03/07/2001
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New Hanover County Health Department
Revenue and Expenditure Summaries for January 2001
Cumulative: 58.33% Month 7 of 12
Revenues
Current Year Prior Year
Type 01 Budgeted Revenue Balance % Budgeted Revenue Balance %
Revenue Amount Earned Remaining Amount Earned Remaining
~-- "---
-~---~_._.
Federal & Stale $ 1,323,298 584,687 $ 738,611 44.18% $1,333,781 726,690 607,091 54.48%
ACFees $ 523,044 289,402 $ 233,842 55.33% $ 516,453 203,854 312,599 39.47%
Medicaid $ 941,900 287,063 $ 654,837 . 30.48% $ 852,884 386,608 466,276 45.33%
Medicaid Max $ 153,479 153,479 100.00% $ 192,301 192,301 100.00%
EH Fees $ 312,900 124,308 188,592 . 39.73% $ 312,900 130,184 41.60%
Hea~h Fees $ 112,015 82,928 29,087 74.03% $ 109,515 80,473 73.48%
Other $ 1,294,423 709,253 585,170 54.79% $ 794,994 469,382 59.04%
Expenditures
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Type 01
Expenditure
Budgeted
Amount
Current Year
Expended Balance
Amount Remaining
%
Budgeted
Amount
Prior Year
Expended Balance
Amount Remaining
%
Summary
Budgeted Actual %
FY 00-01 FY 00-01
Expenditures:
Salaries & Fringe $8,217,655 $4.030,638
Operating Expenses $1.817,925 $867,687
Capital Outlay $573,895 $194,481
Total Expenditures $10.609,475 $5.092,806 48.00%
Revenue: $4,661,059 $2.231.120 47.87%
Net County $$ $5.948.416 $2,861,686 48.11%
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Revenue and Expenditure Summary
For the Month of January 2001
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NEW HANOVER COUNTY HEALTH DEPARTMENT
BOARD OF HEALTH (SOH) APPROVED
GRANT APPLICATION STATUS
12/6/00
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 Dept of Health & Human Services
March of Dimes- March of Dimes Birth
Defects Foundation Eastern Carolina
Chapter
$10,000
$10,000
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
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
Program 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
6ntOO 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
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As of 2/19/01 ~
* Notification received since last report. ~91'fi
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NEW HANOVER COUNTY HEALTH DEPARTMENT
BOARD OF HEALTH (BOH) APPROVED
e GRANT APPLICATION STATUS
MOW Services (Infant Mortality)-NC
Healthy Start Grant Application (2yr Grant:
4/5/00 $85,000 yr 1 and $43,845 yr 2) $128,845 $128,845
Skin Cancer Screening- NC Advisory
Committee on Cancer Coordination and
Control $1,500
WIC Outreach- NC Dept of Health and
Human Services $5,590
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
Healthy Carolinians Task Force- NC
11/3/99 Office of Healthy Carolinians FROZEN) $10,000 $10,000
Operation Reach Women- Susan G.
Komen, Breast Cancer Foundation $19,822 $19,822
North Carolina Chilhood Asthma
InitiatiY~,J\lQ Dept of HeaJ\1} arlc! Human
Services, Women and Children's Health
e Section FROZEN) $7,500
School Health Lice Grant- Carolina Power
and Light Company Corporate Contributions
9/1/99 Fund $4,900 $4,900
Growing Up Buckled Up- National
Highway Traffic Safety Administration
Cooperative Agreement
Model Community Assessment Grant-
North Carolia Community Health Initiative-
Healthy Carolinians- Center for Disease
9/1/99 Control and Prevention $17,375 $17,375
Diabetes Today Community Planning
Initiative-NC Dept of Health and Human
Services - Diabetes Prevention and Control
Unit $10,000
$24,692 $24,692
$50,700 $35,000 $15,700
$!l$:z.!l!l:z U5,5;5(111) $~$4i4lJ!h $.44:Z:!l!l4\
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As of 2/19/01
* Notification received since last report.
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---MEMO
NEW HANOVER COUNTY
INTER-OFFICE
Subj:
Board ofHealJ7.~xecutive Committee
David Rice \'1{)
Janet McCumbee ~
Request for Reclassification -Licensed Practical Nurse to Public Health Nurse
To:
Through:
From:
Date:
2/20/01
We are requesting your approval to forward this reclassification request to Human Resources.
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Candace Artis has been a License Practical Nurse (LPN) in the Smart Start funded Child Care
Nursing Program since July, 1998. After returning to school and completing her Associate
Degree, Candace received her RN license on January 5, 2001. We had anticipated this change in
the present fiscal year and had received approval from Start Start, along with the salary money to
reclassify Candace's position to a Public Health Nurse (PHN) as soon as she received her
license.
Candace has received formal training to be a Child Care Health Consultant and is valued by
Smart Start and our Child Care Nursing Program. As a PHN 1, she will have an expanded role
which will benefit our program greatly. As an LPN, Candace had to be closely supervised by a
PHN and could not independently develop a plan of care for any child. The PHN had to sign off
on all plans. As a PHN, Candace will have a district to serve the Child Care facilities equally
with the other two Child Health nurses.
Ms. Artis' salary is currently at pay grade PT 02 - Step 6 ($31,907). The proposed salary is for
pay grade Nuz 1- Step I ($42,598). We have included the PHN salary in the Smart Start grant
budget for 01-02.
The proposed Position Description Questionnaire is attached for your review. We appreciate your
consideration of this request.
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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
DAVID E RICE, M P H, M A
Health Director
February 20, 2001
To: New Hanover County Board of Health
From: Cynthia W Hewe~usiness Officer
Subject: New Medicaid Rates
LYNDA F SMITH, M P H
Assistant Health Director
--
We received a memo dated January 23, 2001, along with a list of new Medicaid rates, from Dennis E. Harrington,
MPH, Chief of Local Health Services. These rates are retroactively effective January 1, 2001 After reviewing this list,
there are two of our current fees that need to be increased in order to meet the requirement that our fees should be equal
to or greater than Medicaid rates. These two fees are shown below.
Code (Description of Service)
Current Fee Charged New Medicaid Rate Proposed Fee to Charge
99203 (New Patient Level 3-Expanded)
$ 85 00
$ 85.80
Y2044 ( MCC Home Visit)
$ 60 00
$ 72.56
"Yo", Heall}, - 0,,, PriorilJ'"
$ 86.00
$ 72.56
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New Hanover County Health Department Mandated Programs
Revised February 19,2001
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-- .
Program Area Mandated Requirementsl Mandate Source
Administration Provide a county Board of Health, local public North Carolina
health director, and local public health services General Statute
(NCGS)
130A-Article 2
Outlines powers & duties of Local Health NCGS 130A
Director Article 2
Vital Statistic-Births and Deaths NCGS 130A
Article 4
Animal Control Local Health Department must have a rabies NCGS 130A
control program Article 6,
County
Ordinance
Child Health Local Health Department must provide Sickle NCGS 130A
.- ------ .CelL Testing, Lead_P.oisoningPreyenti.on in .--- ---- Article 5
~
Children, Child Fatality Prevention Team,
Establish and administer Maternal & Child
Health Programs including prevention, education
and nutrition
Dental Health The NC Department of Health is mandated to NCGS 130A
provide Dental Health. The state provides a state Article 14
funded dentist who serves several counties and a
dental hygienist serving New Hanover County
full time.
Epidemiology Local Health Department must provide required NCGS 130A
Immunizations at no cost to public Article 6
Local Health Director must provide reports, NCGS 130A
establish Controls, and investigate communicable Article 6
disease
Environmental Restaurants & Other Food handling NCGS 130A
Health Establishments, Meat Markets, Lodging Article 8
(Evaluations, Establishments, Bed and Breakfast Inns/Homes,
Inspections, Summer Camps
Issuance/Denial
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I The North Carolina Department of Health is required to provide numerous public health
services which they administer by awarding state grants or cooperative agreements with
the local health departments. The local Health Department is not required to accept these
grants/agreements and therefore these services may not be considered mandated although
standards are set through the state Mandated Public Health Standards under NCGS 130A-
9 Standards.
16
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Of Permits, Hospitals, Nursing & Rest Homes; Sanitariums; NCGS 130A
Sampling, Sanatoriums; & Educational & Other Institutions; Article 8
Reporting Residential Care Facilities
Compliance)
Cont: Child Care Centers NCGS 110
Article 7
Environmental
Health Lead Poisoning Prevention In Children NCGS 130A
Article 5
Public, Private, & Religious Schools NCGS 130A
Article 8
Local Confinement Facilities NCGS 153A
Article 10
Mass Gatherings NCGS 130A
Article 8
Migrant Housing NCGS 95
.~.- - --- __ _..n - .---.- --~.- - -----~ --.- - -- -Article 19
-- un
Public Swimming Pools NCGS 130A
Article 8
Tattooing NCGS 130A
Article 8
Vector Control NCGS 130A
Article 12
Wastewater Systems NCGS I30A
Article 11
Water Supplies _ NCGS 130A
Jail Health Jail Health Services must be provided by County, NCGS 153A
but not required to be provided by the Health Article 10
Department
Laboratory State Laboratory must be provided. Health NCGS 130A
Department has its on laboratory providing Articles 5, 6, 7,
services for many mandated services as listed in 10, and 13
this document
I The North Carolina Department of Health is required to provide numerous public health
services which they administer by awarding state grants or cooperative agreements with
the local health departments. The local Health Department is not required to accept these
grants/agreements and therefore these services may not be considered mandated although
standards are set through the state Mandated Public Health Standards under NCGS 130A-
9 Standards.
17
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School Health Each Local Education Agency shall make 16 NCAC. 0402
available a registered nurse for assessment, care GS 115C-307C
planning, and ongoing evaluation of students with
special health care services needs in school
setting
Women's Maternal and Child Health Programs: Adolescent NCGS 130A
Health Care Pregnancy Prevention Projects, Prenatal Health Article 5
Care, Family Planning services for women of
childbearing age, education, prevention and
nutrition
Women's, Maternal and Child Health Programs including NCGS 130A
Infants, and prevention and nutrition Articles 5 & 13
Children
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(Mandated programs make up at least 65% of the overall Health Department Budget.)
Ifs/Revised 2/19/01
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J The North Carolina Department of Health is required to provide numerous public health
services which they administer by awarding state grants or cooperative agreements with
the local health departments. The local Health Department is not required to accept these
grants/agreements and therefore these services may not be considered mandated although
standards are set through the state Mandated Public Health Standards under NCGS 130A-
9 Standards.
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NEW HANOVER COUNTY HEALTH DEPARTMENT
SUMMARY OF REQUEST FOR DEPARTMENT PROGRAMS
PRIORITZING MANDATED AND NON-MANDATED PROGRAMS
Request For Department Programs
Fiscal Year: 2001 .2002
Department: Health
Division: Administration. Health
Department Contact Person: Lynda Smith
Department Contact Phone Nbr.: 343.6592
Fund: 110 Agency: 510 Orgn:
e Mandated Program Name Expenditure Revenue County or Net
Y or N Cost
SUMMARY FOR HEALTH 9378752.00 4029752.00 $5349000.00
DEPARTMENT
(TAKEN FROM Y2OOO.2001
ADOPTED BUDGET)
TOTAL EXPENDITURES,
REVENUE (STATE &
FEDERAL GRANTS,
FEES/3RD PARTY, OTHER)
OTHER THAN COUNTY
APPROPRIATIONS,
TOTAL NET COUNTY COST
0.00 0.00 $0.00
Total County Or Net Cost: $5349000.00
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LF8/2/21/2001
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Request For Department Programs
Fiscal Year: 2001 - 2002
Department: Health
Division: Environmental Health
Department Contact Person: Lynda Smith
Department Contact Phone Nbr.: 6592
Fund: 110 Agency: 510 Orgn: 5111
Mandated Program Name Expenditure Revenue County or Net
YorN Cost
Y Priority 1 . Restaurants & 308134.00 12208.00 $295926.00
Other Food handling
e Establishments, Meat Markets,
Lodging Establishments, Bed
and Breakfast Inns/Homes,
Summer Camps, Seafood
Markets & Vehicles
Y Priority 2 - Sewage Disposal 186748.00 174777.00 $11971.00
Y Priority 3 . Private Water 140061.00 66090.00 $73971.00
Supply
Y Priority 4 - Public Swimming 93374.00 65263.00 $28111.00
Pools
Y Priority 5 . Tattooing and Body 4668.00 2600.00 $2068.00
Piercing
Y Priority 6 - Hospitals, Nursing 46687.00 0.00 $46687.00
& Rest Homes; Sanitariums;
Sanatoriums; & Educational &
Other Institutions; Residential
Care Facilities
Y Priority 7 - Child Care Centers 46687.00 0.00 $46687.00
Y Priority 8 . Mass Gatherings 46687.00 7870.00 $38817.00
and Public Festivals
Y Priority 9 - Public, Private, & 46687.00 0.00 $46687.00
tit Religious Schools
Y Priority 10 - Local 9337.00 0.00 $9337.00
Confinement Facilities
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Priority 11 - Lead Poisoning
Prevention In Children
4668.00
2000.00
0.00
0.00
Total County Or Net Cost:
$2668.00
$0.00
$602930.00
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Request For Department Programs
Fiscal Year: 2001 .2002
Department: Health
Division: Vector Control
Department Contact Person: Lynda Smith
Department Contact Phone Nbr.: 6592
Fund: 110 Agency: 510 Orgn: 5112
Mandated Program Name Expenditure Revenue County or Net
lor N Cost
Y Priority 1 -Mosquito Control 397542.00 125353.00 $272189.00
N Priority 1 - Beaver 32142.00 0.00 $32142.00
Management
e N Priority 2 - Other Vector 20089.00 0.00 $20089.00
Control
0.00 0.00 $0.00
Total County Or Net Cost: $324420.00
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Request For Department Programs
Fiscal Year: 2001 - 2002
Department: Health
Division: Animal Control
Department Contact Person: Jean McNeil
Department Contact Phone Nbr.: (910) 341-4197
Fund: 110 Agency: 510 Orgn: 5114
Mandated
YorN
Y
Y
N
Program Name
Priority #1: Rabies
Prev.ention/Control (inCludes
education, shelter & care of
impounded animals, rabies
surveillance & quarantine, and
ordinance enforcement)
Priority #2: Licensing
(includes fee renewals, data
entry, citations, appeals
process, and collections)
Priority #1 : Adoptions
(Adoptions is a way a saving
animals lives and not having
to put as many animals down.)
Expenditure
506955.00
322783.00
88978.00
0.00
Revenue
48908.00
County or Net
Cost
$458047.00
444533.00 $-121750.00
30000.00 $58978.00
0.00
Total County Or Net Cost:
$0.00
$395275.00
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Request For Department Programs
Fiscal Year: 2001 - 2002
Department: Health
Division: Laboratory
Department Contact Person: Susan O'Brien
Department Contact Phone Nbr.: 343-6641
Fund: 110 Agency: 510 Orgn: 5121
Mandated
YorN
Y
Y
Program Name
Priority 1- Laboratory services
to Health Department Clinics
(Women's Preventive Health,
Jail, TB, STD, Lead, Well Baby,
Health Check, Kindergarten
Health, and Neurology).
Medicaid and private
insurance is billed by clinics
for laboratory services and
revenues are included in the
clinic's revenues. Laboratory
provides services to the WIC
Program and supplies are
purchased out of 5141(WIC
Budget)
Priority 2 - Water
bacteriological testing
services for the Environmental
Health Division of the Health
Department and the County's
Department of Environmental
Management The Laboratory
and Environmental Health
split revenues for water
testing 50-50. Water samples
for the County's parks are
tested at no charge.
Expenditure
368939.00
19418.00
Revenue
0.00
2000.00
County or Net
Cost
$368939.00
$17418.00
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0.00 0.00
Total County Or Net Cost:
$0.00
$386357.00
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Request For Department Programs
Fiscal Year: 2001 - 2002
Department: Health
Division: Administration - Health
Department Contact Person: Lynda Smith
Department Contact Phone Nbr.: 343-6592
Fund: 110 Agency: 510 Orgn: 5131
Mandated
YorN
Y
Y
Y
Y
Y
Program Name
Priority 1- Administration
services to Board of Health
and to all divisions arid
programs of Health
Department
Priority2-Human Resources
Management/Personnel/
Payroll
Priority 3-Vital Records (Birth
and Deaths, Deputy Registrar)
Priority 4-Budget/Fiscal
Control/Information
Technology & Management
Priority 5-lnformation and
Switchboard Services
Expenditure
335662.00
61359.00
55031.00
309426.00
49074.00
0.00
Revenue
83340.00
0.00
0.00
0.00
0.00
0.00
Total County Or Net Cost:
County or Net
Cost
$252322.00
$61359.00
$55031.00
$309426.00
$49074.00
$0.00
$727212.00
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Request For Department Programs
Fiscal Year: 2001 - 2002
Department: Health
Division: Board Members
Department Contact Person: Lynda Smith
Department Contact Phone Nbr.: 343-6592
Fund: 110 Agency: 510 Orgn: 5132
Mandated
YorN
Y
Program Name
Priority 1-Board of Health
Members
Payment/subscriptions/travel/
meetings
Expenditure
Revenue
4945.00
0.00
0.00
0.00
Total County Or Net Cost:
County or Net
Cost
$4945.00
$0.00
$4945.00
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Request For Department Programs
Fiscal Year: 2001 - 2002
Department: Health
Division: Child Health Services Coordinator
Department Contact Person: Kim/Marcy
Department Contact Phone Nbr.: 6522/6649
Fund: 110 Agency: 510 Orgn: 5133
Mandated
YorN
Y
Program Name
Child Service Coordination
(meets 99-457 law for serving
children at risk of
developmental delays and
disabilities)
Expenditure
464061.00
0.00
Revenue
464061.00
0.00
County or Net
Cost
$0.00
$0.00
Total County Or Net Cost: $0.00
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Request For Department Programs
Fiscal Year: 2001 - 2002
Department: Health
Division: Women Infants & Children (WIC)
Department Contact Person: Nancy Nail
Department Contact Phone Nbr.: 6541
Fund: 110 Agency: 510 Orgn: 5141
Mandated
YorN
Y
Program Name
Women, Infants & Children
(WIC)-a special nutrition
education-and supplemental
food program for pregnant,
postpartum and nursing
women; infants; and children
up to five years of age who
meet specific eligibility
criteria, including medical and
lor nutritional risks.
Expenditure
325811.00
0.00
Revenue
325811.00
0.00
County or Net
Cost
$0.00
$0.00
Total County Or Net Cost: $0.00
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Request For Department Programs
Fiscal Year: 2001 - 2002
Department: Health
Division: Nutrition - Health
Department Contact Person: Nancy Nail
Department Contact Phone Nbr.: 343-6541
Fund: 110 Agency: 510 Orgn: 5142
Mandated
YorN
Y
N
Program Name
Nutrition coverage at Coastal
High Risk Clinic is necessary
as part of the state contract
addendum for the prenatal
services. This service is
performed by a half-time
Registered Dietitian. Some
services are reimbursed by
Medicaid.
General Nutritionists (full
time) does not perform any
mandated services.
Nutritionist is available for
nutritional referrals from other
health department clinics
(some reimbursed by
Medicaid), provides individual
nutrition consultation as
requested by New Hanover
County citizens, and presents
programs in the community.
This service fits into the
health department strategic
plan (Preventative services &
lifestyles risks; Emerging
health risks.
Expenditure
31816.00
56205.00
0.00
Revenue
11500.00
5000.00
0.00
County or Net
Cost
$20316.00
$51205.00
$0.00
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Total County Or Net Cost:
$71521.00
31
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Request For Department Programs
Fiscal Year: 2001 - 2002
Department: Health
Division: Communicable Disease
Department Contact Person: Kim Roane
Department Contact Phone Nbr.: 343-6522
Fund: 110 Agency: 510 Orgn: 5151
Mandated Program Name Expenditure Revenue County or Net
YorN Coet
Y Priority 1: Childhood 271854.00 29000.00 $242854.00
Immunizations
e (Administration of required
immunizations to children
aged 0-21 years).
Y Priority 2: General 178087.00 8100.00 $169987.00
Communicable Disease
Surveillance & Outbreak
Control
Y Priority 3: Sexually 271854.00 8000.00 $263854.00
Transmitted Disease Program
(Treat & prevent STD's)
Y Priority 4: HIV Counseling & 178087.00 28000.00 $150087.00
Testing (Testing and risk
reduction education for HIV)
Y Priority 5: Immunization 94736.00 37235.00 $57501.00
Tracking(0-24 months) (Actual
compliance monitoring of
immunizations
N Priority 1: Adult 97255.00 91350.00 $5905.00
Immunizations (Immunizations
administered to adults >21
years of age to prevent
e communicable disease)
0.00 0.00 $0.00
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Total County Or Net Cost:
$890188.00
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Request For Department Programs
Fiscal Year: 2001 - 2002
Department: Health
Division: Communicable Disease - TB
Department Contact Person: Kim Roane
Department Contact Phone Nbr.: 343-6522
Fund: 110 Agency: 510 Orgn: 5152
Mandated
YorN
Y
Program Name
Tuberculosis Control
Mandated and required as per
terms of State of NC contract
addendum (Treatment of TB
cases, investigation and
treatment of those having
contact with TB cases.
Screenings of high-risk
population to identify new
infections and treatment and
education to prevent
development of disease.
Includes clinical services and
home visit/outreach.
Expenditure
227832.00
0.00
Revenue
94756.00
0.00
Total County Or Net Cost:
County or Net
Cost
$133076.00
$0.00
$133076.00
34
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Request For Department Programs
Fiscal Year: 2001 - 2002
Department: Health
Division: Communicable Disease - TAP
Department Contact Person: Kim Roane
Department Contact Phone Nbr.: 343-6522
Fund: 110 Agency: 510 Orgn: 5153
Mandated
YorN
N
Program Name
Teen AIDS Prevention
(grant-funded) Peer education
program with objective of
training teen peer educators
to work with at-risk teen
population to educate and
prevent HIV transmission
Expenditure
55000.00
0.00
Revenue
55000.00
0.00
Total County Or Net Cost:
County or Net
Cost
$0.00
$0.00
$0.00
35
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Request For Department Programs
Fiscal Year: 2001 - 2002
Department: Health
Division: Intensive Home Visitation Prog
Department Contact Person: Kim/Marcy
Department Contact Phone Nbr.: 6522/6649
Fund: 110 Agency: 510 Orgn: 5154
Mandated
YorN
N
Program Name
NAVIGATOR Prenatal and
Early Childhood Nurse Home
Visitation Program (grants)
Expenditure
157344.00
0.00
Revenue
157344.00
0.00
County or Net
Cost
$0.00
$0.00
Total County Or Net Cost: $0.00
36
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Request For Department Programs
Fiscal Year: 2001 - 2002
Department: Health
Division: Child Care Health Consultant
Department Contact Person: Kim/Marcy
Department Contact Phone Nbr.: 6522/6649
Fund: 110 Agency: 510 Orgn: 5155
Mandated
YorN
N
Program Name
Child Care Health Consultant
(UNC-CH grant)
Expenditure
48209.00
0.00
Revenue
48209.00
0.00
Total County Or Net Cost:
County or Net
Cost
$0.00
$0.00
$0.00
37
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Request For Department Programs
Fiscal Year: 2001 - 2002
Department: Health
Division: Komen Grant
Department Contact Person: Kim/Marcy
Department Contact Phone Nbr.: 6522/6649
Fund: 110 Agency: 510 Orgn: 5156
Mandated
YorN
N
Program Name
Komen Breast Cancer
Prevention Grant **
Priority 1
.. This grant-funded program
enhances the state mandate to
provide services to women by
funding mammograms and
diagnostic follow-up of
abnormal mammograms for
low-income women in New
Hanover County
Expenditure
11669.00
0.00
Revenue
11669.00
0.00
Total County Or Net Cost:
County or Net
Cost
$0.00
$0.00
$0.00
38
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Request For Department Programs
Fiscal Year: 2001 - 2002
Department: Health
Division: Temp Aid To Needy Families
Department Contact Person: KimlMarcy
Department Contact Phone Nbr.: 6522/6649
Fund: 110 Agency: 510 Orgn: 5158
Mandated
YorN
Y
Program Name
TANF - Temporary Assistance
to Needy Families
Priority 1
- Mandated by the NC
General Assembly to reduce
out-of-wedlock births through
a cooperative effort between
the health department and the
department of social services
A Health Department RN is
stationed @ DSS to initiate
family planning services.
Expenditure
28374.00
0.00
Revenue
28374.00
0.00
County or Net
Cost
$0.00
$0.00
Total County Or Net Cost: $0.00
39
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Request For Department Programs
Fiscal Year: 2001 - 2002
Department: Health
Division: Health/Maternity Care Coordinator
Department Contact Person: Kim/Marcy
Department Contact Phone Nbr.: 6522/6649
Fund: 110 Agency: 510 Orgn: 5159
Mandated Program Name
YorN
Y Maternity Care Coordination
Priority 1
- Mandated through NCGS
130A 124 Article 5 - provision
of maternal and child health
programs to reduce infant
mortality by working
one-on-one with pregnant
women who are high risk and
low-income in order to
improve pregnancy outcomes
through intensive
case-management and
follow-up efforts **
Professional staff includes
RNs, social workers, and
clerical support staff
Expenditure
271503.00
Revenue County or Net
Cost
271503.00 $0.00
40
"
I e y Priority 2 31591.00 31591.00 $0.00
Also included in this budget is
the post-partum home visiting
nurse position which provides
in-home services to new
mothers within 72 hours of
hospital discharge following
delivery. Care includes
physical assessment and
one-on-one teaching for
mothers and their newborns
with early identification of
problems and appropriate
referrals for follow-up **
N Priority 3 25000.00 25000.00 $0.00
Childbirth education classes
are offered through contracted
services with certified
instructors and provided for
maternity clinic patients in
e order to prepare them for
successful deliveries **
** All supported through
Medicaid revenues
0.00 0.00 $0.00
Total County Or Net Cost: $0.00
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Request For Department Programs
Fiscal Year: 2001 - 2002
Department: Health
Division: Health Check
Department Contact Person: Kim, Marcy
Department Contact Phone Nbr.: 6522/6649
Fund: 110 Agency: 510 Orgn: 5160
Mandated
YorN
N
Program Name
Health Check Coordination
(Smart Start grant)
Expenditure
38060.00
0.00
Revenue
38060.00
0.00
Total County Or Net Cost:
County or Net
Cost
$0.00
$0.00
$0.00
42
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Request For Department Programs
Fiscal Year: 2001 . 2002
Department: Health
Division: Personal Health
Department Contact Person: Kim/Marcy
Department Contact Phone Nbr.: 6522/6649
Fund: 110 Agency: 510 Orgn: 5161
Mandated Program Name Expenditure Revenue County or Net
Yor N Cost
y (Mandated if funds accepted 77627.00 0.00 $77627.00
for Neurology budget) .
Priority 1 - Neurology (staff
e support)
y Priority 2 - School Health 263761.00 16501.00 $247260.00
(support staff)
Y Priority 3 . Ja iI 20383.00 0.00 $20383.00
(administration)
y (Mandated if funding 38752.00 0.00 $38752.00
accepted for CSHS budget) .
Priority 4 . Children's Special
Health Services (Orthopedic
and Neurology - staff support)
y Priority 5 . Adult Day Health 880.00 0.00 $880.00
Monitoring
y Priority 6 - Kindergarten 38922.00 4665.00 $34257.00
Health Assessment
N Priority 1-Adult Health 83030.00 500.00 $82530.00
In-home/Clinics
N Priority 2.Child In.home and 76930.00 500.00 $76430.00
Well Baby Clinics
e
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e Y Priority 1-This should be in 70588.00 0.00 $70588.00
budget 5163 as part of
priority 1- Women's Health
Care Public Health Division
Manager's Salary has been
budgeted in 5161. This salary
will be budgeted in
5163-Family Planning budget
in the FY 2002 Budget
Request
N Other:Note, $300,000 in 0.00 300,000.00 $-300000.00
salaries is deducted from the
5161 budget as a projection
for lapse salary. For the
purpose of this Request for
Department Programs, this
$300,000 is shown as
revenue because it is
$300,000 taken from our
-salary line-item and-it returns --
e to the county general fund.
Showing it as revenue is the
only way to reconcile the
revenue and expenditure to
show the net county cost as
in the FY 2001 Adopted
Budget.
0.00 0.00 $0.00
Total County Or Net Cost: $348707.00
e
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Request For Department Programs
Fiscal Year: 2001 - 2002
Department: Health
Division: Matemal Health
Department Contact Person: KimlMarcy
Department Contact Phone Nbr.: 6522/6649
Fund: 110 Agency: 510 Orgn: 5162
Mandated
YorN
Y
Program Name
Maternal Health
- Mandated to provide
services to improve
pregnancy outcomes for high
risk women, improve healthy
starts for newborns, reduce
costs associated with
prematurity and low birth
weight infants and educate the
community re: the need for
early and continuous prenatal
care.
Priority 1
- Support staff for maternal
health programs includes
supervisor, health educator,
licensed clinical social worker
and clerical support (includes
data entry duties), and
contracted pharmacist
- Operating budget
includes prenatal vitamins and
iron for pregnant women,
office supplies, training and
travel for staff
Expenditure
278651.00
Revenue
120829.00
County or Net
Cost
$157822.00
45
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y
Priority 2
- Contracted services for
transportation and interpreter
services
7160.00
0.00
0.00
0.00
Total County Or Net Cost:
$7160.00
$0.00
$164982.00
46
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Request For Department Programs
Fiscal Year: 2001 - 2002
Department: Health
Division: Women's Preventive Health
Department Contact Person: Kim/Marcy
Department Contact Phone Nbr.: 6522/6649
Fund: 110 Agency: 510 Orgn: 5163
Mandated Program Name
YarN
Y Women's Preventive Health
Expenditure
622219.00
_ Priority_L
A. Clinical Services -
Mandated to provide women's
preventive health and birth
control services with an
emphasis on the prevention of
unplanned and unwanted
pregnancies (esp. teen
pregnancy prevention).
Mandate is provided through
daily clinics which include
physical exams, education and
the provision of birth control
supplies - includes specific
programs such as: walk-in
pregnancy testing, breast and
cervical cancer screening,
vasectomy program services,
and teen pregnancy prevention
through walk-in teen clinics.
Program supports nurse
practitioners, RNs, community
health assistants and clerical
support positions.
B. Outreach/Education-
Revenue County or Net
Cost
220078.00 $402141.00
47
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Mandated education services
include individual and group
education sessions, and
outreach to identify young
women in need of services to
prevent unplanned
pregnancies and to promote
healthy behaviors and health
care through programs such
as: walk-in pregnancy testing,
breast and cervical cancer
screening, vasectomy
education, and scheduling for
surgical procedures, home
visiting, health fairs, and male
health education.
0.00
0.00
Total County Or Net Cost:
_.._ ___u ___ _ ~___
,~""~..
$0.00
$402141.00
48
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Request For Department Programs
Fiscal Year: 2001 - 2002
Department: Health
Division: Breast/Cervical Cancer
Department Contact Person: Kim/Marcy
Department Contact Phone Nbr.: 6522/6649
Fund: 110 Agency: 510 Orgn: 5165
Mandated Program Name Expenditure Revenue County or Net
YorN Cost
N Breast and Cervical Cancer 12265.00 24265.00 $-12000.00
-- ControlProgram --........-------.-------
e This grant-funded program
enhances the state mandate to
provide services to women by
funding mammograms and
pap smears for low-income
women in New Hanover
County
$12,000 revenue excess
offsets salaries in the
Women's Preventive Health
budget. #5163
0.00 0.00 $0.00
Total County Or Net Cost: $-12000.00
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Request For Department Programs
Fiscal Year: 2001 - 2002
Department: Health
Division: Partnership For Children Health
Department Contact Person: Kim/Marcy
Department Contact Phone Nbr.: 6522/6649
Fund: 110 Agency: 510 Orgn: 5166
Mandated
YorN
N
Program Name
Partnership for Children (Child
Care-Nursing Program) State
grant
Expenditure
123440.00
0.00
Revenue
123440.00
0.00
County or Net
Cost
$0.00
$0.00
Total County Or Net Cost: $0.00
50
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Request For Department Programs
Fiscal Year: 2001 - 2002
Department: Health
Division: Child Health
Department Contact Person: KimlMarcy
Department Contact Phone Nbr.: 6522/6649
Fund: 110 Agency: 510 Orgn: 5167
Mandated
YorN
Y
Program Name
expenditure
Child Health: Priority I - all
components-of-this-pr-Ogram----- -----
meet the state mandate for
administering Maternal &
Child Health Programs
including general prevention
& education; Child Fatality
Prevention Team; Lead
Poisoning Prevention;
immunizations; Kindergarten
Health screenings; and
providing interpreting/
translating services for
non-English Hispanics
(federal law). Components:
Child Fatality Prevention
Team; Childhood Lead
Poisoning Prevention; Health
Check CliniclWell Baby
Clinics; Admin./Mgml of Child
Health Div.; Health Education
& Parenting Ed.;
interpreting/translating;
follow-up of sickle cell testing;
and SIDS counseling.
318761.00
0.00
Revenue
120139.00
0.00
County or Net
Cost
$198622.00
$0.00
51
,. .'
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Total County Or Net Cost:
e
e
$198622.00
52
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Request For Department Programs
Fiscal Year: 2001 . 2002
Department: Health
Division: Dental Health
Department Contact Person: Lynda Smith
Department Contact Phone Nbr.: 6592
Fund: 110 Agency: 510 Orgn: 5168
Mandated
Y or N
Y
Y
y
y
Program Name
Priority 1 . Dental Screening
and. B.~t~rr.llJ.S!!-",ic~~u n.
Priority 2 . Dental Health
Education for Targeted
Children and Adults
Priority 3 . Preventive Dental
Health Services for Targeted
Children and Adults
Priority 4 . Promotion of
Community Water
Fluoridation
Expenditure Revenue County or Net
Cost
13081.00 0.00 $13081.00
.-- --.---...... ... ...
13081.00 0.00 $13081.00
13081.00
0.00
$13081.00
4616.00
0.00
$4616.00
53
,
,
e The county receives $100,000 0.00 0.00 $0.00
in-kind funds which is not
physically in the health
department's budget, yet the
county benefits. The state
pays salary and operating
cost for a Dentist (serving
several counties) and a dental
hygienist serving New
Hanover County full-time.
This is a mandated service
provided in this county
through in-kind funding from
the Department of Health
and Human Services with the
$100,000 for salaries and
operating for the state
employees (dentist and
dental hygienist) and the
county funding $43,859
through the county budget. as
e stated above. Since the
in-kind funding of $100,000
does not show up in our
budget; it appears the county
pays the entire cost of this
service.
0.00 0.00 $0.00
Total County Or Net Cost: $43859.00
e
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Request For Department Programs
Fiscal Year: 2001 - 2002
Department: Health
Division: School Health
Department Contact Person: KimlMarcy
Department Contact Phone Nbr.: 6522/6649
Fund: 110 Agency: 510 Orgn: 5169
Mandated
YorN
Y
Program Name
(Mandated for schools) -
Priority 1 - School Health
Expenditure
391829.00
0.00
Revenue
391829.00
0.00
County or Net
Cost
$0.00
$0.00
Total County Or Net Cost: $0.00
55
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, "
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Request For Department Programs
Fiscal Year: 2001 - 2002
Department: Health
Division: Neurology
Department Contact Person: Kim/Marcy
Department Contact Phone Nbr.: 6522/6649
Fund: 110 Agency: 510 Orgn: 5172
Mandated
YorN
Y
Program Name
Mandated if funding accepted
- Priority 1 . Neurology
Expenditure
20669.00
0.00
Revenue
27433.00
0.00
Total County Or Net Cost:
County or Net
Cost
$-6764.00
$0.00
$-6764.00
56
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Request For Department Programs
Fiscal Year: 2001 - 2002
Department: Health
Division: Jail Health
Department Contact Person: Kim/Marcy
Department Contact Phone Nbr.: 6522/6649
Fund: 110 Agency: 510 Orgn: 5174
Mandated
YorN
Y
Program Name
(Mandated for sheriff) -
Priority 1 - Jail Health
Expenditure
608762.00
0.00
Revenue
22500.00
0.00
Total County Or Net Cost:
County or Net
Cost
$586262.00
$0.00
$586262.00
57
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"
Request For Department Programs
Fiscal Year: 2001 - 2002
Department: Health
Division: Children's Special Health Service
Department Contact Person: KimlMarcy
Department Contact Phone Nbr.: 6522/6649
Fund: 110 Agency: 510 Orgn: 5178
Mandated
YorN
Y
Program Name
Mandated if funding accepted
- Priority 1 - Children's Special
Health Services
Expenditure
20749.00
0.00
Revenue
24541.00
0.00
Total County Or Net Cost:
County or Net
Cost
$-3792.00
$0.00
$-3792.00
58
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Request For Department Programs
Fiscal Year: 2001 - 2002
Department: Health
Division: Risk Reduction/Injury Prevention
Department Contact Person: Pat Johnson
Department Contact Phone Nbr.: 343-6659
Fund: 110 Agency: 510 Orgn: 5180
Mandated
YorN
Y
Program Name
Risk Reductionllnjury
Prevention*
Priority I . Traffic Related
Reduction (Child Passenger
Safety, Driver Distraction
Reduction)
Priority 2 - Childhood
Suffocation/Fall Reduction
Priority 3 - Injury Reduction
related to Boating, Open
Water, and Pools
Priority 4 . Intentional Injury
Reduction (Handgun Safety)
*This budget supports the
Administrative Support
Technician position that
assists two Health Educators
and one Senior Health
Educator (5181 and 5182), and
programs relating to risk
reduction and injury
prevention.
Expenditure
45491.00
Revenue
21014.00
County or Net
Cost
$24477.00
59
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e
0.00
0.00
Total County Or Net Cost:
e
e
$0.00
$24477.00
60
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Request For Department Programs
Fiscal Year: 2001 - 2002
Department: Health
Division: Project Assist
Department Contact Person: Pat Johnson
Department Contact Phone Nbr.: 343-6659
Fund: 110 Agency: 510 Orgn: 5181
Mandated Program Name
YorN
Y Project ASSIST*
The Project ASSIST Health
Education position supports
efforts to reduce death and
illness related to tobacco use
in New Hanover and
Brunswick Counties. Program
guidelines are established by
the State Office of Tobacco
Prevention and Control, and
the Centers for Disease
Control and Prevention.
Expenditure
41633.00
Program areas include: Adult
cessation services, Youth
prevention and cessation
services, elimination of
Environmental Tobacco
Smoke/Clean Indoor Air, and
elimination of disparities
among population groups in
need of prevention and
cessation services.
Program examples include:
Annual Commit to Quit
smoking cessation contest,
Revenue County or Net
Cost
41633.00 $0.00
61
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Smoke Free Dining Day, Kick
Butts Day, Great American
Smoke Out, World Asthma
Day, Tobacco Awareness
Week, and promotion of smoke
free workplaces.
*This budget supports the
salary and programs of the
Health Educator that
coordinates the Project
ASSIST grant
0.00
0.00
$0.00
Total County Or Net Cost: $0.00
62
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Request For Department Programs
Fiscal Year: 2001 - 2002
Department: Health
Division: Health Education
Department Contact Person: Pat Johnson
Department Contact Phone Nbr.: 343-6659
Fund: 110 Agency: 510 Orgn: 5182
Mandated Program Name
YarN
Y Health Education*
Priority I - State Health
Promotion Contract Addenda -
Counties in receipt of State
Health Promotion funds must
adhere to required guidelines
established by the State Office
of Health Promotion,
Department of Health and
Human Services. Currently,
guidelines require
implementation of long term
health promotion programs
address physical activity,
nutrition, and tobacco use.
Current contract goes through
June 30, 2003.
Priority 2 . Health
Promotion/Disease Prevention
_ Programs address areas of
need as addressed by the
bi-annual Community
Assessment (formerly
Community Diagnosis,
mandated by State.) Current
programs address chronic
Expenditure
101962.00
Revenue County or Net
Cost
35179.00 $66783.00
63
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disease prevention (cancer,
diabetes, heart disease, and
stroke), injury prevention
(including traffic), substance
abuse prevention, and overall
wellness (physical activity,
stress reduction, nutrition,
communicable disease
prevention.
*This budget supports the
salary and programs of one
Health Educator and one
Senior Health Educator.
0.00
0.00
Total County Or Net Cost:
$0.00
$66783.00
64
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o
Live from Chapel Hill via Videoconference
March 26,2001, 5:30pm-7:00pm
Public Health Leadership Program
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"Public HealthAssurance:
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featuring Laurie Garrett
Co-sponsored by
NC DIVISIOn of Pubhc Health
In cooperatIOn wIth the
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.~
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LAURIE GARRETT
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In her latest book, Betrayal 4Trllst: The Collapse 4
Clohall'lIhlic Health, Nell'sday science writer and
health reporter Laurie Garrett talks about real
crisis in global health.
Just as Garrett predicted the outbreak and
resurgence of several communicable diseases,
including the EboJa VIruS, 111 her Nell' 'rink Times
bestseller '/1/(' COlllillg PIa.~lIc, she once again uses her
report1l1g skills, travehng around the world, to
expose rIsks m world globahzatlon and the dIre state
of many health systems.
A dynamic speaker with a captivating and
informative multi-medIa presentatIOn, Garrett forces
her audiences to rethink our public health system
WIth a frank sense of urgency.
Pulitzer Prize-winn.
TALKING POINTS FROM LAURIE GARRETT:
Public health systems are extremely
fragile.
Public health systems are among the first government
tunctions to suffer under societal stress. Exalnples given
supporting this assertion are contemporarv India, all the
tunncr Soviet nations, and centra] Africa, all based on
tlrst hand observation. (For thIS book I did on-sltc
research on five contInents, spannIng five years.)
Wealth gap exacerbates public health
stress.
Public health systems are the first governmcnt functions
to suffer under a severe wealth gap. History shows that
pubhc health prospers when class disparItIes are
lowest when there is a large, self-mterested nnddlc-
class. Today, however, globally and m the United
States speCIfically, we are wltnessmg a record wealth
gap, whIch poses a serIOUS threat to public health.
Public health versus over-used
individualized medicine approaches to
populations.
Western models of mdlvlduahzed medlcme are too
costly and offer little benefit m terms oflife
expectancy. They fail to address the fundamental
roots of bad health in poor countrIes such as un-
clean water, lack of vaccmes, etc.
Growing antibiotic-resistant diseases need
desperately to be addressed and will pose
a serious health problem in the future.
There are strams of strep, for example, which will
undoubtedly be resIstant to available antibIOtics.
Insurmountable illicit drug use.
Public health has never dealt well with illicit drug
and alcohol issues. This inability has encouraged
strong polItICal support fi:,r the criminalization of
substance abuse versus treatment fi,r it. The
population as a whole has, as a result, had Its health
threatened by needle-borne diseases such as hepatitis
B, C, D, and HIV
ing Author To Speak
,~
Antigovernmentalism compounds the
problem.
Rampant antIgovernmentahst fervor m the u.s.
targets, among other thmgs, pubhc health programs
such as those for vaccination of children and
registratIon of infant birth defects.
Racial discrepancies are severe in public
health.
u.s. public health has a truly sorry raCIal legacy
that has never been successfi.llly addressed. Atrican
Americans and, to a lesser degree, Hispanics and
NatIve Amencans, are severely ahenated from the
system, and are least likely to partIcIpate m
populatIon-based control efforts, such as mass
immunizations, HIV educatIOn campaIgns, STD
effilrts, weIl baby programs, ete.
"--~he public health discipline has lost its way.
llblic health, as a dISCIpline and practIce, lost ItS
way dunng the Western health transItIOn (post
WWll, going from infectIOUS dIseases to cancer),
largely because the models of mfectIous dIsease
preventIon dIdn't trallSlate neatly to the chronic
dIsease paradigm. The chromc dIsease paradigm
(except for the case of tobacco) was approached as
a matter of mdlvldual behavior. Public health thus
became not the Great Protector, but the Great
ChastIser, tclhng people that they were personally
responsible for their own illnesses (diet, exercise,
alcohol, ete.) This message rested on often
contradictory data, and the pubhc eventuaIly
stopped listenmg, or only heeded selectIVely. Thus,
m the U.S., for example, Amencans reduced their
cholesterol intake but increased their overall caloric
mtake, beconnng a nlaJonty-obese natIOn.
Managed care as serious challenge to
Jequate public health.
EconomIcs has only addressed pubhc health and
medical issues aggressively in the last decade,
presentmg strong finanCIal arguments m favor of
--,
i
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1
I
preventive and population-based approaches to
health. But health care companies and governments
largely make deCISIons about health-spendmg based
on different priorities. In Europe and North
America this means spending is skewed towards
massive outlays for end stage disease mtervention,
while baSIC needs for the health of the people go
unmet. In poor countnes, corruptIon, mihtary
pnontIes and smgular epidemics snch as TB and
HIV, can tilt all pubhc health spending away from
baSIC mfrastructuralneeds.
Bioterrorism.
The threat ofbioterrorism is growmg at an
uncontrollable pace WIth smallpox, for example,
being cultivated as a means of warfare. Pnblic health
has spawned a virtual bioterronsm prevention
industry in North America and Europe. A backlash
has also emerged, clalmmg the threat IS overblown
post-Cold War paranoia. Public health must insist
that its role in local blOterronsm detectIOn and
response is paramount and resist efforts to
completely mihtanze the Issue. By coIlaboratmg
WIth law enfi.lrcement, It mIght nsk public
credibihty, espeCIally m mmonty commumtles, and It
must take great pams to keep ItS relatIOnshIp WIth
mihtary and law enforcement authontles cordial, but
at arms length.
Registration
There is no charge for the Laune Garrett
presentation but you must regIster m advance m
order to match sIte capaCIty.
Tlm conference IS open to all pubhc health students,
faculty and health care professionals, better health
advocates, and concerned citIzens of the world.
You may register online at www.sph.unc.edu/
oce or by completing the form on the back
panel and faxing it to 919-966-5692.
Public Health Leadership Program
Spring Seminar
Please check any of the following
boxes that apply:
March 26, 2001 5:30pm-7:00pm
D This confirms my fax or telephone
registratIOn.
\
~j
Please mark which site you will attend:
D I Jm J student, statT employee, Of faculty
member at UNC Chapd Hil!.
I Asheville, NC 706020t
Chapel Hill, NC 7()(,()40l
Elizabeth City, NC 7()(,()7lH
Fayetteville, NC 7()()()HI1I
Hickory, NC 7061101
New Bern, NC 7nfi2201
Raleigh, NC 7001401
Sylva, NC 706170!
Wake Forest, NC 7062301
o 1.:J1ll an alUlllna, alumnm nf the UNC
Schoo! of Public Ht'alth.
Wilmington, NC 70()1l)O!
Wilson. NC 70(\20()]
Winston-Salem, NC 70(,:nIJ1
Ifyoll have special Tlt'ed, for karning aids,
and/or taciIity acce~sibility information,
plea,c call m at 91l)-l)(,()-4032
NJnH.'
Sue. See. No.
Agellcy
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(,'"",,"Sl/y,'I.','rrl, (:"",llIlaaICI'''I,,1 Hill.
Uusiness Address
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(:lty
State
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Job Title/Posicioll
Fax
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Return fonn to:
Rcgi~(far
()tlite of Continuing Eduotioll
UNC CH Sf>H, ell #HltJ:J
Tate- TUfIler-Kuralt Building
Ch:lpel Hill. NL 27Sl)() HI fi')
Sute Courier Lode 17-61-lJ4
COllllty of Residence
l!Iiu\'"rlllC.Ir<,lill'l)
E-mail
Day Phone L
Evemng Phone
I
- - - - - - - - - - - - - - Please detach and return form or fax to 919-966-5692 - - - - - - - - - - - - - -
UNe
SCHOOL OF PUBLIC HEALTH
THE NORTH CAROLINA
INSTITUTE FOR
PUBLIC HEALTH
Center for Public Health Practice
Office of Continuing Education
School of Publit HeJlth
The Ulllversity of Nurth Carolina at Chapt'l Hill
CB# H16S, Tate-Turner-Kur.llt llmlding
Chapel HIlI, NC 2Ti')f)-H!t15
No" l'r"fit()rganlZHllltl
U S. l'''~t.lge
PAID
Permit No. 177
Chapel Hill, NC 27':;')') 1\111
Address Correction Requested
SPH586H
DAVID RICE f
NEW HANOVER CO HEALTH DEPT
2029 S 17TH ST
WiUviii\jGTOhi NC
STATE COURIER 04-17-37
f'
RECEIVED
JAN 3 1 200t
N. H. co. HEALTH DEPT.
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New Hanover County Health Department
AEIOU (Assessing, Evaluating, Improving, Our Opportunities are
Unlimited) Team Minutes
February 19, 2001
Attendance: Carol Bottoms, Mamie Carlos, Andrea Carson, Mitzi Chappell, Dianne Harvell, Mary Jo
Newton, Susan O'Brien, Dave Rice, Avery Rollinson, Lynda Smith, Marcy Smith, Bobby Waters
A major issue before the AEIOU Team involved determining the method to use for establishing priorities.
Should indicators be grouped together based on common themes or voted on individually? The team
decided to cluster indicators. Based on the interrelationships of the indicators, several different
combinations of clustering were discussed. Three indicators were eliminated -- IIA 1, IIB1, and VIIIC1
because these issues are being addressed through the strategic planning process.
Clustering resulted in the creation of four priority areas that were then scored according to three criteria,
magnitude, seriousness, and feasibility of correcting the problem. The four priority areas ranked from
highest to lowest were: 1) Community Health Assessment, II1B7, 11103; 2) Access to Health Care, VB2,
VB3; 3) Public Policy - Health Priorities,IVA2; and 4) Personnel Management, VIIC12, VIIC13.
Teams selected to develop action plans to address the top three priorities are: Community Health
Assessment - Bobby, Mitzi, Beth, Mary Jo; Access to Care - Carol, Avery, Mamie, Dianne; and
Public Policies/Health Priorities - Andrea, Susan, Lynda, Marcy. The assignment of each team is to
select two to four prospective participants (staff or community members) to be submitted to Dave Rice by
March 1" New team members will be announced at the next meeting, March 19, at 3 p.m. in the Thomas
Fanning Wood Conference Room.
Respectfully submitted,
Marcy Smith
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STRATEGIC PLANNING PRIORITIES
February 27,2001 Update
I. Access to health care
(Issues #7, 11 & 5)
-+ Cape Fear Teen Health Council: Betty Jo McCorkle participated in a retreat on February 2.
Cape Fear Teen Health Council has been established and is progressing. Subcommittees:
Teen Pregnancy Prevention Month, Male Involvement, Parent Communication, and
Marketing/Advocacy
-+ UNCW RN Access student completing research related to health needs and resources in
each school.
-+ The Women's Health Care Division will begin utilizing the services of a local ob/gyn
physician as a volunteer in our women's preventive health (family planning) clinics. Dr Michael
Reed will join us on the first Thursday of each month for our evening clinic.
-+ Staff sserved on United Way allocations team for health services.
-+ A follow-up meeting with the New Hanover Community Health Center concerning access to
dental care issues is being scheduled for April 10.
-+
II. Preventive services & lifestyle-related risks
(Issues #12 & 15)
-+ Breaslfeeding: In-home breaslfeeding support program (Cooperative Extension) is a
partnership with the WIC Program and the Medical Center Two peer counselors have been
trained.
-+ Women's Health Presentation: Courtney Wilson, NP will make a presentation to the Teen
AIDS Peer Educators.
-+ Influenza Vaccine: Still available. It is not too late to get protected. Press release sent.
-+ Asthma: NHC Childhood Asthma Task Force met last week. Discussed plans for this
spring. Possible events: Physician luncheon - Asthma Treatment Guidelines; World Asthma
Day in May; and Asthma Day Camp in May Task Force will provide some scholarships to
camp.
-+ Asthma Grant received (1/01) to enhance the local Childhood Asthma Task Force and
increase hours of Healthy Homes Nurse to provide Asthma education and environmental
assessments for children with Asthma.
-+ Diabetes Today grant update of activities (Attachment 10).
-+ Folic Acid Grant: Outreach/Awareness efforts are under way
-+ Child Fatality Prevention Team: Met on February 23. NHRMC Director of Women's Health
Services attended. Concerns regarding birthplace safety and interpreting needs were discussed.
-+ CDD staff received state-provided influenza and pneumonia vaccines to be distributed to
medically indigent free. Off-site locations included Tileston clinic, Good Shepherd Day Shelter,
as well as Health Dept clinics. Thus far, 54 doses of pneumonia and 44 doses of influenza have
been given. Additional sites are scheduled to give pneumonia vaccines in several residential
care facilities.
-+
III. Communication, education & marketing (promotion)
(Issue #1 & 4 in part)
-+ Azalea Festival Parade: Paperwork being processed to receive a waiver of the entrance
fees.
-+ Board of Health/Health Department Directory' Updated with changes in titles. Located in
Administration.
-+ In conjunction with Smart Start and Cape Fear Memorial Foundation, Janet McCumbee is
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going to Pediatricians' offices to present a power point program on Case Management and
Home Visiting Services For Pregnant Women and New Parents. This began 01/01
-+ We recently marked our sixth year of offering the National Restaurant Association's SeNing
Safe Food Certification Course. The first session offered this year began Monday, January 22
and concludes on Monday, February 12. This series of classes is scheduled on four
consecutive Monday evenings with each lasting a four-hour period. Cape Fear Community
College became a partner with us on this project in January 1998. With the Community College,
we have explored many scheduling options to optimally accommodate individuals employed by
the local food service industry Over fifty individuals registered for this particular session and
others were put on a waiting list for our Spring series planned to begin in April.
-+ ACS received notice from a local company that translates documents into Spanish. A free
estimate of cost will be determined on several critical forms.
-+ ACS completed a display to be shown at the airport for the month of February It highlights
proper pet care with an emphasis on portions of the county code significant for having a pet at
your home.
-+ Child Service Coordination staff is working with a local committee, which resulted from a NC
Consortium training, to develop a video for parents of babies in the NICU at the hospital. This
video will show parents the local resources for babies with special needs: Child Service
Coordination, Family Support Network, Developmental Evaluation Center, NICU Follow up
Clinic, Early Childhood Intervention. AHEC will be filming, with representatives from all
agencies involved. Donna Vaught, Full Potential Director (AHEC) has coordinated this effort.
-+ The Postpartum Visiting Nurse will begin in March to participate in the childbirth education
class series to educate expectant women about the service and prepare them for a visit
following delivery A display has been created in the WlC waiting room to educate pregnant
women about the service and to reach new mothers when they pick up WIC vouchers
immediately following discharge from the hospital. Space has been reserved in the health
department to provide maternal and newborn assessments in order to reach women as they
come to the health department for other services.
-+ Complaints and media attention to the results of annual school building inspections
prompted an invitation to meet with public school principals and to provide training to janitorial
staff. Tom Stich used the opportunity to emphasize the importance of adequate handwashing
procedures and maintaining toilet facilities in a sanitary condition. A black light handwashing
demonstration proved an effective method of underscoring these concepts.
-+ Volunteer appreciation Brunch 2-08-01
-+ Bill Steuer, Melody Speck, and Jean McNeil & Dianne Harvell met on Wed, Feb 7 Fri, Jan
5, Betty Jo & Dianne Harvell met w/BiII Cabaniss & Misty Watkins to discuss City Of Wilmington
requirements on signage. HD property & Hospital property considered 1-parcel. Only 1-
additional sign will be allowed on 17th St frontage & it will be categorized as auxiliary (Hospital
entrance sign is primary & ER entrance sign is other auxiliary). The group discussed other
restrictions including size & concluded that proposals/bids should be secured from local sign
companies. Also, we should begin to explore sources of grant funding.
-+ Town Hall at the Mall: Health Department will participate with NHC on May 5. This will
coincide with the Grand Opening of the new mall wing on May 3.
-+ ACS Open House: Has been scheduled for March 17 - 10 am - 1 45 pm.
-+ ACS Presentation: Did a puppet show for a kindergarten class at JC Roe Elementary
School on February 26.
-+ TB Information: Information in Spanish has been mailed through the Home Builders
Association.
-+ Nutrition Month: Announcements about staff activities will be made at the General Staff
meeting. The Nutrition Division will be doing the Airport Display in March.
-+ Collaborating with Rotary Club on Immunization Grant.they are making application to work
with CDD to improve immunization rates in Nesbitt Courts.
-+
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IV. Facility utilization & Information technology
(Issues #6 & 4 in part)
-+ Upstairs Storage Area: Continue the process of cleaning the clutter A schedule for
cleaning will be devised and storage shelves will be clearly marked.
-+ ACS staff reviewed pertinent information regarding an on-site spay/neuter facility Two
possibilities were discussed on location of a clinic, in the rear our current building. A list of
needs will be compiled by staff to outfit the facility
-+ We have secured a second air purifier to keep the air clear in the front office. One has been
in the cat holding area for a period of time, and the distinct benefit to enhanced customer service
prompted the purchase
-+ Facilities Task Force Update: Discussed bilingual signs, revenue remaining from medical
records renovation, building space needs, and the facilities assessment surveys on February 5.
(Attachment 11)
-+ Norton Anit-Virus Corporate edition is currently being installed on NHCHD personal
computers. Animal Control, Vector Control and Maternity Services computers will be updated at
a later date.
Information Technology Task Force met February 22 to discuss alternatives to the help desk
concept. IT Task Force: The Health-IT email account will serve as the receiving point for Health
Department information technology requests. More details will be provided at General Staff
meeting on March 1 Implementation of the Health-It email account will begin on March 12.
-+
V. Water quality, storm water management & drainage; & Air
quality (Issues #3 & 8)
-+
VI. Emerging health risks
(Issue #13)
-+ Shigella: Cases requiring visits to childcare facilities as surveillance and investigation
continues. Not a widespread problem at this time. We are still experiencing a Shigella in our
community Since December, we have had 36 cases involving 5 daycares. Shigella: 47 Cases
since December 2000 involving six child care facilities. One facility has 18 cases as of February
19.
-+ On 1-26-01 letters were sent to all New Hanover County pediatricians and family practice
physicians to inform them of the availability of Tri Vi Sol Vitamin Drops distributed free to any
infant over the age of 6 weeks who is exclusively breastfed. This program is a response to the
30 confirmed cases of rickets in breastfed infants in North Carolina. It is a joint effort of the NC
Pediatric Society and the State Health Department. WlC Programs throughout the state serve
as the distribution point.
-+ Hurricane Preparedness: Dave Rice distributed the CDC "Hurricane: A Prevention Guide to
Your Personal Health and Safety" web page to the Management Team (located at
http://www.cdc.gov/nceh/emergency/hurricane.htm). He reviewed NHCHD's past media
releases. He requested the Team review and revise the media releases in preparation for the
upcoming hurricane season, starting June 1
-+ CDD staff attended training in Greensboro on 2-19,20-2001 on "Emerging Pathogens and
Other Public Health Concerns" Presentations on Salmonella, Rabies, NCDA Food inspections,
Global Warming, Indoor Air Quality, Asthma, And West Nile Virus.
-+
VII. Population growth & diversity
(Issue #2)
-+ On February 6, HOLA (Helping Our Latin Americans) will host an educational forum for
professionals in our community The title is "Cultural Differences Between Latino and US
Culture In Reference to the Latino Psyche"
-+ TB program sent information in Spanish to increase TB awareness and encourage
3
screenings to be distributed by Home Builders Association.
..
VIII. Discontinued services picked up by Health Department
(Issue #9)
.. Diabetes Today grant update of activities (Attachment 10).
..
IX. Staff Development & continuing education
(Issue # 14)
.. Management Academy for Public Health: Information given to Management Team
regarding the opportunity to participate as a new team in the MAPH.
.. General Staff Meeting: Scheduled for February 1 March of Dimes will make a
presentation. Meeting minutes will be sent via Lotus Notes, beginning February 1
.. Physician Volunteer Dr Reed has offered to volunteer in Women's Health.
.. Coastal AHEC: "10 Seconds & Counting First Impressions Are Lasting Impressions"
workshop may be scheduled if enough NHCHD interest.
.. Sexual Harassment Training: The scheduling process of NHCHD employees will be
clarified by Frances DeVane
.. County Training for Supervisors: Paul Knott is the new instructor Sessions are getting good
reviews.
.. Student Interns: Two Hurricane Floyd Recovery Corps students' time extended to June
2001
.. Probationary Employees Progress Report: Received from State Personnel.
.. Coastal AHEC: Leadership workshop opportunity on Tuesday, April 3,2001, "Creating a
Healthy Work Culture: Retaining Staff and Giving Quality Care."
.. Carol Bottoms attended "Fighting Fat After 30
.. Carol Bottoms attended "Imagine NC" -Initial workshop on tools for community building to
enhance healthy eating & physical fitness.
.. Animal Control Services compiled a team to attend the Management Academy of Public
Health
.. Management reviewed staff that had completed the Animal Care & Training videos.
.. Staff Appreciation Luncheon has been scheduled for April 12, 2001 The Health
Department facilities will be closed from 11 :30am - 2:00 pm that day Dan Shingleton will be our
featured speaker
.. In-service provided to Laboratory Staff on Billing, CPT Codes and Medicaid at monthly staff
meeting.
.. Public Health Workforce Preparation Grant: UNC-SPH, Department of Epidemiology will be
working with NHCHD on this grant. In addition to focusing on salmonella javiana, there will be
training opportunities for staff. Dr Robin Ryder will meet with the EpiTeam within the next two
weeks.
..
X. Evaluation of services
(Issue #16)
.. CPT/ICD9 Codes 2001 These are currently not being recognized by HSIS or MMIS. These
systems are still using 1999 codes. However, Staff must use the 2001 codes for private pay
patients and for insurance billing.
.. PhoneMail Messages: Employees should change their recorded messages for holidays.
.. Performance Appraisals: Issues of employee self-appraisals and supervisory evaluations
referred to Policy Team.
.. Draft Policies: Six policies (Attendance, Employee Recognition Program - Super Staff
Award, Leaves of Absence With Pay, Leaves of Absence Without Pay, Personal Leave, and
Sick Leave) given to Management Team to discuss with Staff. Management Team will process
them on February 13.
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~ Organization Charts: Received from Divisions. The updates will be submitted to the NHC
Budget Department.
~ Immunization Review for Year 2000: Compliance rate for 24 month olds: NHC 71%, Region
54%, and NC 61%. Data entered into QS and not transmitting to HSIS Immunization Registry
responsible for rate not being higher
~ Staff discussed and put together guidelines for 911 contacts. Brenda Hewlett in the 911
. center was sent a copy, and training opportunities (for the 911 staff regarding ACS protocol) will
be set up in the future
~ AEIOU Team met on February 19 and set four priority areas: (1) Community Health
Assessment, (2) Access to Care - Assurance, (3) Public Policy - Health Priorities, and (4)
Personnel Management. Three teams will develop action plans to address the top three
priorities. Four AEIOU Team members and up to four other people will be on each priority team.
~ Mandated Services list has been reviewed by Kemp Burpeau, Assistant County Attorney
and the Institute for Government. Division Directors have a copy of the list.
~ The Executive Committee and Board of Health will consider a priority listing of Health
Department programs and services as requested by the County Manager
~ The Board of Health will consider a revision to the NHCHD Fee Policy The changes are
due to revised Medicaid rates.
~ Health Department Staff is reviewing operating/capital budgets to determine if funds are
available to assist with a shortfall of approximately $135,000 for the jail. The NHC Budget
Department has asked if we have any funds to help cover these additional expenses. This deficit
situation at the jail has occurred in previous years.
~ Jail Medical Program received the National Commission on Correctional Health Care -
Certificate of Accreditation.
~ OSHA Ergonomics Rule: County Safety Committee to implement the County Standard.
Timeframe is Fall 2001 Susan O'Brien services on the Safety Committee.
~
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Salmonella Javiana in North Carolina
Need for a prospective case-control study?
North Carolina State Public Health Laboratory
& UNC School of Public Health Science Fair
Reported Salmonella Javiana, ] 987-99
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I_eo... ....."'018_.1
t1 It ..
Call rrom PHLlS Su....'em.nee S,'.lem COC Allanla GA
S. Javiana outbreaks
Uncooked tomatoes
Epidemiollnfect 1999;
122(3):385-93
Contaminated cheeses
lAMA 1992;
268(22):3203.7
Salmonella Javiana in the US, ] 997-99
s. Javiana is a rare serotype
_ l%ofSalmllllella cases (1987) -.3.9%(1999)
Increased number of cases
- 497(1987)
1197(1999)
Regional variation
- South Atlantic region -45% of cases
- West South Central region - 20"10 of cases
Reported S. Javiana by region, ] 997-99
...
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~. .rII~cIIJ]II..
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J ~ ./" .,.l' ." ./' .,.,,",
'"
I"
o
DI\lI from PHLlS SUl'\'cillan<:e SVllCm COC All.nla GA
S. Javiana cases in NC, ] 997-2000
Top 3 serotypes
- Typhiumrium
-Newport
- Javiana
1961 cases
970 cases
590 cases
5]%< 5 years old
51.5% female
22% New Hanover County, 11 % Onslow
County
1
Epidemiology' Who?
51% < 5 years old
51.5% female
22% New Hanover & II % Onslow County
No exposure data
SUl'\Ieillance Out~ak Detection Algorithms (SODA)
Labor.wry Conflrmed Salmonella Isolates
1/1/1998101213111998
holllte:l per IOO,OOOu.ma 19'98 CcnsulPopulation
Are.-Nol1hCarolinl SerolYpc"'Javillna
IRa =Q..U o=lIl.ll..2M _U7..6~ _>649
Smveilllll\C.e Ou1brelk Detection Algorithms (SODA)
Laboratory Confinned SaImonellll Isolatcs
1/112000101213112000
1..IaIe.pc:rlOO.0001l1ia.2000CensaIPopullltion
Are.-NortbCIl'OIi:aI Serol)pc"'Ja\iana
IRa <::::;UI.>lU!I ....1I>.l..22.1_l:lh>l _,s
Epidemiology' Where?
,.M'.",":IJ' l"."'"' "'I'" ~.I '"~~
"","",-"""""..".",.,"/,",.,,,,
F"'...."t'''......''r
,-
.l!.7~
.',p........"
.~ .'~;~>
'<..~'j
SurveiUarn:e Outbreak Detection Algorithms (SODA)
LaboralOry Confirmed s.Imonellalsolates
1/1119991012131/1999
IsoilltesperlOO,OOOllsinsl999CensuIPopIIlation
Area-NonhCarolina Serot)-pe-Javillna
IR... =0..,2.1 =12.a,19l _2<;1010,("77 _'677
Epidemiology' When?
"'I
"I
..
;",1
~:I -I
01 -..
.....; ".;...."$.1',1'.1'$$.;".;1'1',,1'.1',1'.1',,...; ".;.N
MODIb-\'ur
o..lD from PHLlS S..(','e;lIancc S,..lem COC AllanlD GA
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2
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Pulsed-field gel electrophoresis
(PFGE) Results
Molecular subtyping within serotypes
CDC PulseNet
- http://www.cdc.gov/ncidodldbmdJpulsenet/pulsenel.htm
Predominant pattern JGGXOL0012
-75/416 ( 18%) PFGE patterns in all 7 states
. NC clusters
- JGGXOl.OOl2 (24 cases) (lane 4,12)
- JGGXOl.0015 (15 cases) (lanes 2,7,9)
- JGGXOl.OOl6 (9 cases) (lone 13)
Hypothesis: Rain?
North Carolina Rainfall Map
JO.Y~M;)mMnui:Jllc:irlal
\967.\996
Proposed case-control study
Continued PFGE of all Javiana isolates
. Hypothesis generating interviews in NC
- to develop questionnaire
- identify demographics
. Non-English speakers?
. Other special populations?
- Begin summer 2001?
S. Javiana PFGE results, 1999
Hypothesis: Birds?
Proposed case-control study
. To determine risk factors for sporadic S.
Javiana infection in North Carolina
. Enroll all culture-confirmed cases
. Controls
- Age and telephone prefix-matched controls
- Friend controls
Begin fall 2001 ?
3
\
NEW HANOVER COUNTY
HEALTH DEPARTMENT
2029 SOUTH 17m STREET
WILMINGTON, NC 28401-4946
TELEPHONE (910) 343-6500, FAX (910) 341-4146
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Ewrywbon._.E"""".
DAVID E. RICE,.M.P.H., M.A.
Health Director
LYNDA F. SMlm, M.P.A.
Assistant Health Director
February 26, 200 I
Representative Thomas E. Wright
528 Legislative Office Building
Raleigh, N.C. 27601-1096
Representative Wright,
We hope this letter finds you well and in good health. We also want to thank you for the hard work you put in on
behalf of our citizens. We at the Health Department also work very hard for the well being of the citizens we serve and
would like to express our views on two issues currently the subject of two North Carolina House Bills. Public policy has
long been a critical component of public health success, and we believe these two issues need strong public policy
components to achieve greater future success in reducing injury, disability, death, and public costs.
The first issue is bicycle helmet use (HE 63 "The Child Bicycle Safety Act"). We support legislation on this issue
and support lIB 63. According to data compiled by the National SAFE KIDS Campaign, bicycle helmets have been shown
Ato reduce the risk of head injury by as much as 85 percent, and reduce the risk of brain injury by as much as 88 percent. The
"mancial and human costs that all of us pay due to thousands of bicycle related crashes, deaths, injuries, and permanent
disabilities to children every year across North Carolina is too great. When a child is hurt, he/she is out of school, parents
miss work, and unnecessary strain is added to our medical care system. When a child is disabled, the costs go on for decades,
draining our community productivity. And when a child dies, we all lose the potential contributions from that person to our
community. Many individuals, businesses, and organizations will continue to work for helmet use by all. This legislation
will be a very important component of these efforts. An importantfina/ note: Dozens of organizations have distributed
thousands of bicycle helmets and will continue to distribute them to low-income families who may see this legislation as a
financial burden.
The second issue is motorcycle helmet use (HE 107 "Motorcycle Safety Act"). We do Dot support anything less
than the present requirement for all drivers and riders of motorcycles on North Carolina roads to wear an approved helmet.
Although adults should be allowed individual determination, in this case public facilities are in use, and there is no getting
around the fact that everyone pays when people are unnecessarily hurt, disabled, or killed.
We hope you agree with our views. None of us wants to legislate people's lives, but legislation plays a very positive
role in helping all of us take good care of each other.
Si~
David E. Rice, M.P.H., M.A.
Health Director
e
~ ,j-J
David Howard, M.P.H.
Injury Prevention Health Educator
N ~ -;:l/e4//!It - t:'~ n-~iff'd",,"
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e
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OPEN BOUSE'"
ANDIAL
CONTROL .&
SERVlCES~. .
MAileD 17, 2001
10 A.II. IINTII.. 1:45 P .11.
220 DIVISION DllIVE
.