12/06/2000
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NEW HANOVER COUNTY BOARD OF HEALTH
Dr. Thomas Fanning Wood Memorial Conference Room
New Hanover County Health Department
AGENDA
Date:
December 6, 2000
Time:
8:00 A.M.
Place:
Dr. Thomas Fanning Wood Conference Room
New Hanover County Health Department
Presiding:
Mr. William T. Steuer, Chairman
Invocation:
Michael E. Goins, OD
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/ - 1 Minutes:
-
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November 1,2000
Recognitions:
- Mr. William T Steuer
Chairman
Personnel:
Years of Service
5 Years
-el1lul BULlUIUi:), ?'~ttt1:tioni!t III, f~uh~b.u1J/WIC
J tJr;t B"'"....Ily :Ol1i""1rn~r7 rlp.rir.~1 ~pp~i~lid T, rnTnRumiealde Dis@r"fe
Nancy Ryan, Shelter Supervisor, Animal Control Services
,/ Anthony Williams, Animal Control Services
New Emnlovees
Kelly Johnson, Public Health Nurse I, Community Health
Thomas 1. Lawrence, Animal Control Officer, Animal Control Services
Other Recol!:nitions: ~ ;w at
Serving Safe Food - Holiday Inn Sunspree ~ ~ f CJ.a& C Fe ~
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Department Focal: Me~~ t<o fnr1 f) ~ n e~
Health Promotion Update
Ms. Betty Jo McCorkle
Women's Health Director
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NHC Board of Health Agenda
December 6, 2000 - Page 2
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$-30
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Monthly Financial Report: October 2000
(Including Grant Status Update)
Ms. Cindy Hewett
Business Officer
33 -5-) FY1999-2000 Financial Report - Final Report
Ms. Cindy Hewett
Committee Reports:
Executive Committee (listed under New Business)
- Mr. William T Steuer
New Business: - Mr William T Steuer
'J"'- 'f Smart Start Grant Application- NAVIGATOR Program Expansion ~
~5 -1-{ Budget Amendment - Medicaid Cost Settlement FY 1998-99 4
Annual Report for FY 1999-2000
e 1- J-- Set Year 2001 Meeting Dates frf
Comments:
Election - Board of Health Officers 1/ I J ,j
hf!ll~ ~{tijr'f 1t ,;}f;;VO
"'r/lf'~, ~Nee~ ~ - Mr. William T. Steuer
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1)' ~' I' ( - Mr. David E. Rice
G,.
Board of Health Members
Health Director
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Strategic Planning Update "
N. C. State Health Director's Conference - January 10-12,2001
Association of N. C. Boards of Health Annual Meeting - January 12,2001
American Public Health Association Annual Meeting
Christmas Luncheon - December 14,2000 ()
SML.) -5et1'5on~ri J.etfcl~r tf-5i ~ . f).
llNC-5P/t P4pl/e JltwIHl ftofprfet/I!~6'~ -1"'?6h~.vISR~
Other Business: _ Mr. William T Steuer
1.
2.
3
4
5.
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, December 6,2000, in the Dr. Thomas Fanning
Wood Conference Room, 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, 00
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
Frances De Vane, Recording Secretary
Invocation:
Dr. Michael Goins gave the invocation.
Minutes:
Mr. Steuer asked for corrections to the minutes of the November 1,2000 New Hanover County Board of
Health meeting. The minutes of the November 1 Board of Health meeting were corrected and approved.
Recognitions:
Mr. Rice recognized the recipients of the New Hanover County Service Awards:
Years of Service
5 Years
Nancy Ryan, Shelter Supervisor, Animal Control Services
Anthony Williams, Animal Control Services
Mr. Rice introduced and welcomed the following new employees and guests:
Personnel
New Emplovees
Kelly Johnson, Public Health Nurse I, Community Health
Thomas L. Lawrence, Animal Control Officer, Animal Control Services
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Other Recognitions:
Servin!!: Safe Food - Holiday Inn Sunspree
I
Mr. Rice presented a Serving Safe Food Certificate to Mr. Randy Pentecost, Head Chef, Holiday
Inn Sun spree, Wrightsville Beach, N. C. He commended the Holiday Inn for participating in the
Serving Safe Food Classes sponsored by Cape Fear Community College and the Health
Department Environmental Health Division. Mr. Rice introduced Ms. Isabelle Charleton
representing the Continuing Education Division, Cape Fear Community College.
Monthly Financial Report - October 2000
Ms. Cindy Hewett, Business Officer, referred the Board to the Monthly October Revenue Report that
reflects an earned revenue balance of $867,277 (20.01%) and a remaining balance of $3,467,403, an
expenditure amount of $2,786,455 (28.06%) with a remaining balance of $7,143,303.
Ms. Hewett reported Federal and State Revenue is less due to the statewide conversion to lCD-CPT
coding for services. School Health ($273,575) and Navigator Program ($41,000) revenues should
reflect increased revenue receipts in the November monthly report. Dr. Speck commended the Animal
Control Services staff for their progress with data entry on the new computer system that is reflected in
earned revenue at $179,829 from $109,708 for the prior year.
Ms. Hewett referred the Board to additional information in the Health Department Revenue and I
Expenditure Summaries Report for October 2000. She presented the following:
Budgeted
FYOO-Ol
Actual
FYOO-Ol
%
Expenditures:
$9,929,758
$2,786,445
28.06%
Revenues:
$4.334,680
$ 867.277
20.01%
Net County $$
$5,595,078
$1,919,178
34.30%
Grant Status Update
Ms. Hewett gave the Grant Status Update from July 1999 through October 2000. The Health
Department grants requested for this period are $862,902. Grants received equal $252,373, pending
grants equal $188,500, and denied grants equal $422,029.
Summarizing the status of grants, Ms. Hewett reported the Cape Fear Memorial Foundation (CFMF)
funded the Health Department $35,000 for a Teen Aids Prevention (TAP) Grant. The Health Department I
recently received two letters of denial from the Z. Smith Reynolds Foundation grant requests for Teen
Aids Prevention ($59,000) and Enhanced Counseling ($48,000). The Childhood Asthma Management
and Control Interventions Grant ($23,000) is pending.
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Fiscal Year 1999-2000 Financial Report - Final Report
I Ms. Hewett presented the Fiscal Year 1999-2000 Final Financial Report as follows:
Budgeted Actual Difference
FY99-00 FY99-00 FY99-00
Expenditures:
Salaries & Fringe $7,208,637 $7,107,403 $101,234
Operating Expenses $1,716,581 $1,526,907 $189,674
Capital Outlay $ 778.1 15 $ 583,897 $194,218
Total Expenditures $9,703,333 $9,218,207 $485,126
Revenue: $4,278.403 $4.124,701 $153,702
Net County $$ $5,424,930 $5,093,506 $331,424
Ms. Hewett explained much of the unexpended amount in operating expenses and capital outlay was
carried forward into FY 2001 Budget and will be expended. She noted county funds expended
($153,702) were less than projected.
Committee Reports:
I
Executive Committee
Mr. Steuer reported the Executive Committee met at 6:00 p.m. on November 28,2000. Items are listed
under New Business on the Board of Health Agenda.
New Business:
Budeet Amendment - Medicaid Cost Settlement FY 1998-99
Mr. Steuer recommended from the Executive Committee for the Board of Health to accept and to
approve the Medicaid Cost Settlement FY 1998-99 Funds in the amount of $153,479 and the Health
Department expenditure requests for budgeting Medicaid Cost Settlement Funds ($153,479).
Motion: Mr. Steuer moved from the Executive Committee for the Board of Health to accept and to
approve the Medicaid Cost Settlement FY 1998-99 Funds in the amount of $153,4 79 and to submit the
associated budget amendment to the New Hanover County Commissioners for their consideration.
Upon vote, the MOTION CARRIED UNANIMOUSLY.
Smart Start Grant Application - NAVIGATOR Proeram Expansion
I
Mr. Steuer recommended from the Executive Committee for the Board of Health to accept and to
approve a NA VIGA TOR Program Expansion Grant Application funded by Smart Start in the amount
of$100,000.
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The purpose of the grant is to expand education and intervention services related to the Navigator
Program (Intensive Home Visiting Program). The budget includes three additional nursing positions
and clerical support (10 hours/week from existing staff), and operating expenses to expand the
Navigator Program. The Cape Fear Memorial Foundation, Smart Start, and the Health Department
support the program. The additional $100,000 Smart Start funding should be expended by June 2001.
Motion: Mr. Steuer moved from the Executive Committee for the Board of Health to accept and to
approve the NA VIGA TOR Program Expansion Grant funded by Smart Start in the amount of
$100,000 and to submit the associated budget amendment to the New Hanover County Commissioners
for their consideration. Upon vote, the MOTION CARRIED UNANIMOUSLY.
Annual Report
Mr. Rice distributed copies of the New Hanover County Health Department FY 1999-2000 Annual
Report to the Board. He reviewed the third edition of the Health Department Annual Report that
includes the Board of Health members, the Health Director's Message, Division Directors, Highlights of
the Fiscal Year, Division Reports, and a Financial Management Report.
Set of 2001 Board of Health Meetine: Dates
Mr. Rice presented a proposed schedule of Board of Health 2001 Meeting Dates. He advised the
regular business meetings are scheduled at 8:00 a.m. on the first Wednesday of each month except the
July Board Health meeting is on Wednesday, July 11 at 8:00 a.m.
The 200 I Meeting and Luncheon dates are:
January 3
February 7
March 7
April 4
April 12 - Staff Appreciation Luncheon
May 2
June 6
July 11
August 1
September 5
October 3
November 7
December 5
December 13 - Christmas Luncheon
It was the consensus of the Board of Health to accept the 200 I Board of Health Schedule as presented.
Election of Board of Health Officers
Mr. Estep, Chairman, Nominating Committee, presented the following nominees for the Chairman and
Vice-Chairman of the 2001 New Hanover County Board of Health: Dr. Wilson O. Jewell, Chairman,
and Ms. Gela N. Hunter, Vice-Chairman.
Mr. Steuer asked for other nominations from the floor. There were no nominations from the floor.
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Motion: Dr. Smith moved, seconded by Dr. Speck for the Board of Health to accept the slate of officers
as presented by the Nominating Committee. Upon vote, the MOTION CARRIED UNANIMOUSLY.
A ballot vote was taken. Mr. Steuer requested Mr. Rice tabulate the votes for the election of officers.
Mr. Rice announced Dr. Wilson O. Jewell was elected as Chairman and Ms. Gela N. Hunter was
elected as Vice-Chairman of the New Hanover County Board of Health for Year 2001.
Mr. Steuer congratulated Dr. Jewell and Ms. Hunter on their election as 2001 Board of Health Officers.
He thanked Mr. Estep, Chairman, Mr. Greer, and Dr. Speck for serving on the Nominating Committee.
Mr. Steuer expressed his appreciation to the Board of Health for their support during his tenure as
Chairman. He stated serving as Chairman has been a rewarding experience and that he had the finest
Board of Health members. Dr. Jewell and Ms. Hunter thanked the Board for their vote of confidence.
Comments:
Board of Health
Appreciation to Mr. Steuer
Dr. Jewell, Dr. Smith, and Ms. Whitted expressed their appreciation to Mr. Steuer for serving as the
Board of Health Chairman from January 1999 - December 2000. On behalf of local veterinarians and
pet owners, Dr. Speck thanked Mr. Steuer for his support of Animal Control Services issues including
the establishment of a Spay Neuter Program. Mr. Link, Mr. Estep, and Ms. Rowe commended Mr.
Steuer for ajob well done to promote public health in our community.
Health Director
Board of Health Information:
Mr. Rice referred the Board to additional information in their Board packet including a Schedule for
2001 Executive Committee Meetings, an EPI Newsletter, a letter to Mr. Allen O'Neal, County Manager,
Re: TRI Detox/Crisis and Clinical/Office Buildings (possible space availability), and a Board of Health
Preference Form for 2001 Committee Assignments.
Dr. Jewell requested Board members select committee assignment preferences and return the Committee
Assignment Preference form to Dr. Jewell within a week or ten days.
Strateeic Plan nine Update
Mr. Rice referred the Board to a Strategic Planing Priorities Update (November 28,2000). He stated
he plans to give this report monthly to advise the Board of the Strategic Planning Task Forces' actions
addressing Strategic Planning Priorities.
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N. C. State Health Director's Conference - January 11-12.2001
Mr. Rice announced the N. C. State Health Director's Conference is to be held on January 11-12,2001, at
the Radison Governor's Inn, Research Triangle Park, N.C.
Association ofN. C. Boards of Health Annual Meeting - January 12.2001
Mr. Rice invited Board members to attend the Association of N. C. Boards of Health 15th Annual
Meeting held in conjunction with the Annual State Health Director's Conference. A reception in honor
of ANCBH Emeriti is to be held at 5:30 p.m. on Thursday, January 11, 2001. Board members should
make reservations for the meeting by January 3.
American Public Health Association (APHA) Annual Meetine - November 10-15.2000
Mr. Rice attended the American Public Health Association Annual Meeting from November 10-15,
2000, in Boston, Massachusetts. He reported the program was resourceful and the theme was
Eliminating Health Disparities. Mr. Rice thanked the Board for the opportunity to attend the APHA
Annual Meeting.
Christmas Luncheon - December 14.2000
Mr. Rice reminded Board members to plan to attend the Health Department Annual Christmas Luncheon
on December 14, 2000. Lunch is served from 11 :30 a.m. - 1: 30p.m.
SPH - Seasoned Leadership Conference December 4-5
Mr. Rice stated he was invited to participate in The University of N.C. School of Public Health
Seasoned Leadership Conference on December 4-5, 2000, in Chapel Hill, N. C. He presented as a
seasoned leader and shared his public health experiences. Partners in the School of Public Health
Preparedness Grant focus on Infectious Diseases.
Other Business:
Adjournment of Business Meeting:
Mr. Steuer adjourned the regular meeting of the Board of Health and announced the Department Focal IS
following the business meeting in the Health Department Auditorium.
Department Focal:
Ms. Betty Jo McCorkle, Women's Health Director, announced the Department Focal is on the Health
Promotion Program Theory and Practice. She introduced Ms. Elizabeth Constandy, Health Educator,
who explained Health Education, a relatively new field, draws from sociology, psychology, education
and behavioral sciences. Health Education positively influences individual health behaviors as well as
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living and working conditions that influence people's health. Ms. Constandy reported North Carolina
is a leader in Health Education and recognizes it as a necessary strategy in the effort to improve the
public's health. The Health Department employs five diverse Health Educators.
Mr. David Howard, Health Educator, presented a Socio-Ecological Model for Health Promotion to
analyze health-related behavior and a way to plan and evaluate Health Promotion programming. He
presented the five "levels of analysis" with respect to how Health Educators look at health-related
behaviors including interpersonal factors, interpersonal processes and primary groups, organizational
factors, community factors, and public policy.
Ms. Constandy explained the Health Promotion Programs include Health Education Strategy, Injury
Prevention, Teen AIDS, Project ASSIST, and Women's Health Programs. She introduced the Health
Educators in the Health Promotion Program, Women's Health Division, ofthe Health Department.
l2=u~/~an
New Hanover County Board of Health
p~
David E. Rice, M.P.H., M.A., Health Director
New Hanover County Health Department
Approved:
7
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, November I, 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
Gela N. Hunter, RN, Nurse Practitioner
W Edwin Link, Jr., RPH
Anne Braswell Rowe
Melody C. Speck, DVM
Members Absent:
Robert G. Greer, Vice-Chair, County Commissioners
Philip P Smith, Sr., MD
Estelle G. Whitted, RN
Others Present:
David E. Rice, Health Director
Lynda F. Smith, Assistant Health Director
Frances De Vane, Recording Secretary
Invocation:
Ms. Anne Rowe gave the invocation.
Minutes:
Mr Steuer asked for corrections to the minutes of the October 4, 2000 New Hanover County Board of
Health meeting. The minutes of the October 4 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
Mania S. Swart, Public Health Nurse I, Community Health
Pamela J. Horne, Clerical Specialist I, Laboratory
10 Years
Thurman Grady, Vector Control Field Operator, Vector Control
Mr. Rice introduced and welcomed the following new employees and guests:
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Grant Application Asthma Initiative ($23.000)
/VOOOD.
,.Jtfc~1t ~
Mr Steuer recommended from the Executive Committee for ihe Board of Health to accept and approve a
Grant Application Asthma Initiative in the amount of $23,000.
The purpose of the grant is to expand education and intervention services related to childhood Asthma.
New Hanover County has a viable Asthma Coalition/Trask Force and is eligible to apply for the grant.
Motion: Mr. Steuer moved from the Executive Committee for the Board of Health to accept and approve
an Asthma Initiative Grant Application in the amount of $23,000 funded by the Women's and Children's
Health Section of the Division of Public Health, North Carolina Department of Health and Human
Service and to submit the grant application to the New Hanover County Commissioners for their
consideration. Upon vote, the MOTION CARRIED UNANIMOUSLY.
School Health Nursinl! Position ($12.400)
Mr. Steuer recommended from the Executive Committee for the Board of Health to accept and approve
an additional School Health Nursing Position (50% 10 months a year) for New Hanover High School in
the amount of $12,400 funded by the New Hanover County Board of Education and to submit the budget
amendment to the New Hanover County Commissioners for their consideration.
The total budget request for $12,400 is to expand the current NHCHD School Health Program and
includes Salary/Fringe for Public Health Nurse 50% for 10-months, Uniform Allowance, and Travel and
Training.
Motion: Mr Steuer moved from the Executive Committee for the Board of Health to accept and
approve the establishment of a School Health Nurse position (50% 10 months a year) for New Hanover
High School in the amount of $12,4000 funded by the New Hanover County Board of Education and to
submit the budget request to the New Hanover County Commissioners for their consideration. Upon
vote, the MOTION CARRIED UNANIMOUSLY.
Appointment of Nominatinl! Committee
Mr. Steuer requested Mr Estep, Chairman, Nominating Committee, ~ report from the Nominating
Committee. Mr Estep submitted the following nominees for the 200 I Board of Health:
Dr Wilson O. Jewell, Chairman
Ms. Gela N. Hunter, Vice-Chairman
Mr. Steuer thanked the Nominating Committee. He advised other nominations from the floor will be
received and the officers will be elected by ballot at the December 6 Board of Health meeting.
Comments:
Board of Health Members
Use of Mobile Telephones While Operating a Motor Vehicle
Ms. Rowe reminded the Board New Hanover County collision rate is the worst in North Carolina. She
referred to a news article regarding mobile cell phone driver distractions and requested the Board of
Health be aware the problem of driver inattention.
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Mr Estep advised Virginia Beach experienced rapid growth several years ago similar to the growth New
Hanover County is experiencing. He stated the problem appears to be inadequate roads and highways
that do not accommodate our area's population growth and probably mobile telephone usage contributes
to the number of collisions. Mr. Steuer concluded there are many driver distractions other than mobile
phones and driver safety is the issue.
Health Director
Board ofHeaIth Information
Mr. Rice referred the Board to additional documents in their supplemental folders including a copy of the
Strategic Planning Priorities, an announcement of an Animal Control Services Inner City Rabies Clinic
on November 4, and two letters of appreciation written from the Board of Health to Dr Rachel Stevens,
N. C. Institute for Public Health Deputy Director, and Mr. William Hertzog, facilitator of the Strategic
Planning Retreat, for their support and assistance with the retreat.
Stratel!ic Planninl! Update
Mr. Rice exhibited a Strategic Planning Priorities poster from the Strategic Planing Retreat held on
Friday, October 6 and Saturday, October 7, 2000, at the Marriott Courtyard. Other laminated copies of
the priorities are posted in the Health Department Auditorium, on the bulletin boards, and are available to
employees for review. Retreat participant committees are addressing the identified priorities. Mr. Rice
expressed the Strategic Planning Retreat was excellent and will serve as a guideline for the health
department.
Health Directors' Lel!al Conference - October 18-19. 2000
Mr Rice stated he attended the Health Directors' Legal Conference on October 18-19 held in Chapel Hill,
N. C. The Legal Conference Agenda included various Public Health issues and legal ramifications.
Convocation of State Epidemiolol!ists - October 23. 2000
Mr. Rice gave the welcome at the Convocation of State Epidemiologists held on October 23, 2000, at the
Blockade Runner at Wrightsville Beach, N. C. State Epidemiologists from Texas to Virginia attended
the meeting. Mr. Rice reported he attended a special session on software updates for epidemiologists.
American Public Health Association Annual Meetinl! - November 10-15. 2000
Mr Rice reminded the Board he plans to attend the American Public Health Association Annual Meeting
from November 10-15, 2000, in Boston, Massachusetts. The program is resourceful and includes leading
edge issues.
NHCBH Invocation Schedule
Mr Rice distributed a Year 2000 Invocation Schedule for Board of Health regular meetings. He
requested Board members who would like to present an invocation sign and designate their date
preference on the schedule.
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Influenza Vaccine
Mr Rice advised the Health Department staff administered 2,500 doses of flu vaccine ordered from a
private vendor The general clinic is currently out influenza vaccine. The public is kept aware of the
availability of flu vaccine and may phone 343-6602 to obtain additional information.
Christmas Luncheon - December 14.2000
Mr Rice extended an invitation to Board members to plan to attend the Health Department Annual
Christmas Luncheon on December 14, 2000. Lunch is served from 11.30 a.m. - I 30p.m.
Animal Control Services Shelter Increases Residents
Mr Rice reported 68 additional animals are residents in the Animal Control Services Shelter After
investigations following citizen complaints, Animal Control Services employees collected 66 dogs and 2
cats from one residence to be housed at the shelter until court proceedings are finalized.
Other Business:
Facility Utilization and Information Technolo!!V (IT) Stratel!ic Planninl! Task Forces
Ms. Lynda F Smith, Chair, Facility Utilization Strategic Planning Task Force, announced Mr Link
volunteered to serve with seven stafImembers on the Facility Utilization Task Force. She reported Ms.
Hewett is Chair of the Information Technology (IT) Task Force. Ms. Smith stated the IT Task Force
consists of seven staff members and does have a volunteer from Board. She asked if a Board member
would like to serve on the Information Technology Task Force, they should notiJy Mr. Rice. The
Communication, Education and Marketing Strategic Planning Task Force will meet today following the
Board meeting in the Family Planning Conference Room.
Adjourn:
Mr Steuer adjourned the regular meeting of the Board of Health at 9:20 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 October 31, 2000
Summary for the New Henover County Health Department
Cumulative % 33.32% Month Reported Mon4 of 12 Oct-oO
Current Year Prior Year
Type of Budgeted Revenue Balance % Budgeted Revenue Balance %
Revenue Amount Eamed Remaining Amount Earned Remaining
Federal & State 1,391,963 302,967 1,088,996 $ 1,388,280 406,361 979,919 29.31%
AC Fees 523,044 179,829 343,215 $ 516,453 109,708 406,745 21.24%
Medicaid 941,900 66,378 875,522 $ 852,884 143,069 709,815 16.n%
Medicaid Max $ 192,301 192,301 0.00%
EH Fees $ 312,900 82,358 26.32%
Heafth Fea. $ 109,515 38,155 34.84%
Othar $ 740,172 205,451 27.76%
Nota: County Appropriation is not calculated abova. Tha County appropriation is the difference between the total amounts on tha
program axpendfture report and the totals on the program revenue report.
The budgeted amount for County Appropriation for FY 00.01 Is ($9,929,756. $4,334,680) = $5,595,078.
The expended amount for County Appropriation for this FY (year-to-date) Is ($2,788,455 . $887,2n) = $1,919,178
Revenue Summary
for Month of OCTOBER 2000
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New Hanover County Health Department
FYOO-01
MONTHLY REVENUE REPORT
As of October 31, 2000
Program:
5111
Environmental Hearth
Cumulatlva %
33.32%
Month Raported
Mon 4 of 12
Oct-OO
Current Vear Prior Vear
Type of Budgeted Revenue Balance % Budgetad Revenue Balance
Revenue Amount Earned Remaining Amount Earned Remaining
17,908 3,750 14,158 17,908
312,900 88,888 224,012 312,900
%
30.30%
26.32%
Program:
5112
Vector Control
Type of
Revenue
Current Year
Revenue Balance
Earned Remaining
%
Prior Year
Revenue Balance
Eamed Remaining
Budgeted
Amount
%
Budgeted
Amount
Program:
5114
Animal Control
Type of
Revenue
Current Year
Revenue Balance
Earned Remaining
%
Prior Year
Revenue Balance
Eamed Remaining
Budgetad
Amount
%
Budgetad
Amount
$ 179,829
Nota: County Appropriation is not figured on the individual program report. The County appropriation In each program is
the difference between the total amounts on tha program expendfture report and the totals on the program revenue report.
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For Month of OCTOBER 2000
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New Hanover County Health Department
FYOO-01
MONTHLY REVENUE REPORT
As of October 31, 2000
Program: 5121 Laboratory
Cumulative % 33.32% Month Reportad Mon40f12 Oct-OO
Current Year Prior Year
Type of Budgeted Revenue Balance % Budgetad Revenue Balance %
Revenue Amount Earned Remaining Amount Earned Remaining
Program:
5131
Administration
Type of
Revenue
Budgeted
Amount
Current Year
Revenue Balance
Earned Remaining
Prior Year
Revenue Balance
Earned Remaining
%
%
Budgeted
Amount
83,340
83,340
33.33%
Program:
5133
Child HeaRh Service Coordination
Current Year PrlorYeaf
Type of Budgeted Revenue Balance % Budgeted Revenue Balance %
Revenue Amount Earned Remaining Amount Earned Remaining
62,997 15,749 47,248 62,997 20,999 41,998
401,084 25,810 375,254 386,946 51,866 335,080
Note:County Appropriation Is not figured on the Individual program report. The County appropriation in each program is
the difference between the total amounts on the program expendRure report and the totals on the program revenue report.
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For Month of OCTOBER 2000
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New Hanover County Health Department
FYOO-01
MONTHLY REVENUE REPORT
As of October 31, 2000
Program:
Women, Infants and Children
5141
Cumulative %
33.32%
Month Reporied
Mon40f12
Oct-oo
Type of
Revenue
Current Year
Revenue Balance
Earned Remaining
Prior Yea,
Revenue Balance
Earned Remaining
%
Budge1ed
Amount
%
Budgeted
Amount
Program:
5142
Nutrition
Type of
Revenue
Current Year
Revenue Balance
Earned Remaining
Prior Vear
Revenue Balance
Earned Remaining
%
%
Budge1ed
Amount
Budge1ed
Amount
20,000
Program:
5151
Communicable Disease (Epidemiology)
Current Yea, Prior Vear
Type of Budge1ed Revenue Balance % Budgeted Revenue Balance %
Revenue Amount Earned Remaining Amount Earned Remaining
Federal & Slate 73,335 18,333 55,002 73,335 24,444 48,891
Medicaid 37,000 1,607 35,393 37,000 7,600 29,400
Medicaid Max
HeaRh Fees 19,907 25,503
Other
4
For Month of OCTOBER 2000
12
.
e
e
e
New Hanover County Health Department
FYOO-01
MONTHLY REVENUE REPORT
As of October 31, 2000
Program:
5152
Tuberculosis
Cumulative %
33.32%
Month Reported
Mon 4 0112
Od-OO
Type of
Revenue
Budgeted
Amount
Currant Year
Revenue Balance
Earned Remaining
Prior Year
Revenue Balance
Earned Remaining
%
%
Budgeted
Amount
Federal & State
Medicaid
Medicaid Max
Heatth Fees
88,756
5,200
14,746
74,010
5,200
79,556 $
4,600 $
26,610
4,072
52,946
528
Program:
5153
Teen Aids Prevention
Type of
Revenue
Budgeted
Amount
Current Year
Revenue Balance
Earned Remaining
Prior Year
Revenue Balance
Earned Remaining
%
%
Budgeted
Amount
55,000
0.19%
Program:
5154
Navigator
Currant Year
Revenue Balance
Earned Remaining
$ $ 57,344
$ $ 100,000
Prior Year
Revenue Balance
Earned Remaining
%
%
Budgeted
Amount
Note: County Appropriation Is not figured on the individual program report. The County appropriation in each program Is
the difference between the total amounts on the program expendtture report and the totals on the program revenue report.
5
For Month of OCTOBER 2000
13
e
e
e
Program:
New Hanover County Health Department
FYOO-01
MONTHLY REVENUE REPORT
As of October 31, 2000
5155 Child Care Heatth Consuttanl
Cumulative %
33.32%
Month Reported
Mon 4 of 12
Oct-OO
Type of
Revenue
Current Year
Revenue Balance
Earned Remaining
37,891
Prior Year
Revenue Balance
Earned Remaining
$
%
%
Budgeted
Amount
Program:
5156 Koman Granl
Current Year
Revenue Balance
Remaining
$
%
Budgeted
Amount
Prior Year
Revenue Balance
Remaining
$
%
Type of
Revenue
Program:
5158
Temporary Assistance for Needy Families
Type of
Revenue
Budgeted
Amount
Current Year
Revenue Balance
Earned Remaining
Prior Year
Revenue Balance
Earned Remaining
%
%
Budgeted
Amount
Program:
5159
Matemlty Care Coordination
Type of
Revenue
Budgeted
Amount
Current Year
Revenue Balance
Earned Remaining
Prior Year
Revenue Balance
Earned Remaining
%
%
Budgeted
Amount
353,094
30,900
322,194
244,892
Program:
5160
Health Check
Type of
Revenue
Budgeted
Amount
Current Year
Revenue Balance
Remaining
$ 34,134
Prior Year
Revenue Batance
Remaining
30,922
%
%
Budgeted
Amount
14
e
New Hanover County Health Department
FYOO-01
MONTHLY REVENUE REPORT
As of October 31, 2000
Program:
5161
Personal Heafth
Cumulative %
33.32%
Month Reported
Mon40f12
Oct-OO
Type of
Revenue
Budgeted
Amount
Current Year
Revenue Balance
Earned Remaining
%
Budgeted
Amount
Prior Year
Revenue Balance
Earned Remaining
%
12,501
4,292
45,179
4,197
Program 5162 Matemal Heafth
e Cunrent Year
Type of Budgetad Revenue Balance %
Revenue Amount Earned Remaining
$ 120,829 $ 30,206 $ 90,623
Budgeted
Amount
. Prlo, Year
Revenue Balance
Earned Remaining
%
$ 40,276 $ 80,553
33.33%
Program
5163
Women's Preventive Health
Type of
Revenue
Budgeted
Amount
Cunrent Yea,
Revenue Balance
Eemed Remaining
%
Budgeted
Amount
Prlo, Year
Revenue Balance
Eemed Remaining
%
e
Federal & State
Medicaid
Medicaid Max
Heafth Fees
164,380
33,198
40,922
3,635
123,458
29,563
164,360
54,800
64,251
5,902
100,129
48,898
7
For Month of OCTOBER 2000
15
e
e
e
New Hanover County Health Department
FY 00 - 01
MONTHLY REVENUE REPORT
As of October 31, 2000
Program:
5165
Breast I Cervical Cancer Control Program
Cumulative %
33.32%
Month Reported
Mon40f12
Od-OO
Type of
Revenue
Current Year
Revenue Balance
Earned Remaining
%
Prior Year
Revenue Balance
Earned Remaining
Budgetad
Amount
%
Budgetad
Amount
Program:
5166
Partnership for Children
Type of
Revenue
Current Year
Revenue Balance
Earned Remaining
%
Prior Year
Revenue Balance
Earned Remaining
Budgetad
Amount
%
Budgeted
Amount
Program: 5167 Child Heanh
Current Ye.r
Type of Budgetad Revenue Balance %
Revenue Amount Earned Remaining
Federal & State $ 102,587 $ 37,109 65,478
Medicaid $ 28,000 $ 2,250 25,750
Heatth Fees $ 2,000 $ 859 1,141
Oti1er
Prior Year
Revenue Balance
Earned Remaining
Budgetad
Amount
%
109,504 $
25,000 $
2,000
29,402
5,219
80,102
19,781
2,000
26.85%
20.88%
Note: County Appropriation is not figured on the individual program report. The County appropriation In each program is
the difference between the total amounta on the program expendtture report and the totals on tI1e program revenue report.
8
For Month of OCTOBER 2000
16
"
.
e
e
e
New Hanover County Health Department
FYOO-01
MONTHLY REVENUE REPORT
As of October 31, 2000
Program: 5169 School Heatth
Cumulative % 33.32% Month Reported Mon40112 Od-DO
Current Year Prior Year
Type 01 Budgeted Revenue Balance % Budgeted Revenue Balance %
Revenue Amount Earned Remaining Amount Earned Remaining
Program:
5172
Neurology
Type 01
Revenue
Budgeted
Amount
Current Year
Revenue Bala~ce
Earned Remaining
Prior Year
Revenue Balance
Earned Remaining
%
%
Budgeted
Amount
Program:
5174
Jail Heatth
Type 01
Revenue
Budgeted
Amount
Current Vear
Revenue Balance
Earned Remaining
Prior Year
Revenue Balance
Eerned Remaining
%
%
Budgeted
Amount
Note: County Appropriation Is not figured on the individual program report. The County appropriation in each program is
the difference between the total amounts on the program expend~ure report and the totals on the program revenue report,
9
For Month of OCTOBER 2000
17
.'
.
.
e
New Hanover County Health Department
FYOO-01
MONTHLY REVENUE REPORT
As of October 31, 2000
Program:
5178
Children's Special Heafth Servioss
Cumulative %
33,32%
Month Reported
Mon 4 01 12
Oct-OO
Type 01
Revenue
Budgeted
Amount
Current Yea,
Revenue Balance
Earned Remaining
Prior Yes,
Revenue Balance
Earned Remaining
%
%
Budgeted
Amount
Program:
5180
Risk Reduction 'Injury Prevention
Current Year PrlorYeer
e Type of Budgeted Revenue Balance % Budgeted Revenue Balance %
Revenue Amount Earned Remaining Amount Earned Remaining
15,760 18,731
e
Program:
5181
Project Assist
Type of
Revenue
Budgeted
Amount
Currant Year
Revenue Balance
Earned Remaining
Prior Year
Revenue Balance
Earned Remaining
%
%
30,404
41,633
Note: County Appropriation is not figured on the Individual program report. The County approprietlOn in each program is
the difference between the total amounts on the program expendfture report and the totals on the program revenue report.
10
For Month of OCTOBER 2000
18
,
.
e
e
e
New Hanover County Health Department
FYOO-01
MONTHLY REVENUE REPORT
As of October 31,2000
Program:
5182
Heailh Education
Cumulative %
33.32%
Month Reported
Mon4of12
Oct-oO
Type of
Revenue
Current Year
Revenue Balance
Earned Remaining
Budgeted
Amount
PriorY"r
Revenue Balance
Earned Remaining
Budgated
Amount
%
%
P,ogram:
5183
Safe Communilles
Type of
Revenue
Current Yea,
Revenue Balance
Earned Remaining
747 $ (747)
$
Budgeted
Amount
10,000
Prior Yea,
Revenue Balance %
Earned Remaining
10,000 100.00%
Budgeted
Amount
%
'I
Program:
Heafthy Carolinians
5185
Type of
Revenue
Current Yea,
Revenue Balance
Earned Remaining
$ 10,000
$
Budgeted
Amount
Prior Yea,
Revenue Balance
Earned Remaining
%
Budgeted
Amount
10,000
%
Note:County Appropriation is not figured on the individual program report. The County appropriation In each program is
the difference between the total amounts on the program expendilure report and the totals on the program ravenue report.
11
For Month of OCTOBER 2000
19
'.
<t'
.t
e
e
e
New Hanover County Health Department
FYOO-01
MONTHLY EXPENDITURE REPORT
As of OCTOBER 31, 2000
Summary fo, the New Hanove, County Health Oepartment
Cumulative %
33.32%
Month Reported
Oct.oo
Man 4 of 12:
Type of
Expenditure
CUrrent Year
Expended Balance
Amount Remaining
Prior Year
Expended Balance
Amount Remaining
%
Budgeted
Amount
%
Budgeted
Amount
Salary & Fringe
Operating
Capital Outlay
Expenditure Summary
For Month of OCTOBER 2000
20
.
t
e
e
e
New Hanover County Health Department
FYOO-01
MONTHLY EXPENDITURE REPORT
As of OCTOBER 31,2000
Program:
5111
Environmental Health
Cumulative %
33.32%
Month Reported
Oct-DO
Mon 4 of 12:
Type of
Expenditure
Budgeted
Amount
Current Year
Expended Balance
Amount Remaining
Prior Year
Expended Balance
Amount Remaining
%
%
Budgeted
Amount
Salary & Fringe
Operating
Capital Outlay
855,085
78,823
211,206
25,953
220,046
24,788
643.879
52.870
Program:
5112
Vedar Control
Type of
Expenditure
Budgeted
Amount
Current Year
Expended Balance
Amount Remaining
Prior Year
Expended Balance
Amount Remaining
%
%
Budgeted
Amount
Program:
5114
Animal Control
Type of
Expenditure
Budgeted
Amount
Current Year
Expended Balance
Amount Remaining
Prior Year
Expended Balance
Amount Remaining
%
%
Budgeted
Amount
Salary & Fringe
Operating
Capital Outlay
2
For Month of OCTOBER 2000
21
..
.
e
e
e
Program:
Cumulative %
Type of
Expenditure
Budgeted
Amount
Salary & Fringe
Operating
Capitai Outlay
312,974
75,383
Program:
Type of
Expenditure
Budgeted
Amount
Program:
Type of
Expenditure
Budgeted
Amount
Program:
Type of
Expenditure
Budgeted
Amount
Salary & Fringe
Operating
Capital Outlay
439,321
24,740
New Hanover County Health Department
FYOO-01
MONTHLY EXPENDITURE REPORT
As of OCTOBER 31, 2000
5121
Laboratory
33.32%
Month Reported
Oct-DO
Mon 4 of 12:
Current Vear
Expended Balance
Amount Remaining
PriorVear
Expended Balance
Amount Remaining
%
%
Budgeted
Amount
92,926
20,670
303,201
66,606
91,922
23,070
211,279
43,536
30.32%
34.64%
220,048
54,713
5131
Administration
Current Vear
Expended Balance
Amount Remaining
Prior Year
Expended Balance
Amount Remaining
%
%
Budgeted
Amount
5132
Board Members
Current Vear
Expended Balance
Amount Remaining
Prior Year
%
Budgeted
Amount
Expended
Amount
Balance
Remaining
%
5133
Child Heaith Service Coordination
Current Year
Expended Balance
Amount Remaining
Prior Year
Expended Balance
Amount Remaining
%
%
Budgeted
Amount
116,946
10,804
304,872
20,993
322,375
13,936
3
For Month of OCTOBER 2000
22
-,
.'
e
e
e
New Hanover County Health Department
FY 00 - 01
MONTHLY EXPENDITURE REPORT
As of OCTOBER 31, 2000
Program:
5141
Women, Infants and Children
Cumulative %
33.32%
Month Reported
Mon4of12:
Oct-OO
Current Year Prior Vear
Type of Budgeted Expended Balance % Budgeted Expended Balance %
Expenditure Amount Amount Remaining Amount Amount Remaining
Salary & Fringe 298,267 92,248 206,019 330,982 96,187 234,795
Operating 37,322 10,429 26,893 34,430 12,440 21,GGO
Capital Outlay
Program:
5142
Nutrition
Type of
Expenditure
Budgeted
Amount
Current Year
Expended Balance
Amount Remaining
Prior Year
Expended Balance
Amount Remaining
%
%
Budgeted
Amount
Salary & Fringe
Operating
Capital Outlay
64,471
3,550
22,461
336
62,010
3,214
79,001
3,550
21,460
975
57,541
2,575
Program:
5t51
Communable Disease (Epidemiology)
Type of
Expenditure
Budgeted
Amount
Current Year
Expended Balance
Amount Remaining
Prior Vear
Expended Balance
Amount Remaining
%
%
Budgeted
Amount
Salary & Fringe
Operating
CapHal Outlay
269,158
39,587
4
For Month of OCTOBER 2000
23
e
e
e
Program:
New Hanover County Health Department
FYOO-01
MONTHLY EXPENDITURE REPORT
As of OCTOBER 31, 2000
5152 Tuberculosis
Cumulative %
33.32%
Month Reported
Mon 4 of 12:
Oc\-OO
Type of
Expenditure
Budgeted
Amount
Current Year
Expended Balance
Amount Remaining
Prior Year
Expended Balance
Amount Remaining
%
%
Budgeted
Amount
Salary & Fringe
Operating
Capi1al Outlay
54,649
11,523
186,855 $
39,139 $
52,004
6,239
134,851
32,900
Program:
5153
Teen Aids Prevention
Type of
Expenditure
Budgeted
Amount
Current Year
Expended Balance
Amount Remaining
Prior Year
Expended Balance
Amount Remaining
%
%
Budgeted
Amount
Program:
5154
Navigator
Type of
Expenditure
Budgeted
Amount
Current Year
Expended Balance
Amount Remaining
Prior Year
Expended Balance
Amount Remaining
%
%
Budgeted
Amount
11,076
6,465
Program:
5155
Child Care Heailh Consuilanl
Type of
Expenditure
Budgeted
Amount
Current Year
Expended Balance
Amount Remaining
Prior Year
Expended Balance
Amount Remaining
%
%
Budgeted
Amount
Salary & Fringe
Operating
Capitel
$
$
$
$
0,00%
0.00%
5
For Month of OCTOBER 2000
24
.
e
e
Program:
New Hanover County Health Department
FYOO-01
MONTHLY EXPENDITURE REPORT
As of OCTOBER 31, 2000
5156 Koman Grant
Cumulative %
33.32%
Month Reported
Moo 4 of 12:
Oct-oO
Type of
Expenditure
Budgeted
Amount
Current Year
Expended Balance
Amount Remaining
Prior Vear
Expended Balance
Amount Remaining
%
%
Budgeted
Amount
Program:
5160
Heanh Checl<
Type of
Expenditure
Budgetad
Amount
Current Vear
Expendad Balance
Amount Remaining
PrlorYesr
Expended Balance
Amount Remaining
%
%
Budgated
Amount
Salary & Fringe
Operating
Capnal Outlay
27,515
10,715
4,693
4,659
22,822
6,056
29,437
5,502
9,681
190
19,756
5,312
6
For Month of OCTOBER 2000
25
.'
I .'
e
New Hanover County Health Department
FYOO-01
MONTHLY EXPENDITURE REPORT
As of OCTOBER 31,2000
Program: 5161 Personal Hea~h
Cumulative % 33.32%
Current Year
Typa of Budgeted Expanded Balance %
Expandlture Amount Amount Remaining
Salary & Fringe 326,334 196,906 129,428
Oparatin9 58,016 6,608 51,410
Capital Outlay
Mon 4 ol12:
Oct-oO
Month Reported
Prior Year
Expanded Balance
Amount Remaining
%
Budgeted
Amount
431,627
52,750
203,144
8,129
228,483
44,621
Program
5162
Matemal Hea~h
Current Yea, Prior Year
e Typa of Budgeted Expanded Balance % Budgeted Expanded Balance %
Expandlture Amount Amount Remaining Amount Amount Remaining
254,786 62,884 191,882 243,276 71,230 172,046
31,045 4,968 26,077 29,680 8,890 20,790
e
Program
5163
Women's Preventive Health
Typa of
Expenditure
Budgeted
Amount
Current Year
Expanded Balance
Amount Remaining
Prior Year
Expanded Balance
Amount Remaining
%
%
Budgeted
Amount
Salary & Fringe
Oparating
Capital Outlay
494,554
127,865
139,234
24,939
355,320
102,726
148,962
24,412
7
For Month of OCTOBER 2000
26
~
,
e
e
e
New Hanover County Health Department
FYOO-01
MONTHLY EXPENDITURE REPORT
As of OCTOBER 31, 2000
Program:
5165
Breast I Cervical Cancer Control Program
Cumulative %
33.32%
Month Reported
Man 4 of 12:
Od-OO
Type of
Expenditure
Budgeted
Amount
Current Year
Expended Balance
Amount Remaining
Prior Yea,
Expended Balance
Amount Remaining
%
%
Budgeted
Amount
Salary & Fringe
Operating
Capital Outlay
12,000
13,542
12,000
13,389
2,248
Program:
5186
Partnership for Children
Type of
Expenditure
BUdgeted
Amount
Current Year
Expended Balance
Amount Remaining
Prior Year
Expended Balance
Amount Remaining
%
%
Budgeted
Amount
113,403
10,037
33,768
1,441
79,635
8,596
88,800
6,200
24,287
1,496
84,513
4,704
Program:
5167
Child Heatth
Type of
Expenditure
Budgeted
Amount
Current Year
Expended Balance
Amount Remaining
Prior Year
Expended Balance
Amount Remaining
%
%
Budgeted
Amount
Salary & Fringe
Operating
Capital Outlay
295,383
35,826
84,403
6,309
210,980
29,517
79,084
12,944
8
For Month of OCTOBER 2000
27
I .
e
e
e
New Hanover County Health Department
FY 00 -01
MONTHLY EXPENDITURE REPORT
As of OCTOBER 31, 2000
Program: 5168 Dental Heafth
Cumulative % 33.32%
Current Year
Type of Budgeted Expended Balance %
Expenditure Amount Amount Remaining
Salary & Fringe 37,801 11,208 26,593
Operating 6,058 1,870 4,188
Capftal Outlay
Mon4of12:
Ocl-OO
Month Reported
Prior Year
Expended Balance
Amount Remaining
%
Budgeted
Amount
35,659
6,058
10,686
1,489
24,973
4,569
Program:
5169 SchoolHeallh
Type of
Expenditure
Budgeted
Amount
Current Year
Expended Balance
Amount Remaining
Prior Year
Expended Balance
Amount Remaining
%
%
Budgeted
Amount
Salary & Fringe
Operating
Capftal Outlay
312,263
44,116
73,896
10,218
238,367
33,898
Program:
5172 Neurology
Type of
Expenditure
Budgeted
Amount
Current Year
Expended Balance
Amount Remaining
Prior Year
Expended Balance
Amount Remaining
%
%
Budgeted
Amount
Salary & Fringe
Operating
Cepftal Outlay
16,466
9
For Month of OCTOBER 2000
2'8
",
",
e
e
e
New Hanover County Health Department
FY 00 - 01
MONTHLY EXPENDITURE REPORT
As of OCTOBER 31, 2000
Program:
5174
Jail Heafth
Cumulative %
33.32%
Month Reported
Oct-oO
Moo 4 of 12:
Type of
Expenditure
Budgeted
Amount
Current Year
Expended Balance
Amount Remaining
Prior Year
Expended Balanca
Amount Remaining
%
%
Budgeted
Amount
362,448
246,484
105,892
44,562
256,556
201,922
228,095
131,727
Program:
5178
Children Special Heafth Services
Type of
Expenditure
Budgeted
Amount
Current Year
Expended Balance
Amount RemainIng
Prior Year
Expended Balance
Amount Remaining
%
%
Budgeted
Amount
Salary & Fringe
Operating
Capital Outlay
16,803
3,946
1,993
540
t4,810
3,406
6,077
3,946
4,262
2,308
Program:
5t80
Risk Reduction
Type 01
Expenditure
Budgeted
Amount
Current Year
Expended Balance
Amount Remaining
Prior Vear
Expended Balance
Amount Remaining
%
%
Budgeted
Amount
Salary & Fringe
Operating
Capital Outlay
39,516
7,610
11,807
600
27,709
7,010
37,252
8,650
26,730
7,585
10
For Month of OCTOBER 2000
29
..
..
e
e
e
New Hanover County Health Department
FYOO-01
MONTHLY EXPENDITURE REPORT
As of OCTOBER 31, 2000._
Program: 5181 Project Assist
Cumulative % 33.32%
Current Year
Type of Budgated Expended Balance %
Expenditure Amount Amount Remaining
Salary & Fringe 33,884 10,352 23,532
Operating 9,749 1,147 8,602
CapUal Outlay
Month Reported
Budgeted
Amount
37,252
12,246
Program:
5182
Hea~h Education
Type of
Expenditure
Current Year
Expended Balance
Amount Remaining
Budgated
Amount
Budgated
Amount
%
Salary & Fringe
Operating
CapUal Outlay
80,112
24,046
23,057
5,659
57,055
18,387
Program:
Safe Communities
5183
Type of
Expenditure
Current Year
Expended Balance
Amount Remaining
Budgeted
Amount
%
Budgeted
Amount
Program:
Hea~hy Carolinians
5185
Type of
Expenditure
Current Year
Expendad Balanca
Amount Remaining
Budgated
Amount
%
Budgated
Amount
11
For Month of OCTOBER 2000
Moo 4 of 12:
Od-QO
Prior Year
Expended Balance
Amount. Remaining
%
10,580
1,429
26,672
10,817
Prior Vear
Expended Balance
Amount Remaining
%
25,288
5,798
56,934
15,052
Prior Year
Expended Balance
Amount Remaining
%
6,100
Prior Year
Expended Balance
Amount Remaining
%
3.0
~
e
e
e
NEW HANOVER COUNTY HEALTH DEPARTMENT
BOARD OF HEALTH (BOH) APPROVED
GRANT APPLICATION STATUS
12/1/99
Child Health Consultant Grant- UNC Dept
of Maternal and Child Health- Contract with
NC Dept of Health and Human Services,
Division of Women and Children's Health
$18,935
11/3/99
Healthy Carolinians Task Force- NC
Office of Health Carolinians (FROZEN
Operation Reach Women- Susan G.
Komen, Breast Cancer Foundation
North Carolina Chilhood Asthma
Initiative- NC Dept of Health and Human
Services, Women and Children's Health
Section FROZEN
$19,822
$10,000
$10,000
$19,822
9/1/99
School Health Lice Grant- Carolina Power
and Light Company Corporate Contributions
Fund
Growing Up Buckled Up- National
Highway Traffic Safety Administration
Cooperative Agreement
$54,730
$4,900
$4,900
9/1/99
Model Community Assessment Grant-
North Carelia Community Health Initiative-
Healthy Carolinians- Center for Disease
Control and Prevention
Diabetes Today Community Planning
Initiative-NC Dept of Health and Human
Services - Diabetes Prevention and Control
Unit
$17,375
$17,375
$24,692
$24,692
$50,700 $35,000 $15,700
.U$2jlld2$11111$QllJ$~~;at.ll$II22;IlUt
As of 11/20/00
. Notification received since last report.
31
NEW HANQVER COUNTY HEALTH DEPARTMENT
BOARD OF HEALTH (BOH) APPROVED
GRANT APPLICATION STATUS
eQat~l
Smart Start applying for Cape Fear
8/2/00 Memorial Foundation Grant (MOW) $52,000 $50,000 $2,000
Enhanced Counseling Program- Z. Smith *
Reynolds Foundation $48,000 $48,000
e Teen Aids Prevention- Z. Smith Reynolds *
Foundation
March Toward TB Elimination- NC Dept
7/12/00 of Health and Human Services (DHHS) $10,000 $7,200 $2,800
Cape Fear Memorial Foundation (TAP $20,000
Pro ram 2 ear re uest $55,000 er ear $55,000 $35,000
Diabetes Today - DHHS Division of Public
Health
Servicios Para Ninos-Rahab Therapy
617100 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
e
;P~iifdjij l;R~iHY~ WP,ijl~diJ
Cape Fear Memorial Foundation-Lice
Eradication Program
$5,000
$5,000
10/4/00
Healthy Carolinians- Office of Healthy
Carolinians, Division of Public Health, North
Carolina De of Health & Human Services
March of Dimes- March of Dimes Birth
Defects Foundation Eastern Carolina
Chapter
$10,000
$10,000
4/5/00
MOW Services (Infant Mortality)-NC
Healthy Start Grant Application (2yr Grant:
$85,000 r 1 and $43,845 yr 2)
Skin Cancer Screening- NC Advisory
Committee on Cancer Coordination and
Control
$128,845
$128,845
As of 11/20/00
. Notification received since last report.
3'2
.
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New Hanover County Health Department
Final Revenue and Expenditure Summaries for FY 99 - 00
--- ---------.
Revenues
Cumulative % 100.00% Month Reported Mon 12 of 12 Jun-OO
Current Year Prior Year
Type of Budgeted Revenue Balance % Budgeted Revenue Balance %
Revenue Amount Earned Remaining Amount Earned Remaining
Federa' & State $ 1,394,968 $ 1,324,619 70,349 94.96% $1,3n,269 $ 1,354,279 22,990 98.33%
AC Fee. $ 516,453 $ 441,964 74,489 85.58% $ 493,100 $ 381 ,906 111,194 n45%
Medicaid $ 801,504 $ 757,447 44,057 94.50% $ 824,754 $ 723,773 100,981 87.76%
Medicaid Max $ 366,891 $ 366,891 100.00% $ 401,769 $ 209,467 192,302 52.14%
EH Fee. $ 312,900 $ 306,470 97.95% $ 243,100 $ 299,857 (56,757) 123.35%
Health Fees $ 109,515 $ 135,667 123.88% $ 96,065 $ 101,178 (3,113) 103.17%
Other $ n6,172 $ 791,643 101.99% $ 574,957 $ 628,832 (53,875) 109.37%
Expenditures
Cumulative %
Month Reported
Man 12 of 12: Jun-OO
100.00%
Type of
Expenditure
CUrrent Year
Expended Balance
Amount Remaining
Budgeted
Amount
Prior Year
Expended Balance
Amount Remaining
Budgeted
Amount
%
%
Summary
BUDGETED ACTUAL DIFFERENCE
FY99-00 FY 99-00 FY 99-00
EXPENDITURES:
SALARIES & BENEFITS $7,208,637 $7,107,403 $101,234
OPERATING EXPENSES $1,716,581 $1,526,907 $189,674
CAPITAL OUTLAY $778,115 $583,897 $194,218
TOTAL EXPENDITURES $9,703,333 $9,218,207 $485,126
REVENUE. $4,278,403 $4,124,701 $153,702
NET COUNTY $$
$5,424,930
$5,093,506
$331,424
As of 11120/00
33
,
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New Hanover County Health Department
FY99-00
FINAL REVENUE REPORT
As of 11/16/00
Summary for the New Hanover County Health Department
Cumulative % 100.00% Month Reported Man 12 of 12 Jun-OO
Current Year Prior Year
Type of Budgeted Revenue Balance % Budgeted Revenue Balance %
Revenue Amount Earned Remaining Amount Earned Remaining
Federal & State 1,394,968 1,324,619 70,349 94.96% 1,377,269 1,354,279 22,990 98.33%
ACFees 516,453 441,964 74,489 85.58% 493,100 381,906 tl1,194 7745%
Medicaid 801,504 757,447 44,057 94.50% 624,754 723,773 100,981 87,76'1(,
Medicaid Max 366,891 366,891 100.00% 401,769 209,467 192,302 52,14%
EH Fees 312,900 306,470 97.95% 243,100 299,857 (58,757) 123,35%
Health Fees 109,515 135,667 123.88% 98,085 101,178 (3,113) 103.17%
other 776,ln 791 ,643 101.99% 574,957 628,832 (53,875) 109.37%
Note: County Approprtation is not calculated above. The County approprtation 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 99 - 00 Is ($9,703,333 - $4,278,403) = $5,424,930.
The expended amount for County Appropriation for this FY (year-tCHlate) Is ($9,218,207 - $4,1224,701) = $5,003,506.
Final Revenue Summary
For FY 99 - 00
34
e
New Hanover County Health Department
FY99-00
FINAL REVENUE REPORT
As of 11/16/00
,
Program:
5111
Environmental HeaRh
Cumulative %
100.00%
Month Reported
Mon 12 of 12
Jun-OO
Current Year Prior Year
Type of Budgeted Revenue Balance % Budgeted Revenue Balance %
Revenue Amount Earned Remaining Amount Earned Remaining
17,908 17,708 18,230 (522) 102.95%
312,900 243,100 299,857 (56,757) 123.35%
Program: 5112 Vector Control
e Current Vear Prior Vear
Type of Budgeted Revenue Balance % Budgeted Revenue Balance %
Revenue Amount Earned Remaining Amount Earned Remaining
Program:
5114
Animal Control
Type of
Revenue
Budgeted
Amount
Current Year
Revenue Balance
Earned Remaining
%
Budgeted
Amount
Prior Vesr
Revenue Balance
Earned Remaining
%
e
Note: County Appropriation is not figunsd on the individual program report. The County appropriation In each program is
the difference between the total amounts on the program expenditure report and the totals on the program revenue report.
2
For FY 99 - 00
35
e
New Hanover County Health Department
FY99-00
FINAL REVENUE REPORT
As of 11/16/00
Program: 5121 Laboratory
Cumuletlve % 100.00% Month Reported Mon 12 of 12 Jun-OO
Current Year Prior Year
Type of Budgeted Revenue Balance % Budgeted Revenue Balance %
Revenue Amount Eerned Remaining Amount Earned Remaining
Program:
5131
Administration
Current Vesr PriorVesr
e Type of Budgeted Revenue Balance % Budgeted Revenue Balance %
Revenue Amount Earned Remaining Amount Earned Remaining
83,340 83,340 100.00%
e
Program:
5133
Child HeaRh SelVioe Coordination
Type of
Revenue
Budgeted
Amount
Current Year
Revenue Balance
Earned Remaining
PriorVesr
Revenue Balance
Earned Remaining
%
%
62,997
302,248
62,997
276,753
Note:County Appropriation Is not figured on the individual program report. The County appropriation In each program Is
the difference between the total amounts on the program expendRure report and the totals on the program revenue report.
3
For FY 99 - 00
36
e
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New Hanover County Health Department
FY99-00
FINAL REVENUE REPORT
As of 11/16/00
Program:
5141
Women, Infants and Children
Cumulative %
100.00%
Month Reported
Mon 12 of 12
Jun.oO
Type of
Revenue
Current Year
Budgeted Revenue Balance
Amount Earned Remaining
Prior Year
Budgetad Revenue Balance
Amount Earned Remaining
%
%
Program:
5142
Nutrition
Type of
Revenue
Budge!ad
Amount
Current Year
Revenue Balance
Earned Remaining
Prior Year
Revenue Balance
Earned Remaining
%
%
Budgetad
Amount
20,000
Program:
5151
Communicable Disease (Epidemiology)
Type of
Revenue
Budgetad
Amount
Current Year
Revenue Balance
Earned Remaining
Prior Year
Revenue Balance
Earned Remaining
%
%
Budgetad
Amount
Federal & SIaIa
Medicaid
Medicaid Max
Hea~h Fees
Other
100.00%
70.80%
100.00%
118.67%
102.10%
12,557
4
For FY 99 - 00
37
e
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New Hanover County Health Department
FY99-00
FINAL REVENUE REPORT
As of 11/16/00
Program:
5152
Tuberculosis
Cumulative %
100.00%
Month Reported
Mon 12 of 12
JuO-OO
Type of
Revenue
Budgated
Amount
Current Year
Revenue Balance
Earned Remaining
Prior Year
Revenue Balance
Earned Remaining
%
%
Budgeted
Amount
Federal & State
Medicaid
Medicaid Max
Hea~h Fees
(275)
(10,864)
Program:
5153
Teen Aids Prevention
Type of
Revenue
Budgated
Amount
Current Year
Revenue Balance
Earned Remaining
Prior Year
Revenue Balance
Earned Remaining
%
%
Budgated
Amount
32,000
30799
1.201
96.25%
Program:
5154
Intensive Home Visitation
Type of
Revenue
Budgeted
Amount
Current Year
Revenue Balance
Earned Remaining
Prior Year
Revenue Balance
Earned Remaining
%
%
Budgated
Amount
Note: County Appropriation Is not figured on the individual program report. The County appropriation in each program is
the difference between the totalamounls on the program expendfture report and the totals on the program revenue report.
5
For FY 99 - 00
38
e
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P,ogram:
New Hanover County Health Department
FY99-00
FINAL REVENUE REPORT
As of 11/16/00
5155 Child Care Hea~h Consultant
Cumulative %
100.00%
Month Reported
Man 12 of 12
Jun.QO
Type of
Revenue
Current Yea'
Revenue Balance
Remaining
$ 15,535
Prlo, Yea,
Revenue Balance
Earned Remaining
$
%
Budgeted
Amount
%
Budgeted
Amount
P,ogram: 5156 Komen Grant
Current Year Prlo' Yea,
Type of Revenue Balance % Budgeted Revenue Balance %
Revenue Earned Remaining Amount Earned Remaining
$ 15,239 $
Program:
5158
Temporary Assistance for Needy Families
Type of
Revenue
Current Yea'
Revenue Balance
Earned Remaining
Prlo, Yea,
Revenue Balance
Earned Remaining
%
Budgeted
Amount
%
Budgeted
Amount
Program:
5159
Matemlty Care Coordination
Type of
Revenue
Budgeted
Amount
Current Yea'
Revenue Balance
Earned Remaining
Prlo' Yea,
Revenue Balance
Earned Remaining
%
%
Budgeted
Amount
Program:
5160
Hea~h Check
Type of
Revenue
Budgeted
Amount
Current Yea,
Revenue Balance
Remaining
$ 1
Prior Yea,
Revenue Balance
Remelnlng
$ 433
%
%
Budgeted
Amount
39
:
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New Hanover County Health Department
FY99-00
FINAL REVENUE REPORT
As of 11/16/00
Program: 5161 Personal Health
Cumulative % 100.00%
Current Year
Type of Budgeted Revenue Balance %
Revenue Amount Eamed Remaining
Mon 120f12
Jun-oO
Month Reported
Prior Year
Revenue Balance
Earned Remaining
%
Budgeted
Amount
49,538 $
5,665 $
7,590
1,693
64.68%
70.11%
41.948
3.972
Program
5162
Matemal Heanh
Type of
Revenue
Budgeted
Amount
Cunrent Year
Revenue Balance
Earned Remaining
Prior Year
Revenue Balance
Earned Remaining
%
%
Budgeted
Amount
$ 120.829 $ 120,829 $
Program
5163
Women's Preventive Health
Type of
Revenue
Budgeted
Amount
Current Year
Revenue Balance
Earned Remaining
Prior Year
Revenue Balance
Earned Remaining
%
%
Budgeted
Amount
Federal & Stele
Medicaid
Medicaid Max
Heanh Fees
7
For FY 99 - 00
40
..
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New Hanover County Health Department
FY 99 -00
FINAL REVENUE REPORT
As of 11116100
Program:
5165
Breast I Cervical Cancer Control Program
Cumulative %
100.00%
Month Reported
Mon 12 of 12
Jun-QO
Type of
Revenue
Budgeted
Amount
Current Year
Revenue Balance
Earned Remaining
Prio,Year
Revenue Balance
Earned Remaining
%
%
Budgeted
Amount
Program:
5166
Partnership for Children
Type of
Revenue
Budgeted
Amount
Current Year
Revenue Balance
Earned Remaining
Prio' Yea,
Revenue Balance
Eerned Remaining
%
%
Budgeted
Amount
Program: 5167 Child Hea~h
Current Year
Type of Budgeted Revenue Balance %
Revenue Amount Earned Remaining
Federal & State $ 109,504 $ 107,461 2,043
Medicaid $ 25,000 $ 23,578 1,422
Hea~ Fees $ 2,000 $ 177 1,823
Other
Prior Year
Revenue Balance
Earned Remaining
%
Budgeted
Amount
93,393 $
25,000 $
95,187
28,015
(1,794)
(3,015)
101.92%
112.06%
Note: County Appropriation is not flQurad on the Individual program report. The County appropriation In each program la
the difference between the total amounts on the program expendrture report and the totals on the program revenue report.
8
For FY 99 - '00
41
:
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New Hanover County Health Department
FY99-00
FINAL REVENUE REPORT
As of 11116100
Program: 5169 School Heatth
Cumulativa % 100.00% Month Reported Mon 12 of 12 Jun-oO
Current Year Prior Year
Type of Budgeted Revenue Balance % Budgeted Revenue Balance %
Revenue Amount Earnad Remaining Amount Earnad Remaining
Program:
5172
Neurology
Type of
Revenue
Budgeted
Amount
Current Year
Revenue Balance
Earned Remaining
Prior Year
Revenue Balance
Earned Remaining
%
%
Budgated
Amount
Program:
5174
Jail Hearth
Type of
Revenue
Budgated
Amount
Current Year
Revenue Balance
Earned Remaining
Prior Year
Revenue Balance
Earned Remaining
%
%
Budgeted
Amount
Note: County Appropriation is not figured on the Individual program report. The County appropriation In each program Is
the diflarence between the total amounts on the program expendrture report and the totals on the program revenue report.
9
For FY 99-00
41
:
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New Hanover County Health Department
FY99-00
FINAL REVENUE REPORT
As of 11116100
Program:
5178
Children's Special Heafth Services
Cumulative %
100.00%
Month Reported
Mon 12 of 12
Jun-QO
Type of
Revenue
Budgeted
Amount
Current Year
Revenue Balance
Earned Remaining
Prior Year
Revenue Balance
Earned Remaining
%
%
Budgeted
Amount
Program:
5180
Risk Reduction I Injury Prevention
Type of
Revenue
Budgeted
Amount
Current Year
Revenue Balance
Earned Remaining
Prior Year
Revenue Balance
Earned Remaining
%
%
Budgeted
Amount
21,014
100.00%
Program:
5181
Project Assist
Type of
Revenue
Budgeted
Amount
Current Year
Revenue Balance
Earned Remaining
Prior Year
Revenue Balance
Earned Remaining
%
%
Budgeted
Amount
$ 41,633 $ 38,154
3,479
Note: County Appropriation is not fogured on the individual program report. The County appropriation in each program is
the difference between the total amounts on the program expendtture report and the tolals on the program revenue report.
10
For FY 99 - 00
43
.
.
Ie
e
e
Program:
Cumulative %
Type of
Revenue
Budgeted
Amount
Program:
Type of
Revenue
Budgeted
Amount
10,000
1,000
New Hanover County Health Department
FY99-00
FINAL REVENUE REPORT
As of 11/16/00
5182
Heatth Education
100.00%
Man 12 of 12
Jun.QO
Month Reported
Current Year
Revenue Balance
Earned Remaining
Prior Year
Revenue Balance
Earned Remaining
%
%
Budgeted
Amount
5183
Safe Communities
Current Year
Revenue Balance
Remaining
746
Prior Year
Revenue Balance
Earned Remaining
%
%
Budgeted
Amount
Note:County Appropriation is not figured on the individual program report. The County appropriation in each program is
the difference between the totel emounts on the program expendijure report and the totals on the program revenue report.
11
For FY 99 -00
44
.j.
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4
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New Hanover County Health Department
FY99-00
FINAL EXPENDITURE REPORT
As of 11/16/00
Summary for the New Hanover County Health Department
Cumulative %
100.00% Month Reported Man 12 of 12: Jun-oO
Current Year Prior Year
Expanded Balance % Budgeted Expanded Balance %
Amount Remaining Amount Amount Remaining
Typa of
Expandlture
Budgeted
Amount
Salary & Fringe
OparaUng
Capital Outlay
Final Expenditure Summary
For FY 99 -00
45
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New Hanover County Health Department
FY99-00
FINAL EXPENDITURE REPORT
As of 11/16/00
Program:
5111
Environmental Health
Cumulative %
100.00%
Month Reported
Mon 12 0112:
Jun-OO
Type 01
Expenditure
Budgeted
Amount
Current Year
Expended Balance
Amount Remaining
Prior Year
Expended Balance
Amount Remaining
%
%
Budgeted
Amount
5,282
3,181
669,905
68,836
671,459
68,803
(1,554) 100.23%
33 99.95%
Program:
5112
Vedor Control
Type 01
Expenditure
Budgeted
Amount
Current Year
Expended Balance
Amount Remaining
Prior Year
Expended Balance
Amount Remaining
%
%
Budgeted
Amount
(5,987)
2,047
11
Program:
5114
Animal Control
Type 01
Expenditure
Budgeted
Amount
Current Year
Expended Balance
Amount Remaining
Prior Year
Expended Balance
Amount Remaining
%
%
Budgeted
Amount
Salary & Fringe
Operating
Capital Outlay
2
For FY 99 - 00
46
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New Hanover County Health Department
FY99-00
FINAL EXPENDITURE REPORT
As of 11/16/00
Program:
5121
Laboratory
Cumulative %
100.00%
Month Reported
Mon 12 of 12:
Jun-QO
Type of
Expenditure
Budgeted
Amount
Current Year
Expended Balance
Amount Remaining
Prior Year
Expended Balance
Amount Remaining
%
%
Budgeted
Amount
Salary & Fringe
Operatin9
Capital Outlay
297,201
66,606
293,176
65,527
292,471
62,080
292,397
61,632
74
448
99.97%
99.28%
4,025
1,079
Program:
5131
Administration
Type of
Expenditure
Budgeted
Amount
Current Year
Expended Balance
Amount Remaining
Prior Year
Expended Balance
Amount Remaining
%
%
Budgeted
Amount
Salary & Fringe
Operating
Capital Outlay
Program:
5132
Board Members
Type of
Expenditure
Budgeted
Amount
Current Yea,
Expended Balance
Amount Remaining
PriorYesr
Expended Balance
Amount Remaining
%
%
Budgeted
Amount
Program:
5133
Chikt Health Service Coordination
Type of
Expenditure
Budgeted
Amount
Current Year
Expended Balance
Amount Remaining
Prior Year
Expended Balance
Amount Remaining
'10
%
Budgeted
Amount
Salary & Fringe
Operating
Capital Outlay
(553)
(53)
387,989
21,946
3
For FY 99 - 00
47
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New Hanover County Health Department
FY99.00
FINAL EXPENDITURE REPORT
As of 11/16/00
Program:
5141
Women, Infants and Children
Cumulative %
100.00%
Month Reported
Mon 12 of 12:
Jun-QO
Type of
Expenditure
Budgeted
Amount
Current Year
Expended Balance
Amount Remaining
PriorYesr
Expended Balance
Amount Remaining
%
%
Budgeted
Amount
Salary & Fringe
Operating
Capilal Outlay
321,518
40,484
322,889
40,251
(1,371)
233
Program:
5142
Nutrition
Type of
Expenditure
Budgeted
Amount
Current Year
Expended Balance
Amount Remaining
Prior Year
Expended Balance
Amount Remaining
%
%
Budgeted
Amount
74,001
3,550
73,236
1,625
765
1,925
Program:
5151
Communicable Disease (Epidemiology)
Type of
Expenditure
Budgeted
Amount
Current Year
Expended Balance
Amount Remaining
Prior Year
Expended Balance
Amount Remaining
%
%
Budgeted
Amount
Salary & Fringe
Operating
Capftal Outiay
4
For FY 99 - 00
48
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New Hanover County Health Department
FY99.00
FINAL EXPENDITURE REPORT
As of 11/16/00
Program:
5152 Tuberculosis
Cumulative %
100.00%
Montih Reported
Mon 12 of 12:
Jun-oo
Type of
Expenditure
Budgeted
Amount
Currenl Yea,
Expended Balance
Amount Remaining
Prlo' Yea'
Expended Balance
Amount Remaining
%
%
Budgeted
Amount
181,855
39,973
178,417
39,602
146,880 $ 148,299
36,509 $ 36,449
(1,419)
60
3,438
371
Program:
5153
Teen Aids Prevention
Type of
Expenditure
Budgeted
Amount
Current Year
Expended Balance
Amount Remaining
Prior Year
Expended Balance
Amount Remaining
%
%
Budgeted
Amount
Salal}' & Fringe
Operating
Capital Outlay
33,790
1,630
23,147
1,630
10,843
16,499
12,501
92
0.00%
Program:
5154
Intensive Home Visitation
Type of
Expenditure
Budgeted
Amount
Current Year
Expended Balance
Amount Remaining
Prlo,Year
Expended Balance
Amount Remaining
%
%
Budgeted
Amount
3,661
222
Program:
5155
Child Care Health Consultant
Type of
Expenditure
Budgeted
Amount
Current Year
Expended Balance
Amounl Remaining
Prior Yea'
Expended Balance
Amount Remaining
%
%
Budgeted
Amount
5
For FY 99 - 00
49
I
I .
e
New Hanover County Health Department
FY99-00
FINAL EXPENDITURE REPORT
As of 11/16/00
Program:
5156
Komen Grant
Cumulative %
100.00%
Month Reported
Mon 12 of 12:
Jun-OO
Type of
Expenditure
Budgeted
Amount
Current Year
Expended Balance
Amount Remaining
Prior Year
Expended Balanca
Amount Remaining
%
%
Budgeted
Amount
Program: 5158 Temporary Assistance to Needy Families
Current Year Prior Year
Type of Budgeted Expended Balance % Budgeted Expended Balance %
Expenditure Amount Amount Remaining Amount Amount Remaining
25,175 16,880 8,295 1,700 1,700
11,264 8,453 2,811 24,674 20,597 4,077
e
Program: 5159 Matemity Care Coordination
Current Year Prior Year
Type of Budgeted Expended Balance % Budgeted Expended Balance %
Expenditure Amount Amount Remaining Amount Amount Remaining
310,099 308,740 1,359 279,294 285,162 (5,668)
7,158 7,124 34 7,490 7,394 96
Program: 5160 Heatth Check
Current Year
Type of Budgeted Expended Balance %
Expenditure Amount Amount Remaining
Salary & Fringe 28,337 28,170 167
e Operatin9 8,102 6,430 1,672
Capital OuUay
Budgeted
Amount
Prior Year
Expended Balance
Amount Remaining
%
26,964
3,830
28,502
3,497
(1,538)
333
6
For FY 99 - 00
50
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New Hanover County Health Department
FY99-00
F.INAL EXPENDITURE REPORT
As of 11/16/00
Program: 5161 Personal Health
Cumulative % 100.00%
Current Year
Type of Budgeted Expended Balance %
Expenditure Amount Amount Remaining
648,327 650,562 (2,235)
55,251 40,479 14,772
Month Reported
Mon 12 of 12:
Jun-OO
Budgeted
Amount
Prior Vear
Expended Balance
Amount Remaining
%
Current Year Prior Year
e Type of Budgeted Expended Balance % Budgeted Expended Balance %
Expenditure Amount Amount Remaining Amount Amount Remaining
243,276 239,204 4,072 242,376 241,916 460
30,680 29,869 811 25,984 25,652 332
e
658,034
45,628
672,281
37,054
(14,247)
8,574
Program
5162
Matemal Health
Program
Women's Preventive Health
5163
Type of
Expenditure
Current Year
Expended Balance
Amount Remaining
Prior Year
Expended Balance
Amount Remaining
Budgeted
Amount
%
Budgeted
Amount
Salary & Fringe
Operating
Capnal Outlay
(1,767)
20,553
7
For FY 99 - 00
%
51
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Type of
Expenditure
Salary & Fringe
Operating
capnal Outlay
Type of
Expendltura
Salary & Fringe
Operating I
capijal Outlay
Type of
Expendltura
Salary & Fringe
Operating
capijal Outlay
New Hanover County Health Department
FY99-00
FINAL EXPENDITURE REPORT
As of 11/16/00
Program:
5165
Breast I Cervical Cancer Control Program
cumulaUve %
100.00%
Month Reported
Mon 12 of 12:
Jun-OO
Budgeted
Amount
Current Vear
Expended Balance
Amount Remaining
Prior Year
Expended Balance
Amount Remaining
%
%
Budgeted
Amount
Program:
5166
Partnership for Children
Budgeted
Amount
Current Year
Expended Balance
Amount Remaining
Prior Year
Expended Balance
Amount Remaining
%
%
Budgeted
Amount
90,300
5,700
90,267
5,692
33
8
78,684
to,7oo
73,099
9,901
5,585
799
Program:
5167
Child Heatth
Budgeted
Amount
Current Year
Expended Balance
Amount Remaining
Priory,ar
Expended Balance
Amount Remaining
%
%
Budgeted
Amount
8
For FY 99 - 00
52
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New Hanover County Health Department
FY99-00
FINAL EXPENDITURE REPORT
As of 11/16/00
Program: 5168 Dental Heatth
Cumulative % 100.00%
Current Year
Type of Budgeted Expended Balance %
Expenditure Amount Amount Remaining
36,059 35,832 227
6,058 5,989 69
Month Reported
Mon 12 of 12:
Jun-OO
Budgeted
Amount
Prior Year
Expended Belance
Amount Remaining
33,298
5,958
33,302
5,663
Program:
5169
School Heatth
Type of
Expenditure
Budgeted
Amount
Current Year
Expended Balance
Amount Remaining
Prior Year
Expended Balance
Amount Remaining
%
Budgeted
Amount
270,009
40,441
255,649
40,435
14,360
6
Program:
5172
Neurology
Type of
Expenditure
Budgeted
Amount
Current Year
Expended Balance
Amount Remaining
Prior Year
Expended Balance
Amount Remaining
%
Budgeted
Amount
Salary & Fringe
Operating
Cap~1 Outlay
9
For FY 99 - 00
%
(4)
295
%
%
53
Current Year
e Type of Budgeted Expended Balance %
Expenditure Amount Amount Remaining
Salary & Fringe 8,077 4,032 2,045
Operating 3,948 3,876 70
Capital Outlay
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New Hanover County Health Department
FY99-00
FINAL EXPENDITURE REPORT
As of 11/16/00
Program:
5174
Jail Hea~h
Cumulative %
100.00%
Month Reported
Mon 12 of 12:
Jun-OO
Type of
Expenditure
Budgeted
Amount
Current Year
Expended Balance
Amount Remaining
Prior Year
Expended Balance
Amount Remaining
%
%
Budgeted
Amount
Salary & Fringe
Operating
Capital Outlay
251,312
277,894
253,171
266,931
(1,859)
10,963
Program:
5178
Children Special Hea~h Services
Budgeted
Amount
PrlorVear
Expended Balance
Amount Remaining
%
15,251
9,769
13,581
5,604
1,670
4,165
program:
5180
Risk Reduction
Current Vear Prior Vear
Type of Budgeted Expended Balance % Budgeted Expended Balance %
Expenditure Amount Amount Remaining Amount Amount Remaining
Salary & Fringe 32,752 32,048 704 34,484 34,334 150
Operating 8,650 6,283 2,367 8,300 5,374 2,926
Cap~al Outlay
10
For FY 99 - 00
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New Hanover County Health Department
FY99.00
FINAL EXPENDITURE REPORT
As of 11/16/00
Program: 5181 Project Assist
Cumulative % 100.00% Month Reported Mon 12 of 12: Jun-OO
Current Year Prior Year
Type 01 Budgeted Expended Balance % Budgeted Expended Balance %
Expenditure Amount Amount Remaining Amount Amount Remaining
40,252 28,630 11,622 30,593 30,455 138
12,246 11,997 249 26,272 23,276 2,996
Program:
5182
Health Education
Type 01
Expenditure
Current Year
Expended Balance
Amount Remaining
Budgeted
Amount
Prior Year
Expended Balance
Amount Remaining
%
Budgeted
Amount
%
Salary & Fringe
Operating
Cap~1 Outlay
2,117
2,055
61,791
7,716
59,674
5,661
Program:
5183
Safe Communtties
Type of
Expenditure
Current Year
Expended Balance
Amount Remaining
Prior Year
Expended Balance
Amount Remaining
%
%
Budgeted
Amount
Budgeted
Amount
11
For FY 99 - 00
55
1
--MEMO
NEW HANOVER COUNTY
INTER-OFFICE
.
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To: Dave Rice
From: Janet McCumbee r'
Subj: Smart Start Grant - NAVIGATOR Program Expansion
Date: 11/27/00
e
'In the last month, our local Smart Start has received additional service money which needs to be
spent by June 2001. Janet Nelson, Janet McCumbee, and Garry Garris (Cape Fear Memorial
Foundation) have discussed expanding our NA VIGA TOR Prenatal and Early Childhood Nurse
Home Visiting Program. There are many more pregnant women eligible for this intensive home
visiting service, and we have a waiting list for MCC and NA VIGA TOR. Smart Start and Cape
Fear Memorial Foundation are very interested in supporting our program. Smart Start would like
to fund 3 additional nurses to expand NAVIGATOR between January and June, 2001 Then we
will submit a grant to continue this expansion with Cape Fear Memorial Foundation money in
July.
This $100,000 would allow us to hire 2 additional nurse home visitors to serve SO more families
who are first time parents under 100% poverty. The third nurse would be a Family Assessment
Coordinator, who would screen all parents during the pregnancy or at delivery, to determine the
need for services and make referrals to all available community resources, This nurse will be a
liaison to other Health Department programs (MCC, CSC, MOWs, PPINB nurse) and the
hospital, private doctors, and community agencies.
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New Hanover County Partnership for Children
January 2001-June 2001 Smart Start Funding Application
Cover Sheet
Activity Title:Intensive Home Visiting Program (IHVP)
Organization:New Hanover County Health Department-Child Health
Address:
2029 S. 17th Street, Wilmington, NC 28401
Executive Director/CEO: David E. Rice, M.P.H., M.A. Telephone: 910-343-6500
Contact Person:
Janet McCumbee, RN
Telephone: 910-343-6559
Title:
rhilrl J.lp~lth Dirpr.tnr
Fax Number' Ql0_~41_414t\
Type of Agency: ( ) Non-Profit (X) Public () Private
Federal Tax Identification Number:
56-0989131
Brief Activity Abstract: The Intensive Home Visiting Program (Navigator) has
followed the Olds Curriculum for the past year in New Hanover County. Two nurses
have reached maximum caseloads and there is documented 229 clients in the target
population, (first time moms, 100% poverty) which could be served with the expansion
of two additional nurses to the program. These nurses will make weekly and biweekly
home visits providing resources for financial, transportation, safety and social support to
high-risk families. With frequent intense home visits the nurse will affect the long-term
prevention of abuse/neglect or crime. A Family Assessment Coordinator would conduct
a detailed assessment on all families and make appropriate referrals to programs and
provide information as needed.
Goal(s) Addressed by this Activity (Appendix A):
Objectives Addressed by the Activity (Appendix A):
IV
IVB
VC
V
VA
Total Activity Budget: Smart Start Funds Requested: $100.000
WiD you seek funding for this activity for a second year? Amount:
Have you ever applied for Smart Start funding? Yes
Have you ever received Smart Start funding? Yes
If yes, please name activity(ies): Health Check Coordination & Preventive Health in Dav Cares
Signature-Executive Director/CEO Date
DO NOT WRITE BEWW THIS LINE.
PURP/SERVCODE _OTHER
COLLABORATION____
LEV FUNDING
ADMIN COST
_ CC-SUB
_CC-OTHER
_HEALTH
_FAMSUPP
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I.
Intensive Home Visiting Program
II. Goals:
IV.
IV-Families will have information and resources.
V-Access to medical care
III. Objectives
IVB-Family Support services is coordinated and supports the development of
health
V A- All children will have a source of primary medical care.
VC- Parents understand importance of preventive care.
Benchmarks
1. By June 30, 2001, 75% of parents of the at-risk children being served
through.. . family support programs have adequate knowledge of healthy
development of their children.
2. By June 30, 2001 90% of all children receiving Smart Start funded health and
family support services are referred to their primary health care provider.
3. By June 30, 2001, there will be a 10% increase in the percentage of children
current on preventive well-check visits and immunizations.
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(2)
Full Description of Activitv
V. A.
The Intensive Home Visiting program (Navigator) was implemented with funding from
the Office of Juvenile Justice in September 1999. Visits are started during the prenatal
period and continue until the child is two years old. Since that time two nurses (training
and curriculum of Dr. aids) and a part time Clerical staff were hired, one nurse with a
maximum caseload of25 clients and one nurse with supervisory duties and a maximum
caseload of 15 clients. The target population for the Navigator Program is first time
moms, 100% poverty and living in New Hanover County. Since referrals were started in
November 1999 the program has received over 90 referrals and as of June 2000 referrals
were limited due to meeting maximum caseload requirements for each nurse. Results of
the program revealed that clients 84% of the time kept OB office appointments, 50% of
clients initiated breastfeeding, and 94% were receiving WIC services. To decrease rapid
repeat pregnancy rates, 90% of clients received a method of birth control. Statistics are
being gathered on all participants to ensure that goals are being met. New Hanover
County research data is being sent to UNC-CH, along with data from other pilot intensive
home visiting programs. Most participants have delivered at this time and a specific
parenting curriculum called P.I.P.E. (Partners in Parenting Education) has become a vital
part of the weekly and biweekly home visits. This curriculum enhances parenting skills,
facilitates mother baby interaction and increases the mother's confidence and ability to
initiate babies developmental skills. This age specific program assists with increasing
brain development, improving parenting skills, enabling moms to recognize and respond
to babies cues appropriately, which results in a decrease in child abuse and neglect by
providing coping skills and support. Dr. aids curriculum also includes health
assessments and health teaching as well as life course development. In addition,
NA VIGA TOR incorporates the Maternity Care Coordination and Child Service
Coordination guidelines, including providing community resources for these families.
A community triage team has been implemented to include representatives from Office
of Juvenile Justice, Department of Social Services, Adolescent Parenting Program, teen
clinics, schools, Maternal Health, private Ob/Gyn offices, and clients. From this
collaborative effort a resource guide has been developed to be distributed to clients and
the community.
Statistics from New Hanover County reflect approximately 229 clients annually are in the
target population and eligible for the Navigator Program. With theses statistics we are
requesting three additional nurses. One nurse will act, as a Family Assessment
Coordinator who will provide a detailed family needs assessment either during pregnancy
orirnmediately after delivery. This nurse will provide screenings daily (including
weekends and holidays), act as liaison between New Hanover County Health
Department, New Hanover Regional Medical Center, private offices (OB and Pediatric)
and surrounding counties. Referrals to appropriate programs will be made with input and
permission from the family If the family refuses services or is not in need of specific
59
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(3)
services at that time the Family Assessment Coordinator (FAC) will continue to be
available to the family for questions, concerns, or referrals as needed.
The additional two positions will provide nurses for the Navigator Program for Intensive
Home Visiting Services, enabling the program to accept referrals, and enroll
(approximately 50) high-risk families and teens. These nurses wil1 help meet the
identified needs in the community. They will also provide relief for the Family
Assessment Coordinator.
A recent publication by the Center for Disease Control (CDC) stated that, "the earlier in a
child's life a parent based intervention begins the more effective it is likely to be"
Interventions aimed at low income, single parents improved the matemallife course,
reduced the number of months mothers received public assistance and food stamps,
reduced behavioral problems associated with drugs and alcohol and reduced the number
of arrests. Dr. OIds Prenatal & Early childhood Nurse Home Visitation Program is
higWighted in this publication.
B. Collaboration
We continue present col1aborative efforts with DSS, Mental Health, DEC, PAT, local
child health providers, Child Advocacy Commission, the NHC school system, family
support network, local hospital staff, Communities That Care, Catholic Social Ministries,
CDC, and UCP. Collaborative efforts involve: Participation on committees to coordinate
and ensure appropriate services; mutual referrals for services and often sharing clients to
provide more comprehensive resources; staff training; child advocacy; community
awareness; family support; parenting education; community planning and needs
assessment; and seeking other grants which benefit our at-risk families. The
NA VIGA TOR Program has already established a Prenatal Triage Team, which meets
quarterly to advice us on programmatic issues, network, and share resources for pregnant
low-income women.
Other programs in the community that provide some in home services are Parents as
Teachers and DSS. Parents as Teachers serves families with children birth to 5 years
who request their program and accepts referrals from the community (no income guides).
Their main emphasis during home visits is on helping parents be their child's best
teacher. They also provide a parent support group. Social services have high-risk
services for families at risk of protective service involvement. A homemaker is assigned
to assist families with children of all ages with immediate resource needs (transportation,
scheduling, budgeting). Adolescent Parenting Prevention Program through Planned
Parenthood serves as a support to teen moms. They have very limited capacity in
numbers served. NA VIGA TOR nurses would establish a relationship with a family
prenatally and continue to support the family long term, until the child is two years old
for optimal development, health, and safety of the children. At age two, the family wil1
be referred to other appropriate family support services.
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(4)
In kind will be staff office space, utilities, regular telephone usage, postage, copying,
faxing, supervision, and administrative staff support. This grant will also be submitted to
Cape Fear Memorial Foundation for possible funding later in the 200 I year. Our state
Women's and Children's Branch is working to get Medicaid reimbursement for the nurse
visits.
NA VIGA TOR is part of a statewide system of pilots. These pilots are being followed,
supported and researched by UNC School of Public Health. The Healthy Families
Coalition in Raleigh, which consists of people from many agencies and organizations
interested in the welfare of children, has pushed for funding of these pilots. The long-
term plan is to look at which of three programs would be best for NC to fund
permanently. I see this as a program that can affect long-term service delivery across
NC. The Health Department has home visiting programs in several areas of Women's
and Children's Health (Matemity Care Coordination and Child Care Coordination) and
therefore has background and experience to pilot this program. Matemity Care
Coordination has a waiting list due to inability to serve all eligible pregnant women.
Child Service Coordination is at maximum capacity.
C. Timeline
January 1, 2001: Recruit and hire nurses
February 2001: Orient staff to public health, in-house services, personnel issues, etc.
March 2001: Train staff on model program; establish screening and referral system
April-June: Begin accepting new referrals and making visits
VI. (Not Applicable)
VlI. Outputs
A. Number of children to be served (January-June)-lO (prenatal mostly)
B. Number offamilies served-50
C. Number of prenatal packets-300
D. Number of referrals for other services-50
E. Number of education sessions (PIPE one on one parenting)-50
F. Number of home visits per month-lOO
VIll. Activity Outcomes
. Program participants will have few reports of abuse and neglect to DSS
. Program participants will have received early regular prenatal care, therefore have
good pregnancy outcomes.
. Children born to participants will have developmental and health problems identified
early and appropriate care offered.
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. Children will have a primary care physician at birth, source of insurance, and
participate in well care.
. Seventy-five percent of participants will continue with the program through the first
year and 50% through the second year.
. A community triage system developed for prenatal patients which models our present
triage system for children 0-5 years to improve our county's continuation of services
. Improvement of parental life course, including preventing subsequent intended
pregnancy, completing education and finding work, and strengthening the family's
formal and informal support system
IX. Evaluation Plan
A. Data Collection
. The home visitors have created logs, charts, etc. as needed to collect data daily
and compile for monthly reports. The state has also developed a computer
data system for us to use.
. Because UNC School of Public Health is involved in the research, we are
given technical assistance in collecting and analyzing the data collected. The
information will be part of long term research for North Carolina, related to
outcomes from the many pilots for Intensive Home Visiting.
. We will report to the PFC all usual required information and pilot results.
UNC-CH data is available quarterly and an end of year report (99-00) done for the Office
of Juvenile Justice is available from the NAVIGATOR Staff.
62
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NAVIGATOR PROGRAM
January 200I-June 2001
11) SalarvlWaeeslBenefits
Home Visitors
SalarylBenefits Nurse (Full Time)-Supervisor- $32,000
SalarylBenefits Nurse (Full Time)-Entry Level- $22,000
Screener
SalarylBenefits Nurse (Full Time)-Entry Level- $22,000
Clerical SUDDort
Additional Hours (IO/wk) to existing staff- $2,500
14) Omce SUDDlies & Materials
Routine desk supplies, software, briefcases, etc.- $500
IS) Service Related SUDDlies
Uniforms ($250 X 3 Nurses) $750
Videos, educational supplies, incentives (safety & health) $1,250
17) Travel
Hotel, meals, mileage for out oftown travel
Training's1meetings $2,000
In town mileage for home visitors (.32S/mile) $1,000
e 18) Communication
Cell phones X 2 ($17/month) $170
Phone installation X 3 $200
Pager X 1 $130
20) Printinl!
Brochures, flyers, forms $1,000
22) Meetinl!lConference Exnense
Supplies/refreshments for client parenting classes
& Advisory committee $200
23) EmDlovee Traininl!
Registration for training $300
38) Furniture ($500+)
Cubicles X 3 (desks/omces) $6,000
39) ComDuter EauiDment/Printers ($500+)
3 Personal computers $6,000
40) Furniture/EauiDment Under $500
Other computer equipment $1,000
Chairs, file cabinets $1,000
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BUDGET
Contractor: New Hanover County Health Department
. Ac:livily' Naviqator Effec:tive Januarv 2001
SMART START OTHER CASH IN-KIND TOTAL
Personnel
11) Salarv/WaoeslBenefits 78. 500 0.00 578,500-
12)Contrac:led Services 0 - 0 -
Supplies and Materials
14) Office Suoolies and Materials !l:500 0.00 5500 -
15) Services Related Suoolies <1:2 000 0.00 !l:2 000 -
Current Obligations
17) Travel 53 000 53 000 -
18) Communication ITeleohone, Postaae, ate,) <1:500 0.00 ..5<;00 -
19 Utilities n - ' n -
20 Printina and Bindino e, nnn 0.00 e, nnn -
21 Reoair and Maintenance n - 0 -
22 MeetinolConfarence Exoense e~nn - ...,nn -
23) Emolovee Trainilililno travel) 5300 - t"lnn -
24) Classified Advertisino n n -
25) In-State Board Member Expense 0 . n .
Fixed Charges and Other Expenses
.Office Rent (Land, Buildinos, etc.) 0 0.00 0.00
Furniture Rental n - n -
Eauioment Rental (Phones, Computer, etc.) n - n -
38 Vehide Rental n . n -
39 Dues and Subscrintions n n -
40 Insurance and Bonds n - ^ -
33 Book/L1brarv Reference Material n - 0.00 ^ -
1;s4) umer t:Xpenses In . 0,00 Iii -
35) Total Fixed Charges & Other Expenses 0 . 0,00 0 .
Capital Outlay
36lBuildinas & Imorovements In - 0 -
37 Leasehold Imorovements In - 0 -
38 Furniture( Non-ComDuter Eaol. $500. + oer item Ii~- nnn - e" nnn -
39 Comouter EouiomentiPrinters, $500. + oer item ~.:nnn - <1:1; nnn -
40 FurnitureiEouot., under $500. ~'nnn - e? nnn -
Contracte & Granta
42) Purchase of Services n - 0
43) Contrac:ls with Service Providers, Relatad n - 0
44) Contrac:ts with Service Providers, Non-Related 0 - 0
45) StipendsiScholarshipsiBonuses 0 - U
46) GrantsiCash Awards, Related Parties 0 . u
47) GrantsiCash Awards,Non Related Parties 0 - 0
48) GrantsiNon-Cash Awards -V - 0
) Total Servlceal Grantal Contraela u . 0
50) Total Participant Training Expense -
51) Total Expenditures 100 000 . . 0.00 iIlil Onn-
64
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@' -" ~~
~ :. ~
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....;-'"::~.
North Carolina
Department of Health and Human Services
Division of Public Health
1915 Mail Service Center. Raleigh, North Carolina 27699-1915
H. David Bruton, MD., Secretary
Memorandum
TO:
Local Health Director (Attn: Financial Assistants/Officers)
Dennis E. Harrington, MPH ~ ~. ~
Chief, Local Health Services ~~ ,-
October 9, 2000
FROM:
DATE:
SUBJEcr:
Medicaid Cost Settlement Reimbursement Claims FY 1998-99
I am pleased that we will be able to electronically transmit to you this week the Medicaid cost settlement fimds for
Fiscal Year 1998-99. The attached shows the reimbursement detail for your health department.
These Medicaid reimbursement fimds are required to be budgeted and expended to further the objectives of the program
that generated the receipts. Consistent with this requirement, these Medicaid receipts may be held in reserve for future
needs or expended for a variety of public health needs and activities, including but not limited to:
Expanding the provision of preventive and primary care services to uninsured and under-insured populations;
Expanding the provision of support services such as interpreter services, care coordination, home visiting and
transportation;
Operating expenses, including medical and laboratory supplies, in programs that generate Medicaid revenue;
Public information, outreach, and other population based services;
Capital improvement such as building construction, renovation and repair - if the capital expenditure would
benefit public health programs other than programs that generated the Medicaid receipts, a simple cost
alIocation plan would need to be developed to assure that the Medicaid receipts are used in the program that
generated the receipts - for example, if 80% of a new health department building would house the child health
program, Medicaid receipts from the child health program could be used to cover 80% of the cost of the new
building;
Automation of clinical, fiscal and administrative operations, if there is a simple cost alIocation plan for
allocating costs appropriately to the programs that generated the Medicaid receipts;
Any othe>< r<>asonable p'Jblic heallh expenditures iftheFe is a simple east alleeatiaft plan fo. aH"""ti..!; w.o.
appropriately to the programs that generated the Medicaid receipts.
Thank you for your continued dedication to provide services to the North Carolina Medicaid population!
Cc:
County Finance Officer
__County_ Mll!1al!C!] ____
Dr. Dennis McBride
Allen GambiIl
-1'fmYantOn------n-..-------.-------.--------.
Gary Fuquay
Chris Hoke
DPH - Public Health Management Team
65
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Medicaid Cost Settlement
Detail by LHDIDEC
October 1998 - September 1999
Procedure
Code
LHD
Number Local Health Department
Applied FFP
Rate
84703 65 New Hanover $2,202.47
90658 65 New Hanover ($17.39)
90732 65 New Hanover ($14.12)
00124 65 New Hanover $51.94
W5131 65 New Hanover ($24.67)
W5132 65 New Hanover ($17.01)
W5141 65 New Hanover ($466.07)
W8010 65 New Hanover $7,746,97
W8012 65 New Hanover $7,282,75
W8016 65 New Hanover $484.67
W8201 65 New Hanover $9,34779
W8202 65 New Hanover $37,006.27
W8204 65 New Hanover $33.55
W8205 65 New Hanover $4.55
Y2001 65 New Hanover $1,840.42
Y2002 65 New Hanover $1,082.65
Y2003 65 New Hanover $506.61
Y2004 65 New Hanover $4,351 48
Y2012 65 New Hanover $4,136.35
Y2013 65 New Hanover $9,308.42
Y2016 65 New Hanover $3,112.99
Y2025 65 New Hanover $10,993.46
Y2041 65 New Hanover $1,910.16
Y2044 65 New Hanover $5,570.19
Y2046 65 New Hanover $13,856.32
Y204 7 65 New Hanover $16,796.18
Y2049 65 New Hanover $294.97
Y2155 65 New Hanover $14,526.14
Y2351 65 New Hanover $1,571.03
$153,479.07
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10/09/2000
Prepared by the Office of Medicaid Reimbursement
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New Hanover County Health Department
SUMMARY PAGE
Medicaid Cost Settlement Funds ($153,479)- Expenditure Requests
For Budget Amendment
$25,000
$15,000
$ 7,500
$16,000
$ 2,000
$ 2,000
$ 3,000
$ 3,000
$ 6,000
$ 6,500
e $ 3,000
$ 3,000
$ 2,300
$11,000
$ 2,400
$ 2,000
$ 4,900
$29,000
$ 1,800
$ 5,400
$ 2,679
Interpreter Costs - all Nursing Divisions for remainder of fiscal year
(5133-3700)
Medical Records - Temporary Medical Records Clerk for remainder of
fiscal year (5151-1050)
Additional amount for Medical Records barcoding projecl..possible cost
increases due to delays
(5151-6400)
Workstations (6) for second floor (Health Promotion area) (5133-6400)
Client Transportation - Women's Health Care Division (5162-3700)
Client Transportation - Child Health Division (5133-3700)
Contracted Services - Child Health - Nurse Practitioner for Health Check
Clinic (5167-3700)
Child Health - Shelving & parts for Nursing office partitions (5167-4210)
COD Supplies...additional cost of flu vaccine due to failure of State
Contract supplier (5151-4210)
TAP salaries -to meet salary requirements of TAP program (5153-1000)
TAP supplies (5153-4210)
Officefumiture & filing cabinets (5151-4210)
Computer & printer for TANF Nurse in WHC (5131-6399) $1200
Equipment, $1100 Computer Supplies
School Health - 5 computers & 2 printers for 5 new nursing positions
(5131-6399) $6000 Computer Equipment, $5000 Computer Supplies
Laboratory - two phlebotomy chairs
Laboratory - computer & printer (5131-6399) $1200 Equip,$800
Computer Supplies)
WiC - 2 computers, printers (5131-6399) $2400 Equip, $2500 Computer
Supplies)
Computer Support Temporary Employee (5131-3700)
Strategic Planning Funds-Board of Health (5132-5200)
LCD Projector (5131-6399)
Bilingual Signs (5131-3700) Infonnalionldirectional sign, both inside and
outside of the main health department building, animal control, and
vector control.
TOTAL = $153,479
--We are keeping all the computer expenditures budgeted in the Administration budget rather than in
various program budgets as in this FY2oo1 budget.
NOTE: See next page Expenditure Request Justification Narrative for specific details of requests.
e November, 2000
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NEW HANOVER COUNTY HEALTH DEPARTMENT
MEDICAID COST SETTLEMENT FUNDS (FORMERLY MEDICAID MAXIMIZATION FUNDS)
EXPENDITURE REQUESTS JUSTIFICATION NARRATIVE
. $ 25,000
. $ 15,000
. $ 7,500
. $ 16,000
. $ 2,000
. $ 2,000
Interpreter Costs - all Nursing Divisions
For remainder of fiscal year (5133-3700)
(Increase in Spanish-speaking clients has driven the cost of
interpreting services higher than the amounts budgeted in the
Nursing Divisions. Based on actual usage year-to-date, this
is the amount projected as needed to cover interpreter costs
for the remainder of the fiscal year)
Medical Records - Temporary Medical Records
Clerk for remainder of fiscal year (5151-1050)
Critical need...workload of Medical Records Clerks has
increased significantly since records were consolidated into
the centralized area. An additional 300 records-related
activities need to be performed each day - far more than can
be handled with the 2 existing clerks. (A budget request will
be submitted for a permanent position in the next FY budget.)
We have already received approval and have hired a Temp.
Budgeting the $15,000 will cover the cost of the Temp and
will enable us to keep the Temp through June 30, 2001.
Additional amount for Medical Records bar-coding
project...possible cost increases due to delays (5151-6400)
(Due to the delay in purchasing the new equipment/services,
the cost will likely have risen. The delay was due to
instructions from the Purchasing Department to go out for
formal bid on these items. Actual cost will not be known
until later this year upon completion of the bidding process)
Workstations (6) for second floor (Health
Promotion area) (5133-6400)
(Needed for additional staff being added who will otherwise
have no workspaces. Some of these employees are grant-funded,
student interns, or volunteers) .
Client Transportation - Women's Health Care Division
(5162-3700)
(Transportation for clients to Health Department's
programs/clinics to allow participation by
high-risk, targeted populations having no
other means of transportation available to them)
Client Transportation Child Health Division (5131-3700)
(Transportation for clients to Health Department's
programs/clinics to allow participation by
high-risk, targeted populations having no
other means of transportation available to them)
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. $ 3,000
. $ 3,000
. $ 6,000
. $ 6,500
. $ 3,000
. $ 3,000
. $ 2,300
Contracted Services - Child Health - Nurse
Practitioner for Health Check Clinic (5167-3700)
(To provide physician extender services to the
Child Health program. Nursing staff is unable to
provide adequate coverage for child physicals due to the heavy
workload from lead screenings and Child Service Coordination
screenings)
Child Health - Shelving & parts for
Nursing office partitions (5167-4210)
(Due to very small workspaces, staff need
additional storage space to utilize as much of the
workstations as possible.)
CDD Supplies...additional cost of flu vaccine
due to failure of State Contract supplier (5151-4210)
(Vendor supplying state-contracted vaccine was
unable to provide flu vaccine. Allen O'Neal
approved purchase of vaccine from an
alternate supplier at a higher rate. Using Medicaid
Maximization funds will eliminate the need
to request a budget amendment from County funds to
supplement the cost of this vaccine.)
TAP salaries - to meet salary requirements
of TAP program (5153-1000)
(Cape Fear Foundation funding received, but will
be inadequate to cover the cost of the full year of the
program. This important position provides excellent
peer-directed HIV/AIDS education to our high-risk
teenage population, otherwise very difficult to reach.)
TAP supplies (5153-4210) (Same as above)
Office furniture & filing cabinets (5151-4210)
(Items will replace very old furniture, which is
falling apart. This office furniture was handed down
about three years ago and the condition
has further deteriorated. Replacing this furniture with
Medicaid Maximization funds will avoid the
need to include in next fiscal year's budget.
Computer & printer for TANF Nurse in WHC (5131-6399)
($1,200 Equipment, $1,100 computer supplies)
Position has increased from part-time to full-time
this year, and increased job duties necessitate that
a computer be provided for this nurse.
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. $ 11,000
. $ 2,400
. $ 2,000
. $ 4,900
School Health - 5 computers & 2 printers for 5 new
nursing positions (5131-6399) ($6000 Equip,$5000 PC Supplies)
(These are new positions added after the last
budget requests had been made for computers.
Computers are needed for processing patient care plans,
Internet research, communications and e-mail. The large
number of staff in School Health overloads the available
computers in the Community Health office... providing these
computers will improve productivity of other staff in the
office needing access to shared PC's.)
Laboratory - two phlebotomy chairs (budget in line 5121-6400)
The Lab has never had a phlebotomy chair and has been using a
makeshift table and odd chairs. We really need the phlebotomy
chairs to allow comfort to our clients and to provide easier
access to clients for the phlebotomists
Laboratory - computer & printer (5131-6399)
($1,200 Equipment, $800 supplies)
The Laboratory Clerks computer is outdated and needs to be
replaced. This computer in the Laboratory office was one of
the first in the Health Department installed in 1990 after our
QS System (Patient Care Management System) was purchased.
WIC - 2 computers, printers (budget in 5131-6399)
($2,400 Equipment, $2500 supplies)
The Nutrition Division is requesting 2 PC's with appropriate
software and printers.
1.0ne computer will be used by Debbie Gregory at Coastal OB
where she is stationed. She currently has no computer there.
A computer will enable her to enter WIC certification data,
check prenatal patient certification
for WIC services, check voucher pick up information, determine
number of nutrition contacts provided at WIC to assure that
Medicaid billing for enhanced nutritional counseling is
appropriate, and allow her to communicate through our
electronic mail system.
2.The second computer will replace a PC that is "on its last
leg' and is not part of the replacement with a new purchase or
"roll down" plan for this fiscal year.
70
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. $ 29,000
Computer Support Temporary Employee (5131-3700) $29,000
We received approval and hired a Temp in August, 2000 (with no
$ budgeted to cover the cost). This position is essential to
provide back-up to our Systems Administrator, provide
technical assistance for hardware and software, trouble
shooting, as well as, networking, and user/training issues.
We have developed a department wide PC based environment and
desperately need this position for daily maintenance.
Budgeting this $ will offset $ taken from our contract
services line (which was budgeted for other purposes) and will
allow us to keep this position through June 30, 2001.
· $ 1,800
Strategic Planning Funds-Board of Health (5132-5200)
The Board of Health requested funds, which were not approved,
in the budget for strategic planning. The Board conducted a
strategic planning session. This is to pay for the $1,800 cost
of the session. The $1,800 was taken from he BOH travel line
item and has left no money for travel/meetings/schools for the
Board.
. $ 5,400 LCD Projector (5131-6399)
LCD projector will enable the divisions to improve
e communication, education, and marketing of public health
programs and services to the community and other agencies.
. $ 2,679 Bilingual signs (inside/outside informational
and directional signs) (5131-4210)
We must upfit the main health department building, animal
control and vector control with Bilingual signs, needed to
meet needs of culturally diversified populations we serve.
(This was a need identified during our strategic planning and
is an objective of the Facilities Task Force to accomplish as
soon as possible to provide friendly environments for our
culturally diversified population.
TOTAL = $ 153,479
We are budgeting computer costs in the Administration budget.
For other items, it's really helpful to keep the money in the
appropriate budgets (as noted), to avoid confusion throughout the year.
e
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e NEW HANOVER COUNTY BOARD OF HEALTH
2001 Meeting Dates
, ~A1<:_
. January 3,2001
. February 7, 2001
. March 7, 2001
. April 4, 2001
. April 12, 2001 - Staff Appreciation Luncheon
. May 2, 2001
tit
. June 6, 2001
. July 11, 2001
. August 1, 2001
. September 5,2001
. October 3, 2001
. November 7,2001
. December 5, 2001
. December 13, 2001 - Christmas Luncheon
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ANNUAL REPORT
1999/2000
Ie
New Hanover County Health Department
Board of Health
Q
The Board of Healrh is appointed by rhe New Hanover County Board of Commissioners as rhe
governing body for the Health Department.
William T. Steuer, PE, RLS
Chainmzn
Proftssiona! E'ngineer
Robert G. Greer
County Commissioner
Melody C. Speck, DVM
Veteri1'ltlrian
Wilson O. Jewell, DDS
VIce Chaimum
Dentist
Gela N. Hunter, RN, FNP
Registered Nurse
Phillip P. Smith, Sr., MD
Physilian
Henry V. Estep, RHU
Public Member
W. Edwin Link, Jr., RPH
Phamuuist
Estelle G. Whitted, RN
Public Member
2 NEW HANOVER COUNTY HEAl.TH DEPARTMENT
Michael E. Goins, 00
Optometrist
(J)
Anne B. Rowe
PublicMember
Frank R. Reynolds, MD
Medical Consulldnt
JJ
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(0
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Directors Message
The New Hanover County Board of Health and the staff of the
New Hanover County Health Department arc pleased to pro-
vide you with our annual report for fiscal year 1999-2000. This
report was created to inform New Hanover County residents
and officials of the diverse programs and services offered oy
your local Health Department. Since 1879, the Health Depart-
ment has provided health promotion, disease prevention and
health protection services to the people of New Hanover County.
Division Directors
Assistant Health Director
Lynda F Smith
Animal Control Services Director
Dr. Jean P. McNeil
Child Health Director
Janet B. McCumbee
Communicable Disease Director
Beth W Jones
Community Health Director
Betty B. Cteech
Dental Health Director
Dr. David W McDaniel
Environmental Health Director
Dianne M. Harvell
Laboratory Director
Susan M. O'Brien
Nutrition Director
Nancy R. Nail
WOmens Health Care Director
Betty Jo McCorkle
Mission Statement
The mission of the New Ha-
nover County Health Depart-
ment is ro protect the public
health and environment, promote
healthy living and optimize the
quality oflife through preventive,
restorative, environmental and
educational services.
Motto
"Your Health - Our Priority"
19')9100 ANNUAL REPORT 3
David E. Rice
''From the Northeast River to Federal Point and }Tom the Cape Fear to
the Sea-City, Suburb, Village and Farm-we are one people strivingftr
healthfUl and usefitlliving "
During Fiscal Year 1999-2000, the Health Department experienced many challenges
and opportunities. Among the most notable experiences were:
. Response, recovery and mitigation efforts to Hurricanes Dennis, Floyd, and Irene
. Medical Record.. Renovation
. Increased Volunteer Services
. WIC/Head Start Collaboration
. Increased School Education Sessions
. NAVIGATOR Program
. Spanish Interpreting Services
. Seal Out 2000 - Dental Sealanrs
. Instituted an improved Animal Control Spay/Neuter Program
. Breast Can<.:er Awareness Button Chair
. Stop Red Light Running Campaign
. Teen AIDS Prevention
. 2000 Azalea Festival Parade Float
. Child Passenger Safety Seats
As you read this report, I'm certain you will agree this has been a very productive year
for the Health Department and its future promises to be bright with ever-increasing
opportunities (0 serve our community. We hope you find our report useful.
David E. Rice, MPH, MA
Health Director
Highlights
Hurricane Response
The vast quamiries of rain that fell in the
area during the season's hurricanes in-
creased the need for mosquito cOlHrol.
The late slimmer and early fall months
hrought garden and saltmarsh varieties of
mosquitoes out in full force and a record
number of citizen complainrs were
received. Vector Control staff worked late
evenings, early mornings and weekends
to ensure a continuous application of in-
sccricide and larvicide products to thwart
the onslaught.
Medical Records
Renovation
Years of planning and preparation culmi-
nated in the construction of a new Medi-
cal Records area within the Health Depart-
ment. The new facility allows centraliza-
tion ot over 70.000 medical records previ-
ollsly housed throughout the building.
The project induded renovations to the
general clinic registration area, bboratory
washroom and new client and staff
rest rooms. Benefits of this project will
be improved record security, staffefficiency
and customer service.
Volunteer Service
Managemem Support Supervisors in the
Communicable Disease Division recruited
volunteers through announcements in
church bulletins, newspapers, public ac-
cess television and E-mail. A (Otal of 34
volunteers donated 434 hours of service,
valued at over $5.400. Volunteers bring
enthusiasm, enhance customer service and
provide relief (0 staff. The position of
Volunteer Coordinator was created (0 de-
velop a manual, conduct orientations and
take over recruitment activities.
WIC/Head Start Collaboration
The Women, InE1I1(s and children (WIC)
Program began a collahorative effort with
the New Hanover County Head Start Pro-
gram. WI C staff were stationed at the
Head Start Center during their summer
enrollment fair Children not receiving
WIC services were identified and certified
for WTC during enrollment. Head Start
staff provided the required WTC nutri-
tion education (0 all children during the
school year and WIC food vouchers were
mailed to parents.
Scbool Nurses Increase
Education Sessions
Sch()ol nurses increased health education
sessions by 2')6u/tJ, addressing optimum
4 NEW HANOvER CllUNTY HEi\LTH OEI'-\RTMEN']
health practices, lllJury prevention and
health problems. The educational sessions
were provided in classrooms to targeted
groups of students and school staff. Pro-
grams, bulletin boards and handouts were
designed to meet the educational needs
of the target populations.
NAVIGATOR Program
The Child Health Division srarred NAVI-
GATOR, a prenaral and early childhood
nurse home visitation program. Nurses
continually visit fIrst time mothers living
at or below 100% of the Federal Poverty
Level during their pregnancy and through
the child's second birrhday. The nurses
have small caseloads and make weekly or
himonrhly visits to assess health status,
teach and evaluate life course goals and
parenting i.~sucs. The first visits were made
in Fa111999 and full casdoad~ were quickly
established.
"Seal Out 2000"
The Dental Health Division continued ef-
forts to place dental scalants on children's
teeth to prevent tooth decay, a leading
public health concern. 'l'he Seal (Jut 2000
Gll11paign was a partnership between local
and state dental health providers and stu-
dc.:nts and was held at Capt: fear Commu-
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niry College. Over 150 free sealants wen:
placed on children's tceth.
Spay/Neuter Program
Animal Control Services implemented an
improved spay/neuter program with the
collaboration of area veterinarians. ACS
now requires rranspon ofa newly adopted
pet din.:crlv (0 a veterinary hospital for sur-
gical procedure prior to placement in the
new owner's home. The compliance rate
for spay/neuter for adopted animals has
risen from '50% to lOOI)t6 and adoption
rates remain steady.
co
Breast Cancer Awareness
Button Chair
In celebration ofPub/ic Ht'tdth Jlvfollth, the
Women's Hcalthcuc Oivision hosted the
Blue Cross/Blue Shield of North
Carolina's Breast Cancer Awareness But-
ron Chair The Button Chair was starred
in a boutique that caters to women with
breast Clncer, with every bunon donated
represcnting a survivor or victim. The chair
now travels throughout North Carolina
with all ilHcractive display that contains
information about breast self exams, early
detection and trcatment.
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Spanish Interpreting Services
The Health Depanment is entering its third
year of using contact interpreters to com-
municate with our Spanish spe-.tking clients.
The Hispanic client population has grown
to several hundred over the past two years,
necessitating the need for full time inter-
preting services. Hispanic cliems access all
Health Department services. The most
heavily used are those for women and
children (WIC, Child Service Coordmatioo,
Prenatal Care and Family Planning). Statf
is challenged daily with communication and
cultural diversity issues.
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RED
LIGHT
PHOTO
ENFORCED
,.
Stop Red Light Running
The Injury Prevention Program assisted
in the implementation of the Stop Red
Light RunningCampaign, in collaboration
with local and state law enforcement agen-
cies. A press conference was held (0 raise
awareness about the initiative. Cameras
have been installed at several major inter-
sections in Wilmington in an effort to re-
duce the number of drivers that run red
lights, a leading cause of car crashes in the
area. Results were seen quickly, with crash
rates at target intersections decreasing al-
most immediately.
Teen AIDS Prel'ention (TAP)
The TAP Program benefited from a
fundraiser called Fami(y Fun DtlJ in the Park.
in which over $3,000 was raised to imple-
ment activities. A local family entenain-
ment group, Triple FX, chose to highlight
TAP during the t.."Vent. which attracted sev-
eral hundred people throughout the day
with games, activities, music and AIDS
awareness programs. Peer educators
helped raise money, planned activities and
wrote and performed a shon play about
HIV prevention for the eVent.
Azalea Festival Parade
The Health Deparrmemwas again presem
in the annual Azalea Festival ParlltU, show-
casing services on our float. This year staff
constructed and decorated the float, in ad-
dition to volunteering to ride in the pa-
rade. Volunteers spent many hours to the
project, which was the highlight of our
Public Health Month Celebration.
--I
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Child Passenger Safety Seats
The North Carolina Safe Kids Coalition
receives grant funding from the North
Carolina Governor's Highway Safety Pro-
gram to provide child passenger safety scats
to local Safe Kids Coalitions. With the
Health Department as the lead agency for
the local coalition, 140 seats were distrib-
uted during the year. Additionally, ')2
adults from the Health Department and
other coalition member agencies were cer-
tified as two-day Child Passenger Safety
technicians. There were 123 sears checked
at child safety scat check-up events, in ad-
dition to numerous one-an-one checks at
the Health DepamnenL
1999/00 ANNUAl. REI'()RT 5
Administration
The Administration Division is responsible for the administra-
tion, operation and fiscal management of the New Hanover
County Health Department.
GOALS
. Assure a positive public image and serve the citizens of
New Hanover County
. Support the Board ofHcalrh, Health Director, Assistant
Health Director, Division Direcwfs and Health Dcpanmenr
Staff
. Provide assistance in administrative, financial, personnel
and vital records
. Monitor and maintain AS400 Computer System
. Assist Property Management with scheduling Health
Department maintenance
Personnel
Vital Records
North Carolina General Statutes 130-A requires the Health De-
partment administer rhe Vital Records Program under the direc-
tion of the Health Director.
GOAL
. Assure vital records are filed as required by Chapter 1.10-A
of North Carolina General Statues and are submiued to
the Nonh Carolina State Division of Vital Records within
the required time period
The Health Direcwr appoints Deputy Registrars to process vital
records. It is the responsibility of the hospital to file binh
certificates and funeral directors to file death certificates with local
deputy registrars. Certified copies of birth and death certificates
are available at the New Hanover County Register of Deeds or
from the North Carolina Office ofYital Records. Fees are charged
for certified copies of the certificates.
The New Hanover County Health Department has 175
personnel positions. r~
GOAL
. Provide personnel services for Health Department
employees and serve as a liaison between the New Hanover
County Department of Human Resources and the Health
Department
Personnel services include processing payroll and personnel ac-
tion forms; orientation to new employees regarding benefits,
policies and procedures; annual open enrollment for county per-
sonnel benefits; and the maintenance of personnel records and
the New Hanover County and Health Department Personnel
Policy and Procedure Manuals.
fIIP.~ ~n ~ ~.,ilili'io,
Dedicated to promoting and protectingpublic health.
Vital Records for Fiscal Years 1995/96 - 1999/00
New Hanover Countv
Birth Certificates
Death Certificates
FY1995/96
2,816
1 ,468
FY1996/97
3,071
1,585
6 NEW HI\NOVER COUNTY HEALTH DEPARTMENT
FY 1997/98
3,549
1,795
FY1998/99
3,604
1,972
FY1999/00
3,446
1,923
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Animal Control Services
The control of rabies is the primary focus of Animal Control
Services (ACS). Since two positive cases occurred in FY 1999/00,
we need to cOlHinuc our vigilant efforts to protect the public
from the danger of rabies.
GOAL
. To protect the community from the threat of rabies virus
exposure and ro ensure proper animal care through preven-
tion, public perception and education
SERVICES
~
ACS provides shdter for unwantl.:d, stray, sick and injured do-
mestic animals of New Hanover Coumy and serves as an emcr~
gency evacuation site for the pets of residents who must leave
their homes. Animal Control Officers quaranrine bite animals,
follow-up with rahies exposure situations, patrol for strays and
investigate service call complaints including dangerous/poten-
tially dangerous dog reports. Surveillance of current rabies vac-
cination status for pets is ensured by linking the current vaccina-
tion with the animal's counry license fee.
Pet overpopulation directly relates (0 the spread of the rabies
virus by increasing the number of viable vectors. With the sup-
port and assistance oflocal veterinarians, a study conducted on
pets adopted from the shelter revealed only ')0% compliance
with spay/ncuter requirements. In Octoher 1999, ACS initiated
a new program to resolve this problem. Adoptcd pets are now
transported to the wterinarian for the surgical procedure prior to
placemt.:nt in the new ownt.:t's home. Compliance soared from
':;0% to 100% in the span of one month. In addition, the
shelter experienced a record number of adoptions during that
same month.
The installation ofChamcleon, a new software package, was the
culmination of years of hard work. Our staff !-'tilized Chame~
([;
The)e kittens represent the many pets awaiting Ildoption {if the
A CS shelter
Animal Control Officer JrUnie Kilgore readying her llehide to serve
thecvmmunity.
leon for county license updates immediately. (Most software
users do not implement this portion of the package until six
months of usage time has elapscd.) The capahilities of the chal-
knging software continue to be realized.
During Hurricanes Dennis, Floyd and Irene pets were again
housed at the sheltcr when owners feared evacuation. Hurricane
Floyd brought 1':;7 dogs, ')7 cats and 4 chickens to ACS, more
animals than any other emergency. Several animals were left at
their homes by owners and required rescue by ACS officers.
Dccember 30, 1999, hrought the last positive:: rabies case of the
millennium. It proved to be an unusual situation, as the victim
and his family had feasted on a raccoon carcass before question-
ing authorities about the dangcrof rabies. Fornlnatcly, the high
temperature of cooking the meat rendered the virus inactive.
The second positive rahies case occurred in April, another rac-
coon, bringing the total to 57 since March 26, 11.)96.
Bob Weedon, DVM, and a class of UNCW honor studems
developed a volunteer manual to attract volunteers (0 assist the
ACS staff. The Y2K-9 Open House was held in January to intro-
duce the manual. to commemorate the shelrcr's five year anni-
versary and to give trihute to the start of a new century.
ACS staff participated in Public Health Month activities including
riding on the Aztzle(l Festit'alfloat, a free rahies clinic in response
to Governor Hum's request for a Rabies 2000 campaign, volun-
teer orientations and discounted rabies vaccinations at area vet-
crinary hospitals. Also, the community received informational
rabies fliers in V;:tl-Pak coupon m;:til-outs, gencrating a wave of
media coverage to increase puhlic awareness.
The annual Pet Adopt-il-thon was successful in finding new homes
for 11 pets, although PETsMART hosted a similar event the
same weekend. Mulriple activities provide::d a friendly educa-
tional atmosphere for the participating community. Next year,
ACS will better collahorate with other organizations.
1999/00 ANNUAL REPORT 7
"I
ACS saw an increase in cruelty cas<:s this fiscal year. Th<: first of
three cas<:s involved a young man who set fire to his aunt's cat.
The second case entailed unsuspecting pets that were lured (0
containers of antifreeze bait<:tl with hot dogs, causing death. A
third case involved a family that housed three dogs in unsanitary
conditions with minim<ll food. Cruelty is difficult to deal with
in most instances hecause the department must prove intent.
Generally, pet owners arc nor inr<:nrionally crud [Q their pets, hut
do not know proper animal care to adequately meet the needs of
their companion animals.
In Jun<: 2000, biweekly radio spots hegan on WAAV radio to in-
crease public awareness of the ACS program and give intormation
to a wider range of the community. These talk segments have heen
<:A-cctive in conveying news [0 the public about the reactivation of
the licensing process. An appeals process has been established to
allow violators an opportunity to voice their disagreement, with
non-compliant accounts suhmitted to a collection agenLJ'.
Effective animal control will always include public education and
preventative measures and is a major goal of the Division. In an
effort to meet this goal many presentations occurred through-
out the year, including a book-reading at an elementary school
with "Rudy," one of our staff's pets. Proper training today
create:s a firm foundation of proper pet care for future gl'llera-
tions.
Child Health
The Child Health Division provides a variety of preventive health
services in home:s, child care: facilities and weekly clinics. The
Division is a multidisciplinary team of nuts<:s, social wotkers,
medical office assistants and management support staff.
GOALS
. Increase community aware:ness of children's preventive
health, safety and lkvdopment
. Increase number of children receiving fOutin<: testing for
lead poisoning with appropriate t()lIow-up
. 80% participation in Health Check well screenings (Medic-
aid-e1igihle children)
. Early detection of health and developmental problems
leading to early intervention and treatment
. Families are supported in parenting young children and in
their utilization of community resources through case
management, parenting classes and home visiting st:fvices
PROGRAMS AND ACTIVITIES
Child Service Coordination has been a statewide program
since 1990, providing home visiting and coordination of S<:f-
vices for hmilies with children ranging from birth to five
years of age identified through a referral process. Nurs<:s and
social workers provide: health, safety and developmental fol-
low-up to over 400 families in the county. The program
receives approximately 40 refnrals per month. Staffis trained
in developm<:nta! screening, parent-child interaction assess-
ment and the early intervention system. Since January, the
state has required monthly contacts with all participating fami-
lies (previously required quarterly). The CSC program is sup-
ported by Medicaid hilling.
The Health Check Clinic provides well check-ups for Med-
icaid-eligible children, who receive a h<:alth history, immuni-
zations, laboratory testing, developmental scr<:ening, mea-
8 NEW HANOVER COUNTY HEALTH DEPARTMENT
-'
--
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Joyce Hatem, S\Xi; administers the Denver Dellelopmenmlscrecning tooL
sllfements, hearing and vision scr<:ening, physical exams, edu-
cation, counseling and referrals. The clinic provides kindc:r~
garten health screening, and Head Stan and preschool/child
care/sports physicals upon request. Children with Health
Choice (BCBS insuranc<:) were seen at the clinic for the first
time this year. which necessiuted a new billing system. All
Health Check screenings arc shared with the child's physician.
Health Check Coordination, a Smart Start funded service,
assists families with Medicaid-eligible children inl11aking doc-
tor and dental appointments. arranging transportation and
making rderrals for other health and social snvices. The
Health Check Coordinator assists clients in the application
process for enrollment or re-enrollment in the Health Check
or Health Choice child health insurance programs. The Health
Check participation ratio increased from 54.8% (FY 1997/98)
to 67 9% (CY 1999/(0) The Health Check Coordinaror
worked closely with Social Services and Smart Stan to ensure
100 % Health Choice enrollment of the target population.
()
CD
C))
v
n
t'
Child Service Coordination Program
3000
2,523
2500
2000
1500
1000
500
Follow-up Health Education
Visits Participants
137131
o
New Patients One V,sit
Enrolled Not Enrolled
Monthly
Contacts
Large increase in monthly contilrts due to changes in
Medicaid biUil1gguidelines.
The Lead Program is a coordinated dl()ft of the Child Health,
Laboratory and Environmental Health Divisions. Of the 1,920
lead tests done in the lahoratory, 183 were above normal. Child
health nurses provide follow-up f()f children with elevated
blood lead levels. Nurses saw a tremendous increase in the
number of families needing f()llow-up home visits, educa-
tion, additional testing, assessmcm of hazards and develop-
mental/nutrition referrals.
The Child Care Nursing Program, funded by Smarr Start.
received funding from a UNe Chapd Hill gram tor an additional
nurse. The two original Child Care Nurses (Child Care Health
Consultants) provide services to all child care facilities including
preventive health services, health education, consultation and
technical assistance upon request from directors, teachers, par-
ents, Environmental HeJ.lrh staff and regulatory consultants.
The new grant-fund<:d nurse pnforme:d assessments of a facility's
Ill.:<:ds, assisted in applying for state money to improve the facil-
ity and participated in research on the effectiveness of the Child
Communicable Disease
Communicable disease control smuegies that pfOt<:ct th<: citi-
zens of New Hanover County arl' immunizations for children
and adults to eliminate vaccine-prevenrable diseas<:s, screcning
and tr<:atment for early identification of certain illnesses, moni-
toring case reports, implementing outbn:ak control measures
and emphasis on preventing disease transmission.
GOALS
. Minimize vaccine-preventabh: dise:ase incidence through
90% childhood immunization series compliance and by
providing vaccines for children and adults
. Provide counseling and treatment for Sexually Transmitted
Diseases, HIV testing, and use client encounters as
opportunities to encourage prevention strategies
'[
Carc Health Consultants.
Healthy Homes was a new initiatiw during fY 1999/00. A
gram-funded nurse visited 44 in-home child-care facilities to pro-
vide an cnvironmental screening, focusing 011 lead hazards and
asthma triggers. The nurse intervened when problems were iden-
tified, made referrals for other services and providcd parent educa-
tion materials on asthma and lead poisoning.
NAVIGATOR is a ncw prenatal and early childhood nurse home
visitation program. In November 1999, nurses made their first
homc visits to serve first time mothers with incomes at or be-
low IOOIJlll of the Federal Poverty Level through funding from
the Office of Juvenile Justice. This program was piloted in
several states during the past 20 years and has proven long term
positive results. Nurses provide health assessments, teaching,
life course guidance and community resourccs through weekly
or hi monthly home visits, which occur from the prcnatal period
until the child's second birthday. The Navigator nurses partici-
pate i.n rcscarch with UNC Chapel Hill under the dircction of the
Division ofWomcn's and Childr<:n's H<:alth.
Quarterly parenting classes are taught for English-speaking
parents with classes available in Spanish on occasion. These
classes provide information on basic child care, child health
issues, safety, nutrition, disciplin<:, devdopmcnt, self csteem
and parental nced....
Division staff served on many community committees including
the Local Interagency Coordinating Council tor Special Needs
Children, the Child Fatality Pr<:v<:ntion Team, the Community
Child Protcction 'Ieam, a Smart Start Quality Enhancement Com-
mittee, the Partnership for Children Board, Communities that
Care, an Asthma Coalition, the Full Potential Advisory Commit-
tee, Kids Count and many consortiums where children are served.
Staff was also involved in many activities during Child Health
Month, Public Health /vfonthand ChildAbuse Prevention Month.
. Provide tuherculosis treatment (including prcventive
medications) to reduce tuberculosis in New Hanovcr
County
. Ensurc required reporting of communicable diseases and
re:spond appropriately to reduce transmission and prevenr
outbreaks
. Serve as a community resource for prevention of commu-
nicable diseases
PROGRAMS FOR PREVENTION AND
OUTBREAK CONTROL
Immunizations should begin in infancy and continue as a life-
long practice to protect citizens from diseases which can seriously
compromise individual and community health. Some vaccines
1999/00 ANNUAl. REPORT 9
are required by law (childhood vaccines), while others such as
influenza, pneumonia and tetanus hoosters are recommended.
The Division provided the above in addition to immunizations
required for specific employment such as Hepatitis B and rabies
vaccine..<;. New vaccines protect against Hepatitis A (Havrix), Lyme
disease (l.ymerix) and meningococcal disease (Menomune). These
arc purchased by clients and are recommended for high-risk ex-
posure situations. Meningococcal was added to the recommended
list of vaccines for college freshman. The last dose of Live Oral
Polio Vaccine (OPY) was given in FY 1999/00 as use of or V
was eliminated. Inactivated polio vaccine (injection) is being
used as polio moves closer to worldwide elimination. The Win-
terize Immunize campaign promoted influenza and pneumonia
vaccinations among hard to reach populations at high risk for
complications, with 1,26'5 flu vaccines administered in 33 off-site
locations. A total of 5,654 influenza and 305 pneumonia vac-
cines were given. Children and adults received 21,395 doses of
vaccine during 16,581 visits. New Hanover C:ounty Health De-
partment (NHCHO) monitors vaccine compliance for children
up to 24 months of age and ha~ a compliance rate of 7'5%
compared (0 tile state rate of '58%. The lack of a centralized
system makes it difficult to monitor immunizations given by
other providers. NHCHD sponsors quarterly meetings of the
Immunization Task force, bringing together medical providers,
schools, child care facilities, hospital st~lff, insurance companies
and vaccine representatives to improve accessibility ofimmuni-
zation data.
Tuberculosis (TB) is a disease transmitted through the air that
pos(.'s a public health threat, especially if acrive cases are not iden-
tified and treated early and adequately. The five activeTB GISeS in
New Hanover County during FY 1999/00 were all on directly
observed treatment, requiring that staff be present when the
medications were taken.
Early identification ofTB infection by a positive tuberculin skin
test (PPD) is critical to prevemingnew cases. frequenrly, preven-
tive medicine is recommended for individuals exposed to TB.
Contact investigations, case follow-ups and home visits assure
adequate treatment to prevent community outbreaks. Tubercu-
lin skin tests, clinical evaluations and tuberculosis medications
are available at NHCHD Of'\.}23 PPDs dooe, 243 (4.6 %)
Reportable Communicable Diseases
AIDS 9 HIV 36
Campylobacter 21 Lyme Disease
Chlamydia 344 Pertussis 6
E. coli 0157:H 7 2 Pneumococcal Meningitis 2
Ehrlichiosis Rocky MIn. Spotted Fever 2
Gonorrhea 383 Salmonellosis 117
Haemophilus Influenzae Invasive 1 Shigellosis 16
Hepatitis A 2 Syphilis 67
Hepatitis B (acute) 15 Streptococcal Group A Invasive 4
Hepatitis B (chroniC carner) 8 Vancomycin Resist. Enterococci
--...}.... "-
Nurse observes patient tttking medicine in his home.
indicated latent infection and 245 individuals were provided pre-
ventive therapy. HIV positive and foreign-born individuals re-
ceiving TB services are increasing.
Sexually Transmitted Diseases (STDs) arc a threat to individuals,
sexual partners and unborn children. The STD program pro-
vides counseling, testing, examination, treatment and education
about STDs including gonorrhea, syphilis, herpes, chlamydia,
human papillomavirus (condyloma) and others. Prevention
and risk reduction education are components of each c1inil."al
visit and condoms arc available. There were 2,6') 1 visits made
for STO services during the year.
Testing for HIY antibodies provides an opportunity for early
identification and referral for medical care before symptoms of
HIY/AIDS appear. Medical advancements provide many treat-
ment options which can prolong and improve quality of life.
HIY antibody testing encourages individual risk assessment and
behavior changes to reduce risk of transmission. There were
1,944 HIV tests done.
North Carolina requires 60 diseases and conditions to be re-
ported. NHCHD monitors and responds to case reports to
prevcnt further cases. In addition to the: reportable illnesses,
physicians and the general population are encouraged to he dili-
gent ahoU[ prompt reporting of unusual conditions which may
pose a threat to public health.
L"lst year, New Hanover County s-aw an increase in the number
of Sa/mone/itl javiana cases. Although extensive outbre;lk investi-
gations were condul."ted, no common source was found. There
were 18 cases of Shigella reported involving four child care facili-
ties and one elementary school.
HEALTH EDUCATION AND OUTREACH ACTIVITIES
Effective communicable disease control requires an alert staff
viewing potential outbreaks as opportunities to educate the public
about prevention methods. Health education and outreach as-
sure pre:venrion messages and treatment reach the community.
10 NEW HANt>VER Ct>UNTY HEALTH DEI'ART!\tENT
o
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Staff provides individual and group education in clinical and
community senings. 1""0 newsletters are written and distrib-
uted by the Communicable Disease Division. EPllnfonnlltion is
a bimonthly newsletter sent to all medical providers in the county
and 5exUtllly Spedkingis a quarterly newsletter distributed to agen-
cies working with populations at risk tor STDs and HIV
Targeted outreach services provided screenings, immunizations
and education at various sites including Cape Fear Community
College, Good Shepherd House, Cure AIDS, Wilmington
Health Access for Teens, rest homes, Tilesron Clinic, churches
and selected work sites. National H IV Testing Day promoted
the theme Take Control; Take the H1V Test, which supports
knowledge of personal H IV status as the first step in comrol-
ling the disease and preventing transmission. Hepatitis educa-
tion and prevention was promoted throughout the year with
special events Juring May, National Hepatitis Month.
Teen AIDS Prevention (TAP) is a program that trains adoles-
cents as peer educators to teach behavioral skills to reduce HIV
and STD transmission among adolescents. Twenty peer edu-
cators received training and delivered risk reduction education
to over 3, 124 adolescents in various community settings. TAP,
funded by the Cape Fear Memorial Foundation, exemplifies
how peer pressure can be a positive influence in decision-mak-
ing. Family FUll Day in the Park selected TAP as beneficiary of
proceeds from their annual event.
Community Health
The CommunitY Health Division provides FJ.mily oriented health
prommion, disease and injury prevention and disease manage-
ment services in clinics, homes, schools and other sites through-
out the county. Services are provided throughout the lifespan.
GOALS
~t
. Promote health and safety of individuals and families
through the provision of preventive, curative and rehabili-
tative health services
. Enable individuals and families to access needed resources
through identification, referral and coordination with local,
state and federal agencies
Promote a healthy environment through identification,
resolution and/or referral of conditions that threaten the
health and safety of residents
. Promote public health and the Health Department's image
through: collaboration with other agcncies; serving on local
and state boards, committees and related organizations;
exercising media and public speaking opportunities; and
coordination of care with other providcrs.
CHILDREN'S HEALTH
f;
Newborn visits provided infant cue assessment and informa-
tion about normal growth and development, injury prevention,
the importance of well-child care and immunizations, poison-
ing prevemion and rderral to communiry resources. Public health
nurses idcmified and coordinated services for health problems
of other family members. Newborn visits declined by ')4% due
to the establishment of an appointment system, necessitatcd by
societal changes.
Well Baby clinics providcd services throughout the county. The
clinics otl'ered physical exams, developmental evaluations, im-
munizations, laboratory testing, TB screening, nutritional and
injury prevention information and referral and follow~up as
needed. Clinic visits decrcased 209il overall, with evening clinics
being the most utilized. The reduction in clinic attendance is
attrihuted to Health Choice insurancc, as families with Health
Choice are now taking their children to private providers.
Child In-home Service visits increased 21 % and provided health
assessment, disease management, access to equipment and sup-
plies, health promotion and injury prcvenrion information and
referral and follow-up as needed. Outreach on topics including
health and safety was provided in churches, clubs and other
community sites.
The Kindergarten Health Assessment Clinic provided physical
examinations, laboratory testing, immunizations, T8 screening,
hearing and vision screening, counseling and referrals. The clinic
served non-Medicaid patients, following the mandate that indi-
gent have access to this service.
Statistics tor the School Health program rdlected a 12% growth
in the number of studenrs with chronic diseases such as epilepsy
and diabetes, displaying a need for increased services. School
Health services consisted of assessing and monitoring student
health problems, physical assessments, development of emer-
gency care plans, coordination of care, education for providers
of carc, consultation with personnel regarding health issues and
the school environmenr, mass screening, health education for
students and faculty, first aid, medication and treatment admin-
istration and monitoring delivery.of care and medical supplies.
Two new public health nurses were employed to accommodate
the increased demand for services, enabling the Health Dcparr-
ment to increase school health hours and provide more compre-
hensive care in elementary, middle and Lakeside schools. The
most critical area of School Health. the development of emer-
gency care plans, increased by 4% this year. Health education
sessions increased 2')6%. Mass screenings including vision, blood
pressure, scoliosis and infestation were completed.
Volunteers, including the American Association of University
Women, played a major role in School Health accomplishments
this year, assisting with vision and scoliosis screenings and infir-
1999/00 ANNUAL REPORT 11
mary duties. Special school projects and
programs included health displays, Smok-
ing is Not Ytmr Friend. American Diabetes
Walk-A- Tbon. Open AirwilYs, sportS physi-
cals, coordination of services with studem
nurses, blood pressure screening and
health education sessions for students
and staff. A grant from New Hanover
Regional Medical Cc:ntc:r's CH If> Program
enabled the Division ro fund additional
demal health services. State School Health
funds were used to access health services
for needy students.
The Orthopedic and Neurology clinics
provided diagnosis and treatmelH of re-
lated diseases, care coordination and
healthy lifestyles counseling. Physicians
volunteered their services or donated their
payment to further program activities. .I'he
primary purpose of these clinics was [()
serve individuals unahle to access services
elsewhere. The Rotary Club of
Wilmington established the Orthopedic
Clinic and continued to support it both
in funding and member volunteers. Over-
all program activities increased by 27(Yil.
ADULT HEALTH
Adult Health clinics arc
located in areas of the
county where there arc
large numbers of eld-
erly individuals, The
dinics offered health as-
sessment and moni-
toring, care coordina-
tion, treatment, immu-
nizations, disease man-
agement and healthy
lifestyle counseling.
Changes in Medicare
coverage, early hospital
discharges and in-
creased longevity cre-
ated the need for tak-
ing health care to
homebound adults.
The Adult In-Home
Services Program pro-
vided health assess-
ment, disease and dis-
ability management,
cnvironmental assess-
n
\
i
\
1
j
ments, immunizations, treatment,
care coordination and healthy lifestyles
counseling. Administered by program
staff, the Ministering Circle Chore Pro-
gram was a valuable resourcc for
homebound patients.
Adult Day Health Monitoring, a state
mandated service for adult day health cen-
ters, was evaluated on a quarterly basis
for provision of health care. Public
health nurses provided assistance with
compliance issues. No new centers
opened this year.
Diabetes Today, a state initiative to raisc
awareness about diabetes and promote
mobilization in dealing with the problem,
was implemented. A coalition was estab-
lished and members received training
based on the Diabetes j'O{hlJ hlodel. The
coalition selectc:d African Americans age
4') and over as the target population, fo-
cllsing on awareness regarding foot and
eye complications. Activities consisted of
printing cards that address blood pressure,
Al C and foot and eye screenings, which
were distributed through mailings and
commulllty acnvltles.
The HL-alth Depanmt:nt, through an agree~
i;;:::-
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-
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-
-
-
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mcnt with the Sheriff's Department, is
responsible for the health care of jail in-
mates. The Jail Medical Program services
increased by 10% and included primary
and preventive health care, dental health
care, health education, consultation and
training of jail personnel and consulta-
tion with the court system and other de-
tention centers. Staff provided consulta-
tion and training [0 other jail health pro-
viders. Volunteer assistance was a valu-
able asset to the Jail Medical Program.
Disaster planning formerly rook a few
hours each spring, but became a year-
round activity with involvement at the
state level. Locally, shelter planning will
eliminate many concerns of the past, re-
duce confusion and misunderstandings
and expedite set-up and delivery of care.
Adequate generator power reduced health
and safety hazards for evacuees and staff.
'l'he increased effects of disasters through-
out the state generated multiple requests
for teaching and consultation. 'I'he UNC
Office ofPuhlic Health Nursing Introduc-
tion to Public Health Nursing course has
added a module on the public health
nurse's role in disaster management,
taught by Division staff.
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Ellen Htl1Tison, RN, provides chronic disease screening in Ii rommunityc/inic.
12 NEW HANOVER CUUNTY HEALTH DEPARTMENT
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Dental Health
GOAL
. T(l promote, protect and assure the
optimal oral health of the citizens of
New Hanover COUll tv
The New Hanover County Dental Pro-
gram demonstrates the cooperative ef-
forts of the North Carolina Dental
Health Section and the New Hanover
County Health Department. The Den-
tal Health Division utilizes numerous
strategies to improve the oral health of
our citizens which involve: increased use
of Dental Sealants; periodic Dcnc:tI As-
sessments with Referral; OCIHal Health
Educuion; Community Water Fluorida-
tion; and School fluoride Mouthrinse.
FY 1999/00 was a productivt' period for
the Division. Approximately 14,OOOchil-
drcn and adults received dental health
education, 5,000+ children received den-
tal assessments and over 9,000 children
participated in the weekly fluoride
mouth rinse program.
During Winter 1999 and Spring 2000, the
Dental HeJ.lrh Division conducted a re-
gional campaign entitled Seal Out 2000ta
pn:vcnt tooth decay by the increased use
of dental sealants. Our sponsors and
partners were the New Hanovc:r Heahh
Network, the North Carolina Dental
He.uth Section, the Wilmington 'IriCounry
Dental Society and the Cape rear Com-
munity College Dental Program. Over 20
Dentists and 30 students from the Cape
Fear Community College Dental Assist-
ing and Dental Hygiene Programs pro-
vitkd over 1 '50 sealants free-of charge (0
area children. Media covefagr..: included
puhlic service announcements on arca ra-
dio and television stations and interviews
KinderY,drt17/ drulfifih grade dentllDlSSessments.
about sealal1ts were conducted. A Seill (Jut
2000 Clinic and Celebration was held at
the Cape rear Community College Dental
Clinic in March.
During Fall 199<;, the New Hanover
County Dental Stafl'conducted the NCIlI
Hanover County ,)eniors' Dental Program in
cooperation with the Wilmington
TriCounry Dental Society, the North
Carolina Dental Health Section and the
New Hanover County Department of
Aging, A series of presentations entitled
Dental Care Jor the Ulder Adult reached ap-
proximately 250 senior adults at six dif-
ferent nutrition sites. The programs in-
cluded information on proper nutrition,
brushing, flossing, care of dentures, ~lS
well as prevention of oral cancer. Addi-
tionally, staff conducted dental scrcenings
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for over 75 scnior adults to check for cavi-
ties, gum disease, ill-fitting dentures and
oral cancer.
Other programs conducted by the Divi-
sion included the Early Childhood Caries
Prellention Program, the Diabetes and Ortd
Health ProgrtUn, Dental Hl'tllth fir a Life-
time parenting programs and the Lets
Ttdk Teeth preschool and daycare classes.
J'lle New Hanover COUJlty Seniors' Dental
Progmm and other dental health educa-
tion and prevention programs demon-
strate how the New Hanover County
Dental Program collaboratcs with vari-
ous organizations and agencies to assure
optimal oral health for thc citizens in our
community.
Environmental Health
Our environment influCI1ces many aspects
of our wdl-bcing. Many diseases can be
initiated, promoted, sustained or stimu-
latcd by cnvironmental factors. The Envi-
ronmental Health Division (EHD) pro-
tects the public health and environment
with a divcrse group of serviccs in thc
community, including evaluation of: all
types of food operations; body art estab-
lishments; child care facilities; foster care
homcs; institutions including hospitals,
nursing homes and private and public
schools; lodging facilities; public swim-
ming pools and other recreational waters;
wastewater systems; and warer supplies.
The Division assesses air quality, identi-
fies/mitigates environmental har.ards, in-
cluding lead and applies control method-
] 999/00 ANNUAL REPORT 13
ology for potential disease vectors such as
mosquitoes and ticks. During disaster re-
sponse and recovery, many services and
supports are offered to facilitate the resto-
ration of normalcy in the everyday lives
of citizens.
GOAL
. Assess, understand and control the
impacts of people on their environ-
ment and the impacts of the
environment on people
FOOD SAFETY
Achieving 100% II1spectIon coverage
(quarterly evaluations) of establishments/
facilities is critical to assuring food safety
practices and reducing the risk of
foodborne illness in the population. A
minimum frequency of inspection is es-
tablished for the various types of estab-
lishments/facilities in the North Carolina
General Statutes and Administrative
Code. Increasing the inspection frequelK)'
is an ongoing objl.:ctive, however, continu-
ous growth in the local food service in-
dustry ha.... a major impact on the Division's
ability to meet this objective.
Changes in state laws brought juice bar
operations. previously exempt from regu-
lation. under the regulatory umbrella.
During recent years many establishments
have begun making drinks from a wide
variety of raw food products. House Bill
9'\7 changed G.S. 130A-247 (4), requiring
establishments making potentially hazard-
ous beverage,.. from raw fruits or veg-
etables be regulated, even if the beverages
arc served in a disposable cup. Most bac-
terial growth is prohibited or restricted by
a pH less than 4.6. f-=ood items with this
property arc not termed potentially haz-
ardous. The juices of almost all vegetables
and some fruits have a pH above 4.6.
which rises even higher when mixed with
water or milk. Also, breaking of the cell
wall when raw fruits and vegetables arc
pulped in a blender releases cytoplasm, C[(,'-
atinga highly nutrient media for bacterial
growth.
Demand for food service industry train-
ing and certifying remains high. Food ser-
vice establishments with at least one tull-
time supervisor who has attended an ac-
credited course and has been certified
through writren examination are awarded
two bonus points on their sanitation
score. Through a joint venture with Cape
Fear Community College (CFCC), EHD
staff instructed five sessions (178 stu-
dents) of the National Restaurant
Association's Sewing Saft Food Certification
Course. More than 94%, 169 students,
obtained the certification credential.
Clarence Fosters Restaurant of
Wrightsvillc Beach received a plaque and
special recognition by the Health Director,
CFCC Dean of Continuing Education
and the Board of Health for having five
certified employees in their operation.
One-on-ollc or small group food safety
instruction was also provided to meet the
needs of an additional 408 individuals.
Of particular note was participation in an
informal residence hall meeting at UN CW
where a student
told of being criti-
cally ill from e.
coli. She was for-
to address the risk of disease transmis-
sion to customers and/or practitioners.
Support for this public health initiative is
strong among local practitioners who of-
ten reference complications and the risks
of substandard practice. With state laws
and rules governing tattoo artists in place,
a comprehensive approach now exists to
manage the risk of disease transmission
in body art businesses.
PUBLIC SWIMMING POOLS
A statt' rule implemented this season is a
requirement that telephones be located at
public swimming pools. In anticipation
of possible confusion over this issue,
EHD staff eXplained the rules to pool
owners and service companies well before
pools opened for the season. This early
contact met with very positive feedback
Establishment/Facility
Inspections
tunate to recover
kidney function
lost during this
illness.
4200
4100
4000
~ 3900
o
:g 3800
ID
g. 3700
E
,. 3600
3500
3400
3300
Along with five
other North Caro-
lina counties,
EHD continued
participation in a
pilot project
where only nu-
merical scores arc
posted for view by
ClIstomers in restaurants/tacilities. The
results of survey instruments distributed
to the public, restaurateurs and staff were
made available to EHD staff and the
Board ofHl'alth. This data was used in a
recommendation to the North Carolina
Commission ror Health Services to change
the method of displaying levels of com-
pliance with food safery and sanitation
standards.
Yr95
BODY ART
Rules Governing Bodv Piercing EsUiblishments
dndPrtUtitioners, patterned after the National
Environmental Health Association Model
Code, became effective September I, 1999,
14 NEW HANOVER COUNTY HE,\LTH DEPARTMENT
Yr96
Yr99
Yr97
Year
Yr98
and enabled speedy permitting of facili-
ties thar met equipmel1t and water CJuality
standards. An initiative to make the mini-
mum of necessary checks on pool, spa
and hot tub operations rook staff to these
locations again during July and August.
This second evaluation helps generate a
more accurate rate of compliance with
safety and water quality standards. Iden-
tifying and mitigating suction hazards was
a strong tocus of evaluations as these pose
serious risks to children.
VECTOR CONTROL
Rebuilding the equipment inventory was
a major focus for the year. A large alumi-
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Environmental Health Specialists co/lectl1 sen-
tinel chicken blood specimm to test jor Ezstem
Equine Encephalitis and\ffst Nile ll;rnses.
num boat for accessing dredge disposal
islands in the Cape Fear River, which are
highly suitable mosquito breeding
habirats, greatly improved safery con-
ditions for staff A new trackhoe re-
placed an outdated piece of equipment
and has proven beneficial on a variety
of water managcmt.:nt projects.
Laboratory
The Laboratory is a technical and testing
support service for Health Department
programs and private health care provid-
ers, providing quality medical and cnvi-
ronmentallaborarory services to the citi-
zens of New Hanover County. The Labo-
ratory is certified by the Federal Govcrn~
mcnt under the Clinical Laboratory Im-
provement AITIt:ndmcnrs of 1988. The
Water Bacteriology Program is licensed by
the Statl.: Laboratory of Public Health.
Staff is to be commended that no defi-
ciencies were found during the bi-annual
inspections of the programs. Proficiency
testing, quality assurance programs, test-
ing quality-control and competent person-
nel enables the Division to continue to
provide the best of services.
'i'he Laboratory performed 121,322 pro-
cedures during FY 1999/00, including:
EHD staff is responsible for a broad
range of disaster response activities. A
new duty added last season was the trans-
port of portable generators to shelters.
Due to the urgent situation hitches were
express shipped and staff rowed the
generators to three shelters before the
arrival ofHurriclI1e Dennis.
Sentinel flocks of chickens arc used at two
different locations (Division Drive and
Marathon Road) to detect the virus that
causes Eastern Equine Encephalitis. This
mosquito season, the thn.:at of the deadly
West Nile virus led to the addition of
flocks at Alexander Road and rort Fisher
Blood was drawn every two weeks, pro-
cessed in the Health Department labora-
tory and shipped to the state public health
laboratory for Eastern Equine Encephali-
tis and West Nile virus screening.
WATER QUALITY
Recreational watcr quality concerns again
brought attention to coastal North Caro-
lina. Many inquiries were directed to the
Health Dcpartment, duc to Wilmington
being the most populous coastal city.
Caller's questions indicated a va..<;tly differ-
23,518 for theSTD Program; 45,.197 for
Women's Preventive Health; 34,830 for
the W1C Program; 2,140 for the Jail
Clinic; 5,424 for Child Health Programs;
1,314 for the Neurology Clinic; 5,078 for
the Tubcrculosis (TB) Program; and
3,621 for the Water Bacteriology Program.
Testing included but was not limited to
gonorrhea and wet smears; urine, throat
and gonorrhea cultures; urinalysis and
microscopic tests on urine; pregnancy
tests; hematology profiles; glucose, cho-
lesterol and liver panels in clinical chem-
istry; tests for the HIV virus, qualitative
and quantitative tests for syphilis; stool
cultures to control shigella outbreak; and
water coliform tests.
The Health Department motto Your
Health - Our Priority was at no time more
evident than during the aftermath of
ent perception of water quality status than
what existed. Throughout the recreational
season, fecal coliform and enterococcus
rcsting in the heavily used beach and in-
land areas demonstrated safe conditions.
A Special Session of the General Assem-
bly convened in December 1999 and
appropriated funds to assist with Hurri-
cane Floyd assessment and recovery.
Approximately $1 ,000,000 was earmarked
to address public health concerns, includ-
ing monitoring watcr quality and the im-
pact of storm flooding on private water
supplies in eastcrn North Carolina. The
state Division of Environmental Health
contracted with the Hcalth Department
to sample and inspect each well with a
post-Floyd positive tcst for coliform. The
wells were sampled for total coliform, fe-
cal coliform and nitrates. The following
issues were addrcssed during this project:
(1) are properly constructed and 100:ated
wells safer than those that are not; (2) are
there clusters of contaminated wells where
residents might easily be connected to a
public water supply; and, (3) is there a con-
tinuing problem of well contamination.
Hurricane Floyd. The laboratory pro-
vided free water bacteriological testing to
protect the health of our county and thc
surrounding area. Over 2,400 samples
were tested for the citizens of New
Hanover County.
One of the major objectives of the State
Hcalth Director is thc elimination oflcad
intoxication in North Carolina children.
Through the combined efforts of the
Laboratory, Nutrition, Community and
Child Health Divisions, there were 1,920
hlood lead samples collected during FY
1999/00.
At rhe beginning of FY ] 998/99, rhe
Laboratory incrcased the test load for the
TB Program. Liver panels were done on
all patient<; in the program including LDH,
Total Biliruhin, Alkaline Phosphatasc,
1999/00 ANNUAL REPORT 15
AST and Creatinine tests for base line in-
humation and use as a monitoring tooL
Over the past twO years, testing has increased
150 per cent,
The Laboratory provides testing and phle-
botomy services for special programs. To
celebrate WorldAIDS Testing Day. the 1200-
ratOl)' and Communicable Disease Divi-
sionswere part ofa special Block Party with
the CURE AIDS Program. Food, music
and monetary incentives provided the back-
ground fi)r more than 80 people to be vol-
untarily tcsted for syphilis and the HIV vi-
rus. Oncc again this year, the Division was
intensely involvcd in a shigella outbreak in
local day care fJ.cilities and provided testing
and laboratory medicine expertise.
Nutrition
The Nutrition Division provides a variety
of slTvices for the residents of New
Hanover County. The two programs
within this division are the Supplemental
Nutrition Program for Women, Infants
and Children (WIC) and the Ceneral Nu-
trition Program.
W1C PROGRAM
WIC is a short-term intervention program
designcd (() inAucncc lifctime nutrition
and health behaviors in a targeted, high-
risk population. Services are provided to
low-income prenatal, postpartum and
breastfeeding women, infa,nts and children
up to five years of age. More than 3,000
residents received WIC benefit.<; during FY
1999/00. WIC has long been recognized
as the nation's premier health program.
W1C PROVIDES:
. Quality nutrition education and
servlccs
. Rreastfeeding promotion and
education
. A monthly t"{lOd prescription
(package)
. Access to maternal, prenatal and
pediatric health-care services
A goal of the New Hanover County WIC
Program was (0 increase WIC participa-
DuringApril ,be LaOO-
ratOl)' celebrated botb
Public Health Month
and National Medical
Labomtory ~ek, A bul-
letin board in the clinic
area displayed available
services and empha-
sized this year's theme,
Lahomtory Proftssiona~,
Guiding Health((lre Into
The New Millennium.
The staff also panici-
pated in many activities
to promote healthy
lifestyles among dients
and employees.
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More than 2.400 water samples were tested following
HumClme Floyd
tion of the identified population at risk.
The program was awarded a WIC Out-
teach Grant from the state Nutrition Ser-
vices Branch (0 fund an intensive outreach
effort. A temporary outreach worker was
hired to distribute information about
WIC services throughout New Hanover
County. Outreach efforts included radio
ads on a popular local radio station; pub-
lic service announcements on other radio
stations; visits to daycare centers, churches,
public housing authorities. doctors' of-
fices and a variety of local businesses; a
newspaper article published about WIC
services; WIC information booths set lip
at local shopping areas during peak shop-
ping hours; and WIC promotion on
McDonald's restaurant tray liners.
The program intensified dl{uts to pro-
vide more support to bn:astfeeding moth-
erswith a goal to increase successful initia-
tion and duration of totally breastfed in-
fants. Several electric breast pumps were
purchased, a loaner program was initiated
and 36 mother-baby pairs participated. All
nutritionists received breastteeding edu-
cator training to provide education, cn-
couragement and support f"{H mothers
who decide to breastfeed and provide the
perfect food for their infants.
The WlC nutritionists provided 8,482 in-
16 NEW HAN()VER COUNTY HEALTH Dl::l'ARTMENT
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Getting measured to assess growth is part ofa
WlCvisit.
dividual nu~rition counseling sessions to
WICdients. Management support issued
WIC food instruments or vouchers worth
more than $1.7 million and redeemable at
local supermarkets and pharmacies.
GENERAL NUTRITION PROGRAM
This year '572 individual counseling ses-
sions and 3'5 community presentations
provided preventive and therapeutic scr~
vices. Direct nutrition services are pro-
vided at the CommunitY Health Division
well baby clinics, Neonatal Intensive Care
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follow-up clinics and Coastal OB/GYN
prenatal clinics. Patients are referred for
nutritional counseling by Child Health
Child Service Coordinators, Women's
Health family planning clinics, Commu-
nity Hl.>aIth orthopedic and neurology clin-
ics and school nurses. Many referrals are
received from private physicians. New
Hanover County residents request indi-
vidual nutrition counseling and inquire
about the most current nutrition infor-
mation concerning such issues as weighr
management, diabetes mellitus. hypercho-
lesterolemia, hyperlipidemia, vegetarian-
ism, food allergies and growth and devel-
opmental concerns.
N utritionist<; attend a variety of conferences
and seminars to stay current on the latest
nutrition research and information. Top-
ics included gl.'Stational diabetes, the DASH
diet for treatment of hypertension, nutri-
tional therapies for vcry low birth weight
premature infants, osteoporosis. alterna-
tive medicine for pediatrics, feeding prob-
lems of special needs children, diabetes
mellitus, women's nutritional health and
nutrition for high risk pregnancies.
Promoting good nutrition throughout
the life cycle for all citizens of New
Hanover COllnty builds a healthy com-
munity. The Nutrition Division promotes
rhe Health Department's mission of Your
Health-Our Priority.
\\/Omens Health Care/Health Promotion
The Women's Health Ca,e (WHC)/
Health Promotion Division is comprised
of Women's Preventivc Health, Maternal
Health and Health Promotion.
GOALS
. Prevent unwanted pregnancies
. Improve the health status of
disadvantaged women
. Provide health education for the
commUnIty
. Build a brighter future for women
and children
. Provide breast and cervical cancer
screening
WOMEN'S PREVENTIVE HEALTH
New H..UloverCoullry Health Deparrml'llt
(NHCHD) provides womens preventive
health (WPH) services which include
health screening, comprehensive phy~icals,
pap smears, breast exams, mammograms
and health education. WPH services are
the only source of pn.'venrive care for
many women. Women's preventive sr..:r-
vices help prevent unwanted pregnancies,
prevent the spread of sexually rransmil{ed
diseasr..:s, proviuevaluahle prevention edu-
cation, reduce health care costs and save
lives. for every $1 spent on \VPH. an aVer-
age of$4.40 is saved in health, welfare and
nurrilional expcnditures. \VPH provided
3,329 clinic services to women last year.
WHC Division goals are early idcntifica-
tion of pregnancy with timely referrals t"{u
prenatal care and improved birth outcomes.
Among the teen population in New
Hanover County in 1998, there were 369
pregnancies in the 10-19 age range (25.8%
repeat prcgnancies). Teenage mothers are
more likely to bear subsequent children
more rapidly and to have more unwanted
and oUH.lf-wedlock births. Unplanned
children are at greater risk for abuse and
neglect, which incrcases with t~lInily size.
Women who have unintcnded ptegnan-
cies are more likely to live in poverty. Teen-
agers are more likely to deliver low birth
weight infants due to poor nutrition and
inadequate prenatal Clfe. l.ow birth weight
infants are at greater risk for physical ;lIld
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developmental disabilities throughout
childhood. The cost for long-term care is
insurmountable and is oft-en funded by
taxpayers. The Division provided 201 preg-
nancy tests among the teen population
during the year and provided counseling
;md referrals for 330 positive pregnancy tests
among teens and adults.
The WHC Division suppons a nurse po-
sition our-posted at the Department of
Social Services to reach young women seek-
ing public assistance. The goal is to ex-
plain and offer contraceptive services and
reduce the number of out-of-wedlock
births in the county.
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Lisa Cans, RN, provides women;. health infOrmation and counseling at the Department of
SocialSenJjecs.
191)9/0U ANNUAL REPORT 17
Since 1960, breast cancer has claimed more American lives than
World War 11, Korea, Vietnam and the Gulf Wars combined.
Breast cancer is the second leading cause of cancer deaths among
women in North Carolina. Nationwide North Carolina rank"
ninth for cervical deaths, fourth highest for African American
women and twelfth for white women. These cancers are pre-
ventable and curable. Routine breast exams and pap smears lead
to early diagnosis and treatment. Every woman is at risk, but
some women are less likdy to obtain scrccningscrvices. NHCHD
provides breast and cervical cancer screening free of charge to
qualified women. WPH conducted 168 mammograms (3
abnormals) and 136 pap smears (10 abnormals). The Division
also emphasizes outreach to Latino women in New Hanover
County.
Male sterilization is the birth control method of choice for some
couples. The Health Department provides education, counseling
and scheduling for vasectomies through arrangements with a local
urological group and the Regional Vasectomy program in Greens-
boro, NC. This service is provided free or at a reduced rate based
on income. Services were provided to 23 men last year.
MATERNAL HEALTH
Early and consistent use of prenatal care provides early identitl.-
cation of high-risk concerns, improves birth outcomes and de-
creases low-weight births and infant mortality. NC's inf..1nt mor-
tality rate continues to be among the top lOin the nation. Pre-
vention of one high-risk pregnancy can save over $250,000.
Adolescents and unmarried women have a greater likelihood of
poor birth outcomes. The Maternity Care Coordination pro-
gram assists porentially eligible clients in applying for Medicaid,
develops a strong referral network and increases community
awareness of expanded Medicaid coverage and benefits for preg-
nant women. The program determines clients' strengths and
needs including psychosocial, nutritional, medical, educational
and financial factors. The goals are aimed at reducing infant
mortality and improving the health status of women and their
newborns. Maternal Health provided 4,500 contacts to this popu-
lation and provided counseling and referrals for 998 new prena-
tal patients.
Psychosocial assessment, clinical observation and counseling for
at-risk pregnant women is essential in cases of domestic vio-
lence, emotional crisis, fdmily dysfunction, impending incarcera-
tion, substance use/abuse, negative feelings about a current or
previous pregnancy and emotional disorders associated with
HIV/ AIDS diagnosis during pregnancy. A licensed clinical so-
cial worker addresses these issues among this population and
provided intensive counseling and referrals for over 200 young
women last year.
Young mothers who deliver newborns in hospitals today re-
ceive little recuperation time or instruction prior to discharge.
Issues such as breast-feeding and newborn care often need rein-
forcement to prevent future problems. Postpartum maternal
18 NEW HANOVER COUNTY HEALTII DEl'ARTMENT
and newborn home visiting provides in-home physical assess-
ments, education and referrals for morher/infant pairs within
72 hours following discharge from the hospital, an opportune
time for early problem identification and intervention. Last
year Maternal Health provided nursing visits to 405 mother!
infant pairs.
Womens Health Care provides quality options for women seek-
ing contraceptive care, routine women's health care services, pre-
natal care and cancer screening. Services are provided free of
charge or on a sliding fee scale based on income. Medicaid and
private insurance arc accepted. Protection of confidentiality is a
priority. We have the opportunity and responsibility to provide
factual, accurate and current information on topics such as sexu-
ality, birth control, abstinence, sexually transmitted diseases and
parental involvement, which are crucial to the health and matu-
rity of young women and could save lives. Staff invites oppor-
tunities to share information about services with parents, civic
groups, churches and othet interested organizations. Preventive
education is provided on osteoporosis, folic acid's role in the
prevention of neural tube defects in newborn, pre-conceptional
health education. breast and cervical cancer screening and preven-
tion, childhood obesity and depression screening.
HEALTH EDUCATION AND HEALTH PROMOTION
Health education activities rcached 9,6')') individuals and included
group education, health fairs, and participation in other events
to raise the awareness of women's health issues. Major accom-
plishments included: formation of a Pink Ribbon Plus commit-
tee to provide outreach to diverse groups to encourage breast
cancer screening and to link women with cancer screening events/
opportunities; display of the Blue Cross/Blue Shield Button
Chair during Public Health Month to raise awareness about bn:ast
cancer screening and early detection; and hosting Nine Months and
Then..., a maternity wellness fair that provided a display of
maternity exhibits, vendors, models, and a guest speaker.
The Health Promotion section strives to improve the
community's health status by providing educational programs
to prevent disease and injury and to enhance the community's
ability to solve health problems through informed decision
making. During FY 1999/00, Health Promotion was incorpo-
rated into the Women's Health Care Division and continues to
focus on injury prevention, robaGco use prevention and cessa-
tion, and other general health education topics. The section pro-
vides health education consultation to all Divisions ofNHCHD
and coordinates event~ such as public awareness campaigns, health
fairs, media coverage, and outreach activities.
Injury Prevention provides programming ro reduce morbidiry
and mortality due to injury in the community, and works with
community agencies, law enforcement, and schools to encour-
age safe environments and behavior change. Initiatives included
Handgun Safery classes, a cooperative effort with the NHC
Sheriff's Department. One hundred two residents attended
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quarterly classes regarding current hand-
gun laws, learned proper use and storage
of a handgun and participated in target
practice at a firing range. Another com-
ponent of Injury Prevention is child pas-
senger safety, which included safety scat
distribution to families that demon-
strated financial need. Parents and guard-
ians received information about current
laws and proper use of the scat. A total
of 140 seats were distributed. Bicycle
safety presentations were made to chil-
dren in schools, daycare, and after-school
and summer programs about safety, rules
of the road and proper maintenance of
the bicycle. Approximately 100 helmets
were distributed to children. The Basics
of Bicycling Program was presented [0
NHC schools, and plans are underway
to implement this school~based curricu-
lum.
Project ASSIST (American Stop Smoking
Intervention Study) works to reduce death
and disability related to tobacco use. For-
merly funded by the National Cancer In-
stitute, the program now receives fund-
ing from the Centers for Disease Control
and Prevention. Local initiatives continue
[0 focus on youth prevention, clean in-
door air and cessation for those addicted
to tobacco. Activities implemented
through the local Coalition included
Smoke-Free Dining Day, compliance checks
of local tobacco merchants, health fairs,
school presentations, and information
sessions for those interested in tobacco
cessation. A highlight for the year was the
GOllemor S Surmnit jOr Youth TObacco Preven-
tion. Hundreds of youth and tobacco con-
trol advocates from around the state at-
tended and were involved in two days of
presentations, seminars, and highlights in
FinancialManagement
~
The New Hanover County Health Depan-
mem Amended Budget (Adopted Bud-
get plus any amendments during the fis-
cd year) lor FY 1999/2000 was $9,703,334.
The Health Department's budget is com-
posed of 33 individual programs. Divi-
sion Directors submit a line item budget
for each program within the division. The
Health Director, Assistant Health Direc-
[Or and the Business Officer review bud-
get requests. Budget hearings are con-
ducted and a Budget Workbook includ-
ing all programs with line item narrative
justifications is prepared and submitted
to the Board ofHcalth for approval.
Figure 1 illustrates how the expenditure
budget is divided among Salaries/
Fringes, Operating and C1pital appropria-
(Jon unlts.
c
Figure 2 illustrates the brcakdown of the
Health Department's total revenue
($4,278,403) through Health Fees, Medic-
aid, Environmental Health (EH) Fees,
Animal Control Fees and Other (includ-
ing miscellaneous grants and school con-
tributions). It also shows State/Federal
Grants through the North Carolina De-
partment of Health and Human Services
($1,394,968 which is included in the abovc
total revenue figure) and County Appro-
priations ($5,424,931).
The Health Department's Business Of-
ficer is responsible for preparing expendi-
ture reports to ensure billing and reccipt
of state grant funds. The Health Depart-
ment complies with New Hanover Counry
financial Policies and Procedures that in-
cludes an annual audit.
Fig. 1
Total Expenditures:
$9,703,334
Operating
$1,716,581
18%
Capital
Outlay
$778,115
7%
Salaries & Fringes
$7,208,638
74%
youth tobacco prevention. Another ac-
complishment was the second annual
TObacco Awareness Week. Approximately
'5,500 students in New Hanover and
Brunswick Counties were reached through
presentations, information booths and
"survival stations" where cessation infor-
mation was available. Other events for the
week included a Mayor's Proclamation, a
tree planting cercmony and Teens Against
Tobacco Use (TATU) presentations. Fifrv-
five area high-school students were trained
as peer educators in TATU, which enables
teens to present information on thc dan-
gers of tobacco lIse to younger children.
Fig.2
Total Revenue:
$9,703,334
Health Fees:
$109,515
1%
Federal & State
$1,394,968
14%
EH Fees:
$312,900
3% Medicaid
$1,168,395
12%
Animal Control
Fees: $516,453
5%
Other
$776,172
8%
County
Appropnatlons'
$5,424,931
57%
(Note: Ofthe$UG8,395 Medicaid Rn'enue,
$3(JEJ,891 isMediCttid MaximiZAtion FlOuts.)
1999/00 ANNUAl. REPORT 19
coasta~
AHEC
2029 South 17th Street 0 Wilmington, NC 2840 I
(910)343-6500 o fax (91Ol 341-4146
The New Hanover County Health Department's 1999-00 Annual Report is published with
assistance from the Coastal Area Health Education Center, Wilmington, NC.
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STRA TEGle PLANNING PRIORITIES
November 28, 2000 Update
I. Access to health care
(Issues #7, 11 & 5)
. Beth Jones spoke with a dentist in the community who is one of few who sees Medicaid
clients. (Attachment 2)
. NHCHB approved a part-time school health nurse on November 1, 2000.
. Wilson Jewell met with the Wilmington Tri County Dental Society at their regularly scheduled
meeting on November 7 They discussed the need for more Dental services for Medicaid eligible
children in New Hanover County The group responded favorably to the possibility of the Health
Department providing dental care for this population in the future. Dr Jewell will talk to New
Hanover Community Health Center and Tileston Clinic about the possibility of expansion of their
dental services.
. Information on the cost of contract interpreter services and the need for the interpreter to be a
Health Department employee (Attachment 3).
. New Hanover Community Health Center: Brochure listing NHCHC staff and board was
distributed.
. Speech and Hearina Clinic: Has been discontinued at the Development Evaluation Center
(DEe). Resources redirected to newborn screening.
. Flu Vaccine: Yesterday was largest day in recent years with 371 shots given. Additional
shipments expected over the next two weeks. Assistance from other clerical and nursing staff
requested to provide relief in Communicable Disease. See Beth Jones or Kim Roane. Vaccine
now available for the general public and Health Department employees.
. ReQistratlon Area: New renovation being well received by customers. Thanks to Lynda and
Beth.
. Issues Associated with Treatina Adolescents: An informational sheet from the Institute of
Government was copied to DD's (Clinical and legal issues to consider).
. Lenscrafters Vision Van: At the mall November 21-22. Exams and glasses are being
provided to students who have been unable to obtain an appointment.
.
II. Preventive services & lifestyle-related risks
(Issues #12 & 15)
. NHCHB approved an asthma initiative grant application on November 1, 2000.
. HealthY Carolinians Conference: Lynda Smith, Elisabeth Constandy, and David Howard
attended on October 17-18. Healthy Carolinians 2010 N. C. Plan for Health and Safety, a Report
of the Governor's Task Force for Healthy Carolinians, manual was passed around for review
. Diabetes Today: Ginny Peterson has replaced Trish Snyder as facilitator of this grant.
. Diabetes Coalition: Ginny Peterson, Diabetes Coalitions Coordinator, of second year grant
funding activities. UNCW nursing students to distribute Diabetes information on November 7 at
election poles. Sugar Angels Support Group meets monthly (2nd and 4th Saturday) to assist
patients and families with managing Diabetes.
. Asthma Task Force: Task Force to meet and review grant application for grants addressing
Asthma interventions and environmental issues affecting children with Asthma.
. Flu Vaccine: Three Categories (I, II, and III) have been established to determine the
administration of the limited supply of flu vaccine. Category 1 (those over 65 years of age or those
having chronic diseases) is the first group now receiving vaccine. Categories II (providers of care
for those in category I and others who are at risk based on caregiving) and III (the healthy
population who want flu vaccine protection) should all be able to get the vaccine in the near future
(a week or two). General Clinic averaging 300 flu injections daily. There should be enough flu
1
vaccine to supply all three categories. Flu injections were offered at County Fun Day to county
employees as traditionally done. Master cards had to be pulled for county employees. Health
Department employees are asked to get their vaccinations at the health department rather than at
the county fun day, which makes the workload issue easier IE pulling master cards and off-site
injections. The goal of the Communicable Disease Division is to get people immunized against
influenza. A compliment was extended to the General Clinic staff for their courteous, efficient
service from a client receiving a flu injection
. Inter City Rabies Clinic: To be held Saturday, November 4 at 5 Point Community Center
.
III. Communication, education & marketing (promotion)
(Issue #1 & 4 in part)
. A concern was addressed from staff that management team meeting information was not
being shared consistently throughout the department. It was recommended that we publish
minutes from our management team meetings each week and distribute to staff. The first official
minutes were distributed to staff on October 17
. Group #3 Task Force (Communication, Education & Marketing (promotion)) met November 1
Our plans are as follows: Investigate specific signage for consistent display of prevention
messages; Discussed infant car seat instruction; discussed Latino education and the need for
emphasis on English as a second , and established a regular meeting time - month Iy -
immediately following BOH meetings.
. Communicable Disease Division educationai messages (Attachment 4).
. Cold Weather Care of Animals: Press release on October 9.
. 2nd Case of Rabies in 2000: A child is being treated for a raccoon bite.
. Latino Fest: Volunteers needed on November 4.
. Health Fairs: Health Promotion is screening events for participation by Health Department
. Seafood and Jazz Festival: Laboratory and CDD staff provided STD/HIV testing and
counseling at the Seafood and Jazz Festival on October 21
. Web PaQe Update: Submit web page updates to Dave Rice.
. Child Health Month: More than 200 outreach contacts made during October
. Maternity Wellness Fair: Scheduled for November 1 at Health Department.
. Mundo Latino: Advertising in monthly newspaper discussed.
. "Eat for Pete": Fund-raiser for Animal Control Services Trust Fund, November 5-11 at
participating restaurants.
. Maternity Wellness Fair: "9 Months & Then" was a very successful event.
. Health Department Display at Airport: Changed to Smoking Prevention on November 6
. General WaitlnQ Area Bulletin Board:
. FY 1999-2000 Annual Report: Going to printer today Will be available on December 6.
. WAAV Radio Vacancies: January 2 and 30, February 13 and 27 available.
.
IV. Facility utilization & Information technology
(Issues #6 & 4 in part)
. Formed two task forces regarding issues relating to facilities and information technology
Facilities Task Force members: Betty Creech, Beth Jones, Nancy Nail, Lynda Smith, Tom Stich,
Diane Vosnock, and Edwin Link. Information Technology Task Force Members: Frances DeVane,
Cindy Hewett, Susan O'Brien, Jean McNeil, Betty Jo McCorkle, Sharon Neuschafer, and Marilyn
Roberts.
. Updates on Facilities Task Force (Attachment 5).
. IT Strategic Planning Committee met on November 14 (Attachment 6)
. New Hanover County IT Trainina Center: Operational. Health Department is documenting
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our needs.
. Information TechnoloQv' Installation of fiber line at New Hanover Network is complete. Staff
is working with ICD9/CPT Code conversion daily
. SEMH Facilities: Letter drafted to County Manager regarding the status of Southeastern
Mental Health facilities, should they become available in the (distant) future.
Information TechnolollV Task Force: Developing an assessment tool for input on information
technology issues.
. Trackinll Database: Currently working with NHC IT Department to implement tracking
database for staff to use related to computer issues.
.
V. Water quality, storm water management & drainage; & Air
quality (Issues #3 & 8)
. Dianne Harvell is assembling a listing of county & state agencies other than NHCHD who
monitor air & water She plans to contact them & request their data/interpretation of their data.
This should paint a picture of what is now known re: quality of our environment & should give us
some direction as to where we should proceed. Also, She is working w/management support staff
to develop new systems of managing data we now receive, i.e. groundwater contamination, sewer
spills, etc.
.
VI. Emerging health risks
(Issue #13)
. Mosquito Control: New wetland sites that breed mosquitoes are being located for next
yea~s plan of attack.
. West Nile Virus: Health officials announced a dead crow found by a biologist at Jordan Lake
last month tested positive for the West Nile virus (the first incidence of the mosquito-borne disease
in N. C.).
. Rabies: 3rd positive case in 2000 (59 since 1996) confirmed. Located on North Hampton.
. Public Health Preparedness Grant through UNC-SPH.
.
VII. Population growth & diversity
(Issue #2)
. Mundo Latino: Advertising in monthly newspaper discussed.
. Information on the cost of contract interpreter services and the need for the interpreter to be a
Health Department employee (Attachment 3).
. The Great Divide: Understanding and Eliminating Health Disparities Conference on
December 12-13.
.
VIII. Discontinued services picked up by Health Department
(Issue #9)
. Child Birth Classes from NHRMC and Coastal AHEC.
. Discussions regarding Home Health and Coastal Diabetes
.
IX. Staff Development & continuing education
(Issue # 14)
. Substance Abuse Workshop: November 3 in Auditorium.
3
. Health Directors' Leaal Conference: on October 18-19.
. Emplovee Traininll and Development Prollram: Supervisors are encouraged to focus on
the Supervisory Training. A basic supervisory course is a prerequisite to other training
opportunities.
. New Hanover County IT Traininll Center: Operational. Health Department is documenting
our needs.
. Disciplinary Action Traininll: Scheduled on December 19 after Regular Management Team
. meeting at 8:30 a.m. in Conference Room at 9:00 a.m. in the Health Department Auditorium.
John Beasley, training facilitator Copies of Disciplinary Action Section, Personnel Manual of
Local Government Employees Subject to the State Personnel Act, to be distributed during the
training. All Health Department supervisors should plan to attend.
. How to Help Kids Succeed: Child Health staff participated in parental inservice on Saturday,
October 30, and reviewed book entitled How To Help Kids Succeed.
. Health Insurance Portabilitv and Accountability Act IHIPPA): Seminar on November 1-2.
. American Public Health Association Annuai Meetinll: David Rice circulated the meeting
sessions to Division Directors for review He handed out information on performance standards
and Healthy People 2010.
. Environmental Health Supervisors Association Annual Meetinll: Alicia Pickett presented
our experience with the Food Grading Pilot Project. Mixed reviews of the project across the state
ofNC.
. Public Health Series: On Public Events Network. Begins November 16 at 9:00 pm. Will
continue on 2nd Thursday of every month.
. Asthma and Indoor Air Quality issues: Tom Stich attended this workshop in Greenville
N.C.
. Volunteers: volunteers with public health background asking for relevant assignments.
Volunteer recognition event has been scheduled for February 8, 2001
.
X. Evaluation of services
(Issue #16)
. Orllanizational Capacity: Yesterday, the AEIOU Team reduced the number of indicators to
evaluate to 23. Staff improvement teams will be formed when opportunities are identified from
these indicators. Please contact an AEIOU Team member for more information.
. Stratellic Planninll Priorities: Displayed on walls of Health Department Conference Room,
Auditorium, and on bulletin boards. Facilities Committee will meet in Mid-November and discuss
health department signage. Information Technology (IT) Committee plans to meet also in
November
. Fee Policv Update: Will be distributed to Staff after NHCBH approves.
. Medicaid Cost Studv: Reports for this study will be printed and distributed.
. Volunteer Hours: Should be tracked for all divisions. Committee formed to address this
issue.
. FY2000-G1 Vacancies and Overtime Information: Information being gathered for the
Budget Office.
. Travel Expenditure Reports: Appropriate reporting by employees and the review of reports
by supervisors was discussed.
. WIC On-slte Printinll of Vouchers: Vouchers are now being printed, effective November 20.
Training has been provided for Health Department employees. HSIS identification is being set up
for staff requesting access to WIC data.
. AEIOU Team: The form for suggestions was again discussed and will be made available at
Staff bulletin boards.
. Pav and Classification studv: New Hanover County will implement results of the study
during the January 23 - February 5, 2001 pay period. According to The Morning Star, the Health
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Department will receive $353,338 of the $1.8 million allotted to implement the pay and
classification study in FY 2000-01
. Credit Cards: A demonstration relating to the use of credit cards will be held November 29 at
10am.
. Community Health Assessment: Will be submitted to State this week.
. Volunteers: Committee met to discuss method of reporting volunteer hours worked.
Recommendation was for every Division to use draft form and submit it to Kim Roane monthly
Management Team approved the form.
. Manaaement Team Composition: Dave Rice announced the composition of the
Management Team, effective December 5, 2000. The members are: Frances DeVane, Jean
McNeil, Beth Jones, Betty Creech, Dianne Harvell, Lynda Smith, Betty Jo McCorkle, Janet
McCumbee, Nancy Nail, David McDaniel, Susan O'Brien, Cindy Hewett, Elisabeth Constandy, and
Dave Rice.
.
5
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Department for evaluation.
Medications for preventive
treatment are free through
the Tuberculosis Control
Program.
TB websites that may be
helpful are:
. NC TB site:
http://tbnc.mc.duke.edul
index.htm
. American Lung
Association:
www.lungusa.org
. American Thoracic
Society:
www.thoracic.org
. Centers for Disease
Control and Prevention
Division of
Tuberculosis
Elimination:
www.cdc.gov/nchsto/tb/
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Experts in sexually
transmitted diseases
are at work discussing new
research and formulating
revisions for the CDC's
guidelines for the
treatment of sexually
transmitted diseases. Dr.
Judith Wasserhut; MD,
MPH, director of the
CDC's DivisionofSm
Prevention, says new
guidelines will reflect
trends in sms, with
increasing emphasis on
STDs in pregnancy and
reproductive health, and in
men who have sex with
men.
Bacterial vaginosis (BY)
has received recent
attention because of its role
in premature delivery and
increasing susceptibility to
HIV. Thus far there are no
changes in treatment
regimens, with oral
metronidazole 500 mgm
twice a day for 7 days
recommended for non-
pregnant women. There
appears to be no
significant difference in
the effectiveness of oral
and intravaginal
preparations of
metronidazole for the
non-pregnant woman.
However, three
randomized treatment trials
of intravaginal
metronidazole in pregnant
women after 24 weeks of
pregnancy showed no
better results than with
placebo, and the
intravaginal preparation
may increase the risk for
prematurity.
How to manage recurrent
BV received mixed
opinions, some suggesting
adding topicals to oral
regimens, and some
switching antibiotics
empirically to longer
regimens. The role of
maintenance therapy to
prevent recurrences
remains unknown.
The screening and
treatment of high-risk
asymptomatic women
was supported, especially
those who undergo
abortion, invasive
procedures, or reproductive
tract surgery.
Communicable Disease Statistics
New Hanover County
July 1, 2000 - October 31, 2000
..." ;-- :",': . "'"-'-"::::":':--':':-::-:-:--".:<:'::'::""':::'::.:'\:'::-:-.::::-.:.:-::-:-:;:::-" ..
..~I[)S....~.'............~}.......,....,...,}.,..,................7. ...... ......~~~lm;:Ii'~[:I;;;;I:.
g~i~~~~~~f~~;<;;....:i.~2~i....... . ............Pe~ijijsis..;;...:...;;...'/;..A;....;i.<P....'
...E;)C;:oUi()t~?:1;'7".'/...i';......./()'.'.'.'.'" .....R~y;tJ!1.to;..~P~~~f~,,~~q....
Gonorrhea. .. .n .148S~liri~il~lfl)Si~';';.f;if;~t
}He~#!i!ii~<:.;...'... .........1... .$Iligellp.~is;,.;:.:;.;~~
H~pllti~i~~(~cutel ..... 2 Strep;Gtol.lp~ll1vil~i,,~~i
Hepati!i~~(pj""ierl... 7 Syphilis..;;;~ ,:,'.~:3
HepjtitlsC(ai::utel O. Tuberculosis. ...".,3
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EPllnformation
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November 2000 New Hanover County Health Department Betsy Summey F N P Editor
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New legislation (SB
1234) "An Act to
Require that Adult Care
Homes and Nursing Homes
Ensure that Residents and
Employees are Immunized
Against Influenza Virus
and that Residents are Also
Immunized Against
Pneumococcal Disease",
passed during the 2000
session of the North
Carolina Legislature.
In summary, the law
requires that nursing homes
and adult care homes be
required to ensure that both
residents and employees
are immunized against
influenza virus and
pneumococcal disease.
There are two effective
dates. The effective date
for the pneumococcal
requirement is September
CONTENTS
STO Treatment .... 2
Slats............. 2
1,2000, while the effective
date for the influenza
requirement is September
1,2001. The immunization
and documentation
required shall occur no
later than November 30 of
each year.
Please note the exemptions
to these immunization
requirements: "(e) No
individual shall be required
to receive vaccine under
this section if the vaccine is
medically contra-
indicated, or if the vaccine
is against the individual's
religious beliefs, or if the
individual refuses the
vaccine after being fully
informed of the health
risks of not being
immunized."
A detailed article about the
new legislation was
distributed to nursing
homes through the North
Carolina Health Care
Facilities Association.
lllllllllllllllllltlllliI1l1fll,j'llll'!i
With U.S. tuberculosis
case rates declining
in the past two years to an
all-time low of 6.4 cases
per 100,000 population in
1999, the opportunity to
completely eradicate TB in
the U.S. is a very
obtainable goal. Key
factors will be persistent
and aggressive efforts to
complete therapy on all
cases, and adequate
treatment of all patients
with latent TB infection
(L TBI) with significant
risks for progression to TB
disease.
Subsequently, the newest
guidelines for tuberculosis
control issued by the
Centers for Disease
Control (CDe) and the
North Carolina
Tuberculosis Control
Program show a broader
age range for treatment of
L TBI. The new
guidelines, when
considering whether to
treat, are risks for being
infected with MTB and
for progression to
disease. Age of the
patient, important in
monitoring drug side
effects, is not an important
factor in considering
whether to start preventive
medication.
e
Any patient with a positive
TB skin test who has never
received preventive
treatment, should be
referred to the Health
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NEW HANOVER COUNTY BOARD OF HEALTH e
2001 Executive Committee Meeting Dates
. January 29, 2001 (Monday)
. February 27, 2001
. March 27, 2001
. April 24, 2001
. May 29, 2001
. June 26, 2001
. July 24, 2001
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. August 28, 2001
. September 25, 2001
. October 30, 2001
. November 27, 2001
. December 18,2001
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ANCBH
- Reception -
(in honor of Emeriti)
Thursday, January 11, 2001
5:30 p.Ol. to 7:30 p.Ol.
Radisson Governor's Inn
1-40, Exit 280 @ Davis Dr., Research Triangle Park, N.C.
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- Meetings -
Friday, January 12, 2001
Radisson Governor's Inn
(Refer to Accommodations and Directions.)
8:00 a.m.
9:00 a.m.
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11:30 a.m.
lZ:OO p.m.
lZ: 15 p.m.
12:40 p.m.
lZ:45 p.m.
1:30 p.m.
1:45 p.m.
2:15p.m.
2:30 p.m.
3:00 p.m.
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AGENDA
ANCBH Registratioa
Exhibits & RefresbmeDts (8:00 a.m. to lZ:OO p.m.)
ADDual NC State Health Director's CoufereD": "Commou BoDds: The Unk
BetweeD PubUc Health & Goueti.." - A_rds Breakfast (ANCBH Members
wekome. Pi.... iudieate oa the Preregistratiou Form.)
AIVCBH Fifteenth A1UWI1/ Meeting BegIns
Additioaal RegistratiuulExhibits
A_rds LaDcbeou
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Awards Presentation: Suo Adams, Past President
"Outstanding Board of Health Award"
. "Carl Durham Award"
"The Robert Ed Strother Partnership Award"
"The President's Award"
~
PresideDt's Greetiag: Lee Kyle A1ku
Topic: Board. of Healtb & Effective Supervisioa: "Wbat works!"
Key Note Speaker: Wayse A. Clark, Pb.D., PresideDt, The AddisoD Group
Discussion
Basis... Meetiag: Lee Kyle AIIea, PresideDI, PresidiDg
. Election ofDireclors
. Nominating Committee
. Treasurer's Report
Bylaws
Other Business
aosiag RemarkslDrawiag fur Door Prizes
Board of Directors' MeetiDg: Lee Kyle AileD, PresideDI, PresidiDg
Election of Position ofPrcsident Elect
. Election of Position of Secretary
. Election of Position of Treasurer
. Other Business
Adjourn
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.
.
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ANCBH Fifteenth Annual Meeting Preregistration Fo
January 11 & 12,2001
Name:
County:
Address:
Phone (Day):
Phone (Evening):
Ernail:
Fax:
Circle the appropriate fee:
Members $55
Non-Members $60
Health Directors $35
ANCBH Emeriti None
(Fee includes materials, lunch, & program.)
NOTE: An additional $10 will be added
to the fees listed for registration at the
door. Thanks!
Check yes or no to indicate your attendance at the Reception. Please record the name of the
guest who will be accompanying you:
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_Yes, 1 will be at1endingthe ANCBH Reception on Thursday, January 11,2001.
_No, 1 will not be attending the ANCBH Reception on Thursday, January 11, 2001.
Check yes or no to indicate your attendance at the Awards Breakfast for the State Health
Director's Annual Conference, "Common Bonds: The Link Between Public Health &
Genetics. "
_Yes, I will be attending the State Health Director's Awards Breakfast on Friday, January
12,2001.
-No, 1 will not be attending the State Health Director's Awards Breakfust on Friday,
January 12, 2001.
Complete this form and return with your appropriate preregistration fee no
later than December 29,2000. For immediate preregi8tration,fax this form to
(919) 677-4200 or call (919) 677-4132.
Make checks payable to: ANCBH Return to: ANCBH, P.O. Box 4449, Cary,
N.c. 27519-4449. No refunds after January 5, 2001. Thank you!
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Accommodations
CALL: Radisson Governor's Inn, 1-40 at Davis Drive, Exit 280, Research Triangle Park,
N.C., (919) 834-9900 For Radisson Worldwide Reservations: 1-800-333-3333 CaD by
January 3, 2001 to make your reservations. State your attendance at the
Association of North Carolina Boards of Health (ANCBH) 15th Annual Meeting
in order to secnre the foDowing room rates.
ROOM RATE: $60.00 + II % tax per night for single occupancy. $70.00 + II % tax per
night for double occupancy. Check In time is 3:00 p.m. and Check Out time is 12:00 p.m.
Please let the hotel know if you need to extend your Check Out time. The hotel has multiple
in-room amenities; outdoor activities include Tennis, Volleyball, and Basketball courts,
Swimming Pool, and Workout Trail; In-house Exercise Room; Free privileges at RTP Fitness
Center; Restaurant; Bar & Grill; and transportation at no charge to Airport and RTP
(including Triangle Factory Shops). For more information about the Radisson
Governor's Inn, go to www.radisson.com and enter Research Triangle Park for
city name under the "Find a Hotel" selection.
NOTE: If you would like to know about other hotels in the area, please call Catherine
Moon at (919) 677-4137 or email: cmoon@ancbh.org.
Directions
The Radisson Governor's Inn is in Research Triangle Park, centrally located to Raleigh,
Durham, and Chapel Hill near the cross street ofNC Hwy.54 and Davis Drive at 1-40.
From 1-40 West take Exit 280 (Davis Dr.), left onto Davis Dr., right at first traffic light,
Hotel is on the right.
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From 1-40 East take Exit 280 (Davis Dr.) and continue straight through traffic light, Hotel is
on the right.
From 1-85 North merge with 1-40 East, take Exit 280 (Davis Dr.) and continue straight
through traffic light, Hotel is on the right.
From 1-85 South follow to the Durham Freeway/147 South continue onto 1-40 East, take Exit
280 (Davis Dr.) and continue straight through traffic light, Hotel is on the right.
Annual State Health Director's Conference
The Annual State Health Director's Conference: "Common Bonds: The Link Between Public
Health & Genetics."will be held in conjunction with the ANCBH Fifteenth Annual Meeting on
January, II - 12,2001 at the Radisson Governor's Inn, Research Triangle Park, N.C. There
is a separate registration fee to attend this event. For registration materials and
information, please contact Deirdre Boyer, Continuing Medical Education,
School of Medicine, UNC-Chapel HiD at (919) 843-6382 or (919) 962-2118 and
at deirdre _ hoyer@med.nnc.edu.
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NEW HANOVER COUNTY
INTER-OFFICE
MEMO
MEMORANDUM
TO:
Allen O'Neal, New Hanover County Manager
FROM:
/J11/'
William Steuer, Cbairman, New Hanover County Board ofHealtb Er"'"(7
DATE:
November 27,2000
SUBJECT: TRI County DetoxlCrises and Clinical/Offices Buildings
During tbe New Hanover County Board ofHcaltblHealtb Department Strategic
Planning Retreat, on October 6 &7, 2000, we identified many facility needs and
seIeeted a Facilities Task Foree to look at tbose needs. We are now looking into
possibilites for obtaining mucb needed spaee.
Ideally we need a new facility witb tbe ability to bouse aU our programs wbicb are
currently in our building at 2029 Soutb 17t1l Street. In tbe interim, we bave an
urgent Deed for space to alleviate overerowding, lack of storage spaee for
medical/office supplies, sbortage of medical examination rooms, undesirable
working environment, and severely limited parking.
We know tbat Soutbeastern Mental Healtb Center (SEMH) bas acquired land and
is looking for funding to build a new facility (facilites). If the 2 SEMH
buildings, TR1 County DetoxICrises Center (10,000 sqUll1'efeet) and TR1
County C/inicaVOfflCes (20,000 sqUllre feet), become vacant, we are
requesting notifICation and consideration of those 2 buildings for use by
New Hanover County Health Department.
CC: New Hanover County Board of Healtb
New Hanover County Healtb Department Facilities Task Foree
Dr. Art Constantin!, Sontbeastern Mental Healtb Director
David E. Rice, Healtb Director
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Board of Health Departmental Focal
December 6, 2000
Health Promotion
Notes on Socio - Ecological Model for Health Promotion
First, a definition: Ecology => study of human interaction with their environments
Social => human interactions with each other on various levels
This model is both a way of analyzing health-related behavior and a way to plan I
evaluate health promotion programming. It is ecological just as the more traditional
Public Health Triad of Host - Agent - Vector The main differences are as follows:
. This Socio - Ecological model recognizes many environments with which humans
interact, whereas the Triad lumps all environments together
. This Socio - Ecological model focuses on health - related behaviors as the
outcomes of interest, whereas the Triad focuses on morbidity and mortality as the
outcomes of interest leaving behaviors as characteristics of the Host
e
Importance of an Ecological Perspective:
It broadens our outlook to include environmental interventions that may support the behavior
change process
Purpose. of an Ecological Model for Health Promotion:
It focuses attention on environmental causes of behavior and identifies environmental
interventions while expecting responsible individual behavior as well
Limitation of Socio - Ecological Model for Health Promotion:
It's effectiveness is limited by the extent to which behavior contributes to health or illness
relative to the extent economic inequities, discrimination, genetics, toxic exposures, unemployment,
and other non behavoiral factors have on health or illness
The five "levels of analysis' with respect to how we look at health-related behaviors are:
1) intrapersonal factors - characteristics of the individual such as knowledge, attitudes, beliefs,
self-concept, skills, etc. This includes the developmental history of. the individual (everything
they have ever leamed and intemalized)
2) interpersonal processes and primary groups - formal and informal social network and social
support systems (including the family, work group, friendship networks, persons perceived as
knowledgable)
3) organizational factors - social institutions with organizational characteristics and formal (and
informal) rules and regulations for operation. (daycares, schools, universities, fratemities I
sororities, worksites, faith groups, professional associations, civic clubs, neighborhood
associations, etc.)
4) community factors - relationships among institutions, geopolitical boundries, and persons.
(coalitions, community task forces, industry associations, churches, families, advocacy I lobby
groups, municipal alliances, business alliances)
5) public policy - local, state, and national laws and policies. (ordinances, resolutions, laws,
executive orders, and policies by EPA, DHHS, DENR, County Commissioners, City Council,
Boards of Health)
. McLeroy, Bibeau, et al. Health Education Quarterly, Winter (1988), Vol. 15(4): 351-377
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