03/02/1994
I
I
I
I
l
J:J
Mr. John Coble called the regular business meeting of the New
Hanover County Board of Health (NHCBH) to order at 8:00 A.M. on
Wednesday, March 2, 1994, at the New Hanover County Animal
Control Center, 220 Division Drive, New Hanover County Health
Department (NHCHD), Wilmington, North Carolina.
Members Present:
John M. Coble, Chairman
Spiro J. Macris, DDS, Vice-Chairman
Mary Lou Alford
Thomas V. Clancy, MD
Mary King Dean
W. Keith Elmore, RPh.
Robert G. Greer
Dennis L. Jackson, DVM
Laura Pitts Maness
Edward L. Paul, Jr., OD
Mark A. Veenstra,PE
Members Absent:
Others Present:
Robert S. (Bob) Parker, Health Director
Frances F. De Vane, Recording Secretary
Mr. Elmore presented the invocation.
Recognition:
Memorial Prayer for Dr. John B. Codington
Mr. Coble held a moment of silent prayer in memory of Dr. John B.
Codington, physician and North Carolina State Senator.
Mr. Coble moved for the Board of Health to write a letter of
condolence to Mrs. Codington and Family. Upon vote, the MOTION
CARRIED.
Mr. Coble called for corrections to the minutes of the meeting on
February 2, 1994. The minutes were approved.
Committee Reports:
Executive
Mr. Coble, Chairman, Executive Committee, reported that the
Executive Committee met at 6 P.M. on February 18, 1994. The
Committee reviewed and recommends to the Board the proposal for
health department expanded services and the establishment of four
new staff positions.
)4
Budget
I
Mr. Veenstra, Chairman, Budget Committee, stated the Budget
Committee met at 5:30 P.M. on February 21, 1994.
Environmental Health
Dr. Macris, Chairman, Environmental Health Committee, reported
th~ Environmental Health Committee met at 7 P.M. on February 21,
1994. A budget analysis of the cost of services versus fees is
being addressed. Rules Governing the Operation of Temporary Food
Facilities have been drafted and will be presented to the Board.
New Business:
Expanded Services Report
Mr. Parker presented an Improved and Expanded Health Department
Services Proposal (Attachment #1) recommended by the NHCHD
Visions Committee. He requested that the Board review the
Visions Committee plan for improved patient services and endorse
a staff work schedule necessary to accommodate the increased
services. Mr. Parker suggested April 1994, Public Health Month,
as the tentative date for the implementation of
increased/improved services for New Hanover County citizens.
After discussion of the above plan, Mr. Coble moved from the
Executive Committee, for the Board of Health to approve the
Improved and Expanded Health Department Services Proposal
including an alternate staff work schedule. Upon vote, the
MOTION CARRIED.
I
Approval of Revised Division of Maternal and Child Health Sliding
Fee Scale
Mr. Parker presented a request to the Board for their approval of
the revised Maternal and Child Health Division Sliding Fee Scale
for use in the Family Planning and Maternal and Child Health
(MCH) Clinics.
Mrs. Alford moved for the Board to approve the Revised Division
of Maternal and Child Health Sliding Fee Scale to be used in
Family Planning and MCH Clinics effective immediately. Upon
vote, the MOTION CARRIED.
Board of Health Recessed
At 8:26 A.M. Mr. Coble recessed the business meeting of the Board
of Health for the Groundbreaking Ceremony of the New Hanover I
County Animal Control Center, 220 Division Drive, Wilmington,
North Carolina.
I
I
I
'u5
Departmental Focal:
"Groundbreaking - New Hanover County Animal Control Center"
At 8:36 A.M. the Ground Breaking Ceremony of the Animal Control
Center sponsored by the New Hanover County Board of
Commissioners, the New Hanover County Board of Health and the
Animal Control Advisory Committee was held on the site of the
new building. Mr. Coble welcomed attendees and introduced the
following guests:
Mr. Robert G. Greer, Chairman, New Hanover County Commissioners
Mr. E. L. Mathews, Jr., Vice-Chairman, N.H. County Commissioners
Mr. Allen O'Neal, County Manager
Dr. Lee Hunter, DVM, N. C. Department of Environmental, Health
and Natural Resources (DEHNR)
Mrs. Donna Neal, Chairman, NHCHD Animal Control Advisory
Committee
Canine Boris and Deputy John Almedia, Special Guests
Chairman Greer, and Vice-Chairman Mathews, County Commissioners;
Mr. Coble, Board of Health Chairman; and Mrs. Neal, Animal
Control Advisory Chairman; assisted by K-9 Boris and Deputy John
Almeida broke the ground for the new NHCHD Animal Control Center.
Speakers for the groundbreaking ceremony were Mr. Greer, Mr.
Coble and Dr. Hunter. A reception followed the ceremony.
Board of Health Business Meeting
At 9:10 A.M. Mr. Coble reconvened the Board of Health meeting.
New Business:
Spraying Program for Gypsy Moth in New Hanover County
Mr. Coble requested that Dr. Hunter, Public Health Veterinarian,
DEHNR, address the proposed Spraying Program for the Gypsy Moth
strains introduced last year in portions of New Hanover/Brunswick
Counties by military cargo. Dr. Hunter introduced Peter Morris,
M.D., M.P.H., Medical Epidemiologist,ODEHNR and Mr. Lloyd Garcia,
North Carolina Department of Agriculture (NCDA) to the Board of
Health. Dr. Hunter expressed that the moth itself does not pose
a true human threat.
Mr. Garcia explained that the Department of Agriculture plans to
spray for the Asian gypsy moth with two pesticides: Bacillus
thuringiensis (Bt) and Gypcheck. During favorable weather
conditions pesticides will be applied by airplanes. He stated
there will be announcements alerting the public of the exact date
of spraying applications if possible.
16
Dr. Hunter stated the
regarding the spraying
informational memorandum
Society.
NCDA hosted several public meetings
of pesticides and has prepared an
to the New Hanover/Pender Medical
I
Dr. Morris explained that no deleterious health effects to the
public resulted from these pesticides in the Pacific Northwest.
Mr. Greer inquired if the spraying project
responsibility. Mr. Garcia informed the Board that
federal responsibility since the infestation of
national environmental and economical problem.
is a state
funding is a
moths is a
Mr. Coble thanked Dr. Hunter, Dr. Morris and Mr.
addressing the Board on the moth eradication issue.
Garcia for
Request for Five New Health Department Positions
Mr. Coble presented from the Executive Committee a recommendation
for the Board of Health to approve a request for the
establishment of the following four new staff positions:
Public Health Nurse II - Home Health
Home Care Aide - Home Health
Public Health Nurse I - Epidemiology
Physician Extender - Maternal and Child Care
I
Mr. Coble explained that originally five new positions were
requested; however, the Executive Committee recommended the
postponement of the Home Health Assistant Health Director
position.
Mr. Coble moved from the Executive Committee for the Board to
approve the recommendation for the establishment of four new
positions (Public Health Nurse II and a Home Care Aide, Home
Heal th; Public Health Nurse I, Epidemiology; and Physician
Extender, Maternal and Child Care) and to submit the request for
the establishment of these positions to the New Hanover County
Commissioners. Upon vote, the MOTION CARRIED.
Family Planning
"
Ms. Betty Jo McCorkle presented a proposal for the expenditure of
additional Family Planning state revenues. She stated the
primary goal of the proposal is to increase the Family Planning
caseload. The plan includes the expansion of clinic hours and
space, establishment of an additional Nurse Practitioner
position, enhancement of computer capabilities, provision of a
better patient plan of care and transportation, improvement of
patient health habits and the initiation of a "Well Bucks"
incentive at the cost of $6,000, which is to provide gifts to I
patients for program compliance.
I
I
I
J r¡
Ms. McCorkle informed the Board that the NHCHD Family Planning
Program received $27,144 in December and January, $10,727
Maternal and Child Health Block Grant (One-Time Funds for Women's
Health Services), and $16,417 FY 1994 Expansion Funds to be
expended in the Fiscal Year 1993-94 Budget. She explained that
FY 95 Expansion Funding will be used to fund a portion of a
full-time Nurse Practitioner position to be utilized in Family
Planning, Epidemiology and Child Health Programs.
Mr. Elmore moved that the Board of Health approve the proposal
for the expenditure of the additional Family Planning funding.
Upon vote, the MOTION CARRIED.
Comments:
Board of Health Members
Mr. Coble announced a Home Health Strategic Planning Session will
be held on May 25 and 26, 1994 to project the future Home Health
needs.
Health Director:
Mr. Parker encouraged Board members to attend the Boards of
Health training session on Health Care Reform to be held on April
28, 1994, from 6:30 P.M. 9.P.M. at the Wilmington Hilton
(dinner included).
Mr. Parker presented an annual report on the Measurement of
Immunization Goals. He commended the New Hanover County Health
Department for reaching 78% of their goal.
Mr. Parker reported that Ms. Beth Day, Epidemiology Director, and
he attended Governor Hunt's Kickoff Breakfast for Immunizations
in Raleigh, North Carolina on February 25, 1994. Ms. Day
presented a slide presentation on the NHCHD Immunization Program
entitled, "The Winning Shots-Immunize". Mr. Parker presented an
immunization campaign sweatshirt to Governor Hunt.
Mr. Parker invited Board of Health members to participate with
staff in health department services and/or clinics. He announced
that the Board plans to host and sponsor a staff cookout on
Friday, April 29, 1994 during April, Public Health Month.
Norplant Clinic Utilization
Ms. McCorkle informed the Board that the health department
inserted approximately 250 Norplants in FY 92-93 and 59 Norplants
in FY 93-94. Depo-Provera injections were started in February
1994, and to-date this method has been provided to three
patients.
)8
Personnel Evaluation
Mr. Coble requested that Board members submit their performance I
appraisals on Mr. Parker to Mr. Coble.
There being no further business Mr. Coble adjourned the meeting
at 10: 00 A.M.
£:-Lm"> ~
Mr. John M. Coble
Chairman, Board of Health
ClQ~M~
Robert S. (Bob) Parker
Secretary to the Board
Approved:
I
I
/
J
.
DEFINITIONS
CH
ElI
EPI
LAB
MCC
WIC
l. EH-
2. CH -
Attachment No. 1
NEW HANOVER COUNTY HEALTH DEPARTMENT
IMPROVED AND EXPANDED SERVICES
AS APPROVED BY THE
VISIONS COMMITTEE
NEW HANOVER COUNTY HEALTH DEPARTMENT STAFF
FEBRUARY 21, 1994
Community Health Division
Environmental Health Division
Epidemiology Division
Laboratory Division
Maternal and Child Care Division
Women, Infants and Children Supplemental Food Division
Open from 12 NOON to 1:00 P.M., Monday - Friday
Old - Closed
Addi tional Well Baby Clinic in Ogden Area, 5: 30 P. M.
every other month initially (M.D. Present)
Old - No Ogden Well Baby Clinic Services Offered
Services Offered:
Growth and Development Evaluations
Immunizations
Physical Exam
Well Child Instruction
3. WIC - Open from 12 NOON to 1: 00 P.M. Tuesday - Friday
Old - Open Tuesday - Thursday (added Friday)
4. EPI - Open from 7:00 A.M. - 7:00 P.M. every Thursday
Old - 8:00 A.M. - 5:00 P.M.
Services Offered: Chest X-rays, Immunizations, HIV
Counseling and Testing, Tuberculosis Testing and
Medications
5. MCC - Family Planning Evening Clinic Every 4th Thursday from
5:00 P.M. - 9:00 P.M.
Old - No 4th Thursday Evening Clinic
Services Offered: Teen Walk-In, Adult Annual
Appointments, Pill Pick-Up, Health Education
6. EH - Will Open at 7:00 A.M. during Daylight Savings Time
Old - 8:00 A.M.
7. WIC - Evening Clinics the 1st, 2nd and 3rd Thursdays from
5:00 P.M. - 7:00 P.M.
Old - No 5:00 P.M. - 7:00 P.M. Clinics
Services Offered: Food Instrument Issuance
I
I
8.
CH - Neurology Clinic Expanded to 6:00 P.M. (M.D. Present)
Old - 5:00 P.M.
Services Offered: Diagnosis and Treatment of
Neurological Problems, Referrals, Health Education
9. MCC - Healthy Children and Teens Evening Clinic every
Thursday (except 5th Thursday) from 5:00 P.M. to
7:00 P.M. (RN Clinic)
Old - Only 3rd Thursday Evening Clinics (Added 1st,
2nd and 4th Thursdays)
Services Offered: Physical Exam, Lab, Health
Education, Vision Screening, Hearing Screening,
Developmental Screening, Referrals
10. WIC - Patients Who Miss Appointments for Recertification
¡Voucher Pickup will receive a Telephone Call
Concerning Next Appointment
Old - No Telephone Call
11. MCC - Five additional Family Planning Patient Appointments on
the 2nd and 4th Mondays
Old - Five Less Appointments
12. WIC - Hours of Service Posted in WIC Waiting Area
Old - No Posted Hours of Service
13. EH - Hours of Service and Charges Posted in EH Waiting Area
Old - No Posted Hours of Service or Charges
14. MCC - Family Planning - Open from 12 NOON TO 1:00 P.M.,
Monday - Friday
Old - Closed
Services Offered: Pill Pick-Up, Patient Information,
Appointments
15. WIC - Will Begin Advertising Services and Hours of Service
once Every Quarter in the Wilmington Morning Star and
Wilmington Journal
Old - Did Not Advertise
16. MCC - Child Health - Child Service Coordination Expanded
Hours: 7:30 A.M. - 7:00 P.M., Monday - Friday
Old - 8:00 A.M. - 5:00 P.M.
Services Offered: Home Visits, Telephone Contacts,
Record Documentation
17. MCC - Maternal Health - Maternity Care Coordination Expanded
Hours: 7:00 A.M. - 6:00 P.M., Monday - Friday
Old - 8:00 A.M. - 5:00 P.M.
Services Offered: Home Visits, Telephone Contacts,
Record Documentation
I
I
18. WIC - Certification of Post Partum (After Delivery) Mothers
Initiated at New Hanover Regional Medical Center
(Waiting Time Reduced)
Old - Certification Process Started With Mother's
During Next Visit to the Health Department
19. CH - Connnunity Health Expanded Hours - 7:30 A.M. - 6:00 P.M.,
Monday - Thursday
Old - 8:00 A.M. - 5:00 P.M.
Services Offered: Telephone Contacts, Home Visits,
Neurology Medication Pick Up, Patient Certification
20. MCC - Family Planning - Appointment Reminder Telephone Calls
Old - No Telephone Calls
21. EPI - Primary Care Services Expanded (Physician Extender)
a. Acute Care Treatment
1. Kindergarten Health Assessment Patients
2. Chest Clinic Patients
b. Clinical Evaluations
1. Tuberculosis Patients
2. Communicable Disease Contacts Prior
to Medication (Example Meningitis}
c. Exams and Treatment Every Day to Sexually
Transmitted Disease (STD) Patients
d. STD Clinic Services Expanded to Include:
1 . Wet Smears
2. Chlamydia Cultures
3. Pap Smears
Old - None of Above Services Offered
22. EPI - EPI INFORMATION NEWSLJS·,rJ:.ISK Published Bimonthly
Old - Published Quarterly
23. EPI - Immunizations Added on 1-1-94 by State Law
a. Measles, Mumps, Rubella (MMR) Vaccine - Available
to Boost 10 and 11 Year aIds
b. Second MMR Required for Kindergarten and College
Entrance
c. Hepatitis B for Infants
d. Haemophilus Influenza B (Hib) Vaccine - Available
for 3-5 Year Olds
Old - None of Above Immunizations
J
.
24. LAB - CH
a.
Provide a Laboratory Technician to draw blood lead
specimens in Well Baby Clinics during regular
working hours. This will average one clinic a
week.
Provide a Laboratory Technician to draw blood lead
specimens during a new Well Baby Clinic to be set
up in the Odgen area of the county. This Clinic
will begin at 5:30 P.M. once every other month.
Provide Cholesterol screening for hypertension
outreach activities. This testing will be
provided during regular working hours with the
specimens being drawn by the nursing staff and the
testing being provided by the LAB staff.
Provide laboratory services to expanded Neurology
Clinic.
b.
c.
d.
25. LAB - EPI
a. Expand laboratory services to the Sexually
Transmitted Disease (STD) Clinic to include Pregnancy
Tests, Urine Cultures, Wet Smears, and Pap Smears.
b. Expand laboratory services to cover the new
expanded hours of STD services available to the
public. The expansion now has STD services
available from 8:00 A.M. - 5:00 P.M. Monday - Friday.
c. Expand laboratory services to 7:00 P.M. on the first,
second, third and fourth Thursdays of each month.
This expansion will include HIV testing and
laboratory services to the TB clinic.
26. LAB - MCC
a. FAMILY PLANNING CLINIC
The addition of another night clinic to be held
from 5:00 P.M. - 9:00 P.M. on the fourth Thursday
of each month. All laboratory services will be
available to the family planning clinic.
b. HEALTHY CHILDREN AND TEENS (HCT} CLINIC
Expanded laboratory services for new Early periodic
Screening Diagnosis and Treatment EPSDT/HCT Clinics
to be held on the first, second, third, and fourth
Thursdays of each month to 7:00 P.M.