02/07/2001
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New Hanover County Health Department
Revenue and Expenditure Summaries for December 2000
Revenues
Cumulative % 50.00%
Current Year
ype of Budgeted Revenue Balance %
evenue Amount Earned Remaini"
$ 1,323,298 440,234 $ 883,064
$ 523,044 249,790 $ 273,254
$ 941,900 243,180 $ 698,720
$ 153,479
$ 312,900 114,611
$ 112,015 76,235
$ 1 284 923 590,168
Month Reported
Mon60f12
Dec-O
Budgeted
Amount
Prior Year
Revenue Balance
Earned Remainl"
$1,333,781
$ 516,453
$ 852,884
$ 192,301
$ 312,900
$ 109,515
$ 775172
701,585
342,173
528,181
Expenditures
Cumulative %
50.00%
Month Reported
Mon6of12:
Dec-OO
Current Year
Prior Year
Budgeted
Amount
Expended
Amount
Balance
Remainin
%
Budgeted
Amount
Expended
Amount
Balance
Remalnln
Summary
Budgeted Actual %
FY 00-01 FY 00-01
Expenditures:
Salaries & Fringe $8,189,755 $3,424,292
Operating Expenses $1,734,546 $764,028
Capital Outlay $522,195 $180,915
Total Expend~ures $10,446,496 $4,369,235 41.82%
Revenue: $4,498,080 $1,867,697 41.52%
Net County $$ $5,948,416 $2,501,541 42.05%
Revenue and EXllenditure Summary
For the Month of DECEMBER 2000
%
4740
33.75
38.07
100.00
34.76
59.91
5t.15
%
8
NEW HANOVER COUNTY HEALTH DEPARTMENT
BOARD OF HEALTH (BOH) APPROVED
GRANT APPLICATION STATUS
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12/6/00
11/1/00
Cape Fear Memorial Foundation-Lice
Eradication Program $5,000 $5,000
Healthy Carolinians- Office of Healthy
Carolinians, Division of Public Health, North
10/4/00 Carolina Dept of Health & Human Services $10,000 $10,000
March of Dimes- March of Dimes Birth
Defects Foundation Eastern Carolina
Chapter
Enhanced Counseling Program for HIV /
9/6/00 AIDS - Elton John Aids Foundation
e 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
Teen Aids Prevention- Z. Smith Reynolds
Foundation $59,000
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
Pro ram 2 ear re uest $55,000 er ear $55,000 $35,000 $20,000
Diabetes Today - DHHS Division of Public
Health
Servicios Para Ninos-Rahab Therapy
6/7/00 Foundation $50,000 $50,000
Family Planning Outreach Initiative-NC
Division of Public Health- WPH Unit (Year
One $21,538 and Year Two: $22,615) $21 ,538 $21,538
Healthy Homes Initiative-NC Childhood
Lead Poisoning Prevention Program $7,552
Project Assist-American Legacy
e Foundation Grant ($57,500 for each of 3
5/3/00 years) $57,500 $57,500
As of 1/17/01
* Notification received since last report. 9
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As of 1/17/01
* Notification received since last report.
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NEW HANOVER COUNTY
ANIMAL CONTROL DIVISION
220 DIVISION DRIVE
WILMINGTON, NORTII CAROLINA 28401
TELEPHONE (910) 341-4197
FAX (910) 341-4349
DAVID E. RICE
H.alth Director
JEAN P. McNEIL
Animal Control Director
New Hanover County Animal Control Services
220 Division Drive
Wilmington. N.C. 28401
(910) 341-4197
Application for Appointment to Animal Control Advisory Committee
Category Interest:
Ca:L-.:Lo.~, ,., eo -t
Name: ""':)I'l).('\r'\i,_ i "~na("d
Address: ;./C!1.::l;, ("'1O'f,L Past
City: L0;IWli"''atQ\''')
Telephone: Home: ::3'1,a. 753]
J.LJt~
Business:
..:?:~5 . 7 q ;Jl.o
Why do you wish to serve on the Animal Control Advisory Committee? jo ~i.'"3+ ;r\
bi"'d Q .-S+-nl""~ (Y1r""+tl'lu'nrd....JM II ~.1I- be.in04-
Q", i l'V)n I~ I Y'\ N \-\ c....
What areas of concern would you like to see the Committee address?
r
cJ.if\ic..- f~ AC" (,)lIufY'pJla+iot'\
Date:
'/ Ii 01
1~~
"~Aj
Signature
CJjou.', dfealth - Du't qJ'tw'ti1!J
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New Hanover County Animal Control Services
220 Division Drive
Wilmington. N.C. 28401
(910) 341-4197
Apolication for Aooointment to Animal Control Advisorv Committee
C{"'-~
Category Interest:-1:l o-\I\.O\1.ur {.L.. Q. V\ V\ {.l
Name: 3";) ~" ~, ~ 0 0 .2-t.v ~
I
Address: 5)u5 LJ"'j h-b0.lk ~ ,
City: LA.)', \\'1.'\ " ~~ 6'.... iN C ~ V 03
Telephone: Home: I'll - 3150 Business: ~
Why do you wish to serve on the Animal Control Advisory Committee?
-;;; h~ {A. II Y^'ff0 U IV\.. tllAiWl.J.. ;iI\~.{,IIR~ 6.>1'\u-vn:"j
)J 4"'-J ~ ~v-"V '
What areas of concern would you like to see the Committee address?
~ v---l L~.. tLcd i'^^- e-J o..w o-..v~ v. < S 5
S~S:: ~~ I c-J 'lQ.5~V'-'S~ b k DW"LV<,l;p
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Date: II d>J 01
12
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NEW HANOVER COUNTY
INTER-OFFICE
MEMO
r~*~'%.'%~%\~Wff,;~g',:;~'-::0Rf,%.%iR~*,'~~%:.."~\*-%*\*fu'%l&B+*\\'1:~~~~*~~;:i-%<<~:i\~\:<<\~:.' " ~,\,' :.P':,~" ", .,:::.'1: ~ "
NEW HANOVER COUNTY HEALTH DEPARTMENT ENVIRONMENTAL HEALTH
REQUEST TO TRANSFER WATER SAMPLING PROJECT FUNDS
Water Sampling Project Funds of $63,000 were appropriated in 110.510.5111.1000
Salaries/Fringe. Revenues were earned by providing water sampling for a state funded
program.
These funds were appropriated for a Management Support Technician and an Environmental
Health Specialist for one year.
A Management Support Technician was hired in this position in August, 2000. The anticipated
amount to be expended for the Management Support Technician is $28,000. The amount of
$35,000 not spent is due to an Environmental Health Specialist not being hired. See explanation
below
We have not been able to employ an Environmental Health Specialist with the Water Sampling
Funds.
Environmental Health Soecialist
We recruited 5 or 6 times in an effort to fill this position between Jul.Sep & Nov-Dec. We had no
experienced applicants for this position. An inexperienced individual will have to go through on
the job training (OJT) & obtain authorization from the North Carolina Department of Environment
and Natural Resources (NCDENR) in order to contribute the necessary amount to the workload.
Typically, this takes about 6 mos. The next state training session (approx 8 wks in length) does
not begin until early Feb '01 By Dee, it became apparent that if we employed anyone, it was
going to be an inexperienced individual + we would end up using the balance of funding/time on
OJT with no assurance of seeing return on this expenditure.
Environmental Health needs to purchase the fOllowing which will offset anticipated projections for
Vector Control 2001-2002 budget: If approved these funds would need to be transferred from
Environmental Health to Vector Control.
Grizzly Mosquito Spray Machines 4@ $26,940
GIS Computer Software $ 1,500
Permanone Insecticide 200 gallon@$34/gal $ 6.800
$35,240
110-510.5112.6400
110.510.5112-6400
110.510-5112.4210
13
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Cindy Hewett
01/09/2001 12:32 PM
To: Lynda Smith/NHC@NHC
cc:
Subject: Re: Water Sampling Project Funds ~
Lynda-
Thanks for offering to take care of this amendment- but I have gone ahead and prepared it as
requested with the following exception- I have transferred the $1500 for GIS Software into
5131-6399 instead of 5112-6399 We are trying to consolidate all computer related purchases into
the 5131 budget (with the exception of some grants).
I will place this in your door.
Lynda Smith
f:r:~~~'~~'ww
t.: "'L Lynda Smith
..",,~ 01/09/200111'41 AM
To:
cc:
Cindy Hewen/NHC@NHC
David E Rice/NHC@NHC, Dianne Harvell/NHC@NHC, Sharon Neuschafer/NHC@NHC
Subject: Re: Water Sampling Project Funds
Cindy, please prepare an expense budget amendment for the information in Dianne's message.
Since this is to go to the Board of Health, please give it to me by Friday 01/12/2001 so I will have
this in hand before we get involved with budgets. This will be an expenditure budget request
asking to move the $ from the salary line item. (The positions and salary money were budgeted in
5111 not5112.)
Transfer from:
110-510-5111-1000
$35,240
Transfer to:
Permanone Insecticide 200 gallon@$34/gal
Grizzly Mosquito Spray Machines 4@
GIS Computer Software
$ 6.800
$26,940
$ 1,500
110-510-5112-4210
110-510-5112-6400
110-510-5112-6400
$35,240
(The GIS Computer Software may need to be budgeted into a line item other than 6400.)
Let me know if you would like me to prepare this budget amendment. since I know you are trying to
get equipment out. I will be happy to do so.
_m___m_________m Forwarded by Lynda Smi.h/NHC on 01109/2001 10:54 AM m_m__m_mm___m__
Lynda Smith
15
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David E Rice
~ -;::David E Rice .
a>k'>
i~@& 01/04/2001 10:58 AM .....................................,....,..'.......................-...................._.. ~..' _..........
;.;,;:;:.&'::x:::::ww~:i..;;;W;~.:.',;:~.::::;;:::;:'.:.~.>'~,;~:MO:::::::::::$:Jo:.'::~.~~,,~:"';';: ,. ~ .~': ..". ~ ~ ",,~'-,;c.,,-,-
To: Lynda Smith/NHC@NHC
cc: Dianne Harvell/NHC@NHC
Subject: Re: Water Sampling Project Funds ,,\[l
Lynda,
Please proceed with a budget amendment for the NHCBH Executive Committee to consider
Lynda Smith
From:
Cam Griffin on 01/03/2001 02:58 PM
Lynda Smith/NHC@NHC
Toni Shields/NHC@NHC, Pat Melvin/NHC@NHC
To:
cc:
Subject: Re: Water Sampling Project Funds JgJ
I am not comfortable transferring the salary funds from the unfilled Environmental Health Specialist
position without taking the budget amendment to the Commissioners.
The agenda Item from the 4/1 7/00 Agenda clearly states the two new positions are critical to
perform the work postponed by the Water Sampling Program. I think the Board of Health and
County Commissioners would need to approve using the funds for another purpose.
Please let me know if you have any questions or need any additional information.
____mm___m__m_ Forwarded by Lynda Smilh/NHC on 01/03/2001 05:28 PM ____mm___m_mmm_
f~:r:r~^..^'
, . :
("'" L Lynda Smith
:.=- M 01/02/2001 12:54 PM
To: Cam Griffin/NHC@NHC
cc: David E Rice/NHC@NHC, Dianne Harvell/NHC@NHC, Cindy Hewett/NHC@NHC
Subject: Water Sampling Project Funds
Cam, please review Dianne's note below We have tried unsuccessfully to hire someone. Can we
use the money from that unused salary as Dianne requests?
___m______m__m__ Forwerded by Lynda Smilh/NHC on 01/02/2001 12:50 PM ____m____m_m__m____
_,~;.......~. .sA" :",^","''''A''''
>.....>>,...
L Dianne Harvell
00', 12/15/200002:15 PM
16
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To:
cc:
David E Rice/NHC@NHC, Lynda Smith/NHC@NHC, Cindy Hewett/NHC@NHC
Subject: Water Sampling Project Funds
We have not been able to employ an EHS w/above noted funds. We would like to consider
spending this $ in VC Program for the items listed. Please advise.
DH
Grizzly Mosquito Spray Machines 4@
GIS Computer Software
Perman one Insecticide 200 gallon@$34/gal
$26,940
$ 1,500
$ 6.800
$35,240
110-510-5112-6400
110-510-5112-6400
110-510-5112-4210
---------------------- Forwarded by Dianne Harvell/NHC on 12/15/2000 01 :59 PM _______n____....__________
rT:.~ )^~'rT"'W'N.
~.~.. . ..... L Sharon Neuschafer
C' *~ 12/15/200001 :38 PM
To: Dianne Harvell/NHC@NHC
cc: Ken Sholar/NHC@NHC
Subject: Water Sampling Project Funds
Water Sampling Project Funds $63,000 (appropriated in salaries and fringe)
These funds were appropriated for a Management Support Technician and Environmental Health
Specialist for one year
A Management Support Technician was placed in this position in August 2000. The funds
expended and anticipated to be expended for the Management Support Staff - $28,000.
An Environmental Health Specialist has not been hired with the remaining $35,000.
Environmental Health needs to purchase the following which will offset anticipated projections for
Vector Control 2001-2002 budget: If approved these funds would need to be transferred from
Environmental Health to Vector Control.
Grizzly Mosquito Spray Machines 4@
GIS Computer Software
Permanone Insecticide 200 gallon@$34/gal
$26,940
$ 1,500
$ 6.800
$35,240
110-510-5112-6400
110-510-5112-6400
110-510-5112-4210
17
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DAVID E. RICE, M,P,H" MA.
Health Director
To
From.
Date:
Subject:
NEW HANOVER COUNTY
HEALTH DEPARTMENT
2029 SOUTH 17TH STREET
WILMINGTON, NC 28401-4946
TELEPHONE (910) 343-6500, FAX (910) 341-4146
Everywhere. Everyday. Everybody.
LYNDA F SMITH, MP.A,
Assistant Health Director
New Hanover County Board of Health Executive Committee
Cynthia Hewett, Business Officer
()11144
January 22, 200 I
Budget Workbook Fiscal Year 01-02
Enclosed is your Budget Workbook for Fiscal Year 200 1-2002. The first 8 pages provide summaries of the
information contained within the workbook
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Our total Budget Request FY 2001-2002 is $11,116,899 This is an increase of $510,924 over the
Approved Budget FY 01 amount of$10,609,475 A significant portion ($444,361) of the increase is due
to the request for 12 new positions.
Revenues through federal and state grants, fees, Medicaid, and other sources show an increase of $47,642.
The net increased cost to the county is $463,282 (773%). The budget request does not include a projection
for salary market adjustment or merit.
Our Budget Request FY 2002 is due to the County Budget Office on February 15,2001, for review by
the County Manager, Allen O'Neal, and his Budget Committee. In May we will receive the County
Manager's Recommended Budget FY 200 I for the Health Department. Any revisions to our original Budget
Request will be presented to you at a later date. On May 21, 200 I, a Public Hearing on budget is scheduled
and you will have an opportunity to appear before the Commissioners to discuss budget matters.
C Board of Health Budget Committee
David E. Rice, Health Director
Lynda F Smith, Assistant Health Director
Health Department Management Team
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NEW HANOVER COUNTY
INTER-OFFICE
rMEMO .,'",'?,' <<",'"..,,," ,',>".." ""~",, "'N;'W""t'W~"@Wwr'~'""'YW''';''',,,,,,,%,', "'"'v,s "",,' ,
FROM:
Department Heads
Allen O'Neal, County Manag~
Cam Griffin, Budget Director cJ5
TO:
DATE:
January 31, 2001
RE:
FY 2001.2002 BUDGET
As you may have seen in the press, we are facing a very challenging budget in FY
2001-2002. Basically, the revenues are not increasing at a sufficient rate to fund the
expenditures of a growing County that is providing a high level of services to its citizens.
You are currently in the process of preparing budget requests for FY 2001-2002.
Please keep your operating requests at the FY 2000-2001 level or below. Department
requests for operating expenses should not exceed the amount approved in FY 2000-
2001. Note: approved, not amended.
e
Minimal capital outlay will be approved in FY 2001-2002. Please review and prioritize
your capital requests and only request items that are essential to your operation.
Very few, if any, new positions will be recommended. If you have submitted requests
for new positions, make sure they have been prioritized.
By February 21, please submit to the Budget Department a list of services and/or
programs your department provides and the associated net County costs. These
should be in priority order and noted if they are mandated. Make sure that the total cost
of the services and/or programs equals your total budget. A Lotus Notes form will be
available on Monday (February 5) for you to use.
There are difficult decisions that need to be made to balance the FY 2001-2002 budget,
and the information you provide will assist in these decisions. If you have any
suggestions for eliminating, reducing, or performing at a lower cost in your department,
please do not hesitate to convey the ideas to the Budget Department staff.
Thank you in advance for your teamwork, cooperation, and input as we continue
through the budget formation process. Please let us know if you have questions or
need additional information.
-e- cc: Board of County Commissioners
~ - .
e .1. ;(?pavld E Rlce.~.
~ 02105/2001 09:08 AM .~
'':''::'~ k'R~~"'~~~li\'Jl'~AA\1b~~..~;.-!~""~~;'k,,',~",,,;"-:'-:-~l~
To: 02seedoC@wilmington.net, bgreer@co.new-hanover.nc.us, gelajim@hotmail.com. wojewell@aol.com,
linkrx@aol.com, annerowe@mail.lig.bellsouth.net, ppsmithsr@aol.com, wsteuer541@aol.com,
hankestep@isaac.net
cc: Allen O'Neal/NHC@NHC, Pat MelvinINHC@NHC, Cam Griffin/NHC@NHC, Lynda SmithINHC@NHC
Subject: FY2001-2002 Budget- Important Message
NHCBH Members:
Please review the County Manager's memo. Allen O'Neal requests that we submit operating
expenses at the current fiscal year level. As in the past, he requests staff to prioritize new
positions and capital requests. This year he goes further and asks staff to prioritize programs.
The Health Department received this notice (January 29) after the NHCBH Executive Committee
recommended the NHCHD FY2001-G2 Budget to the full Board of Health for consideration. The
Board of Health will be considering our budget Wednesday morning, February 7. We wanted you
to have this Information prior to processing our budget.
I will be meeting with Pat Melvin this afternoon. I will discuss with her our situation and will ask
her for direction. Please be assured that NHCHD Staff Is willing and able to address these budget
concerns.
e TO: Department Heads
FROM: Allen O'Neal, County Manager
Cam Griffin, Budget Director
DATE: January 31, 2001
RE: FY 2001-2002 BUDGET
As you may have seen in the press, we are facing a very challenging budget in FY 2001-2002. Basically,
the revenues are not increasing at a sufficient rate to fund the expenditures of a growing County that is
providing a high level of services to its citizens.
You are currently in the process of preparing budget requests for FY 2001-2002. Please keep your
operating requests at the FY 2000-2001 level or below Department requests for operating expenses
should not exceed the amount approved in FY 2000-2001 Note: approved, not amended.
Minimal capital outlay will be approved in FY 2001-2002. Please review and prioritize your capital
requests and only request items that are essential to your operation.
Very few, if any, new positions will be recommended. If you have submitted requests for new positions,
make sure they have been prioritized.
e
By February 21, please submit to the Budget Department a list of services andlor programs your
department provides and the associated net County costs. These should be in priority order and noted if
they are mandated. Make sure that the total cost of the services andlor programs equals your total
budget. A Lotus Notes form will be available on Monday (February 5) for you to use.
r.
e
e
e
There are difficult decisions that need to be made to balance the FY 2001-2002 budget, and the
information you provide will assist in these decisions. If you have any suggestions for eliminating,
reducing, or performing at a lower cost in your department, please do not hesitate to convey the ideas to
the Budget Department staff.
Thank you in advance for your teamwork, cooperation, and input as we continue through the budget
formation process. Please let us know if you have questions or need additional information.
cc: Board of County Commissioners
-------------------- Forwarded by David E Rice/NHC on 02/0512001 07:56 AM --------------------------
f . ! ~. ...-.....'
<'~,.i,. "! ~~.
i"f,~ Lynda Smith
02105/2001 07:54 AM
To: David E Rice/NHC@NHC
cc:
Subject: FY2001-2002 Budget
Dave, I had discussed this memo with you, but do not think you received this since it is addressed to
budget staff.---------------- Forwarded by Lynda Smith/NHC on 02/05/2001 07:52 AM ----------------------
From: Cam Griffin on 0210112001 04:47 PM
To: BudgeCSupport_Staff, kent-wooten@ncsu.edu
cc:
Subject: FY2001-2002 Budget
Please find attached a memo that was sent to Department Heads this week explaining some restrictions
on the amount that can requested for operating expenses.
Also attached is a spread sheet providing the total operating expenses for each organization.
This spread sheet is helpful, but it is limited in that it shows only expenditures, and the restriction is that
net operating expenses must be the same as the amount adopted in FY2001-02.
The form to prioritize your programs is now available in Budget on Lotus Notes. Choose Create you will
see Request for Department Programs. This is the form you need to fill out and submit by Feb 21
Please let me know if you have any questions or need any additional information.
IiJ
~
np.nrtrtmp.nt Hp.rtrlc; FY ?001 .n? F
no.() 1 Arlnntp.rl nnPr.::tt
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STRATEGIC PLANNING PRIORITIES
January 29, 2001 Update
I. Access to health care
(Issues #7, 11 & 5)
~ Drs. Jewell and McDaniel met with the New Hanover Community Health Center Dental
Advisory Committee on 1-18-01 to discuss the Strategic Planning Retreat and the issue of
access to dental care in New Hanover County Representatives from the NHCHC Dental
Program, Cape Fear Community College Dental Program, Wilmington TriCounty Dental Society,
and the New Hanover County Health Department were present. An update on the NHCHC
Dental Program was presented. Ideas of building additional resources for providing dental care
in our community were discussed. Concerning the NHCHC Dental Program, it was announced
that plans are proceeding to hire an additional dentist by summer Participants discussed the
possibility of expanding hours at the clinic to include evenings and Saturdays. Concerning the
Tileston Program, the idea of expanding hours was discussed. It appears this is not a possibility
at this time due to the fact that the dental clinic must operate concurrently with the medical clinic.
There was an offer of possible use of the clinic by another organization. Concerning Cape Fear
Community College Dental Programs, some patients are already receiving cleanings, x-rays,
etc. and being referred back to the NHCHC Dental Program. CFCC does not have the
resources to provide extensive restorative services at this time. CFCC did offer possible use of
their clinics by volunteer dentists, etc. Concerning the possibility of establishing a Children's
Dental Program at the Health Department, the group felt this could be a valuable community
resource. It was noted that at full operation, the NHCHC Dental Program would only be able to
provide services to less than one fourth of the eligible Medicaid population in New Hanover
County A follow-up meeting with the NHCHC is being planned.
~ Partnership for Children, Child Care Consultant amendment
~ Access to Dental Care: Dr Jewell and Dr McDaniel will meet with the New Hanover
Community Health Center Dental Advisory Committee on January 18.
~ Willie M Program: Has been discontinued in North Carolina. Southeastern Mental Health
will receive less money and will prioritize children into "at risk" categories. (Willie M was a
program for special kids in North Carolina, which originated from a class action lawsuit. The
formation of Willie M began in October 1979 when several people representing a group of North
Carolina youths took legal action asking that the children receive treatment and educational
services they had repeatedly been denied.)
~ Jail Diversion Program: Southeastern Center for Mental Health, Substance Abuse, and
Developmental Disabilities will provide intensive case management. May assist NHCHD with
health law violators.
~ Free Vaccine: Requested pneumonia and influenza vaccine for the State. Communicable
Disease Division will offer immunizations to Tileston Clinic and Good Shepherd.
~ Wilmington Regional Resource Center for the Deaf and Hard of Hearing: Received a Kate
B Reynolds grant to provide hearing aides to people who cannot afford them in Southeastern
North Carolina.
~ Possibility of placing a public health nurse at the new Good Shepherd facility The new
facility is probably 2 years from opening.
~ Nursing homes do have beds available in New Hanover Currently more indigent beds than
private. Ombudsman reported that currently beds in county sufficient. She says she receives a
very low percentage of complaints about patient care in nursing homes, very isolated events.
Facilities monitored by Facility Services annually and when there are complaints. The
Community Services Advisory Committee visits the homes at intervals and reports to the
ombudsman. The Ombudsman has 24-hour access to all nursing homes and says that she
visits at all hours. She says there is a problem in finding staff for nursing homes, here and
throughout the state.
~ Regarding proposed meeting of the Board of Health and the Board of Education: Dr Morris
suggested that if our Board wants to meet, that it be at the regular meeting with the County
Commissioners.
II. Preventive services & lifestyle-related risks
(Issues #12 & 15)
~ Women's Health Care Division received unofficial notice that March of Dimes approved our
grant application. Will distribute multi-vitamins to women of childbearing age as well as
information about the importance of folic acid.
~ Asthma Grant: NHCHD Child Health Division was awarded $10,285. Additional hours will
be added to Healthy Homes nurse to build the Asthma Task Force.
~ Asthma Summit: Held last week. Middle School survey results were released. More than
30% of NHC participating students had asthma or wheezing.
~ ACS assisted the Sheriffs Department in the capture of multiple dogs from an owner's
residence on Star Harbor A total of fourteen dogs were recovered from the home. A court
order required removal of the dogs, so that the lot could be cleared off of debris.
III. Communication, education & marketing (promotion)
(Issue #1 & 4 in part)
~ Radio Spots and Advertisement: WAAV Spots for January 30 and February 6 are available.
UNCW advertising was discussed. Elisabeth will research options.
~ Azalea Festival Parade: Management Team will review options January 23. Management
Team decided to use the "Safe Kids" van rather than the float for 2001 Additional NHCHD
vehicle(s) may be included and covered under the $175 entrance fee.
~ Local Pediatricians: Janet McCumbee and Janet Nelson will be conducting lunch meetings
at pediatrician offices on "Case Management and Home Visiting Services for Pregnant Women
and New Parents."
Communication, education and marketing (promotion) Task Force met on January 3. (Attachment 8)
~ Biweekly WAAV radio spots continue every other Thursday morning at 6:30 am. Topics
include animals at large, responsible pet ownership, volunteer opportunities at the facility, and
other items pertinent at the time of broadcast.
IV. Facility utilization & Information technology
(Issues #6 & 4 in part)
~ Clinical area started accepting charge cards as a method of payment on January 19.
~ Personal Computers: 35 of 36 of the ordered PCs are expected to arrive this week.
~ Un-Escorted Customers: Problem with customers wondering around facility without
assistance. Suggestion: Contact Staff person to escort customer One concern is phone mail
delays. We will need input from support staff.
~ Facilities Task Force: January 8 meeting to be rescheduled.
~ Storage Area: NHCHD Upstairs storage area still not cleaned out. A list of items for
possible disposal was distributed. Management Team must claim these items by January 5 or
they will removed.
~ Meeting Room Committee: Will address security of NHCHD building due to after-hour
meetings at next Management Team Meeting on January 16. Presented recommended
revisions to Meeting Room Policy and Request form for Outside Agencies. Revisions to policy
and form adopted.
~ Parking Lot Lighting: Most lights have been repaired. Property Management is looking at
the electrical capacity for the possibility of using stronger bulbs. Auditorium side of building still
pending.
~ Facilities Assessment Survey distributed on January 4. (Attachment 9)
~ A portion of this year will be spent in pursuit of plans to develop an on-site spay/neuter clinic
for adoptive animals at the facility In formation on cost and statistics on adoption must be
collected to justify the need for the clinic.
.
. ~
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V. Water quality, storm water management & drainage; & Air
quality (Issues #3 & 8)
~ Vector Control: Program evaluation to be conducted January 10-12. Dr Charles Apperson
from NCSU and Dr Bruce Harrison from NC DENR (Entomologists) will conduct the evaluation.
VI. Emerging health risks
(Issue #13)
~ Epi Team met on January 8, 2001 Shigellosis was the major issue.
~ Dead Seagulls: NC State Ports reported finding a number of dead seagulls on January 5.
NHCHD Vector Control communicated with State Pest Management and the Wildlife Resources
Commission. Samples were submitted to Wisconsin lab for testing. To be tested for West Nile
Virus.
~ Polio Outbreak: Outbreak in the Dominican Republic and Haiti causes concern for
individuals emigrating from these countries. Important to assess immunization status.
VII. Population growth & diversity
(Issue #2)
~ LEP Workshop: A workshop entitled, "Title VI in Working with Persons with Limited English
Proficiency (LEP) will be held at James Sprunt Community College. To be held on January 25,
9:45am-12:30pm.
~ HOLA. An educational session has been scheduled for February 6, 12 noon-2pm. More
details later
~ Animal Control Officers attended Human Resources classes for Spanish, and a booklet of
informational phrases was compiled for staff use. We discussed getting some of the more
pertinent ACS documents translated into Spanish for use in the office and field situations.
VIII. Discontinued services picked up by Health Department
(Issue #9)
IX. Staff Development & continuing education
(Issue # 14)
Student Interns: UNCW students will be working with the Women's Health Care Division (folic
acid project) and the Community Health Division (school health).
~ Management Team Meeting Ground Rules: The Management Team set the following
meeting ground rules Attendance, promptness, participation, interruptions, basic conversational
courtesies, confidentiality, assignments, responsibilities, meeting place and time.
~ Disciplinary Action Training: Scheduled for January 23, 2001 Health Department
supervisors attended.
~ Hepatitis Workshop: Will be held for NHCHD Staff on January 25 from 12noon-3pm.
~ The Team Handbook: Distributed to all Management Team Members.
~ HSIS: Users Group scheduled for January 25. Cindy Hewett will coordinate trip.
~ Partnership for Children Board Retreat: Scheduled for January 17 to discuss Smart Start
programs for the next two years. Janet McCumbee will attend.
~ Student Intern: Michelle Jones to work with the Child Health Division, starting next week.
~ NCALHD, State Health Director's Conference, and ANCBH Meetings: David Rice attended
these meetings January 10-12. Dr Jewell and Dr Goins attended the ANCBH Meeting.
Genetics and Public Health was the topic of the State Health Director's Conference. The topic of
the ANCBH Meeting was Boards of Health and Effective Supervision.
~ ACS staff has been encouraged to include HR educational classes as a portion of their
yearly work plan. Some form of self-improvement training is required during the fiscal year
Supervisors are working through the supervisory HR tract and doing an in-house study of
leadership.
X. Evaluation of services
(Issue #16)
-+ AEIOU Team: Completed the analysis of the ten opportunities to improve on January 22.
On February 19, the AEIOU Team will look at opportunities that seem to cluster around a
common theme. The Team will rank the clusters in order of priority, based on magnitude,
seriousness, and feasibility of correcting the problem. Priority teams will be established after the
clusters have been prioritized.
-+ NHC Budget Office: Requested NHCHD to submit major increases for FY2001-02 Budget.
Board of County Commissioners to review January 27-28. Also requested we submit list of
mandates with cost figures.
-+ NHCHD Performance Measures: Due to Health Director by January 16. Due to NHC
Budget January 17
-+ Vector Control: Program evaluation to be conducted January 10-12. Dr Charles Apperson
from NCSU and Dr Bruce Harrison from NC DENR (Entomologists) will conduct the evaluation.
-+ CLlA Inspection: Clinical Laboratory Improvement Act (CLlA) inspection of NHCHD
Laboratory is scheduled for January 11, 2001 We passed with no deficiencies. Congratulations
to our Laboratory Staff!
-+ Payroll Policy' Adopted as amended by Management Team.
-+ Financial Status: Revenue and Expenditure Summary for December 2000 was reviewed.
-+ 41.54% of revenues have been collected for FY2000-01 Expenditures are at 41.82%.
-+ Discussion regarding the cost of owned pet euthanasia prompted an increase in the amount
from $5 to $20 for personal pets brought into the shelter, effective January 1, 2001
.
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Page 1 of3
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Analysis of Organizational Opportunities for Improvement
2000/01
Worksheet
1/22/01
Definition Of Strength Or Problem Related Factors Action
APEx/PH Priority
Indicator Briefly state any strengths or Briefly describe the sources of each strength
Reference I-Top
Number(s) problems suggested by the scoring or problem; list resources and barriers to the II = Middle
of the indicators. solution of each problem. 111- lowest
IIA1 The Health Oept. needs to have a Sources: Lack of structured process for
system that actively involves community involvement in service delivery
individuals and groups affected by Resources: Customers; Coastal AHEC;
its services. hospitals; community assessment; faith
community; media; county public information
officer; Board of Health; various task forces;
input into programs
Barriers: Lack of appropriate
communication; bureaucracy; mandated
services; limited resources
1 S: lack of documented plan; lack of
The Health Oept. needs a organized information system; lack of
documented plan for informing the collaboration between all health care
public about the current health providers
status of the community R: COC data; OHHS and OENR; School of
Public Health; professional associations;
vital records; Coastal AHEC; media; GIS;
Health Oept. annual report; community
assessment
B: lack of resources to process information
11103 The Health Oept. lacks a standard S: Standard process not in place
ongoing process to examine internal R: OHHS; OENR; Centers for Disease
and external trends, to make Control (COC); UNC-W/other universities;
forecasts, and to systematically staff
develop long term plans for its B: Staff capacity; limited resources
future.
11187 The Health Oept. should conduct or S: Stable funding
support periodic risk factor surveys R: Coastal AHEC; NHHN; health educators;
to identify community risk factors, community health assessment; youth
their prevalence, and behavior risk factor survey; United Way;
interrelationships. UNC system; SCHS; community participants
B: Limited resources
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APEx/PH
Indicator
Reference
Number(s)
IVA2
VB2
VB3
Page 2 of3
Analysis of Organizational Opportunities for Improvement
2000/01
Worksheet
Definition Of Strength Or Problem Related Factors
Briefly state any strengths or
problems suggested by the scoring
of the indicators.
The Health Oept. and the
community need to set priorities for
addressing health problems based
on the results of the community
health assessment.
The Health Oept. seeks to assure
that all citizens receive personal
health services regardless of their
ability to pay
The Health Oept. identifies barriers
to access to health care and
develops plans to minimize them.
Briefly describe the sources of each strength
or problem; list resources and barriers to the
solution of each problem.
Sources: Limited community involvement:;
limited resources; lack of structural process
for community involvement in setting
priorities
Resources: Dedicated community
agencies; Health Oept. staff; Board of Health
Barriers: Institutionalized process; lack of
communication/collaboration; programmatic
funding; diverse population
S: Community health care providers; lack of
providers for indigent care; large medically
indigent population
R: Community health assessment; health
care providers; funding sources; Health
Oept. staff
B: lack of and changing community
resources; lack of national policy; updated
resources
s: lack of identification process; access to
health care - transportation, indigent/at-risk
populations, dental services, senior facilities
(assisted care. quality assurance),
language barrier, outreach and satellite
services; broke ring and assurance of a
Health Oept. voice on community boards;
access to school-based services - local
Health OepUSchool Board partnership
R: Community health assessment; health
care providers; funding sources; Health
Oept. staff; community partners
B: lack of and changing community
resources; lack of national policy; updated
resources; hours of operation; location of
services; lack of information and application;
lack of emphasis on health; community
attitudes
.
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Action
Priority
I-Top
II = Middle
III - lowest
f
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APEx/PH
Indicator
Reference
Number(s)
VIlC12
VIlC13
VIIIC1
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Page 3 00
Analysis of Organizational Opportunities for Improvement
2000/01
Worksheet
Definition Of Strength Or Problem Related Factors
Briefly state any strengths or
problems suggested by the scoring
of the indicators.
The Health Dept. has a staffing plan
to enable critical scheduled
operations to continue without
interruption.
The Health Dept. has the ability to
fill new and vacant positions in a
timely manner
The Health Dept. has a
comprehensive information
technology system.
Briefly describe the sources of each strength
or problem; list resources and barriers to the
solution of each problem.
Sources: Limited and competing resources;
lack of communication
Resources: Human Resources Dept.; work
teams; student interns; volunteers; colleges
and universities
Barriers: Lack of resources
S: Lack of resources; steps in hiring
process; lack of qualified applicants
R: Human Resources Dept., pay and
classificatio!1 study; institutions of leaming
B: Pay and classification study; steps in
hiring process; lack of qualified applicants;
limited resources
S: Limited resources; lack of computer
support staff
R: County's information technology
department; Health Dept. information
technology plan; supportive Board of Health
and county administration
B: Limited resources; lack of computer
support staff; limited space
Action
Priority
I-Top
II = Middle
III - Lowest
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NEW HANOVER COUNTY
ANIMAL CONTROL DIVISION
220 DIVISION DRIVE
WILMINGTON, NORTH CAROLINA 2840]
TELEPHONE (9]0) 34]-4]97
FAX (9]0) 34]-4349
DAVID E. RICE
Hcalth Director
.JEAN I'. McNEIL
Animal Control DiI"Cctor
TO: The New Hanover County Board of Health
FROM: Dangerous Dog Determination Hearings
CONCERNING: The cases heard__the entire year of 2000
NUMBER OF CASES HEARD 96
DECISIONS:
DANGEROUS 5
POTENTIALLY DANGEROUS 70
NOT DANGEROUS 15
(OWNER BITES___under new rules)
PJC no longer used
PJC REVISED 1
PJC REVOKED 2
EU LETTER 3
AGE OF VICTIMS 18 children 51 adults 26 animals
REQUIRED MEDICAL ATTENTION --- all biteS--
NOT UNDER CONTROL all
NOTES:
While most all breeds are involved: Pit Bulls, Labradors,
Rottweilers, German Shepards, Huskies, and Terriers are
the most seen. A high precentage of the dogs involved are
not neutered.
iJakM~ {3(;()",-)&J
<yOWl. df ealtl'z - rDu.'1. gJ'l.w'l.i1!J
NEW HANOVER COUNTY
DAVID E. RICE
Health Director
ANIMAL CONTROL DIVISION
220 DMSION DRIVE
WILMINGTON, NORTH CAROLINA 28401
TELEPHONE (9]0) 34]-4]97
FAX (9]0) 34]-4349
e
.JEAN P. McNEIL
Animal Control Dir'crtor
TO: The New Hanover County Board of Health
FROM: Dangerous Dog Determination Hearings
CONCERNING: The cases heard__October, November, December, 2000
NUMBER OF CASES HEARD 21
DECISIONS:
DANGEROUS 0
POTENTIALLY DANGEROUS 16
NOT DANGEROUS 4
(OWNER BITES under new rules)
PJC no longer used
PJC REVISED 0
PJC REVOKED 0
EU LETTER 1
AGE OF VICTIMS 4 children 10 adults 6 animals___
REQUIRED MEDICAL ATTENTION all bites
NOT UNDER CONTROL all
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NOTES:
One attack involved veternarian bills in excess of $1000.00
Spring is coming and rabies is still a very serious threat.
iJ ()0{fA- !3t1u'-;i-)0aJ
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...............COU..II"'.~'.,.~
EPllnformation
January 2001 NevI Hanover County Health Department Betsy Summey F N P Eclrtor
HUlllan Rabies
In the U S
Five people died of
rabies in the United
States in the year 2000.
These were the first
diagnosed cases of human
rabies since 1998.
The cases occurred in
California, New York,
Georgia, Minnesota, and
Wisconsin. All but one of
the cases were caused by
exposure to an infected
bat, although not one of
the victims sought medical
attention at the time of the
initial exposure; and
indeed, the history of being
bitten or scratched by a bat
was not elicited.
Patients or their families
did acknowledge the
patient's handling bats
ungloved or knowing of
their presence in the home.
The remaining source was
an unvaccinated puppy in
the patient's home country
of Ghana.
CONTENTS
TB
BSE
Slats
2
2
2
Symptoms
Initial presentations of the
patients were varied from
arm pain and paresthesias,
to back pain alternating
with abdominal pain to
intractable vomiting and
hematemesis. The
neurological symptoms
progressively worsened
with all patients dying
within two weeks of their
initial presentation.
In the United States,
infection with indigenous
rabies virus variants
associated with
insectivorous bats and
infection with foreign
canine rabies viruses
accounted for 30 of the 32
cases of human rabies
since 1990. Although
rabies is usually
transmitted by a bite,
persons may minimize
the medical implications
and not seek medical
attention.
Prevention
Unless the patient is aware
that rabies may be a threat,
he will not likely think the
bat exposure significant,
not relay it to the medical
provider, and not seek
post-exposure prophylaxis.
Post-exposure
prophylaxis could have
prevented these five
deaths.
ListeriOSIS
In November 2000,
Forsyth County began
investigating an outbreak
of listeriosis in its Hispanic
community. The source is
homemade soft cheese
made from raw milk and
sold door-to-door, in
small stores, and from
vehicles. The production
of raw-milk cheeses in
homes is a common
occurrence in some of the
native countries of
Hispanics. Investigators
have found homemade
cheeses in several North
Carolina counties.
Until now listeriosis has
been a relatively rare
foodbome disease, with
only 2,500 cases annually
in the U.S. It dispro-
portionately strikes
pregnant women and
their fetuses, the
immunocompromised,
and the elderly. The
victims thus far support
this risk distribution.
There have been five
stillbirths, two infants
born prematurely, two
infants born early but
near term, and two
deaths, one a 70 year old
man and a 19 year old
female. Note also that a
fetus/infant and its mother
counts as one case.
Think TB
Although cases of
active tuberculosis
(TB) in New Hanover
County have declined
dramatically in the past
year, they have been
nonetheless deadly. The
third death in the past 12
months, directly or
indirectly related to TB,
emphasizes the need for
preventive treatment when
at all possible.
The new guidelines from
the Centers for Disease
Control (CDC) advise
preventive treatment for
anyone with a positive
PPD and risk for
developing TB disease
regardless of age.
Consequently, many older
patients who were not
offered preventive
treatment previously, will
be offered it now. As
always, they will be
closely monitored for side
effects of medications.
The goal to eradicate TB
can now be more easily
attained with these
broader guidelines for
preventive treatment.
Vaccines Derived
I
frolll BOVine Derived
I
Materials
The Center for
Biologies Evaluation
and Research (CBER) of
the U.S. Food and Drug
Administration warned
earlier this year that some
vaccines were being
manufactured with bovine
materials in countries
where bovine spongiform
encephalopathy (BSE)
exists.
e
An investigation was
launched by CBER to
determine the risk of
acquiring BSE from
vaccines. CBER
concluded the risks
presented to them in
scenarios were
theoretical and remote
because of the low risk of
the bovine materials
involved and the
dilutions of materials
during manufacture.
As a precautionary
measure, however, the
committee recommended
that manufacturers replace
all vaccines made with
materials from a country
known to have BSE with
those made in countries
that have no risk.
Manufacturers have agreed
and the change will be
completed in 200 I.
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Communicable Disease Statistics
New Hanover County
July 1. 2000 - December 31.2000
.:.: " , : ' - , _: " : ,- . . ' , , ~";:::,:: :~::_,:-:::::):::-::(;::;.:):::::::::::;: : ?:.,.,::.';'::,::/::(,:'::,'/::. :.,:::.::::{:::;:;:,:::?::,:,::',:,:::::,'::,::::,:,::::/:::,:}:::>:\:::::/
:::~:::::;:::::')::::::r,:;::::~,~:}:\:'::::::t::,}::'t:
",'," , ''''':':':'::'''':'::''':''''''''''':'''-':'''':''':''''',:,:"""':';':':::.':::';:"":. .,."."':.,.,,,.,,:"..-.-,',::::::::::':::',::'::::.:":':":.::":::':":',','::','::";":':':":";":':"'",:":
::":":":":":":':::"",:"':":':":":":":".':":
iAI~$' .;.....,....;;....;.. .;.:;....;... ......;.......\10......\... .......IiIV,jj(~PtiQ"...;i;...;...;;....;;\;........t4....
...Camp.,i6b~~~i"...;..;.;...;..;........r~......... .....\~vm.P!~1I~6...;j;j[i;..j....j ......2
....~hiamy~!~;... ....'....i....;..... ..,....i........l~~t.............. ......p$1U$.ili...l..;;',..U;t...,...;;'iO.....
'.ECollo15'tH1 .. ... ...........C)rij~y;Mmi~P9n!~f~!~t;1
il)Il~~!B!~!.;+;i:;;i!~~~.~~lm~Q!lto.I;;i;ii~!
.....~...........:... Pp:........~.......!.~......'.:...:..............=... l....a......c....~.u........~....e.....i. \..............;.:..........:.... ;....:.....................~.i.................
.................... StHgii'lOslS;;;;;;U;;;?57
.............................................5S.............uyp........ 8P.........h..........'..,....,......Gs.....................~........ou.........................................p..............
..,......A.......................................m.........................~..................8......................s..............i.......V.............8.......................,..............,.....
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.~~ij~!i~i~....~i~m~f!}iij;i.~.................. . . .
.'.'.Hliiiatitis...~..I.!!CiJt'I..i;.i'..;:i:........O................... ........,...').!Jjerpjjto.I.......;.;...;...;!.....;....;i;...;..........~..,.
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NEW HANOVER COUNTY
HEALTH DEPARTMENT
2029 SOUTH 17TH STREET
WILMINGTON, NC 28401-4946
TELEPHONE (910) 343-6500, FAX (910) 341-4146
Everywhere_ Everyday. Everybody
DAVID E. RICE, M.P.H., M.A.
Health Director
LYNDA F. SMITH, M.P.A.
Assistant Health Director
Memorandum
To: Members of the New Hanover County Board of Health
From: Dr. Wilson O'Kelly Jewell, Chairman
New Hanover County Board of Health
Date: February 7,2001
Re: Evaluation of David E. Rice, Health Director
Enclosed is an evaluation form I am asking you to complete. After you complete this
form, please retum it to me in the enclosed addressed stamped envelope by
February 16, 2000.
The Executive Committee will review these evaluations on February 27 Upon
completion of the review, we will submit our recommendations and findings to the
Board of Health. If you give a rating of anything other than "expected" on a
performance factor, please give specific reasons in comment area of the evaluation
form. Please call me regarding your concerns. It is very important and fair to let
David know what performance area(s) needs improvement or is unsatisfactory, and
what he needs to do to improve. My telephone numbers are:
791-6113 - Home
791-2401 - Office
Thank you.
" Your Aealth - Our priority"
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