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10/01/2003 e e e Revenues Type of Revenue Federal & State nimal Control Medicaid Medicaid Max EH Fees Health Fees Other Ex enditures Type of Ex enditure New Hanover County Health Department Revenue and Expenditure Summaries for August 2003 Cumulative: 16.67% Month 2 of 12 Budgeted Amount Current Year Revenue Balance Earned Remaini" % Prior Vear Revenue Balance Earned Remalnln Budgeted Amount $ 1,659,620 $ 570,161 $ 1,044,080 $ $ 300,212 $ 113,850 $ 2,183,420 463,661 91,147 81,637 $ 1,195,959 $ 479,014 $ 962,443 $1,692,429 $ 587,944 $1,035,386 $ $ 312,900 $ 112,850 $1,272,101 $ 1,578,744 $ 498,022 $ 958,397 113,685 89,922 76,989 6.72% 15.29% 744% 264,361 $ Budgeted Amount Expended Amount Balance Remalnln % BUdgeted Amount Expended Amount Balance Remalnln % 8,798,590 $ 1,183,482 1,839,543 $ 220,135 148,964 $ 2,017 Summary - Budgeted Actual % FY 03-04 FY03-04 Expenditures: Salaries & Fringe $ 9,748,182 $ 1,185,987 Operating Expenses $ 1,377,535 $ 185,746 Capital Outlay $ 57,614 $ 12,738 Total Expenditures $ 11,183,331 $ 1,384,471 12,38% Revenue: $ 5,871,343 $ 762,769 12.99% Net County $$ $ 5,311,988 $ 621,702 1170% Revenue and Expenditure Summary For the Month of August 2003 10 Date (BOH) Grant Reauested Pendina Received Denied New Hanover County Safe Schools- Uniting for Voulh "U4Youth"(funding will be received over a 9/312003 3 year grant period) $49,000 $49,000 , Safe Kids Coalition- Fire Prevention $2,500 $2,500 ,-. /fA'" , 8/612003 NC DHHS- OPH Preparedness and Response $82,350 $31,950 $50,400 . Smart Start- Partnership for Children (Grant 7/3/2003 Increase for Part Time Nurse Position) $5,523 - $5,523 Cape Fear Memorial Foundation - Diabetes '~rOtiJ Today (two-year request; $42,740 annualiy) $85,480 $85,480 Duke University Nicholas School of the I Environment-Geographic Information Systems Grant (Env Health) $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 $12,500 Smart Start- Partnership for Children: Child 51712003 Care Nursing Program (Preliminary Approval) $171,977 $172,500 Smart Start. Partnership for Children: Health Check (Preliminary Approval) $41,035 $41,747 UNC-CH: Child Care Health Consultant $62,849 $64,495 Cape Fear Memorial Foundation (through Partnership for Chlidren): Navigator Program $178,707 $180,000 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 Fabruary 2003. 1/812003 NC DHHS- OPH Preparedness and Response $115,950 $33,600 $82,350 12/412002 No activity to report for Dacember 2002. NC Health and Weliness Trust Fund-Teen Tobacco Use Prevention & Cessation Program 111612002 ($100,000 per year for 3 years) $100,000 $100,000 Safe Kids Buckle Up Program-North Carolina 10/212002 Safe Kids $5,000 $5,000 Developing Geographic Information Systems (GIS) Capacity in Local Health Department In Eastern North Carolina-Duke University Nicholas School of the Environment and Earth Sciences (NSEES) $18,000 $18,000 No actiVity to report for september 2002. No activity to report for August 2002. No activity to report for JulY : Totals $988,371 $186,980 $569,792 $238,273 NHCHD BOARD OF HEALTH APPROVED GRANT APPLICATION STATUS FY 03..Q4 e e e 18.92% Pending Grants 4 25% Funded Total Request 8 50% Partiallv Funded 2 13% Denied Total Request 2 13% Numbars of Grants Applied For 16 100% As of 9/1612003 . NOTE: Notification reoaivad since last repert. 57.65% 24.11% 11 , e e e NEW HANOVER COUNTY BOARD OF COMMISSIONERS Request for Board Action Agenda:D Consent Meeting Date: 10/01/03 Agenda: 0 Deoartment: Health Presenter' David Rice, Health Director Contact: Janet McCumbee, Personal Health Services Director Sub'ecl: Re uest for A roval of Additional State Maternal Funds Brief Summary' Health Department will receive additional funds from the State to implement the MCC Best Practice Pilot Model. NHC Health Department was chosen to pilot a more standardized MCCIMOW program for NC. The State will provide $7500 in additional support as an incentive. All MCCslMOWs have received free training to im lement the ro ram be inni November 2003. Recommended Motion and Requested Actions: NHCHD to accept $7,500 from the state to be added to their Maternal Child Grant funds routinely received each year, and to a rove the related bud et amendment when the contract is received. Funding Source: NC Dept of Health and Human Services, Division of Public Health,Women's and Children's Health Section. Will above action result in: ONew Position Number ofPosition(s) Dposition(s) Modification or change 0No Change in Position(s) Explanation: The funds are to be used to offset any revenue loss during initial implementation of the pilot, and to add funds to operating for mileage for required home visits. I Attachments: Letter from State Women's Health Branch on MCC/MOW Best Practice Pilot 12 < ~ . North Carolina Department ofHea1th an4 Human Services Division of Public Health - Women's llt Cbildreo's Health Section 1929 Mail Service Center . Raleigh, Nottb CaroIiDa 17699-1929 Tel919-733-7791. Fax 919-715-3410 a(~D3 C'.aDnm Hooker Odom, Seaowy e MidIad F. Easley, Governor July 17, 2003 MEMORANDUM From: Selected Health Directors and Community Health Center Directors who provide MCC and/or MOW Services BelindaPettiCord, Supervisor ~ ~I #If- Perinatal Health and Family Support Unit Women's Health Branch To: Subject: Invitation to Participate in the 2003-04 MCClMOW Best Practice Pilot You are invited to participate in the 2003-04 MCC/MOW Best Practice Pilot in collaboration with the Women's Health Branch. As you know, Maternity Care Coordination (MCC) services arepresently available to all women eligible for _Medicaid through local health departments and a select group of community health centers. Maternal Outreach Worker. _ (MOW) services are provided in approximately 6Q% ofNC counties to provide additional support under the care plan of an MCC. The overall goal of the ten-county pilot is to match the identified needs with appropriate service provision and focus the resources and efforts to those individuals with the greatest need. Medicaid eligibility will not be the sole determining factor for MCCIMOW service provision, but services will be driven by client identified needs. Your site has been selected due to your existing program efforts and your interest in strengthening your MCClMOW service provision. The Regional Social Work Consultant for your county has also made contact with a member of your MCC/MOW team. The attachment provides an overview of the changes that will be piloted. In order to be a pilot site the following is required: . Attendance at the informational teleconference . All MCC and/or MOW staff must follow the pilot guidelines (no variations) . All MCC and/or MOW staff must attend a full day training on September 10,2003 (travel and overnight accommodations will be covered by the~) . Participation in random record audits . All MCC and/or MOW staff must attend a follow-up training in early 2004 (travel and overnight accommodations will be covered by the state) . Participate in data collection for specific elements . Service capacity (i.e. staff infrastructure) must be maUrtained e The informational teleconf.nce has been scheduled for Wednesday, July 30, 2003 from 9:00 -12:00 noon. The teleconference sites include Hickory, Wilson, and Raleigh. If you are interested in participating in.the pilot, we are requiring the MCC/MOW Supervisor along with you and/or your designee to attend. During this session, a formal presentation will be provided and time allotted for questions and answers. Once the teleconference has concluded, you will be requested to make a formal commitment to participate in the 2003-2004 MCCJMOW Best Practice Pilot by Monday, August 11". 13 * t .....,;~. mo St. MoIy'. Su=. Raleigb.N.C 27605 An Equal Oppommity Emp1ayer Page 2 July 17, 2003 Best PractiCe Pilot We have secured limited funding in the amount of $7500-$8000 per site that is available to assist sites during this pilot period and to ensure that sites commit to the pilot for the entire period of September 2003 - June 2004. If you are interested in attending the informational teleconference, please contact Renee Hannah, State Baby Love Program Manager, by Monday, Jnly 2811>. She can be reached at 919-715-5293 or renee.hannah[aJ.ncmail.net. Should you have additional questions or concerns, feel free to contact me at 919- 715-3399 or belinda.Dettiforduv.ncmail.net. We look forward to this new collaboration. Thanks for your consideration of this request! C: Kevin Ryan, MO, MPH, Section Chief Joe Holliday, MO, MPH, Branch Head Renee Hannah, MSW, Program Manager Regional Social Work Consultants . ~ , e e e 14 e e e Concept Presently the Maternity Care Coordination (MCC) program is available to all women eligible for Medicaid through local health departments and a select group of community, rural, and migrant health centers and private providers. We are proposing a pilot MCC/MOW project in ten targeted counties in which Medicaid eligibility will no longer be the sole determ;n;ng factor for MCCIMOW service provision that will: . Focus the resources and efforts to those individuals with the greatest need . Match the identified needs with appropriate service provision . Ensure that the identified needs can be adequately addressed and/or impacted by the MCCIMOW programs . Increase efficiency by having the client complete a self-screen . Increase/improve coordination among providers involved in.care of clients . Enhance service delivery quality by standardizing service provision through the use ofbest practice methods of care Proposed Program Changes New Self-Screeninl! Tool All potentially eligible pregnant women will complete a self-screening tool that will focus on such issues as access to care (e.g" transportation, child care), living conditions (e.g., homelessness, stability), substlince use, domestic violence, depression/mental illness, and pregnancy intendedness. The MCC will review the results of the screening toOl with the client. and determine whether the client needs basic written information or a complete MCC Program Assessment. If the provider determines that issues/circumstances have changed with the client, a second point of entry can be either provider or self-referral. Revised Assessment and Planninl! Process All participants needing an assessment will be enrolled into the MCC Program. This will be the initial entry into the MCC/MOW program. During the assessment phase, the MCC will conduct a more in-depth analysis of the situation and ascertain the level of service provision for the patient. Through utilization of a best practice assessment and care planning process ("Maternity Care Coordination Pathways"), the MCC and client will conduct a structured assessment interview;. S~bsequently, in conjunction with the client, the MCC will develop a plan of care in which.the established risk factors will drive the direction of service delivery. A re-screen will be conducted within the third trimester (28-40 weeks) to verify any status and service provision change in clients who initially screened negatively out of participation will be supplied with written information specifying who/how to contact at the agency and what change(s) in situation would constitute reconsideration. MCCs and MOWs will be required to maintain their documentation (e.g., screening tool, assessment, care plans, narrative notes, etc.) in the agency medical record rather than in a separate MCC or MOW record. Providers will be asked to conduct regular coordination 15 . conferences (at a m;nimum of quarterly) among themselves to ensure that issues are being appropriately addressed. e Mandatorv Home Assessment The pilot will also require a home visit within sixty (60) days to complete an on-site home environment assessment. The premise in the proposed pilot is that an initial home visit is a critical step in assuring the assessment's accuracy and precision. During this assessment, data will be collected pertaining to living situations (e.g., in-door plumbing, food availability, workable appliances, etc.). In agencies with an MOW, the home assessment will be conducted by the MOW. This is an appropriate role for the MOW in that they function outside of the clinic in a community-based function. If an agency does not have an MOW program, the MCC will conduct the home assessment. For agencies with an MOW program, the completion of the home assessment by the MOW permits the MCC to focus their efforts on client care coordination. MOW Focus MOWs will have a greater focus on outreach and education for "hard to reach" families. During the pilot process MOWs will also be paired directly with women who need assistance in housing, transportation, childcare, food, financial resources, and educational/employment needs. Follow- up must be delivered on identified issues. They will be the primary points of contact for families while working with the MCC. Evaluation and Renortinl! e In addition to the present policy requirement that Maternity Care Coordinators complete and submit a Pregnancy Outcome Summary/Report within 30 days of service discontinuation, the proposed pilot incorporates an evaluation plan that strives to analyze the basic premise for instituting a different approach to service delivery within the current environment. Data collection for specific elements is a condition of pilot participation. Regional Social Work Consultants will conduct random record audits periodically. All Maternity Care Coordinators, Maternal Outreach Workers and their supervisors (at a m;n;mum) will be mandated to participate in one basic training at the onset of the pilot. . e 16 e I- Z w ::E Q Z w ::E c( I- W C) Q ~ m w - > W 0:: e , 0 0 I-w_ II) Z ..."Il ,... ~O~ oL ::EzO <( cO + .. 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"fI/I'7...- EEE.!1i)'E z cucucuco CDlD 0 ZZZO -g1ii ~ iii "",", iii .c::!; ::E ~~~f)~~ a; ...."00... - 0 c.Q)'-o. c:: LL c.>.c.c. ..'- i!!: <( Ol <(co <( Z Gl -l<: c: 0'" ..J m . 0 _::3 ,'E: c._~... c( Ol lD,m;cJ2cnZ E '-Z~OlO 'l:: Ec(C:"'i= '" E..I.QC:- :it" 0 D..t) C o )(0 "" -Z ~ ~ Bj!!Q) <Um1O 000 '" ~~.9:! i=;t:;t: 1-1- .,; Ol .r: u ~ '" .!!! .r: u c: f! lD .r: - iii Ol J: '" -CO Gl E o ~ o z E ,g ~ :m Gl ...I 18 ,10 ~ e e e NEW HANOVER COUNTY BOARD OF COMMISSIONERS Request for Board Action Agenda: 0 Consent Meeting Date: 10/01/03 Agenda: [gI Department: Health Presenter Janet McCumbee, Personal Health Services Director Contact: Cindy Hewett, Business Manager, ext 6680 Subject: Request for approval to accept Temporary Assistance for Needy Families TANF fundin intheamountof$17,827. Brief Sununary: New Hanover County Health Department will receive $17,827 funding from NC Department of Health and Human Services, Division of Public Health, Women's and Children's Health Branch to provide clinical family planning services to at- risk individuals who are not covered by Medicaid. (The Health Department has received T ANF funding in the past but was informed by the State (at the time of budget preparation) that we would not be receiving these funds this fiscal year; therefore T ANF fundin was not included in bud eted revenue for FY04. Recommended Motion and Requested Actions: To approve receipt ofTANF funding in the amount of$17,827 and associated budget amendment Funding Source: NC DHHS, Division of Public Health, Women's and Children's Health Section Will above action result in: DNew Position Number ofPosition(s) DPosition(s) Modification or change [g\No C e in Position s Explanation: These funds will be used to support salary and fringe of public health nursi staff rovidin above listed services. I Attachments: Copy of Contract Addenda. 19 .. DMSION OF PUBLIC JlEALTH AGREEMENT ADDENDA .. . . eNr:w Hitnover County Health Department Contractor Name Women's and ChUdren's Health , Seetion Women's Haith Brancb 5151 - Family Planning Activity Number and Title Women's Preventive Health Unit July 1,2003 - June 30,2004 , Effective Pericd (&.ginning and Ending Date) 3 Revision # 9-02-2003 Date This revision increases T ANF Out-of.- Wedlock birth prevention funds by the amounts in the table below. Funds are to be used to support activities detailed on the attached Section C-2 Agreement Addenda. See instnJctions in first paragraph of C.2. \ . I 01 ALAMANCE $ 14,624 35 FRANKLIN , ' $ 5,989 67 ONSLOW $ 15,564 214 ALBEMARLE REG $ 16,995 36 GASTON $ 25,895 68 ORANGE $ 7,650 02 ALEXANDER $ 2,602 38 GRAHAM $ 585 69 PAMLlCO $ '1,278 04 ANSON $' 5,249 221 GRAN-VANCE $ 15,995 71 PENDER $ 4,494 204 APPALACHIAN $ 3,941 40 GREENE $ 2,818 73 PERSON $ ,,4,449 07 BEAUFORT $ 6,989 41 GUILFORD $ 54,033 74 PITT $ 20,829 09 BLADEN $ 6,050 42 HALIFAX $ 12,684 76 RANDOLPH $ 12,301 10 BRUNSWICK $ 8,021 43 HARNETT $ 12,161 77 RICHMOND $ 10,114 , 11 BUNCOMBE $ 20,382 44 HAYWOOD $ 3,694 78 ROBESON $ 31,745 12 BURKE $ 9,452 45 HENDERSON $ 6,127 79 ROCKlNGHAM $ 11,484 13 CABARRUS $ 12,346 209 HERT-GATES $ 6,436 80 ROWAN $ "\5,857 14 CALDWELL $ 9,145 47 HOKE $ 6,743 216 R"P-M $ 12.932 16 CARTERET $ - 48 HYDE $ 724 82 SAMPSON $ 9-'-314 17 CASWELL $ 2,278 49 IREDELL $ 13,946 83 SCOTLAND $ 9;283 18 CATAWBA $ , 14,810 ' 50 JACKSON $ 2,894 84 STANLY $ .6,174 19 CHATHAM $ 4,494 51 JOHNSTON $ 13,701 85 STOKES $ - 20, CHEROKEE, $ 1,616 52 JONES $ 1,093 .86 SURRY $ 6,374 22 CLAY $ 400 53 LEE $ 8,343 87 SWAIN $ 2,340 23 CLEVELAND $ 14,132 54 LENOIR $ 12,623 205 TOE RIVER $ 2;587 24 COLUMBUS $ 10,268 55 LINCOLN $ 6,312 88 TRANSYLVANIA $ 2;278 25 CRAVEN $ 12,377 56 MACON $ 1,862 90 UNION $ 12,115 26 CUMBERLAND $ 47,708 57 MADISON ' $ 1,231 92 WAKE $ , 54,115 28 DARE $ 2,063 218 MAR-TYR-WASH $ 8,528 93 WARREN $ 2,894 29 DAVIDSON $ 15,564 60 MECKLENBURG $ 85,120 96 WAYNE $ 16,549 30 DAVIE $ 2,171 62 MONTGOMERY $ 4,649 97 WILKES $ 5,834 31 DUPLIN $ 8,928 63 MOORE $ 8,205 98 WILSON $ 14,700 32 DURHAM $ 33,328 64 NASH $ 1350M 99 YADKlN $ 3,018 33 EDGECOMBE $ 15,902 I HANOVER $ 17,82 TOTAL $ 1,000,000 34 FORSYTH $ 43,849 66 NORTt1I\Mt', ;p 4,"l!:Cn e Page 1 ofl 08-2003 //4 ;2p/l!4P3 Local Health DiIector Signature and Date 20 oOrlglDal RevIsIon #1. . . Activity #I 5151 Activity Nome: Famuy rlaDDmg . .. Nole: TANF Iunds... dls_1D IUpporI Qut.ol-WedIock birth p8\I8(llIon _In _ wilIIlhe oppIOVOd TANF IlIock Grant Plan lor FY 2003-2004. ... . ROW 1 -- ............". - .........,.".. ~,lRC ............... .... .11I1.-n T_ of AD D-..t- . ~ .--..1 DMteil!I ~-~~ . ~- . . . ~- . . . .- . . 0IIDt1A WfWIM ....... . - . - ~ ~ R.i.' - . ~ - . - . . ~-~ ~ . r~ - ~ ~ . .....-- COUNTY Sources 01 AlAMAIlCE 8 1..624 81..62..00 214 ALBEMARLE REG 8 16,995 816,895.00 02 ALEXANDER 8 2,602 82.602.00 ~ ANSON 8 5,249 S5,2.ri.00 2~ APPALACHIAN $ 3,841 13,941.00 07 BEAUFORT $ 6.969 $8 9B9.oo 09BLADEN $ 8.050 $8,050.00 10 BRUNSWICK $ e.o21 $8 021.00 11 BUNCOMBE $ 20 382 $20 382.00 12 BURKE $ U52 $9.e2.oo 13 CABARRUS S 12,349 S12.MB.00 1. CALDWEU. S 9.1015 $91015.00 18 CARTERET I - $0.00 17 CASWELL $ 2.278 ---..; 18 CATAWBA $ 1.,BIO 81U10.oo 19 CHAlHAM 8 U94 $U94.oo 20 CHEROKEE 8 1.816 $U16.OO 22 CLAY $ .00 $400.00 23 CLEVElAND $ 1.132 ' 81. 2. COLUMBUS $ 10.268 810 25 CRAVEN $ 12.377 812,3 28 CUMBERLAND I .7708 M77_ 26 DARE 2,063 82,063.00 2B DAVIDSON 151184 115 .....00 $0 DAVIE 2.171 12.171.00 31 DUPUN 8.826 $8 928.00 32 DURHAM 33 326 OM 326.00 33 EllClEllOMBE 15.902 I1B llO2.OO 304 FORSYTH ~M9 M3849.oo 35 FRANKUN 5,889 15 989.00 36 GASTON 25.89' $2S 895.00 38 GRAHAM 185 S565.oo 221 GRAN-VANCE 15895 $1519&;00 .0 'GREENE .. 12.818.00 2.61B .. .1 GUILFORD S '801.033 sM.033.oo .2 NAUFAX S 1'884 $12,884.00 ~ HARNETT . 12.181 $1' 161.00 .. HAYWOOD S 3.694 13 "".00 015 HENDERSON . ,8127 $8127 .DO 20B HERT-GATES . 8A38 ,,- .., HOKE . 6.7015 "T~.DO 48 HYOE . . $724.00 724 .9 IREDELL . 13.148 $13.948.00 e 21 11 " Fund/RCCIPRC 1111'1111.- n """"""'" . . " hu...... hfted It o..PMtCMI ,. IIIIOva ....1:--1 .. -'-- ~... D71O'1A-OiatIM !l;-'-~ I $ 2,894 I JOHNSTON $ 13,701 Z JONES $ 1,093 3 LEE , I 8343 ~ LENOIR . $ 12,823 ;5 UNCOLN $ 6,312 ie'MACON I 1,862 i7 MADISON $ 1,231 IB MAR-TYR-wASH $ 6.52B 10 MECKLENBURG $ 65,120 52 MO~""ERV I .,849 63 MOORE $ B 205 84 NASH I 13,501 65 NEWHANOVER I 17,627' 66 NORTHAMPTON $ 4,325 87 ONSLOW $ 15,164 6B ORANGE $ 7,650 BB PAMUCO $ 1,278 71 PENDER $ U84 n'PERSON $ U49 7. PITT $ 20 B2B 7B RANDOLPH $ 12.301 77 RICHMOND I 10,11. 7B R08ESON $ 31,745 .,,7 KINGHAM II 11,* 15,B57 21B _ . 12.932 62 SAMPSoN ,I 9,314 B3 SCOTLAND $ 9,26$ 84 STANLY S 8.174 - 65 STOKES I . 66 SURRY $ 6,374 ,87 SWAIN $ 2.MO 205 TOE RIVER I 2.587 6B TRANSYLVANIA I 2.27B '90 UNION I 12.115 B2 WAKE '1 84,115 B3 WARREN, $ 2,684 BI WAYNE $ 16,549 B7 WlLKESI5,B$4' 9B WILSON I 14,700 89 YADKlN "$ 3,01B TOTALS BY CENTER $ 1,000 000 $0.00 CHECK~DTOTAI $ 1,000,000 . ",.A (T/&' '8'-/3-03 S~onIoJt.. ~PH p.,nm Admln_ . J ' 1f.7 La ./I--A"~ 6/;1/0:> _~nond~'DPH_ClI\oI ~ P~w....~ DlMkMI . . Dotfted rM__"_ il' ~.- ~ ~ ~DMteII ., ~- ~ ... ~ ~ hftad e......... hNId .... . o.ted , 10.00 I~OO $0.00 J.A L- ~/r51o~, 81gnollll..:"-.DP JBudgolOnf- '="" TOllII of All Soun:ee $2.B84.oo 113,701.00 $1,093.00 18,~.00 112.823.00 $6,312.00 ' '1,662.00 11,231.00 18,528.00 $85,120.00 M 848.00 $6,205.00 $13501.00 117827.00 M,325,oo II51M.00 17 650.00 $1,276.00 14 4~.00 M ~9,oo $20 629.00 112.301.00 110 114,00 131,7~.00 ,11H84.oo $15,857.00 $12.932.00 19314.00 $9,263.00 16,17~.00 $0.00 ".174.00 $2.MO.oo .. 587.00 $2.278.00 $';115,00 $84.115.00 $'.684.00 $18,549,00 IS _.00 ,$1000.00 13.01'S.00 10.00 11,000,000,00 11,000,000.00 22 e I- Z w ::!: c z w ::!: <C I- W Cl c ~ In W ~ W a::: e ~ !l: o w ~ '" a; ~ ~ " l5 z o o l"- N I-W_ <0 Z....'" r-: :JOO:: ..... 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CUcamm ZZzC 24 ,.. , - e e \ NEW HANOVER COUNTY BOARD OF COMMISSIONERS Request for Board Action Agenda:D Consent I Meeting Date: 10/01/03 Agenda. ~ Department: Health Presenter: Cindy Hewett, Business Manager Contact: Cindy Hewett, Business Manager, ext 6680 Subject: Additional State Grant Funding for Breast and Cervical Cancer Control Pro ram BCCCP Brief Summary: The New Hanover County Health Department will receive $28,175 in funding from the NC Department of Health and Human Services, Division of Public Health, Breast and Cervical Cancer Control Program which is an additional $3,910 above the a roved bud eted amount of $24,265 for FY04. Recommended Motion and Requested Actions: To approve additional funding of $3,910 and associated budget amendment. I Funding Source: NC DHHS, DPH, BCCCP Will above action result in: DNew Position Number ofPosition(s) Dposition(s) Modification or change [8lNo Chan e in Position(s) Explanation: These funds will be used to support contracted services for the BCCCP ro ram. I Attachments: Funding Authorization attached. 25 ~ - I- Z w ::i o Z w ::i c( I- W C) o ~ a:l . > w It:: e "' ::\ !l Q W ~ "' ~ ~ ~ r;: ... Q Z Q Q 0 .... I-w_ a> Z..JU) c<i ~OC:: 0"5 ~..J :2 zO <( ~o + ... 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'0 j::g c: C'fi) <'6 z <1J . '" E CO.- zc: 0 1:: E :5.2 j:: '" E <1J is a. 0 I~ ., <1J II ~ IS! 26 e I- Z w ::i o z w ::i c( I- W C) o ~ a:l ~ >< w e '" ::\ !l Q W Q ~ '" ~ ~ ~ r;: b z Q Q I-w_ 0 .... Z..J'" a> ~Oo:: C'") 0"5 ~..J :2 zO <( ~o + ... I + 0 OI-l- wwz Ul"=> -00 Gi=>:2 O::lD<( 1-1-1- Zwz w,,=> 0::00 0:: =>:2 5lD<( I- Ul II w W -. II lD 5 0 0:: W Ul 0 W l- II ~ I- Z 0 II 0 0 .... '" ~ 2; t3 0 0 < 0 N "-'Z 000 0::- t:lL~ ZlLo:: =><lL , -z Zo ~~ '" <0 ~ '" Z a. 0 ...J ;:: W ~ :I: E ~ '" e a. e - c: 0 II ~ Ql U c: <Il II m u '~ Ql W II :;; "C < c: Z <Il ~ u; '" ~ l!! w lD ~ Z w C) 0 < ~ '" 0 Z => 0 "- ~ ~ ~ I- W 8~ => to ~ ::li C) Z -0 1-0 z_ =>0:: Ow tllL ~ I- zo:: Ww ::litO =>::li tl=> gz ~ z w ~ to W Z 0 ~w <0 (J)O ~tl I- .,.; <0 N '" ..f ~ N .... ~ '" '" ~ ~ JBS.! "E " "''''''' 0 000 E <Il Qi '" "C " .c "C <1J > e 01- a. a. WW <Il (/)(!) m -0 !jj=> c: 0::'" " ';:;, 'E:: ..J 0 i5 0 E I- ~ ~ a. - c: ~ .9:!Q)Q) " --- i=i=i= ~ .l!! Ul a. II II II lD <1J .s::; - E e - "C ,; ~ <1J '8 .s::; u l!! ~ ~ 0 c: ~ 0 m "" <'i .IS .... 'E:: ~ 0 '" .s::; '0 - c: " .2 '" '" m c: c: '6 0 c: "" " '6 u.. "C <1J<1J" '" .. EEE~ _ ,z <1J"'O tOm co co "'.... - Zzzo "C~I- ".0<( (0...:..:10 .cN:i >~m> 0"'0:: o > 0 I-~o """-co.... ftQ)Q. Ou.. ..C:z <( iil 0.<( z",_ -~<(c: 0'- .l!! 0,2 _ ",..I c: I-C:<( <1J '" <'6Z E ai .111 zc:o E :5"- 1:: -I- <Il E a..!i5 a. 0 <1J II ><.!o 27 NORTH CAROLINA DEPARTMENT OF HEALTH AND HUMAN SERVICES DIVISION OF PUBLIC HEALTH FUNDING AUTHORIZATION ISSUED TO: NEW HANOVER COUNTY STATE FISCAL YEAR Public Health DepartmentJDistrict FROM: July 1,2003 through June 30, 2004 NAME OF PROGRAM: Breast and Cervical Cancer Control EFFECTIVE DATE 07/01/03 AUTH# 1 FUNDING SOURCE: 536961 5452 INITIAL ALLOCATION $28,175.00 PRIOR ADJUSTMENTS YEAR TO DATE... INCREASE (DECREASE) INCREASE (DECREASE) THIS AUTHORIZATION $0.00 $0.00 NET ANNUAL ALLOCATION $28,175.00 GRANT INFORMATION TvneofFund Service Months Payment Months Codes Amount CFDA# Federal June-May July-June 1551 5452 EK $28,175.00 93.919 ~;~3 Local Health Director Local Finance Officer AUTHORIZED SIGNATURE -J/-oA d-n DATE: 9/17/03 DHHS-CO 7-01 28 r I I I I I I "1l ." (/)g> 00 w~ (/)1; O~ :I:(/) wz :I:S:: (/) 0-. S.S ."g. S. .,,~ "'g "'3 "'0 ai5: ~i S.a; s.iil 5.3 s.5- -CIl "'0 l'?:3 :>." ~S!. g . g- ~5 go. ~~ ",g ~!!. ",0 '" '" o . = .;! ~ :> ~ CIl c :<1 "1l m > !!;o~ (/):I:~. :> ",.:!lo. (/) -. :> _. ~."a iH' .,,~ gO:I: S.~ :>CD -.'" ~ "'3- -f!!.'" g~CD =", 1:3- CD = ~- '" ~ '" :> - e. 3 !!. :I: CD '" = ~ g ~ ~ I I I I I I I I ;;;'a > (/)(/) ~ CIl"1l 0 0 CIl(/)> CDc ;Os:: "g"TI ~ :<1"" ~ -68 CD CD g.o OC ~ CDcO -."8 CIl3 89: :>3 ~~ ",!II. s.~ ~ 1:;:1. c- 1liil Cil~ ~ c ~2. iH. 0", :> .85- g::l.:I: - ;:1.3 ~- CD ,8" ;:1.1- "C:> ~ '" (/) CD I >i ...'" 3= > "1l -~ III 0 ~:I: II~ cC iilll!, all: -.iil :>~ _.~ g3 g 0 :> '" e . e , ii g ~ ... f? ~ ~ sf &tio ~o~ ... oS! " !O!""'I II o t ~ R' III ~ il - ~ ~ i' . e e NEW HANOVER COUNTY HEALTH DEPARTMENT 2029 South 17th Street Wilmington, NC 28401-4946 Telephone: (910) 343-6500, Fax: (910) 341-4146 ~ ell eff tV; "Your Health, Our Priority" 31 " e - NEW HANOVER COUNTY HEALTH DEPARTMENT 2029 SOUTH 17TH STREET Wll..MINGTON, NC 28401-4946 TELEPHONE (910) 343-6500 FAX (910) 341-4146 ~ Peof05ELJ ~ "Healthy People, Healthy Environment, Healthy Community" 32 e e .~ ..-. Ii North Carolina Department of Health and Human Services Division of Public Health - Women's & Children's Health Section 1914 Mail Service Center. !Weigh, North CaJ:olina 27699-1914 Tel 919-733-2973 . Fax 919-733-1384 Michael F Easley, Governor Carmen Hooker Odom, Secretary September 10, 2003 Letter of Commendation North Carolina WIC Program Dave Rice Health Director New Hanover County Health Department 2029 S. 17th Street Wilmington, NC 28401-4946 Dear Mr. Rice, On behalf of the North Carolina WIC Program, I am pleased to send this letter of commendation in recognition of the outstanding quality of the New Hanover County WIC Program. The performance oflocal agency WIC programs is reviewed at least every two years. This review includes scrutiny of both the administrative and clinical components of the program. Due to the many regulations that must be met to both protect the public interest and serve the eligible citizen, the WIC Program prese!lts many challenges to administer. In addition, the standards for quality nutrition care must be met for every client. Very rarely is a program review completed without findings, known as funding conditions, which must be corrected. It gives me great satisfaction to recognize the superior effort of the New Hanover County WIC staff that has resulted in a review without funding conditions. This is a testimony to the hard work and dedication of the WIC staff and their efforts are to be commended. Please share this recognition with the WIC Program staff. It is extended with my sincere appreciation for their efforts in providing high quality WIC Program services to the citizens of New Hanover County. Best Regards, ~. J~~v;L- Alice Lenihan, RD, MPH, LON State WIC Program Director C: Kevin Ryan Nancy Nail Janet Bryanf * Location: U30 S, Mary's Streer. Raleigh, N.C. 27605 An Equal Opportunity Employer e e e The North Carolina W;seWoman Project: Improving Women's Cardiovascular Health . WI)[WOM^N" o""r""";;""''''''I'''Oh,",,,,,,o r"w", ."",,, ,'"" ~'''"., Carolyn Townsend, RN, MPH, Warren Freas, ME, Dianah Bradshaw, RN, MSHA, Pat Cannon, RN, MPA N.C. Department of HeaKh and Human Services DivisiOrl of P\lblic Health Purpose . Provide expanded cardiovascular disease screening, intervention counseling and referral services to NCBCCCP eligible women. . Promote community-based activities to enhance heart healthy behaviors. . Deliver participant services in 41 local health agencies. Leading Causes of Death among North Carolina Women, 2001 Cerebrovascular Diseases 9.3"10 S""rce.NCC."lorforli..IIl1S..,.tIco How Did the WISEWOMAN Program Start? . Established by u.s. Congress in 1993 . Demonstration project within the National Breast and cervical Cancer Early Detection Program (NBCCEDP) . CDC funded first three projects in 1995 . Currently 11 states have WISEWOMAN projects Who is Eligible for WrSEWOMAN? . Women 40 to 64 years of age . Enrolled and participate in the NC Breast and Cervical Cancer Control Program (NCBCCCP) Services Provided . Blood pressure screening . Cholesterol screen i ng . Educational programs related to CVD risk reduction . Referral to physician if needed . Referral/linkage to community resources I e e e What Makes WISEWOMAN Special? . Individually crafted counseling sessions teach women about healthy foods and ways to add them to their meals. . Educational tip sheets encourage participants to build physical activity into their lifestyles. . Heart healthy eating and being physically active are two behaviors that help protect women against heart disease. NC Wise Woman Project . Screening &. Follow-up Services - history - height & weight - blood pressure -serum cholesterol / HDL -blood glucose (optional) - referrals for abnormal values -lifestyle interventions NC W;seWoman Project Counties FY 2003 - 2004 . WlseWonuln counties NC W;seWoman Client Services # clients 6854 Women have been screened since 1998 I " --~_./ r:.:/ I "..~-;(I 1 . ,I" I r"-" 1 I 1 1 . , ,., " 1 1 (;,Jil"1 ve,'];, 1 1ft" , "..:-~Ji] 1 ilikfll I I. 1 .. I L:J 1/1 /1 L:J I iA FY 98-99 FY 99-00 FY 00-01 FY 01-02 FY 02-03. I 'Fiscal yearto date total. NC WiseWoman Serves a Diverse Community ... IBasedonFIICllIVHr2001-2002S<:...nlngs I ". with different educational backgrounds. " <9th grade 12% H.S.or GED ,,% I BasedonFlscaIVHr2001.Z002S<:...nlngsI 2 e e e NC WiseWoman Clients have many CVD Risk Factors % of clients previously diagnosed with High BP High Chol Diabetes . 20 5. 3. .. 10 lanedonFilcalvHr2001-200ZSGl'1HInlngl I Range of Clinical Values TotCbol 0% 40% 80% 60% 20% s...edon FI.~aIY..r2001-2002 Sentenln",; BP stag..,... billed on JNC7. Many of our NC WiseWoman Clients are on Medication "ood Pressure 41% Diabetes .. " " " " IsultdonflscaIYMr2001-200Zk...nlnQsl Prevalence of Obesity among Wise Woman Clients Obese 53% Basltdon~putedBMIY.lu..fJunFI'ClIIY..rZOO1-2D02ScreenlnIlS Many Clients Smoke Every Day 27% IBasedonFIluIYur2001-2002kreenlngl I Reducing CVD Risk . with Lifestyle Interventions - Diet - Physical Activity - Smoking Cessation - Diabetes management A """ Loaf . U_'.....,"',"~.. - Osteoporosis risk ~. 3 e .e e Improving Women's Health Since 1998 we have ... Iy diagnosed cases of diabetes o 200 400 . aystollcBP > 140,dlutollc>90 u tobl cholesterol> 240 600 1000 800 Referrals for Immediate Medical Intervention . 314 participants with clinical values requiring immediate medical attention . 270 participants with systolic blood pressure ~ 180 mm Hg or diastolic blood pressure ~ 110 mm Hg . 36 participants with blood glucose levels> 375 mg/dl . 12 participants with total serum cholesterol levels> 400 mg/dl Individual Success Stories . Healthy lifestyle changes to manage hypertension . Quality 1:1 time aids individual nutritional goal setting . Controlling diabetes: " I feel better." Community Success Stories . Group activities: Women learning from each other in group lifestyle sessions in Cumberland Co. . Access to care partnership with Community Free Clinic in Cabarrus Co. . Healthwise Partnerships with YWCA for physical activity in Forsyth Co. 4 - September 2003 New Hanover County Health Department Betsy Summey, FNP, 343-6531 There's Damp, and Then carpet due to their inability epi.state.nc.usJepi/air. There's Wet! Mold, to be thoroughly cleaned. html. Mosquitoes, and Semi-porous materials such Hurricanes as wood can often be Arborviral Surveillance cleaned, thoroughly dried North Carolina's unusu- and reused. Non-porous A rborviral illnesses have ally wet summer has materials such as metal and continued to increase contributed to a host of plastic can be cleaned and in numbers and spread health problems, with the dried. A complete removal throughout North Carolina. potential for more when hur- of the mold is necessary to As of 9/13/03 arborviral iII- ricanes come our way. Mold prevent regrowth. nesses in humans have been formation, both inside and diagnosed in residents of 15 outside, has serious implica- Detergent and water counties from the coast to tions for the health of many. should be used for the mountains. The break- Mold experts with the North cleanup. Disin- down is as follows: 14 cases e Carolina Division of Public f""",,, . ""',, II of West Nile Virus (WNV), Health recommend reducing all should be used II human cases of laCrosse, the exposure to mold in any with caution to and one case of Eastern building through identifica- prevent health Equine Encephalitis (EEE). tion of its presence and risks from the chemicals. The equine population has abatement. Protection of the person been more severely affected cleaning, including a mask, with 54 cases of WNV and Where there's moisture eye protection, and protec- I 07 cases of EEE. there's mold, tion of the skin, is necessary and moisture The North Carolina State inside build- About one in ten people is Laboratory of Public Health ings is the especially sensitive to mold, in Raleigh has continued to factor that experiencing common symp- monitor arborviral activity can be best controlled. toms such as sneezing, irri- using several different meth- Plumbing leaks, water tated eyes, the triggering of ods-sentinel chicken and leaks through roofs or asthma symptoms and diffi- dead bird test- walls. flooding, and con- cult breathing. In rare cases, ~ ing, mosquito densation on windows, indoor exposure to mold / ' ~ pool monitor- walls, and air ducts may cause infectious respira- ing, equine ne- should be searched out tory disease in the immuno- cropsy, and and corrected. compromised. Some types testing of human clinical of mold can produce tox- specimens. With September e Afterward the mold must be ins that may cause illness. one of the highest months removed. Experts recom- for mosquito activity and in- mend throwing out porous More information is avail- creased moisture as a result materials like drywall and able on the web at www. of recent storms, their job may be far from over. We cations in stock are lim- Of interest is the data should continue to encour- ited to a very few over- that the highest average age patients to employ the-counter type prepara- annual incidence of re- protective measures. tions such as aspirin, ported tetanus was - acetaminophen, etc. among persons aged 60 Hurricane Shelter . EMT squads are grounded years and older, persons during the hours immedi- Reminders ately preceding, during, of Hispanic ethnicity, and and after a storm. Do not older adults who have Thankfully, we were spared depend on them to come diabetes. Fifteen percent from the worst of Hurricane to the rescue. of cases are among injec- Isabel, but a refresher in what . Patients on oxygen should tion drug users. to tell patients who need to be experienced in refilling evacuate to shelters is appro- their own tanks and alert With those cases with a priate. their oxygen providers as known injury, only 37 per- to their whereabouts. cent sought medical care, and . Patients with needs for . Time away from home only 63 percent of those eli- could well be 3 to 4 days, assistance should have a gible received tetanus toxoid friend or family member sometimes longer. with them at a shelter- for wound prophylaxis. Sev- . Bring all medications enty-five percent of the taken on a regular basis, they should not be alone. deaths were in those 60 as well as those on an as- Tetanus Risk years and older, but no needed basis, especially asthma-related inhalers, deaths occurred in those nebulizer medications, Tetanus is a severe and with up-to-date etc. often fatal infection. ;mm"'''tio", ~ . When hurricane watches The incidence of reported Rem.mb~. ) 0 are issued, check medica- cases in the United States has it's important e ticn supplies to be sure declined steadily since intro- to monitor they are ample. duction of tetanus toxoid patient im- . There are no pharmacies vaccines in the United States. munization status. at shelters, and any medi- Communicable Disease Statistics New Hanover County July 1, 2003 - August 31, 2003 AIDS .........................................13 Campylobacter .......................... 2 Chlamydia ................................ 84 Ehrlichiosis, Monocytic ............ 1 Gonorrhea................................ 43 Haemophilus Influenza, Invasive .................................0 Hepatitis A................................. 0 Hepatitis B (acute)..................... 0 Hepatitis B (chronic carrier)..... 7 Hepatitis C (acute)..................... 0 HIV Infection ............................ 13 Legionellosis ............................. 0 Listeriosis .................................. 0 Lyme Disease ............................ 2 Meningitis Pneumococcal............O Meningococcal Disease ...............0 Pertussis .......................................2 Rky. Mtn. Spotted Fever ...............0 Salmonellosis .............................21 Shiga-Toxin Producing Infection (formerly E. coli 0157:H7)..........0 Shigellosis ....................................0 Strep, Group A, Invasive ..............0 Syphilis..........................................5 Toxic Shock Syndrome................O Tuberculosis .................................2 Typhoid (acute).............................O Vancomycin Resistant Enterococcus ............................ 3 e e. NEW HANOVER COUNTY BOARD OF HEALTH 2029 South 1 T" Street Wilmington, N.C. 28401-4946 Telephone (910) 343-6500, FAX (910) 341-4146 Everywhorc. Everyday. ~y. W Edwin Unk, Jr., RPh, Chairman Melody C. Speck, DVM, Vice-Chairman Donald P Blake Henry V Estep, RHU Marvin E. Freeman, SI. Commissioner Robert G. Greer Gela N. Hunter, RN, FNP Sandra L. Miles, DDS Philip P Smith, Sr., MD John S. Tunstall, PE Edward Weaver, Jr., 00 David E. Rice, MPH, MA Health Director Memorandum e To: Members of the New Hanover County Board of Health From: W Edwin Link, Jr., Chairman New Hanover County Board of Health Date: October 1 , 2003 Re: Evaluation of David E. Rice, Health Director Enclosed is an evaluation form I am asking you to complete. Mer you complete this form, please return it to me in the enclosed addressed stamped envelope by October 10, 2003. The Executive Committee will review these evaluations on October 28. Upon completion of the review, we will submit our recommendations and findings to the Board of Health on November 5. If you give a rating of anything other than "expected" on a performance factor, please give specific reasons (positive or negative) in comment area of the evaluation form. Please call me regarding your concerns. My telephone number is 763-0845. Thank you. - ~~Your Health - Our PrioritY' e .... ii ~ - l! .fJ - ~ "0-= III ...11) C .1lI s::. .9........ '5 .8g ~ CD i! e .~g C "i 0 U 0 ~- i ca ~ ~~ l!! 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FAX (910) 341-4146 ............,.....-. DAVID E. RICE; M.P.H., M.A. Health Director March 6, 2002 LYNDA F. SMITH, M.P.A. Assistant Health Director Mr. Andre Mallette, Director . New Hanover County Human Resources Department 320 Chestnut Street, Suite 405 Wilmingtc:lO, NC 28401 Dear Mr. Malletl8: e The New Hanover County Board of Health approved the performance appraisal for David E. Rice, Health Director. New Hanover County Health Department on March 6, 2001..Mr. Rice's overall performance rating was above expected with an average score of 1.9. The scoring range was 1-5 (1 = exceptional, 3 = ~xpected, and 5 = unsatisfactory). . Inclu~ed is a copy of Mr. Rice's performance appraisal with an attachment. The Board of Health continues to be pleased with his performance. $incerely.. .. /i~i1# Gela N. Hunter, RN, FNP Chairman New Hanover County Board of Heal1h e "7jOIU' J./eaAk _ OIU' P,.io,.U, n : .. 'J \ t)O', . . \ . . . -, _'",...... 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Overall Total Scores 1.9 which indicates that overall Mr. Rice is perfonning above the eJpeeted leveL , Comments: 1. Overall, 1 think that Mr. Rice does a very good job for the H.Dept. 2. He consistently does an exceptional job.We are fortunate to have bini as director. 3. His strengths: devotion to job;judgement in deddoD making process; well infonned on fianances; executes board decisions effectively; relationship with the media and other entities in the county. 4. He continues to exceed expeetions on many levels. His organization and attention to deuiil while keeping the big picture in focuS helps keep the department and the board moving in the right direction. S. He certainly seems to be a good administrator in that he designates to staffwell. He effectively gets to know his board members. .. 6. I am not c1tar if all issues and problems of the H.Dept. are brought to full boards attention. 7. I don't know about staff morale and issues relating to staff. 8. I am concerned that staff morale could be improved upon even within the budget constraints. I think that some staff do not feel an ease ~f expressing concerns to administration.