09/06/2000
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NEW HANOVER COUNTY BOARD OF HEALTH
Dr. Thomas Fanning w~ Memorial Conference Room
New Hanover County Health Department
AGENDA
Date:
September 6, 2000
Time:
8:00 A.M.
~/AP:;isht:J.~!l!~~fjl Conference Room
New Hanover County Health Department
Place:
Presiding:
~vocation:
I-I ~ Public Hearingr~ \
\,J t.l.;Q )
Mr. William T Steuer, Chairman
Mr. William T Steuer
1'7..,fCl
_ / Minutes:
Recognitions:
New Hanover County Board of Health Amendments to Rules Governing the
Fencing and Opera~T oJ!fvate Swinuning Pools in New Hanover County,
North Carolina /fetft?
August 2, 2000
- Mr. William T Steuer
Chairman
Years of Service
5 Years
Leigh J Jackson, Environmental Health Specialist, Environmental Health
John M. Minneci, Environmental Health Specialist, Environmental Health
10 Years
Sarah Harrell, Clerical Specialist I, Environmental Health
Personnel
New EmDlovees
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Regina Abate, Clerical Assistant, Administration
Lorna Blackler, Licensed Practical Nurse, Child Health
Lee Ann Cook, Licensed Practical Nurse II, Communicable Disease
Dina Sarro, Nutritionist I, Nutrition! WIC
Beth Topping, Social Worker II, Child Health
Courtney Wilson, Physician Exten er, Women's Health Care
un(J) 1J~ /
NHC Board of Health Agenda
September 6, 2000 - Page 2
e
Other Recognitions:
Serving Safe Food.. Elijah's Restaurant
Pilot House Restaurant
JO-;).{ M)'l}t.hl[!inanc!;tl. ~eBJi: July 2000
;;q. - ').'j 0 t.IfX/l ~ tJ IIlIt{tt.
Ms. Cindy Hewett
Business Qfficer
Committee Reports:
Executiv~ommittee (liste}l under New llJJsin~)
1'4# ?l1/{rt,fe-s ~ I1K~ /
Environme tal Health Committee (listed under New Business)
- Mr. William T Steuer
- Mr. W Edwin Link
New Business: - Mr William T Steuer
'--.1~'f3 Grant Application (i!t~ ~~- "it~) Counseling Program ($48,000) ~
'f'f-lfj Proposed Regulation of the Use of Mobile Telephones While Operating a Motor Vehicle fr
e Strategic Planning Process {OL[)ER-
60-5{
evision of Hea,.;ation
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· IlHa,Pf) fA~.,'!/l$r~~~)
.. roof} Tttt...1< ..MLWiII' TS ~
.. SEhJ,a., ,,1tFe'" I-CVLJ ~e;-~~ '"0
. ElIIJJf!;eIl.1-~.v'1 Put. ~e.E ~ .
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- Mr. DaVid E. Rice
Comments:
Board of Health Members
Health Director
5"" -(,7-
1 Eastern Equine Encephalitis Update
2. AEIOU Update- Strengths Analysis
3 Media ReJe.lutloftS Symposium - August 29, 2000 do. J -fI::': ~ _ . __ J
4 NHCHD Volunteer Orientation- August 30, 2000 19 V~ ~
t. P;:::~:;:l)" ~;g;lth Asp~Xn Annual Conference- September 20-22, 2000
Other Business: ~ - Mr. William T Steuer
Department Focal:
- Mr William T Steuer
e
Communicable Disease Resource Fair
- Ms. Beth Jones
Communicable Disease Director
Adjourn:
- Mr. William T Steuer
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Mr. William T Steuer, Chairman, called the regular business meeting of the New Hanover County
Board of Health (NHCBH) to order at 8:00 a.m., Wednesday, September 6, 2000, in the Carl T
Durham Memorial Auditorium of the New Hanover County Health Department, 2029 South 17th Street,
Wilmington, North Carolina.
Members Present:
William T. Steuer, Chairman
Wilson O'Kelly Jewell, DDS, Vice-Chairman
Henry V. Estep, RHU
Michael E. Goins, OD
Robert G. Greer, Vice-Chair, County Commissioners
Gela N. Hunter, RN, Nurse Practitioner
W. Edwin Link, Jr., RPH
Anne Braswell Rowe
Philip P. Smith, Sr., MD
Melody C. Speck, DVM
Estelle G. Whitted, RN
Members Absent:
Others Present:
David E. Rice, Health Director
Lynda F. Smith, Assistant Health Director
Kimberly Roane, Recording Secretary
Invocation:
David E. Rice gave the invocation.
Public Hearing:
A Public Hearing was held to discuss the New Hanover County Board of Health Amendments to
Rules Governing the Fencing and Operation of Private Swimming Pools in New Hanover County,
North Carolina. With no requests made to speak before the New Hanover County Board of Health,
the Public Hearing was closed by Mr. Steuer at 8:08 a.m.
Minutes:
Mr. Steuer asked for corrections to the minutes of the August 2, 2000 New Hanover County Board of
Health meeting. The minutes of the August 2, 2000 Board of Health meeting were approved as
submitted.
Recognitions:
Mr. Rice recognized the recipients of the New Hanover County Service Awards:
Years of Service
5 Years
Leigh J. Jackson, Environmental Health Specialist, Environmental Health
John M. Minneci, Environmental Health Specialist, Environmental Health
10 Years
Sarah Harrell, Clerical Specialist I, Environmental Health
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Personnel
Mr. Rice introduced and welcomed the new employees and guests.
New Emplovees
Regina Abate, Clerical Assistant, Administration
Lorna Blackler, Licensed Practical Nurse, Child Health
Lee Ann Cook, Licensed Practical Nurse II, Communicable Disease
Dina Sarro, Nutritionist I, NutritionlWlC
Courtney Wilson, Physician Extender, Women's Health Care
Guests
Rachael Page, student, UNCW School of Nursing
Brandi Lewis, student, UNCW School of Nursing
Amy Gunn, student, UNCW School of Nursing
Other Recognitions:
Mr. Rice introduced Ms. Isabelle Charleton, representative of Cape Fear Community College. Mr
Steuer presented plaques to participants of the Serving Safe Food classes sponsored by the Cape
Fear Community College and the Health Department. Plaques were accepted by Bryan Gibson,
General Manager, and Vincent Drayton, Executive Chef, on behalf of Elijah's Restaurant, and
presented to Jason Branch, General Manager, and Kathy Seagraves, Executive Chef, on behalf of the
Pilot House Restaurant.
July 2000 Monthly Financial Report:
Ms Lynda Smith, Assistant Health Director, presented the Monthly Financial Report for July 2000
Ms. Smith noted that, due to a change in State and Federal requirements, monthly revenues are now
billed monthly instead of quarterly, and July revenues have been billed but not yet received.
Dr. GOins asked when a final financial report for the past fiscal year would be received. Ms. Smith
stated that a final report would be available in October
Summarizing the status of grants, Ms. Smith advised the Board that the March Toward TB Elimination
Grant was awarded in the amount of $7,200. Mr. Rice advised that notification was Just received of
approval of the Diabetes Today grant funding in the amount of $10,000.
Committee Reports:
Executive Committee
Mr. Steuer reported the Executive Committee met at 6:00 p.m. on August 29, 2000. Items are listed
under New Business on the Board of Health Agenda.
Environmental Health Committee
Mr. Link, Chairman, Environmental Health Committee, reported the Environmental Health Committee
met at 6:00 p.m. on August 9, 2000. The committee reviewed the proposed New Hanover County
Board of Health Amendments to Rules Governing the Fencing and Operation of Private Swimming
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Pools in New Hanover County, North Carolina. Mr. Link recognized Susan Wright, Environmental
Health Specialist, for her significant research efforts to gather important information for the rule
amendment proposal.
Unfinished Business:
New Business:
Grant Application - Elton John Foundation - Enhanced Counselina Proaram ($48,000)
Mr. Steuer recommended from the Executive Committee for the Board of Health to accept and
approve the Elton John Foundation Enhanced Counseling Program Grant Application for $48,000 and
to submit the grant application to the New Hanover County Commissioners for their consideration.
Mr. Rice stated this is the same grant that was submitted last month to the Z. Smith Reynolds
Foundation. Dr. Speck questioned if it would be possible to extend the program a second year If
approval is obtained from both funding sources. Mr. Rice explained that we would use the funding in
the current fiscal year to expand the program.
Motion: Mr. Steuer moved from the Executive Committee for the Board of Health to accept and
approve the Elton John Foundation Enhanced Counseling Program Grant Application for $48,000 and
to submit the grant application to the New Hanover County Commissioners for their consideration.
Upon vote, the MOTION CARRIED UNANIMOUSLY.
Proposed Reaulation of the Use of Mobile Telephones While Operatina a Motor Vehicle
Mr. Steuer reported from the Executive Committee a recommendation to refer the matter of mobile
telephone regulation to the Personal Health Committee.
Ms. Rowe stated she would like for the Board of Health to be instrumental in starting an effort in this
region to regulate the use of mobile telephones. She considers this analogous to a resolution passed
by the New Hanover County Board of Health on 6/23/90 to regulate smoking in public places.
Ms Rowe believes there may be community support, as evidenced by the recent AAA Carolinas
statement In support of mobile telephone legislation. She asked Mr. Estep, Chair of the Personal
Health Committee, to consider recommendation of regulation.
Ms. Whitted expressed support of regulation and would like the Board of Health to move forward. She
related personal experience in witnessing distracted drivers talking on mobile telephones. Dr. Smith
agreed and added that the distraction is the main issue. He referred to the National Highway Traffic
Safety Administration website, stating it would be desirable to have the information contained on that
webslte reproduced and distributed. Dr. Smith stated that taking a stand on regulation is the correct
thing to do.
Mr. Steuer reported receiving letters both pro and con and stressed that this is not a simple Issue,
perhaps not to be handled alone. He welcomes the AAA Carolinas' effort to take this issue to the
legislature. Mr. Steuer explained that thirty states attempted to legislate this without success. He
stressed the need to gather adequate information before moving forward.
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Ms. Rowe suggested that the actions taken by other states should not affect proposals of this Board I
of Health and cited the many supportive comments received. Dr. Smith referred to a recent
newspaper article listing New Hanover County as the county with the greatest likelihood of having a
traffic accident and of sustaining injury in a traffic accident, and believes this sufficient reason for the
Health Department to take the lead in regulation. Mr. Estep suggested this is a complicated matter
that involves mental distraction with mobile telephones only one source of distraction. He expressed
concern over the difficulty in attempting to control mental functions of drivers. Ms. Rowe suggested
combining public education with regulation.
Mr. Link raised the possibility of hands-free mobile communication, and his concern over the negative
impact regulation of mobile phones would have on tourism for this county. He suggested working with
state legislature to bring change, believing this to be a more difficult area to regulate than was
smoking.
Motion: Dr. Goins moved and Ms. Rowe seconded to refer the issue of mobile telephone regulation
to the Personal Health Committee for research and recommendation. Upon vote, the MOTION
CARRIED UNANIMOUSLY.
Revision of Health Director Evaluation Form
Mr. Steuer recommended from the Executive Committee for the Board of Health to accept and
approve revision of the Health Director Evaluation Form as submitted.
Dr. Link expressed concern that the new form would not provide a good quantitative evaluation I
without assignment of a rating number for each performance area. Dr. Smith stated he thought the
old format was better, allowing more effective evaluation of all criteria. Ms. Whitted added that,
without individual evaluation ratings, it will not be clear which areas require improvement.
Ms. Hunter suggested a format with columns on the side and ratings clearly stated at the top of each
column, allowing for checks in a specific rating column, from "poor" to "exceptional" for clarity. Dr.
Goins agreed with this suggestion for form layout.
Motion: Mr. Steuer moved from the Executive Committee for the Board of Health to accept and
approve revision of the Health Director Evaluation Form as submitted. Upon vote, the MOTION DID
NOT CARRY.
Mr. Steuer stated he was satisfied with the old form and sees no need to change. Dr. Speck stated
the old form caused confusion with ratings, and she prefers to change the format providing columns
to check for numeric ratings. Dr. Jewell agreed.
Motion: Dr. Goins moved and Ms. Hunter seconded to approve the revision of the Health Director
Evaluation Form in landscape format with the addition of rating columns to the side of the form. Upon
vote, the MOTION CARRIED UNANIMOUSLY.
Strateaic Plannina Process
Mr Steuer stated the Strategic Planning Retreat is being held October 6-7, 2000 at the Marriott I
Courtyard Hotel. Mr. Rice has received most of the responses. The majority of the surveys have
been entered into the computer, and Mr. Estep will meet with Mr. Rice on 9/13/00 to organize the
information. Packets will be distributed two weeks prior to the retreat. Mr. Estep thanked the Board of
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Health members and staff for efforts extended throughout the interview phase of the Strategic
Planning Process.
Comments:
Board of Health Members
Board of Health Recoanition to Mr. Steuer
Dr. Goins presented a plaque to William T. Steuer, Chairman, New Hanover County Board of Health,
in recognition of extraordinary dedication and commitment to securing generators/hookups at the New
Hanover County emergency shelters.
MOSQuito Problem
Mr. Greer raised the issue of the mosquito problem. Mr. Steuer stated spraying has been extensive
and commended the Vector Control staff for doing a good job. Mr. Steuer reported occasionally
horses are lost due to Eastern Equine Encephalitis. Dr. Speck agreed mosquitoes are a problem, but
agreed New Hanover County has an excellent Mosquito Control Program. Ms. Whitted inquired about
donut-shaped repellant seen on television. Dianne Harvell, Environmental Health Director, explained
the B.T.I. donuts are used in standing water. Mr. Rice suggested use of Permethrin (10%), a
chemical spray found at home and garden supply stores. Dr. Smith stated the importance that
residents take personal responsibility for controlling their living areas and suggested education to
increase public awareness. Ms. Rowe cited a recent television interview with Ken Sholar, of New
Hanover County Vector Control, who did an excellent job of public education. Mr. Greer suggested
staff give information to Mark Boyer, Public Information Officer, for media distribution.
Availabilitv of Public Restroom
Ms. Whitted reported receiving a call from a citizen, reporting a lack of public restrooms at a business
on Kerr Avenue. A child was sent outside the building to the facility next door. Ms. Whitted
considered this a public health matter and inquired as to regulations for public restrooms. Ms. Harvell
stated this is governed by the State, and she believes public restrooms are not required in small retail
establishments. Mr. Steuer referred the matter to the Environmental Health Committee for further
research.
Flu Vaccine
Dr. Smith inquired about flu vaccine availability. Ms. Beth Jones, Communicable Disease Director,
explained we have not yet received vaccine that was ordered last Spring. The CDC has advised a
delay in mass immunization campaigns until later in November. The reason for the delay is a lack of
FDA approval of vaccines already produced, resulting in additional production efforts. Ms. Jones
reported that this may result in a shift in priority of vaccine administration, but we are waiting before
reacting and have not yet changed plans. Mr. Steuer asked if pneumonia vaccine was also affected,
but Ms. Jones stated it was not.
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Health Director
Eastern Eauine Encephalitis
Mr. Rice discussed the statewide status of Eastern Equine Encephalitis. Dr. Smith asked for a
comparison to past years. Ms. Jones reported no significant increase, stating there are always a few
positive results found during testing of sentinel chicken flocks.
AEIOU Strenaths Analvsis
Mr. Rice reviewed the strengths analysis effort of the AEIOU (Assessing, Evaluating, Improving, Our
Opportunities are Unlimited) team, reporting 75 strengths met as compared to 60 highly met strengths
in 1998.
Media Relations Svmposium
Having attended the Media Relations Symposium on August 29, 2000, Mr. Rice reported the need to
be more vigilant in getting information to the public. He stated this issue will be examined during the
Strategic Planning process. Mr. Rice commended Ms. Betty Fennell, reporter for the Wilmington Star
News, on her fair and accurate reporting of Health Department information.
NHCHD Volunteer Orientation
Mr. Rice reported a group Volunteer Orientation was held August 30, 2000. Nineteen volunteers
attended the session which was led by Ms. Julia Bibbs, NHCHD Volunteer Coordinator. Mr. Rice
commended Ms. Bibbs, Ms. Jones, and Ms. Roane for efforts implementing the Health Department's
Volunteer Program. Dr. Smith suggested submission of information in the Volunteer Connection
section of the Wilmington Star News. Ms. Roane stated we have already announced volunteer Job
opportunities in that section and have received responses as a result.
North Carolina Public Health Association (NCPHA) Annual Conference
Mr. Rice reported the NCPHA Annual Conference will be held in Wilmington September 20-22, 2000.
Board of Health members may attend free of charge. As the host county, NHCHD will offer a tour of
the Health Department facility on Wednesday, September 20. Mr. Steuer will welcome the attendees.
Dr. Goins inquired about the registration process. Mr. Rice stated forms could be returned to him, or
taken to the Hilton Hotel at the time of registration.
Other Business:
Proposed Mobile Telephone Reaulation
Mr. Steuer revisited the mobile telephone regulation issue, commending David Howard, Health
Educator, for an excellent job researching mobile phone usage and regulation across the country. Mr.
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Steuer reiterated that the Board of Health considers this a very serious and complex issue, carefully
considering the appropriate direction in which to move.
Department Focal:
Information Fair
Ms. Beth Jones, Communicable Disease Director, invited Board members to accompany her outside
the auditorium to participate in the department focal. Ms. Jones and staff presented a Health
Information Fair with displays depicting the many programs of the Communicable Disease Division.
Adjourn:
Mr. Steuer adjourned the regular meeting of the Board of Health at 9:25 a.m.
~if~
William T. Steuer, PE/RLS, Chairman
New Hanover County Board of Health
David E. Rice, M.P.H., M.A., Health Director
New Hanover County Health Department
Approved: October 4, 2000
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Mr William T Steuer, Chairman, called the regular business meeting of the New Hanover County
Board of Health to order at 8:00 a.m. on Wednesday, August 2,2000
Members Present:
William T Steuer, Chairman
Wilson O'Kelly Jewell, DDS, Vice-Chairman
Henry V Estep, RHU
Michael E. Goins, OD
Gela M. Hunter, RN
Mr Robert G. Greer
Anne Braswell Rowe
Estelle G. Whitted, RN
Members Absent:
W Edwin Link, Jr., RPH
Philip P Smith, Sr., MD
Melody C. Speck, DVM
Others Present:
Mr David E. Rice
Frances De Vane, Recording Secretary
Invocation:
Dr Wilson Jewell gave the invocation.
Minutes:
Mr. Steuer asked for corrections to the minutes of the July 12, 2000 New Hanover County Board of
Health meeting. The Board of Health approved the minutes of the July 12, 2000 Board of Health
meeting.
Public Comment:
Proposed Rel!ulation for the Use of Mobile Telepboues While Operatiul! a Motor Vehicle
Dr Joseph Hooper, former Board of Health Chair and New Hanover County Commissioner, thanked the
Board of Health for the opportunity to appear before the Board to present a proposed regulation to
prohibit the use of hand-held cell phones while driving an automobile. He expressed hand-held mobile
phones are a threat to the safety, cause injuries and automobile accidents, and are a health hazard to
New Hanover County citizens. Dr Hooper advised other states have pending mobile phone usage
regulation and some municipalities and other countries have banned the use of cell phones. He chose to
submit the Proposed Regulation for the Use of Mobile Telephones While Operating a Motor Vehicle to
the Board of Health, because under North Carolina General Statue 130-A-1.l the Board has the authority
to promote and make public health and safety regulations.
Ms. Rowe asked if the proposed cell phone regulation would infringe on individual rights. Dr Hooper
responded cell phones need to be regulated for safety reasons, and the proposed regulation has nothing to
do with the freedom of speech. Mr Steuer asked if the Board should wait for the state or federal
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governments to restrict cell phone usage while driving a motor vehicle. Dr. Hooper encouraged the
Board of Health to consider the recommendation as presented.
e Mr Steuer thanked Dr Hooper for presentation to the Board. The Proposed Regulation for the Use of
Mobile Telephones While Operating a Motor Vehicle will be presented to the Executive Committee of
the Board of Health for their consideration.
Recognitions:
Service Awards
Susan O'Brien - 25 Years
Mr Rice recognized and congratulated Ms. Susan O'Brien, Laboratory Director, as a recipient of a New
Hanover County Service Award. He acknowledged Ms. O'Brien is a cornerstone of the Health
Department, and he commended her for 25 years of dedicated public health service.
Personnel
New Emolovees
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Joan Hulette, Clerical Specialist I, Communicable Disease
Maureen Lamphere, Public Health Nurse I, Communicable Disease
Lenora Kay Lunceford, Clerical Specialist I, Communicable Disease
Harvey Eugene Young, Environmental Health Specialist, Environmental Health
Department Focal:
WIC Outreach
Ms. Nancy Nail, Nutrition Director, presented a department focal on WIC Outreach. She explained the
New Hanover County Health Department received a WIC Outreach Grant ($10,000) that provided an
outreach worker from mid-May through June. The objective of the WIC Outreach Grant was to recover
the caseload lost as a result of Hurricane Floyd. Outreach campaigns included storefront set-ups, radio
spots and public service announcements, newspaper articles, and community visits. WIC informational
booths were set up at Wal-Mart, K-Mart, and Roses from 10:00 a.m. to 4:00 p.m. on high volume
shopping days. Public service announcements were aired in English and Spanish on W AA V &
WMYT/WDVV An article entitled Women, Infants, and Children Program Improves Health of Low-
Income Children was featured in the Wilmington Journal. To reach the target population outreach
workers were made to doctor's office, WIC vendors, Childcare Centers, housing authorities, churches,
and Headstart Center to encourage new and former clients to participate in the WIC Program. As a
result of these efforts, 17 additional appointments were scheduled for new WIC participants.
Mr Steuer thanked Ms. Nail for her presentation.
Monthly Financial Report - June 2000:
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Ms. Cindy Hewett, Business Officer, presented the June Health Department Financial Summary Monthly
Revenue and Expenditure Report that reflects an eamed revenue remaining balance of $224,914
(9474%), an expenditure remaining balance $974,896 (89.95%), and a cumulative percent of 100%.
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Ms. Hewett advised revenue and expenditure balances are basically on schedule and in line compared to
last year She explained most of the Capital Outlay remaining balance $237,640 (6946%) is to be
carried forward to FY Budget 2001 for the Medical Records renovation.
Ms. Hewett referred the Board to an earned revenue remaining balance of $76,836 (85 13%) that is an
increase of earned revenue of approximately $60,000. She reported Animal Control Services earned
more revenue this year as a result of the installation of the new computer system. Additional Medicaid
monies will be posted later Ms. Hewett explained this financial report is not the final yearend report
from the county The revised report could be as late as September
Committee Reports:
Executive Committee
Mr Steuer reported the Executive Committee met at 6:00 p.m. on Tuesday, July 25, 2000. Items are
listed under New Business on the Board of Health Agenda.
Environmental Health Committee
Mr Link, Chairman, Environmental Health Committee, reported the Executive Committee met at 6:00
p.m. on July 15, 2000. Items are listed under New Business on the Board of Health Agenda.
Personal Health Committee
Mr Estep reported the Personal Health Committee met at 6:00 p.m. on Julyl8, 2000. Items are listed
under New Business on the Board of Health Agenda.
Unfinished Business:
Generators/Hookups at Emel1!encv Shelters
Mr Rice referred the Board to a memo from Dennis Ihnat, School Retrofit Projects, New Hanover
County Emergency Services, containing an Update on Generators and Manual Electrical Transfer
Switches for Schools Used as Emergency Shelters. On April 18, 2000, the county signed a contract
with Watson Electric Company to install manual switches with a required completion date of July 22.
The contract price is $211,851 Manual electrical transfer switches are installed at the Central Office
Freezer, Dorothy B. Johnson, Eaton, Noble, and Trask Schools. Plans are to install an additional
generator switch at Codington School in August 2000.
Motion: Motion passed to remove the Generators/Hookups at Emergency Shelters under Unfinished
Business from the monthly New Hanover County Board of Health Agenda. Upon vote, the MOTION
CARRIED UNANIMOUSLY.
On behalf of the Health Department staff, Mr. Rice expressed appreciation to Mr Steuer, Ms. Hunter,
and to the Board of Health members for addressing the need to install generators/hookups and to
improve conditions at the disaster shelters. He praised Mr Steuer for his leadership and tenacity and
thanked Ms. Hunter for first presenting the evacuation shelter issues to the Board of Health. Mr Steuer
thanked Mr Greer, Vice-Chairman, New Hanover County Commissioners, and the County
Commissioners for their support of this project.
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New Business:
Grant Status Update
Ms. Hewett presented a Grant Status Report from March 3, 1999 through July 12,2000. The Health
Department submitted 29 grant applications ($1,075,62) and received II grants ($291,284). Five grant
proposals ($182, 500) are pending. Eleven (II) grant applications ($555,742) were denied. Ms. Hewett
advised the 4 grants approved by the Board of Health in June and July are indicated as pending grants
and will be submitted to the New Hanover County Board of Commissioners at their August 7 meeting.
Mr. Steuer reported the Executive Committee decided the Grant Status Report should be completed on a
fiscal year basis and will be retroactive from July 1,999
Smart Start Applvinl! for Cape Fear Memorial Foundation Grant - Maternity Outreach Workers
($52,000)
Mr Steuer recommended from the Executive Committee for the Board of Health to accept and approve
a budget amendment of $52,000 if Smart Start receives the Cape Fear Memorial Foundation Grant to
fund the salary of two Health Department Maternity Outreach Workers and operating expenses.
Ms. Lynda F Smith, Assistant Health Director, clarified if Smart Start is awarded the $52,000 grant
from the Cape Fear Memorial Foundation, the Health Department will hire and supervise the MOW
positions and will receive $52,000 funding. She advised after Smart Start receives the grant, a budget
amendment will be submitted to the County Commissioners. The purpose of the Smart Start Cape Fear
Memorial Foundation Grant Application is to provide services to high risk pregnant women during
pregnancy and to provide services to the child for the first year life.
Motion: Mr. Steuer moved from the Executive Committee for the Board of Health to accept and approve
a budget amendment of $52,000 if Smart Start receives the Cape Fear Memorial Foundation Grant to
fund the salary of two (2) Health Department Maternity Outreach Workers and operating expenses.
Upon vote, the MOTION CARRIED UNANIMOUSLY.
Grant Application - Z. Smith Revnolds Foundation. Inc.. Enhanced Counselinl! Prol!ram ($48,000)
Mr. Steuer recommended from the Executive Committee for the Board of Health to accept and approve a Grant
Application for an Enhanced Counseling Program for $48,000 from the Z. Smith Reynolds Foundation,
Inc.
The purpose of the grant is to provide enhanced counseling services to newly diagnosed mV-infected
individuals and high-risk Sexually Transmitted Disease (STD) clinic clients. The budget includes a
Masters level Social Worker Position ($45,503) and operating expenses ($2,497) to implement the
program with total in-kind support of $12,849
Motion: Mr Steuer moved from the Executive Committee for the Board of Health to accept and
approve a Grant Application for an Enhanced Counseling Program for $48,000 from the Z. Smith
Reynolds Foundation, Inc, and to submit the grant application to the New Hanover County
Commissioners for their consideration. Upon vote, the MOTION CARRIED UNANIMOUSLY.
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Grant Application - Z. Smith Revnolds Foundation. Inc. Teen AIDS Prevention ($59.000)
Mr. Steuer recommended from the Executive Committee for the Board of Health to accept and approve a Grant
Application for Teen AIDs Prevention (TAP) for $59,000 from the Z. Smith Reynolds Foundation, Inc.
The purpose of the Teen AIDS Prevention Grant is to continue the TAP peer education program. The
grant application is in addition to the Cape Fear Memorial Foundation TAP Grant Application
($55.000). If the Health Departments receives both grants from the two funding sources, the TAP
Program is to be enhanced and expanded.
Motion: Mr Steuer moved from the Executive Committee for the Board of Health to accept and approve
a Grant Application for Teen AIDs Prevention (TAP) for $59,000 from the Z. Smith Reynolds
Foundation, Inc. and to submit the grant application to the New Hanover County Commissioners for
their consideration. Upon vote, the MOTION CARRIED UNAMIOUSL Y.
Fundinl! for School Health Nurse Positions ($192.520)
Mr Steuer recommended from the Executive Committee for the Board of Health to accept and approve five
(5) new School Health Nurse positions to be funded by the New Hanover County Board of Education.
The $192,520 budget includes Salaries/Fringes, Operating Expenses, and Capital Outlay for FY2000-
2001 Health Department staff will hire and supervise the additional ten-month School Health Nurse
positions.
Motion: Mr Steuer moved from the Executive Committee for the Board of Health to accept and approve
five (5) new School Health Nurse positions to be funded by the New Hanover County Board of
Education and to submit the budget request ($192,520) to the New Hanover County Commissioners for
their consideration. Upon vote, the MOTION CARRIED UNAMIOUSL Y.
StratCl!ic Planninl! Process
Mr Steuer recommended from the Executive Committee for the Board of Health to accept and approve
a List of Key Stakeholders and Community Leaders, the forms for Interview for Key Stakeholders and
Community Leaders, the DepartmentJDivisional Survey, and the Expectations from Planning Process for
the Health Department Strategic Planning Process.
Mr Estep, Chairman, Personal Health Committee, reported the List of Key Stakeholders and Community
Leaders and Strategic Planning questionnaires were reviewed by the Personal Health and Executive
Committees. Each Board member and retreat participant will be requested to interview three (3)
community leaders and to complete the interview and participant questionnaire forms by August 25,
2000.
Mr Rice distributed to the Board a Strategic Planning Process packet including a list and three
questionnaires (a List of Key Stakeholders and Community Leaders, the Interview for Key Stakeholders
and Community Leaders form, the DepartmentJDivisional Survey, and the Expectations from Planning
Process for the Health Department Strategic Planning Process). He advised on August 9 a letter will be
mailed to community leaders (including a copy of the Interview for Key Stakeholders and Community
Leaders form) prior to their interview by a Strategic Planning Retreat participant.
Mr Rice gave a computer presentation on the completion of the planning process forms. The three
interview forms and questionnaires due to Mr Rice by August 25 may be entered on computer diskettes
or handwritten. If possible, retreat participants should personally interview their designated community
leaders.
17
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Dr. Goins clarified the Health Department Strategic Planning Process should be proactive not reactive,
should perceive and identify problems in advance. Mr Rice eXplained the Health Department Mission
Statement is included on the interview forms to assist the selected community leaders. The original List
of Key Stakeholders and Community Leaders included 278 people and the Executive Committee's
revised list includes 78 people. Mr Rice reported Mr William T Herzog, facilitator of the Strategic
Planning Retreat, will review the vital statistics and summary reports prior to the retreat on October 6
and 7, 2000. Mr Rice plans to prepare the pre-retreat Strategic Planning informational packet and
distribute it to retreat participants by September 22, 2000.
Motion: Mr Steuer moved from the Executive Committee for the Board of Health to accept and
approve a List of Key Stakeholders and Community Leaders and forms for the Interview for Key
Stakeholders and Community Leaders, the Department/Divisional Survey, and the Expectations from the
Planning Process for the Health Department Strategic Planning Process. Upon vote, the MOTION
CARRIED UNAMIOUSLY.
Comments:
Board of Health Members
Ms. Whitted stated it is reassuring to know if needed generators/hookups are available in the emergency
evacuation shelters.
On behalf of the Personal Health Committee, Mr Estep thanked the Board of Health for their support
with the Health Department Strategic Planning Process.
Ms. Rowe advised the Board Dr Hooper requested public comment before the Board of Health
regarding his concern about the use of mobile telephones while driving. She emphasized it is a public
health and safety issue that needs to be addressed. Mr Estep suggested this issue be referred to the
Personal Health Committee. Mr Steuer recommended and the Board of Health concurred to refer the
mobile telephone usage while driving a motor vehicle recommendation to the Executive Committee and
then possibly to the Personal Health Committee.
Health Director
Meetin!!: with State Health Director
Mr Rice reported he was honored to meet with Dr A. Dennis McBride, State Health Director, and other
selected Regional Health Directors, on July 18, 2000. The group discussed the State Expansion Budget
and made plans to meet quarterly to address Public Health issues.
N. Co Association of Local Health Directors (NCALHD)
Mr Rice attended the NCALHD meeting held on July 26-27, 2000. He reported for two years, the
Information Technology Committee has researched the feasibility of implementing and developing a
statewide computer system for local health departments. The current state system is the Health
Services Information System (HSIS ) and our local Health Department computer system is QS.
Medicaid Maximization funds ($3,000,000) were appropriated for this new computer system. Mr Rice
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advised the NCALHD is developing Legislative Priorities for the next legislative session. He referred
the Board to a copy of A Legislative Summary of the General Assembly Short Session adjourned on
July 13
AEIOU Update
Mr Rice reported the AEIOU (Assessing, Evaluating, Improving, Our Opportunities are Unlimited
Team met on July 17, 2000. The Team completed the analysis of 50 of 75 strengths identified though the
Organizational Capacity Survey In 1998, the AEIOU Team identified 60 strengths. Upon completion
of the analysis of strengths, the team will analyze opportunities to improve.
Information for Board of Health
Mr Rice referred the Board to supplementary information in their folders including a letter of
appreciation on behalf of the Board of Health and Health Department Staff to Mr William A. Caster,
Chair, and to the Board of County Commissioners and letters from Mr William K. Atkinson, President
and CEO, New Hanover Health Network, from two concerned citizens regarding drainage problems; a
Legislative Summary of Short Session Highlights; and an issue of the NALBOH NewsBrief
Other Business:
Ms. Smith announced the new generator for the Health Department pharmacy is being installed. The
Medical Records Renovation is nearing completion.
Adjournment:
Mr Steuer adjourned the regular meeting ofthe New Hanover County Board of Health at 9:05 a.m.
William T Steuer, PE/RLS, Chairman
New Hanover County Board of Health
David E. Rice, M.P.H.,M.A., Health Director
New Hanover County Health Department
Approved:
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New Hanover County Health Department
FYOO-01
MONTHLY REVENUE REPORT
As of July 31, 2000
Summary for the New Hanover County Health Department
Cumulative 0/0
8.33%
Month Reported
Type of
Revenue
Budgeted
Amount
Current Year
Revenue Balance
Earned Remaining
%
Budgeted
Amount
Federal & State
AC Fees
Medicaid
Medicaid Max
EH Fees
Heelth Fees
Other
1,311,466
523,044
916,900
4,668
38,316
1,306,798
484,728
916,900
$ 1,363,135
$ 476,909
$ 852,684
$
$
$
$
Monlof12
Jul-OO
Prior Year
Revenue Balance
Earned Remelnlng
%
50,272
26,421
1,312,863
450,486
852,864
Note: County Appropriation is not calculated above. The County appropriation is the difference between the total amounts on the
program expenditure report and the totals on the program revenue report.
The budgeted amount for County Appropriation for FY 00 - 01 is ($9,378,752 - $4,029,551) = $5,349,201
The expended amount for County Appropriation for this FY (year-to-<late) is ($256,880 - $77,419) = $179,461
Revenue Summary
For Month of JULY 2000
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New Hanover County Health Department
FYOO-01
MONTHLY EXPENDITURE REPORT
As of JULY 31, 2000
Summary for the New Hanover County Health Department
Cumulative %
8.33%
Month Reported
Ju~O
Monl0112:
Type of
Expenditure
Current Year
Expended Balance
Amount Remaining
Prior Year
Expended Balance
Amount Remaining
%
Budgeted
Amount
%
Budgeted
Amount
Salary & Fringe
Operating
Capital Outlay
235,719
37,283
r f1
Expenditure Summary
For Month of JULY 2000
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NEW HANOVER COUNTY HEALTH DEPARTMENT
BOARD OF HEALTH (BOH) APPROVED
GRANT APPLICATION STATUS
Date (BOH) Grant Requested Pending Received Denied
Smart Start applying for Cape Fear
8/2/00 Memorial Foundation Grant (MOW) $52,000 $52,000
:>l: Enhanced Counseling Program- Z. Smith
Revnolds Foundation $48,000 $48,000
Teen Aids Prevention- Z. Smith Reynolds
Foundation $59,000 $59,000
March Toward TB Elimination- NC Dept ri)fiJ
7/12/00 of Health and Human Services (DHHS) $10,000 $10,000
Cape Fear Memorial Foundation (TAP I
ProQram)2 vear request $55,000 per vear $55,000 $55,000 I,d..........
Diabetes Today - DHHS Division of Public \0 . \j.1:) I~~~
Health $10,000 $10,000
....,
Servicios Para Ninos-Rahab Therapy
6n/00 Foundation $50,000 $50,000
Family Planning Outreach Initiative-NC
Division of Public Health- WPH Unit (Year
One $21,538 and Year Two: $22,615) $21,538 $21,538
Healthy Homes Initiative-NC Childhood
Lead Poisoning Prevention Program $20,000 $12,448
Project Assist-American Legacy
Foundation Grant ($57,500 for each of 3
5/3/00 years) $57,500 $57,500
MOW Services (Infant Mortality)-NC
Healthy Start Grant Application (2yr Grant:
4/5/00 $85,000 vr 1 and $43,845 vr 2) $128,845 $128,845
Skin Cancer Screening- NC Advisory
Commillee on Cancer Coordination and
Control $1,500 $1,500
WIC Outreach- NC Dept of Health and
3/1/00 Human Services $5,590 $5,590
No activity to repOrt for Jan and Feb 2000
Child Health Consultant Grant- UNC Dept
of Maternal and Child Health- Contract with
NC Dept of Health and Human Services,
12/1/99 Division of Women and Children's Health $48,210 $29,275
Healthy Carolinians Task Force- NC
11/3/99 Office of Healthy Carolinians (FROZEN) $10,000 $10,000
Operation Reach Women- Susan G.
Komen, Breast Cancer Foundation $19,822 $19,822
North Carolina Chilhood Asthma
Initiative- NC Dept of Health and Human
Services, Women and Children's Health
Section (FROZEN) $7 500 $7,500
No ac:lIvltvto ret>Ort rorOCt 1_
As of 8/23/00
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NEW HANOVER COUNTY HEALTH DEPARTMENT
BOARD OF HEALTH (BOH) APPROVED
GRANT APPLICATION STATUS
Date (BOH) Grant Requested PendinQ Received Denied
School Health Lice Grant- Carolina Power
and Light Company Corporate Contributions
9/1/99 Fund $4,900 $4,900
Growing Up Buckled Up- National
Highway Traffic Safety Administration
Cooperative Agreement $54,730 $54,730
Model Community Assessment Grant-
North Carolia Community Health Initiative-
Healthy Carolinians- Center for Disease
9/1/99 Control and Prevention $17 ,375 $17,375
Diabetes Today Community Planning
Initiative-NC Dept of Health and Human
Services - Diabetes Prevention and Control
Unit $10,000 $10,000
No ac:lIvltY to ,....... fof Auo 1999.
Healthy Women First- Community Health
7n/99 Improvement Program $24,692 $24,692
Teen Aids Prevention-Cape Fear
Foundation Grant $50,700 $35,000
Totals $766,902 $341,500 $135,173 $248,042
As of 8/23/00
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t-\ EA.L T+-\
NEW HANOVER COUNTY BOARD OF (Oh'IlIII)'"~I(INr.c>
REQUEST FOR BOARD ACTION
Meeting Date: 09/06/00
Department: Health Presenter: Beth Jones, Communicable Disease Director
Contact: Seth Jones 343.6648
SUBJECT:
ELTON JOHN AIDS FOUNDATION grant for $48,000 to fund an Enhanced
Counseling Program for HIV/AIDS prevention
BRiEr SUMMARY:
We are requesting approval of a grant application to the ELTON JOHN AIDS FOUNDATION for a
grant of $48,000 to start an Enhanced Counseling Program, which will include a new full.time
Masters level Social Worker to implement the program. We will provide enhanced counseling
services to newly diagnosed HIV.infected individuals and high risk Sexually Transmitted Disease
(STD) clinic users. We will offer multiple counseling sessions to two types of clients seen at the
health department:
1 Individuals infected with HIV or other STDs
2. Individuals at high risk for acquiring STDs
The Enhanced Counseling Program will assist these individuals in preventing the transmission of
their disease to others and in accessing the resources that will help them cope with their
diagnosis.
It is time to stop focusing sOlely on treatment; we must put more effort into prevention.
Enhanced counseling aims to prevent infected individuals from transmitting their disease to
others and to prevent all clients from acquiring any additional STDs or HIV. We can achieve this
through intense counseling sessions that focus both on behavioral change interventions and on
linking individuals to long.term resources such as case management; substance abuse
treatment; mental health counseling; domestic violence shelters; and health care.
See attached 19 pages of information including grant application, budget information, and letters
of support.
(This is our second grant application for this Enhanced Counseling Program funding. At the
August BOH meeting, you approved an application to Z. Smith Reynolds Foundation, Inc. for
this same purpose. Application to several sources increases our chance of funding.)
RECOMMENDED MOTION AND REOUESTED ACTIONS:
Approve grant application or $48,000 and approve related budget amendment if grant awarded.
FUNDING SOURCE:
ELTON JOHN AIDS FOUNDATION
ATTACHMENTS:
YES.19 pages of information including the grant application, budget information, and letters of
support.
24
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VISION:
To provide national leadership and resources that
will result in educational programs on the prevention
of HIVlAlDS and the improvement of care for
individuals living with HIVIAlDS
MISSION:
To provide funding for educational programs
targeted at HIV/AlDS prevention and/or the
elimination of prejudice and discrimination against
HIV/AIDS affected individuals. and for programs that
provide services to people living with HIV/AIDS.
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BACKGROUND:
With offices in Los Angeles and London. the Elton
John AIDS Foundation is an i~onaJ non-proflt
organization funding prevention education programs
and direct patient care services worldwide. The
charity was established in 1992 by Elton John. who
serves as its Chairman.
In 1993, the North American-based Elton John AIDS
Foundation established a collaborative effort with
the National AIDS Fund, a community based
prevention and service provider located in
Washington DC. This collaboration was established
in order to facilitate the distribution of grants on a
nationwide basis. These grants are issued as a
challenge to the National AIDS Fund's local
community member partnerships who then multiply
the efforts of the Elton John AIDS Foundation.
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Funding from the Elton John AIDS Foundation
encompasses a broad spec\lUm of direct care
services supporting men, woman. young adults.
children. infants. minorities and entire families living
with HIV I AIDS. Grants support programs and
services ranging from education outreach programs,
harm reduction models. early testing and treatment
advocacy. legal aid, buddy programs, food banks,
meal cIeIivery programs, hospice care and adoption
services for children orphaned and/or living with
http://www.ejaf.orgtmission.html
E_" opeoch to
bCNN_
Repad Ct.A.r.NIIC6
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blton John AU)::; rounaatlon
HIV.
The Elton John AIDS Foundations (both Los
Angeles and London) are pleased to announce
that the combined total of grants dispersed has
surpassed $20 million to datel From 1992 through
1999, the Elton John AIDS Foundation funded more
than 1,160 grants in North America. To date, the
Elton John AIDS Foundation has distributed $14
million in grants in North America and $7 miilion
intemationally In North America over eighty percent
of all money raised goes directly to patient care
grants, making the Elton John AIDS Foundation one
of the largest public non-profrt organizations in the
AIDS arena.
4l CclpyrigI1l 2000. Efton Jdln AIDS FoundaIkn. All rtghIs .......-d.
http://www.ejaf.orglmission.html
26 8/1/00
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NEW HANOVER COUNTY
HEALTH DEPARTMENT
2029 SOUTH 17m STREET
WILMINGTON, NC 28401-4946
TELEPHONE (910) 343-6500, FAX (910) 341-4146
DAVID E. RICE, M.P.H., M.A.
Health Director
LYNDA F. SMJTH, M.P.A.
Assistant Health Director
Elton John AIDS Foundation
P.O. Box 17139
Beverly Hills, CA 90209-3139
March 27, 2000
Dear Grant Administrator:
e
New Hanover County Health Department (NHCHD) is submitting a letter of inquiry to determine
whether there are funding possibilities through your foundation. We are pursuing funding for a
demonstration project to address a gap in services for individuals in this CODlDlunity, but reflects a
deficiency in the health care delivery system. Heightened efforts must be made to serve people
who are transmitting diseases to others. Our focus is I-llV and Sexually Transmitted Diseases
(STDs) Prevention. Our target population consists of people who are infected with HIV and
other STDs, which arc primarily young people, people of color, women, and men who have sex
with men.
A January, 2000 articIein the American Joumal of Public Health (Diamonj1 C, Buskin S.
Continued risky behavior in HIV -infected youth) asserts that HIV -infecte.d individuals continue to
exlnbit risk)' behaviors, including unsafu sex and needle sharing, after learning of their HIV
diagnosis. The study found that 66% ofHIV-infected young women, 46% of infected adult
women, 28% of infected young men, and 16% of infected adult men exhibited evidence ofrisky
behaviors after they learned of their diagnosis. The results of this study demonstrate the glaring
need to focus prevention effurts on HIV+ people. Traditionally, prevention and treatment
services have been separate when, in fact, these two interventions must coincide to lower the rates
ofHIV and STD infection.
e
Currently, NHCHD offurs SID screening, treatment, education, and mv counseling and testing
services. Clinical testing and treatment services include the provision of detailed information but
do not allow time for client-centered counseling with follow-up visits specifically designed to
reduce risky behaviors among infected individuals. Quite often, infected individuals are wrestling
with issues that complicate their ability to make behavioral changes, such as substance abuse,
domestic violence, denial, and mental health problems. Resources to overcome these difficulties
have either not been available or not utilized by these individuals. Services including case
management, substance abuse treatment, mental health counseling, and health care exist in our
community to benefit HIV+ individuals, and are offered to these individuals during their one post-
test counseling session at the NHCHD. However, according to the case manager for the HIV
/I '/jour ..J..Jeaftk _ Our priorit,,11
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Care Team at New Hanover Health Network, approximately 30% ofthese newly diagnosed HIV+
clients are lost to follow-up, and do not seek additional services. By offering these individuals
increased awareness of and accessibility to these resources, along with enhanced client-centered
counseling to confront the underlying issues, the NHCHD can both empower infected individuals
and protect others by preventing tranSmission ofIDV and other STDs.
The plan is to provide transitional support services to individuals newly diagnosed with HIV or
other STDs in the period inunediately following diagnosis. It is during this vulnerable time that
newly diagnosed individuals are most in need of information and support. With thorough
infonnation and appropriate support, newly diagnosed individuals are much more likely to make
healthy choices that will lead to a decrease in HIV transmission. By offering transitional client-
focused interventions, the specific goals of the program are:
. To provide a patient education program that enables newly diagnosed individuals to learn
about their infuction and effectively navigate the existing system ofresources available to
them.
. To empower individuals to take control of their health after receiving an HIV or STD
diagnosis.
. To prevent newly diagnosed HIV+ individuals from spreading the AIDS virus to other
people.
To prevent repeat sm clinic clients from acquiring HJV or additional SIDs.
Please refer to the Attachment if you are interested in learning the strategies developed to achieve
these goals.
We would appreciate the opportunity to submit a grant proposal to your foundation if this effort
is consistent with your funding priorities.
We look forward to hearing from you soon.
Sincerely,
~~
Jessica Nakell, MSW, MPH
TAP Program Coordinator
~~
Beth Jones, RN
Communicable Disease Director
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Attachment
Strategies for reaching the goals of the demonstration project
.
Offer individuals up to six visits with a trained MSW counselor at the NHClID after they
receive their HIV or STD diagnosis.
Collaborate with the three mv case managers in New Hanover County. Encourage
HIV+ clients to select a case manager to follow up with their care at the concl~ion of the
six sessions at the NHCHD. Ensure follow through of clients with their case manager.
IdentifY and assess the readiness of each client for behavioral change, and help facilitate
behavior change to adopt safe behaviors.
Assess the client's inunediate needs for medical, preventive, and psychosocial support.
Establish a plan for continuing medical care and psychological support, including mental
health or substance abuse treatment services, for HIV+ and repeat SID clients. IdentifY
necessary referrals and assist the client in contacting them.
Discuss with HJV+ clients the responsibility to ensure that sex and/or needle-sharing
partners are notified of their exposure to HlV and the need for them to seek mv
screening.
Assist clients in developing a plan that ensures that all partners are counseled about their
exposure to HIV and/or other STDs.
Discuss how the client will notifY other persons ofbislber HIV status including future sex
and needle-sharing partners, medical personnel, and dental providers.
Inform repeat STD clients that the presence ofan STD greatly increases a person's risk of
aCquiring HIV.
IdentifY and explore obstacles that the client has encountered in adopting safe behaviors.
Discuss with newly diagnosed individuals their specific short term plans and ensure that
they have access to support systems during this transitional time of adjusting to the
diagnosis.
Foster the self-efficacy of individuals to follow through with behavioral interventions
through self-esteem work, assertiveness training, and role plays.
.
.
.
.
.
.
.
.
.
.
.
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EXECUTl\'t. BOARD
QlAII\MAN
ELTtlN JOHN
PIESIIlOOIEXECIII1VE D\P.EClOP.
JOlIN scan
SECIEI'All
VIPoGI>IIA BANI<S
nEAS\IIEIl
llIOlB.E BUI\NS
......EOS
DAVID FURNISH
CONNIE PAl'PAS lIILLMAN
ROBERT JCEY
SARAH MCM1lLIDl
OANA MIW1l
HOWMDP.OSE
BJSWDY
....Otl SEGAR
ADVISOR.Y IOAIlD
.am.. 8WIS
/ JOlIN 8WIS
COUNBBL
EIlGARBR_JR.
ROBEITEAI\L
QWU.ES FARTHING. M.D.
JANE FONDA
HELENE D. GA YU. M.D~ MoP.It
WHOOP! GOLDBERG
GREG GORMAN
_=0
.......I.EVY
DOUGlAS P. MORRIS
JESM-
EIHAN_
......IWUND
IlWIIE TAUIIN
w_
-YOiJrlG
e
fLiON JOHN AIDe fOUNDATION
Dear Grant Applicant:
Please supply the following documents to the Elton John AIDS Foundation
in order to process your grant request:
CONCISE BACKGROUND SUMMARY
BUDGET FOR 1998, 1999 & 2000 t~",_N-
~
-L
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/
./
./
~c;o~.i..""
COPY OF NON-PROFIT STATUS
AMOUNT OF GRANT REQUEST
SPECIFIC PURPOSE OF GRANT
THREE REFERENCES WITH ADDRESS & PHONE NUMBER
PLEASE FORWARD THE REQUESTED DOCUMENT /5 TO THE
FOLLOWING:
ATTN: JOHN SCOTT
EXECUTIVE DIRECTOR & PRESIDENT
ELTON JOHN AIDS FOUNDATION
P.O. BOX 17139
BEVERLY HILLS, CA 90209-3139
~Ic-S"::.~" r1'1"5
POBOX 17139 BEVERLY HILLS, CALIFORNIA 90209-31330
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Concise Background Summary
The New Hanover County Health Department (NHCHD) is a local public health
department serving the citizens of New Hanover and surrounding counties. The mission of the
organization is to protect the public health and environment, promote healthy living, and optimize
the quality of life through preventive, restorative, environmental and educational services. The
NHCHD has eleven divisions that offer programs for the prevention of disease and the promotion
of health. The Communicable Disease Division (COD) provides medical and educational services
to screen, treat, and prevent the spread of communicable diseases. The CDD also participates in
the Southeastern North Carolina HlV Prevention Regional Community Planning .Group, which is
a group of collaborating organizations, agencies, and individuals who meet monthly to identifY
local needs and improve HlV prevention efforts.
The CDD ofNHCHD administers the Sexually Transmitted Diseases (STD) treatment
clinic and the Human Immunodeficiency Virus (HlV) Counseling, Testing, and Prevention
program. The SID clinic has been in existence for over fifty years, and the HlV Counseling and
Testing Clinic has been operating since 1986. Between July 1, 1999 and June 30, 2000, the
NHCHD received 2,651 SID clinic visits and performed 1,944 HlV tests. In the month ofJune,
2000, there were 227 SID clinic visits and 244 HlV tests performed.
CDD program staffprovide pre-exam assessments and post-exam counseling/treatment
sessions to all patients who visit the STD/lllV clinic. During this post-exam counseling session,
staff counsel SID-infected patients about the nature of their SID, explain measures to avoid
transmitting the disease to others or acquiring additional SIDs, and offer informational literature
to them. In addition, HlV program staff provide HlV-diagnosed patients with numerous resources
for follow- up care.
This one time session, however, is not sufficient to prevent many of these clients from
continuing their risky behaviors. According to Esther Adams, SID Nurse Coordinator at the
NHCHD, approximately 50% of individuals who visit the SID clinic are repeat clients; in other
words, they come to the clinic more than once for treatment of a new STD.
In addition, professionals highly recommend that newly diagnosed HlV-infected
individuals receive follow-up care after learning of their diagnosis. It is important for these
individuals to receive a medical examination, begin HlV treatment medication, and obtain referrals
to any necessary mental health or substance abuse services. In order to prevent the spread ofHlV
in a connnunity, it is crucial that newly diagnosed IDV-infected individuals receive follow-up care
with professionals who can provide them with information and skills to prevent the transmission
ofIDV to others. According to Vivian Mears, HlV Program Nurse, 18 individuals have been
diagnosed with HlV at NHCHD between 1998 and February, 2000. Ofthese 18 individuals,
eleven are currently linked to HlV health care providers; the seven reDlRining individuals have
either been lost to follow up or have chosen not to receive care.
It is because ofthese statistics that NHCHD has decided to take a more direct, active, and
client-centered approach to HlV/STD prevention. The enhanced counseling program offers an
innovative method of providing enhanced behavioral change skills to repeat STD clinic users and
newly diagnosed HlV -infected individuals in order to prevent the spread of their infections to
others.
31
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BUDGET FOR 1998, 1999, & 2000
The enhanced counseling program is a new program, so there is no budget for 1998, 1999, or
2000. A proposed budget for the program is enclosed.
32
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NEW HANOVER COUNTY
HEALTH DEPARTMENT
2029 SOUTH 171H STREET
WlLMINGTON, NC 28401-4946
TELEPHONE (910) 343-6500, FAX (910) 341-4146
DAVID E. RICE, M.P.H., M.A.
Health Director
COpy OF NON-PROFIT STATUS
E-,-_.E_.
LYNDA F. SMITH, M.P.A.
Assistant Health Director
New Hanover County Health Department is a political subdivision of the state of North Carolina,
and as such is a nonprofit entity, and is thus exempt from taxes.
~~
/K/l
Beth Jones
Communicable Disease Director
David Rice
Health Director
N ~ :f/e.,mI- t'4* ~.e'4l'<<~ '"
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Enhanced Counseling Program Budget
Project Budget:
From October 1,2000
To September 30. 2001
Expenses (by Category)
Salaries/Wages ...... _ _ . . . $37,193
Fringe Benefits. . . .. .. ..... 8,310
Total . . . . . . . . . . . . . . . . . . . . $45,503
Income (by Sources)
Elton John AIDS Foundation . $48,000
Operating Expenses
Printing.. ........ . .... _ $200
Dept. Supplies ............... 647
Employee Mileage ............ 800
TraininglTravel ............... 850
Total Operating Expenses ... $2,497
NHCHD In-Kind Support. . . .. $12,849
TOTAL................... $48,000
NHCHD In-Kind Support
Management Support
2 hrs/wk x 52 wks x $12/hr .. . . 1,248
Fringe (25%).. ............. 312
Administration
1 hrlwk x 52 wks x $25/hr . . . . . 1,300
Fringe (25%) . .. .. .. . . .. .. ... 325
Professional Staff Support ..... 3,900
3 hrs/wk x 52 wks x $25/hr plus
40 hours initial training
Fringe . . . .. ............... 975
Space
(36 sq ft x $7/sq ft x 12 mol . . . 3,024
Telephone. . . . . . . . . . . . . . . . . .. 200
Utilities .....................600
Copier Services .............. 300
Employee Mileage ..... _ _ . . . .. 165
Dept. Supplies ............... 500
Totalln-Kind ............. $12,849
Total Expenses
(including in-klnd) . . . . . . . .. $60,849
Total Budget
$60.849
34
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Amount of Grant Request:
The specific amount being requested is $48,000.
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Specific Purpose of Grant
New Hanover County Health Department would like to start a new program to provide enhanced
counseling services to newly diagnosed HIV-infected individuals and high risk STD clinic users. The
program will offer multiple counseling sessions to two types of clients seen at the health department:
individuals infected with mv or other Sexually Transmitted Diseases (STDs) and individuals at high risk
of acquiring STDs, as determined during the initial clinic interview. The purpose of the enhanced
counseling program is to assist these individuals in preventing the transmission of their disease to others,
avoiding the acquisition of additional STDs, and accessing the resources that will help them cope with
their diagnosis and other relevant issues, such as substance abuse or mental health services.
This program will address a gap in services for individuals in this community. Heightened efforts must be
made to serve people who are transmitting diseases to others. The focus is maintenance and restoration
of health and HIV/STD Prevention. The target population consists of people who are infected with
HIV /STDs or who are at high risk for infection, which are primarily young people, people of color,
women, and men who have sex with men.
Currently, New Hanover County Health Department (NHCHD) offers STD screening, treatment,
education, and HIV counseling and testing services. A client-centered counseling model is utilized, but a
single risk-reduction session is not sufficient to effect change in those at greatest risk for contracting HlV
or other STDs. Quite often, infected individuals are wrestling with issues that complicate their ability to
make behavioral changes, such as substance abuse, domestic violence, denial, and mental health
problems. Resources to overcome these difficulties have either not been available or not utilized by these
individuals. Services including case management, substance abuse treatment, mental health counseling,
and health care exist in our community to benefit HIV+ individuals,. and are offered tQ these individuals
during their one post-test counseling session at NHCHD. However, this post-test counseling session, in
which test results are given, is not the ideal time to address all the ramifications of the diagnosis and
develop a treatment plan. According to the case manager for the HIV Care Team at New Hanover
Health Network, approximately 30% of these newly diagnosed HIV+ clients do not follow up to seek
additional services. The CDC reports a one to five year delay between HIV -infected youth learning their
test results and seeking treatment. The enhanced counseling program will overcome this gap between
diagnosis and treatment by reaching individuals at the time of their diagnosis. When individuals receive
their HlV- or STD-diagnosis during their one post-test counseling session, they will be informed about
the transitional counseling program and introduced to the MSW-Ievel counselor who will facilitate the six
enhanced counseling sessions. During the post-test session, the counselor will set up an appointment
with the client for the first of six enhanced counseling sessions, and, if the client fails to show up for the
session, will contact the client by phone in order to encourage follow-up. This strategy will help to
ensure that the client will attend the enhanced counseling program during the time when helshe is still
processing the diagnosis. By offering individuals increased awareness of and accessibility to available
resources, along with enhanced client-centered counseling to confront the underlying issues, the program
can both empower individuals to take care of their health and protect others by preventing the
transmission ofHIV and other STDs.
A January, 2000 article in the American Journal of Public Health (Diamond C, Buskin S. Continued risky
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behavior in HlV -infected youth) asserts that HlV -infected individuals continue to exln"bit risky behaviors,
including unsafe sex and needle sharing, after learning their mv diagnosis. The study fo\Dld that 66% of
HIV-infected young women, 46% of infected adult women, 28% of infected young men, and 16% of
infected adult men exhibited evidence of risky behaviors after they learned their diagnosis. Several
studies document that SID incidence rates in mY-infected women do not significantly differ from those
among women who do not have HlV. These studies demonstrate the need to focus prevention efforts on
HIV+ people. Traditionally, prevention and treatment services have been separate when, in fact, these
two interventions must coincide to lower the rates ofHlV and STD infection. The project proposed by
NHCHD will unite these two formally disparate interventions. Instead offocusing mv prevention
efforts exclusively on undiagnosed individuals while shifting newly diagnosed HIV -infected individuals
into treatment programs, NHCHD proposes approaching prevention by working direct1y with HlV-
infected individuals, who are the ones spreading the virus.
The plan is to provide transitional support services to individuals newly diagnosed with HlV or other
SIDs in the period immediately following diagnosis. The program will accept referrals from private
providers as well in order to offer transitional support services to all newly diagnosed mv+ individuals in
the community. It is during this vulnerable period right after learning of their diagnosis that these
individuals feel devastated and are most in need of infonnation and support. The new program will also
offer client-centered counseling services to individuals at high risk ofacquiring HIV/STDs who visit the
STD clinic, including teenagers under the age of 17, individuals who visit the clinic three or more times
per year, teens brought fromlhe Juvenile Detention Center, and individuals engaging in high risk
behavior, as detennined in the initial interview.
The program will serve approximately 700 individuals during a one year period. In 1999, 50 cases of
HlV or AIDS were diagnosed in New Hanover County, either through NHCHD or through a private
provider; as ofJune, 2000, 23 cases ofHlV/AIDS have been diagnosed in the county in the year 2000.
Taking these figures into account, approximately 40-60 newly diagnosed HlV+ individuals will be
referred to the enhanced couQseling program during its first year, and approximately 650 individuals who
either have an STD other than HIV or are at high risk will be referred to the program.
The specific goals and objectives of the program, the ways in which they will be achieved, and the
method and criteria for evaluation of the project are descnbed in the following chart:
Goal #1: Empower newly diagnosed individuals and individuals at high risk for HIV/SIDs by teaching
them about HlV / STDs and how to effectively navigate the existing system of resources available to
them.
Objectives
I. 85% of participants score at least a 30% increase on a pre-post knowledge instrument that measures
knowledge about tran')fTIi,;sion, prevention, and similar issues.
2. 85% of participants score at least a 20% increase on a pre-post instrument that assesses knowledge of
available resources in community.
3. 50% of those clinic users who are referred to program attend at least 4 of the 6 counseling sessions.
Activities
1. Provide mv _ and STD-infected individuals and other hi risk clients with u to 6 visits with a
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trained MSW therapist.
2. Collaborate with the 3 HIY case managers in the county. Encourage HIV+ clients to select a case
manager and make an appointment with them as soon as possible.
3. IdentifY referrals for psychological support, including mental health or substance abuse services.
4. Make referrals to other needed services as indicated.
Outcomes
Initial
I. Clients are knowledgeable about their infection and ways to take care of their health.
2. Clients learn about resources available to meet medical, psychological, and psychosocial needs.
3. Clients learn how to prevent the spread ofHIY/SIDs to others.
Intermediate
I. Clients contact the resources available to them, as indicated.
2. Clients practice behavioral skills learned in one-on-one sessions.
Longterm
I. Clients access the needed resources to treat their medical or psychosocial issues.
2. mY-and SID-infected individuals utilize leamed behaviors to reduce transmission to others.
3. Clients take res onsibili for rotectin ese' Irestorin their own health.
Goal #2: Prevent HIV-infected individuals, STD-infected individuals, and other SID clinic clients from
transmitting or contracting SIDs.
Objectives
1. 75% of participants do not receive a diagnosis for a new SID for a one year period following the end
of their counseling sessions.
2. 85% ofHIY-infected participants remain in contact with their chosen case manager at least 6 months
after their first appointment.
3. 85% of participants score at least a 30% increase on a pre-post instrument that measures behavioral
change and intention to change behavior.
Activities
I. Provide 6 client-centered counseling sessions that assess readiness for behavioral change and teach
behavioral change techniques for adopting safer behaviors.
2. IdentifY and explore obstacles that client has encountered in adopting safe behaviors.
3. Foster self-efficacy of individuals to follow through with behavioral change through self-esteem work,
assertiveness training, and role plays.
4. Ensure HIV+ clients are compliant with control measures listed in N.C. Administrative Code.
5. Practice ways that HIV+ clients will notifY future sex/needle sharing partners ofHIV status.
Outcomes
Initial
I. Participants are knowledgeable about safer sex behaviors.
2. Participants possess skills that will lower their risk of acquiring SIDs or transmitting SIDs to others.
3 HIV+ clients learn how to notifY future partners ofHIV status.
Intermediate
1. Participants follow safe sex and/or needle sharing practices necessary to avoid getting or giving SIDs.
2. Partici ants ain assertiveness and self-esteem skills neces to' lement behavioral change.
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Longterm
I. Participants do not acquire additional STDs.
2. IllV - and STD-infected participants do not spread their disease to other individuals.
3 Partici ants achieve sitive behavioral chan e, as measured the behavioral instrument.
For the evaluation, the behavioral change instrument is a modified version of an evaluation tool
developed by The Measurement Group and the HRSA/HAB's SPNS Cooperative Agreement Steering
Committee. The knowledge and resource evaluation instruments were developed by NHCHD staff.
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1.
2.
References
Susan O'Brien
(HIV Coordinator for New Hanover Regional Medical Center)
New Hanover Regional Medical Center, Zinuner Center
PO Box 9000
WJlmington, NC 28402-9000
(910) 342-3122
Thomas Warren
(HIV Case Manager)
PO Box 1953
Wilmington, NC 28402-1953
(910) 763-5611
3.
Deborah E. Bowen, MSW, LCSW
(Therapist for mv+ clients, runs support group for HIV+ women)
4608 Cedar Avenue, Suite] II
Wilmington, NC 28403
910-799-7764
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LETTERS OF SUPPORT
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~~lP;:
~",,_~'f;ARE MANA GEMENT
el~~~
POBox 1'53
22 Bardll)l ll'rlb Road
W"dmingtorr, NC 28402-1'53
August 2, 2000
New Hanover County Health Department
South 1"" Street
Wilmington, No. Carolina 28401
Dear Vivian,
e
I am writing in support of the New Hanover County Health Departments' effort to enhance
counseling services to newly diagnosed HIV - infected individuals and high risk STD clinic users.
Such a transitional support service that incorporate risk reduction counseling and other issues
that might be complicating the newly diagnosed clients' ability to make behavioral changes is a
service that is long overdue and I support the health department's effort in this endeavor and will
be a referral source for clients once the program has been implemented.
Please feel free to call me if I can further assist you in this matter.
Y!/L,&
Thomas Wanen, Psy. D.
_: 91o.76J-8<U
e PIaN: 910 763-56/1
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July 6, 2000
Beth Jones
Communicable Disease Director
New Hanover County Health Department
2029 South] 7th Street
Wilmington, NC 2840]-4946
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Dear Ms. Jones:
The HIV Care Team at New Hanover Regional Medical Center (NHRMC)
enthusiastically supports the proposed enhanced counseling program outlined in
NHCHD's grant application. As the clinical provider of HI V care for a seven county
area, NHRMC has recognized the objectives stated in the proposal as essential for the
continuum of care for people with H]V and other STDs.
As stated in the proposal, prevention and care must be interwoven in order for either to be
successful. Although NHCHD and NHRMC have always worked closely to ensure newly
diagnosed patients are entered into clinical care, a tremendous gap exists in the
acceptance and knowledge phases of the disease process. Often patients will come for
one appointment and not return, as they have not dealt with the diagnosis emotionally.
]n order to reduce the transmission of these diseases and provide optimal quality of life for the
patients, there must be intensive and repetitive education provided. The program proposed by
NHCHD will be instrwnental in achieving this.
Sincerely,
~ (j'~
Susan O"Brien
HIV Coordinator
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New Hanover Regional Medical Center
PO. Box 9000 i 2131 S. 17th Streell Wilmington. NC 28402.9000
910-343-7000
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.~.... {.;,.
DRAFT
A REGULATION
OF THE
NEW HANOVER COUNTY
BOARD OF HEALTH
WHEREAS, the New Hanover County Board of Health is charged pursuant to North
Carolina General Statute I 30A- I I with promoting and contributing to the public health of the
citizens of New Hanover County; and
WHEREAS, the Board of Health believes that the operation of a motor vehicle on the
public roadways while using a telephone may cause the operator to maintain less than full
attention to the operation of said motor vehicle; and
WHEREAS, the Board of Health finds that the regulation of the use of mobile telephone
while operating a motor vehicle in the County wiJl enhance the safety of those persons operating
motor vehicles and other persons using the roadways;
NOW, THEREFORE, BE IT ORDAINED BY THE NEW HANOVER COUNTY
BOARD OF HEALTH that a regulation be adopted to read as follows:
Section 1.0 Definitions:
As used in this Ordinance:
(I) "Mobile Telephone" means, including but not limited to cellular, analog,
wireless and digital telephones.
(2) "Use" means to use a mobile telephone in:
(A) Dialing
(B) Answering
(C) Talking
(0) Listenin,g
(3) "Park" means for an automatic transmission vehicle that the vehicle is in
the Park gear; for a standard transmission vehicle that the vehicle is in the
neutral gear and the brake is being utilized or otherwise stationary.
Section 1. I Use; Restrictions:
(1)
No person shall operate a motor vehicle on any street or highway while
engaging in any conquct defined as the "Use" of a mobile telephone unless
the operator maintains both'hands on the applicable steering device.
Division (1) of this section does not apply to a person who is using the
mobile teiephone:
( a) To contact public safety forces, or
(b) While m~~ainin.ll t!1e,vehicle in ~ Park position either on public
!' ..
(2)
-
- ,
.,.~ ;'
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(c)
or private property, or
With a .. handsjree device" which aJlows the operator to maintain
both hands on the vehicle while using the mobile telephone.
Section 2.1 Penalties
(A) Whoever violates any of the provisions of this regulation shall be guilty of
a misdemeanor, subject to a fine of Fifty ($50.00) DoJlars.
(B) All fines imposed pursuant to this regulation shall inure to the benefit of
the New Hanover County Board of Education.
This regulation shall be effective
ADOPTED THIS
DAY OF
,2000.
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Facsimile Cover Sheet
INSTITUTE OF GOVERNMENT
CB # 3330, Knapp Building
UNC-Chapel Hill
Chapel Hill, NC 27599-3330
To:
David Rice
Agency:
New Hanover County Healtb Department
Fax:
910-.341-4146
From:
JiD Moore
Pbone:
919/!166-4442
Fax:
9191962-0654
Email:
moore@iogmail.ioll:,unc.edu
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Date: August 23. 2000
Pages including tills cover page: 3
Comments: 0rigiDaI being sent via us mail.
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08/23/2000 10:12
glggG2270G
INST CF OOV I
r"'~ u.,u~
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INSTITUTE afGOVERNMENT
August 23. 2000
David Rice, Health Director
New Hanover County Health Department
2029 South I'" Street
WilminstOD, North Carolina 28401
Dear Dr. Rice:
You asked me whether a local board of health has the authority to regulate the use of
mobile telephones by drivers operating motor vehicles on the public highways. I have
completed my research and 1 conclude that it is unelear under existing law whether a rule
on this issue would be within the local board of health's authority. This letter summarizes
the law that would govern the issue if the rule were adopted and subsequently challenged.
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Local boards of health "have the responsibility to protect and promote the public health
.. [and] the authority to adopt rules necessary for that purpose." O.S. 130A-39(a).
There is nothing in the statutes that further explains the meaning of terms such as "protect
and promote" or "necessary for that purpose," However, the North Carolina Court of
Appeals in a 1996 case provided a five-part test for determining when a local board of
health rule is within ita authority:
[A] board of health acts within its rule making powers when it enacts a regulation
which (I) is related to the promotion or protection ofbealtb, (2) is reasoDllble in
light of the heahh risk addressed, (3) is not violative of any law or constitutional
provision, (4) is not discriminatory, and (5) does not make distinctions bued upon
policy concema traditionally reserved for legislative bodies.
City of Roanoke RDpids v. Peedi(l, 124 N.C. App. 578, 587, 478 S.E.2d 528 (1996).
In the Peedin case, the Court of Appeals strode down a smoking control rule adopted by
the Halifax County Board ofHeahb. The Court concluded that the Halifax Board's rule
failed part (5) of the above test. Acwrding to the Court, the rule failed because it applied
different standards to dift'erent types of restaurants (e.g~ large versus small-upacity
restaurants) when it lacked a heahh-specific rationale for doing so. The Court stated that
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The University of North Carvli~. a1 Chapel ~III
C:U- 3330 Knapp Building . Ch;"l~ Hill. NC 2i599-3330
919 '66-5:\81 .. 919 ~2.o6:;4 (fox)
48
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Dr, Rice
August 23, 2000
Page Two
the distinctions had "no foundation in consideration of public health" but were instead
made out of <:oncems for economic hardship and difficulty of enforcement-matters that
a board of health la<:ks authority to consider in adopting a rule. The Coun concluded,
"the statutes cannot be held to permit the Board to consider factors other thaD health in
promulgating its rules."
e
As you consider the developmeM of your rule, I would advise you to consider c:arefuUy
each of the five factors enunciated in Peedin and, when appropriate, include findinp in
the rule that address the factors. For example, I would recommend that you specifically
make note of the studies you told me about thst demonstrate an increased risk ofinjury
assoc:iated with the use ofphoncs in vehicles. Unfortunately, the Peedin Court did not
offer guidance as to how the first four factors in the five-part test would be applied; thus,
I am not able to predict whether your proposed rule would satisfy those factors.
Another issue I considered is whether a board ofhealth would be precluded from making
a rule that affects the operation of motor vehicles, since that matter is usually regulated
by the Nonh Carolina General Assembly I consulted with two of my colleagues who
specialize in motor vehicle law, 1im Drennan and Ben Loeb. They told me that there is
nothing in North Carolina's motor vehicle law that expressly prohibits a local
government unit from acting in this area, but there Is also nothiDg In the law that
expressly authorizes it. Most loc:aI actions that affeel motor vehicle law have specific
facilitating language in the statute or a local ac:t of the General Assembly supportill8
them.
I hope this information is useful to you and your Board. Please c:all me if! may be of any
further assistance.
Sincerely,
'\U~
Jill D. Moore
Assistant Professor
e
'49
;
..
Health Director Evaluation Process
e
DRAFT
Performance Scale:
. Exceptional (Consistently exceeds performance expectations)
. Above Expected (Often exceeds performance expectations)
. Expected (Meets performance expectations)
. Needs Improvement (slightly below expectations)
. Unsatisfactory (Fails to meet minimum requirements)
Place an (X) in the area you have rated the Health Director
'~~~~~~~J,Cll ,j~rtl~: "",ti>,~~~M'>,f;~;.iia,,'nl~"t iY~.'fflIj:'"
Please consider the following factors in your evaluation.
e
A.
Relationship with Board
1. Keeps the board informed on issues, needs and operation ofthe
Health Department.
2. Offers professional advice to the board on items requiring board
action, with appropriate recommendations based on thorough study
and analysis.
3. Interprets and executes the intent of board policy.
4. Supports board policy and action to the public and staff.
5. Uses board members as resources
e
B. Community RelationshiDS
1. Develops friendly and cooperative relationships with news media.
2. Works effectively with public and private groups.
50
1
,
e c. Staff and Personnel Relationships
1. Develops and executes sound personnel procedures and practices.
2. Develops good staff morale and loyalty to the organization.
3. Treats all personnel fairly, without favoritism or discrimination, while
insisting on performance of duties.
4. Delegates authority and responsibility to staff members appropriate
to the position each holds.
5. Recruits and assigns the best available personnel.
6. Encourages participation of appropriate staff members and groups
in planning, procedures and policy interpretation.
7. Evaluates performance of staff member, giving commendation for
good work as well as constructive suggestions for improvement.
D. Public Health Leadership
1. Understands and keeps informed regarding all aspects of Health
e Department programs.
2. Maintains a sound philosophy of public health needs of all county
citizens.
3. Participates with staff, board, and community in studying and
developing publiC health improvements.
4. Organizes a planned program of public health evaluation and
improvement.
E. Business and Finance
1. Keeps informed on needs of the health department programs - plant,
facilities, equipment, supplies.
2. Supervises operations, insisting on competent and efficient
performance.
3. Determines that funds are spent wisely, with adequate control and
accounting.
4. Evaluates financial needs and makes recommendations for adequate
e financing.
2 51
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F.
Personal Qualities
1. Defends principles and convictions in the face of pressure and partisan
influence.
2. Maintains high standards of ethics, honesty, and integrity in all
personal and professional matters.
3. Earns respect and standing among prOfessional colleagues.
4. Exercises good judgment in arriving at decisions.
5. Devotes his time and energy to his job.
Comments: Are there any concerns that you wish to express or additional
information that will aid the evaluation process?
Health Director's Signature
Board Chairman's Signature
Date of Evaluation
Evaluation Period
NHcHD 8/00
3
5Z
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Health Director Evaluation Process
Performance Scale (enter appropriate number in space provided)
1. Exceptional (Consistently exceeds performance expectations)
2. Above Expected (Otten exceeds performance expectations)
3. Expected (Meets performance expectations)
4. Needs Improvement (slightly below expectations)
5. Unsatisfactory (Fails to meet minimum requirements)
Please leave blank any questions that, for lack of information, you cannot
complete.
A. Relationship with Board
1. Keeps the board informed on issues, needs and operation
of the Health Department.
2. Offers professional advice to the board on items requiring
board action, with appropriate recommendations based on
thorough study and analysis.
3. Interprets and executes the intent of board policy.
4.
Supports board policy and action to the public and staff.
5. Uses board members as resources.
B. Community Relationships
1. Develops friendly and cooperative relationships with news
media.
2. Works effectively with public and private groups.
C. Staff and Personnel Relationships
1. Develops and executes sound personnel procedures and
practices.
2. Develops good staff morale and loyalty to the organization.
3. Treats all personnel fairly, without favoritism or
discrimination, while insisting on performance of duties.
1
l/,",-H:;f. ,
FOtM
53
4. Delegates authority and responsibility to staff members
e appropriate to the position each holds.
5. Recruits and assigns the best available personnel.
6. Encourages participation of appropriate staff members and
groups in planning, procedures and policy interpretation.
7. Evaluates performance of staff member, giving
commendation for good work as well as constructive
suggestions for improvement.
D. Public Health Leadership
1. Understands and keeps informed regarding all aspects of
Health Department programs.
2. Maintains a sound philosophy of public health needs of all
county citizens.
3. Participates with staff, board, and community in studying
and developing publiC health improvements.
e 4. Organizes a planned program of public health evaluation
and improvement.
E. Business and Finance
1. Keeps informed on needs of the health department
programs - plant, facilities, equipment, supplies.
2. Supervises operations, insisting on competent and efficient
performance.
3. Determines that funds are spent wisely, with adequate
control and accounting.
4. Evaluates financial needs and makes recommendations
for adequate financing.
F. Personal Qualities
1. Defends principles and convictions in the face of pressure
e and partisan influence.
2 ,54
.
.
.
.
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-
2.
Maintains high standards of ethics, honesty, and integrity
in all personal and professional matters.
3. Earns respect and standing among professional
colleagues.
4. Exercises good judgment in arriving at decisions.
5. Devotes his time and energy to his job.
Comments: Are there any concerns that you wish to express or additional
information that will aid the evaluation process?
Health Director's Signature
Board Chainnan's Signature
Date of Evaluation
Evaluation Period
NHCHD 2100
3
55
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56
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APEX/PH
Indicator
Reference
Number(s)
IA1
IA2
IA5
183
IB5
IB9
IC1
Analysis of Organizational STRENGTHS
Year 2000 Survey
Definition of Strength
or Problem
Briefly state any strengths or
problems suggested by the
scoring of the indicators
Legal authority to ensure
enforcement of public health laws
Authority to develop and enact local
regulations
Exercises authority delegated by
state or federal government
Access to North Carolina
Commission for Health Services
Regularly consulted by local elected
officials
Formal and productive working
relationship with Dept. of Health &
Human Services (DHHS) and Dept.
of the Environment and Natural
Resources (DENR)
Health Dept. has available legal
counsel
Worksheet
Page 1 of 11
Revised 8/21/2000
Related Factors
Briefly describe the sources of
each strength or problem; list
resources and barriers to the
solution of each problem.
State statutes; Board of Health
regulations; city and county
ordinances; NC Administrative Code
Board of Health as defined by state
statute
Power of state statutes and
administration codes; federal laws
Representation and participation on
state-wide committees and advisory
boards; public health issues
addressed state-wide for
consistency; public hearings
Health Dept. considered as credible
resource, a leader in public health,
and perceived as apolitical
Consolidated contract for services
with evaluation; regional consultants;
state program staff
County attorney; district attorney;
Institute of Government; Attorney
General; state program personnel
Action
Priority
I = Top
II = Middle
III = Lowest
57
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Page 2 of 11
Analysis of Organizational STRENGTHS/Opportunities for Improvement
APEX/PH
Indicator
Reference
Number(s)
IC2
liAS
IIB2
IIB3
IIB5
II1A1
IIIA2
Worksheet
Definition of Strength
or Problem
Briefly state any strengths or
problems suggested by the
scoring of the indicators.
Maintains file of all relevant statues
and regulations
Medical advisers and consultants
assist in maintaining relationships with
the medical community
Local media looks to the Health Dept.
as a source of information about the
health of the community
Regularly provides news and
information
Staff participation on councils, boards,
and committees of public health or
other community-related organizations
Mission statement that staff is capable
of explaining in relation to their duties
Conducts or participates in community
health assessment to develop a
community health plan every two
years
Related Factors
Briefly describe the sources of
each strength or problem; list
resources and barriers to the
solution of each problem.
Public health laws of North Carolina;
Administrative Code of North Carolina;
NHC codes; federal laws; municipal
ordinances; Board of Health regulations
Respected physicians, competent
Health Dept. staff; sufficient number of
physicians; residency rotation;
community-spirited physicians
Comfort level of staff; accessible staff;
knowledgeable staff; credible staff;
regularly scheduled contacts
News releases; public service
announcements; health promotion
programs; county public information
officer; legal notices; interviews; web
site; willingness of media and staff
Support by management; financial
support; dedicated staff
Written mission statement; staff
orientation; practiced statement
Community collaboration; state
leadership; committed Board of Health
and Health Dept. staff
Action
Priority
I = Top
II ~ Middle
III = Lowest
58
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Page 3 of 11
Analysis of Organizational STRENGTHS/Opportunities for Improvement
APEX/PH
Indicator
Reference
Number(s)
II1B2
IIIB3
II1B4
IIIB5
IIID2
IVA1
IVA5
Definition of Strength
or Problem
Briefly state any strengths or
problems suggested by the
scoring of the indicators.
Available to receive communicable
disease reports on a daily basis
Health Department has qualified
professionals to review and analyze
reported morbidity and mortality data
Pertinent morbidity and mortality data
are reviewed and analyzed for
appropriate action on a regular
schedule
Responsible for collecting, processing
and reporting birth and death
certificates
Use health data in our community
health planning process
Health department director assures
and facilitates the completion of a
community health assessment
process
Board of Health adopts community
health assessment plan
Worksheet
Related Factors
Briefly describe the sources of
each strength or problem; list
resources and barriers to the
solution of each problem.
State laws and administrative codes;
24-hour reportable phone line; EPI
Information newsletter; E-mail access;
special educational sessions, EPI team
Staff with appropriate education and/or
training; access to consultants and
resources; access to data
NC State Center for Health Statistics;
vital records system; access to
consultants and resources; staff with
appropriate education and/or training;
access to data
State laws and administrative codes;
available and competent staff; vital
records system
Available health data; competent staff;
ongoing process
Portions of community health
assessment required; state guidelines
and NC Communitv Assessment Guide
Book and training; regional health and
human services partners; competent
and willing staff
Executive Committee and full Board of
Health involved in process
Action
Priority
I = Top
II = Middle
III = Lowest
59
Page 4 of 11
e Analysis of Organizational STRENGTHS/Opportunities for Improvement
Worksheet
APEX/PH
Indicator
Reference
Number{s}
IVA6
IVA7
IVB4
IVB5
VA3
VA4
VA5
Definition of Strength
or Problem
Briefly state any strengths or
problems suggested by the
scoring of the indicators
The Board of Health utilizes the
community health assessment plan for
the allocation and procurement of
resources
The Board of Health reviews the
community health assessment plan
and monitors progress in
implementation
Health department facilitates the
formulation of public health policy in
the community
Board of Health and Health Director
monitor and evaluate the impact of
public policy on specific health
problems
Health Department assures or
provides direct services for priority
health needs identified in community
health assessment
Health Department assures and
implements legislative mandates and
statutory responsibilities
Health Department maintains a level
of service without interruption to
protect the public's health
Related Factors
Briefly describe the sources of
each strength or problem; list
resources and barriers to the
solution of each problem.
Health Director, Executive Committee;
Board of Health; County
Commissioners; competent staff; the
community health assessment plan
Board of Health; Health Director;
Division Directors; community health
assessment plan
Competent staff; strong state
partnership; concerned citizens; Board
of Health
Input from community and staff to
Board of Health; Board of Health
meetings open to public; committees of
Board of Health; active and committed
Board of Health and Health Director;
Health Department management team
Collaborative effort to assess status of
community health and identify
resources; community partnerships
Initiative to educate and enforce; legal
counsel; informed decisions made;
state associations; public health laws of
NC; Administrative code of NC; NHC
codes; federal laws; municipal
ordinances; Board of Health regulations
Ongoing programs and services;
regularly scheduled services;
emergency response capability; state
and local financial support; user fees;
health department visible in community
Action
Priority
I = Top
II ~ Middle
II I = Lowest
60
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Page 5 of IJ
Analysis of Organizational STRENGTHS/Opportunities for Improvement
APEX/PH
Indicator
Reference
Number{s)
VB4
VIA1
2
VIA3
VIA5
VIA6
e
Worksheet
Definition of Strength
or Problem
Briefly state any strengths or
problems suggested by the
scoring of the indicators
Health Dept. provides the public health
services necessary to assure a
healthy environment for the
community
Department budget is adopted
annually by the Board of Health and
Board of County Commissioners
Budget reflects established priorities
Proposed budget justifications reflect
Health Department programs and
health problems within its jurisdiction
Health Department management staff
develops the proposed budget
Health Department receives local
appropriations from the county
Related Factors
Briefly describe the sources of
each strength or problem; list
resources and barriers to the
solution of each problem.
Competent staff; ongoing programs
and services; regularly scheduled
services
Active and committed Board of Health;
state and local requirement; Board of
Health members review division
budgets
Federal and state mandates; program
guidelines; community health
assessment; Board of Health and staff
commitment
Department heads aware of community
needs; staff involvement; statistical
analysis; internal auditors; Board of
Health committees
Division directors with staff input;
county budgetary guidelines; DHHS
consolidated contract and contract
addenda
Strong financial county support; Board
of Health and County Commissioners'
support
Action
Priority
I = Top
II ~ Middle
II I = Lowest
61
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Page 6 of 11
Analysis of Organizational STRENGTHS/Opportunities for Improvement
APEX/PH
Indicator
Reference
Number(s)
VIA?
VIC3
VIC4
VIC5
VIC6
VIE2
Worksheet
Definition of Strength
or Problem
Briefly state any strengths or
problems suggested by the
scoring of the indicators
Health Department has authority to
recommend and charge fees for some
services it provides
Financial reports are understood by
Board of Health and administrative
and supervisory staff
Financial position of the Health
Department is routinely reviewed by
the Board of Health, administrative,
and supervisory staff
The Health Director oversees all
finances of the Health Department
Board of Health and staff understand
their legal accountability as well as
their responsibility for appropriate use
of public funds
Appropriate financial records are kept
using acceptable accounting
procedures
Related Factors
Briefly describe the sources of
each strength or problem; list
resources and barriers to the
solution of each problem.
State statutes prohibit charging for
some services; Health Dept. fee policy;
county ordinances; third party
reimbursement; community acceptance
of user fee concept
Local government financial system
(LGFS) and budget training;
knowledgeable supervisors,
administrative staff and Board of
Health; standardized system of
financial record keeping
Monthly financial reports from staff,
state, and county; LGFS accessibility
NHC financial staff; county attorney;
Health Dept. business officer; division
directors, supervisors, and
administrative staff; Board of Health
oversight
Responsible staff and Board of Health;
purchasing policy and procedures;
fiscally conservative staff and Board of
Health
Internal auditors; competent financial
director and finance departmental staff;
county poliCies and procedures
requiring adequate documentation;
financial records retention policy
Action
Priority
I ~ Top
II = Middle
III = Lowest
62
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Page 7 of 11
Analysis of Organizational STRENGTHS/Opportunities for Improvement
APEX/PH
Indicator
Reference
Number(s)
VIIA1
VIIA2
VIIA3
VilA?
VIIA8
VIIB1
VIIB2
Worksheet
Definition of Strength
or Problem
Briefly state any strengths or
problems suggested by the
scoring of the indicators
Written job description, including
minimum qualifications, exists for each
position in the Health Department
Written personnel policies and
procedures are developed or revised
with staff input
Personnel recruitment, selection, and
appointment procedures are
documented
There are documented procedures for
employee grievances, reprimands,
suspensions, and dismissals
There is a documented, structured pay
and classification plan designed to
attract and retain competent staff
Health Director is responsible for
internal administration of the
department
Board of Health employs the Health
Director and conducts a periodic,
written appraisal of the director's
performance
Related Factors
Briefly describe the sources of
each strength or problem; list
resources and barriers to the
solution of each problem.
State personnel and county human
resources personnel policies and
procedures; standardized
classifications; periodic review and
revision of job descriptions; written
minimum requirements
State and county personnel policies
and procedures; Health Dept. policies
and procedures; staff appointed to
committees; staff input to committees
County human resources and Health
Department personnel policies and
procedures
Grievance procedure adopted by Board
of Health; disciplinary action according
to state personnel guidelines
Written pay and classification plan;
administered by county Human
Resources Department
Health Director's job description;
organizational chart; North Carolina
statute 130A, state personnel and
county guidelines
Written appraisal; Board of Health
policy and procedures; county
guidelines
Action
Priority
I = Top
II = Middle
II I = Lowest
63
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Page 8 of 11
Analysis of Organizational STRENGTHS/Opportunities for Improvement
APEX/PH
Indicator
Reference
Number(s)
VIIB3
VIIB4
B6
VIIB7
VIIB9
VIIB10
VIIC2
Worksheet
Definition of Strength
or Problem
Briefly state any strengths or
problems suggested by the
scoring of the indicators
Written performance appraisals are
conducted by supervisors with
employees at least once per fiscal
year
Performance appraisal system is
monitored by the Health Director
Health Department announcements
and program information are available
to all employees
There are regularly scheduled
meetings by work group, division, and
department
Health Director appoints qualified staff
Health Department provides
appropriate confidentiality for all
personnel records
Health Department has a written
policy regarding staff recruitment,
selection, development, and retention
Related Factors
Briefly describe the sources of
each strength or problem; list
resources and barriers to the
solution of each problem
County Human Resources personnel
policies and procedures; standardized
performance appraisal tool
County guidelines require Health
Director's signature; summary review of
individual appraisals
Broadcast system; phone mail; Lotus
Notes; division bulletin boards;
meetings (team, staff, and
management)
Regularly scheduled meetings; monthly
staff meetings; weekly management
team meetings; periodic work groups
and divisional meetings
Job classification; division directors'
recommendations; qualified applicants;
county guidelines
Competent staff; limited access to
records; secured records
County policies and procedures; Board
of Health policy; equal opportunity
employer
Action
Priority
I Top
II Middle
III Lowest
64
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Page 9 of 11
Analysis of Organizational STRENGTHS/Opportunities for Improvement
APEX/PH
Indicator
Reference
Number(s)
VIIC3
VIIC4
C5
VIIC10
VIIC11
VIID3
VIIE1
e
Worksheet
Definition of Strength
or Problem
Briefly state any strengths or
problems suggested by the
scoring of the indicators
Employees have structured
opportunities to discuss work related
issues with their respective
supervisors
Health Department staff has access to
training provided by the state
Health Department has access to the
staff development resources from
schools of public health, other
educational institutions and agencies
Personnel policies and procedures are
reviewed with each new Board and
staff member
Health Department encourages and
supports staff participation in
professional organizations
Exit interviews are conducted by
Human Resources with every
employee
Written Health Department policy and
procedures manuals are available
Related Factors
Briefly describe the sources of
each strength or problem; list
resources and barriers to the
solution of each problem.
Competent staff; required work plans
Availability of state training; input into
state training; Coastal AHEC; state
program consultants; regional office
UNC School of Public Health;
consolidated university system;
community college system; Centers for
Disease Control; USDA, FDA, EPA,
and other federal agencies; county
training program
Policy and procedures manuals;
orientation of Board and staff;
personnel clerk
Travel budget; travel time
County policy and procedures; county
Human Resources Department
Policy and procedure manuals; policy
review
Action
Priority
I ~ Top
II ~ Middle
III = Lowest
65
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Page 10 of 11
Analysis of Organizational STRENGTHS/Opportunities for Improvement
APEX/PH
Indicator
Reference
Number(s)
VIIE2
VIIE3
E4
VIIE5
VIIE6
VIIIA1
VIIIA3
VIIIA4
e
Worksheet
Definition of Strength
or Problem
Briefly state any strengths or
problems suggested by the
scoring of the indicators.
All personnel transactions are
documented
Up to date coordinated, structured,
and confidential file is maintained for
every employee
All job descriptions are written and
available
All procedures for recruitment,
selection, appointment, and applicant
grievance are written and available
The salary administration plan is
written and available
Operating programs authorized by
Board of Health
There is a current organizational chart
which shows all divisions and
positions of the Health Department
Staff meetings are held at reasonable
frequencies
Related Factors
Briefly describe the sources of
each strength or problem; list
resources and barriers to the
solution of each problem.
New Hanover County personnel
system; federal and state statutes;
substantial equivalency to state
personnel system; employees receive
copies of transactions
Personnel folder accessible to the
employee; New Hanover County
personnel system
State personnel; NHC personnel
system; access to available personnel
information
State and county personnel system;
access and availability of the system
NHC personnel system; pay and
ciassification plan
Federal and state statutes; county
ordinances; Board of Health approval
Available updated organizational chart;
part of orientation process
General staff meetings monthly;
divisional meetings; inter/intradivisional
team meetings; management team
meetings weekly
Action
Priority
I ~ Top
II = Middle
III = Lowest
66
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Page 11 of 11
Analysis of Organizational STRENGTHS/Opportunities for Improvement
APEX/PH
Indicator
Reference
Number(s)
VIIIA5
IX1
IX3
IX5
IX6
IXB
e
Worksheet
Definition of Strength
or Problem
Briefly state any strengths or
problems suggested by the
scoring of the indicators
Health Department maintains staff (on
site or on call) to respond to local
public health emergencies
Board of Health members attend
Board and committee meetings
Board of Health meetings monthly
Board of Health meetings deal
primarily with policies, authorizations,
and evaluating the effectiveness of the
Health Department
There are written Board and
administration policies consistent with
the mission statement
Minutes of Board and committee
meetings are written and circulated to
Board members and are available to
Health Department staff
Related Factors
Briefly describe the sources of
each strength or problem; list
resources and barriers to the
solution of each problem.
Updated New Hanover County Health
Department emergency policies and
procedures; emergency phone card
available
Outstanding attendance; committees
include: Executive Committee,
Environmental Health Committee,
Personal Health Committee, and
Budget Committee; chairman appoints
committee members; every Board
member serves on a committee; staff
support and participation
Meets first Wednesday of every month;
bylaws
Staff reports and requests: committee
assignments; composition and
expertise of Board
Adopted mission statement; Board
minutes; bylaws; rules and regulations
Meetings open to general public;
written minutes
Action
Priority
I = Top
II = Middle
III ~ Lowest
67
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FORMAT: PUBLIC HEARING
NEW HANOVER COUNTY BOARD OF HEALTH
Carl T. Durham Auditorium
New Hanover County Health Department
AGENDA
Date:
Time:
Place:
September 6, 2000
8:00 A.M.
New Hanover County Health Department
2029 South 17th Street, Wilmington, North Carolina
Mr. William T Steuer, Chairman
Presiding:
Call the Meetin!! to Order: I call a special session of the New Hanover County Board of Health
Meeting to order.
Invocation:
Mr. Steuer
Public Hearin!!:
I call the Public Hearing to order. The purpose of the Public Hearing is to receive Public
Comments on the New Hanover County Board of Health Rules Governing the Fencing and
Operation of Private Swimming Pools in New Hanover County, North Carolina. The rules will be
considered for adoption at October 4, 2000 Board of Health meeting.
I extend a welcome to attendees.
I would like to ask the Board of Health members to introduce themselves and designate their
category of representation on the New Hanover County Board of Health.
Prior to the meeting, Speakers were asked to sign up for three-minute presentations.
The Board of Health will not respond t%r entertain questions morning. W~remarks
regarding these regulations will be accepted by the Board of Health on/or before ~r 16, 2000,
and should be submitted to_ ~vid E. Rice, Health Director, at the New Hanover County Health
Department on or before ~r 16, 2000.
Speakers may now address the Board of Health in the order that they signed in on the sign-up sheet.
If you wish to speak and have not signed up to speak, please do so at this time.
I call for any public comments concerning the draft of the Rules Governing the Fencing and
Operation of Private Swimming Pools in New Hanover County.
(After the speakers speak who have signed up speak. )Are they any additional comments from
the floor?
If there are no additional comments, thank the speakers and attendees for their interest in the New
Hanover County Board of Health Rules Governing the Fencing and Operation of Private Swimming
Pools in New Hanover County, North Carolina.
I close the Public Hearing ofthe Board of Health. . . . . . . . .
At this time, I would like to return to the regular business meeting of the New Hanover County
Board of Health.
THEN: Are there any additions or corrections to the..... Minutes of August 2,2000
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NEW HANOVER COUNTY BOARD OF HEALTH PUBLIC HEARING RULES
GOVERNING THE FENCING AND OPERATION OF PRIVATE SWIMMING POOLS
IN NEW HANOVER COUNTY, NORTH CAROLINA
Public Hearing - September 6, 2000
NAME
ESTABLISHMENT
ADDRESS
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NEW HANOVER COUNTY BOARD OF HEALTH PUBLIC HEARING RULES
GOVERNING THE FENCING AND OPERATION OF PRIVATE SWIMMING POOLS
IN NEW HANOVER COUNTY, NORTH CAROLINA
Public Hearing - September 6, 2000
NAME
ADDRESS
ESTABLISIIMENT
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."_~ North Carolina
U ""'....,,'".."..""~......
. Division of Public Health. State LaboratOl)' of Public Health
~, 306 North WBmington Street. Post Office Box Raleigh, N. C. 27611-8047
.... Tel: 919.733.7544 Fax: 919.715.7700
...._~ H. David Bruton, M.D., Secretary. Steve Cline, DDS, MPH, Acting Director
~
MEMORANDUM
Date. August 29,2000
To:
North Carolina Arboviral Surveillance Network
From.
J. Todd McPherson, Head, Virology/Serology Branch
Arboviral Surveillance Numerator Data: North Carolina - 2000
(CDC Week #34. August 19-25)
Subject;
The NC State Laboratory of Public Health in Raleigh is an active participant in a multidisciplinary
statewide arboviral surveillance program. Numerous specimens for arboviral testing have been
received at this laboratory and are currendy still on test with results pending. To date, the following
specimens have testing completed and been determined to be either presumptive eI!idence of recent
infection or are laboratory confirmed cases of arboviral infection; (New data for week #34 is recorded in
bold print.)
Human Arboviral Surveillance bv County. (Totals: 3 LAC and 1 EEEJ
. Transylvania. one child (KB) died of LAC (IFA IgG & IgM & RTPCR) in week 26
. Camden: one woman (pA) seropositive to EEE (IFA 19G & 19M) in week 29
. Buncombe. one child (FG) seroconverted to LAC (IFA 19G & IgM) in week 32
one child (SC) seropositive to lAC (IFA IgG & IgM) in week 34
Veterinat'V (non-avian) Surveillance bv County: (Totals: 5 EEEJ
. Richmond. one mule (#V2766) culture positive for EEE in week 29
. New Hanoven one horse (#V2700) culture positive for EEE in week 30
. Washington. one horse (#V2837) culture positive for EEE in week 31
. Craven: one horse (#V2938) culture positive for EEE in week 32
. Johnston: one horse (#V3031) culture positive for EEE in week 33
Veterinarv Avian Surveillance bv County. (Totals, 8 EEEJ
. Craven: one emu culture positive for EEE in week 29
. Gates: three zebra finches culture positive for EEE in week 29
. Johnston. four emus culture positive for EEE in week 32
Mosauito Surveillance bv County. (Totals: 3 EEEJ
. Camden: two pools (#11 & #22) of Cs. melanura culture positive for EEE in week 30
. Perquimans. one pool (#004) of Cs. meIanura culture positive for EEE in week 30
North Carolina: Host of the 1999 Special Olympic World Summer Games
Page #2.
Subject:
Arboviral Surveillance Numerator Data. North Carolina - 2000 [continued]
(CDC Week #34: August 19-25)
Sentinel Chicken Surveillance bv County. (Totals: 23 EEEJ
. Beaufort:
. Bladen:
. Carteret.
. Craven.
f::
. New Hanover.
. Onslow.
. Perquimans.
one chicken seroconverted via IFA to EEE in week 31
one chicken seroconverted via IFA to EEE in week 26
one chicken seroconverted via IFA to EEE in week 28
three chickens seroconverted via IFA to EEE in week 30
one chicken seroconverted via IFA to EEE in week 30
two chickens (455, 825) seroconverted via IFA to EEE/WEE in week 34
one chicken seroconverred via IFA to EEE in week 28
three chickens seroconverted via IFA to EEE in week 30
four chickens seroconverted via IFA to EEE in week 33
two chickens seroconverted via IFA to EEE in week 31
one chicken seroconverted via IFA to EEE in week 33
one chicken seroconverted via IFA to EEE in week 30
one chicken seroconverted via IFA to EEE in week 31
one chicken (#457) seroconverted via IFA to EEE in week 33
Norlh Carolina: Host of the 1999 Special Olympic World Summer Games
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Volunteer
Handbook
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Your Health - Our Priority
New Hanover County Health Department
2029 South 17th Street
Wilmington, NC 28401
(910) 343-6500
Table of Contents
c
Welcome ...................................................................3
Synopsis ....................................................................4
Motto/Mission Statement ...........................................6
Vision/Goal................................................................ 6
Service Hours............................................................ 7
Holiday Observances ................................................7
Division Services....................................................... 8
Examples of Work Assignments............................... 11
Guidelines ...............................................................12
Schedule .................................................................13
Dress Code.............................................................. t3
Code of Ethics .........................................................13
Confidentiality Policy...............................................14
Liability Policy .........................................................14
At Your Service........................................................15
Ten Commandments for Volunteers......................... 16 ("-
What Are Volunteers? ..............................................17 ~
Board of Health .......................................................18
Board of County Commissioners .............................18
Health Department Staff ..........................................19
Notes....................................................................... 22
2
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Welcome
Dear Volunteer,
It is great to greet and welcome you to New
Hanover County Health Department where we hope
you will feel at home.
It is our desire that you will find a most
wholesome atmosphere. We treasure your presence
and promise to do all in our power to make your
volunteer hours worthwhile and productive.
C Thank you for your willingness to serve others
as you give your time freely. We have the utmost
confidence you will be a success to the volunteer
program and will do a tremendous job.
Sincerely,
~
Julia Bibbs
Volunteer Coordinator
3
Synopsis of
New Hanover County
Health Department
"'--",
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The New Hanover County Health Department (NHCHD)
is a public health facility that provides services to
citizens of New Hanover County. Funding comes from
state and local government for most programs and
services. Some revenues are generated through fees
and grants.
The New Hanover County Board of Health, the oldest
Board of Health in the state of North Carolina, was
formed June 14, 1879 with Co!. William L. Smith as its
first chairman. The Board of Health organized into four
committees: Drainage and Water Supply, Epidemics,
Sanitary Condition of Public Buildings, and Public
Nuisances. The Board's first action was taking
precautions against yellow fever. Today, the Health
Department has as its mission the protection of the
public health and environment, promotion of healthy
living, and optimization of the quality of life through
preventive, restorative, environmental, and
educational services.
C
Public health is credited with adding 25 years to the life
expectancy of people during the 20th Century, yet
many citizens remain unclear about what "public
health" means. The New Hanover County Health
Department wants to remind citizens how far we've
come, how we got here, and exactly what public health
is: the active protection of our county's health and
safety, credible information to enhance health
decisions, and partnerships with other organizations to
promote good health.
4
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Ten public health achievements ofthe 20th Century
include:
. Vaccination,
. Motor-vehicle safety,
. Safer work places,
. Control of infectious diseases,
. Decline in deaths from coronary heart disease and
stroke,
. Safer and healthier foods,
. Healthier mothers and babies,
. Family planning,
. Fluoridation of drinking water, and
. Recognition of tobacco use as a health hazard.
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New Hanover County
Health Department
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: MOTTO
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: Your Health - Our Priority
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: MISSON STATEMENT
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: The mission ofthe New Hanover County Health :
. Department is to protect the public health and .
: environment, promote healthy living, and optimize the :
. quality of life through preventive, restorative, .
: environmental, and educational services. :
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: VISION
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: Better health, brighter futures for individuals and our :
: community. C)
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. GOAL
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. To provide medical, educational, and environmental .
: health services to all persons regardless of race, age, :
. religion, gender, marital status, national origin, or .
: handicap. :
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...... .... ....a........ ........... ...
New Hanover County
Health Department
Qervice Hours (2)
Most offices are open from 8 a.m. to 5 p.m., Monday
through Friday.
Child Health hours are from 7 a.m. to 6 p.m., Monday
through Friday.
Environmental Health: 7 a.m.-5 p.m.
General Clinic:
Mon., Tues., Wed., Fri.
Thursday
8:15 a.m. - 4:30 p.m.
8:15 a.m. - 6:45 p.m.
WIC/Nutrition program hours:
Monday-Wednesday
Thursday
Friday
8 a.m. - 5:30 p.m.
9:15 a.m. - 5:30 p.m.
8 a.m. - 4:30 p.m.
Women's Preventive Health Clinic: In addition to regular
I C~i1Y clinics, hours are extended to 7 p.m. on the first and
, Jurth Thursdays of each month.
Holiday Observances
New Year's Day - January
Martin Luther King, Jr. Birthday - January
Good Friday - April
Memorial Day - May
Independence Day - July
Labor Day - September
Veteran's Day - November
Thanksgiving - November
Christmas - December
7
New Hanover County
Health Department
Division Services
Administration
Health Director - David E. Rice
Assistant Health Director - Lynda F. Smith
. Board of Health
. Personnel
. Financial Management
. Vital Records
. Disaster Services
Animal Control Services
Director. Jean McNeil
. Rabies Control
. Animal Licensing
. Animal Shelter Services
. Bite Investigation
Child Health
Director - Janet McCumbee
. Child Services Coordination
. Health Check
. Childhood Lead Program
. Preventive Health Services for Child Care
Facilities
· Parenting Classes
. SIDS Counseling
. Newborn Screening Follow-Up
. Health Education
Communicable Disease
Director - Beth Jones
· Immunizations (children and adults)
. Tuberculosis Control
. Sexually Transmitted Diseases
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8
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. HIV/AIDS Counseling, Testing, and Prevention
. Surveillance of Other Reportable Diseases
. Outbreak Control
. Health Education
. EPI Newsletter
Community Health
Director - Betty Creech
. Newborn Visits
. Well Baby Clinic
. Orthopedic Clinic
. Neurology Clinic
. Kindergarten Physical Clinic
. In-Home Nursing Services
. School Health
. Adult Health Clinic
. Hypertension Screening
. Adult Day Care Monitoring
. Jail Health
Dental Health
Director - Dr. David McDaniel
. Community Water Fluoridation
. School Prevention Dental Program (mouthrinse,
sealants, screenings, referrals, and education)
. Adults (oral health assessments, referrals, and
education)
Environmental Health
Director. Dianne Harvell
. Food Protection, Institution and Lodging
Sanitation Regulations
. Air Quality Monitoring and Sampling
. Lead Hazard Investigations
. Public Swimming Pool Safety
. Water Quality and Waste Regulations
. Pest Management 9
Laboratory
Director - Susan O'Brien
. Technical and Testing Support Services
· State Approved Laboratory for Water C' \
Bacteriology Examinations Testing .
. Resource for Private and Community Health
Programs
. Licensed by the Federal Government to Provide
Medical Laboratory Testing
,
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Examples of Volunteer
Work Assignments
Nutrition
Director - Nancy Nail
. Women, Infants, and Children (WIC) -
Supplemental Nutrition Program
. General Nutrition - Nutritional Dietary
Assessment and Counseling; Nutrition
Education
· Register children for sixth grade Hepatitis B shots
. Greet patients entering General Clinic, guiding
them to registration for flu shots
· Filing and typing
Women's Health Care
Director - Betty Jo McCorkle
Family Planning
. Daily Clinics (teen and adult)
. Evening Clinics Available
. Complete Physical Exams
. Birth Control Supplies
· Pregnancy Testing ()
. Health Education
. Breast and Cervical Cancer Control Program
. Vasectomy Program
. Home Visiting
Maternal Health
. Daily Maternity Clinics (teen and adult)
. Complete Physical Exams
. Maternity Care Coordination
. High-Risk Home Visiting - Prenatal
. Postpartum Home Visiting - Mother and Infant
Pair
. Baby Talk - Prenatal Group Education 10
. Telephone answering; receptionist duties
. Assistance with child care during Parenting
Classes
· Nurses-giving immunizations; following up on
tuberculosis medications
. Copying and sorting paperwork
. Physician services for jail inmates
· Educating the public about health-related
information at Health Fairs
11
~ ~
'"
Guidelines
MERITS/BENEFITS
. Service that is needed and appreciated
. Opportunity to work with the public, staff members,
and other volunteers, providing assistance and
touching the lives of others
. Opportunity to learn new ideas, etc.
. Promote health and well-being of volunteers
c~
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RECOGNITION
. Year runs from July 1 to June 30
. Volunteer recognition program held
annually to acknowledge the efforts of
volunteers
. Name tag with "Volunteer" designation to
wear with pride
~
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CHECKING IN AND OUT r
. By recording volunteer hours, accurate documentatior~)
of volunteer hours can be provided on Health
Department applications for grants, etc.
. Log book is located in the copier room of the Health
Department
VOLUNTEER NAME TAGS
. Wear name tag while working in the Health Department
. Pick up name tag in the copier room when signing the
log book
. Return your name tag to the copier room before
leaving 12
Schedule
1
1
Cancellations:
Of unable to volunteer on the day and time scheduled,
please notify the Volunteer Coordinator at 793-7527 so a
replacement can be assigned.
Tardiness:
If you will be late for your scheduled shift, please contact
the person to whom you are to report for duty as soon as
possible. The Health Department's main phone number is
343-6500.
Dress Code
New Hanover County Health Department has an
employee dress code. Volunteers are asked to dress
appropriately while on assignments for the Health
Department.
o
Code of Ethics
!
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A public health worker is endowed with the public trust
and has a special responsibility to promote, protect, and
preserve the public health.
A public health worker must be competent, prompt, and
diligent in the performance of all duties, responsibilities,
and obligations.
A public health worker must seek to improve, protect,
and promote the public health, to assure fair and
reasonable distribution of services, and to advance
continuous quality improvement of services. 13
Many responsibilities are set out in personnel policies,
procedures, directives, rules, and law. However,
ethical standards also guide the public health worker. O' .
The public health worker must strive to attain the -
highest level of knowledge, skills, and abilities to
exemplify the ideals of public service.
Confidentiality Policy
The Health Department staff and volunteers are
required to follow guidelines regarding confidentiality
of services provided to patients. All services provided,
regardless of the nature of the service are to be kept
strictly confidential.
Liability Policy
Health Department liability insurance will cover
volunteers during scheduled work hours.
C\
)
14
At Your Service
Parking
OVolunteers are welcome to park in any available space
used for visitors or staff. Please notify the volunteer
coordinator if parking presents a frequent problem
since spaces are limited.
.,
Rest Rooms
II
~Microwave/
0Refrigerator
II
Telephones (for local calls)
II
Vending Machines/
Break Room
.
Friendly Staff: Your presence is
valuable to staff. You are a tremendous
asset to the agency and the community.
Staff will be delighted to answer any
questions you may have-just ask any
member of our staff!
15
Ten Commandments for Volunteers
1. Understand the job you undertake to do.
2. Accept training appreciatively, and contribute
your knowledge and experience.
3. Match your interests to the needs about you and
therefore to the job.
4. Serve with faithfulness and continuity, listen for
and report new insights about your work.
5. Discover its meaning to the total program of which
it is a part.
6. Open yourself to opportunities for growth - in
skills, sympathy, self-confidence, and responsibility.
7. Value your special two-way roles as a community
interpreter.
8. Contribute to supervision by self-evaluation and a
willingness to ask.
9. Give loyalty to your institution, its staff, and its
program.
10. Take pride in the volunteer's career. It pays
handsomely in treasures of the spirit.
Adapted from writings of Dr. Daniel Thursz and Mrs.
Leonard Weiner
0:)
o
:)
WHAT ARE VOLUNTEERS?
Volunteers are like Ford...
lhey have better ideas.
Volunteers are like Coke...
lhey're the real thing.
Volunteers are like Pan Am...
lhey make the going great.
Volunteers are like Pepsi...
lhey've got a lot to give.
Volunteers are like Dial Soap...
lhey care more: Don't you wish everybody did?
Volunteers are like VO-5 hair spray...
lheir goodness holds in all kinds of weather.
Volunteers are like Hall Mark cards...
lhey care enough to give their very best.
Volunteers are like Standard Oil...
You expect more and you get it.
But most of all...
Volunteers are like Frosted Flakes...
lhey're GREEEEEEAAAAA:ITll'll !!!!!!!!
Author Unknown
17
16
New Hanover County
Board of Health
William T. Steuer, PE/RLS, Chairman
Wilson O'Kelly Jewell, DDS, Vice-Chairman
Henry V. Estep, RHU
Michael E. Goins, OD
Robert G. Greer
Gela N. Hunter, RN, FNP
W. Edwin Link, Jr., RPH
Anne Braswell Rowe
Philip P. Smith, Sr., MD
Melody C. Speck, DVM
Estelle G. Whitted, RN
Frank Reynolds, MD, Med. Cons.
Board of County Commissioners
William A. Caster, Chairman
Robert G. Greer, Vice-Chairman
Buzz Birzenieks
Ted Davis, Jr.
Charles R. Howell
0::)
o :)
18
New Hanover County
Health Department Staff
(listing updated annually)
Administration
David E. Rice - Health
Director
Lynda Smith - Asst.
Health Director
Frances DeVane
Cindy Hewett
Shirley Lloyd
Kathy Nuttall
Glenda Slappy
Animal Control
Jean McNeil - Director
Daisy Brown
Charles Craft Murdis
Kellie Daughtry
Judy Evonko
Wayne Foster
Jennifer Grainger
Hazel Hewitt
Jamie Kilgore
Delisa Lloyd
Helen Millinor
Jimmy Price
Chloe Rivenbark
Nancy Ryan
Stacy Skinner
Shannon Slocum
Sarah Smith
Doris Sanders
Anthony Williams
Child Health
Janet McCumbee - Dir.
Maryann Adkins
Candace Artis
Beverly Bass
Lorna Blackler
Joan Blue
Paula Calvert
Mamie Carlos-Nixon
Lauri Fish
Deborah Goodwin
Joyce Hatem
Pamela Heath
Margaret Horton
Gail Jernigan
Kristen Keenan
Joan Michael
Felecia Myott
Barbara Perilla
Carmen Potter
Vivian Purifoy
Betty Rauth
Juanita Richardson
Susan Sanderford
Renee Tootoo
Beth Topping
Communicable Disease
Beth Jones - Director
Esther Adams
Beverly Buckner
Kathy Bundy
Kimberly Carder
Ginger Clegg
Ruth Foy
Anne Gallagher
Joan Hulette
Regina James
Paula Jenkins
Maureen Lamphere
Anne Lawrence
Mildred Lincoln
19
Communicable Disease
continued
Michelle Locklear
Kay Lunceford
Cammie Marti
Vivian Mears
Jessica Nakell
Eileen Redolphy
Kim Roane
Ruth Roethlinger
Marcy Smith
Betsy Summey
Nikki Todd
Bobby Waters
Diana Williams
Community Health
Betty Creech - Director
Carolyn Allen
Vivian Anderson
Dot Ashbaugh
Susan Barfield
Rose Bauerlein
Evelyn Bowden
Teresa Cooper
Fay Day
Carol Drummond
Beverly Fussell
Sherita Josey
Ellen Harrison
Patty Hochwalt
Doris Holland
Pat McSwain
Frankie Mincey
Mary Jo Newton
Charlotte Norris
Penny Raynor
Marilyn Roberts
Candace Sancilio
Teresa Stanley
Mania Swart
Jeri Taylor
Barbara Thrift
Gloria Umstetter
Leslie Yusko
Cherie West
Dental
Dr. David McDaniel - Dir.
Norma Davis
Environmental Health
Dianne Harvell - Director
William Elliott
Bart Furlow
Joe Garcia
Ricky Gibbs
Thurman Grady
Sarah Harrell
Leigh Jackson
Robert Keenan
Harold Kelly
Debbie Lovett
John Minneci
Sharon Neuschafer
Alicia Pickett
Brian Scott
Ken Sholar
B. J. Stallings
Tom Stich
Keith Studt
Cathy Timpy
Susan Wright
Laboratory
Susan O'Brien - Dir.
Mitzi Chappell
Pam Horne
Sheila Jamerson
Monique Simon
Diane Vosnock
Nutrition/WIC
Nancy Nail - Director
o
o
20
.:)
Nutrition/WIC continued
Margaret Eaton
Debbie Gregory
Lynetta Huffman
Carmen Larkins
April MacAlpine
Lisa Gans
Alfreda Gee
Caritza Henry
David Howard
Pat Johnson
Francine Moore
Cristy O'Herron
Mary Piner
Regina Randall
Gail Robinson
Avery Rollinson
Nancy Russ
Catherine Stukes
Margaret Swann
Page Tootoo
Courtney Wilson
Martha Wright
Women's Health Care
Betty Jo McCorkle - Dir.
Cathie Barger
Barbara Berkemeier
Sandra Brooks
Sylvia Brown
Andrea Carson
DeAnne Chryst
Dot Colson
Elisabeth Constandy
Pam Cooke
~
21
. . ........ ........ ................... .......
Notes
C. }
"---' :
I
I .
I :
o ~
~ A Worl~
~ of Heart
Your Dedication
and Caring...
22 23
.. ........ . ...... . ... ........ ...
NEW HANOVER eouNIY HEAUH DEPARTMENT
Also in Ihis issue...
(
"-
2 Times Change-
But the basics of food
safety never do
2 Produce Rinses-
A better bath for
broccoli?
3 Federal Scrutiny-
What's being done to
improve produce safety
3 Sprouting IIInesses-
This "health food" can
actually be a health risk
4 Killer Bananas!-
The truth behind an
Internet rumor
\
~I
4 Waxed Produce-
Is it a cucumber or a
candle?
Copyright 2000
Pike & Fischer, Inc.
1-800-255-8131
Fall 2000
Meloncholy Returns
As baseball great Yogi Berra once said, "It was deja vu all over again", another
Salmonella outbreak from cantaloupe. Details are still sketchy, but in April and May of
this year at least 43 people became ill after eating fresh cantaloupe. Five were hospital-
ized. Illnesses were reported in California, Colorado, Nevada, Utah, Washington State
and British Columbia.
FDA officials are still investigating the cause of this outbreak, so they cannot say
publicly yet whether the contaminated melons were grown in this country or imported. It
is known that several of the melons were purchased by consumers in retail markets.
This is the sixth time in the last decade that melons have been responsible for out-
breaks of Salmonella, and the fifth time that cantaloupes were the cause. Contamination
on the skin of the melon is transferred through the flesh when the melon is cut. If the cut
melon is not refrigerated, the bacteria grow rapidly
While not as common as E. coli 0157:H7 in ground beef or Salmonella Enteriditis in
eggs, pathogenic contamination of melons poses a puzzle to FDA. Why are cantaloupes
responsible for more outbreaks than any other type of melon?
"I wish I knew the answer," said Jack
Guzewich of the FDA. He also said that FDA
is currently conducting several projects to
learn more about the commercial cantaloupe
industry to isolate the practice that leads to
this type of contamination.
Because cut melons are a potentially
hazardous food, FDA has issued spedal
handling requirements far them:
. Hold cut melons below 41 0 F at all
times in a refrigerator Do not simply
display cut melons on ice.
. Cut melons must be date marked if they
are going to be held for more than 24
hours. If they are not used within seven
days after cutting, cut melons must be
thrown away
In addition, the fallowing precautions
must be taken with all produce:
. Wash hands before handling produce.
. Workers who are sick must never
handle produce or any other food.
. Avoid touching produce with bare
hands if it's not going to be cooked
Salmonella Outbreaks from Melons
I',nked to cantaloupe
1998-22 cases,
\ 'ked to cantaloupe
1997 24 cases, "' \
- \' k d to waterme an
91 26 cases, In e
19 - I' ked to cantaloupe
91-400+ cases, In
19 \- ked to cantaloupe
1990--245 cases, In
later Instead, use clean gloves, deli
paper, utensils, etc.
. Wash all fruits and vegetables with cool
tap wat~r before cutting them, includ-
ing oranges, melons and other foods
where the skin is not usually eaten.
. Scrub non-delicate produce, like mel.
ons, apples, potatoes and cucumbers
with a clean brush.
. Do not use soap or detergent to wash
produce. (See related story, pg. 2.1
. Use only clean and sanitized utensils,
cutting boards, knives, etc.
. Cut away any bruised or damaged areas.
. Wash, rinse, sanitize, and air dry all
surfaces and utensils that touch raw
produce during preparation.
Food Talk
f
@
dD
.,.. \,
~
1i.e<1-\::
Keep it hot!
C.olef
Keep il cold!
Keep it clean!
Times Change, but the
Basics Never Do
Each year, the folks at the Centers for Disease ControllCDC) in Atlanta,
Georgia, collect data on how many Americans got sick with specific diseases,
and how many food borne illness outbreaks occurred. They crunch and
interpret the numbers.
The good news is that in 1999 the number of people in the U.S. that were
infected with Campylobacter, Salmonella Enteriditis, Shigella and E. coli
0157:H7 was significantly lower than it was in 1996 when the CDC first started
collecting this information. The CDC notes that this decrease occured at the same
time the USDA issued new requirements for meat and poultry processors, and
that the new FDA Model Food Code for food service was introduced.
While the number of individuals made ill from food has decreased, the
number of outbreaks (or clusters of illness) remained the same, according to
another CDC tracking effort. From 1993-1997, the average number of
outbreaks each year was the same as it had been from 1988-1992, and the
same mistakes in the kitchen caused the vast majority of those outbreaks.
According to the CDC, several other factors were also unchanged. Salmo-
nella Enteriditis was still a "major cause" of outbreaks, while "multi-state
outbreaks caused by contaminated produce" remained prominent.
Causes of Foodborne Illness Outbreaks ('93.'97)
Cause Number of outbreaks
Improper holding temperatures u.u.u.u.u.u.u.uu.u. 938
PDDr persDnal hygiene uuuu.mmmuuummmuuuum 490
Contaminated equipment ..........uumm..uum.u.u.u 400
Inadequate <ooking uuuuummuuuuummuuuuuuuu 274
Fall 2000
C.ook
Cook it well!
TemperCltUf"€-
Check it with a
thermometer!
~~OOd fl ~
{ .,,P'
=- ,
. . .,
" ..\' {: "
" '--'~
Hand
Washing
Wash your
hands!
Produce Rinses: A Better Bath for Broccoli?
We use SDap fDr handwashing to remove germs. Why
not use soap when washing produ<e? The FDA says not
to use any kind of hand SDap Dr dish detergent when
washing produ<e, be<ause they <an leave residues on
fODd. Not Dnly <an these residues taste bad, nobody
knDws whether they ore harmful. For those whD are
concerned that water isn't enough, two manufacturers
have introdu<ed new products spedfitally tD wash
produ<e. At least Dne major restaurant <hain has started
to use a produ<e rinse produ<t on 011 their produ<e.
PrDder and Gamble is selling Fit, whith tontains,
among Dther natural ingredients, dtrit odd and grape.
fruit oil. There are two versions of Fit, one for home
consumers and one for restaurant use. Procter and
Gamble have data showing that the Professional line Fit
will kill pathogenit bode ria and some viruses on wt
produ<e. They estimate that the overage restaurant will
spend S600 per year using Fit.
Their tompetitor is tolled Vidory, sold by E<olab.
Vittory has been approved by the EPA os on antimitra-
bioi wash for produ<e. like Fit, Vittory is designed to
not leave any taste or odor on the produ<e, and tosts
about SI per day.
The United Fresh Fruit and Vegelable Assodation
believes that produce rinses ore unnecessary for the
home tonsumer, but has supported their development
for food service. For more information on whether
these treatments ore right for your operation, contact
the manufadurers at <www.pg.<om> and
<www.etolab.tom> Dr your ID<al health department.
-,
---./
-...,
--./
Fall 2000
I
'-
Sprouting
III nesses
A Growing Problem
c
Everyone knows that sprouts
ore "health food," right? Well,
that's what we used to think.
But, since the late 1990s sprouts
hove caused several severe
foodborne illness outbreaks.
Many different types of sprouts,
os well os different types of
bacteria, hove been responsible.
The most recent outbreak
occurred in the spring of 2000.
Salmonella in mung bean
sprouls sickened at least 47
people in Northern California. In
011, more than 1,300 people ore
known to hove gotten sick from
eoting sprouts. Because of this
history, FDA defines row sprouts
os 0 potentially hazardous food.
WHAT'S THE PROBLEM?
Bacteria con exist naturally
on seeds before sprouting. In
order to grow, sprouts, whether
they ore alfalfa, bean, clover or
broccoli need moisture, nutri-
ents, the correct ocidity, worm
temperatures and time-just
like bacteria. As the sprouts
grow, so do the bacteria.
WHAT'S BEING DONE?
The FDA has issued instcuc-
tions to the sprout industry that
should help prevent food borne
illnesses from sprouts. Among
the new instructions ore require-
ments that sprouters treat their
seeds with 0 chlorine solution
before sprouting, and that they
test their irrigation water for
pathogens. Inspections of the
sprouters verify that those
instructions ore being followed.
However, the FDA also warns
consumers thot there is a risk
associated with eating 011 row
sprouts.
Food Talk
Produce Comes Under the
Federal Microscope
Over the last 20 years or so, the amount of fresh produce eaten by Americans
has risen. We now realize that our mothers were right when they told us that
fruits and veggies were good for us. And, because modern shipping brings us
produce from all over the world, we can now enjoy a wide variety of fruits and
vegetables year 'round, and sample exotic items that our mothers never heard of
At the same time, according to FDA, the percentage of food borne illness out-
breaks caused by fruits and vegetables, while still small, is also rising.
How does produce gel conlominoled?
In many ways, the fact that produce is contaminated with bacteria and viruses
is not surprising. Fruits and vegetables are not grown under factory-clean
conditions. As they grow and ripen they are exposed to dirt, manure, irrigation
water, animals, birds and insects, all of which are known to carry many different
types of microorganisms. In addition, many people handle our produce when it is
picked, washed, and packed. Poor hygiene or sanitation can add contamination
at any of these stages before the produce reaches your kitchen.
Whol is being done?
Assuring that produce sold in this country is safe is a priority for the FDA.
Over the last several years, the agency has initiated several programs focusing
on produce safety They have issued voluntary, science-based guidance to assist
all levels of the produce industry in reducing the amount of bacteria and viruses
on their product. This guidance outlines what the agency considers to be "Good
Agricultural Practices" and "Good Manufacturing Practices" for produce handling.
The guidance document offers recommendations for handling manure, irrigation
water, pest control, equipment sanitation, and of course, employee hygiene. In
addition, FDA is conducting a large-scale sampling project to collect data
on the amount of contamination that is on our produce, .__~.
both imported and domestic.
But, despite FDA's
protection, some
amount of contamina-
tion can still occur in
the fields and packing
houses. It's still up to
you to handle produce
safely
_ --'~e~s~s of food
d~osnlog '5 f foods tnat
11\-\00 'a\\Y Of "
--espec', roduce,
safetY '.ad "ke p Plesldent,
.....t coo~" , I 'lice' .
ore ......Steve GlOve, t ~dottOn
__-;~~_~~RestoUfon r-
.-
-,,-,-
Food Talk
Is it a Cucumber or a Candle?
Why are Some Fruits
and Vegetables Waxed?
Cucumbers, apples and other produce are coated
with a small amount of wax to replace a natural
coating that is removed when the produce is
washed, according to the Produce Marketing Asso-
ciation (PMA) Without this coating, fruits and
vegetables would lose their moisture quickly and
would mold and generally become undesirable before
they could reach our kitchens.
Although some people worry that the wax
coatings are harmful to their health, they are not. The
federal government regulates wax coatings just like
any other food additive.
The waxes can be made from plant materials,
petroleum products, beeswax and occasionally from
animal sources. People who follow kosher dietary
laws, as well as some vegetarians, may worry about
eating wax from animal sources. For this reason, all
waxed produce must have a label identifying the
origin of the wax.
The wax cannot be washed off it is there to stay
If you don't want the wax, PMA recommends that you
peel waxed produce or seek out unwaxed options.
Do you want to pick up some more juicy informa-
tion on fruits and vegetables? Call FDA's Food
Information Hotline at 888/SAFEFOOD Online. visit
the government's food safety web site at
< www.foodsafety.gov> or the Produce Marketing
Association at < www.pma.com >
FOOD TALK ~
NEW HANOVER COUNIY HWTH DEPARTMENT
ENVIRONMENTAl HWTH DMSION
2029 SOUTH 17TH STREET
WILMINGTON, NC 28401
DaVId Rice
Health Director
Health Department
Prmted on recycled paper
fall 2000
DID YA MEA~ THE
ONE ABOUT THE
BANANA)?
-J
This spring, 0 widely
circulated e-mail rumor
linked eating bananas
imported from Casto Rico
with the condition necrotiz-
ing fasciitis, better known as
IIflesh eating disease" No
one knows where the e-mail
orginiated, but just like the old
story about alligators living in
the New York City sewers, this
rumor was completely false.
The Centers for Disease Control (CDC) did not receive
any reports of illnesses cause~ by bananas. In 0 press
release, CDC said that bananas were unlikely to spread this
disease, because the bacteria responsible for the condition
are usually spread "from person to person," and "connot
survive long on the surface of 0 banana."
Tim Debus, vice president of the International Banana
Association, described the rumor os"another case of
Internet terrorism" like the Love Bug computer virus and
hacker ollocks on popular web sites.
Remember that no one monitors the truthfulness of the
information on the 'Net. Uke graffiti on 0 locker room wall,
urban legends tronsmilled on the Internet should be token
with 0 groin of salt. It is best to rely on sites like those
belonging to FDA, CDC and other well-known, well-re-
spected organizations.
I, .
-
e
e
erving Safe Food
November 7, 9, 14, 16
4:00 pm - 8:00 pm
(Tota/16 hour course)
New Hanover County Health Department Auditorium
2029 S 17th Street . Wilmington
$55.00 plus text
The National Restaurant Association Educational Foundation offers
certification to those who successfully complete this course. New Hanover
County Environmental Health Specialists will teach the course.
Pre-registration required. Space limited. Register today!
251-5696
Cape Fear Community College
Wilmington, NC 28401
e-mail: bigcenter@cfcc.net
411 N. Front Street
web: cfcc.net
Registration Form Fill out and mail with check or bring to 411 N. THIRD. Classes are
filled on first-pay. first-served basis.
Class Title Class Start Date
Class Fee $
Ido NOT include book charge) Check if senior waver (65+)_Social Security#
Last Name
First Name M.I._
Mailing Address
City State_Zip
Date of Birth (me/day/year)
Sex: Male Female Race: White Black Indian Hispanic Asian
Highest Grade Completed 1-17
Or check_if passed high scheel equivalency County of Residence
Telephone: Home
Work
fax
e-mail
"
Employment: (circle one) Retired Unemployed Part-time Employed Full-time Employed
Company Student Signature
Make Check Payable and Mail to:
Cape Fear Community College * Attn: BIG Center * 411 N. Front Street * Wilmington, NC 28401
Office Use
Office Use
e
e
e
EPllnformation
July 2000 New Hanover County Health Department Betsy Summey F N P Editor
111~llllr"lltfjl
The recent report of a
death from Eastern
Equine Encephalitis (EEE)
on the Outer Banks of
North Carolina requires us
to look at this disease as a
very real threat to our
community. Transmitted by
the mosquito, the illness is
severe at best, fatal at its
worst. The infection has
been found in other areas of
the U.S. in the horse
population - namely
Louisiana.
State officials check sentinel
flocks of chickens and on
June 26, 2000 one of the
indicator chickens in Bladen
County tested positive.
Transmission can be
lessened by encouraging
patients to take preventive
measures.
Many of our patients depend
on health care providers to
keep them abreast of
immediate threats to their
health - help us achieve this
goal.
Preventive Mosquito
Measures
. Eliminate mosquito
breeding grounds by
removing any receptacle
that collects water such as
old tires, empty buckets,
saucers, pots, and
birdbaths.
. Wear protective clothing
on arms and legs.
. Wear insect repellent.
. Place insect-repellent
candles on decks and
patios when occupied.
The Centers for Disease
Control and Prevention
(CDC) published a press
release on June 22, 2000
advising providers of
immunization services that
they should expect delays in
flu vaccine shipments and
that it is possible there will be
reductions in the amount of
vaccine available for the
2000-200 I season.
The FDA and CDC briefed the
Advisory Committee on
Immunizations Practices (ACIP).
The ACIP is urging health care
providers to think about
delaying adult mass influenza
vaccination campaigns to
November based on supply
availability, and to consider ways
to ensure high-risk patients
receive vaccination if a severe
vaccine shortfall occurs. The
following points are important to
remember:
1. The FDA, CDC, and vaccine
manufacturers are confident
there will be enough vaccine
available for those at highest
risk of complication from
influenza, including those over
65 and those immuno-
compromised.
2. If a substantial shortfaU
were to occur, the ACIP and
CDC would provide modified
recommendations for the
2000-2001 season that
emphasize vaccinating those
at highest risk and those
who care for them, and then
others as supply becomes
available.
3. The amount of vaccine
available is complicated by
continued
two important factors: a)
The yield for this year's
influenza A component
(H3N,) appears to be
lower than expected and
b) "other manufacturing
issues." Manufacturers are
working closely with the
FDA to address these
issues.
4. Information regarding this
issue is expected to be
available in the coming
months with updates
available per the CDC and
FDA.
The most recent ACIP
recommendation on
hepatitis A (dated 10-1-99)
notes that travelers are one
group at increased risk for
hepatitis A. The
recommendation is titled
"Prevention of Hepatitis A
Through Active or Passive
Immunization," and contains
the following information for
travelers:
"Persons from developed
countries who travel to
developing countries are at
substantial risk for acquiring
hepatitis A. Such persons
include tourists, military
personnel, missionaries, and
others who work or study
abroad in countries that have
high or intermediate
endemicity of hepatitis A.
"The risk varies according
to region visited and the
length ofstay. Traveling to
most places in the world
(except Western Europe,
New Zealand, Australia,
Canada, Japan, and the
United States) increases the
risk for hepatitis A virus
infection. It has increased
even among travelers who
report that they observe
measures to protect
themselves against enteric
infection or stay only in
urban areas, in luxury hotels,
or in both.
"In the United States,
children account for
approximately one third of
reported travel-related
cases. "
On May 15,2000 CDC posted
on its Web site an
interactive web-based training
program called "Hepatitis C:
What Clinicians and Other
Health Professionals Need to
Know." The program is at
www.cdc.20v/heoatitis.
e
This program provides users
with up-to-date information on
the epidemiology, diagnosis,
and management of hepatitis C
~rusOIC10infectionand
HCV-related chronic disease.
Users also can test their
knowledge of the material
through study questions at the
end of each section and case
studies at the end of the program.
Continuing medical and nursing
education credits are available
free from CDC on completion of
the training. The American
Academy of Family Physicians
also will grant the academy's
education credits on completion
of training and filing with the
academy.
e
Communicable Disease Statistics
New Hanover County
July 1, 1999 - June 30, 2000
AI[)S .:..;',..". ;..,; '..9'" ....~::::S~i~~~~.{::::::.:. 1..
I . Rky. Min.spottedFllver~~
"'~.H~'.:e;~pt'a.'fti'l~itr'OI.':s..t':A~.;.i:..t.~';...:,I~"':"~';'~':':""~;~'('.;2~' - 117
,;:' ;0!(0F:?'~...'5"; 'i~
Hej)atiiisB (acute)'.; ,.. 15 Strep. Group A Invasive . 4.
Hepatitis B (carner) 8' ". STuY' ~~~IiCUSI.oa'i~S<.'........., ....., :.......~....,.~...............~... ............,..6.......57.
~~~ii~~o~~u.~~)~::::: 3~ ~
-