02/03/1999
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Mr. William T. Steuer, Chainnan, called the regular business meeting of the New Hanover County
Board of Health (NHCBH) to order at 8:00 a.m., Wednesday, February 3, 1999, in the Conference
Room, New Hanover Community Health Center, 925 North 4th Street, Wilmington, North Carolina.
Members Present:
William T. Steuer, Chainnan
Wilson O'Kelly Jewell, DDS, Vice-Chainnan
Henry V. Estep, RHU
Michael E. Goins, OD
Gela N. Hunter, RN, Nurse Practitioner
W. Edwin Link, Jr., RPH
Anne Braswell Rowe
Melody C. Speck, DVM
Estelle G. Whitted, RN
Members Absent:
Robert G. Greer, Vice-Chair, County Commissioners
Philip P. Smith, Sr., MD
Others Present:
David E. Rice, Health Director
Lynda F. Smith, Assistant Health Director
Cynthia W. Hewett, Business Officer
Frances F. De Vane, Recording Secretary
Invocation: Mr. W. Edwin Link gave the invocation.
Minutes:
Mr. Steuer asked for corrections to the minutes of the January 6, 1999 New Hanover County Board of
Health Meeting. The Board of Health corrected and approved the minutes of the January 6, 1999
meeting.
Recognitions:
Personnel
Mr. Rice introduced the following new health department employees:
Renu Daryani, Health Educator, Health Promotion
Cynthia W. Hewett, Business Officer, Administration
Nancy R. Nail, Nutrition Director, Nutrition/WlC
Jessica L. Nakell, Health Educator I, Communicable Disease
Service Awards
Mr. Rice recognized and congratulated the following New Hanover County Service Award recipient:
Fifteen (15) Year Service Award
Barbara J. Perilla, Clerical Specialist I, Child Health
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Semi-Annual Super Staff Award
Mr. Rice recognized Ms. Catherine Stukes, Community Health Aide, in Women's Health Care I
Division, recipient of the 1999 Semi-Annual Super Staff Award. She was nominated by her peers.
Ms. Stukes was selected by the Executive Committee of the New Hanover County Board of Health.
Mr. Rice stated Ms. Stukes' nomination focused on her dedication to clients, to public health, to her
team, and to her work as a team member.
Mr. Steuer welcomed new employees, commended Ms. Perilla for her years of public health service in
New Hanover County, and congratulated Ms. Stukes, winner of the Semi-Annual Super Staff Award.
Department Focal:
Mr. Alford Thomas, Executive Director, New Hanover Community Health Center, presented the
department focal on "New Hanover Community Health Center, " (NHCHC), a private, nonprofit
health center. He welcomed the New Hanover County Board of Health members to the NHCHC.
Mr. Thomas explained the Community Health Center's services include primary medical care, disease
prevention, and promotion of good health habits and lifestyles to families.
Mr. Thomas advised the staff has 3 family practitioners and 1 physician pediatrician. They are
developing plans to promote Dental Health. The center accepts private pay, Medicare, Medicaid, and
applies a Sliding Fee Scale for services. Mr. Thomas expressed his appreciation to Mr. Rice, Health
Director, and to the health department staff for the collaboration of services between the health
department and the Community Health Center.
Dr. Speck asked about the funding for the NHCHC. Mr. Thomas advised initially the county funded
NHCHC. Mr. Thomas advised the center's budget is $2.3 million. It is supported by grant revenues I
and fees for services.
Mr. Thomas conducted a tour of the NHCHC for the Board of Health members. Mr. Steuer expressed
he is impressed with the health care facility. He thanked Mr. Thomas for his hospitality and for
hosting the Board of Health meeting. Ms. Whitted advised her local minister designed the NHCHC.
Mr. Thomas reiterated he appreciates the Board of Health's support and their meeting at the NHCHC.
Committee Reports:
Budget Committee
Ms. Anne Rowe, Chainnan, Budget Committee, thanked the Budget Committee and health department
staff for their work on the FY1999-2000 New Hanover County Health Department Budget. She
reported the Executive Committee met at 6:00 p.m. on Tuesday, February 2, and reviewed the
changes to the budget requests.
Ms. Lynda F. Smith, Assistant Health Director, advised she distributed the FY 1999-2000 Budget
Request Workbooks to the Executive Committee at their meeting on Tuesday, January 26. The
workbooks contain budget summaries, program line items and revenue, computer requests, temporary
salaries, overtime and on call, and new position requests. The FY1999-2000 Budget Request is
$8,669,533 (revised 03/03/99) and does not include a projection for salary market adjustment or merit.
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Ms. Cindy Hewett, Business Officer, gave a PowerPoint presentation on the FY1999-2000 Health
Department Budget Request including the Executive Committee's recommendations and changes to
the original budget request. The overview included summaries of expenditures, capital outlay
requests, projected salary and fringe for 7 new positions, and projected revenue.
Ms. Hewett presented the following Budget Summary Report:
Summary of the Cost to New Hanover County
$
6,766,180
1,421,407
481,946
8,669,533
211,533
Salary & Benefits (7 New Positions = $190,115)
Operating Expenses
Capital Outlay
Total Expenditures
Difference from FY98-99
Total State & Federal Revenue
3,597,873
Difference from FY98-99
(239,512)
451,045
Total Increase Cost to County
Ms. Hewett explained Projected Salary and Fringe includes the following 7 new positions: Animal
Control Services: 1 Officer, 1 Clerical; Administration: 1 Clerical; Child Health: 1 Medical
Office Assistant; School Health: 1 Public Health Nurse I, Jail: 1 Clerical; and Environmental
Health: 1 Environmental Epidemiologist.
Ms. Hewett reported the Capital Outlay request ($481,946) includes $10,000 for computers, $358,946
for other equipment, $66,000 for 3 vehicles, and $47,000 for building improvements. The new
vehicles are 3 pickup trucks (2 to replace existing and 1 for new staff) in Animal Control Services.
The $47,000 building improvement includes tables, benches, and deck (concrete/wood) for an
employee outside eating/conference area.
Ms. Hewett advised the net increase to the county is $451,045. The budget request does not include a
salary market adjustment or merit increase.
Ms. Hewett presented the following Projected Revenue Report:
Summary of Projected Revenue
State Money
Fees
Medicaid
Other
$
( 6, 139)
50,450
(252,145)
(31,678)
(239,512)
Total Decrease in Revenue
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Ms. Hewett reminded the Executive Committee of a $260,000 Medicaid Maximization payment the
health department received in FYI998-99. She explained due to the decrease of $260,000.(Medi~aid I
Maximization) the net difference is actually an increase in revenue of $20,488. Ms. SmIth advIsed
when they receive a Medicaid Maximization Payment this year, they will put it in the budget. Mr.
Steuer noted the $96,600 revenue decrease in Animal Control Services. He advised the 25% revenue
decrease was due to lack of documentation in the citation program.
A discussion followed on the Capital Outlay: Other Equipment and Building Improvements Budget
Request. Ms. Smith advised the one small breakroom is inadequate. She explained the outside
eating/conference area will seat 20 people. It will be covered with a metal canopy and enclosed with a
brick wall. Ms. Hunter asked if they will allow smoking. Ms. Smith advised they will not allow
smoking. Dr. Goins reported the Executive Committee recommended the $47,000 budget request.
Mr. Steuer reported the Capital Outlay Budget Request includes 1 trackhoe ($112,000), 1 wheel loader
(9,500), 1 trailer ($15,000), 1 Dump Truck ($79,000), and 1 Steam Cleaner ($2,500) for Vector
Control mosquito control measures. He advised the Corps of Engineers reimbursement for heavy
equipment use will recover the capital outlay investment for equipment within approximately three-
years. Also, the heavy equipment will be used for cleaning other outfall areas and for other projects in
the county.
Ms. Hewett summarized the Total Projected Budget FY1999-2000 is $8,669,533 with an overall 3%
increase compared with FY 98-99.
Ms. Smith stated County Manager Allen O'Neal and his Budget Committee will review FY99-00
Budget Request. In May, Assistant County Manager Ms. Pat Melvin, Mr. Rice, Ms. Smith, and Ms.
Hewett will review the County Manager's Recommended Budget and report any changes to the
Budget Committee and to the Executive Committee of the Board of Health.
Mr. Steuer reported the Executive Committee approved the changes to the FY99-00 Budget Request
on February 2, 1999, but did not make a motion to recommend the approval of the entire budget
request. He asked for a motion from the Executive Committee to approve the Health Department
FY99-00 Budget Request.
MOTION: Motion passed for the Executive Committee to recommend to the Board of Health the
approval of the FY1999-2000 New Hanover County Health Department Budget.
MOTION: Mr. Steuer moved from the Executive Committee for the Board of Health to accept and
approve the FY1999-2000 New Hanover County Health Department Budget as submitted by the
Executive Committee of the Board of Health. Upon vote, the MOTION CARRIED
UNANIMOUSLY.
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Mr. Steuer expressed his appreciation to Ms. Rowe, Chair, Budget Committee, to the staff, and to the
Budget Committee for their work during the budget process.
Executive Committee
Mr. Steuer, Chainnan, reported the Executive Committee met at 6:00 p.m. on January 26, 1999, and
on February 2, 1999. Items are on listed under New Business on the Board of Health Agenda.
Unfinished Business:
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Generators/Hookups at Emergency Shelters
Mr. Steuer reported Mr. Greer will report to the Board of Health the status of obtaining
generators/hookups for emergency shelters in New Hanover County.
New Business:
Reclassifications
Mr. Steuer reported the Executive Committee reviewed and approved the following reclassification
requests at their meeting on January 26, 1999. The reclassification requests were based upon program
growth and each position's increased functional responsibilities.
Public Health Nurse I to Public Health Nurse II
Mr. Steuer recommended from the Executive Committee for the Board of Health to approve a request
to reclassify Ms. Pamela Heath, Public Health Nurse I, to a Public Health Nurse II in the Child Health
Division.
MOTION: Mr. Steuer moved from the Executive Committee for the Board of Health to approve the
request to reclassify Ms. Pamela Heath, Public Health Nurse I (Grade 119) to Public Health Nurse II
(Grade 121) in the Child Health Division of the New Hanover County Health Department. Upon
vote, the MOTION CARRIED UNANIMOUSLY.
Administrative Assistant I to Administrative Assistant II
Mr. Steuer recommended from the Executive Committee for the Board of Health to approve a request
to reclassify Ms. Daisy S. Brown, Administrative Assistant I, (Grade 113) to Administrative
Assistant II (Grade 11) in the Administration Division.
MOTION: Mr. Steuer moved from the Executive Committee for the Board of Health to approve the
request to reclassify Ms. Daisy S. Brown, Administrative Assistant I, (Grade 113) to Administrative
Assistant II (Grade 114) in the Administration Division. Upon vote, the MOTION CARRIED
UNANIMOUSLY.
Administrative Assistant I to Administrative Assistant II
Mr. Steuer recommended from the Executive Committee for the Board of Health to approve a request
to reclassify Ms. Sharon Neuschafer, Administrative Assistant I (Grade 113) to Administrative
Assistant II (Grade 114) in the Environmental Health Division.
MOTION: Mr. Steuer moved from the Executive Committee for the Board of Health to approve the
request to reclassify Ms. Sharon Neuschafer, Administrative Assistant I (Grade 113), to
Administrative Assistant II (Grade 114) in the Environmental Health Division of the New Hanover
County Health Department. Upon vote, the MOTION CARRIED UNANIMOUSLY.
Public Health Nurse Director 1 to Public Health Nurse Director II
Mr. Steuer recommended from the Executive Committee for the Board of Health to approve a request
to reclassify Ms. Janet McCumbee, Public Health Nurse Director I (Grade 124) to Public Health
Nurse Director II (Grade 125) in the Child Health Division
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Mr. David E. Rice, Health Director, explained when they created the Public Health Nurse Director
position, the staff and program size under this position were smaller. Since then, staff size and I
program complexity which the Public Health Nursing Director I is responsible have grown. He
advised Mr. Andre R. Mallette, Director, Human Resources Department, recommended the
reclassification of Ms. McCumbee and the collapse of the two levels of classifications into one Public
Health Nursing Director II classification at Grade (125).
MOTION: Mr. Steuer moved from the Executive Committee for the Board of Health to approve the
request to reclassify Ms. Janet McCumbee, Public Health Nurse Director I (Grade 124) to Public
Health Nurse Director II (Grade 125) in the Child Health Division of the New Hanover County
Health Department. Upon vote, the MOTION CARRIED UNANIMOUSLY.
Clerical Specialist I to Clerical Specialist II
Mr. Steuer recommended from the Executive Committee for the Board of Health to approve a request
to reclassify Ms. Lynette Fennel, Clerical Specialist I, to Clerical Specialist II in the Nutrition/WlC
Division.
MOTION: Mr. Steuer moved from the Executive Committee for the Board of Health to approve the
request to reclassify Ms. Lynette Fennell, Clerical Specialist I (Grade 111) to Clerical Specialist II
(Grade 112) in the Nutrition/WlC Division of the New Hanover County Health Department. Upon
vote, the MOTION CARRIED UNANIMOUSLY.
Vector Control Boat
Mr. Steuer reported on February 2, 1999, the Executive Committee reviewed Boat Options for the
Vector Control Program with Ms. Harvell, Mr. Ken Sholar, Vector Control Manager, and Mr. John I
Minneci, Environmental Health Specialist, Environmental Health. The Executive Committee
recommended the purchase of an Alumacraft 20-foot boat for the Vector Control Program in the
Environmental Health Division.
Mr. Steuer advised he would like to readdress the boat issue since he is not comfortable with the
decision to purchase the Alumacraft 20-foot boat for the Vector Control Program. He stated the safety
issue needs to be thoroughly addressed. Mr. Steuer advised he is concerned about the aluminum
semi-vee boat in the river. He stated the river can be rough and even become a life or death
threatening issue. Mr. Steuer advised a vee-bottom boat would be safer in the river and in rough
water. He asked the Board of Health to consider letting the Boat Committee meet again, resolve the
issue, and have the authority to act upon the selection of the Vector Control boat.
MOTION: Dr. Goins moved and seconded by Dr. Speck for the Boat Committee to readdress the
staff needs and safety of a boat for the Vector Control Program, to resolve the issue, and to have the
authority to select the Vector Control Program boat. Upon vote, the MOTION CARRIED.
7 ~ye
1 Nay (Dr. Jewell)
Comments:
Board of Health
Mr. Estep commended Ms. Rowe, Chainnan, Budget Committee and the health department staff or a
job well done on the preparation of the FY1999 - 2000 Budget.
Dr. Goins requested Mr. Rice send a note of appreciation to Mr. Thomas and to the NHCHC staff for
hosting the February New Hanover County Board of Health meeting.
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Health Director
New NHCBH Members Orientation
Mr. Rice reported he conducted orientation sessions with Dr. Smith and Dr. Speck. He encouraged
new Board members to participate in the staff orientation sessions. Dr. Speck expressed the
orientation sessions were helpful before reviewing her program budget.
AEIOU Update
Mr. Rice reported the Assessment Protocol for Excellence in Public Health (APEX/PH) process has
been in place in the health department since March 1998. The AEIOU Team (Assessing, Evaluating,
Improving, Our Opportunities are Unlimited) has identified opportunities to improve. The three action
teams are Public Infonnation Team, Internal Communication Team, and Internal Evaluation Team.
The Internal Evaluation Team is assessing the need for a consultant and accreditation for the health
department. The Internal Communication Team prepared a staff survey. Out of 159 surveys, 123
were completed. They will report the results to the Board of Health. The Internal Communication
Team planned two Lunch and Learn sessions. One Lunch and Learn was on the health department
voice maiVphone system and the second session will focus on the Internet. The Public Infonnation
Team is focusing on the Community Diagnosis and community involvement.
State Health Directors/ANCBH Meetings
Mr. Rice reported Dr. Goins, Dr. Jewell, and Mr. Rice attended the Local Boards of Health: Working
with the Media," 13th Annual Meeting of the Association of North Carolina Boards of Health on
January 22, 1999, at the North Raleigh Hilton, Raleigh, North Carolina. Dr. A. Dennis McBride,
State Health Director, addressed the following 1999 Hot Buttons: Tobacco Settlement, School Health
Infrastructure, Health Choice, Asthma Prevention and Control, Bioterrorism, HIV / AIDS Prevention
and Treatment, and Environmental Health Issues. Mr. Rice reported the environmental issues included
State Ecology Plan, Resolution of State Organization, Intensive Livestock Operations, Harmful Algae
Blooms - Pfiesteria, Safe Drinking Water, Wastewater Management, Indoor Air Pollution, and Lead
Poisoning. Mr. Steuer expressed the hog industry is a real problem to the Cape Fear Area.
Mr. Robert S. Parker, fonner New Hanover County Health Director, received the ANCBH Carl
Durham A ward for his significant contributions to public health. He was instrumental in the
development of ANCBH in 1985, in the creation of Wood Endowment for the North Carolina Public
Health Association, and started a NCPHA scholarship. Also, Mr. John Coble, Fonner Board of Health
Chair and Member is ANCBH President.
Rotary Club of Wilmington Presentation - January 19.1999
Mr. Rice stated he presented a PowerPoint presentation, an Overview of the Health Department to the
Wilmington Rotary Club on January 19, 1999.
New Hanover County Board of Commissioners Meeting - February 15.1999
Mr. Rice announced that he will present the New Hanover County Health Department Annual Report
and the North Carolina Public Health "Everywhere, Everyday, Everybody" video at the County
Commissioners meeting on Monday, February 15, 1999. It is an opportunity to promote public health
and raise visibility.
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Dangerous Dog Panel
Mr. Rice reported the Animal Control Services Dangerous Dog Panel will be tonight at 7:00 p.m. The
owners of CHET plan to appear before the panel.
Public Health Prevention Specialist
Mr. Rice reported the New Hanover County Health Department did not receive the Pubic Health
Prevention Specialist Intern from the Communicable Disease Center.
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Other Information
Mr. Rice distributed the following to the Board of Health members:
CDC Hurricane Guide
A Corps of Engineers Letter Re: Improvements to Wilmington Harbor
Hog Industry & Public Health
BCCCP Fact Sheet
EPI Newsletter
Other Business:
Expression of Appreciation
Mr. Steuer expressed his appreciation to the Board of Health members for their kindness and for the
lovely flowers he received during his recent illness.
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Adjourn:
There being no other business, Dr. Jewell adjourned the regular business meeting of the Board of
Health at 9:55 a. m.
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William T. Steuer, PE S, Chainnan
New Hanover County Board of Health
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David E. Rice, M.P.H., M.A., Health Director
New Hanover County Health Department
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Approved: March 3,1999
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