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08/06/2003 r ------ e~', - New Hanover County Health Department Revenue and Expenditure Summaries for June 2003 Cumulative: 100.00% Month 12 of 12 Revenues Current Year Prior Year Type of Budgeted Revenue Balance % Budgeted Revenue Balance % Revenue Amount Earned Remalnln Amount Earned Remalnln Federal & Slale $ 1,721,838 $ 1,478,542 $ '243,296 $1,579,435 $ 936,137 $ 643,298 59.27% C Fee. $ 587,944 $ 573,089 $ 14,855 $ 533,044 $ 541,686 $ (8,642) 101.62% Medicaid $ 1,035,386 $ 858,557 $ 176,829 $1,012,934 $ 878,299 $ 134,635 66.71% Medicaid Max $ $ 273,333 $ 165,773 $ 165,775 100.00% EH Fee. $ 312,900 $ 280,796 $ 312,900 $ 269,141 66.02% Heafth Fees $ 112,850 $ 163,940 $ 125,850 $ 152,344 121.05% Other $ 1,799,544 $ 1,684,866 $1,531,336 $1,388,561' 90.68% Expenditures Type of Ex endlturs Current Year Expended Balance Amount Remalnln Balance Remalnln % Prior Year Budgeted Amount % Budgeted Amount Expended Amount Summary Budgeted Actual % FY 02-03 FY 02-03 Expenditures: Salaries & Fringe $ 9,083,424 $ 8,488,336 Operating Expenses $ 2,128,028 $ 1,875,408 Capital Outlay $ 315,453 $ 135.106 Total Expenditures $ 11.526,905 $ 10,498.850 91.08% Revenue: $ 5,570,462 $ 5,313,123 95.38% Net County $$ $ 5,956.443 $ 5,185,727 87.06% e Revenue and Expenditure Summary For the Month of June 2003 11 r e; e e NEW HANOVER COUNTY HEALTH DEPARTMENT BOARD OF HEALTH (BOH) APPROVED GRANT APPLICATION STATUS FY 03-04 Date (BOH) Grant Reauested Pendlnll Received Denied Smart Start. Partnership for Children (Grant 71312003 Increase for Part Time Nurse Position) $5,523 $5,523 Cape Fear Memorial Foundation. Diabetes Today (two-year request: $42,740 annually) $85,480 $85,480 Duke University Nicholas School of the Envlronment.Geographic Information Systems Grant (Env Heallh) $10,000 $10,000 Safe Kids Coalition. Safe Kids Mobile Car Seat Check up Van $50,000 $50,000 Safe Kids Coalition. Risk Watch Champion 6/412003 Team $10,000 $10,000 Smart Start. Partnership for Children: Child 51712003 Care Nursing Program (Preliminary Approval) $171,977 $171,977 Smart Start- Partnership for Children: Health Check (Preliminary Approval) $41,035 $41,035 UNC-CH: Child Care Health Consultant $62,849 $62,849 Cape Fear Memorial Foundation (through Partnership for Children): Navigator Program $178,707 $178,707 4/312003 No activity to report for April 2003. 3/512003 No activity to report for March 2003, 2/512003 No activity to report for February 2003. 1/812003 NC DHHS- OPH Preparedness and Response $115,950 $33,600 $82,350 12/412002 No activity to report for December 2002. NC Health and Wellness Trust Fund.Teen Tobacco Use Prevention & Cessation Program 11/6/2002 ($100,000 per year for 3 years) $100,000 $100,000 Safe Kids Buckle Up Program.North Carolina 101212002 Safe Kids $5,000 $5,000 Developing Geographic Information Systema (GIS) Capacity In Local Health Department In Eastern North Carollna.Duke University Nicholas School ofthe Environment and Earth Sciences (NSEES) $18,000 $18,000 No actlv ty to report for saptemt>er 2002. No activity to report for August 2002. No activity to report for July 2002. PROJECT STOP.Prenatal Health Education and Information/Referral Services- March of Dimes Community Grant Program (TN...- e. en inteirt to apply for 149,975- the actual application for this grant went 6/512002 ttYough In Odober 2002- the amount changed to $50. $50,000 $48,280 $1,720 Totals $904,521 $151,003 $569,448 $184,070 . . . . 16.69% 62.96% 20.35% Pending Grants 4 29% Funded Total Request 7 50% Partially Funded 2 14% Denied Total Request 1 7% Number of Grants Applied For 14 100% 12 As of 7/23/2003 * NOTE: Notification received since last report. i J ~ friends of felines June 16, 2003 Animal Control Services Animal Control Advisory Board 220 Division Drive Wilmington, NC 28401 To Whom It May Concern, JoE Needham will be replacing Timmi Evans as the Friends of Felines representative on the Animal Control Advisory Board. Sincerely, e ~~ Audrey Mizrahi Treasurer, Friends of Felines e "Helping the forgotten ones" 13 e e e NEW HANOVER COUNTY BOARD OF COMMISSIONERS Request for Board Action Agenda: Consent Meeting Date: 08/18/03 A enda:[8J De artment: Public Health Presenter Cind Hewett, Business M r Contact: Cindy Hewett, Business Mana er, ext 6680 Subject: $3,000 State Bioterrorism Grant for the purchase of a computer and printer for the Health De artment Laborato . Brief Summary: All 100 health departments in the state of North Carolina have available a maximum of$3,000 from the State Bioterrorism Program to purchase a computer and printer for use in the laboratory This is very time sensitive. These items must be urchased, received, invoiced and aid b Au t 30, 2003. Recommended Motion and Requested Actions: To approve the $3,000 State Bioterrorism Grant for the purchase of a computer and printer for the Health Department Laboratorv and associated budget amendment. I Funding Source: State Bioterrorism Program Will above action result in: DNew Position Number ofPosition(s) Dposition(s) Modification or change [8JNo Chan e in Position s Ex lanation: No chao e in osition as a result ofthis I Attachments: Supporting documentation and budget amendment. 14 e """ z w ::!!: c z w ::!!: c( """ w C) c ~ al - W > w a::: e "' ili a: < c w c ;l; "' ;!; ~ ~ u: >- o z o o w ~ ~ 0 ~ ~ 0 ;:: .c Z m w ...J >- U Z W .., 0 <( ~ III 0 Z :J 0 u. ~ ~ ~ I- W 8~ :J <Xl ~ :;; .., Z -0 Izo ::Iii: Ow ua. ~ Izet: Ww :;;<Xl :J:;; U:J gz >- U Z W ~ <Xl et: Z 0 t3w <(0 ",0 ZU c:! I- e e """W- e Z..J~ C") ::I ~::s O~..J ~zg <l:'=- + ... , + 0 01-1- wwz (/)C):::l -00 (ij:::l::!! 0:::a1<( 1-1-1- Zwz wC):::l 0:::00 O::::::l::!! 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E 8 cu ~ .E .2- ~ "" .g 0. l/J "0 Q) l/J => Q) 00 .9 E ~ OJ e a. E l/J .'" e ~ ~ o iii ~ .l!l (I) E .g "0 Q) > .~ l!! o o o M Q) QJ Q)" ~ Z EEE~ Q) 0 CUmeuCUcn t= ZZZO -g <( iij >.~ ~.c :E i3a1g!e~~~ c.. "C e a. i.: 1.1. a.Q)c.a...,gz <( ill 0.<( Z III - -:.:: <( c: O...J ...J ~ c:i.~ i;; "E ~ Q) . l/J .... Q) 0 E aI.-ZE 1:: ~ 51:: E [ oo.[cc Q) 0 X Q) c: o E c: Q) E g "0 OJ c: :e o 0. 0. :J l/J "0 Q) .c: o ~ cu 3l (I) e e e David E Rice 07/21/200310:59 AM Please process through Cindy Diane Vosnock ~.;;c~~-~;~~~ ~~~;:O:~~:':1 AM ~~~~~ To: Diane VosnocklNHC@NHC ee: chewett@nhcgov.com@NHC, (bee: archive) Subject: Re: BT money for lab computers~ To: David E Rice/NHC@NHC, Cindy HewettINHC@NHC ee: (bee: archive) Subject: BT money for lab computers I received the fax cover letter but not the five pages accompanying it. Should we pursue this? __ Forwarded by Diane VosnocklNHC on 07/21/2003 10:48 AM- . IIsa ballance . " <lIsa.ballance@ncmall. , net> 07/17/200305:12 PM To: brussell <brussell@email.co.anson.nc.us>. Orella McMillian <omcmilllan@co.cumberland.nc.us>, Leona Cromartie <Icromartie@bladenco.org>, Dwayne Sholar <dwayne.sholar@ncmall.net>, Shawanna James <sjames@hokehealth.com>, Becky Plttmen <bplttman@mail.co.johnston.nc.us>, jill winstead <jill.winstead@ncmail.net>, Tammy Home <tammLhome@co.onslow.nc.us>, clemmason@lnterster.net, Ann Mckenzie <Ann.Mckenzie@ncmail.net>, Pat Thompson <pgthompson@wilson-co.com>, cheryl harris <cheryl.harris@ncmail.net>, Shaw Oldham <soldham@co.moore.nc.us>, James Gurgone <James.Gurgone@co.wake.nc.us>, Tina Blackmon <tblackmon@hamett.org>. dhuneycutt <dhuneycutt@co.stanly.nc.us>. dsawyer <dsawyer@brunsco.net>, Victoria Smith <vsmith@brunsco.net>, Diane Vosnock <dvosnock@nhcgov.com> ee: (bee: archive) Subject: BT money for lab computers -------- Original Message -------- Subject:BT money for lab computers Date:Thu, 17 Jul2003 17:07:21 -0400 From:lisa ballance <lisa.ballance@ncmail.net> To:Pat Thigpen <Pat.Thigpen@ncmail.net> Attention Laboratory Managers: A memo dated July 15,2003 from Dennis Harrington, Chief, Administrative, Local and Community Support Section was sent out to all local health directors this week. The subject line of this memo read "Use ofBT Funds for Federal Fiscal Year 03." This memo contains very time critical information affecting your laboratories in regards to the purchase of a laboratory PC and printer with bioterrorism (BT) funds the state has available. All 1 00 health departments have available a maximum of a $3,000 reimbursement for these purchases. Please note that to be eligible for reimbursement from the state, these purchases must be made with the goods 17 received, invoiced and paid by your local health department by August 30, 2003, which is ... approximately only 6 weeks away! Please ensure that your health director has received this .. information and gives it top priority. The State Lab has written an agreement addendum for the local health departments, which outlines all the specifications for the equipment and software purchases, Please note that these computers are for LABORA TORY use and must be placed either within the lab or the lab manager's office. If you already have a lab PC, I would recommend that you move that PC elsewhere because the recommended PC for purchase will most likely have updated features and greater expandability, as well as providing consistency in hardware in this developing networking project. It is also imperative that you let me know either by voice mail or fax once your agency places the order for the above described equipment. Please make sure that purchasing protocols/authorizations for your agency are followed. We want to ensure that all health department laboratories benefit from the financial resources available. I will faxing you additional information tomorrow including: . A copy of Dennis Harrington's memo (which defines the health departments' authority to receive reimbursement if these purchases are closed out on their books by August 30, 2003.) . State Laboratory of Public Health Agreement Addendum (this gives your agency all the specifications for the PC, software, and printer purchases.) . The Budgetary Estimate to local health departments (a listing of money available, .. please note that districts of more than 1 health department are eligible for $3,000 per ., health department. Once you receive the faxed materials, please do not hesitate to call me (910) 486-4111 or Vickie Whitaker (919) 733-7186 with any questions you may have. Thanks for you prompt attention to this time sensitive matter. Lisa e 18 . Mosquito-Borne Illness in North Carolina: The Facts Background Although a lot of media attention has focused on West Nile Virus (WNV) since its 1999 arrival in the United States, North Carolina has a long history of dealing with other mosquito-bome illnesses. In addition to WNV, North Carolinians may also become infected with Eastem Equine Encephalitis virus (EEE) and La Crosse virus. EEE is the most serious of these diseases, with a fatality rate up to 50 percent. EEE survivors are often left with severe, permanent neurological problems. EEE is relatively rare-North Carolina averages about one EEE case a year, often in children. e WNV first appeared in North Carolina in October 2000, when an infected bird was discoverad in Chatham County. North Carolina experienced its first human WNV cese in 2002. According to the Centers for Disease Control and Prevention (CDC), the majority of people infected with WNV will have no symptoms. The CDC estimates that only 1 in 150 people infected with WNV will experience severe infection, which is called West Nile encephalitis (inflammation of the brain), meningitis (inflammation of the lining of the brain and spinal cord) or meningoencephalitis, a combination of both. La Crosse virus is the most common mosquito-borne illness in North Carolina. It is found predominantly in the westem part of the state. There are, on average, 70 cases of La Crosse virus annually in America. In 2002, North Carolina had 20 cases of La Crosse. La Crosse is rarely fatal, although a Transylvania County girl died from the disease in 2001. All three illnesses are most likely to affect people over 50 and children. Early symptoms of all three diseases are similar - aches, headaches, high fever and neck stiffness. TransmIssion All three illnesses are spread by mosquito bites. The diseases are not contagious - an infected person can't infect another person. Infected birds or animals can't infect humans or each other To date, none of these diseases have cures or vaccines for use on humans, though scientists are working to change that. Treatment is limited to managing the symptoms of the diseases, so the best way to protect yourself from these diseases is prevention. e You can prevent mosquito-bome illness in two ways - taking personal protection measures and reducing the population of infected mosquitoes. e e e Personal protection means limiting your exposure to mosquito bites: . Anyone over two months old should wear mosquito repellent containing 30 percent DEET. . Wear Iight-colored, long pants and long-sleeved shirts. . Avoid the outdoors at dusk and dawn, when mosquitoes are most active. You can eliminate mosquito breeding areas in the following ways: . Remove any containers that can hold water, even a small amount - especially old tires; . Keep gutters clean and in good repair; . Repair leaky outdoor faucets and change the water in bird baths and pet bowls at least twice a week; . Use screened windows and doors and make sure screens fit tightly and are not tom. Tracking the Diseases North Carolina tracks the spread of mosquitoes infected with EEE, WNV and La Crosse virus by looking for infected animals, birds and mosquitoes. Eastem Equine Encephalitis is usually fatal for unvaccinated horses. This year, North Carolina has had 80 EEE horse cases. Thars compared to just three for all of 2002. Although much of the activity has been centered in the southeast quadrant of North Carolina, an infected horse has been found as far west as Henderson County. All North Carolina residents, particularly those in the southeast, should be aware of this disease and take appropriate precautions. The State Health Director issued the season's first mosquito-bome illness waming on June 25, when four horse EEE cases had been identified in southeast North Carolina. That waming was reiterated on July 22, when 26 horses cases had been reported, and on August 22, when the first human case was identified. WNV-infected birds and mosquitoes have been found from Manteo to Murphy. The risk of WNV is the same for all North Carolinians. North Carolina's Current Situation WNV has infected three North Carolinians this year. A central NC man died from the disease. An eastem NC man had a mild form of the disease and has recovered. The most recent victim is a Wake County man in his mid-50s. He was hospitalized with meningoencephalitis, but is now at home recovering. EEE has infected one North Carolinian this year, a Scotland County child is hospitalized in critical condition with the disease. La Crosse virus has infected five North Carolinians so far in 2003. . . i ~ . ~ tn ....... iz Cft: lCD i< Q. -. .. ge ctn :2 ~:I> CD 02, ::7 _. ~< CD::;: ::7"< &.... =e::r za 1= 'Ce OCQ !::r ~. :I> ere :::;'CQ ie Otn ..... ::71\) ~...... CD-- 01\) o o w (I' e -,e . WEST NILE VIRUS ACTIVITY Thre human cases: A Wake County man with meningoencephalitis who is recovering; one mild case in eastern North Carolina; one fatal case in central NC Counties with positive birds Unless otherwise noted, one bird only In general testing is halted after county has one positive Alamance Alexander Allegheny Ashe Bladen 2 Brunswick Buncombe 2 Burke Cabarrus 2 Caldwell Camden Carteret Catawba Cherokee Chowan Cleveland 2 Craven 6 Cumberland 5 Currituck Dare 2 Davidson Duplin Durham Forsyth 3 Gaston Gates Guilford Henderson 2 Iredell 4 Jones Lincoln Macon Madison 2 Mecklenburg 5 Moore New Hanover Northampton Onslow Pasquotank 2 Pender 2 Perquimans Polk Richmond Robeson Rockingham Rutherford 2 Sampson 2 Stokes Wake 4 Watauga Counties with positive horses Unless otherwise noted, reflects one horse Bladen 2 Currituck Brunswick Davie Cabarrus Gates 2 Catawba Granville Columbus Iredell 2 Cumberland 2 Lenoir Lincoln Martin Pasquotank Perquimans Wake Warren Counties with positive sentinel chicken flocks Brunswick :1 'e - - July 2003 New Hanover County Health Department A Tribute to Service Three major names asso- ciated with communica- ble disease activities at the Health Department have moved on... producing g' .. changes in :. J " your usual lIi"'>lMOYE.Cg\lIlTVHli~.'''~'' contact people. Esther Adams, the STD Pro- gram Nurse, retired June 30. Esther was well respected for running a tight ship, for persistent and relentless fol- low-up, and for ensuring that every patient who needed to be seen was seen in a timely manner Vivian Mears, RN, has assumed her du- ties. Vivian's phone num- ber is 343-6650. Maureen Lamphere, the TB Control Program Nurse, re- signed July 3 to take another position. Known for her "street smarts", Maureen tackled the toughest situa- tions without reservation. The accomplishments of the TB Program under her direc- tion have been outstanding. Betsy Summey, 343- 6531, is now the contact person for TB. And finally, Beth Jones. Beth was the nursing supervisor for all communicable disease activities in the Health De- partment. In her 28 years at the Health Department, with accomplishments far too nu- merous to list, she has most recently been at the helm of our efforts against bioterror- ism. She developed a small- pox plan for the Health De- partment and partnered with other agencies to bring train- ing to front-line workers. The staff she supervised rec- ognized her as creative, fair, and a facilitator of excellence in practice. She will be taking a position with the North Carolina Pediatric Society working with private pedia- tricians to start up the immu- nization registry. Page Dunn, RN, is assuming Beth's duties and can be reached at 343-6648. Each unique in her own right, these nurses represent over 50 years of public health ser- vice. The Mosquitoes Are Outl Reports of West Nile Vi- rus (WNV) and Eastern Equine Encephalitis (EEE) are coming in from across the Betsy Summey, FNP, 343-6531 state. In recent years, the emphasis has been on WNV as it has spread across the United States. This year EEE has affected sev- eral animals in southeastern North Carolina including one in New Hanover County ~-" / -, I ,'- The state veterinarian, Dr. David Marshall, advises own- ers of horses, ponies, don- keys and mules to have their animals vaccinated against EEE. Be- tween 50 and 90 percent of animals ex- hibiting symptoms of EEE will die and the remainder are likely to suffer permanent im- pairments. There is no spe- cific treatment once infected. Not so fortunate are humans for whom no vaccine exists. Although rare, EEE does occur in humans and is fatal in about 50 percent of cases. Young children and the elderly are at par- ticular risk. Survivors may have long term neurological effects. Again, therapy is lim- ited to symptomatic treat- ment. continued West Nile Virus and Eastern Equine Encephalitis are both transmitted by mosquitoes. Our best efforts should be di- rected toward patient educa- tion for prevention of disease. Mosquito Disease Prevention Guidelines . Turn over buckets, pails, and flower pots to reduce breeding grounds. . Keep gutters clean and in good repair . Screen all open windows and doors. . Repair leaking outdoor faucets to minimize puddles. . Change water in bird baths and outdoor pet bowls every 2 to 3 days. . Wear long-sleeved shirts and long pants when working out- side. . Avoid being outside at dusk and dawn when mosquitoes are most prevalent. . Use insect repellant with DEET f. coli 0157:H7 So Much for that Rare Steakl Until very recently, ground beef was the source of E coli 0157:H7 infection in hu- mans, the result of contamina- tion of surface E coli in the grinding process. In June, Stampede Meat Inc. recalled 739,000 pounds of frozen meat with the USDA code "EST 19113" and pro- duced between March 17 and March 22, 2003. It is potentially con- taminated with E coli. Distributed to restaurants, retail groceries, institu- tions, and door-to-door meat sales companies, its "Best if Used By" date is September 13-18,2003. This makes it likely that potentially contaminated meat is still in the home. e Unlike ground beef, these steaks were subjected to two processes which could have introduced surface contamina- tion into the center of the meat, including needle tender- ization and injection of flavor enhancing additives. Cooking the surface only may not be adequate to kill the in- ternal contamination. - , Communicable Disease Statistics New Hanover County July 1, 2002 - June 30, 2003 AIDS .........,............................... 35 Campylobacter ........................16 Chlamydia .............................. 559 Ehrlichiosis, Monocytic ............ 0 Gonorrhea.............................. 221 Haemophilus Influenza, Invasive ................................. 0 Hepatitis A................................. 3 Hepatitis B (acute)................... 11 Hepatitis B (chronic carrier) ...17 Hepatitis C (acute)..................... 0 HIV Infection ............................ 57 Legionellosis ............................. 1 Listeriosis ..................................1 Lyme Disease ............................ 6 Meningitis Pneumococcal............1 Meningococcal Disease ...............1 Pertussis .......................................3 Rky. Mtn. Spotted Fever ...............5 Salmonellosis .............................95 Shiga-Toxin Producing Infection (formerly E. coli 0157:H7)..........3 Shigellosis ....................................6 Strep, Group A, Invasive ..............3 Syphilis..........................................7 Toxic Shock Syndrome ................1 Tuberculosis ...............................10 Typhoid (acute).............................O Vancomycin Resistant Enterococcus..........................10 e .- "'" . , . . ' . ,-'" . .. ... ., ' . :-:< ,': r- " Published for Members of Local Boards of Health May 2003 President's Message Connie Tattan, Acting President We all have times in our lives when things don't turn out as expected. Life throws us a curve and we are forced to reprioritize. Ken Hartke, our President, is dealing with such a situation. Because of family health and personal issues, Ken has decided to resign as President of NALBOH. The NALBOH Board of Directors appreciates his devotion to family and wishes him well. As President-Elect, the board has appointed me to fulfill his term as President. Even though Ken will be missed, the work goes on. The 4th Annual Ned E. Baker Lecture in Public Health was held in Bowling Green, Ohio on April 4, 2003. The featured lecturer was Vincent Covello, Ph.D., founder and Director of the Center for Risk Communication. He is a nationally and internationally recognized trainer, researcher, consultant, and expert in conflict, change, risk and crisis communications. Dr Covello defined risk and crisis communication as "a science-based approach for communicating effectively in high concern, high stress, emotionally charged or controversial situations." Who has not had the fear of having to deal with a concerned, irate public and media under volatile circumstances? Dr Covello provides the tools and training to help health officers, board members and others to communicate in stressful situations. Dr. Covello stated that communication goals in general include exuding knowledge and Continued on Page 2 What Do You Have to Do to Apply for A Septic System Permit? Phil Lyons, Past President Many local health departments require a permit for the construction of septic tank and drainfield systems. The permit must be approved before construction can begin. The installed system must be inspected and approved before anyone can live on the site. A site evaluation is required during the permit application process. Soil survey maps and previOUS soil tests may be available and can be used by the health department as part of the site evaluation. Some areas of the county require ground water table monitoring for up to a year before the site assessment is completed. Early contact with the health department is essential to avoid delay in the permitting process. Whomever the homeowner hires to perform the soil exploration and percolation test must be certified by the health department to do soils work. They will coordinate a site visit with the health department so a health official can observe the site evaluation test. Site tests and evaiuations are conducted to determine the suitability of the site for a septic tank and drainfield system. Soils are examined and observation of the texture, hydraulic conductivity (percolation tests) and depth of the soil layers are recorded. Other criteria such as the depth to bedrock, water table, slopes and other features are observed and recorded to finalize the site Continued on Page 3 I ~s.~ Q1 Q1 OZ-iC QJ z ,.. < ,..,. 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On m ~ . :, ::1:- '" ID- 8' III III ". -~ . ....ID ~ ::r... v ." w <0 ro '" [NALBOH'S 11th Annual Conference] ~ Boards of Health: Stewards of Local Public Health ".......,../ July 16-19, 2003 Wyndham Baltimore Inner Harbor Baltimore, Maryland Birthplace of Our National Anthem "0 say can you see, by the dawn's early light;' a large red, white and blue banner? "Whose broad stripes and bright stars were so gallantly streaming!" over the star-shaped Fort McHenry during the Battle of Baltimore, September 13-14, 1814. The valiant defense of the fort by 1,000 dedicated Americans inspired Francis Scott Key to write "The Star-Spangled Banner" Regardless of the "rockets red glare, the bombs bursting in air" the defenders of Fort McHenry stopped the British advance on Baltimore and helped to preselVe the United States of America - "the land of the free and the home of the brave." Take Time Out to Visit Our Nation's Capital! Only two blocks from the Wyndham Inner Harbor Hotel, visitor's can take a fairly inexpensive commuter line that runs between Baltimore, MD and Washington, DC. The MARC Train has two lines that make this one hour commute. . Camden Line, which runs from the Camden Yards Station, in Baltimore's Inner Harbor to Union Station in Washington, DC . Penn Line, which runs from Penn Station in Baltimore You can obtain more information about the MARC Trains by visiting their website at <www.mtamaryland.com> or if need ticket information and packages visit <www.CommuterDirect.com> r-"o, If you are interested in shuttle selVices, visit <www.baltimore.org/pages/trans_detail.jsp?scat=BUS> -...J ' Conference registration forms and a program summary is available online. Visit <www.nalboh.org> or call the NALBOH office at (419) 353-7714 to obtail a copy available by email or via mail. For a virtual tour of the Wyndham Inner Harbor Hotel, visit <www.wyndham.com/hotels/BWIIH/main.wnt#> National Association of Local Boards of Health 1840 East Gypsy Lane Road Bowling Green, OH 43402 E-mail: <nalboh@nalboh.org> Website: <www.nalboh.orQ> NON PRom ORG. U.S. Postage PAlO Bowling Green, OH Permit No.4 7 n\ , ) ........