. The full a licatiorn is due Jul 15, 2008. Recommended Motion and Requested Actions: To ratify the grant application to Cape Fear Memorial Foundation (due 7/15) for Men's Preventive Health for three years for $232,000 , and to a rove an budget amendment related to the receipt of the funds- Fundin Source: Ca pa Fear Memorial Foundation- No count match would be re uired. Will above action result in: New Position Number of Position(s) ®Position(s) Modification or change ONo Change in Position(s) Explanation: The grant request would include a 20 hour nurse and 10 hours of administrative support. These may be temporary positions, no benefits, or added to current part time staff hours- Any positions resulting from the grant would exist only as funds are available. Att-h-ts: Letter of Intent; Letter of Acce tance; Grant A lication 11 C Y New Hanover County v ^(7 l~~ Health Department o`a 2029 South 17th Street - Z z Wilmington, NC 28401-4946 NEW NIINOVER COUNTY NLNS~ ?r Phone (910)798-6500 FAX (910) 341-4146 'ff1A.LISHR~".' March 5, 2008 Mr. Garry A. Garris, President Cape Fear Memorial Foundation 2508 Independence Blvd., Ste. 200 Wilmington, NC 28412 Dear Mr. Garris: We would like to request approval to submit a grant in the July cycle for a new initiative from the New Hanover County Board of Health. At their last meeting, they approved that we go forward with a project to provide additional preventive health services to men in our community over the next three years, in hopes that we can affect the morbidity and mortality of that population. As a result of funding streams and state mandates, many of our traditional services are focused on women's health and children's health. Upon review of our community assessment data for the years 2001-2005, we see that the leading causes of death continue to be diseases of the heart, cerebrovascular disease, and cancer. Our department has not had the resources to provide preventive health care for these conditions, and the Board would like for us to seek grant opportunities to focus on male health in these areas over the coming years. If we can receive funds to focus on male health, the board has recommended that we hold quarterly health fairs that provide screenings and education to uninsured/underinsured males or those not having regular access to health care. We would focus the screenings on cardiovascular health, prostate cancer screening, prevention of lung cancer, and detection of diabetes. We would work with community agencies or organizations such as churches to take the staff and equipment out to the target population. Men screened at these quarterly health fairs/screenings would be followed by a nurse and health education staff to ensure they receive care. We would attempt to track these men over three years to determine whether our screenings, education, and continued follow up have reduced their risk of heart attacks, stroke, diabetes, and cancer. To accomplish this new initiative and provide the services free of charge to the target population, we would need additional supplies, equipment, contract services, and staff time. Our grant proposal would include a request for approximately $232,000 over three years to cover the expenses of this project, with a goal of serving at least 200 men per year. We hope future data will show improvement of morbidity and mortality of men in our community over the three years, as well as the feasibility of integrating some of the screenings into our routine clinical services over time. Thank you for consideration of this letter of intent to apply for funding in the July, 2008 cycle. If you have any questions, please call Janet McCumbee RN at 798-6559. Sincerely 'L David E. Rice, M.P.H., M.A. Dr. Sandra L. Miles, Chair Health Director New Hanover County Board of Health "Healthy People, Healthy Environment, Healthy Community" 12 - ~ a e F(E) c j r C~ ~v MEMORIAL FOVNE:>A'TION 2508 INOEPENtJENCE BLVp. (910) 452-061 l PHONE WILMINGTON. NC 28412 5- 200 (910) 452-5879 FAX -cf mf dri.org April 17, 2008 Mr_ David F. Rice, MPH, MA Health Director I J _ 1Vew Hanover County Health Department 2029 South Pith strrot - Wilmington, NC 2-8401-4946 0_,~~ R73: Rcqucst ID: 1031 /JnvA'//" Mato Health Initiative BO..RO OF OGRE CTORS: Dear 1%4r_ Rice: A~~+ES R. BEI.ME Thank you £or your interest in Cape Fear Memorial Fotndation_ We w..~.,... G..MEno.+ have r~eived your letter of inquiry in which you shared information about J. R~cr.~.o Go.nEri. M.p-. F_A_C R_ yOUr organization and services- We are interested IrL learning more about your project so that we may decide if a grant from Cape Fear Memorial Foundation would further the objectives of the Foundation and help you w c....EF MEB/+E. 111 better serve our commuraity. Ro,...ie s...«..~« Therefore, we ask that you complete the enclosed Grant Application RoeEr~ F- W.+vw~cc. CPA Forma and return to us on or before July 15. 2008, if you~w~is/ms h~~ to be considered in the next grant cycle- If Progress Repoli for are enclosed for R.c~.i.EO L. W-- projects previously funded, for which an annual report has not y=t been made, pleas= complete the Terms and return with this application- Please do not - send any mailing io th= Foundation requiring a recipient`s signature- If Gnwnt G..ertE. PvESVew` confirmation of receipt is required, organizations are encowaged io follow up with an ~tt-aail or telephone call_ If you would like to receive the application by c-mail, please let us 1s`Taow and we will be glad to forward it to you- Additionally, we ask that you e-mail the completed grant application to beth@cfmfdn_org if you have - acoess to the intemet_ However, the grant application is not offici ally acc=ptcd until the signed original is received in our o£fico_ We make grant awards twice yearly- The deadline dates for accepting applications are January 15 and 3uly 15- We look forward to hearing from yOU. S i n t j~ e~ i ll yj Gar (Xdrris Pa~iodseytm p 70 Aav{aNCING GOfl'S DESIRE FOR OUR HE^LING ANA HEALTH 13 A PPLIC-~JJON F'OR FL.04'I)JNC Yl'Ji_I_ JSF_.4 CCF_PTFJJ ONL]'IFA LETTER OF INL?L>/KY HA.S XF_E:1'SUJ3.A4JTTFD J3Y YOUR OItGA NILA %'/ON' A VU APPROVED B CF/Y/F PKLsS1DE/VT a wear AEMORIAL FOUNaAT10N GRANT APPLICATION FORM PAR T I: YOUR OR GANIZA TION Or~iani~cstion Iss~ormrstion Name" New Hanover County Health Department street Address" 2029 S_ 17" Street City, State, Zip Code- Wilmington, NC 28401 Mailing Address= 2029 S. 17- Street City, State, Zip Code: Wilmington, NC 28401 Telephone 4" 910-798-6500 Fax 4: 910-341-4146 E-mail Address: Web Site: www.nhchd_org Fiscal Year End' June 30 Federal Tax ID#: 56-6000324 Contact Insormation Name of Key Contact Person: Janet McCumbee, RN Title of Contact- Personal Health Services Manager Telephone 4 : 910-798-6559 Fax It : (910) 341-4146 E-mail Address: jmccumbee@nhcgov.com 1. Is your organization a nonprofit, tax-exempt organization under IRS Code Section 501(.)(3) or a governmental unit? If not, you do not qualify for a grant. If your organization is a 501(.)(3), please attach a. copy of your current II2S Itzx-cac mpCion Zeller with this Application. Yes - Our organization is considered a unit of local govern ment_ We are not a 501(.)(3) organization_ 2. Is your organization a private, non-operating foundation? If Yes, you do not qualify for a grant. No 3_ Would a grant from Cape Fear Memorial Foundation in the amount being requested jeopardize your tax- exempt status? No 4. Will any of these funds be used to pay a nationally affiliated organization? If yes, please explain. No 5. Does your organization now, or does it plan in the future, to engage in any way in the promotion or advancement of political causes? If yes, please explain. No 14 CAPE FPAR MEMORIAL. FOLNOATION Page 1 0} 1 O ORANT APPL1CATlON FOAM Lass Raviacd: 01/12/09-Gd 6. Summarize your organization's background, goals and current programs. Also, discuss your assets in - personnel, services and programs that could be built upon by the Foundations help- The New Hanover County Health Department (NHCHD) has provided health services to the community for over 125 years- In 2004, NHCHD received one of the tfrst local health d¢pa rtm ent acc-ait.ti-ns_ This year NHCHD was re-accredited, which validates the high standards of public service provided by a first-class health department- The NHCHD has also participated in several strategic planning processes over past years, identifying the greatest needs in the community. One of the top goals of our department is "Access to Car¢"_ We continue to strive to meet the health care needs of the citizens of New Hanover County and/or ensure access to care- Another strategic planning goal has been to focus on the problem of obesity. We have worked within the local Healthy Carolinians to develop programs in our community through various groups to increase physical activity and encourage healthy eating- One such program I. "Eat Smart Move More"_ The Personal Health Services Division is comprised of multi-disciplinary teams of nurses, clinicians, social workers, nutritionists, laboratory staff, mental health therapists, and dental professionals. The Personal Health Services Manager is responsible for managing the many bealth programs, with support from the Support Services Division- The list of programs and services provided is long and is focused on communicable disease prevention and contro\, provision of women's and children's health services, case management services for prenatal clients and families with young children; school nursing and mental health, dental care for children, and nutritional services- Personal Health staff are working jointly with our Health promotion staff to implement programs on wellness in the county departments and in the c ommunity_ Our department also strives to decrease tobacco use through our Project Assist Program and unintentional deaths through our Injury Pr¢v¢nt\on Coordinator and Safe Kids_ -WOO Our newest goal is to establish a men's preventive health program- We have assembled a committee to plan new men's preventive health services per Board of Health request this yea r_ We have the expertise to provide these services to rnen; however, we need additional nursing and support services manpower to Focus on this new program- 7_ Describe your organization's structure and attach a list ofyout offrcers ar:cl directors- The NHCHD I. a county human services department that operates according to county and state regulations, with the Board of Health providing oversight. All health services are in the Personal Health Services Division, managed by the Personal Health Services Manager and Health Director- The Personal Health Services Division consists of S teams providing many programs -Child Service Coordination, Clinic Services, Community Services, Laboratory Services, Maternal Health, Nutrition Services, School Mental Health, and School 14-Ith_ The supervisors for these teams report to the Manager. Attachments: 1) Board of Health members 2J Management Team members 3) NHCHD and Personal Health Services organizational chart 15 CAPE FEAR MEMORIAL FOI.iNOATION Psga 2 oP 1 O GRANT APPL1CATlON FORM l.as~ RriseO: OI/12/00-bd _ PART Its PROJECT/PROGRAM ( uanti w/=enever ossible_ I . Describe the problem/need that the program/project will address. Introduction The New Hanover County Health Department (NH CHD) is requesting funding to initiate a new Men's Preventive Health Program_ In March 2008, the New Hanover County Board of Health approved the concept of the Men's Preventive Health Program_ The program plans to provide health fairs or screenings quarterly in the community for low income or uninsured and underinsured m¢n_ The purpose is to target prevention o£ the leading causes of death: heart disease, cancer, and stroK¢s_ Currently, the NHCHD provides many services for women and children in our various programs, as a result o£ our Funding streams and state/federal req uir¢ments_ Our Board of Health would like the health department to expand services to include a men's preventive health program. Without additional £u -ding, we cannot provide this new quality health service_ We will address the access to care issue with low income and uninsured men, by reducing barriers to care and providing s r¢¢nings, referrals, and follow-up_ With support from Cap¢ Fear Memorial Foundation (CFMF) for three years, w¢ will to b¢ able to show positives outcomes for men sc r¢en ed through this project and the need to continue services. Our first men's preventive health fair will be held on September 6, 2008_ We want to make this type -jr service available on a regular quarterly basis. P robl¢m/Need The leading causes of death for New Hanover County residents are heart disease, cerebrovasculav (stroKes), and --s- Being uninsured or und¢rinsu red is a major barrier to accessing and receiving health services and relates directly with education, poverty and low-income wages- Other barriers to ca r¢ are transportation, lack of understanding of need for preventive car-e, and affordable care- According to the Sheps 2004 Update, New Hanover County has 27,753 people lacking health insurance, accounting for over 18-4_ of the population_ This ranks New Hanover County 31 in the state. New Hanover County ranks better than the state in terms o£ the ratio per physician per population' 33.10 % compared to 20-80-,'- in North Carolina; however, these physicians serve citizens from the whole region- There is also a lack of affordable care for the uninsured_ The current safety net providers' New Hanove/r~ Health NetworK, Tilcston Clinic, and N¢w Hanover Community Health Center, are available as ref~/rraI sites- The challenge has been to get these men to access these providers. In the "2005 North Carolina Health Risks Among North Carolina Adults", approximately 24-,'- stated they do not have a personal doctor and 12% attributed not seeing a doctor to the cost_ In the 2007 New Hanover County Community Assessment Survey, health insu ranc¢ was ranked number one as the response of what most people said they lact-l funds to purchase- Uninsured people typically seek treatment in a later and more dangerous stage of illness_ Age-Adjusted Death Rates (per 100,000) for Selected Causes 2002-2006" New Hanover County North Carolina Heart Disease 216_1 217_9 Cerebrovascular Disease 54.0 61_1 Cancer 192_5 196.4 -E-en though New Hanover County rates are slightly better than the state, we have room for im prov¢m ent_ 16 CAPE FEAR MEMORIAL FOIiNDATION Page 3 of 1 O GRAM APPLICATION FORM LaA Rwixtl: OI/12/00-btl Leading Causes of Death for Males in NC: 1. Cancer 2. Heart disease 3. Chronic lower respiratory disease 4. Cerebrovascular disease 5. Other unintentional injuries 6_ Motor vehicle injuries 7_ Diabetes According to t/t¢ 2005 Centers ofDis¢as¢ Control (CDC) Behavioral Risk Factor Surv¢ilLanc¢ System Survey in New Hanover Count ~NHC)t 36_5 % of respondents ranked overweight 23-S -Z- of respondents ranked obese- 14_6 % o£ respondents reported not participating in any physical activity in the past 30 days- According to DivZsion of Public Health's H¢till/t Profl¢ of North Caroliniansr 2007 Update. • Researchers report obesity-r¢Zai¢d -Ii--I costs for adults in NC totaled 2.14 billion in 2003, • Obesity contributes to hypertension, heart disease, diabetes, cancer, asthma, and strokes, • People with diab¢Y¢s are two to four times more likely to have cardiovascular disease (h¢arY disease, stroke, and ath¢roscl¢rosis),- • In 2005, cardiovascular account¢dfor approximat¢Zy one-third of-IZ deaths in the state, • The leading causes ofcanc¢r deaths in NC are Zang cancer, cancer of the colon and rectum, breast cancer, and prostate cancer- Prostate Cancer Facts- The prostate is a gland found only in men_ It is walnut-sized and is located in front o£ the rectum underneath the urinary bladder- Most prostate cancers grow slowly- During the period o£ 2002-2006, 77 cases of prostate cancer were reported in New Hanover County_ Plan o£ Action The New Hanover County Community Needs Assessment and the NHC Health Department Strategic Plan highlight the need for access to care- NHCHD plans to target the modifiable risk factors associated with the leading causes of death: overweight/obesity, poor diet, physical inactivity and tobacco use through our Health Promotions and Personal Health teams- New Hanover County Health Department, Healthy Carolinians, New' Hanover Health Network, and other community partners plan on utilizing this assessment to strategically plan access to services and programs that will best impact the community's health outcomes_ Our partner agencies will assist us with these men's preventive health screenings when possible. This Men's Preventive Health Program will provide health screenings for groups of men in the target population of uninsured/underinsured or men not accessing health care. We plan to deliver the services in the communities where these men reside- The screenings will include blood tests for diabetes (which can complicate other risks T- heart disease)o and cholesterol, blood pressure checks, health histories for risks, and weight/heightsBody Mass Index (BM". We will provide Follow up and tracking of the men screened, noting progress to healthy lifestyles and monitoring of chronic diseases. During the month of September each year, we will also provide prostate exams and PSA blood tests to highlight Prostate Cancer Awareness Month- Participants screened will be referred to appropriate and affordable health care- 17 CAPE FEAR FIEMORIAL FOUNDATION PaQa 4 OF 1 O GRAN' APPL~CATtON FORM Last ReviseA: O V 12/09-W 2. Describe the objective(s) of the project/program and indicate how individual lives of the recipients will be changed and what benefits are expected to result. Objective #1: To provide quarterly health screenings to a target population of uninsured/ underinsured men or men not receiving any health care, in New Hanover County, to identify risks for leading causes of death: cardiovascular (heart disease), cancer, diabetes, and cerebrovascular disease (stroke.) Objective #2: To assist all participants with obtaining a regular medical home, and to provide follow up of the men with abnormal test results for treatment of positive findings and ongoing health care to reduce future risks. Objective #3: To evaluate the participant's risks pre and post screening, to determine effectiveness of the men's preventive health program. Objective #4: To track the participants over a three year period, to show access to routine health care, reduction of risks, treatment of health conditions found during screening. 3. Describe the strategies you will develop to accomplish the objective(s). Strategy #1: To partner with agencies such as New Hanover Health Network, Cape Fear Health net, Healthy Carolinians, and other health care providers and community organizations to hold quarterly Men's Preventive Health Fairs in the community, for the target population. Strategy #2: To screen participants at each fair for diabetes, high cholesterol, obesity, hypertension, and other health risks. In addition, we will screen for prostate cancer in September of each year. Strategy #3: To collect data on participants at fairs to track their progress toward accessing regular health care, follow up, and treatment based on risks and test results. Routine follow up will be done by a nurse to determine compliance and positive outcomes. Strategy #4: To assure access to health care for men with no primary care physician through partnering with area safety net providers. Strategy #5: To integrate health education into all fairs, so that participants receive information on risks, and ways to improve their overall health through better nutrition, increased physical activity levels, and preventive care. 18 CAPE FEAR MEMORIAL FOUNDATION Page 5 of 10 GRANT APPLICATION FORM Last Revised: 01112107-bd 4_ State how, when, and who will conduct an evaluation t0 measure how well your project/program is - meeting its objective(s)- If' funded, the N— Hanover County Health Department will employ a part time nurse and support staff to lead the efforts of the project t¢-m_ The project team consists of many in-house staff (nurses, support staff, health educators) and representatives from partner agencies. They will develop the tools needed to gather data and document follow up on participants from the health fairs- Customer satisfaction surveys will be used at fairs to document quality oFservices and satisfaction of participants_ The following outcomes will he evaluated by the project team with a goat of at least 300 men participating over three years: Number of men screened Percentage of men with identified health risks (abnormal test results, elevated BMl, etc-) N—b¢r of men identified with no health care provider Number o£rnen who received routine health care after referral Percentage o£ improved test results (over project period) Percentage o£ improved lifestyles behaviors (risk behavior survey) Th¢ evaluation components, to be further developed, will he based on the following questions: Did w¢ serve our target population? - Did we connect these men to a primary care provider? 0001 Did we reduce the barriers to access care? Did we see lifestyle changes? Did w¢ see improved health outcomes? 19 CAPE FEAR MEMORIAL FOUNDATION Psg~ 6 OF 1 O GRANT APPLICATION FORM Lasl RwiavM_ OIA3/00-bd PART III: FINANCIAL INFORMATION I . Amount requested From Cape Fear Memorial Foundation. ~Jfzaz u[[iyearjunding is requested, also sped how you wish [his [o be paid per year.) Three-year funding total request of $232,000_ Year 1 = $75000 Year 2 = $76,000 Year 3 = $81000 2. Develop a complete project/prograrn budget; including expenses and income, for the period you are requesting Funds. Also please attach a copy of your most rc-cent (a) 996, and (b) oudil orfin[zzz ci-l Nr"r p Pzt with this application. Project Budget: From Jul 1, 2008 To June 30, 2009 Ex ansas (13(--ate o ) Income B Sources Salaries NHCHD In-Kind Contributions: Registered Nurse (20 hrs/wk) 32,750 Supervisor Sz Ad-in Salary 8c Fringe 17,250 Admin. Support Tech_ (10 hrs/wk) 11,000 Physician/testing services 5,000 In-Kind Supervision 8c Administration 17,250 Office Space/Utii hies/Housekeeping 1,000 In-Kind Physician/Equipment services 5,000 Operating Contracted Services -Labs 3,500 Contracted Services - Interpreter 9,750 Contracted Services - Physicians 5,250 Advertising 1,500 Printing 500 Postage 250 Lab Supplies 6,000 Office Supplies 600 Mileage Reimbursement 1,250 Training and Tra--1 1,000 Pharmacy 1 ,3 50 Client Transportation 300 in-Kind Office Space / Utilities 8c. 1,000 Housekeeping Total Ex en ses: $98,000 Total Income: $23,000 Project Budget: From Jul 1 2009 To June 30 201 O Ex en ses B Cate o Income (B Sources Salaries NHCHD In-Kind Contributions: Registered Nurse (20 hrs/wk) 35,250 Supervisor 8c Ad-in Salary 8/ Fringe 5,500 Admin- Support Tech. (10 hrs/wk) 11,750 Physician testing services 5,000 In-Kind Supervision 8c Administration 5,500 Off ce Space/i_ltilities/Housekeeping 1,100 In-Kind physieian/Equipmant services 5,000 Operating Contracted Services - Labs 3,750 Contracted Services - Interpreter 9,750 Contracted Services - Physicians 3,900 Advertising 1,000 Printing 200 Postage 250 Lab Supplies 6,500 Office Supplies 600 Mileage Reimbursement 1,300 Training and Travel 600 i,.. Pharmacy 850 Client Transportation 300 In-Kind Office Space / Utilities 8c 1,100 Housekeeping Total Expenses: $87,100 Total lncoma: $11,100 CAP£ FEAR MFMORIAl. FOIINOAT~ON Papa 'l OT l O GRAM APPL~CATaON FORM Laat Revised: 01/12/09-W 2. (budget continued) Project Budget: From July 1, 2010 To June 30, 2011 Ex enses (B Cate o Income (B Sources Sala rids NHCHD In-Kind Contributionsc Registered Nurse (20 hr./wk) 37,000 Supervisor 8c Admin Salary 8c Fringe 5,750 Admin. Support Tech. (10 h-/-k) 12,500 Physician/testing services 5,000 ]n-Kind Supervision Administration 5,750 Office Space/Utilitics/housekeeping 1,200 In-Kind Physician/Equipment services 5,000 Operating Contracted Services - Labs 4,250 Contracted Services - Interpreter 10,640 Contracted Services - Physicians 4,100 Advertising 1 , 1 00 Printing 200 Postage 300 Lab Supplies 7,000 Office Supplies 600 Mileage Reimbursement 1,500 Training and Travel 600 Pharmacy 850 Client Transports[ion 360 1n-111-ind Office Space / Utilities 8c 1,200 Housekeeping Total Ex enses= $ 92,450 Total Income: $ 11,450 3- List the names of organizations, both public and private, to which you have applied for support for this specific project/program. Also show the amount requested and the status (pending, approved or di.. roved)- Organization Amount Status Ministering Circle $ 1,300 One time grant funds to purchase cholesterol testing equipment Total Amount $1_300 21 CAPE FEAR MEMORIAL FOLtNOAT~ON Paga 8 of l O GRANT APPL~CAT~ON FORM Las, Revisal[ Ol/l2/09-bd 4. Describe how your project/program will become self-sufficient within 3 years. We hope to show positive health outcomes for the project participants and determine the need and community response to these services. If there is a great need to continue men's preventive health services, there may be several possibilities for future funding through other private grantors or funds from Healthy Carolinians. Healthy Carolinians has the ability to secure grants for access to care for indigent patients to support the safety net providers' capacity to see more patients. Based on the effectiveness of this three year program, we may be able to justify integrating more men's services into the health department clinic on a routine basis. At that time, without grant funds, we would set up a fee schedule to cover costs of services. 5. If the funds are to be used for construction or equipment acquisition, explain the bidding process. N/A ~kw 22 CAPE FEAR MEMORIAL FOUNDATION Page 9 of 10 GRANT APPLICATION FORM Last Revised: 01/12107-bd PAR T I V: REPORTING RE UIREMENTS 7 . Do you agree to furnish to Cape Fear Memorial Foundation, in a timely manner, periodic progress reports informing the Foundation of the progress made by your project/program? Yes Not¢x Jf Progress R¢pnrlforms are ¢uc/osedfor projects previously fund¢dfor w/xich axx oxxxxua/ report has nol y¢1 b¢¢xx made, p/ease couxp!¢!e the forms and r¢lursx with this Applicatfon_ SUBMITTED BY- David E. Rice Typed or Printed Name of Chief Executive Officer of Requesting Organization Signature of Chief Executive Officer Date Health Director Title Sandra L_ Miles, DDS Typed or Printed Name of Chairman of-the Board o£ Directors Signature of Chairman of the Board of Directors Date APPLICATION CHECKLIST (1J Executive Director AND Chair Signature on signature page (2) Board of Directors/Officers List (Ti4 "taaE:' {-tc. 3iipY,f2i'agarti2sl '.3 POtTP 14 ~ ~ th1~ LS11 e (6) Mail the original application and attached. information to the Foundation oti3ce via regular mail or hand delivery only by 5:00 p_m_ on the grant cycle deadline date (January 15 or July 15) (7) Ei-nail application to beth~7cfmfZln_org ~.rr ~""F 'x ""Please cull ('910 452-0611 fl-y"" all uestions or concerns"-Ye CAPE FEAR MEMORIAL FO\.lNOAT~ON Page 1 O Of 1 O GRANT APPLICATION FORM Lasa RwisaO- O~/12/OO-bd 23 NEW HANOVER COUNTY BOARD OF COMMISSIONERS .r Request for Board Action Agenda- Consent Meeting Date: A enda: ® BOH- July 9, 2008 Roane, Support Services Department Health Department Presenter: ana Kimer Division M Contact: Kim Roane 798-6522 Subject: Budget Amendment for Audiology Services - Personal Health Services - $63,900 Brief Summary: The New Hanover County Health Department Has received notification from the North Carolina Department of Public Health, Children and Youth Branch (NCDPH WCH) of funding for the provision of audiology services for newborn hearing screenings through the North Carolina Early Hearing Detection and Intervention (NC EHDI) program. The mission of the NC HHDI program is to ensure that all infants are screened for hearing Ioss by one month of age, that children with congenital hearing loss are identified by six months of age and that they are provided access to appropriate audiological, educational, and medical intervention by six months of age- The services of this program will be provided to 15 surrounding counties, fully funded by the state- Motion and Requested Actions: To approve the establishment of audiology services and the associated budget amendment of $63,900 to support the North Carolina Early Hearin Detection and Intervention ]Program - Funding Source: Fully funded by the North Carolina Department of Public Health, Children and Youth Branch- No matching County funds required- Program will be provided only as lon as funds are provided b the state to support the services. Will above action result in: New Position Number o£ Position(s) OPosition(s~> ModiScation or change ®No Change in Position(s) Ex lanation- Attachments: A regiment Addendum from State of North Carolina Division of Public Health 24 Division of Public Health Agreement Addendum FY 08-09 Page 1 of 5 New Hanover WCH / Children and Youth Branch Local Health Department Name DPH Section/Branch Name 324 - Speech and Hearing Kathleen Watts 919-707-5632 Activity Number and Description DPH Program Contact Name, Telephone Number (with area code) and Email 06/01/08 - 05/31/09 Service Period MM/DD/1'YYY-MM/DD/YYYY DPH program signature (only required for negotiable agreement addendum) 07/01/08 - 06/30/09 Payment Period MM/DD/YYYY-MM/DD/YYYY ® Original Agreement Addendum ? Agreement Addendum Revision # (please do not put the Aid to County revision # here) 1. Background: Hearing loss is the most common congenital birth defect, affecting as many as three infants per thousand born. Left undetected, hearing loss in infants can negatively impact speech and language acquisition, academic achievement, and social and emotional development. If detected, however, these negative impacts can be diminished and even eliminated through early intervention. Infants who fail the initial newborn hearing screening are at a higher risk than the general population of having a hearing loss. It is estimated that approximately half of all children in the United States are "lost to follow up" following a failed newborn hearing screen. The mission of the NC Early Hearing Detection and Intervention (EHDI) Program is to ensure that all infants are screened for hearing loss by one month of age, that children with congenital hearing loss are identified by six months of age and that they are provided access to appropriate audiological, educational, and medical intervention by six months of age. II. Purpose: The EHDI Program provides consultation, technical assistance and resources to public and private agencies to develop and implement effective Early Hearing Detection and Intervention programs. The desired outcome is fewer children with congenital hearing loss who have poor communication, social and emotional Health Director Signature (use blue ink) Date Local Health Department to complete: LHD program contact name: (If follow up information is needed by DPH) Phone number with area code: Email address: Si nature on this page sip-nifies you have read and accepted all paces of this document. 25 Revised 9/27/2007 i Page 2 of 5 skills and/or who require academic assistance as the result o£ not being identified before three month of age and receiving curly intervention by six months. IV_ Scone of Work and Deliverables= The Health Department shall= A. Provide up to one audiologist (1.0 PTE) to perform as the Division of Public Health (DPH) Child Health Audiology Consultant (CHAC) in the following counties: Bladen, Brunswick, Carteret, Columbus, Craven, Cumberland, Duplin, Harnett, Johnston, Lenoir, New Hanover, Orrslow, Robeson, Sampson and Scotland. This individual must have a master's degree in audiology. B. Include the following activities in the workplan for the audiologist: 1. CONSULTATION AND TECHNICAL ASSISTANCE Consultation and technical assistance to Women's and Children's Health Section/Children and Youth Branch/Genetics and Newborn Screening Unit program staff, birthing/neonatal facilities, otolaryngologist's and pediatrician's offices and other health providers. Duties will include but not be limited to: a) Provide consultation and technical assistance to birthing/neonatal facilities regarding the implementation and ongoing management of local Newborn Hearing Screening programs, including but not limited to, the Division of Public Hcalth Guidelines for Newborn Hearing Screening, reporting requirements, screening protocols, follow-up protocols, troubleshooting, quality control. b) Identify and lirzk with community referral sources (i.e., pediatricians, otolaryngologists, audiologists, hearing aid fitters, Family Practice Physicians, etc). c) Consult and collaborate with other regional consultants and programs regarding a child's hearing health, including but not limited to, public health programs, children's health care providers, audiological and medical community, hospitals, Child Service Coordinators, health departments, Social Services, educators of the deaf, speech/larnguage pathologists, occupational therapists, physical therapists, local education agencies, etc. d) Consult with community audiologists (private practice or public agency staff) during the period between a child's follow-up evaluations regarding the status o£ equipment, need for testing etc. e) Provide consultation to private providers regarding the Guidelines for Newborn Hearing Screening and reporting requirements of the Universal Newborn Hearing Screening Program. f) Consult with programs (e.g., Early Intervention for Children who are Deaf/I lard-o£-Hearing, Department of Public Instruction, Public School Preschool Programs) to facilitate the transition of children who are deaf/hard of hearing from services through the Individuals with Disabilities Education Act (Part to Part 13)- g) Collaborate with local audiologists in the expansion and development of local pediatric audiological services for infants and children to age 21. h) Consult with families o£ newly identified children, as needed, through home visits to provide information regarding hearing loss, anatomy and physiology, review of audiological tests performed. i) Consult with parents/families, as needed, to discuss their child's diagnosed hearing loss, -mo communication approach, present level o£ functioning, auditory potential, current and future goals, expectations for parent participation and need for any changes in the child's services. 26 Page 3 of 5 j) Make referrals and collaborate, as appropriate, with services and support programs (e.g. BEGINNINGS, Child Service Coordination, Genetic Counseling, Otolaryngology, Early Intervention Program for Children Who Are Deaf/Hard of Hearing,). k) Consult with local agencies, providers and programs regarding the identification and referral of children, birth to 21, with suspected hearing loss. 1) Attend Individualized Family Service Plan (IFSP) and Individualized Education Program (IEP) meetings, as needed, to assure proper interpretation of audiograms and to consult regarding proper hearing related devices and services. m) Consult with private providers and agencies in the development of programs to identify and refer children with suspected late onset hearing loss. n) Consult with cochlear implant centers to provide information regarding hearing aid use, communication approach, current placement and present level of functioning during a child's/family's evaluation process. o) Consult with dispensing audiologists, vendors and other providers regarding procurement of devices/services under the Assistive Technology, Children's Special Health Services, and Health Choice Programs. p) Consult with classroom and itinerant teachers regarding daily/weekly hearing aid/cochlear implant check, troubleshooting listening checks and sound detection/discrimination/identification tasks. q) Maintain professional knowledge of current and future trends in audiological/amplification services for deaf and hard of hearing infants/children and Newborn Hearing Screening Programs. r) Consult with local agencies, health departments and school systems regarding the development and implementation of hearing screening projects. s) Identify state and local funding resources for hearing related devices. ,r 2. SUPPORT SERVICES Audiological Management provided by the Child Health Regional Audiology Consultant would begin with those newborns that referred on their second hearing screening and are being referred for a diagnostic evaluation, and older children at the point of diagnosis. The management component can include any of the services listed below and is meant for those children for whom local audiological management (either privately or through public agencies) is not available or accessible. a) To assist the Child Health Regional Speech Language Consultants in assuring initial and /or follow-up hearing screenings for infants (a) who did not receive physiologic hearing screening prior to discharge from birthing facility and/or (b) who referred on their initial newborn hearing screening. b) Support the management of audiological follow-up services by the child's local audiologist i.e. otoscopy, tympanopmetry, hearing aid/cochlear implant check. c) Support appropriate fitting and amplification of hearing aids for pediatric population. d) Create and manage loaner hearing aids and FM inventory as needed. e) Perform clinical review for provider requests for hearing related equipment and/or services through Purchase of Medical Care Services, Assistive Technology Program and /or Health Choice Programs. f) Conduct needs assessments and provide recommendations for FM technology, including, but not limited to, classroom, home and daycare settings. g) Facilitate the acquisition of properly fit earmolds for children whose families are unable to make or keep appointments (make appointments, arrange transportation etc). h) Facilitate the procurement of unaided/aided audiological testing. i) Assist with unaided/aided testing with local audiologists, as necessary. 27 Page 4 of 5 j) Observe individual children in home-based and classroom-based settings to determine necessary IFSP and IEP services. k) Facilitate the ordering, fitting, training and technical assistance to parents and professionals regarding the use of FM systems. 1) Facilitate repair services for malfunctioning equipment. 3. T12AINING AND EDUCATION a) Develop and supply educational materials related to hearing loss and hearing screening for parents, providers and program stuff'- b) Provide training to hospitals and private providers regarding the Newborn Hearing Screening Program policies and procedures. c) Provide annual in-services at birthing/neonatal facilities regarding Newborn Hearing Screening program checklist, Division of Public Health Newborn Hearing Screening Guidelines, reporting requirements, screening tecl r iques, screening protocols, use of hearing screening devices, etc. d) Promote public awareness of hearing loss and related issues. e) Train new regional Division of Public Health consulting audiology staff f) Provide training, as needed, to private providers regarding the reporting requirements of the Newborn Hearing Screening Program and the benefits of early hearing detection and intervention. g) Provide training and technical assistance to parents and professionals regarding the use of FM systems and/or other assistive devices. h) Provide training and technical assistance to private and public providers for audiological services (e.g., diagnostic procedures £or children, amplification technology, funding, cochlear implant technology, educational options)- Within five working days notify the Division of Public Health Speech and Hearing Of£ce of any staff changes as a result of employment termination of the person designated as the Child Health Audiology Consultant- D. Agree not to bill families or third parties for services provided under this agreement. IV. Performance Measures/ReoortinQ Requirements. Perfox-niance Measure # 1 : Evidence of the number of consultations and trainings provided for hospitals in the montbly service logs required of all consultants on the DPH Speech and Hearing Team. Perfoniiance Measure #2c Evidence of the number o£ consultations with providers and interventions with families will be documented in the service logs will document. Entries will also be made in the WCSWeb Hearing Link notes section to document counseling and education provided to families of children who failed the newborn hearing screening, and consultation with their direct service providers. Performance Measure 43: Evidence of expanded resources and coordination of service delivery for children with hearing loss will be documented in service Iogs, showing Hearing Link training and other in- services provided to community collaborators and private providers, the number of public awareness -.000 activities, and the number of hearing screenings provided at mass screening events. _ 2S Page 5 of 5 V. Performance Monitoring and Quality Assurance: The Child Health Audiology Consultant (CHAC) is part of the Early Hearing Detection and Intervention Team. Child Health Speech and Hearing Consultants (CHSLCs) and Child Health Audiology Consultants (CHACs) provide training, technical assistance and consultation about EHDI to public and private agencies in all counties in North Carolina. The CHAC reports to the EHDI Program Manager, as well as to the Health Department in which she/he is housed. The EHDI Program Manager will: A. Review all service logs; B. Stay in touch regularly via phone and email; C. Conduct site visits at least twice per year; D. Review the CHAC's workplan semi-annually; E. Review data on hospitals served by the CHAC quarterly; F. Meet with the CHSLC during DPH Speech and Hearing Team Meetings and other DPH required activities. Should the performance of the CHAC be inadequate because of non completion of expected activities, poor communication with team members or community collaborators or insufficient documentation, a meeting will be convened with the CHAC's Health Department supervisor to determine an action plan or the ~4w corrective measures to be taken. VI. Funding Guidelines or Restrictions: (if applicable) Funding shall only be used to support the hourly contractual rate for the position. 29 NEW HANOVER COUNTY BOARD OF COMMISSIONERS Request for Board Action Agenda: Consent Meeting Date: Agenda: ® BOH: July 9, 2008 Co Comm: Jul 21, 2008 Services Department: Health Department Presenter: Kim Roane, Support Division Mana ar Contact: Kim Roane 798-6522 Subject: Establish Fee for Permitting of Tam ora Food Establishments Brief Summary: The New Hanover County Health Department has received notification from the North Carolina Department of Environment and Natural Resources, Division of Envirotztzzental Health, that effective July 2008, local health departments are mandated to collect a $50.00 fee for temporary food establishments (TFEs) as required in GS.130A-248(d)_ Fees are to be charged with each issuance o: Ca permit, as well as when a TFE is relocated or when the permit has expired. Local health departments shall retain these funds in support of local Food 8c Lodging programs- The collection o£ these fees is not a local option and required by the State and the fees may not be increased or dccreased- Recommended Motion and Requested Actions: To approve the establishment or a $50.00 fee for the permitting of Temporary Food Establishments, and to allow this than e to be included in the New Hanover Count Health De artment's Fee Polic Funding Source: Fees collected from the public- Revenues from permit fees are ex ected to exceed $5,000 in FY09 Will above action result in: =New Position Number of Position(s) =Position(s) Modification or change ®No Change in Position s Ex lanation- Attachments: Memo from Terry Pierce, Director, North Carolina Department of Environment and Natural Resources, Division of Environmental Health. 30 LHDmemo-TFE fees t State of North Carolina Michael F. Easley, Governor Division of Environmental Health Department of Environment and Terry L. Pierce, Director Natural Resources William G. Ross, Secretary MEMORANDUM To: Local Health Directors From: Terry L. Pierce, Director Division of Environmental Health Date: April 27, 2008 subJ'ect: Collection of Fees for the Permitting of Temporary Food Establishments Pursuant to a request from the N.C. Association of Local Health Directors, local health departments will begin collecting a $50.00 fee for temporary food establishments (TFE), as required in Gs. 130A248( d). After consulting with the Attorney General's staff, TFE are determined to be subject to the fee set forth in the law cited above. Furthermore, it was determined that a fee should be charged for each issuance of a permit. when a TFE is relocated or when the permit has expired, a new permit and fee is appropriate. Accordingly, all local health departments are directed to collect this fee, effective July 1, 2008. This fee shall be collected for all TFE, except for those establishments that are exempted from fees by law or rule. Collection, retention and disbursement of these state fees will be prescribed in the consolidated Agreement. Each local health department will report these funds to the Division through the Consolidated Agreement Addenda (DENR 3300), Local Health Department Budget (DENR 2948) and Local Expenditure Report. Prior to July 1, the consolidated Agreement will be revised to facilitate this process. The Local Expenditure Report and Local Health Department Budget forms have been revised to include a category for the accounting of these collected fees. This week, Teresa Abbott will electronically distribute these revised forms to each health department. Please disregard her Page 1 31 L HDmemo-TFE fees previous a-mail message containing the previous versions of these documents_ =f you have questions regarding the changes described in this memorandum, please contact Bart Campbell at C9193 715-7148 or bart_campbell@ncmailnet, or contact me at C919:) 733-2352 or terry_pi e r ce@ncmai l_ net_ =-F you have specific questions regarding any of the forms or the reporting procedures, contact Teresa Abbott at <9193 715-0940 or teresa_abbott@ncmailnet. cc: John Barkley Joy Reed Kris-ti Nixon Teresa Abbott Chris Hoke Bart Campbell NCEHSA Jackie Glenn Dennis Harrington Larry Michael 1630 mail Service Center, Ralei h, North Carolina 27699-1630 Phone 09193 733-2870 / Fax C919~ 715-3242 http://- .ncenvi roheal th_ org An Equal Opportunity / Affirmative Action Employer D Page 2 moo, :12 NEW HANOVER COUNTY BOARD OF COMMISSIONERS Request for Board Action Agenda:= Consent Meeting Date: Agenda: ® BOH: 7/9/08 Co Comm- 7/21/08 Department: Health Presenter: Kim Roane, Support Services Division Mama er Contact: Kim Roane 798-6522 Subject: Request to Change Health Department Fee Policy to change the fee structure for the administration of injectable vaccines to be compatible with current Medicaid reimbursements. Brief Summary: Medicaid has, in the past, paid an immunization one flat administration fee per patient, regardless o£ whether one dose or multiple doses are given. Medicaid has changed their reimbursement process, and now splits the reimbursement into two fees: 904711F-11 is the new code for administration of one injectable vaccine, and 90472EP is the new code for administration of multiple injectable vaccines (per dose. If a patient is administered multiple vaccines in one visit, Medicaid will now pay multiple administration fees, one per each dose administered. We request approval to make changes to the New Hanover County Health Department Fee Policy to incorporate the new Change in Medicaid a meats as per the attached documentation- Recommended Motion and Requested Actions: To approve the revision to the New Hanover County Health Department Fee Policy to include the fee schedule and fee policy Chan es as listed- Funding Source: Medicaid reimbursements. Revenues are expected to exceed $5,000 for FY09_ No bud et amendment is re nested at this time- Will above action result in: =New Position Number of Position(s) OPosition(s) Modification or change ®No Chan e in Position s Ex lunation' Attachments: New Hanover County Health Department Fee Policy Cha-ges and excerpt from the Medicaid Bulletin 33 Immunization Administration Code and Fee Changes Effective July, 2008 Medicaid is currently paying $27.42 for a child whether one dose our four doses are given. The new code/fee (90471 EP) will pay $17.25 for one dose. Code 90472EP will pay $9.71 for doses 2 or more. A claim for a child receiving four doses would pay $17.25 (dose #1) plus $29.13 (doses #2, #3, #4) for a total of $46.38. N.C. Medicaid Special Bulletin II Apri12008 Local Health Department Providers An immunization administration fee may not be billed if the immunization(s) is provided in addition to a Health Check screening visit. The immunization administration CPT codes 90465, 90467, 90468, 90471, 90473 or 90474 with the EP modifier may be billed if immunizations are the only services provided that day or if any immunizations are provided in conjunction with an office visit. • Administration of one injectable vaccine is billed with CPT code 90471 (one unit) or 90465 (one unit) with the EP modifier and is reimbursed at $17.25. • Additional injectable immunization administrations are billed with CPT code 90472 or 90466 with the EP modifier and are reimbursed at $9.71 for each unit. The appropriate number of units must be billed for each additional immunization administration CPT procedure code with the total charge for all units reflected on the detail. • Administration of one vaccine that is an intranasal/oral immunization is billed with the administration CPT code 90467 with EP modifier and is reimbursed at $11.33 or 90473 with the EP modifier and is reimbursed at $11.67. Note: CPT codes 90467 or 90473 can only be billed if the intranasal/oral vaccine is the only immunization provided on that date of service. Neither code can be billed with another immunization administration code on that date of service. See guidance in next bullet for further clarification. A second intranasal/oral immunization cannot be billed at this time. • Administration of an intranasal or oral immunization vaccine provided in addition to one or more injectable immunization administrations is billed with CPT code 90468 or 90474 with the EP modifier. CPT code 90468 is reimbursed at $8.61. CPT code 90474 is reimbursed at $7.94. • CPT vaccine codes for the vaccines administered must be reported or billed, as appropriate, even if the administration codes are not being billed. • Immunization administration codes cannot be billed in conjunction with Health Check Screening. Report the CPT vaccine code(s) without billing the administration codes. 34 t NEW HANOVER COUNTY BOARD OF COMMISSIONERS Request for Board Action Agenda- Consent Meeting Date: Agenda: ® BOH: 07/09/08 CC: 07/21/08 Department- Health Presenter: Scott Harrelson, Deputy Health Director Contact: Am Cook 798-6548 Subject: Grant Application - Eat Smart Move More - Health Programs Administration - $20,000 Brief Summary: The Eat Smart Move More Grant proposes to provide the infrastructure for the New Hanover County wellness program which aims to increase knowledge, attitudes and skills of individuals to make the behavioral changes related to healthy eating and/or physical activity- Funding of $20,000 will provide wellness programs for New Hanover Count citizens via the health de artment- Recommended Motion and Requested Actions: To ratify approval to submit an application for the NC Eat Smart Move More grant for funding to provide administration and support to dcvelo local wellness ro rams in New Hanover County- ~r Funding Source: North Carolina Division of Public Health Physical Activity and Nutrition Branch Chronic Disease and Injury Section- There are no matching County funds re uired. Will above action result in: QNcw Position Number of Position<s) OPosition(s~ Modification or change ®No Chan a in Position s Ex lanation- Attachments: Bud et Sheet 35 Eat Smart Move More Grant Category Expense Eat Smart Move More Grant FY 08-09 Program Administration $6000.00 .10 FTE to support salary & fringe benefits of existing Health Educator Program Expenses $6000.00 Wellness Program Software & wellness program materials Marketing/Outreach $3000.00 Printed posters, fliers, brochures Customized wellness cups, ens, stress balls Educational Materials $2500.00 Brochures & teaching models on healthy lifestyles, stress management, chronic disease management and display boards Incentives $2000.00 Gym memberships, gym bags, yoga mats, pedometers, health cook books, exercise videos, health books, etc. Travel $500.00 Travel to promote wellness policies and programs throughout the county Total $20,000.00 $20,000 will provide wellness programs for New Hanover County citizens via the health department. 36 i NEW HANOVER COUNTY BOARD OF COMMISSIONERS Request for Board Action Agenda: Consent Meeting Date: Agenda: ® BOH: July 9, 2008 Co Comm: Jul 21, 2008 Department: Health Department Presenter: Kim Roane, Support Services Division Manager Contact: Kim Roane 798-6522 Subject: Establish Fee for Permitting of Temporary Food Establishments and Approve Bud et Amendment to increase Revenues and ]Expenditures b $11,000 Brief Summary: The New Hanover County Health Department has received notification from the North Carolina Department of Environment and Natural Resources, Division o£ Enviroritizental Health, tbat effective July 2008, local health departments are mandated to collect a $50-00 fee for temporary food establishments (TFEs) as required in GS.130A-248(d)- Fees are to be charged with each issuance of a permit, as well as when a TFE is relocated or when the permit has expired. Revenue collections for fiscal year 09 are estimated to exceed $11,000 ($50.00 fee for 230+ Temporary Food Establishments)- Local health departments shall retain these funds in support of local Food 8c Lodging programs- The collection of these fees is not a local option and required by the State, is r not a local option, and the fees may not be increased or decreased- Funds will be used to pay for temporary contract services for an Envirori ri~ental Health Specialist to conduct field inspections for the Food and Lodging program - Currently, these services are available via the North Carolina Alliance of Public Health Agencies. Recommended Motion and Requested Actions: To approve the establishment of a $50.00 fee for the permitting of Temporary Food Establishments, the associated budget amendment to increase revenues and expenditures for FY09, and to allow this fee chan e to be included in the New Hanover Count Health Department's Fee Polic Fundin Source: Fees collected from the ublie- Will above action result in: =New Position Number o£ Position(s) =Position(s) Modification or change ®No Change in Position(s) Ex lanation- Attachments: Memo from Terry Pierce, Director, North Carolina Department of Environment and Natural Resources, Division of Environmental Health. Rice, David From: Rice, David ent: Friday, June 13, 2008 7:56 AM To: Roane, Kim Cc: Jenkins, Paula; Standfest, Maria; Roberts, Marilyn Subject: RE: F.A.C.T. Recommendation First bullet is approved. Second bullet will be placed on the NHCBH Executive Committee Agenda. David E. Rice, MPH, MA Health Director New Hanover County Health Department I 2029 South 17th Street Wilmington, NC 28401 910-798-6591 driceCo.nhc4ov.com htt2://www.nhchd.or,g From: Roane, Kim Sent: Thursday, June 12, 2008 4:41 PM To: Rice, David Cc: Jenkins, Paula; Standfest, Maria Subject: F.A.C.T. Recommendation Dave, The F.A.C.T. meeting held Wednesday, June 11, 2008 resulted in the following recommendations: • Establish a new code for Microgestin FE, at a fee of $10.00/cycle. This is a new birth control product. Revenues 11#4r will be well below $1,000/year and therefore require Health Director approval to implement. • Establish a new fee for permits for Temporary Food Establishments at $50.00/permit. The revenues for this new fee are expected to be $5,000/year or greater, requiring Board of Health and County Commission approval. Request your permission to submit as an agenda item for the July Board of Health meeting. Thank you for your consideration, Kim Kim Roane Support Services Manager New Hanover County Health Department (910) 798-6522 fax (910) 341-4146 1 g \ - O woNTY HEPLSN NEW HANOVER COUNTY Child Fatality Prevention Team 2007 Summary Presented to the Board of Health July 2008 Joyce _ ~jiat csw Vim„ CFP eview Coordinator Zo-c~SS Je r Grundy, BSw Date CFPT/R~ eview Coordinator / J cCumbee, RN, BSN Da etet Person Health Services Manager id E_ Rice, H, MA. Datc Health Director I. INTRODUCTION The New Hanover County Child Fatality Prevention Team comprised of community representatives from diverse agencies and ds ciplines, c urrentl with 19 members. Members are appointed by their agency board or New Hanover y County Board of Commissioners, per state legislation. The mission of the NHC CFPT is to promote the development of a community wide approach to understanding the causes of childhood fatalities, identify the deficiencies in public services to children and families, and to make and carry out recommendations for change to prevent future childhood deaths. The NHC CFPT meets on a quarterly basis. II. 2007 CHILD DEATH REVIEWS During 2007, the team reviewed 22 deaths that occurred in 2006. The following chart explains the different causes of the child deaths reviewed in New Hanover County. III , , 1 Complications from Prematurity 8 Accidental Suicide I1 Genetic Disorders 4 Other Medical Conditions 5 SIDS I Total 22 III. PROBLEMS IDENTIFIED/RECOMMENDATIONS /ACTIONS TAKEN PROBLEM: Several deaths were not reported to Department of Social Services as required or were not reported in a timely manner for investigative purposes. RECOMMENDATION: For county entities to follow current protocol for notification. ACTION TAKEN: The Assistant Director of Social Services met with many community organizations' members to reiterate the protocol and stress the importance of notification to Social Services. PROBLEM: The New Hanover County Health Department is not being notified of all SIDS deaths. RECOMMENDATIONS: To work with local medical examiners to report SIDS deaths to the trained SIDS counselor at the Health Department for follow up with families per state guidelines. Healthy People, Healthy Environment, Healthy community" 1 ACTION: Contact made by letter and phone call to the County Medical Examiner to review the protocol for notification. 3. PROBLEM: Autopsies are not being completed on all deceased children by a Pathologist who has additional training/certification in Pediatric Pathology. This is the standard of care in many states. RECOMMENDATION: That child autopsies be completed by a Pediatric Pathologist. ACTION: The CFPT Quarterly Report to the State office included a recommendation for Pediatric Pathologists to complete the autopsies. This was also recommended in the State Review Report and the Annual Report which were submitted to the State Fatality Task Force. A letter was written by team physician and submitted to the State Program Coordinator. 4. PROBLEM: Inaccuracies in recording cause of death for the State Center for Health Statistics. Inaccurate information skews data and changes the overall picture. RECOMMENDATION: To include more information on the cause of death as listed on the death certificate. Create consistent reporting across the state. ACTIONS: A letter drafted by the team physician was sent to the State Review Coordinator with specific examples of inaccurate and incomplete information listed as V4W the cause of death. Recommendations were also included in the quarterly report to the State. IV. ADDITIONAL ACTIVITIES • The Team Review Coordinator, DSS Director, DSS Assistant Director, DSS Supervisor, and one Registered Nurse from New Hanover Regional Medical Center attended a CFPT Statewide conference in Chapel Hill, North Carolina. • NHC CFPT was chosen as a pilot county to test online quarterly reporting to the State. Two members attended training in Raleigh to practice the software while also providing feedback for improvement. Now all 100 counties are online for the 2007 annual CFPT report to the state. • Three team members gave a presentation at the local Child Watch Forum titled "Soothing Parents: Preventing Shaken Baby Syndrome • Members of the Team participated in two local State Fatality Reviews. A State Review is conducted when the family has been involved with the Department of Social Services (DSS) before the death. Ir° Healthy People, Healthy Environment, Healthy Community" 2 • The local Review Coordinator met with a detective from the Carolina Beach Police Department in an effort to complete a thorough review on one case. • The team physician investigated building codes for private residencies and reported this information back to the team for a better understanding of one accident. • A team member researched current services regarding bereavement counseling within the school system to ensure support following suicide. • The NHC CFPT receives a small amount of funds annually from the Department of Health and Human Services (DHHS). During the 2006-2007 review year, funds were used to purchase car seats that are distributed through the New Hanover County Health Department. Funding was also used for transportation to the two out-of-town trainings. V. CONCLUSION The New Hanover County Child Fatality Team continues to work to improve participation of its members and invite persons related to investigations of child deaths to be a part of the review process. Attendance has been steady, and members are sharing agency information with the coordinator prior to the reviews when they are unable to attend. The team has worked diligently to obtain and review needed records and work collaboratively in the process of the actual review of each child death. Goals for next year include: 1) to improve the team's ability to identify system problems surrounding child deaths and 2) to enhance the communication between local CFPT and State Fatality Task Force. Healthy People, Healthy Environment, Healthy Community" 3 ml ~ s. 'a w¢ a r a- '.+~r i s t.. ~a r'S 1 1 I ~qv t~ ~ X14 in school ew drama-ticall Nurs g Y under Dean Adams' leaclership When Virginia W" Adams arrived at UNC Wilmington in t 994 to lead the School of Nursing, she inherited a program with tremendous potential. Using her extensive experience as a nurse and military leader, Dean Adams assessed the program's condition and charted a course for the school's remarkable growth. x To thrive, the nursing school needed: 14-year tenure, increasing the more scholarships to recruit and number of full-time faculty by 40 retain students; more faculty to percent, enrollment by 46 percent, teach students as well as funds to the school's operating budget by provide them with adequate salaries 49 percent, student graduation rates and to support their research; by 68 percent and scholarships by n c. ra a a a rn s strong community partnerships; a phenomenal 176 percent- enhanced clinical experiences For founded two rural health clinics in students locally regionally and Under Dean Adams' leadership, the Bnynswick and Columbus counties. acade progr school strengthened partnerships The nursin school develoPed a abroad; mic programs tailored g - to serve Wilmington's burgeoning with New Hanover Regional. Medical Center and other Ca a Fear area rePutation for innovative degree pharmaceutical industry; and a P programs - such as a bachelor's health care agencies, established building designed specifically for degree in clinical research -and ~l 21st century health care instruction. a research and exchange program outstanding instruction in huma{n- with a university in Japan, initiated pati ent simulation- The School of Nursing achieved a community health course with remarkable success during her indigenous people in Peru, and In 2006, Dean Adams spearheaded the university's efforts to obtain state funding to construct a building for B'41-- rtC fI- SSt.-* t" 11 - : t 1111 I I. i Ci tl gift t' ? t I: I L' SC3. the School of Nursing. The General - Assembly earmarked $30.1 million Charlotte, N.C., philanthropist Irwin "Ike" Belk established for the project; the groundbreaking is a $1 million distinguished professorship in April to recruit scheduled for the fall 2008 semester. and retain experts in technology-enhanced applied learning. In April, the nursing school received A business executive and hi her education advocate, Belk its first $1 million professorship, g established by and named in honor of provided a major gift, enabling the university to receive Irwin "Ike" Belk_ matching funds from the Spangler Foundation of Charlotte and North Carolina's Distinguished Professors "I am so proud of the accomplishments Endowment Trust Fund. our School of Nursing achieved since 3' ° r rc 1994," said Dean Adams, who begins "Nursing faculty are the key to solving the nursing shortage in a new role as special assistant to the North Carolina," said Dean Virginia W. Adams. "The number of stud enYS vice provost in July. "Our students, that we may accept is directly related to the number of faculty we have- faculty and staff are the best; I Unfortunately, this year we had to turn away one-third of the students eligible enjoyed working with them and for admission to our nursing program because we did not have enough look forward to making even greater educators available. That's why A.Ir. Be1Ks gift is so critical." con. tributions to nursing practice and In NIay, the university presented Belk with an honorary Doctor of Humanities nursing education in the future." degree in recognition of his generosity- gym, yhjs?'1F e... In r E2nl0ry Eo „tman ef.~ma ms~n saituraaY Srof'av fof ~ooa.: r...s„a - .~,=-~v ~r.~a r,ng UVC 'N e.,,.ns, .n s of M-ElrZjtlerite fvlary Hopkins, The School of Nursing mourns the loss DeCeZllber 2007 a77d Ma 2008 actuates of Marguerite Hopkins, a lecturer in y gr the School of Nursing, who died in an Ori the job across the Stag automobile accident March 17, 2008. A faculty member starting in 1991, In the past six months, 89 prelicensura and 13 clinical research nursing students Hopkins retired in 1999 after a 25-year have graduated from the university many of them accepting positions with career in nursing. She returned to health-care agencies and companies in North Carolina- Employers include UNC Wilmington in 2003 in response cardiac diabetic, nephrology, pediatric neurology and surgical centers in New to the shortage of nurse educators in Hanover County as well as a labor and delivery unit in Craven County an the School of Nursing. Her colleagues emergency room in Wake County and a pediatric and neonatal intensive care wil remember her ready smile, never- unit at Duke University I~.4edical Center. ending jokes, flair For fashion and ha order to make a nursing education available to more students, the School international travel in addition to her of Nursing began two years ago to accept a spring class of students into the professional contributions. program. Prior to that, all students began the program in the fall. The Hopkins was an experienced public December 2007 graduates were the first students admitted in the spring t0 health nurse- Her past professional complete the program. experience included the role of "The majority of our nursing graduates stay in the state to take jobs and practice supervising public health nurse in nursing," said Deborah Pollard, nursing professor and coordinator of the the Suffolk County Department of prelicensura program. "This is a great time to pursue a career in nursing. There Health Services in Hauppauge, N.Y. are many jobs available and unlimited opportunities for qualified, dedicated She received both her anbachelor's nurses.'" degree in nursing d her master's degree with a concentration in In Fact, the starting wages for many graduates are $25-30 per hour, and some psychology/public health nursing new nurses obtained positions with annual salaries that exceed $55,000. from SUNY Stony Brook. The spring Graduation Recognition and _\w ards Ceremony held Nlay 9, was Marguerite is survived by five children extra-special For Brook Tr--ell '08, who received a marriage proposal on stage. and 11 grandchildren. be said yes. 2010: School of Nursing Building to open Plans are well underway for the new School of Nursing, a $30.1 million building a~f r scheduled to open in fall 2010. The building's features will include state-of- u the-art classrooms, a conference center 4 and 250-seat lecture hall, virtual hospitals and hospice simulation units, faculty - and administrative offices, research labs p and the Technology-Enhanced Applied Learning (TEAL) Center. At press time, the building's groundbreaking was scheduled for December 2008. Please visit the School of Nursing Web site at www.uncw.edu/son for updates. - Scholarships for nursing students on the rise 'The amount of scholarship funding exceed $1,000," she said. available to nursing students continues "Although many of our to increase, topping $90,000 for the students work, their GG7-08 academic year. In comparison, clinical rotations and the students enrolled in 2006-07 received more than $72,000 in scholarship and to practice essential support, in 2005-06, students received skills prohibit most of about $64,000 in scholarship funding. them from maintaining Increasing scholarship support for full-time jobs. nursing students is a critical component Scholarships help them of addressing the nursing shortage in afford to study full-time C,ance!~ur pc,emaryePaoiaa irh North Carolina, according to Paula and to enter the health-care workforce aiu33jt Kennedy-Dudley, director of student in a timely fashion." of riu ~,~n y r,~ . ,s _ services for the School of Nursin ` 4i v g. Want to establish a scholarship to "in addition to textbooks and course support nursing students? Contact materials, our nursing students development directors Terri MCDermot must purchase uniforms and health at 910.962.2525 or Kevin Williamson assessment equipment that can easily at 910.962.2424. ~icooi of Nursing received a $400.1100 m the N.C. GlaxoSmithKline 1,3tion for Camp BONES, a university/ Y partnership to prepare _ n..,2d and underrepresented youth for y lu\ careers in nursing and health science. athre Camp BONES (Brigade of " L:<p):3rinrg Seahawks) introduces d r-inth graders from Now Hanover d ,d tine Cape Fear region to careers { The program has becomes a mcdei a the Scroot of Nursing plans t cis-Saiem State Un€versit-y'sith ? E rnifar camp for Tried youth. x.. FR°0Ma IN: n ih 14 ~ 'f 4 t 5'i... .[y= ~+pg~ ~''SN'° ..•%t}. 1 F i r f School of Nursing recognizes outstand_iizg -,,,,a„~~ ~~~~~--r alun-ini~ faculty Lorle Moore Floyd '90, vice president of home care services For Liberty Home Care has t-- named Outstanding Alumni " _ a - _ s _ - of the Year by the School of r z ,g. The preli--- class - ~y of 2ooS selected lecturer M---3F alurd oelc, a nurse with the mother/baby unit at New H ~ cr Regional Medical Center, as Faculty of the Year winner. Associate professor Rutftjk--- 1Gui f- received the Chancellor's Teaching Excellence Award_ v.. a. o ~z n.a,. zoo <op•=+ or m.: o~ei< m<..•..~... cn...<w <o,: o, zbs :n o, s 6s a• <vo.-<c s. ,.n-. ~o_. i_ 4w S66S-£Ob8Z ON 'uo16u!w I!M paoa a6allop 41noS L09 xauuty iCC pi~~ 6uisanN to looyog uo~Bulw11M eullo~>?p y1.loN }o iClls~an!un bb4 'oN 1!w~ad OIVd ~1\ I, ¦ asoelsod "S_n ~~~llllll 1 }ez!ue6~0 u 1!lo~duoN New Hanover N Regional Medical Center Free M en's H ea.mth Screenings Date: September 6th Time: 8 AM - 12 NOON Location: 2029 South 17th Street at the New • Hanover County Health ' Department y"tijr • • - • • 798-65"00: . 2 Virc~sss 42, :Aricl • - Prioritv it' QP o~ VNEW HANOVER COUNTY HEA~~~ ention MOO FREE!! Health Screenings Worth $500 (Men without health insurance) September 6, 2008 8-12 Noon New Hanover County Health Department Call for appointment 798-6500 Press #2, and then press #2 again Ycour • New Hanover g Priurity 4 Regional Medical Center Q~ ' a~ NEW HANOVER COUNTY HEAV